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https://www.readbyqxmd.com/read/28107024/the-host-response-in-sepsis-patients-developing-intensive-care-unit-acquired-secondary-infections
#1
Lonneke A van Vught, Maryse A Wiewel, Arie J Hoogendijk, Jos F Frencken, Brendon P Scicluna, Peter M C Klein Klouwenberg, Aeilko H Zwinderman, Rene Lutter, Janneke Horn, Marcus J Schultz, Marc M J Bonten, Olaf L Cremer, Tom van der Poll
RATIONALE: Sepsis can be complicated by secondary infections. We explored the possibility that sepsis patients developing a secondary infection while in the Intensive Care Unit (ICU) display sustained inflammatory, vascular and procoagulant responses. OBJECTIVE: To compare systemic proinflammatory host responses in patients with sepsis who acquire a new infection with those who do not. METHODS: Consecutive sepsis patients with a length of ICU stay >48 hours were prospectively analyzed for the development of ICU-acquired infections...
January 20, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28100215/a-discrete-event-simulation-model-to-evaluate-the-use-of-community-services-in-the-treatment-of-patients-with-parkinson-s-disease-in-the-united-kingdom
#2
Reda Lebcir, Eren Demir, Raheelah Ahmad, Christos Vasilakis, David Southern
BACKGROUND: The number of people affected by Parkinson's disease (PD) is increasing in the United Kingdom driven by population ageing. The treatment of the disease is complex, resource intensive and currently there is no known cure to PD. The National Health Service (NHS), the public organisation delivering healthcare in the UK, is under financial pressures. There is a need to find innovative ways to improve the operational and financial performance of treating PD patients. The use of community services is a new and promising way of providing treatment and care to PD patients at reduced cost than hospital care...
January 18, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28087295/postconditioning-induced-neuroprotection-mechanisms-and-applications-in-cerebral-ischemia
#3
REVIEW
Yan-Ying Fan, Wei-Wei Hu, Fang Nan, Zhong Chen
Ischemic postconditioning (PostC) is defined as a series of rapid intermittent interruptions of blood flow at the phase of reperfusion, which produces neuroprotection against cerebral ischemia/reperfusion injury via mobilizing the brain's own endogenous adaptive mechanisms. Now the concept of conventional ischemic PostC has been extended to limb remote ischemic PostC and chemical PostC with hypoxia, volatile anesthetic, CO2, etc. According to the different temporal profile of PostC, it is divided into rapid and delayed PostC...
January 10, 2017: Neurochemistry International
https://www.readbyqxmd.com/read/28086871/the-integrated-care-pathway-for-post-stroke-patients-icapps-a-shared-care-approach-between-stakeholders-in-areas-with-limited-access-to-specialist-stroke-care-services
#4
Aznida Firzah Abdul Aziz, Nor Azlin Mohd Nordin, Mohd Fairuz Ali, Noor Azah Abd Aziz, Saperi Sulong, Syed Mohamed Aljunid
BACKGROUND: Lack of intersectoral collaboration within public health sectors compound efforts to promote effective multidisciplinary post stroke care after discharge following acute phase. A coordinated, primary care-led care pathway to manage post stroke patients residing at home in the community was designed by an expert panel of specialist stroke care providers to help overcome fragmented post stroke care in areas where access is limited or lacking. METHODS: Expert panel discussions comprising Family Medicine Specialists, Neurologists, Rehabilitation Physicians and Therapists, and Nurse Managers from Ministry of Health and acadaemia were conducted...
January 13, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28086867/process-evaluation-of-an-integrated-care-pathway-in-geriatric-rehabilitation-for-people-with-complex-health-problems
#5
Irma H J Everink, Jolanda C M van Haastregt, Jose M C Maessen, Jos M G A Schols, Gertrudis I J M Kempen
BACKGROUND: An integrated care pathway in geriatric rehabilitation was developed to improve coordination and continuity of care for community-living older adults in the Netherlands, who go through the process of hospital admission, admission to a geriatric rehabilitation facility and discharge back to the home situation. This pathway is a complex intervention and is focused on improving communication, triage and transfers of patients between the hospital, geriatric rehabilitation facility and primary care organisations...
