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Poul Jennum, Anne Sabers, Jakob Christensen, Rikke Ibsen, Jakob Kjellberg
PURPOSE: Epilepsy surgery has been a standard treatment for refractory epilepsies that cannot be controlled by standard medical treatment. We aimed to evaluate the health and social consequences of resective surgery relative to controls from a study of national data. METHODS: Using the Danish National Patient Registry we identified all subjects with an epilepsy diagnosis between 1996 and 2009 and compared them with a group of patients with an epilepsy diagnosis who had had neither epilepsy surgery nor a vagus stimulation diagnosis by the index date, and who were matched by gender, index year for epilepsy diagnosis, and index year for epilepsy surgery...
October 6, 2016: Seizure: the Journal of the British Epilepsy Association
Carol Chu, Melanie A Hom, Megan L Rogers, Ian H Stanley, Fallon B Ringer-Moberg, Matthew C Podlogar, Jameson K Hirsch, Thomas E Joiner
BACKGROUND: Insomnia is a robust correlate of suicidal ideation and behavior. Preliminary research has identified thwarted belongingness (c.f. social disconnection) as an explanatory link between insomnia and suicidal ideation. OBJECTIVES: This study replicates and extends previous findings using both cross-sectional and longitudinal designs in four demographically diverse samples. Additionally, the specificity of thwarted belongingness was evaluated by testing anxiety as a rival mediator...
October 11, 2016: Journal of Affective Disorders
S J Lain, C L Roberts, D M Bond, J Smith, J M Morris
OBJECTIVE: This study is an economic evaluation of immediate birth compared with expectant management in women with preterm prelabour rupture of the membranes near term (PPROMT). DESIGN: A cost-effectiveness analysis alongside the PPROMT randomised controlled trial. SETTING: Obstetric departments in 65 hospitals across 11 countries. POPULATION: Women with a singleton pregnancy with ruptured membranes between 34(+0) and 36(+6) weeks gestation...
October 21, 2016: BJOG: An International Journal of Obstetrics and Gynaecology
Guan-Yu Lin, Yu-Kai Lin, Jiunn-Tay Lee, Meei-Shyuan Lee, Chun-Chieh Lin, Chia-Kuang Tsai, Chi-Hsin Ting, Fu-Chi Yang
BACKGROUND: Although the comorbidity of migraine and restless legs syndrome (RLS) has been well-documented, the association between RLS and migraine frequency has yet to be elucidated. The present study aims to evaluate the prevalence of RLS among individuals who experience low-frequency, high-frequency, or chronic migraine presenting with and without aura. METHODS: We conducted a cross-sectional, case-controlled study involving 505 participants receiving outpatient headache treatment...
December 2016: Journal of Headache and Pain
Chi-Liang Cheng, Nai-Jen Liu, Jui-Hsiang Tang, Yen-Lin Kuo, Hsiang-Ling Hung, Yi-Ning Tsui, Bai-Ping Lee, Cheng-Hui Lin
BACKGROUND: A 3-l polyethylene glycol (PEG) solution provided better bowel cleansing quality than a 2-l solution for outpatient colonoscopy. Predictors of suboptimal preparation using a 3-l PEG have not been previously reported. AIMS: To investigate the possible predictors of suboptimal bowel preparation using 3-l of PEG. METHODS: We analyzed a database of 1404 consecutive colonoscopies during a 27-month period at a community hospital. A split-dose PEG regimen was provided for morning colonoscopies, and a same-day PEG regimen was provided for afternoon colonoscopies...
October 21, 2016: Digestive Diseases and Sciences
Christoph Lübbert, Lisa Zimmermann, Julia Borchert, Bernd Hörner, Reinier Mutters, Arne C Rodloff
INTRODUCTION: Clostridium difficile infection (CDI) is the most common cause of health-care-associated infectious diarrhea. Recurrence rates are as high as 20-30% after standard treatment with metronidazole or vancomycin, and appear to be reduced for patients treated with fidaxomicin. According to the literature, the risk of CDI recurrence increases after the second relapse to 30-65%. Accurate data for Germany are not yet available. METHODS: Based on the research database of arvato health analytics (Munich, Germany), a secondary data analysis for the incidence, treatment characteristics and course of CDI was performed...
October 21, 2016: Infectious Diseases and Therapy
W A Wan Zaidi, W F Wan Jamaludin, N R Tumian, S F Abdul Wahid
Pulmonary toxicity is a rare complication of Rituximab therapy. Although Rituximab is relatively safe and can be administered in an outpatient setting, Rituximab-associated lung disease has been reported and may cause mortality despite early detection. Typically the pulmonary toxicity occurs at around the fourth cycle of Rituximab. High index of suspicion is crucial and other concurrent pathology such as infective causes should be excluded. Radiological imaging and histological confirmation should be obtained and early treatment with corticosteroid should be initiated...
