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https://www.readbyqxmd.com/read/29342019/hot-spotting-as-a-strategy-to-identify-high-cost-surgical-populations
#1
Sarah P Shubeck, Jyothi R Thumma, Justin B Dimick, Hari Nathan
OBJECTIVE: The aim of this study was to determine the feasibility of "hot spotting" in elective surgical populations. BACKGROUND: Prospective identification of high-cost patients, known as "hot spotting," is well developed in medical populations, but has not been performed in surgical populations. Population-based management of surgical expenditures requires identification of high-cost surgical patients to allow for effective implementation of cost-saving strategies...
January 16, 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29341936/rheumatic-manifestations-among-cancer-patients-treated-with-immune-checkpoint-inhibitors
#2
REVIEW
Merav Lidar, Eitan Giat, Daniela Garelick, Yuval Horowitz, Howard Amital, Yael Steinberg-Silman, Jacob Shachter, Ronnie Shapira-Frommer, Gal Markel
BACKGROUND: The use of immune checkpoint inhibitors (ICI) has grown incessantly since they were first approved in 2014. These monoclonal antibodies inhibit T cell activation, yielding a dramatic tumor response with improved survival. However, immunotherapy is frequently hampered by immune adverse events (iAE) such as hypophysitis, colitis, hepatitis, pneumonitis and rash. Until recently, rheumatic side effects were only infrequently reported. Aim To describe the rheumatic manifestations encountered among patients treated with ICIs in a large tertiary cancer center in Israel METHODS: The cancer center's patient registry was screened for patients who had ever been treated with ipilimumab, pembrolizumab and/or nivolumab with relevant data gathered from clinical charts...
January 13, 2018: Autoimmunity Reviews
https://www.readbyqxmd.com/read/29340619/recurrent-serious-infections-in-patients-with-rheumatoid-arthritis-results-from-the-british-society-for-rheumatology-biologics-register
#3
Sujith Subesinghe, Andrew Ian Rutherford, Rachel Byng-Maddick, Kimme Leanne Hyrich, James Benjamin Galloway
Objectives: To establish the rate of recurrent infection in RA patients recruited to the British Society for Rheumatology Biologics Register - Rheumatoid Arthritis. Secondary objectives were to establish whether the organ class of index infection predicted future serious infection (SI). Methods: Using data from the British Society for Rheumatology Biologics Register - Rheumatoid Arthritis, a prospective observational cohort, we identified patients with at least one episode of SI...
January 10, 2018: Rheumatology
https://www.readbyqxmd.com/read/29338994/both-patients-and-maternity-care-providers-can-benefit-from-payment-reform-four-steps-to-prepare
#4
Malini A Nijagal, Neel T Shah, Jeff Levin-Scherz
Many Medicaid programs and private health plans are implementing new models of maternity care reimbursement, and clinicians face mounting pressure to demonstrate high quality care at lower cost. Clinicians will be better prepared to meet these challenges with a fuller understanding of new payment models and the opportunities they present. We describe the structure of maternity care "episode payments" and recommend four ways that clinicians can prepare for success as value-based payment models are implemented: identify opportunities to improve outcomes and experience, measure quality, reduce waste and work in teams across settings...
January 12, 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29338537/antidepressant-prescriptions-and-mental-health-nurses-an-observational-study-in-dutch-general-practice-from-2011-to-2015
#5
Tessa Magnée, Derek P de Beurs, Francois G Schellevis, Peter F Verhaak
PURPOSE: The purpose of this study was to investigate developments in antidepressant prescriptions by Dutch general practitioners, alongside the national introduction of mental health nurses. Antidepressant prescriptions are very common in general practice, but are often not in line with recommendations. The recent introduction of mental health nurses may have decreased antidepressant prescriptions, as general practitioners (GPs) have greater potential to offer psychological treatment as a first choice option instead of medication...