January 13, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28079591/point-of-care-diagnostics-extending-the-laboratory-network-to-reach-the-last-mile
#6
Paul K Drain, Christine Rousseau
PURPOSE OF REVIEW: More point-of-care (POC) diagnostic tests are becoming available for HIV diagnosis and treatment in resource-limited settings. These novel technologies have the potential to foster decentralized HIV care and treatment for the benefit of clinical laboratories, HIV clinics, and HIV-infected patients. There continue to be many business, technological, and operational challenges that limit product development and regulatory approval, which limits products available for the required operational and cost-effectiveness studies and delays policy adoption and implementation...
January 11, 2017: Current Opinion in HIV and AIDS
https://www.readbyqxmd.com/read/28068481/micrornas-and-periodontal-homeostasis
#7
X Luan, X Zhou, J Trombetta-eSilva, M Francis, A K Gaharwar, P Atsawasuwan, T G H Diekwisch
MicroRNAs (miRNAs) are a group of small RNAs that control gene expression in all aspects of eukaryotic life, primarily through RNA silencing mechanisms. The purpose of the present review is to introduce key miRNAs involved in periodontal homeostasis, summarize the mechanisms by which they affect downstream genes and tissues, and provide an introduction into the therapeutic potential of periodontal miRNAs. In general, miRNAs function synergistically to fine-tune the regulation of biological processes and to remove expression noise rather than by causing drastic changes in expression levels...
January 1, 2017: Journal of Dental Research
https://www.readbyqxmd.com/read/28062603/combining-qualitative-and-quantitative-operational-research-methods-to-inform-quality-improvement-in-pathways-that-span-multiple-settings
#8
Sonya Crowe, Katherine Brown, Jenifer Tregay, Jo Wray, Rachel Knowles, Deborah A Ridout, Catherine Bull, Martin Utley
BACKGROUND: Improving integration and continuity of care across sectors within resource constraints is a priority in many health systems. Qualitative operational research methods of problem structuring have been used to address quality improvement in services involving multiple sectors but not in combination with quantitative operational research methods that enable targeting of interventions according to patient risk. We aimed to combine these methods to augment and inform an improvement initiative concerning infants with congenital heart disease (CHD) whose complex care pathway spans multiple sectors...
January 6, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/28060211/service-delivery-in-the-healthcare-and-educational-systems-for-children-following-traumatic-brain-injury-gaps-in-care
#9
Juliet Haarbauer-Krupa, Angela Ciccia, Jonathan Dodd, Deborah Ettel, Brad Kurowski, Angela Lumba-Brown, Stacy Suskauer
OBJECTIVE: To provide a review of evidence and consensus-based description of healthcare and educational service delivery and related recommendations for children with traumatic brain injury. METHODS: Literature review and group discussion of best practices in management of children with traumatic brain injury (TBI) was performed to facilitate consensus-based recommendations from the American Congress on Rehabilitation Medicine's Pediatric and Adolescent Task Force on Brain Injury...
January 5, 2017: Journal of Head Trauma Rehabilitation
https://www.readbyqxmd.com/read/28057111/-health-economic-evaluation-of-a-23-value-pneumococcal-polysaccharide-vaccination-pilot-programme-among-elderly-chronic-obstructive-pulmonary-disease-patients-in-china
#10
Y P Qiu, K Zhao, X Li, L W Shi, W D Guo, X R Qi, B Y Sui, R M Zhou
Objective: From the perspective of health economics, to evaluate 23 pneumococcal polysaccharide vaccination programme among chronic obstructive pulmonary disease (COPD) patient. Methods: In the pilot counties of the project of integrated care pathway for COPD patient (Hanbin district of Hanzhong city in Shanxi Province, Qianjian district of Qingqing city, Huandao district of Qindao city in Shangdong Province, Wen county of Jiaozuo city in Henan Province), information of insurance participants of New Rural Cooperative Medical System (NRCS) was collected by local NRCM information system, which included general information as well as records of medical care and medical fee...
