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https://www.readbyqxmd.com/read/28749593/developing-better-practices-at-the-institutional-level-leads-to-better-outcomes-after-pancreaticoduodenectomy-in-3-378-patients-domestic-audit-of-the-japanese-society-of-pancreatic-surgery
#1
Sohei Satoi, Tomohisa Yamamoto, Hideyuki Yoshitomi, Fuyuhiko Motoi, Manabu Kawai, Tsutomu Fujii, Keita Wada, Hidehito Arimitsu, Masayuki Sho, Ippei Matsumoto, Satoshi Hirano, Hiroaki Yanagimoto, Masayuki Ohtsuka, Michiaki Unno, Hiroki Yamaue, Masanori Kon
PURPOSE: To assess recent trends in pancreaticoduodenectomy (PD) and the role of institutional standardization on the development of post-operative complications in 3,378 patients who underwent PD in Japan. METHODS: Data were collected from 3,378 patients who underwent PD in 2006, 2010, and 2014 at 53 institutions. A standardized institution (SI) was defined as one that implements ≥7 of 13 quality initiatives according to departmental policy. There were 1,223 patients in the SI group and 2,155 in the non-SI group...
July 27, 2017: Journal of Hepato-biliary-pancreatic Sciences
https://www.readbyqxmd.com/read/28749571/l-ornithine-l-aspartate-in-bouts-of-overt-hepatic-encephalopathy
#2
Sandeep Singh Sidhu, Barjesh Chander Sharma, Omesh Goyal, Harsh Kishore, Navpreet Kaur
High quality data on efficacy of L-Ornithine L-Aspartate (LOLA) in cirrhotics with bouts of overt hepatic encephalopathy (OHE) is missing. We aimed to evaluate the efficacy of intravenous LOLA in reversal of bouts of OHE in cirrhotics. In this prospective double-blind randomized placebo controlled trial conducted at two tertiary care institutes in India, 370 cirrhotics with bouts of OHE were screened. After exclusion, 193 (52.16%) patients were randomized to receive either intravenous infusions of LOLA (n=98), 30 grams daily or Placebo (n=95) for 5 days...
July 27, 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/28749550/combined-resistance-and-endurance-training-at-a-moderate-high-intensity-improves-physical-condition-and-quality-of-life-in-liver-transplant-patients
#3
Diego Moya-Nájera, Ángel Moya-Herraiz, Luis Compte-Torrero, David Hervás, Sebastien Borreani, Joaquin Calatayud, Marina Berenguer, Juan C Colado
BACKGROUND: Although currently, moderate and high intensity concurrent physical exercise is prescribed in populations with special needs due to its greater effect on physical condition and health-related quality of life (HRQOL), there are no data in the liver transplantation (LT) setting. AIM: To evaluate changes in maximal strength, aerobic capacity, body composition, liver function, and HRQOL in LT patients after a moderate to high intensity combined resistance-endurance training...
July 27, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28749530/parents-willingness-to-invest-in-their-children-s-oral-health
#4
Jannetje Berendsen, Clarissa Bonifacio, Martine van Gemert-Schriks, Cor van Loveren, Erik Verrips, Denise Duijster
OBJECTIVES: This study aimed to evaluate parents' Willingness to Invest (WTI) in their children's oral health in terms of money, visits to a dental practice, and brushing minutes. Objectives were to assess the association between parents' WTI and a) children's dental caries experience, b) children's oral hygiene behavior (OHB), and c) maternal education level and ethnic background. METHODS: A sample of 630 five to six-year-old-children was recruited from pediatric dental centers in the Netherlands...
July 27, 2017: Journal of Public Health Dentistry
https://www.readbyqxmd.com/read/28749479/communicating-prognosis-with-parents-of-critically-ill-infants-direct-observation-of-clinician-behaviors
#5
R D Boss, M E Lemmon, R M Arnold, P K Donohue
OBJECTIVE: Delivering prognostic information to families requires clinicians to forecast an infant's illness course and future. We lack robust empirical data about how prognosis is shared and how that affects clinician-family concordance regarding infant outcomes. STUDY DESIGN: Prospective audiorecording of neonatal intensive care unit family conferences, immediately followed by parent/clinician surveys. Existing qualitative analysis frameworks were applied. RESULTS: We analyzed 19 conferences...
