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https://www.readbyqxmd.com/read/28528537/intraoperative-mechanical-ventilation-state-of-the-art
#1
Lorenzo Ball, Federico Costantino, Giulia Orefice, Karthikka Chandrapatham, Paolo Pelosi
Mechanical ventilation is a cornerstone of the intraoperative management of the surgical patient and is still mandatory in several surgical procedures. In the last decades, research focused on preventing postoperative pulmonary complications (PPCs), both improving risk stratification through the use of predictive scores and protecting the lung adopting so-called protective ventilation strategies. The aim of this review is to give an up-to-date overview of the currently suggested intraoperative ventilation strategies, along with their pathophysiologic rationale, with a focus on challenging conditions, such as obesity, one-lung ventilation and cardiopulmonary bypass...
May 19, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28528365/the-value-of-evidence-in-the-decision-making-process-for-reimbursement-of-pharmacogenetic-dosing-of-warfarin
#2
Andrej Janzic, Igor Locatelli, Mitja Kos
BACKGROUND: After early clinical trials that evaluated pharmacogenetic (PG) algorithms, many healthcare payers were reluctant to cover this technology and, consequently, PG dosing of warfarin could not be translated into clinical practice. OBJECTIVE: The aim of this study was to estimate the value of upgrading evidence relating to PG dosing of warfarin from the healthcare payer perspective. METHODS: Randomized controlled trials (RCTs) that evaluated PG dosing of warfarin were identified through a systematic literature search, and their findings were combined by a cumulative meta-analysis...
May 20, 2017: American Journal of Cardiovascular Drugs: Drugs, Devices, and Other Interventions
https://www.readbyqxmd.com/read/28528246/the-canadian-hypoglycemia-assessment-tool-program-insights-into-rates-and-implications-of-hypoglycemia-from-an-observational-study
#3
Ronnie Aronson, Ronald Goldenberg, Damir Boras, Rasmus Skovgaard, Harpreet Bajaj
OBJECTIVE: The true prevalence of hypoglycemia in insulin-treated patients with diabetes and its impact on patients, employers and healthcare providers is poorly appreciated owing to a paucity of real-world data. The global Hypoglycemia Assessment Tool (HAT) study addressed this issue, and here we report data from the Canadian cohort of patients. METHODS: This noninterventional, 6-month retrospective and 4-week prospective study enrolled patients aged ≥18 years receiving insulin treatment for >12 months from community endocrinology practices...
May 17, 2017: Canadian Journal of Diabetes
https://www.readbyqxmd.com/read/28527755/perioperative-neurologic-complications-during-spinal-fusion-surgery-incidence-and-trends
#4
Parthasarathy Thirumala, James Zhou, Piruthiviraj Natarajan, Jeffrey Balzer, Edward Dixon, David Okonkwo, D K Hamilton
BACKGROUND CONTEXT: Perioperative neurologic complications after spine surgery may increase morbidity and healthcare costs related to the procedure. PURPOSE: We estimate the national incidence of perioperative neurologic complications following anterior cervical discectomy and fusion (ACDF), posterior cervical fusion, and thoracolumbar fusion procedures using the Nationwide Inpatient Sample (NIS) data from 1999 to 2011. Additionally, we identify risk factors for developing perioperative neurologic complications and the effects of these injuries on quantifiable patient outcomes...
May 17, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28527687/cost-effectiveness-analysis-of-typhoid-conjugate-vaccines-in-five-endemic-low-and-middle-income-settings
#5
Marina Antillón, Joke Bilcke, A David Paltiel, Virginia E Pitzer
BACKGROUND: Typhoid fever remains endemic in low- and middle-income countries. Programmatic use of existing vaccines is limited, but upcoming typhoid conjugate vaccines (TCVs) could warrant wider use. We evaluated the cost-effectiveness of five TCV delivery strategies in three urban areas (Delhi and Kolkata, India and Nairobi, Kenya) and two rural settings (Lwak, Kenya and Dong Thap, Vietnam) with varying incidence. METHODS AND FINDINGS: We evaluated routine infant vaccination with and without catch-up campaigns among older individuals...
