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https://www.readbyqxmd.com/read/28737984/evaluating-the-training-responsibilities-and-practices-of-p-t-committee-members-and-nonmember-contributors
#1
Ryan Rodriguez, Brett J Kelly, Mary Moody
BACKGROUND: Pharmacy and therapeutics (P&T) committees are responsible for managing drug formularies in numerous health care settings. Although pharmacy practice and health care organizations provide general recommendations of responsibilities and skills for members and nonmember contributors of P&T committees, the study investigators hypothesized that there is diversity in the training, responsibilities, and practices of these members and contributors. OBJECTIVE: To describe the training, responsibilities, and practices of members and nonmember contributors of P&T committees in a variety of health care settings, using an online survey...
August 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28737951/monitoring-of-small-bowel-crohn-s-disease
#2
Uri Kopylov, Anastasios Koulaouzidis, Eyal Klang, Dan Carter, Shomron Ben-Horin, Rami Eliakim
In recent years, the therapeutic paradigm in Crohn's disease has shifted from a mere symptom-oriented approach, to aiming to healing of the underlying inflammation and prevention of long-term structural complications. Such "treat-to-target" approach may allow for a more stable disease course with less hospitalizations, lower requirement for surgery and improved quality of life. In Crohn's disease, the small bowel is affected in the majority of patients; frequently, Crohn's involves only the small bowel, which remains inaccessible to conventional ileocolonoscopic techniques...
July 24, 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28737869/management-of-cirrhotic-ascites-in-children-review-and-recommendations-part-1-pathophysiology-diagnostic-evaluation-hospitalization-criteria-treatment-nutritional-management
#3
REVIEW
David F Bes, M Cristina Fernández, Ivone Malla, Horacio A Repetto, Daniel Buamsch, Susana López, Roxana Martinitto, Miriam Cuarterolo, Fernando Álvarez
Ascites is a major complication of cirrhosis. There are several evidence-based articles and guidelines for the management of adults, but few data have been published in relation to children. In the case of pediatric patients with cirrhotic ascites (PPCA), the following questions are raised: How are the clinical assessment and ancillary tests performed? When is ascites considered refractory? How is it treated? Should fresh plasma and platelets be infused before abdominal paracentesis to prevent bleeding? What are the hospitalization criteria? What are the indicated treatments? What complications can patients develop? When and how should hyponatremia be treated? What are the diagnostic criteria for spontaneous bacterial peritonitis? How is it treated? What is hepatorenal syndrome? How is it treated? When should albumin be infused? When should fluid intake be restricted? The recommendations made here are based on pathophysiology and suggest the preferred approach to its diagnostic and therapeutic aspects, and preventive care...
August 1, 2017: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/28737412/integrated-care-clinic-creating-enhanced-clinical-pathways-for-integrated-behavioral-health-care-in-a-family-medicine-residency-clinic-serving-a-low-income-minority-population
#4
Jerica M Berge, Lisa Trump, Stephanie Trudeau, Damir S Utržan, Michele Mandrich, Andrew Slattengren, Tanner Nissly, Laura Miller, Macaran Baird, Eli Coleman, Michael Wootten
INTRODUCTION: Research examining the implementation and effectiveness of integrated behavioral health (BH) care in family medicine/primary care is growing. However, research identifying ways to consistently use integrated BH in busy family medicine/primary care settings with underserved populations is limited. This study describes 1 family medicine clinic's transformation into a fully integrated BH care clinic through the development of an Integrated Care Clinic (ICC) and enhanced clinical pathways to promote regular use of behavioral health clinicians (BHCs)...
July 24, 2017: Families, Systems & Health: the Journal of Collaborative Family Healthcare
https://www.readbyqxmd.com/read/28737325/-systemic-lupus-erythematosus-a-french-general-hospital-experience
#5
Anne-Lise Lecapitaine, Redouane Bakir, Jean-Luc Delassus, Hélène Gros, Marie-Anne Bouldouyre
: Our patients had similar clinical features to those reported in large series, except for a lower prevalence of renal injuries. Therapeutic management was in accordance with guidelines, with frequent discussion with teaching hospitals. We identified measures to improve our follow-up : more cardiovascular prevention, more vaccinations and adjustment of hydroxychloroquine monitoring.<np pagenum="048"/> </ce:para>.
