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https://www.readbyqxmd.com/read/28437620/american-association-of-clinical-endocrinologists-and-american-college-of-endocrinology-guidelines-for-management-of-dyslipidemia-and-prevention-of-cardiovascular-disease
#1
Paul S Jellinger, Yehuda Handelsman, Paul D Rosenblit, Zachary T Bloomgarden, Vivian A Fonseca, Alan J Garber, George Grunberger, Chris K Guerin, David S H Bell, Jeffrey I Mechanick, Rachel Pessah-Pollack, Kathleen Wyne, Donald Smith, Eliot A Brinton, Sergio Fazio, Michael Davidson
OBJECTIVE: The development of these guidelines is mandated by the American Association of Clinical Endocrinologists (AACE) Board of Directors and American College of Endocrinology (ACE) Board of Trustees and adheres with published AACE protocols for the standardized production of clinical practice guidelines (CPGs). METHODS: Recommendations are based on diligent reviews of the clinical evidence with transparent incorporation of subjective factors, according to established AACE/ACE guidelines for guidelines protocols...
April 2017: Endocrine Practice
https://www.readbyqxmd.com/read/28437313/enhanced-recovery-after-surgery-for-noncolorectal-surgery-a-systematic-review-and-meta-analysis-of-major-abdominal-surgery
#2
Anthony Visioni, Rupen Shah, Emmanuel Gabriel, Kristopher Attwood, Moshim Kukar, Steven Nurkin
OBJECTIVE: To evaluate the impact of enhanced recovery after surgery (ERAS) protocols across noncolorectal abdominal surgical procedures. BACKGROUND: ERAS programs have been studied extensively in colorectal surgery and adopted at many centers. Several studies testing such protocols have shown promising results in improving postoperative outcomes across various surgical procedures. However, surgeons performing major abdominal procedures have been slower to adopt these ERAS protocols...
April 21, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28436924/harnessing-the-promise-of-moral-distress-a-call-for-re-orientation
#3
Alisa Carse, Cynda Hylton Rushton
Despite over three decades of research into the sources and costs of what has become an "epidemic" of moral distress among healthcare professionals, spanning many clinical disciplines and roles, there has been little significant progress in effectively addressing moral distress. We believe the persistent sense of frustration, helplessness, and despair still dominating the clinical moral distress narrative signals a need for re-orientation in the way moral distress is understood and worked with. Most fundamentally, moral distress reveals moral investment and energy...
2017: Journal of Clinical Ethics
https://www.readbyqxmd.com/read/28436583/physical-activity-and-exercise-for-chronic-pain-in-adults-an-overview-of-cochrane-reviews
#4
REVIEW
Louise J Geneen, R Andrew Moore, Clare Clarke, Denis Martin, Lesley A Colvin, Blair H Smith
BACKGROUND: Chronic pain is defined as pain lasting beyond normal tissue healing time, generally taken to be 12 weeks. It contributes to disability, anxiety, depression, sleep disturbances, poor quality of life, and healthcare costs. Chronic pain has a weighted mean prevalence in adults of 20%.For many years, the treatment choice for chronic pain included recommendations for rest and inactivity. However, exercise may have specific benefits in reducing the severity of chronic pain, as well as more general benefits associated with improved overall physical and mental health, and physical functioning...
April 24, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28435754/establishing-successful-patient-centered-medical-homes-in-rural-hawai-i-three-strategies-to-consider
#5
Melissa Nelson Scribner, Kasey Kehoe
The challenges to healthcare delivery posed by Hawai'i's unique geography, physician shortages, and dispersed population are of particular importance in light of implementing the Affordable Care Act (ACA). This study draws on central goals laid out in the ACA - to decrease costs, increase access, and improve patient outcomes. The use of the Patient-Centered Medical Homes (PCMHs) is a care model that has the potential to meet all three goals. How to identify the most effective way to develop PCMHs in the specific context of Hawai'i is the focus of this study...
