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https://www.readbyqxmd.com/read/28645203/neurosurgical-randomized-controlled-trials-distance-travelled
#1
Tej D Azad, Anand Veeravagu, Vaishali Mittal, Rogelio Esparza, Eli Johnson, John P A Ioannidis, Gerald A Grant
BACKGROUND: The evidence base for many neurosurgical procedures has been limited. We performed a comprehensive and systematic analysis of study design, quality of reporting, and trial results of neurosurgical randomized controlled trials (RCTs). OBJECTIVE: To systematically assess the design and quality characteristics of neurosurgical RCTs. METHODS: From January 1961 to June 2016, RCTs with >5 patients assessing any 1 neurosurgical procedure against another procedure, nonsurgical treatment, or no treatment were retrieved from MEDLINE, Scopus, and Cochrane Library...
June 21, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28645181/the-clinical-benefits-of-perioperative-antioxidant-vitamin-therapy-in-patients-undergoing-cardiac-surgery-a-meta-analysis
#2
Jun Geng, Ju Qian, Weijun Si, Hao Cheng, Fuhai Ji, Zhenya Shen
The clinical benefits of perioperative antioxidant vitamin therapy in cardiac patients remain controversial. Here, we conducted a meta-analysis to determine the strength of the evidence supporting the perioperative use of antioxidant vitamins in patients undergoing cardiac surgery. We searched 4 databases (PubMed, EMBASE, Science Citation Index and Cochrane Library) for randomized controlled trials that reported the effects of antioxidant vitamin therapy on patients undergoing cardiac surgery until 6 June 2016...
June 22, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28645125/-epidemiology-of-parkinson-s-disease-and-current-concepts%C3%A2-of-outpatient-care-in-germany
#3
Lars Tönges, Reinhard Ehret, Michael Lorrain, Peter Riederer, Martina Müngersdorf
The ambulatory care of patients with Parkinson's disease (PD) in Germany has been established for a long time. As the prevalence of Parkinson's disease continues to increase, the outpatient neurological sector is becoming more and more important and needs to adapt itself to current needs. This includes an optimization of the care structures for Parkinson's patients as well as adequate concepts for the execution of differentiated diagnostics and therapy. For many patients care is provided by non-specialized neurological practices or general practitioners, without exchange of views with neurologists or a specialized university outpatient clinic for movement disorders...
June 2017: Fortschritte der Neurologie-Psychiatrie
https://www.readbyqxmd.com/read/28645119/the-application-of-enhanced-recovery-after-surgery-eras-fast-track-surgery-in-gastrectomy-for-gastric-cancer-a-systematic-review-and-meta-analysis
#4
REVIEW
Jie Ding, Benlong Sun, Peng Song, Song Liu, Hong Chen, Min Feng, Wenxian Guan
BACKGROUND: The study aimed to compare the safety and effectiveness of Enhanced recovery after surgery (ERAS) with conventional care in gastrectomy for gastric cancer. METHODS: Search strategy from Pubmed, Embase, Web of science, Cochrane library and reference lists was performed. The collected studies were randomized controlled trials and published only in English, and undergoing ERAS in gastrectomy for gastric cancer from January 1994 to August 2016. RESULTS: A total of eight studies including 801 patients were included...
June 20, 2017: Oncotarget
https://www.readbyqxmd.com/read/28645118/outcome-of-patients-treated-for-myelodysplastic-syndromes-with-5q-deletion-after-failure-of-lenalidomide-therapy
#5
Thomas Prebet, Thomas Cluzeau, Sophie Park, Mikkael A Sekeres, Ulrich Germing, Lionel Ades, Uwe Platzbecker, Katharina Gotze, Norbert Vey, Esther Oliva, Mary M Sugrue, Cecile Bally, Charikleia Kelaidi, Najla Al Ali, Pierre Fenaux, Steven D Gore, Rami Komrokji
While lenalidomide (LEN) is the standard of care for the lower-risk myelodysplastic syndromes (MDS) patients with deletion 5q, 35% will not respond to or do not tolerate the drug. Moreover, most of the patients will lose their response after a few years. Defining the outcome of patients with LEN failure and determining the impact of subsequent therapies is therefore important to develop alternative strategies. Based on an international collaboration, we were able to compile a total of 392 patient cases of lower-risk MDS patients with 5q deletion and to analyze their outcome after failure of lenalidomide...