May 17, 2017: Vaccine
https://www.readbyqxmd.com/read/28527520/recent-advances-in-smart-biotechnology-hydrogels-and-nanocarriers-for-tailored-bioactive-molecules-depot
#6
REVIEW
Gesmi Milcovich, Stefania Lettieri, Filipe E Antunes, Bruno Medronho, Ana C Fonseca, Jorge F J Coelho, Paolo Marizza, Francesca Perrone, Rossella Farra, Barbara Dapas, Gabriele Grassi, Mario Grassi, Silvia Giordani
Over the past ten years, the global biopharmaceutical market has remarkably grown, with ten over the top twenty worldwide high performance medical treatment sales being biologics. Thus, biotech R&D (research and development) sector is becoming a key leading branch, with expanding revenues. Biotechnology offers considerable advantages compared to traditional therapeutic approaches, such as reducing side effects, specific treatments, higher patient compliance and therefore more effective treatments leading to lower healthcare costs...
May 9, 2017: Advances in Colloid and Interface Science
https://www.readbyqxmd.com/read/28527093/income-disparities-in-healthcare-use-remain-after-controlling-for-healthcare-need-evidence-from-swedish-register-data-on-psoriasis-and-psoriatic-arthritis
#7
Sofia Löfvendahl, Anna Jöud, Ingemar F Petersson, Elke Theander, Åke Svensson, Katarina Steen Carlsson
We used a southern Swedish cohort of psoriasis (PSO) and psoriatic arthritis (PsA) patients and population-based referents (N = 57,800) to investigate the influence of socioeconomic and demographic factors on the probability of healthcare use and on healthcare costs when controlling for need as measured by PSO/PsA and common additional morbidities such as diabetes, depression and myocardial infarction. People with PSO/PsA were identified by ICD-10 codes in the Skåne Healthcare Register 1998-2007. Resource use and costs for years 2008-2011 were retrieved from the Skåne Healthcare Register and the Swedish Prescribed Drug Register, and socioeconomic data were retrieved from Statistics Sweden...
May 19, 2017: European Journal of Health Economics: HEPAC: Health Economics in Prevention and Care
https://www.readbyqxmd.com/read/28526271/an-in-vitro-urinary-catheterization-model-that-approximates-clinical-conditions-for-evaluation-of-innovations-to-prevent-catheter-associated-urinary-tract-infections
#8
R Y R Chua, K Lim, S S J Leong, P A Tambyah, B Ho
BACKGROUND: Catheter associated urinary tract infections (CAUTI) account for about 25% of nosocomial infections globally and often result in increased morbidity and healthcare costs. An added concern is the presence of microbial biofilms which are major reservoirs of bacteria, especially antibiotic resistant bacteria, in catheters. Since the practice of the closed drainage system, innovations to combat CAUTI have not produced significant improvements in clinical outcomes. The lack of a robust laboratory platform to test new CAUTI preventive strategies may impede development of novel technologies...
May 16, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28526026/a-qualitative-study-of-telehealth-patient-information-leaflets-tils-are-we-giving-patients-enough-information
#9
Reem Kayyali, Iman Hesso, Evelyn Ejiko, Shereen Nabhani Gebara
BACKGROUND: The provision of patient information leaflets regarding telehealth has been perceived by potential consumers as a strategy to promote awareness and adoption of telehealth services. However, such leaflets need to be designed carefully if adoption and awareness among potential users is to be promoted. Therefore, the aims of this study were: first, to see how telehealth was portrayed in some of the existing telehealth leaflets (THLs). Second, to explore patients' perceptions of the existing THLs and their engagement with the concept and how THLs can be optimised...
May 19, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28525473/is-total-disk-replacement-a-cost-effective-treatment-for-cervical-degenerative-disk-disease
#10
Bernd Wiedenhöfer, Joachim Nacke, Mike Stephan, Wiltrud Richter, Claus Carstens, Markus Eichler
STUDY DESIGN: A retrospective study. OBJECTIVE: The objective of this study was to assess the cost-effectiveness and clinical outcome of motion-preserving versus fusion procedures in cervical spine surgery. SUMMARY OF BACKGROUND DATA: During the last decade there has been a huge growth in spine surgery with a concurrent increase in the economic burden. Currently, there appear to be no differences in clinical outcome between cervical total disk replacement (TDR) and spinal fusion (SF)...