July 27, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28749435/allelic-complexity-in-long-qt-syndrome-a-family-case-study
#6
Alberto Zullo, Giulia Frisso, Nicola Detta, Berardo Sarubbi, Emanuele Romeo, Angela Cordella, Carlos G Vanoye, Raffaele Calabrò, Alfred L George, Francesco Salvatore
Congenital long QT syndrome (LQTS) is associated with high genetic and allelic heterogeneity. In some cases, more than one genetic variant is identified in the same (compound heterozygosity) or different (digenic heterozygosity) genes, and subjects with multiple pathogenic mutations may have a more severe disease. Standard-of-care clinical genetic testing for this and other arrhythmia susceptibility syndromes improves the identification of complex genotypes. Therefore, it is important to distinguish between pathogenic mutations and benign rare variants...
July 27, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28749402/coverage-of-childhood-vaccination-among-children-aged-12-23-months-tamil-nadu-2015-india
#7
Manoj V Murhekar, P Kamaraj, K Kanagasabai, G Elavarasu, T Daniel Rajasekar, K Boopathi, Sanjay Mehendale
BACKGROUND & OBJECTIVES: District-Level Household Survey-4 (DLHS-4) indicated that during 2012-2013, only 56 per cent of children aged 12-23 months in Tamil Nadu were fully vaccinated, which were lesser than those reported in earlier national surveys. We, therefore, conducted cluster surveys to estimate coverage of childhood vaccination in the State, and also to identify the factors associated with low coverage. METHODS: Cross-sectional surveys were conducted in 15 strata [municipal corporation non-slum (n=1), municipal corporation slum (n=1), hilly (n=1), rural (n=6) and urban (n=6)]...
March 2017: Indian Journal of Medical Research
https://www.readbyqxmd.com/read/28749396/validity-of-broselow-tape-for-estimating-weight-of-indian-children
#8
Vivek Shah, Sandeep B Bavdekar
BACKGROUND & OBJECTIVES: The Broselow tape has been validated in both ambulatory and simulated emergency situations in the United States and is believed to reduce complications arising from inaccurate drug dosing and equipment sizing in paediatric population. This study was conducted to determine the relationship between the actual weight and weight determined by Broselow tape in the Indian children and to derive an equation for determination of weight based on height in the Indian children...
March 2017: Indian Journal of Medical Research
https://www.readbyqxmd.com/read/28749392/evaluation-of-evidence-for-pharmacokinetics-pharmacodynamics-based-dose-optimization-of-antimicrobials-for-treating-gram-negative-infections-in-neonates
#9
REVIEW
Nusrat Shafiq, Samir Malhotra, Vikas Gautam, Harpreet Kaur, Pravin Kumar, Sourabh Dutta, Pallab Ray, Nilima A Kshirsagar
BACKGROUND & OBJECTIVES: Neonates present a special subgroup of population in whom optimization of antimicrobial dosing can be particularly challenging. Gram-negative infections are common in neonates, and inpatient treatment along with critical care is needed for the management of these infections. Dosing recommendations are often extrapolated from evidence generated in older patient populations. This systematic review was done to identify the knowledge gaps in the pharmacokinetics-pharmacodynamics (PK-PD)-based optimized dosing schedule for parenteral antimicrobials for Gram-negative neonatal infections...
March 2017: Indian Journal of Medical Research
https://www.readbyqxmd.com/read/28749364/bayesian-random-vector-functional-link-networks-for-robust-data-modeling
#10
Simone Scardapane, Dianhui Wang, Aurelio Uncini
Random vector functional-link (RVFL) networks are randomized multilayer perceptrons with a single hidden layer and a linear output layer, which can be trained by solving a linear modeling problem. In particular, they are generally trained using a closed-form solution of the (regularized) least-squares approach. This paper introduces several alternative strategies for performing full Bayesian inference (BI) of RVFL networks. Distinct from standard or classical approaches, our proposed Bayesian training algorithms allow to derive an entire probability distribution over the optimal output weights of the network, instead of a single pointwise estimate according to some given criterion (e...
