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https://www.readbyqxmd.com/read/29452560/health-care-efficiencies-consolidation-and-alternative-models-vs-health-care-and-antitrust-regulation-irreconcilable-differences
#1
Michael W King
Despite the U.S. substantially outspending peer high income nations with almost 18% of GDP dedicated to health care, on any number of statistical measurements from life expectancy to birth rates to chronic disease, 1 the U.S. achieves inferior health outcomes. In short, Americans receive a very disappointing return on investment on their health care dollars, causing economic and social strain. 2 Accordingly, the debates rage on: what is the top driver of health care spending? Among the culprits: poor communication and coordination among disparate providers, paperwork required by payors and regulations, well-intentioned physicians overprescribing treatments, drugs and devices, outright fraud and abuse, and medical malpractice litigation...
November 2017: American Journal of Law & Medicine
https://www.readbyqxmd.com/read/29452356/baseline-anticholinergic-burden-from-medications-predicts-incident-fatal-and-non-fatal-stroke-in-the-epic-norfolk-general-population
#2
David T Gamble, Allan B Clark, Robert N Luben, Nicholas J Wareham, Kay-Tee Khaw, Phyo K Myint
Background: Stroke is primarily a disease of older age, with a substantial impact on global mortality and morbidity. Medications with anticholinergic effects are widely used, but no studies have been conducted to examine the relationship between anticholinergic burden (ACB) and stroke in a general population. Method: The sample was drawn from the EPIC-Norfolk cohort. Baseline assessments were carried out during 1993-97 and participants were followed up until March 2016...
February 14, 2018: International Journal of Epidemiology
https://www.readbyqxmd.com/read/29451406/cancer-costs-and-outcomes-for-common-cancer-sites-in-the-finnish-population-between-2009-2014
#3
Paulus Torkki, Riikka-Leena Leskelä, Miika Linna, Suvi Mäklin, Jukka-Pekka Mecklin, Petri Bono, Vesa Kataja, Sakari Karjalainen
BACKGROUND: The cost of cancer and outcomes of cancer care have been discussed a lot since cancer represents 3-6% of total healthcare costs and cost estimations have indicated growing costs. There are studies considering the cost of all cancers, but studies focusing on the cost of disease and outcomes in most common cancer sites are limited. The objective of this study was to analyze the development of the costs and outcomes in Finland between 2009 and 2014 per cancer site. METHODS: The National cost, episode and outcomes data were obtained from the National register databases based on International Statistical Classification of Diseases (ICD)-10 diagnosis codes...
February 16, 2018: Acta Oncologica
https://www.readbyqxmd.com/read/29450516/paid-family-and-childbearing-leave-policies-at-top-us-medical-schools
#4
Nicholas S Riano, Eleni Linos, Erin C Accurso, Dawn Sung, Elizabeth Linos, Julia F Simard, Christina Mangurian
No abstract text is available yet for this article.
February 13, 2018: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29443031/ultrasound-cyclo-plasty-in-eyes-with-glaucoma
#5
Giuseppe Giannaccare, Stefano Sebastiani, Emilio C Campos
Glaucoma is a chronic disease caused by the progressive degeneration of the optical nerve fibers, resulting in decreased visual field that can lead to severe visual impairment, and eventually blindness. This manuscript describes a simple, surgeon-friendly, non-incisional technique, named Ultrasound Cyclo Plasty (UCP), for reducing intraocular pressure (IOP) in glaucoma patients. The technique determines a selective coagulation necrosis of the ciliary body; in addition, the stimulation of supra-choroidal and trans-scleral portions of the uveo-scleral outflow pathway has been recently proposed...
January 26, 2018: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/29439532/a-quick-surgical-treatment-of-conjunctivochalasis-using-radiofrequencies
#6
Alexandra Trivli, Georgios Dalianis, Chryssa Terzidou
The purpose of our study is to present a quick surgical procedure for the treatment of Conjunctivochalasis (CCH) and to evaluate its effectiveness. Thirty consecutive patients, in whom CCH was diagnosed on clinical examination, were investigated for the presence of symptoms of dry eye. The 60 eyes were evaluated according to their symptomatology and the 40 symptomatic eyes were grouped in two stages using the LIPCOF (stage 1, one small fold; stage 2, more than two folds but not higher than the tear meniscus) classification and included in the study...