March 6, 2017: Santé Publique: Revue Multidisciplinaire Pour la Recherche et L'action
https://www.readbyqxmd.com/read/28737064/the-effects-of-delirium-prevention-guidelines-on-elderly-stroke-patients
#6
Jihye Song, Minkyung Lee, Dukyoo Jung
This study aimed to evaluate the effectiveness of the delirium prevention interventions recommended by the Delirium Prevention Guidelines for Elderly Stroke Patients (DPGESP). The DPGESP comprises nine dimensions with 28 interventions, including risk factor assessment, orientation disorder prevention, sleeping pattern maintenance, sensory interventions, constipation, dehydration, hypoxia and infection prevention, pain management, and appropriate nutrition maintenance. This quasi-experimental study used a nonequivalent control group and a pretest-posttest design...
July 1, 2017: Clinical Nursing Research
https://www.readbyqxmd.com/read/28736994/intraoperative-hemodynamic-factors-predicting-early-postoperative-renal-function-in-pediatric-kidney-transplantation
#7
Daphné Michelet, Christopher Brasher, Lucile Marsac, Nabil Zanoun, Mona Assefi, Alaa Elghoneimi, Stephane Dauger, Souhayl Dahmani
BACKGROUND: The anesthetic management of kidney transplantation in children remains somewhat empirical. The goal of the present study was to investigate intraoperative hemodynamic factors affecting posttransplantation kidney function. METHODS: We performed a retrospective analysis of data from patients undergoing kidney transplantation in our pediatric teaching hospital from 2000 to 2014. Data collected included: donor and recipient demographic data, recipient comorbidities, fluids administered intraoperatively, and intraoperative blood pressure and central venous pressure...
July 24, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28736862/quality-management-of-ultrasound-surveillance-for-hepatocellular-carcinoma-under-the-korean-national-cancer-screening-program
#8
Moon Hyung Choi, Seung Eun Jung, Joon-Il Choi, Woo Kyoung Jeong, Hyun Cheol Kim, Yongsoo Kim, Yeol Kim, Boyoung Park
OBJECTIVES: The aim of this study was to investigate the quality of ultrasound (US) examinations for hepatocellular carcinoma surveillance under the Korean National Cancer Screening Program and to assess knowledge and experience about liver US of physicians who perform US examinations. METHODS: The investigation about the quality of liver US for hepatocellular carcinoma screening was based on the results of a nationwide quality assurance (QA) evaluation between 2012 and 2014 at all medical institutions participating in the National Cancer Screening Program...
July 24, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28736841/outcomes-of-blalock-taussig-shunts-in-current-era-a-single-center-experience
#9
Navaneetha Sasikumar, Antony Hermuzi, Chun-Po Steve Fan, Kyong-Jin Lee, Rajiv Chaturvedi, Edward Hickey, Osami Honjo, Glen S Van Arsdell, Christopher A Caldarone, Arnav Agarwal, Lee Benson
OBJECTIVES: Mortality associated with the modified Blalock-Taussig shunt (MBTS) remains high despite advanced perioperative management. This study was formulated to provide data on (1) current indications, (2) outcomes, and (3) factors affecting mortality and morbidity. DESIGN: A retrospective single center chart review identified 95 children (excluding hypoplastic left heart lesions) requiring a MBTS. Mortality and major morbidity were analyzed using the Kaplan Meier method and risk factor analysis using Cox's proportional hazard regression...
July 24, 2017: Congenital Heart Disease
https://www.readbyqxmd.com/read/28736809/dose-evaluation-of-grid-therapy-using-a-6-mv-flattening-filter-free-fff-photon-beam-a-monte-carlo-study
#10
Immaculada Martínez-Rovira, Josep Puxeu, Yolanda Prezado
PURPOSE: Spatially fractionated radiotherapy is a strategy to overcome the main limitation of radiotherapy, i.e., the restrained normal tissue tolerances. A well-known example is Grid Therapy, which is currently performed at some hospitals using megavoltage photon beams delivered by Linacs. Grid Therapy has been successfully used in the management of bulky abdominal tumors with low toxicity. The aim of this work is to evaluate whether an improvement in therapeutic index in Grid Therapy can be obtained by implementing it in a flattening filter-free (FFF) Linac...
