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Appropriate use criteria

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https://www.readbyqxmd.com/read/28926388/opportunistic-use-of-ct-imaging-for-osteoporosis-screening-and-bone-density-assessment-a-qualitative-systematic-review
#1
Elizabeth B Gausden, Benedict U Nwachukwu, Joseph J Schreiber, Dean G Lorich, Joseph M Lane
BACKGROUND: The purpose of this study was to determine the clinical opportunities for the use of computed tomography (CT) imaging for inferring bone quality and to critically analyze the correlation between dual x-ray absorptiometry (DXA) and diagnostic CT as reported in the literature. METHODS: A systematic review of the MEDLINE database was performed in February 2016 using the PubMed interface. The inclusion criteria were English language, studies performed using living human subjects, studies pertaining to orthopaedics, use of conventional diagnostic CT scans, studies that measured cancellous bone, and studies that reported Hounsfield unit (HU) measurements directly rather than a computed bone mineral density...
September 20, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28925726/traumatic-brain-injury-amongst-indigenous-people-a-systematic-review
#2
Ali Lakhani, Clare Townsend, Jason Bishara
OBJECTIVES: To identify the types of research focusing on Traumatic Brain Injury (TBI) amongst Indigenous people in order to (i) synthesise their findings and (ii) ascertain where research gaps exist. METHODOLOGY: A systematic review using the PRISMA approach was employed. Eight databases were searched for peer-reviewed literature published at any date. FINDINGS: Twenty-six studies met the inclusion criteria and were included in this review...
September 19, 2017: Brain Injury: [BI]
https://www.readbyqxmd.com/read/28925418/mhealth-application-areas-and-technology-combinations-a-comparison-of-literature-from-high-and-low-middle-income-countries
#3
Haitham Abaza, Michael Marschollek
BACKGROUND: With the continuous and enormous spread of mobile technologies, mHealth has evolved as a new subfield of eHealth. While eHealth is broadly focused on information and communication technologies, mHealth seeks to explore more into mobile devices and wireless communication. Since mobile phone penetration has exceeded other infrastructure in low and middle-income countries (LMICs), mHealth is seen as a promising component to provide pervasive and patient-centered care. OBJECTIVES: The aim of our research work for this paper is to examine the mHealth literature to identify application areas, target diseases, and mHealth service and technology types that are most appropriate for LMICs...
August 8, 2017: Methods of Information in Medicine
https://www.readbyqxmd.com/read/28924630/role-of-in-vitro-release-methods-in-liposomal-formulation-development-challenges-and-regulatory-perspective
#4
Deepak Solomon, Nilesh Gupta, Nihal S Mulla, Snehal Shukla, Yadir A Guerrero, Vivek Gupta
In the past few years, measurement of drug release from pharmaceutical dosage forms has been a focus of extensive research because the release profile obtained in vitro can give an indication of the drug's performance in vivo. Currently, there are no compendial in vitro release methods designed for liposomes owing to a range of experimental challenges, which has created a major hurdle for both development and regulatory acceptance of liposome-based drug products. In this paper, we review the current techniques that are most often used to assess in vitro drug release from liposomal products; these include the membrane diffusion techniques (dialysis, reverse dialysis, fractional dialysis, and microdialysis), the sample-and-separate approach, the in situ method, the continuous flow, and the modified United States Pharmacopeia methods (USP I and USP IV)...
September 18, 2017: AAPS Journal
https://www.readbyqxmd.com/read/28922696/does-air-gas-aesthesiometry-generate-a-true-mechanical-stimulus-for-corneal-sensitivity-measurement
#5
Daniela S Nosch, Heiko Pult, Julie Albon, Christine Purslow, Paul J Murphy
BACKGROUND: Belmonte Ocular Pain Meter (OPM) air jet aesthesiometry overcomes some of the limitations of the Cochet-Bonnet aesthesiometer. However, for true mechanical corneal sensitivity measurement, the airflow stimulus temperature of the aesthesiometer must equal ocular surface temperature (OST), to avoid additional response from temperature-sensitive nerves. The aim of this study was to determine: (A) the stimulus temperature inducing no or least change in OST; and (B) to evaluate if OST remains unchanged with different stimulus durations and airflow rates...