January 17, 2018: Scandinavian Journal of Primary Health Care
https://www.readbyqxmd.com/read/29337440/-addictions
#6
Jacques Besson, Jeremy Grivel, Alexander Tomei, Mélina Andronicos, Daniele Zullino, Gabriel Thorens, Stergios Tsartsalis, Isabelle Gothuey, Monique Séguin
This year, the actuality for addictions in this edition addresses four points. The disease model of addiction is criticized by the cognitive neurosciences which need to consider the agentivity of the persons. Regarding the societal actuality, clinical pharmacology review of cannabidiol presents an update on legal cannabis. The suicidality of excessive gamblers may be prevented specifically. Addiction and first psychotic episodes need an integrated care.
January 10, 2018: Revue Médicale Suisse
https://www.readbyqxmd.com/read/29336749/heroic-measures-for-an-american-hero-attempting-to-save-the-life-of-general-douglas-macarthur
#7
Theodore N Pappas
General Douglas MacArthur was a towering public figure on an international stage for the first half of the 20th century. He was healthy throughout his life but developed a series of medical problems when he entered his 80s. This article reviews the General's medical care during two separate life-threatening medical crises that required surgical intervention. The first episode occurred in 1960 when MacArthur presented with renal failure due to an obstructed prostate. Four years later after his 84th birthday, MacArthur developed bile duct obstruction from common duct stones...
December 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/29336240/treatment-of-anemia-in-patients-with-solid-tumors-receiving-chemotherapy-in-palliative-setting-usual-practice-versus-guidelines
#8
Robin de Putter, Karen Geboes, Marc De Man, Simon Van Belle
Background Anemia is frequent in patients with cancer and is often multifactorial. Treatment depends on etiology and can consist of transfusions, intravenous iron (IV Fe), and/or erythropoiesis-stimulating agents (ESA). Several studies have shown that cancer-related anemia is undertreated. The aim of this study is to compare usual practice in a university hospital with the international guidelines. Methods Using the hospital and pharmacy informatics all adults (≥18 years), who received a treatment for anemia (transfusion, IV Fe, ESA) from February to August 2016 during palliative chemotherapy, were identified...
January 16, 2018: Acta Clinica Belgica
https://www.readbyqxmd.com/read/29335813/organic-acidurias-in-adults-late-complications-and-management
#9
Ali Tunç Tuncel, Nikolas Boy, Marina A Morath, Friederike Hörster, Ulrike Mütze, Stefan Kölker
Organic acidurias (synonym, organic acid disorders, OADs) are a heterogenous group of inherited metabolic diseases delineated with the implementation of gas chromatography/mass spectrometry in metabolic laboratories starting in the 1960s and 1970s. Biochemically, OADs are characterized by accumulation of mono-, di- and/or tricarboxylic acids ("organic acids") and corresponding coenzyme A, carnitine and/or glycine esters, some of which are considered toxic at high concentrations. Clinically, disease onset is variable, however, affected individuals may already present during the newborn period with life-threatening acute metabolic crises and acute multi-organ failure...
January 15, 2018: Journal of Inherited Metabolic Disease
https://www.readbyqxmd.com/read/29335397/pediatric-renal-transplantation-focus-on-current-transition-care-and-proposal-of-the-rise-to-transition-protocol
#10
Rupesh Raina, Joseph Wang, Vinod Krishnappa, Maria Ferris
The transition from pediatric to adult medical services is an important time in the life of an adolescent or young adult with a renal transplant. Failure of proper transition can lead to medical non-adherence and subsequent loss of graft and/or return to dialysis. The aim of this study was to conduct a systematic review and survey to assess the challenges and existing practices in transition of renal transplant recipient children to adult services, and to develop a transition protocol. We conducted a literature review and performed a survey of pediatric nephrologists across the United States to examine the current state of transition care...