June 14, 2017: Oncotarget
https://www.readbyqxmd.com/read/28645073/analysis-of-ldlr-variants-from-homozygous-fh-patients-carrying-multiple-mutations-in-the-ldlr-gene
#6
Long Jiang, Asier Benito-Vicente, Ling Tang, Aitor Etxebarria, Wei Cui, Kepa B Uribe, Xiao-Dong Pan, Helena Ostolaza, Shi-Wei Yang, Yu-Jie Zhou, Cesar Martin, Lu-Ya Wang
BACKGROUND AND AIMS: Familial hypercholesterolemia (FH) is an autosomal dominant disease with widespread global prevalence that partially accounts for the high prevalence of premature coronary heart disease. Although the majority of research on FH has focused on single heterozygous LDLR mutations, there have been limited reports of double LDLR mutations on the same chromosome. The aim of this study was to gain insight into the clinical consequences of the presence of multiple mutations in the LDLR gene...
June 8, 2017: Atherosclerosis
https://www.readbyqxmd.com/read/28645065/cross-validation-of-short-forms-of-the-screener-and-opioid-assessment-for-patients-with-pain-revised-soapp-r
#7
Matthew D Finkelman, Robert N Jamison, Ronald J Kulich, Stephen F Butler, William C Jackson, Niels Smits, Scott G Weiner
BACKGROUND: The Screener and Opioid Assessment for Patients with Pain-Revised (SOAPP-R) is a 24-item assessment designed to assist in the prediction of aberrant drug-related behavior (ADB) among patients with chronic pain. Recent work has created shorter versions of the SOAPP-R, including a static 12-item short form and two computer-based methods (curtailment and stochastic curtailment) that monitor assessments in progress. The purpose of this study was to cross-validate these shorter versions in two new populations...
June 13, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/28645011/transient-portal-venous-gas-associated-with-reversible-non-occlusive-mesenteric-ischemia-a-case-report
#8
Gaël Piton, Brice Paquette, Eric Delabrousse, Gilles Capellier
OBJECTIVES: To report the utility of abdominal ultrasonography (US) to identify the presence of portal venous gas (PVG) during non-occlusive mesenteric ischemia (NOMI), and to follow the disappearance of portal venous gas after resolution of the NOMI. DATA SOURCES: This was a clinical observation of a patient, with images of abdominal computed tomography (CT), and a video of portal venous gas identified by ultrasonography. DATA SYNTHESIS: We describe the case of an adult patient admitted to our ICU for NOMI developing 48h after cardiac surgery...
June 16, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28644962/validity-and-reproducibility-of-the-modified-start-back-tool-dutch-version-for-patients-with-neck-pain-in-primary-care
#9
Jasper D Bier, Raymond W J G Ostelo, Bart W Koes, Arianne P Verhagen
OBJECTIVE: To evaluate the reliability and validity of the Dutch version of the STarT Back screening Tool (SBT), for patients with neck pain. METHODS: We modified the SBT to fit patients with neck pain. General practitioners and physiotherapists included patients who completed both a baseline and a follow-up questionnaire at 3 days and 3 months, respectively. The construct validity was assessed using Pearson's correlation between the SBT and the reference questionnaires...
June 15, 2017: Musculoskeletal Science & Practice
https://www.readbyqxmd.com/read/28644945/complications-and-cost-of-syndactyly-reconstruction-in-the-united-states-analysis-of-the-pediatric-health-information-system
#10
Maria F Canizares, Lanna Feldman, Patricia E Miller, Peter M Waters, Donald S Bae
BACKGROUND: Syndactyly is one of the most common congenital differences of the upper extremity and offers an exceptional opportunity to evaluate value-based care in pediatric orthopedic surgery. We designed a study to characterize complications and cost associated to syndactyly surgery among US pediatric hospitals. METHODS: A total of 2047 patients were identified for syndactyly surgery at 38 pediatric hospitals from 2009 to 2012 using the Pediatric Health Information System (PHIS) database...
