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https://www.readbyqxmd.com/read/28092168/associations-between-at-risk-alcohol-use-substance-use-and-smoking-with-lipohypertrophy-and-lipoatrophy-among-patients-living-with-hiv
#1
Marisela Noorhasan, Daniel Drozd, Carl Grunfeld, Joe Merrill, Greer Burkholder, Michael J Mugavero, James H Willig, Amanda Willig, Karen L Cropsey, Kenneth Mayer, Aaron Blashill, Matthew Mimiaga, Mary E McCaul, Heidi Hutton, Geetanjali Chander, William C Matthews, Sonia Napravnik, Joseph J Eron, Katerina Christopoulos, Rob Fredericksen, Robin Nance, Joseph Chris Delaney, Paul Crane, Michael Saag, Mari M Kitahata, Heidi Crane
OBJECTIVE: To examine associations between lipohypertrophy and lipoatrophy and illicit drug use, smoking, and at-risk alcohol use among a large diverse cohort of persons living with HIV (PLWH) in clinical care. METHODS: 7,931 PLWH at 6 sites across the US completed 21,279 clinical assessments including lipohypertrophy and lipoatrophy, drug/alcohol use, physical activity level, and smoking. Lipohypertrophy and lipoatrophy were measured using the FRAM body morphology instrument and associations were assessed with generalized estimating equations...
January 16, 2017: AIDS Research and Human Retroviruses
https://www.readbyqxmd.com/read/28091969/quality-of-life-as-predictor-for-the-development-of-cardiac-ischemia-in-high-risk-asymptomatic-diabetic-patients
#2
Philip Haaf, Myriam Ritter, Leticia Grize, Matthias E Pfisterer, Michael J Zellweger
BACKGROUND: Ischemia induced by psychological stress and depression is a common phenomenon in stable coronary artery disease (CAD). We evaluated the quality of life (QoL) of diabetic patients screened for CAD and assessed the prognostic value of mental and physical QoL scores to predict the development of new cardiac ischemia. METHODS: Prospective multicentre outcome study. The study comprised 400 asymptomatic diabetic patients without history or symptoms of CAD...
January 13, 2017: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
https://www.readbyqxmd.com/read/28089817/patient-centered-specialty-practice-defining-the-role-of-specialists-in-value-based-healthcare
#3
REVIEW
Lawrence Ward, Rhea E Powell, Michael L Scharf, Andrew Chapman, Mani Kavuru
Healthcare is at a crossroads, under pressure to add value by improving patient experience and health outcomes and reducing costs to the system. Efforts to improve the care model in primary care, such as the patient-centered medical home, have enjoyed some success. Yet primary care accounts for only a small portion of total healthcare spending, and there is a need for policies and frameworks to support high quality, cost-efficient care in specialty practices of the "medical neighborhood". The Patient-Centered Specialty Practice (PCSP) model offers ambulatory-based specialty practices one such framework, supported by a formal recognition program through the National Committee for Quality Assurance...
January 13, 2017: Chest
https://www.readbyqxmd.com/read/28089084/predicting-the-need-for-intra-operative-large-volume-blood-transfusions-during-thoraco-abdominal-aortic-aneurysm-repair
#4
M Pieri, P Nardelli, M De Luca, G Landoni, S Frassoni, G Melissano, A Zangrillo, R Chiesa, F Monaco
OBJECTIVE: Thoraco-abdominal aortic aneurysm (TAAA) repair is a complex procedure performed in patients at high cardiovascular risk. High volume intra-operative bleeding is often recorded, and the amount of intra-operative blood product transfusion is associated with relevant morbidity and mortality. The aim of the study was to identify pre-operative predictors of intra-operative large volume blood transfusions (LVBT) to stratify patients pre-operatively. METHODS: This was a retrospective analysis of prospectively collected data of all patients who underwent open TAAA surgery at San Raffaele Scientific Institute from January 2009 to December 2015...
January 6, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28086959/e-learning-programs-in-oncology-a-nationwide-experience-from-2005-to-2014
#5
Jan Degerfält, Staffan Sjöstedt, Per Fransson, Elisabeth Kjellén, Mads U Werner
BACKGROUND: E-learning is an established concept in oncological education and training. However, there seems to be a scarcity of long-term assessments of E-learning programs in oncology vis-á-vis their structural management and didactic value. This study presents descriptive, nationwide data from 2005 to 2014. E-learning oncology programs in chemotherapy, general oncology, pain management, palliative care, psycho-social-oncology, and radiotherapy, were reviewed from our databases. Questionnaires of self-perceived didactic value of the programs were examined 2008-2014...