February 12, 2018: Healthcare (Basel, Switzerland)
https://www.readbyqxmd.com/read/29436901/an-anti-tl1a-antibody-for-the-treatment-of-asthma-and-inflammatory-bowel-disease
#7
Adam W Clarke, Lynn Poulton, Doris Shim, David Mabon, Danyal Butt, Matthew Pollard, Vanya Pande, Jean Husten, Jacquelyn Lyons, Chen Tian, Anthony G Doyle
TL1A is an attractive therapeutic target for the treatment of mucosal inflammation associated with inflammatory bowel disease (IBD) and asthma. Blockade of the TL1A pathway has been shown to reduce inflammatory responses while leaving baseline immunity intact, and to be beneficial in animal models of colitis and asthma. Given the therapeutic potential of blocking this pathway in IBD and asthma, we developed C03V, a human antibody that binds with high affinity to soluble and membrane-bound TL1A. In an assay measuring apoptosis induced by exogenous TL1A, C03V was 43-fold more potent than the next most potent anti-TL1A antibody analyzed...
February 13, 2018: MAbs
https://www.readbyqxmd.com/read/29432082/enhancing-meaning-when-facing-later-life-losses
#8
Janet Anderson Yang, Breanna L Wilhelmi, Krista McGlynn
OBJECTIVE: This article presents several client cases to illustrate psychotherapeutic interventions for helping older adults facing later life losses enhance their sense of meaning. METHODS: Cases are derived from the client population of a community mental health clinic which provides psychotherapy for low income, seriously mentally ill, culturally diverse older adults, many of whom experience serious medical illnesses. Over the course of 24 years in this setting, the primary author has observed various interventions which offer possibilities to provide hope and meaning for clients with severe problems...
January 29, 2018: Clinical Gerontologist
https://www.readbyqxmd.com/read/29430403/adverse-events-in-critical-care-search-and-active-detection-through-the-trigger-tool
#9
Francisco J Molina, Paula T Rivera, Alejandro Cardona, Diana C Restrepo, Oralia Monroy, Daniel Rodas, Juan G Barrientos
AIM: To investigate the incidence of disadvantageous events by using the Global Trigger Tool in an intensive care unit (ICU). METHODS: A retrospective descriptive study was performed in a 12-bed university ICU in the city of Medellin, Colombia. Clinical charts of hospitalized patients were reviewed, between January 1 and December 31, 2016, with the following inclusion criteria: subjects aged over 18 years, with at least 24 h of hospitalization and who had a complete medical history that could be accessed...
February 4, 2018: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29430350/bioactive-properties-of-chamaerops-humilis-l-antioxidant-and-enzyme-inhibiting-activities-of-extracts-from-leaves-seeds-pulp-and-peel
#10
Sandra Gonçalves, Joana Medronho, Elsa Moreira, Clara Grosso, Paula B Andrade, Patrícia Valentão, Anabela Romano
In this work we evaluated methanolic extracts from different parts (leaves, seeds, fruit peel and pulp) of Chamaerops humilis L. for antioxidant activity and the ability to inhibit enzymes linked with neurodegenerative diseases: acetylcholinesterase (AChE), butyrylcholinesterase (BChE) and tyrosinase (TYR). The total content of phenolics, flavonoids and condensed tannins was also determined. The antioxidant and inhibitory activities of the extracts varied significantly according to the tissue. Seed extracts showed the greatest ability to scavenge DPPH (IC50 = 81...