September 18, 2017: Clinical & Experimental Optometry: Journal of the Australian Optometrical Association
https://www.readbyqxmd.com/read/28921935/assessing-causal-relationships-using-genetic-proxies-for-exposures-an-introduction-to-mendelian-randomisation
#6
Srinivasa Vittal Katikireddi, Michael Green, Amy E Taylor, George Davey Smith, Marcus R Munafò
BACKGROUND AND AIMS: Studying the consequences of addictive behaviours is challenging, with understanding causal relationships from observational data being particularly difficult. For example, people who smoke or drink excessively are often systematically different from those who do not, are less likely to participate in research, and may misreport their behaviours when they do. Furthermore, the direction of causation between an addictive behaviour and outcome may be unclear. Mendelian randomisation (MR) offers potential solutions to these problems...
September 18, 2017: Addiction
https://www.readbyqxmd.com/read/28921739/a-rapid-review-of-needs-assessment-tools-for-post-treatment-cancer-survivors
#7
REVIEW
M Jiao, A E Hall, L Nolte, A Piper, K Lisy, M Jefford
Relevant, comprehensive and psychometrically rigorous needs assessment tools are needed to ensure appropriate care is delivered to cancer survivors who have completed treatment. The aim of this rapid review was to identify and describe needs assessment tools that are used in cancer survivors post-treatment, assess their psychometric properties and describe their use in clinical care. The electronic databases Medline, Cochrane Library, CINAHL and PsycINFO were searched. Six studies were identified that described five needs assessment tools used in cancer survivors post-treatment...
September 18, 2017: European Journal of Cancer Care
https://www.readbyqxmd.com/read/28921731/inter-observer-agreement-in-pediatric-cervical-spine-injury-assessment-between-prehospital-and-emergency-department-providers
#8
Lorin R Browne, Hamilton Schwartz, Fahd A Ahmad, Michael Wallendorf, Nathan Kuppermann, E Brooke Lerner, Julie C Leonard
BACKGROUND: Investigators have derived cervical spine injury (CSI) decision support tools from physician observations. There is a need to demonstrate that prehospital emergency medical services (EMS) providers can use these tools to appropriately determine the need for spinal motion restrictions and make field disposition decisions. OBJECTIVE: To determine the inter-observer agreement between EMS and emergency department (ED) providers for CSI risk assessment variables and overall gestalt for CSI in children after blunt trauma...
September 18, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28921613/voxel-based-multi-model-fitting-method-for-modelling-time-activity-curves-in-spect-images
#9
David Sarrut, Adrien Halty, Jean-Noel Badel, Ludovic Ferrer, Manuel Bardiès
PURPOSE: Estimating the biodistribution and the pharmacokinetics from timesequence SPECT images on a per-voxel basis is useful for studying activity nonuniformity or computing absorbed dose distributions by convolution of voxel kernels or Monte-Carlo radiation transport. Current approaches are either region-based, thus assuming uniform activity within the region, or voxel-based but using the same fitting model for all voxels. METHODS: We propose a voxel-based multi-model fitting method (VoMM) that estimates a fitting function for each voxel by automatically selecting the most appropriate model among a predetermined set with Akaike criteria...
September 17, 2017: Medical Physics
https://www.readbyqxmd.com/read/28919793/burden-of-uterine-fibroids-in-italy-epidemiology-treatment-outcomes-and-consumption-of-health-care-resources-in-more-than-5-000-women
#10
Marco Chiumente, Mauro De Rosa, Andrea Messori, Enrica Maria Proli
BACKGROUND AND PURPOSE: Epidemiological studies on uterine fibroids (UFs) are mostly based on surveys or analyses of small samples of patients. In 50% of women, the quality of life is worsened by disease-related symptoms; furthermore, treatments imply a remarkable health care cost. The aim of this observational study was to analyze a large sample of Italian patients with UFs and to assess the epidemiology, the appropriateness of treatments, and the consumption of disease-related resources...