June 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28524904/metastatic-lung-cancer-and-distress-use-of-the-distress-thermometer-for-patient-assessment
#11
Victoria Sherry, Carmen Guerra, Anjana Ranganathan, Susan M Schneider
BACKGROUND: Patients with metastatic lung cancer experience high levels of distress related to their disease trajectory and treatment. Oncology nurses are experts in patient care and symptom management, giving them an opportunity to screen and treat patients' distress.
. OBJECTIVES: The objectives of this study were to screen patients for distress and manage their symptoms to positively affect their quality of life, treatment adherence, and clinical outcomes, and to reduce healthcare costs...
June 1, 2017: Clinical Journal of Oncology Nursing
https://www.readbyqxmd.com/read/28524248/how-should-hospital-reimbursement-be-refined-to-support-concentration-of-complex-care-services
#12
Chris Bojke, Katja Grašič, Andrew Street
The English National Health Service is promoting concentration of the treatment of patients with relatively rare and complex conditions into a limited number of specialist centres. If these patients are more costly to treat, the prospective payment system based on Healthcare Resource Groups (HRGs) may need refinement because these centres will be financially disadvantaged. To assess the funding implications of this concentration policy, we estimate the cost differentials associated with caring for patients that receive complex care and examine the extent to which complex care services are concentrated across hospitals and HRGs...
May 19, 2017: Health Economics
https://www.readbyqxmd.com/read/28523995/alternative-therapies-for-diabetes-a-comparison-of-western-and-traditional-chinese-medicine-tcm-approaches
#13
Eric Xiao, Luguang Luo
BACKGROUND: Across the world, the economic and health costs of diabetes are rising at an alarming rate. Each year in the United States, billions of dollars are spent on T2 Diabetes mellitus (T2DM) treatments, but such treatments are not always effective and can lead to adverse events. Many pharmacological treatments exist to control the primary and secondary symptoms of T2DM, but these medications are not always efficacious, do little to treat secondary T2DM symptoms, and often carry adverse side effects...
May 18, 2017: Current Diabetes Reviews
https://www.readbyqxmd.com/read/28523579/primary-care-and-hepatology-provider-perceived-barriers-to-and-facilitators-of-hepatitis-c-treatment-candidacy-and-adherence
#14
Shari S Rogal, Rory McCarthy, Andrea Reid, Keri L Rodriguez, Linda Calgaro, Krupa Patel, Molly Daley, Naudia L Jonassaint, Susan L Zickmund
BACKGROUND: Provider perceptions regarding barriers to and facilitators of hepatitis C (HCV) treatment initiation and adherence have not been fully evaluated in the interferon-free treatment era. New treatments have provided opportunities for non-specialists to treat HCV, underscoring the importance of understanding primary care provider (PCP) and specialist perspectives. METHODS: Based on qualitative sampling principles, 12 PCPs and 12 hepatology providers (HPs) from the VA Pittsburgh Healthcare System completed audio-recorded semi-structured interviews...
May 18, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28523483/modeling-the-long-term-cost-effectiveness-of-ideglira-in-patients-with-type-2-diabetes-who-are-failing-to-meet-glycemic-targets-on-basal-insulin-alone-in-the-netherlands
#15
Barnaby Hunt, Divina Glah, Maarten van der Vliet
INTRODUCTION: Insulin degludec/liraglutide (IDegLira) is the first basal insulin and glucagon-like peptide-1 receptor agonist (GLP-1 RA) in a single pen injection device, and a once-daily treatment option for patients with type 2 diabetes mellitus (T2DM) who are uncontrolled on basal insulin and require treatment intensification. The objective of this analysis was to evaluate the long-term cost-effectiveness of IDegLira versus basal-bolus therapy (insulin glargine U100 + 3× daily insulin aspart) for patients with T2DM uncontrolled on basal insulin [HbA1c >53 mmol/mol (>7%)] in the Netherlands...