February 2018: 3 Biotech
https://www.readbyqxmd.com/read/29430053/exercise-as-a-vital-sign-a-preliminary-pilot-study-in-a-chiropractic-setting
#11
Scott Howitt, Kyle Simpson, Darren Suderman, Andrew Mercer, Susan Rutherford, Christopher deGraauw
Background: The association between physical inactivity and non-communicable disease risk has been well documented in recent literature. An exercise vital sign (EVS) is a measure that can routinely capture vital information about a patient's physical activity behaviour. The objective of this study is to understand if (1) patient exercise minutes per week (EMPW) are being recorded by chiropractic interns, and (2) whether these patients are exceeding, meeting or falling short of the current recommendations provided by the Canadian Physical Activity Guidelines (CPAG)...
December 2017: Journal of the Canadian Chiropractic Association
https://www.readbyqxmd.com/read/29428245/sick-leave-after-surgery-for-thumb-carpometacarpal-osteoarthritis-a-population-based-study
#12
Jennifer Moriatis Wolf, Isam Atroshi, Caddie Zhou, Jon Karlsson, Martin Englund
PURPOSE: Patients undergoing surgery for thumb carpometacarpal (CMC1) osteoarthritis often require sick leave owing to postoperative immobilization, pain, and decreased function. Our goal was to evaluate the amount of sick leave after surgery for 2 common CMC1 arthroplasty procedures. METHODS: Using registry data from the Skåne region of southern Sweden, cross-linked with employment data showing person-specific sick leave, 2 cohorts of CMC1 surgical patients, between ages 40 and 59 years, were examined...
February 7, 2018: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29426288/clinical-effectiveness-of-care-managers-in-collaborative-care-for-patients-with-depression-in-swedish-primary-health-care-a-pragmatic-cluster-randomized-controlled-trial
#13
Cecilia Björkelund, Irene Svenningsson, Dominique Hange, Camilla Udo, Eva-Lisa Petersson, Nashmil Ariai, Shabnam Nejati, Catrin Wessman, Carl Wikberg, Malin André, Lars Wallin, Jeanette Westman
BACKGROUND: Depression is one of the leading causes of disability and affects 10-15% of the population. The majority of people with depressive symptoms seek care and are treated in primary care. Evidence internationally for high quality care supports collaborative care with a care manager. Our aim was to study clinical effectiveness of a care manager intervention in management of primary care patients with depression in Sweden. METHODS: In a pragmatic cluster randomized controlled trial 23 primary care centers (PCCs), urban and rural, included patients aged ≥ 18 years with a new (< 1 month) depression diagnosis...
February 9, 2018: BMC Family Practice
https://www.readbyqxmd.com/read/29416223/pregnacy-and-delivery-in-a-patient-after-tetralogy-of-fallot-surgery-being-undergone
#14
Anis Cerovac, Dzenita Ljuca, Bedreldin Khodary, Gordana Grgic
Aim: The aim of the paper is to present the risk of pregnancy for mother and her child in a young patient who had a surgery to repair Tetralogy of Fallot (ToF), who gave a birth to her firstborn by having a cesarean section. Case report: 23 years old patient, in 28 weeks of pregnancy was admitted to the clinic due to her medical record. She did not have any subjective complaints. She had two surgeries to repair ToF. After the surgery, she had residual ventricular septal defect (VSD)...
February 2018: Medical Archives
https://www.readbyqxmd.com/read/29413393/the-broken-lens-of-bpsd-why-we-need-to-rethink-the-way-we-label-the-behavior-of-people-who-live-with-alzheimer-disease
#15
Susan Macaulay
For the past 20 years, the behaviors of people who live with dementia (PLWD) that others find challenging or problematic have primarily been ascribed to Alzheimer disease and related dementias and have been assessed through the biomedical lens of Behavioral and Psychological Symptoms of Dementia (BPSD). This has led to the root causes of these behaviors being overlooked, which in turn leaves them unaddressed. Further, using the artificial construct of BPSD has led to many PLWD being inappropriately prescribed (off-label) medications that are largely ineffective in resolving the behaviors because they do nothing to remedy the underlying psychosocial and environmental causes...