July 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28644939/an-economic-analysis-of-mac-versus-walant-a-trigger-finger-release-surgery-case-study
#11
Jason L Codding, Suneel B Bhat, Asif M Ilyas
BACKGROUND: There has been recent interest in wide awake hand surgery, also referred to as "wide awake local anesthesia with no tourniquet" (WALANT) surgery. Using a model of single trigger finger release (TFR) surgery, a hypothesis was made that WALANT would result in decreased hospital time and cost than patients receiving sedation with monitored anesthetic care (MAC). METHODS: Consecutive cases of single TFR surgery with MAC were compared with WALANT. All surgeries were performed in the same manner, at the same facility, and by the same surgeon...
July 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28644938/preoperative-epoxy-embolization-facilitates-the-safe-and-effective-resection-of-venous-malformations-in-the-hand-and-forearm
#12
Brian P Holly, Yuval A Patel, James Park, Laura M Fayad, E Gene Deune, Sally E Mitchell, Clifford R Weiss
BACKGROUND: The standard of care for treatment of low-flow venous malformations (VMs) is percutaneous sclerotherapy. These lesions are seldom surgically resected, especially if the malformation is in an anatomically difficult location. Percutaneous sclerotherapy is safe and effective. However, the drawbacks to sclerotherapy are the need for repeated treatments and risks of skin ulceration, deep venous thrombosis, scarring/contractures, and nerve damage. Surgical resection can be difficult because of intraoperative bleeding, intraoperative lesional decompression, and difficulty in localization...
July 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28644931/quadrigia-and-productivity
#13
John Ingraham
Financial productivity in academic surgery is important and deserves great emphasis, yet it is but one of many vital elements of a healthy practice. Productivity must be carefully balanced with many other vital goals such as maximizing patient safety, maintaining excellent outcomes, optimizing resident and medical student education, and earning outstanding patient feedback. The following editorial explores this elusive balance and the importance of not swaying too far in the direction of revenue.
July 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28644930/trends-in-open-and-endoscopic-cubital-tunnel-release-in-the-medicare-patient-population
#14
Tsun Yee Law, Zachary S Hubbard, Lee Onn Chieng, Harvey W Chim
BACKGROUND: Cubital tunnel syndrome (CUT) is the second most common peripheral neuropathy with an annual incidence of 24.7 per 100 000, affecting nearly twice as many men as women. With increasing focus on cost-effectiveness and cost-containment in medicine, a critical understanding of utilization of health care resources for open and endoscopic approaches for cubital tunnel release is of value. The purpose of this study was to evaluate the costs and utilization trends of open and endoscopic cubital tunnel release...
July 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28644913/supplement-2-for-the-2004-update-of-the-aapm-task-group-no-43-report-joint-recommendations-by-the-aapm-and-gec-estro
#15
Mark J Rivard, Facundo Ballester, Wayne M Butler, Larry A DeWerd, Geoffrey S Ibbott, Ali S Meigooni, Christopher S Melhus, Michael G Mitch, Ravinder Nath, Panagiotis Papagiannis
Since publication of the 2004 update to the American Association of Physicists in Medicine (AAPM) Task Group No. 43 Report (TG-43U1) and its 2007 supplement (TG-43U1S1), several new low-energy photon-emitting brachytherapy sources have become available. Many of these sources have satisfied the AAPM prerequisites for routine clinical purposes and are posted on the Brachytherapy Seed Registry managed jointly by the AAPM and the Imaging and Radiation Oncology Core Houston Quality Assurance Center (IROC Houston)...