January 16, 2018: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/29335336/periodontal-disease-regular-dental-care-use-and-incident-ischemic-stroke
#11
Souvik Sen, Lauren D Giamberardino, Kevin Moss, Thiago Morelli, Wayne D Rosamond, Rebecca F Gottesman, James Beck, Steven Offenbacher
BACKGROUND AND PURPOSE: Periodontal disease is independently associated with cardiovascular disease. Identification of periodontal disease as a risk factor for incident ischemic stroke raises the possibility that regular dental care utilization may reduce the stroke risk. METHODS: In the ARIC (Atherosclerosis Risk in Communities) study, pattern of dental visits were classified as regular or episodic dental care users. In the ancillary dental ARIC study, selected subjects from ARIC underwent fullmouth periodontal measurements collected at 6 sites per tooth and classified into 7 periodontal profile classes (PPCs)...
January 15, 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29334532/cost-effectiveness-and-improved-parent-and-provider-satisfaction-with-outpatient-management-of-pediatric-oncology-patients-with-low-risk-fever-and-neutropenia
#12
Abhishek Bavle, Amanda Grimes, Sibo Zhao, Daniel Zinn, Andrea Jackson, Binita Patel, Timothy Porea, Ankhi Dutta, Heidi Russell, Andras Heczey
On the basis of significant evidence for safety, the international pediatric fever and neutropenia committee recommends the identification and management of patients with "low-risk fever and neutropenia" (LRFN), outpatient with oral antibiotics, instead of traditional inpatient management. The aim of our study was to compare the cost-per-patient with these 2 strategies, and to evaluate parent and provider satisfaction with the outpatient management of LRFN. Between March 2016 and February 2017, 17 LRFN patients (median absolute neutrophil count, 90/μL) were managed at a single institution, per new guidelines...
January 12, 2018: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/29334229/physical-and-psychological-health-of-carers-of-young-people-with-first-episode-psychosis
#13
Abner Weng Cheong Poon, Jackie Curtis, Philip Ward, Celia Loneragan, Julia Lappin
OBJECTIVE: Carers of people with psychosis may experience psychological distress and caregiving burden. However, few studies have examined both psychological and physical health of carers of young people with first episode psychosis (FEP). METHOD: A total of 32 young people with FEP and 42 of their carers were recruited from a mental health service. Standardised scales were administered to assess carers' psychological distress and risk for development of Type 2 diabetes...
January 1, 2018: Australasian Psychiatry: Bulletin of Royal Australian and New Zealand College of Psychiatrists
https://www.readbyqxmd.com/read/29330038/asthmatic-wheezing-phenotypes-in-preschool-children-influential-factors-health-care-and-urban-rural-differences
#14
Susanne Kutzora, Alisa Weber, Stefanie Heinze, Lana Hendrowarsito, Uta Nennstiel-Ratzel, Erika von Mutius, Nina Fuchs, Caroline Herr
BACKGROUND: Different wheezing and asthmatic phenotypes turned out to indicate differences in etiology, risk factors and health care. We examined influential factors and urban-rural differences for different phenotypes. METHODS: Parents of 4732 children filled out a questionnaire concerning children's health and environmental factors administered within the Health Monitoring Units (GME) in a cross-sectional study in Bavaria, Germany (2014/2015). To classify respiratory symptoms, five phenotype groups were built: episodic, unremitting and frequent wheeze, ISAAC (International Study of Asthma and Allergies in Children) - asthma and physician-diagnosed asthma (neither of the groups are mutually exclusive)...
December 24, 2017: International Journal of Hygiene and Environmental Health
https://www.readbyqxmd.com/read/29328779/transforming-the-treatment-of-schizophrenia-in-the-united-states-the-raise-initiative
#15
Lisa B Dixon, Howard Goldman, Vinod H Srihari, John M Kane
The schizophrenia spectrum disorders are neurodevelopmental illnesses with a lifetime prevalence near 1%, producing extensive functional impairment and low expectations for recovery. Until recently, treatment in the United States has largely attempted to stabilize individuals with chronic schizophrenia. The identification and promotion of evidence-based practices for schizophrenia via the Patient Outcomes Research Team, combined with international studies supporting the value of early intervention, provided the foundation for the Recovery After an Initial Schizophrenia Episode (RAISE) project...