July 25, 2017: IEEE Transactions on Cybernetics
https://www.readbyqxmd.com/read/28749321/design-and-implementation-of-an-affordable-public-sector-electronic-medical-record-in-rural-nepal
#11
Anant Raut, Chase Yarbrough, Vivek Singh, Bikash Gauchan, David Citrin, Varun Verma, Jessica Hawley, Dan Schwarz, Alex Harsha Bangura, Biplav Shrestha, Ryan Schwarz, Mukesh Adhikari, Duncan Maru
INTRODUCTION: Globally, electronic medical records are central to the infrastructure of modern healthcare systems. Yet the vast majority of electronic medical records have been designed for resource-rich environments and are not feasible in settings of poverty. Here we describe the design and implementation of an electronic medical record at a public sector district hospital in rural Nepal, and its subsequent expansion to an additional public sector facility.DevelopmentThe electronic medical record was designed to solve for the following elements of public sector healthcare delivery: 1) integration of the systems across inpatient, surgical, outpatient, emergency, laboratory, radiology, and pharmacy sites of care; 2) effective data extraction for impact evaluation and government regulation; 3) optimization for longitudinal care provision and patient tracking; and 4) effectiveness for quality improvement initiatives...
June 23, 2017: Journal of Innovation in Health Informatics
https://www.readbyqxmd.com/read/28749318/probabilistic-linkage-to-enhance-deterministic-algorithms-and-reduce-data-linkage-errors-in-hospital-administrative-data
#12
Gareth Hagger-Johnson, Katie Harron, Harvey Goldstein, Robert Aldridge, Ruth Gilbert
 BACKGROUND: The pseudonymisation algorithm used to link together episodes of care belonging to the same patients in England (HESID) has never undergone any formal evaluation, to determine the extent of data linkage error. OBJECTIVE: To quantify improvements in linkage accuracy from adding probabilistic linkage to existing deterministic HESID algorithms. METHODS: Inpatient admissions to NHS hospitals in England (Hospital Episode Statistics, HES) over 17 years (1998 to 2015) for a sample of patients (born 13/28th of months in 1992/1998/2005/2012)...
June 30, 2017: Journal of Innovation in Health Informatics
https://www.readbyqxmd.com/read/28749273/a-retrospective-review-of-western-lowland-gorilla-gorilla-gorilla-gorilla-mortality-in-european-zoologic-collections-between-2004-and-2014
#13
Victoria Strong, Kerstin Baiker, Marnie L Brennan, Sharon Redrobe, Frank Rietkerk, Malcolm Cobb, Kate White
An understanding of the main causes of mortality among captive gorillas is imperative to promoting their optimal care, health, and welfare. A retrospective observational review of mortality among the European zoo-housed western lowland gorilla ( Gorilla gorilla gorilla) population from 2004 to 2014 was carried out. This is the first published study of mortality in this population. Relevant postmortem data were requested from each collection reporting a death during the study period. Age at death enabled grouping into discrete age categories...
June 2017: Journal of Zoo and Wildlife Medicine: Official Publication of the American Association of Zoo Veterinarians
https://www.readbyqxmd.com/read/28749255/pharmacokinetics-of-orally-administered-voriconazole-in-african-penguins-spheniscus-demersus-after-single-and-multiple-doses
#14
Michael W Hyatt, Nathan P Wiederhold, William W Hope, Katharine E Stott
Aspergillosis is a common respiratory fungal disease in African penguins ( Spheniscus demersus ) under managed care, and treatment failures with itraconazole due to drug resistance are increasingly common, leading to recent use of voriconazole. Empirical dosing with voriconazole based on other avian studies has resulted in adverse clinical drug effects in penguins. The objective of this study was to determine oral voriconazole pharmacokinetics (PK) in African penguins (n = 18). Single and once daily multiple oral doses of 5 mg/kg voriconazole were evaluated with a 4-mo washout period between trials...
June 2017: Journal of Zoo and Wildlife Medicine: Official Publication of the American Association of Zoo Veterinarians
https://www.readbyqxmd.com/read/28749228/-it-changed-everything-and-not-all-in-a-bad-way-reflections-of-pediatric-cancer-experiences
#15
Monica L Molinaro, Paula C Fletcher
Pediatric cancer, otherwise known as childhood cancer, is devastating to both children and their families. All individuals in a family are often physically, psychologically, and socially affected. Using the qualitative theoretical orientation of interpretive phenomenology, interviews were conducted with 10 pediatric cancer survivors and 9 of their support persons to gain a more holistic understanding of the pediatric cancer experiences of children and their families. A total of 4 themes emerged from the data, however only the past experiences of the survivors and their recollection of their pediatric journeys will be discussed...