January 13, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28086784/health-related-quality-of-life-assessment-in-acute-coronary-syndrome-patients-the-effectiveness-of-early-phase-i-cardiac-rehabilitation
#6
Lawrence Anchah, Mohamed Azmi Hassali, Melissa Siaw Han Lim, Mohamed Izham Mohamed Ibrahim, Kui Hian Sim, Tiong Kiam Ong
BACKGROUND: Acute Coronary Syndrome (ACS) is one of the most burdensome cardiovascular diseases in terms of the cost of interventions. The Cardiac Rehabilitation Programme (CRP) is well-established in improving clinical outcomes but the assessment of actual clinical improvement is challenging, especially when considering pharmaceutical care (PC) values in phase I CRP during admission and upon discharge from hospital and phase II outpatient interventions. This study explores the impact of pharmacists' interventions in the early stages of CRP on humanistic outcomes and follow-up at a referral hospital in Malaysia...
January 13, 2017: Health and Quality of Life Outcomes
https://www.readbyqxmd.com/read/28081216/real-time-monitoring-of-placental-oxygenation-during-maternal-hypoxia-and-hyperoxygenation-using-photoacoustic-imaging
#7
Chloé J Arthuis, Anthony Novell, Florian Raes, Jean-Michel Escoffre, Stéphanie Lerondel, Alain Le Pape, Ayache Bouakaz, Franck Perrotin
PURPOSE: This preclinical study aimed to evaluate placental oxygenation in pregnant rats by real-time photoacoustic (PA) imaging on different days of gestation and to specify variations in placental oxygen saturation under conditions of maternal hypoxia and hyperoxygenation. MATERIAL AND METHODS: Placentas of fifteen Sprague-Dawley rats were examined on days 14, 17, and 20 of pregnancy with a PA imaging system coupled to high-resolution ultrasound imaging. Pregnant rats were successively exposed to hyperoxygenated and hypoxic conditions by changing the oxygen concentration in inhaled gas...
2017: PloS One
https://www.readbyqxmd.com/read/28079461/building-the-evidence-base-for-tele-emergency-care-efforts-to-identify-a-standardized-set-of-outcome-measures
#8
Yael Harris, Boyd Gilman, Marcia M Ward, Jonathan Ladinsky, Jacqueline Crowley, Cannon Warren, Craig Caplan
BACKGROUND: To enhance the quality of emergency department (ED) care, some rural hospitals have adopted the use of telemedicine (tele-ED). Without a common set of metrics, it is difficult to quantify the impact of this technology. INTRODUCTION: To address this limitation, the Health Resources and Services Administration funded the identification and testing of a core set of measures that could be used to build a business case for the value of tele-ED care. METHODS: A comprehensive environmental scan was conducted to identify existing measures relevant to assessing ED care and the use of telemedicine...
January 12, 2017: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/28078497/anti-inflammatory-effect-of-naravelia-zeylanica-dc-via-suppression-of-inflammatory-mediators-in-carrageenan-induced-abdominal-oedema-in-zebrafish-model
#9
Sanmuga Priya Ekambaram, Senthamil Selvan Perumal, Selvaranjani Pavadai
The traditional herbal medicines are receiving great importance in the health care sector, especially in Indian system of medicine, i.e, Ayurveda. The present study focused on the standardization of Naravelia zeylanica (L.) DC in terms of its active phytochemicals and to evaluate the anti-inflammatory activity of ethanol extract of N. zeylanica (ENZ). An analytical method was developed by high-performance liquid chromatography for simultaneous determination of β-sitosterol, lupeol and oleanolic acid in ENZ...
January 11, 2017: Inflammopharmacology
https://www.readbyqxmd.com/read/28078459/endotherapy-in-case-of-relapse-of-neoplastic-barrett-s-esophagus-after-successful-initial-endoscopic-resection
#10
Sébastien Godat, Fabrice Caillol, Aurélie Autret, Erwan Bories, Christian Pesenti, Jean Philippe Ratone, Chiara De Cassan, Flora Poizat, Marc Giovannini
BACKGROUND: Endotherapy in cases of neoplastic Barrett esophagus (BE) relapse after successful initial endoscopic management is commonly accepted, but few studies analyze this topic and also take into account the metachronous lesions. AIMS: To evaluate the efficiency of endotherapy in the case of neoplastic BE relapse after successful complete endoscopic eradication of neoplastic BE and metaplastic BE. METHODS: Retrospective review of medical records was collected in a computerized and prospective manner between 2000 and 2015, in a single tertiary care center...