January 12, 2018: Annual Review of Clinical Psychology
https://www.readbyqxmd.com/read/29327405/from-non-encounters-to-autonomic-agency-conceptions-of-patients-with-low-back-pain-about-their-encounters-in-the-health-care-system
#16
Riikka Holopainen, Arja Piirainen, Ari Heinonen, Jaro Karppinen, Peter O'Sullivan
Low back pain is a considerable health problem which affects people around the world, causing major healthcare costs. The use of qualitative research methods enables us to describe and understand patients' experience of, and attitudes to, healthcare. The aim of the present phenomenographic study was to identify and describe the contextual nature of the conceptions of patients with low back pain of their encounters in the HCS. Seventeen patients with chronic or episodic low back pain classified as "high risk" were interviewed in open recall interviews, using videos of patients' initial physiotherapy sessions that had been recorded previously...
January 12, 2018: Musculoskeletal Care
https://www.readbyqxmd.com/read/29326815/case-series-with-literature-review-surgical-approach-to-megarectum-and-or-megasigmoid-in-children-with-unremitting-constipation
#17
James G Glasser, James M Nottingham, Martin Durkin, Michael E Haney, Sean Christensen, Riley Stroman, Tyler Hammett
Background: The role of surgery in treating children with functional constipation (FC) is controversial, because of the efficacy of bowel management programs. This case series is comprised of failures: 43 children, spanning 25 years' practice, who had megarectosigmoid (MRS) and unremitting constipation. Purpose: To determine whether these children were helped by surgery, and to contribute to formulating a standard of care for children with megarectum (MR) and/or redundancy of the sigmoid colon (MS) who fail medical management...
February 2018: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/29324277/readmission-in-psychiatry-inpatients-within-a-year-of-discharge-the-role-of-symptoms-at-discharge-and-post-discharge-care-in-a-brazilian-sample
#18
Fernanda Lucia Capitanio Baeza, Neusa Sica da Rocha, Marcelo Pio de Almeida Fleck
INTRODUCTION: Readmission into inpatient psychiatric beds is a useful outcome for patients, care providers, and policymakers. This study aims to investigate the role of level of symptoms at discharge and type of post-discharge care in determining readmissions after a year before a psychiatric admission. METHODS: We performed a prospective and observational study in a general hospital psychiatric facility. Patients were assessed at admission, discharge, and one year after discharge...
December 2, 2017: General Hospital Psychiatry
https://www.readbyqxmd.com/read/29322987/complications-related-to-sitting-position-during-pediatric-neurosurgery-an-institutional-experience-and-review-of-literature
#19
Priyanka Gupta, Girija P Rath, Hemanshu Prabhakar, Parmod K Bithal
BACKGROUND: Sitting position is preferred during posterior fossa surgeries as it provides better anatomical orientation and a clear surgical field. However, its use has been declining due to its propensity to cause life-threatening complications. This study was carried out to analyze the perioperative complications and postoperative course of children who underwent neurosurgery in sitting position. MATERIALS AND METHODS: Medical records of 97 children (<18 years) who underwent neurosurgery in sitting position over a period of 12 years, were retrospectively analyzed...
January 2018: Neurology India
https://www.readbyqxmd.com/read/29322220/diabetes-and-pregnancy-national-trends-over-a-15%C3%A2-year-period
#20
Sharon T Mackin, Scott M Nelson, Joannes J Kerssens, Rachael Wood, Sarah Wild, Helen M Colhoun, Graham P Leese, Sam Philip, Robert S Lindsay
AIMS/HYPOTHESIS: We aimed to examine time trends in national perinatal outcomes in pregnancies complicated by pre-existing type 1 or type 2 diabetes. METHODS: We analysed episode-level data on all obstetric inpatient delivery events (live or stillbirth) between 1 April 1998 and 31 March 2013 (n = 813,921) using the Scottish Morbidity Record (SMR02). Pregnancies to mothers with type 1 (n = 3229) and type 2 (n = 1452) diabetes were identified from the national diabetes database (Scottish Care Information-Diabetes), and perinatal outcomes were compared among women with type 1 diabetes, type 2 diabetes and those without diabetes...
January 11, 2018: Diabetologia
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