July 24, 2017: Medical Physics
https://www.readbyqxmd.com/read/28736455/using-kaizen-to-improve-employee-well-being-results-from-two-organizational-intervention-studies
#11
Ulrica von Thiele Schwarz, Karina M Nielsen, Terese Stenfors-Hayes, Henna Hasson
Participatory intervention approaches that are embedded in existing organizational structures may improve the efficiency and effectiveness of organizational interventions, but concrete tools are lacking. In the present article, we use a realist evaluation approach to explore the role of kaizen, a lean tool for participatory continuous improvement, in improving employee well-being in two cluster-randomized, controlled participatory intervention studies. Case 1 is from the Danish Postal Service, where kaizen boards were used to implement action plans...
August 2017: Human Relations; Studies Towards the Integration of the Social Sciences
https://www.readbyqxmd.com/read/28736384/-revisional-surgery-for-nonstandard-gastric-bypass-a-case-report
#12
Yu Gao, Zhi-Gang Ke, Jian-Guo Liu, Wei-Dong Tong
Bariatric surgery is the most effective treatment for obesity with or without type 2 diabetes mellitus and its complications. With the growing incidence of type 2 diabetes mellitus, the number of hospitals performing bariatric surgery and surgical cases increase substantially. The problems in operation standardization, quality control of operation and postoperative management of the patients cause the failure in weight loss, hypoglycemia and severe complications, and revisional surgery is often required to correct the condition...
July 20, 2017: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
https://www.readbyqxmd.com/read/28736178/neonatal-solid-tumors
#13
Aravindan Chandrasekaran
BACKGROUND: Neonatal tumors are different from tumors of the older children and knowledge gained from treating older children can not be extrapolated to neonates. Neonates have immature physiology and their haematopoietic and immune systems are not fully developed and the response to therapy is unpredictable. Hence it is imperative to study these tumors as separate entity. The aim of this study is to analyse this rare set of tumors in terms of their incidence, clinical features and management...
July 11, 2017: Pediatrics and Neonatology
https://www.readbyqxmd.com/read/28736006/advantages-of-epidural-analgesia-on-pulmonary-functions-in-liver-transplant-donors
#14
H K Atalan, B Gucyetmez, R Donmez, A Kargi, K Y Polat
OBJECTIVE: Epidural analgesia (EA) has positive effects on anesthetic requirement, blood loss, postoperative analgesia, and pulmonary function tests (PFTs). The purpose of the present study was to investigate the effect of EA on postoperative PFTs in liver transplant donors (LTDs). METHODS: In the present study, 66 LTDs were classified as total intravenous anesthesia (TIVA) and TIVA+EA groups. Patient's age, sex, body mass index, induction and maintenance dose of propofol (IDP and MDP), operation duration, forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), FEV1/FVC ratio, visual analog scale (VAS), atelectasis scores, and lengths of intensive care unit (ICU) and hospital stays were recorded...
July 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28735860/are-oral-and-maxillofacial-surgery-residents-being-adequately-trained-to-care-for-pediatric-patients
#15
Shelly Abramowicz, Leonard B Kaban, Andrew S Wurtzel, Steven M Roser
OBJECTIVE: To evaluate whether current oral and maxillofacial surgery (OMS) residents are receiving adequate training and experience to perform specific surgical procedures and anesthesia for pediatric patients. STUDY DESIGN: A 17-question survey was sent electronically to fellows of the American Academy of Craniomaxillofacial Surgeons. Descriptive data for individual surgeons, their associated residency programs, and the quantity of specific pediatric procedures they performed were collected...
May 4, 2017: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
https://www.readbyqxmd.com/read/28735722/-is-the-introduction-of-clinical-management-programs-for-patients-with-chronic-obstructive-pulmonary-disease-useful-comparison-of-the-effectiveness-of-two-interventions-on-the-clinical-progress-and-care-received
#16
Ingrid Solanes, Ignasi Bolíbar, Maria Antònia Llauger, Meritxell Peiro, Pepi Valverde, Mar Fraga, Casimira Medrano, Teresa Bigorra, Montserrat Freixas, Iskra Ligüerre, Maria Antònia Pou, Leandra Domínguez, Carles Valero, Judit Solà, Jordi Giner, Vicente Plaza
OBJECTIVE: To evaluate the effectiveness of two management programs on patients with chronic obstructive pulmonary disease (COPD). DESIGN: A study with a quasi-experimental design was used to evaluate the effectiveness of two interventions (I1, I2) for the care of patients with COPD after a mean follow-up of 31.2months. SETTING: Primary Care Centres in two Barcelona Health Areas and their referral hospitals. PARTICIPANTS: Patients with COPD selected by simple random sampling using any disease code corresponding to COPD...