June 23, 2017: Medical Physics
https://www.readbyqxmd.com/read/28644837/real-world-first-line-treatment-and-overall-survival-in-non-small-cell-lung-cancer-without-known-egfr-mutations-or-alk-rearrangements-in-us-community-oncology-setting
#16
Amy P Abernethy, Ashwini Arunachalam, Thomas Burke, Caroline McKay, Xiting Cao, Rachael Sorg, David P Carbone
PURPOSE: To establish a baseline for care and overall survival (OS) based upon contemporary first-line treatments prescribed in the era before the introduction of immune checkpoint inhibitors, for people with metastatic non-small cell lung cancer (NSCLC) without common actionable mutations. METHODS: Using a nationally representative electronic health record data from the Flatiron dataset which included 162 practices from different regions in US, we identified patients (≥18 years old) newly diagnosed with stage IV NSCLC initiating first-line anticancer therapy (November 2012- January 2015, with follow-up through July 2015)...
2017: PloS One
https://www.readbyqxmd.com/read/28644835/physician-assessments-of-drug-seeking-behavior-a-mixed-methods-study
#17
Michael A Fischer, John B McKinlay, Jeffrey N Katz, Eric Gerstenberger, Felicia Trachtenberg, Lisa D Marceau, Lisa C Welch
BACKGROUND: Pain complaints are common, but clinicians are increasingly concerned about overuse of opioid pain medications. This may lead patients with actual pain to be stigmatized as "drug-seeking," or attempting to obtain medications they do not require medically. We assessed whether patient requests for specific opioid pain medication would lead physicians to classify them as drug-seeking and change management decisions. METHODS AND FINDINGS: Mixed-methods analysis of interviews with 192 office-based primary care physicians after viewing video vignettes depicting patients presenting with back pain...
2017: PloS One
https://www.readbyqxmd.com/read/28644822/the-effect-of-a-lay-led-group-based-self-management-program-for-patients-with-chronic-pain-a-randomized-controlled-trial-of-the-danish-version-of-the-chronic-pain-self-management-programme
#18
Mimi Mehlsen, Lea Hegaard, Eva Ørnbøl, Jens Søndergaard Jensen, Per Fink, Lisbeth Frostholm
The Stanford Chronic Pain Self-Management Programme (CPSMP) consists of six 2½-hour weekly workshops focusing on how to manage pain in daily life. The workshops are facilitated by two workshop leaders of whom at least one must suffer from a long-term pain condition. The program is highly structured and manualized. Only few controlled trials testing the effect of CPSMP exist.Enrolled in the study were 424 adults from 19 Danish municipalities, (72% women; age: 25-93 years) with pain of any etiology and great variation in pain history (0-50 yrs)...
June 22, 2017: Pain
https://www.readbyqxmd.com/read/28644791/culture-and-moral-distress-what-s-the-connection-and-why-does-it-matter
#19
Nancy Berlinger, Annalise Berlinger
Culture is learned behavior shared among members of a group and from generation to generation within that group. In health care work, references to "culture" may also function as code for ethical uncertainty or moral distress concerning patients, families, or populations. This paper analyzes how culture can be a factor in patient-care situations that produce moral distress. It discusses three common, problematic situations in which assumptions about culture may mask more complex problems concerning family dynamics, structural barriers to health care access, or implicit bias...
June 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/28644790/strategies-for-promoting-high-quality-care-and-personal-resilience-in-palliative-care
#20
Katherine E Heinze, Heidi K Holtz, Cynda H Rushton
Palliative care (PC) clinicians are faced with ever-expanding pressures, which can make it difficult to fulfill their duties to self and others and lead to moral distress. Understanding the pressures that PC clinicians face and the resources that could be employed to ease their moral distress is crucial to maintaining a healthy PC workforce and to providing necessary PC services to patients. In this paper, we discuss recommendations related to two promising pathways for supporting PC clinicians in providing high-quality PC: (1) improving systemic PC delivery and (2) strategies to promote ethical practice environments and individual resilience...
June 1, 2017: AMA Journal of Ethics
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