March 2017: Hawai'i Journal of Medicine & Public Health: a Journal of Asia Pacific Medicine & Public Health
https://www.readbyqxmd.com/read/28435495/areas-of-potential-impact-of-the-patient-protection-and-affordable-care-act-on-ems-a-synthesis-of-the-literature
#6
REVIEW
Daniel G Ostermayer, Charles A Brown, William G Fernandez, Emily Couvillon
INTRODUCTION: This comprehensive review synthesizes the existing literature on the Patient Protection and Affordable Care Act (ACA) as it relates to emergency medical services (EMS) in order to provide guidance for navigating current and future healthcare changes. METHODS: We conducted a comprehensive review to identify all existing literature related to the ACA and EMS and all sections within the federal law pertaining to EMS. RESULTS: Many changes enacted by the ACA directly affect emergency care with potential indirect effects on EMS systems...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28434707/in-hospital-complications-after-implantation-of-cardiac-implantable-electronic-devices-analysis-of-a-national-inpatient-database-in-japan
#7
Sandeep Shakya, Hiroki Matsui, Kiyohide Fushimi, Hideo Yasunaga
BACKGROUND: Complications after implantation of cardiac implantable electronic devices (CIEDs), including permanent pacemakers (PMs) and other CIEDs, are associated with increased patient mortality and healthcare costs. This study aimed to investigate overall complications after implantation of CIEDs, analyze the associated risk factors, and compare complications after PM implantation between hospitals that performed only PM implantations (PM-only hospitals) and hospitals that implanted other CIEDs, as well as PMs (all-CIED hospitals)...
April 20, 2017: Journal of Cardiology
https://www.readbyqxmd.com/read/28434482/how-to-implement-clinical-guidelines-to-optimise-familial-hypercholesterolaemia-diagnosis-and-treatment
#8
Michel Farnier, Fernando Civeira, Olivier Descamps
BACKGROUND AND AIMS: Familial hypercholesterolaemia (FH) is a genetic disorder associated with significantly elevated plasma low-density lipoprotein cholesterol (LDL-C) and premature coronary heart disease (CHD). Optimal management of FH relies on early identification and treatment with statins alone or in combination with other lipid-lowering therapies. A lack of awareness of FH and its manifestations among primary care physicians and specialists has led to many individuals being misdiagnosed in the early stages of the disease, further increasing the risk of CHD and requiring much more intensive lipid-lowering strategies...
April 2017: Atherosclerosis. Supplements
https://www.readbyqxmd.com/read/28434458/relationship-between-state-malpractice-environment-and-quality-of-health-care-in-the-united-states
#9
Karl Y Bilimoria, Jeanette W Chung, Christina A Minami, Min-Woong Sohn, Emily S Pavey, Jane L Holl, Michelle M Mello
BACKGROUND: One major intent of the medical malpractice system in the United States is to deter negligent care and to create incentives for delivering high-quality health care. A study was conducted to assess whether state-level measures of malpractice risk were associated with hospital quality and patient safety. METHODS: In an observational study of short-term, acute-care general hospitals in the United States that publicly reported in the Centers for Medicaid & Medicare Services Hospital Compare in 2011, hierarchical regression models were used to estimate associations between state-specific malpractice environment measures (rates of paid claims, average Medicare Malpractice Geographic Practice Cost Index [MGPCI], absence of tort reform laws, and a composite measure) and measures of hospital quality (processes of care, imaging utilization, 30-day mortality and readmission, Agency for Healthcare Research and Quality Patient Safety Indicators, and patient experience from the Hospital Consumer Assessment of Healthcare Providers and Systems [HCAHPS])...
May 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28434416/introduction-of-health-technology-assessment-for-medicines-in-slovakia
#10
Tomas Tesar, Adam Hloska, Martin Wawruch, Lubica Lehocka, Miroslava Snopkova, Lucia Masarykova
OBJECTIVES: The aim of our study was to describe approaches to health technology assessment (HTA) for medicines in the Slovak healthcare system and the related decision-making processes concerning reimbursement for medicines. METHODS: Analysis of the Slovak legislative framework related to HTA and the reimbursement process for medicines was performed. Additionally, current practices of the Working Group for Pharmacoeconomics, Clinical Outcomes and Health Technology Assessment of the Slovak Ministry of Health were evaluated...