2017: ClinicoEconomics and Outcomes Research: CEOR
https://www.readbyqxmd.com/read/28919609/psychiatric-disorders-in-drop-out-from-educational-attainment-attending-mental-health-facilities-a-descriptive-cross-sectional-study
#11
M S Islam, M H Rashid, M N Uddin, R K Singha, M A Rahman, M A Haque, C K Saha, M F Abedin
Studies of the impact of mental disorders on educational attainment are rare. Mental disorders, those beginning in childhood or adolescence may increase the risk of early drop out from education. The latter has been shown to have adverse life-course consequences on individuals such as greater demand on social welfare entitlements. A descriptive cross sectional study was carried out at the department of Psychiatry, Comilla Medical College, Comilla, Bangladesh. All cases were selected from patients attending at Comilla Medical College Hospital and Private Mental Health Facilities in Comilla City from March 2015 to February 2016...
July 2017: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/28918351/susceptibility-profiles-of-bacteria-causing-urinary-tract-infection-in-southern-tunisia
#12
Sonda Guermazi-Toumi, Sirine Boujlel, Mouna Assoudi, Riadh Issaoui, Sonia Tlili, Mohamed Ennaceur Hlaiem
OBJECTIVES: The aim of this study was to determine the epidemiological profile and the antibiotic resistance of bacteria responsible for urinary infections diagnosed in the department of microbiology of the regional hospital Houcine Bouzaiene (Gafsa) in the south west of Tunisia. METHODS: All the cytobacteriological urine samples analyzed from 1 January 2015 to 30 June 2016 were included in the study. The adopted criteria to define urinary infection were: leukocyturia >10(4)/ml and bacteriuria >10(5)CFU/ml...
September 13, 2017: Journal of Global Antimicrobial Resistance
https://www.readbyqxmd.com/read/28918006/factors-influencing-organochlorine-pesticides-distribution-in-the-brisbane-river-estuarine-sediment-australia
#13
Godfred Odame Duodu, Ashantha Goonetilleke, Godwin A Ayoko
Sediment samples collected from Brisbane River were analysed for organochlorine pesticide residues (OCPs). The factors influencing OCPs distribution in the sediment were investigated using multivariate analytical tools. Thirteen OCPs were detected in the sediment with concentrations ranging between below detection to 83.9ng/g, and detection frequency >90%. With the exception of dieldrin, the OCP inputs appear to be historical and may cause adverse ecological impacts. Multi-criteria ranking of the factors influencing the OCPs (except dieldrin) distribution in the sediment revealed that TOC>silt>intensive urban land use>population>seasons...
September 13, 2017: Marine Pollution Bulletin
https://www.readbyqxmd.com/read/28917648/challenges-of-conducting-a-prospective-clinical-trial-for-older-patients-lessons-learned-from-ncctg-n0949-alliance
#14
Nadine J McCleary, Joleen Hubbard, Michelle R Mahoney, Jeffrey A Meyerhardt, Daniel Sargent, Alan Venook, Axel Grothey
OBJECTIVES: While the risk of developing colorectal cancer increases with age, there are limited prospective data regarding best treatment in the older adult population. We launched a phase III trial to evaluate difference in treatment outcome for older adults (aged ≥70years) with advanced colorectal cancer. Here we review the challenges faced and reasons for poor accrual to N0949. MATERIALS AND METHODS: We describe the conceptualization, development and limited results of N0949, a randomized phase III study of fluoropyrimidine/bevacizumab with or without oxaliplatin (mFOLFOX7 or XELOX) as first line chemotherapy for metastatic colorectal cancer...
September 13, 2017: Journal of Geriatric Oncology
https://www.readbyqxmd.com/read/28917110/prevalence-and-predictors-of-potentially-inappropriate-prescribing-of-central-nervous-system-and-psychotropic-drugs-among-elderly-patients-a-national-population-study-in-korea
#15
Hyeonseok Cho, Junjeong Choi, Young-Sang Kim, Sang Joon Son, Kang Soo Lee, Hee-Jin Hwang, Hye-Young Kang
OBJECTIVES: To investigate the prevalence of potentially inappropriate prescribing (PIP) of central nervous system and psychotropic (CNS-PS) drugs to the Korean elderly population, and to identify PIP-associated factors. METHODS: Ambulatory care visits were identified from the 2013 National Aged Patient Sample (HIRA-APS-2013) data, composed of 20% random samples of all enrollees in the universal health security program aged ≥65 years. The CNS-PS section of Screening Tool of Older Person's potentially inappropriate Prescriptions (STOPP) criteria version 2 was used to identify PIP at these visits...