January 11, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28078082/core-components-for-effective-infection-prevention-and-control-programmes-new-who-evidence-based-recommendations
#11
Julie Storr, Anthony Twyman, Walter Zingg, Nizam Damani, Claire Kilpatrick, Jacqui Reilly, Lesley Price, Matthias Egger, M Lindsay Grayson, Edward Kelley, Benedetta Allegranzi
Health care-associated infections (HAI) are a major public health problem with a significant impact on morbidity, mortality and quality of life. They represent also an important economic burden to health systems worldwide. However, a large proportion of HAI are preventable through effective infection prevention and control (IPC) measures. Improvements in IPC at the national and facility level are critical for the successful containment of antimicrobial resistance and the prevention of HAI, including outbreaks of highly transmissible diseases through high quality care within the context of universal health coverage...
2017: Antimicrobial Resistance and Infection Control
https://www.readbyqxmd.com/read/28077345/tips-and-traps-lessons-from-codesigning-a-clinician-e-monitoring-tool-for-computerized-cognitive-behavioral-therapy
#12
Frederick Sundram, Susan J Hawken, Karolina Stasiak, Mathijs Fg Lucassen, Theresa Fleming, Matthew Shepherd, Andrea Greenwood, Raechel Osborne, Sally N Merry
BACKGROUND: Computerized cognitive behavioral therapy (cCBT) is an acceptable and promising treatment modality for adolescents with mild-to-moderate depression. Many cCBT programs are standalone packages with no way for clinicians to monitor progress or outcomes. We sought to develop an electronic monitoring (e-monitoring) tool in consultation with clinicians and adolescents to allow clinicians to monitor mood, risk, and treatment adherence of adolescents completing a cCBT program called SPARX (Smart, Positive, Active, Realistic, X-factor thoughts)...
January 11, 2017: JMIR Mental Health
https://www.readbyqxmd.com/read/28077228/levers-for-addressing-medical-underuse-and-overuse-achieving-high-value-health-care
#13
REVIEW
Adam G Elshaug, Meredith B Rosenthal, John N Lavis, Shannon Brownlee, Harald Schmidt, Somil Nagpal, Peter Littlejohns, Divya Srivastava, Sean Tunis, Vikas Saini
The preceding papers in this Series have outlined how underuse and overuse of health-care services occur within a complex system of health-care production, with a multiplicity of causes. Because poor care is ubiquitous and has considerable consequences for the health and wellbeing of billions of people around the world, remedying this problem is a morally and politically urgent task. Universal health coverage is a key step towards achieving the right care. Therefore, full consideration of potential levers of change must include an upstream perspective-ie, an understanding of the system-level factors that drive overuse and underuse, as well as the various incentives at work during a clinical encounter...
January 6, 2017: Lancet
https://www.readbyqxmd.com/read/28077046/rational-use-of-rasburicase-for-the-treatment-and-management-of-tumor-lysis-syndrome
#14
Suhail A Shaikh, Bernard L Marini, Shannon M Hough, Anthony J Perissinotti
Purpose There is a lack of high-level evidence identifying meaningful outcomes and the optimal place in therapy of rasburicase in patients with, or at high risk for tumor lysis syndrome. The primary objective of this study was to evaluate and characterize outcomes resulting from an institution-specific guideline emphasizing supportive care, xanthine oxidase inhibitors, and lower doses of rasburicase. Methods In this retrospective chart review, we compared conservative rasburicase dosing, in accordance with newly developed UMHS tumor lysis syndrome guidelines, with aggressive rasburicase in adult patients (≥ 18 years of age) with hematological or solid tumor malignancies, and a uric acid level between 8 and 15 mg/dL...
January 1, 2017: Journal of Oncology Pharmacy Practice
https://www.readbyqxmd.com/read/28075702/features-of-patient-centered-primary-care-and-the-use-of-ambulatory-care
#15
Paul Wong, Laura Panattoni, Ming Tai-Seale
This study explores the association between patients' use of ambulatory care resources and features of patient-centered primary care (PCPC), specifically clinic-level National Committee for Quality Assurance (NCQA) recognition of PCPC, continuity of care, and care team communication. Data for this study were compiled from the electronic health records of a large multispecialty group practice in California, covering the period between 2009 and 2010 for 37,042 nonelderly patients under capitated managed care plans...