May 18, 2017: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
https://www.readbyqxmd.com/read/28523341/cost-of-unnecessary-testing-in-the-evaluation-of-pediatric-syncope
#16
Connor Redd, Cameron Thomas, Martha Willis, Michelle Amos, Jeffrey Anderson
Syncope is a common and a typically benign clinical problem in children and adolescents. The majority of tests ordered in otherwise healthy pediatric patients presenting with syncope have low diagnostic yield. This study quantifies testing and corresponding patient charges in a group of pediatric patients presenting for outpatient evaluation for syncope. Patients seen between 3/2011 and 4/2013 in the multi-disciplinary Syncope Clinic at Cincinnati Children's Hospital Medical Center were enrolled in a registry which was reviewed for patient information...
May 18, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28523206/tackling-the-challenge-of-the-aging-society-detecting-and-preventing-cognitive-and-physical-decline-through-games-and-consumer-technologies
#17
REVIEW
David Wortley, Ji-Young An, Almas Heshmati
OBJECTIVES: This study seeks to review some of the approaches employed to address health and well-being issues in the elderly population. METHODS: This article reviews and analyses a range of projects and approaches designed for the elderly population and aimed at preserving and/or enhancing physical and cognitive capabilities in later life. RESULTS: Various intervention measures have been developed across the globe to preserve and/or enhance physical and cognitive capabilities of the elderly population...
April 2017: Healthcare Informatics Research
https://www.readbyqxmd.com/read/28523128/comparison-of-medicines-management-strategies-in-insurance-schemes-in-middle-income-countries-four-case-studies
#18
Warren A Kaplan, Paul G Ashigbie, Mohamad I Brooks, Veronika J Wirtz
BACKGROUND: Many middle-income countries are scaling up health insurance schemes to provide financial protection and access to affordable medicines to poor and uninsured populations. Although there is a wealth of evidence on how high income countries with mature insurance schemes manage cost-effective use of medicines, there is limited evidence on the strategies used in middle-income countries. This paper compares the medicines management strategies that four insurance schemes in middle-income countries use to improve access and cost-effective use of medicines among beneficiaries...
2017: Journal of Pharmaceutical Policy and Practice
https://www.readbyqxmd.com/read/28522924/use-of-the-4kscore-test-to-predict-the-risk-of-aggressive-prostate-cancer-prior-to-prostate-biopsy-overall-cost-savings-and-improved-quality-of-care-to-the-us-healthcare-system
#19
Jeffrey D Voigt, Yan Dong, Vincent Linder, Stephen Zappala
The 4Kscore® Test (BioReference Laboratories, Elmwood Park, NJ) is a blood test that accurately determines the risk of aggressive prostate cancer and significantly reduces prostate biopsies and associated overdiagnosis and overtreatment of indolent cancer. A budget impact model was developed to test the hypothesis that the 4Kscore Test can improve quality of care and deliver cost savings for patients who are suspected of having prostate cancer and would otherwise undergo prostate biopsy under the current standard of care (SOC) in the United States...
2017: Reviews in Urology
https://www.readbyqxmd.com/read/28521785/expect-with-me-development-and-evaluation-design-for-an-innovative-model-of-group-prenatal-care-to-improve-perinatal-outcomes
#20
Shayna D Cunningham, Jessica B Lewis, Jordan L Thomas, Stephanie A Grilo, Jeannette R Ickovics
BACKGROUND: Despite biomedical advances and intervention efforts, rates of preterm birth and other adverse outcomes in the United States have remained relatively intransigent. Evidence suggests that group prenatal care can reduce these risks, with implications for maternal and child health as well as substantial cost savings. However, widespread dissemination presents challenges, in part because training and health systems have not been designed to deliver care in a group setting. This manuscript describes the design and evaluation of Expect With Me, an innovative model of group prenatal care with a strong integrated information technology (IT) platform designed to be scalable nationally...
May 18, 2017: BMC Pregnancy and Childbirth
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