September 6, 2017: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/28916120/does-early-and-appropriate-antibiotic-administration-improve-mortality-in-emergency-department-patients-with-severe-sepsis-or-septic-shock
#16
Robert Sherwin, Michael E Winters, Gary M Vilke, Gabriel Wardi
BACKGROUND: Severe sepsis and septic shock remain significant public health concerns. Appropriate emergency department management includes early recognition, hemodynamic resuscitation, source control, and prompt antibiotic administration. Current international guidelines strongly recommend administration of early and appropriate antibiotics for patients with severe sepsis and septic shock. Interestingly, a recent Cochrane Review found insufficient evidence to provide a similar recommendation on antibiotic administration...
September 12, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28916012/preliminary-outcomes-from-an-integrated-pediatric-mental-health-outpatient-clinic
#17
REVIEW
Gary R Maslow, Adrienne Banny, McLean Pollock, Kristen Stefureac, Kendra Rosa, Barbara Keith Walter, Katherine Hobbs Knutson, Joseph Lucas, Nicole Heilbron
An estimated 1 in 5 children in the United States meet criteria for a diagnosable mental disorder, yet fewer than 20% receive mental health services. Unmet need for psychiatric treatment may contribute to patterns of increasing use of the emergency department. This article describes an integrated pediatric evaluation center designed to prevent the need for treatment in emergency settings by increasing access to timely and appropriate care for emergent and critical mental health needs. Preliminary results showed that the center provided rapid access to assessment and treatment services for children and adolescents presenting with a wide range of psychiatric concerns...
October 2017: Child and Adolescent Psychiatric Clinics of North America
https://www.readbyqxmd.com/read/28915208/appropriate-use-criteria-for-cardiac-computed-tomography-impact-on-diagnostic-utility
#18
Karan Bami, Manuja Premaratne, Jasmine Lamba, Yeung Yam, Alomgir Hossain, Marissa Keenan, Tony Haddad, Saipriya Anand, Ian G Burwash, Terrence D Ruddy, Girish Dwivedi, Benjamin J W Chow
BACKGROUND: Appropriate Use Criteria (AUC) guidelines for cardiac computed tomography (CCT) were developed to limit testing to reasonable clinical settings. However, significant testing is still done for inappropriate indications. This study investigates the impact of AUC on evaluability of CCT to determine if inappropriate tests result in a greater proportion of nondiagnostic results. METHODS: Investigators reviewed the medical records of 2417 consecutive patients who underwent CCT at the University of Ottawa Heart Institute...
September 2017: Journal of Computer Assisted Tomography
https://www.readbyqxmd.com/read/28914747/appropriate-use-criteria-for-cardiac-computed-tomography-does-computed-tomography-have-incremental-value-in-all-appropriate-use-criteria-categories
#19
Fernanda Erthal, Manuja Premaratne, Yeung Yam, Li Chen, Jasmine Lamba, Marissa Keenan, Tony Haddad, Kishu Pharasi, Saipriya Anand, Rob S Beanlands, Ian G Burwash, Girish Dwivedi, Terrence D Ruddy, Benjamin J W Chow
PURPOSE: Cardiac imaging expenditures have come under scrutiny, and a focus on appropriate use criteria (AUC) has arisen to ensure cost-effective resource utilization. Although AUC has been developed by clinical experts, it has not undergone rigorous quality assurance testing to ensure that inappropriate indications for testing yield little clinical benefit. The objective of the study was to evaluate the potential incremental prognostic value of coronary computed tomographic angiography (CCTA) in the different AUC categories...
September 13, 2017: Journal of Thoracic Imaging
https://www.readbyqxmd.com/read/28914744/cardiac-computed-tomography-before-and-after-cardiac-surgery
#20
Fernanda Erthal, Joao R Inacio, Samir Hazra, Vincent Chan, Benjamin J W Chow
Cardiac computed tomography angiography (CCTA) is a noninvasive imaging technique that has been rapidly adopted into clinical practice. Over the past decade, technological advances have improved CCTA accuracy, and there is an increasing amount of data supporting its prognostic value in the assessment of coronary artery disease. Recently, "appropriate use criteria" has been used as a tool to minimize inappropriate testing and reduce patient exposure to unnecessary risk and inconclusive studies. This review will summarize the appropriate uses of CCTA in patients before and after cardiac surgery...
September 13, 2017: Journal of Thoracic Imaging
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