April 24, 2017: International Journal of Technology Assessment in Health Care
https://www.readbyqxmd.com/read/28434413/drug-evaluation-and-decision-making-in-catalonia-development-and-validation-of-a-methodological-framework-based-on-multi-criteria-decision-analysis-mcda-for-orphan-drugs
#11
Antoni Gilabert-Perramon, Josep Torrent-Farnell, Arancha Catalan, Alba Prat, Manel Fontanet, Ruth Puig-Peiró, Sandra Merino-Montero, Hanane Khoury, Mireille M Goetghebeur, Xavier Badia
OBJECTIVES: The aim of this study was to adapt and assess the value of a Multi-Criteria Decision Analysis (MCDA) framework (EVIDEM) for the evaluation of Orphan drugs in Catalonia (Catalan Health Service). METHODS: The standard evaluation and decision-making procedures of CatSalut were compared with the EVIDEM methodology and contents. The EVIDEM framework was adapted to the Catalan context, focusing on the evaluation of Orphan drugs (PASFTAC program), during a Workshop with sixteen PASFTAC members...
April 24, 2017: International Journal of Technology Assessment in Health Care
https://www.readbyqxmd.com/read/28433672/montreal-accord-on-patient-reported-outcomes-use-series-paper-1-introduction
#12
Susan J Bartlett, Sara Ahmed
BACKGROUND: Patient-centered healthcare, where we design and deliver care to address the needs and preferences of patients, represents an important paradigm shift. Patient reported outcomes (PROs) are critical to capture the patient voice, understand how illness and treatments affect people, and establish how well services and treatments address what matters most to patients. OBJECTIVE: Originally developed for use in research, PROs are now used to monitor individuals and populations, manage care, evaluate services and providers, and inform policy...
April 19, 2017: Journal of Clinical Epidemiology
https://www.readbyqxmd.com/read/28433579/distinguishing-septic-from-normal-donors-by-detection-of-spla2-iia-from-human-plasma-using-a-microsieve-based-immunoassay
#13
Daniel R Zweitzig, Arjan G Tibbe, Mark J Kopnitsky, Kathleen Cichonski, Leon W M M Terstappen
Bloodstream infections that progress to septic shock are responsible for hundreds of thousands of deaths each year, and are associated with significant healthcare costs. Recent studies have shown that a member of the secreted phospholipase protein family, termed sPLA2-IIA, may play a role during the innate immune response to bacterial infections, and is elevated in the plasma of septic patients. In this report, the feasibility of a simple microsieve-based sPLA2-IIA detection immunoassay was explored. Microsieves containing 5μm pores were covalently coupled with a sPLA2-IIA-specific monoclonal antibody at 0...
April 19, 2017: Journal of Immunological Methods
https://www.readbyqxmd.com/read/28433247/outpatient-laparoscopic-appendectomy-feasible-in-a-public-county-hospital
#14
David R Rosen, Kenji Inaba, Paul J Oh, Adam C Gutierrez, Aaron M Strumwasser, Subarna Biswas, Melody Cala, Glenn T Ault
BACKGROUND: Outpatient laparoscopic appendectomy is being used increasingly as a treatment option for acute, uncomplicated appendicitis. This was a prospective validation study in a large, urban, public safety-net hospital. STUDY DESIGN: From 2014 to 2016, all patients undergoing laparoscopic appendectomy for acute, uncomplicated appendicitis were enrolled in a prospective observational trial. Standard baseline perioperative practice (control group) was documented for 1 year...
March 13, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28433120/additional-cost-because-of-pneumonia-in-nursing-home-residents-results-from-the-incidence-of-pneumonia-and-related-consequences-in-nursing-home-resident-study
#15
Nadège Costa, Emiel O Hoogendijk, Michael Mounié, Robert Bourrel, Yves Rolland, Bruno Vellas, Laurent Molinier, Matteo Cesari
OBJECTIVES: Pneumonia is a frequent condition in older people. Our aim was to examine the total healthcare cost related to pneumonia in nursing home (NH) residents over a 1-year follow-up period. DESIGN: This was a prospective, longitudinal, observational, and multicenter study that was a part of the Incidence of Pneumonia and related Consequences in Nursing Home Resident study. SETTING: Thirteen NHs located in Languedoc Roussillon and Midi-Pyrénées regions in France were included...