July 20, 2017: Atencion Primaria
https://www.readbyqxmd.com/read/28735650/prognostic-utility-of-neuroinjury-biomarkers-in-post-out-of-hospital-cardiac-arrest-ohca-patient-management
#17
S S Gul, K W Huesgen, K K Wang, K Mark, J A Tyndall
Despite aggressive intervention, patients who survive an out-of-hospital cardiac arrest (OHCA) generally have very poor prognoses, with nationwide survival rates of approximately 10-20%. Approximately 90% of survivors will have moderate to severe neurological injury ranging from moderate cognitive impairment to brain death. Currently, few early prognostic indicators are considered reliable enough to support patients' families and clinicians' in their decisions regarding medical futility. Blood biomarkers of neurological injury after OHCA may be of prognostic value in these cases...
August 2017: Medical Hypotheses
https://www.readbyqxmd.com/read/28735562/diagnostic-and-therapeutic-knowledge-and-practices-in-the-management-of-congenital-syphilis-by-pediatricians-in-public-maternity-hospitals-in-brazil
#18
Raquel Rodrigues Dos Santos, Roberta Pereira Niquini, Francisco Inácio Bastos, Rosa Maria Soares Madeira Domingues
The study aimed to assess conformity with Brazil's standard protocol for diagnostic and therapeutic practices in the management of congenital syphilis by pediatricians in public maternity hospitals. A cross-sectional study was conducted in 2015 with 41 pediatricians working in all the public maternity hospitals in Teresina, the capital of Piauí State, Northeast Brazil, through self-completed questionnaires. The study assessed the conformity of knowledge and practices according to the Brazilian Ministry of Health protocols...
January 1, 2017: International Journal of Health Services: Planning, Administration, Evaluation
https://www.readbyqxmd.com/read/28735551/quality-of-pharmacist-managed-anticoagulation-therapy-in-long-term-ambulatory-settings-a-systematic-review
#19
Beenish S Manzoor, Wei-Han Cheng, James C Lee, Ellen M Uppuluri, Edith A Nutescu
OBJECTIVE: To perform a systematic review to evaluate the quality of warfarin anticoagulation control in outpatient pharmacist-managed anticoagulation services (PMAS) compared with routine medical care (RMC). DATA SOURCES: MEDLINE, SCOPUS, EMBASE, IPA, CINAHL, and Cochrane CENTRAL, from inception to May 2017. Search terms employed: ("pharmacist-managed" OR "pharmacist-provided" OR "pharmacist-led" OR "pharmacist-directed") AND ("anticoagulation services" OR "anticoagulation clinic" OR "anticoagulation management" OR "anticoagulant care") AND ("quality of care" OR "outcomes" OR "bleeding" OR "thromboembolism" OR "mortality" OR "hospitalization" OR "length of stay" OR "emergency department visit" OR "cost" OR "patient satisfaction")...
July 1, 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28735379/multidisciplinary-management-of-clival-chordomas-long-term-clinical-outcome-in-a-single-institution-consecutive-series
#20
Petter Förander, Jiri Bartek, Michael Fagerlund, Hamza Benmaklouf, Ernest Dodoo, Alia Shamikh, Pär Stjärne, Tiit Mathiesen
OBJECTIVE: Chordomas of the skull base have high recurrence rates even after radical resection and adjuvant radiotherapy. We evaluate the long-term clinical outcome using multidisciplinary management in the treatment of clival chordomas. METHODS: Between 1984 and 2015, 22 patients diagnosed with an intracranial chordoma were treated at the Karolinska University Hospital, Stockholm, Sweden. Sixteen of 22 were treated with Gamma Knife radiosurgery (GKRS) for tumour residual or progression during the disease course...
July 22, 2017: Acta Neurochirurgica
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