January 11, 2017: Population Health Management
https://www.readbyqxmd.com/read/28074802/goal-directed-therapy-improves-the-outcome-of-high-risk-cardiac-patients-undergoing-off-pump-coronary-artery-bypass
#16
Poonam Malhotra Kapoor, Rohan Magoon, Rajinder Singh Rawat, Yatin Mehta, Sameer Taneja, R Ravi, Milind P Hote
BACKGROUND: There has been a constant emphasis on developing management strategies to improve the outcome of high-risk cardiac patients undergoing surgical revascularization. The performance of coronary artery bypass surgery on an off-pump coronary artery bypass (OPCAB) avoids the risks associated with extra-corporeal circulation. The preliminary results of goal-directed therapy (GDT) for hemodynamic management of high-risk cardiac surgical patients are encouraging. The present study was conducted to study the outcome benefits with the combined use of GDT with OPCAB as compared to the conventional hemodynamic management...
January 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28074789/extracorporeal-membrane-oxygenation-in-severe-influenza-infection-with-respiratory-failure-a-systematic-review-and-meta-analysis
#17
Shashvat Sukhal, Jaskaran Sethi, Malini Ganesh, Pedro A Villablanca, Anita K Malhotra, Harish Ramakrishna
INTRODUCTION: Extracorporeal membrane oxygenation (ECMO) has been extensively used for potentially reversible acute respiratory failure associated with severe influenza A (H1N1) pneumonia; however, it remains an expensive, resource-intensive therapy, with a high associated mortality. This systematic review and meta-analysis aims to summarize and pool outcomes data available in the published literature to guide clinical decision-making and further research. METHODS: We conducted a systematic search of MEDLINE (1966 to April 15, 2015), EMBASE (1980 to April 15, 2015), CENTRAL, and Google Scholar for patients with severe H1N1 pneumonia and respiratory failure who received ECMO...
January 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28074585/a-good-death
#18
Tia Powell, Adira Hulkower
A good death is hard to find. Family members tell us that loved ones die in the wrong place-the hospital-and do not receive high-quality care at the end of life. This issue of the Hastings Center Report offers two articles from authors who strive to provide good end-of-life care and to prevent needless suffering. We agree with their goals, but we have substantial reservations about the approaches they recommend. Respect for the decisions of patients and their surrogates is a relatively new and still vulnerable aspect of medical care...
January 2017: Hastings Center Report
https://www.readbyqxmd.com/read/28074421/community-based-accompaniment-with-supervised-antiretrovirals-for-hiv-positive-adults-in-peru-a-cluster-randomized-trial
#19
Megan M McLaughlin, Molly F Franke, Maribel Muñoz, Adrianne K Nelson, Olga Saldaña, Janeth Santa Cruz, Milagros Wong, Zibiao Zhang, Leonid Lecca, Eduardo Ticona, Jorge Arevalo, Eduardo Sanchez, Jose Luis Sebastián, Sonya Shin
We conducted a cluster-randomized trial to estimate effects of directly observed combination antiretroviral therapy (DOT-cART) on retention with viral suppression among HIV-positive adults in Peru. We randomly allocated facilities to receive the 12-month intervention plus the standard of care, including adherence support provided through accompaniment. In the intervention arm, health workers supervised doses, twice daily, and accompanied patients to appointments. Among 356 patients, intention-to-treat analyses showed no statistically significant benefit of DOT, relative to no-DOT, at 12 or 24 months (adjusted probability of primary outcome: 0...
January 10, 2017: AIDS and Behavior
https://www.readbyqxmd.com/read/28073146/value-based-care-in-hepatology
#20
REVIEW
Mario Strazzabosco, John I Allen, Elizabeth O Teisberg
The migration from legacy fee-for-service reimbursement to payments linked to high value health care is accelerating in the United States because of new legislation and re-design of payments from the Centers for Medicare and Medicaid Services (CMS). Since patients with chronic diseases account for substantial use of health care resources, payers and health systems are focusing on maximizing the value of care for these patients. Since chronic liver diseases impose a major health burden worldwide affecting the health and lives of many individuals and families as well as substantial costs for individuals and payers, hepatologists must understand how they can improve their practices ...
January 10, 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
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