February 2018: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/29412015/differentiation-of-malignant-and-benign-adrenal-lesions-with-delayed-ct-multivariate-analysis-and-predictive-models
#16
Chaan S Ng, Wei Wei, Emre Altinmakas, Xiao Li, Payel Ghosh, Nancy A Perrier, Elizabeth Grubbs, Victor G Prieto, Jeffrey E Lee, Brian P Hobbs
OBJECTIVE: The purpose of this study is to identify imaging and patient parameters that affect the diagnostic performance of delayed contrast-enhanced CT for distinguishing malignant from benign adrenal lesions larger than 1 cm in adult patients and to derive predictive models. MATERIALS AND METHODS: This retrospective study assessed 97 pathologically proven adrenal lesions that had undergone unenhanced, portal venous, and 15-minute delayed CT. Quantitatively, single-parameter evaluations of lesion attenuation (in Hounsfield units) and absolute percentage enhancement washout (APEW) and relative percentage enhancement washout (RPEW) were performed...
February 7, 2018: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/29411485/leaving-surgical-training-some-of-the-reasons-are-in-surgery
#17
REVIEW
Deanne Forel, Meegan Vandepeer, Joanna Duncan, David R Tivey, Stephen A Tobin
In 2014, the Royal Australasian College of Surgeons identified, through internal analysis, a considerable attrition rate within its Surgical Education and Training programme. Within the attrition cohort, choosing to leave accounted for the majority. Women were significantly over-represented. It was considered important to study these 'leavers' if possible. An external group with medical education expertise were engaged to do this, a report that is now published and titled 'A study exploring the reasons for and experiences of leaving surgical training'...
February 7, 2018: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/29409383/variance-in-state-protection-from-exposure-to-norm-and-tenorm-wastes-generated-during-unconventional-oil-and-gas-operations-where-we-are-and-where-we-need-to-go
#18
Elizabeth Ann Glass Geltman, Nichole LeClair
Radioactive materials for the medical, technological, and industrial sectors have been effectively regulated in the United States since as early as 1962. The steady increase in the exploration and production of shale gas in recent years has led to concerns about exposures to Naturally Occurring Radioactive Materials (NORM) and Technologically Enhanced Naturally Occurring Radioactive Materials (TENORM) in oil and gas waste streams. This study applied policy surveillance methods to conduct a cross-sectional fifty-state survey of law and regulations of NORM and TENORM waste from oil and gas operations...
January 1, 2018: New Solutions: a Journal of Environmental and Occupational Health Policy: NS
https://www.readbyqxmd.com/read/29409162/antipsychotic-reduction-and-or-cessation-and-antipsychotics-as-specific-treatments-for-tardive-dyskinesia
#19
REVIEW
Hanna Bergman, John Rathbone, Vivek Agarwal, Karla Soares-Weiser
BACKGROUND: Since the 1950s antipsychotic medication has been extensively used to treat people with chronic mental illnesses such as schizophrenia. These drugs, however, have also been associated with a wide range of adverse effects, including movement disorders such as tardive dyskinesia (TD) - a problem often seen as repetitive involuntary movements around the mouth and face. Various strategies have been examined to reduce a person's cumulative exposure to antipsychotics. These strategies include dose reduction, intermittent dosing strategies such as drug holidays, and antipsychotic cessation...
February 6, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29408207/examining-the-epidemiology-and-microbiology-of-clostridium-difficile-carriage-in-elderly-patients-and-residents-of-a-health-care-facility-in-southern-ontario-canada
#20
Gabriella Mallia, Jane Van Toen, Joyce Rousseau, Latha Jacob, Patrick Boerlin, Amy Greer, Devon Metcalf, JScott Weese
BACKGROUND: While Clostridium difficile has been extensively studied in acute care facilities (ACFs), there is limited information about long-term care facilities (LTCFs), despite the high occurrence of putative risk factors (e.g. age, antimicrobial use, healthcare system contact). AIM: To evaluate C. difficile colonization in elderly patients and residents from ACF and its associated LTCF. METHODS: Stool swabs were collected from 884 LTCF and elderly (>65 years) hospital patients...
February 2, 2018: Journal of Hospital Infection
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