December 6, 2016: Zhonghua Yu Fang Yi Xue za Zhi [Chinese Journal of Preventive Medicine]
https://www.readbyqxmd.com/read/28039845/midwives-perceptions-and-experiences-of-caring-for-women-who-experience-perinatal-mental-health-problems-an-integrative-review
#11
REVIEW
Maria Noonan, Owen Doody, Julie Jomeen, Rose Galvin
BACKGROUND: perinatal mental health is an important public health issue and consideration must be given to care provision for effective support and care of women in the perinatal period. AIM: to synthesise primary research on midwives' perceived role in Perinatal Mental Health (PMH). DESIGN: integrative review. METHODS: Whittemore and Knafl's (2005) framework was employed. A systematic search of the literature was completed...
December 12, 2016: Midwifery
https://www.readbyqxmd.com/read/28027990/dual-sexual-and-drug-related-predictors-of-hepatitis-c-incidence-among-sex-workers-in-a-canadian-setting-gaps-and-opportunities-for-scale-up-of-hcv-prevention-treatment-and-care
#12
Shira M Goldenberg, Julio Montaner, Melissa Braschel, Eugenia Socias, Silvia Guillemi, Kate Shannon
BACKGROUND: Hepatitis C virus (HCV) represents a significant cause of morbidity and mortality globally. While sex workers (SWs) may face elevated HCV risks through both drug/sexual pathways, incidence data among SWs are severely lacking. We characterized HCV incidence and predictors of HCV seroconversion among women SWs in Vancouver, BC. METHODS: Questionnaire and serological data were drawn from a community-based cohort of women SWs (2010-2014). Kaplan-Meier METHODS: and Cox regression were used to model HCV incidence and predictors of time to HCV seroconversion...
December 24, 2016: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/28026983/comprehensive-diagnostic-assessment-of-health-status-of-patients-with-asthma-or-copd-a-delphi-panel-study-among-dutch-experts
#13
Edmée F M M van den Akker, Alex J Van't Hul, Erwin Birnie, Niels H Chavannes, Maureen P M H Rutten-van Mölken, Johannes C C M In't Veen
A comprehensive diagnostic assessment is needed to improve understanding of the health status of patients with chronic obstructive pulmonary disease (COPD) or asthma. Therefore, this study investigated which components and subsequent instruments should be part of a holistic assessment in secondary care. We also explored which data need to be exchanged for an adequate transfer of patients between primary and secondary care, and vice versa. A cross-sectional Web-based survey was conducted among Dutch healthcare professionals using a Delphi-like procedure; these included professionals working in primary or secondary care, medical advisors of health insurance companies and patients' representatives...
December 27, 2016: COPD
https://www.readbyqxmd.com/read/28024548/canadian-cardiovascular-society-canadian-cardiovascular-critical-care-society-canadian-association-of-interventional-cardiology-position-statement-on-the-optimal-care-of-the-postarrest-patient
#14
Graham C Wong, Sean van Diepen, Craig Ainsworth, Rakesh C Arora, Jean G Diodati, Mark Liszkowski, Michael Love, Chris Overgaard, Greg Schnell, Jean-Francois Tanguay, George Wells, Michel Le May
Out of hospital cardiac arrest (OHCA) is associated with a low rate of survival to hospital discharge and high rates of neurological morbidity among survivors. Programmatic efforts to institute and integrate OHCA best care practices from the bystander response through to the in-hospital phase have been associated with improved patient outcomes. This Canadian Cardiovascular Society position statement was developed to provide comprehensive yet practical recommendations to guide the in-hospital care of OHCA patients...
January 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28011746/the-pharmacology-of-autonomic-failure-from-hypotension-to-hypertension
#15
REVIEW
Italo Biaggioni
Primary neurodegenerative autonomic disorders are characterized clinically by loss of autonomic regulation of blood pressure. The clinical picture is dominated by orthostatic hypotension, but supine hypertension is also a significant problem. Autonomic failure can result from impairment of central autonomic pathways (multiple system atrophy) or neurodegeneration of peripheral postganglionic autonomic fibers (pure autonomic failure, Parkinson's disease). Pharmacologic probes such as the ganglionic blocker trimethaphan can help us in the understanding of the underlying pathophysiology and diagnosis of these disorders...