September 2017: Compr Child Adolesc Nurs
https://www.readbyqxmd.com/read/28749065/concise-review-the-high-cost-of-high-tech-medicine-planning-ahead-for-market-access
#16
REVIEW
Dawn Driscoll, Stephanie Farnia, Panos Kefalas, Richard T Maziarz
Cellular therapies and other regenerative medicines are emerging as potentially transformative additions to modern medicine, but likely at a staggering financial cost. Public health care systems' budgets are already strained by growing and aging populations, and many private insurer's budgets are equally stretched. The current systems that most payers employ to manage their cash flow are not structured to absorb a sudden onslaught of very expensive prescriptions for a large portion of their covered population...
August 2017: Stem Cells Translational Medicine
https://www.readbyqxmd.com/read/28748893/complication-rate-and-diagnostic-yield-of-percutaneous-native-kidney-biopsies-a-10-year-experience-at-a-tertiary-care-hospital-in-pakistan
#17
Sonia Yaqub, Nayla Ahmed, Urooj Fatima, Ayesha Maqbool, Waqar Ashif, Syed A Hussain
The use of an automated biopsy device, and real-time ultrasound for percutaneous kidney biopsies (PKBs) has improved the likelihood of obtaining adequate tissue for diagnosis and also has reduced the complications associated with the procedure. We aimed to determine the frequency and type of complications associated with PKB and to determine the diagnostic yield. It was a retrospective file-based review of cases who underwent PKB of native kidney between January 2003 and December 2013 at the Aga Khan University Hospital in Karachi, Pakistan...
July 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28748892/clinical-profile-of-geriatric-acute-kidney-injury-in-a-tertiary-care-center-from-south-india
#18
Eshwarappa Mahesh, Praveen Nallamuthu, Mahesh Kumar, Parampalli Rakesh Madhyastha, Gurudev Konanna
The incidence of acute kidney injury (AKI) is high in the elderly, who comprise an ever-growing segment of the population. Elderly patients pose a different set of diagnostic and therapeutic challenge owing to their associated comorbidities. AKI in the elderly is associated with an increased risk of mortality, morbidity, prolonged length of stay, and progression to chronic kidney disease. Data regarding the clinical profile of AKI in the elderly from the South Indian population are limited. Hence, we present this analysis of the etiological and prognostic factors associated with AKI in elderly population from South India...
July 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28748883/epidemiology-and-outcome-of-tuberculosis-in-immunocompromised-patients
#19
Abdul Massiah Metry, Issa Al Salmi, Seif Al-Abri, Faisal Al Ismaili, Yaqoub Al Mahrouqi, Alan Hola, Faissal A M Shaheen
The United States Renal Data System showed 1.2% and 1.6% incidences of tuberculosis (TB) in patients on peritoneal dialysis and hemodialysis (HD), respectively. Kidney transplant (KTX) patients have higher rates. We studied the epidemiology and outcome of TB in patients with kidney dysfunction in a tertiary care hospital in the past decade. We examined data of patients with TB with and without kidney dysfunction from 2006 to 2015 through an electronic system. Statistical analysis was completed using Stata software, Chicago, IL, USA...
July 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28748875/a-comparative-study-to-evaluate-factors-that-influence-survival-in-multidisciplinary-predialysis-educated-patients-and-crashlanders
#20
Khairulsadek Zukmin, Irfan Ahmad, Aung Kyaw Wynn, Yee Yin Lim, Lin Naing, Vui Heng Chong, Muhammad Abdul Mabood Khalil, Jackson Tan
Integrated multidisciplinary predialysis education (MPE) is usually provided to support and prepare the pre-end-stage renal disease (ESRD) patients before the initiation of renal replacement therapy (RRT). However, the impact of MPE is not known in our population, which is comprised patients of Asian origins and recipients of a totally subsidized health-care system. This research compared the survival probability, sociodemographic, and clinical characteristics of MPE patients and non-MPE patients (or crashlanders)...
July 2017: Saudi Journal of Kidney Diseases and Transplantation
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