May 1, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28431671/where-are-we-now-a-clinicians-guide-to-the-use-of-follow-on-insulin-for-patients-with-diabetes
#16
Steven V Edelman, Priscilla A Hollander, Eugene E Wright
Insulin has been used as a standard treatment for patients with diabetes for almost 100 years. Over time, advances in insulin development have improved its pharmacologic properties. (Online access: http://courses.elseviercme.com/t2dm/666). Most recently, the US Food and Drug Administration approved a novel, follow-on basal insulin agent, with more expected to be commercially available in the near future. With the imminent availability of follow-on basal insulin agents, clinicians need to be aware of the potential benefits and concerns in order to facilitate informed decision making and to provide the best possible advice and guidance to their patients with diabetes...
May 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28431633/greater-healthcare-utilization-and-costs-among-black-persons-compared-to-white-persons-with-aphasia-in-the-north-carolina-stroke-belt
#17
Charles Ellis, Rose Y Hardy, Richard C Lindrooth
PURPOSE: To examine racial differences in healthcare utilization and costs for persons with aphasia (PWA) being treated in acute care hospitals in North Carolina (NC). METHODS: NC Healthcare Cost and Utilization Project State Inpatient Database (HCUP-SID) data from 2011-2012 were analyzed to examine healthcare utilization and costs of care for stroke patients with aphasia. Analyses emphasized length of stay, charges and cost of general hospital services. Generalized linear models (GLM) were constructed to determine the impact of demographic characteristics, stroke/illness severity, and observed hospital characteristics on utilization and costs...
May 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28431545/optimising-spatial-accessibility-to-inform-rationalisation-of-specialist-health-services
#18
Catherine M Smith, Hannah Fry, Charlotte Anderson, Helen Maguire, Andrew C Hayward
BACKGROUND: In an era of budget constraints for healthcare services, strategies for provision of services that improve quality whilst saving costs are highly valued. A proposed means to achieve this is consolidation of services into fewer specialist centres, but this may lead to reduced spatial accessibility. We describe a methodology which includes implementing a combinatorial optimisation algorithm to derive combinations of services which optimise spatial accessibility in the context of service rationalisation, and demonstrate its use through the exemplar of tuberculosis clinics in London...
April 21, 2017: International Journal of Health Geographics
https://www.readbyqxmd.com/read/28431457/precision-medicine-and-pharmacogenetics-what-does-oncology-have-that-addiction-medicine-does-not
#19
Henry R Kranzler, Rachel V Smith, Robert Schnoll, Afaf Moustafa, Emma Greenstreet-Akman
BACKGROUND AND AIMS: Precision, personalized or stratified medicine, which promises to deliver the right treatment to the right patient, is a topic of international interest in both the lay press and the scientific literature. A key aspect of precision medicine is the identification of biomarkers that predict the response to medications (i.e. pharmacogenetics). We examined why, despite the great strides that have been made in biomarker identification in many areas of medicine, only in oncology has there been substantial progress in their clinical implementation...
April 21, 2017: Addiction
https://www.readbyqxmd.com/read/28430754/biomarkers-for-early-acute-kidney-injury-diagnosis-and-severity-prediction-a-pilot-multicenter-canadian-study-of-children-admitted-to-the-icu
#20
Jennifer Palermo, Allison B Dart, Alanna De Mello, Prasad Devarajan, Ronald Gottesman, Gonzalo Garcia Guerra, Greg Hansen, Ari R Joffe, Cherry Mammen, Nick Majesic, Catherine Morgan, Peter Skippen, Michael Pizzi, Ana Palijan, Michael Zappitelli
OBJECTIVE: Acute kidney injury occurs early in PICU admission and increases risks for poor outcomes. We evaluated the feasibility of a multicenter acute kidney injury biomarker urine collection protocol and measured diagnostic characteristics of urine neutrophil gelatinase-associated lipocalin, interleukin-18, and liver fatty acid binding protein to predict acute kidney injury and prolonged acute kidney injury. DESIGN: Prospective observational pilot cohort study...
April 20, 2017: Pediatric Critical Care Medicine
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