January 2017: Pharmacological Reviews
https://www.readbyqxmd.com/read/28006062/association-between-benign-breast-disease-in-african-american-and-white-american-women-and-subsequent-triple-negative-breast-cancer
#16
Lisa A Newman, Azadeh Stark, Dhanajay Chitale, Margaret Pepe, Gary Longton, Maria J Worsham, S David Nathanson, Patricia Miller, Jessica M Bensenhaver, Erica Proctor, Monique Swain, Christos Patriotis, Paul F Engstrom
Importance: Compared with white American (WA) women, African American (AA) women have a 2-fold higher incidence of breast cancers that are negative for estrogen receptor, progesterone receptor, and ERBB2 (triple-negative breast cancer [TNBC]). Triple-negative breast cancer, compared with non-TNBC, likely arises from different pathogenetic pathways, and benign breast disease (BBD) predicts future non-TNBC. Objective: To determine whether AA identity remains associated with TNBC for women with a prior diagnosis of BBD...
December 22, 2016: JAMA Oncology
https://www.readbyqxmd.com/read/28003288/protocol-for-a-multicentre-study-to-assess-feasibility-acceptability-effectiveness-and-direct-costs-of-triumph-treatment-and-recovery-in-psychosis-integrated-care-pathway-for-psychosis
#17
Shanaya Rathod, Christie Garner, Alison Griffiths, Borislav D Dimitrov, Katherine Newman-Taylor, Chris Woodfine, Lars Hansen, Paul Tabraham, Karen Ward, Carolyn Asher, Peter Phiri, Farooq Naeem, Pippa North, Tariq Munshi, David Kingdon
INTRODUCTION: Duration of untreated psychosis (time between the onset of symptoms and start of treatment) is considered the strongest predictor of symptom severity and outcome. Integrated care pathways that prescribe timeframes around access and interventions can potentially improve quality of care. METHODS AND ANALYSIS: A multicentre mixed methods study to assess feasibility, acceptability, effectiveness and analysis of direct costs of an integrated care pathway for psychosis...
December 21, 2016: BMJ Open
https://www.readbyqxmd.com/read/28002511/the-prognostic-and-clinical-significance-of-neuroimagistic-and-neurobiological-vulnerability-markers-in-correlation-with-the-molecular-pharmacogenetic-testing-in-psychoses-and-ultra-high-risk-categories
#18
Laura Alexandra Nussbaum, Lavinia Maria Hogea, Nicoleta Ioana Andreescu, Raluca Claudia Grădinaru, Maria Puiu, Andrei Todica
We approach an integrated, multidisciplinary, innovative research-action model in children and adolescents with psychosis and ultra high-risk categories. Our main focus was: to investigate the prognostic and clinical significance of neuroimagistic and neurobiological vulnerability markers in correlation with the molecular pharmacogenetic testing in psychoses and ultra high-risk categories; the dynamic evaluation of the clinical evolution for the studied groups in correlation with specific neurobiological and neuroimagistic variables and markers...
2016: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
https://www.readbyqxmd.com/read/27985968/career-planning-for-the-non-clinical-workforce-an-opportunity-to-develop-a-sustainable-workforce-in-primary-care
#19
Jacqueline A Tavabie, Jacqueline M Simms
Many health and social care systems worldwide have been developing a variety of navigator and signposting roles to help patients negotiate care through increasingly complex systems and multiple provider agencies. This UK project aims to explore, through a combination of job description review and workshops of stakeholders, the common competencies and features of non-clinical roles. The information is collated to develop common job descriptions at four key levels. These form the basis for a career pathway supported by portfolio-based educational programmes, embracing Apprenticeship Training Programmes...
December 16, 2016: Education for Primary Care
https://www.readbyqxmd.com/read/27979662/exploring-the-experiences-of-parents-caring-for-infants-with-developmental-dysplasia-of-the-hip-attending-a-dedicated-clinic
#20
REVIEW
Heather J Jennings, Martina Gooney, Joseph O'Beirne, Linda Sheahan
Specialised DDH (developmental dysplasion of the hip) clinics are developing around Ireland but are, however, variable in how they are operated. A DDH clinic was set up in the South-east of Ireland in 2002 with the goal of achieving an integrated care pathway between the orthopaedic surgical team and nursing team, working to an explicit protocol while also fostering a strong collaboration with the ultrasound department. This paper aims to explore the effectiveness of this dedicated clinic in the Southeast of Ireland...
November 5, 2016: International Journal of Orthopaedic and Trauma Nursing
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