August 2016: Medical Journal of Malaysia
M Mafauzy, H Zanariah, A Nazeri, S P Chan
AIMS: The aim of the study was to re-evaluate the relationship between hospital based diabetes care delivery and prevention of complications. METHODS: DiabCare is an observational, non-interventional, cross-sectional study of hospital-based outpatient diabetes care. RESULTS: A total of 1668 patients participated in the study: mean age 57.8 ± 11.0 years, duration of diabetes 13.0 ± 8.6 years, and duration of insulin treatment 5.6 ± 5.5 years...
August 2016: Medical Journal of Malaysia
Denise M Hynes, Michael Fischer, Linda A Schiffer, Rani Gallardo, Ifeanyi Beverly Chukwudozie, Anna Porter, Michael Berbaum, Jennifer Earheart, Marian L Fitzgibbon
INTRODUCTION: Using a quasi-experimental design, we implemented the Patient-Centered Medical Home for Kidney Disease (PCMH-KD), a comprehensive, multidisciplinary care team to improve quality of life and healthcare coordination for adult chronic hemodialysis (CHD) patients. This paper highlights our experience in the first two years of the study.We focus on the process dimensions of Reach, Adoption, and Implementation within the context of the RE-AIM framework. MATERIALS AND METHODS: We established a new PCMH-KD model at two outpatient dialysis centers...
October 18, 2016: Contemporary Clinical Trials
Shara I Feld, Sarah E Tevis, Alexander G Cobian, Mark W Craven, Gregory D Kennedy
BACKGROUND: Many studies have evaluated predictors of postoperative complications, yet little is known about the development of multiple complications. The goal of this study was to assess complication timing in cascades of multiple complications and the risk of future complications given a patient's first complication. METHODS: This study includes 30-day, postoperative complications from the American College of Surgeons National Surgical Quality Improvement Program for all patients who underwent major inpatient and outpatient operative procedures from 2005-2013...
October 18, 2016: Surgery
Mark Brittan, Troy Richardson, Chén Kenyon, Marion Sills, Evan Fieldston, Matt Hall, David Fox, Samir Shah, Jay Berry
OBJECTIVES: To assess the relationships between postdischarge emergency department visits, oral corticosteroid (OCS) use, and 15- to 90-day asthma readmission in children. STUDY DESIGN: Retrospective study of 9288 children from 12 states in the Truven MarketScan Database, ages 2-18 years, hospitalized between January 1, 2009, and June 30, 2011, with asthma, and continuously enrolled in Medicaid for 6 months prior and 3 months after hospitalization. The primary outcome was 15- to 90-day readmission for asthma...
October 18, 2016: Journal of Pediatrics
Yeshwondm Mamuye, Balkachew Nigatu, Delayehu Bekele, Mekonen Getahun
BACKGROUND: Maternal cytomegalovirus (CMV) and Rubella infections result in adverse neonatal outcomes. Both CMV and Rubella are more widespread in developing countries and in communities with lower socioeconomic status. Thus, the aim of this study was to determine IgM specific to CMV and Rubella among newborns and Maternal CMV-seroprevalence and to identify risk factors. METHOD AND FINDING: Using cross sectional study design a total of 312 (156 newborns and 156 mothers) study participants were recruited by simple random sampling technique from gynecology outpatient department (OPD) and ward, starting from April 1, 2015 to June 30, 2015...
October 21, 2016: BMC Research Notes
Dominique Ryan, Fiona Pelly, Elizabeth Purcell
BACKGROUND: Extending the scope of practice of allied health professionals has been a strategy adopted in the United Kingdom to address issues within the health system. Australia's health system is currently undermined by similar issues, heightening government interest in adopting the extended scope health care model. The aim of the current study was to describe the activities and outcomes of a dietitian-led gastroenterology clinic which operated under an extended scope of practice model in an outpatient gastroenterology department at a tertiary hospital in regional Queensland, Australia, and to assess patient satisfaction with the initiative...
October 21, 2016: BMC Health Services Research
Chia-Yu Liu, Jui-Ying Chu, Jen-Huai Chiang, Hung-Rong Yen, Chung-Hua Hsu
BACKGROUND: To characterize the utilization of Traditional Chinese Medicine (TCM) among patients with hepatitis C (HC). METHODS: This study examined datasets from the National Health Insurance Research Database in Taiwan. One cohort, including one million patients randomly sampled from the beneficiaries of the National Health Insurance Programme from January 1 to December 31 in 2010, was chosen for this analysis. People who had at least three outpatient or inpatient records and had been diagnosed with hepatitis C virus infection from 2000 to 2010 were defined as patients with HC...
October 21, 2016: BMC Complementary and Alternative Medicine
Michèle M Kislan, Adam T Bernstein, Loretta R Fearrington, Timothy J Ives
BACKGROUND: Clinical Pharmacist Practitioners are advanced practicing pharmacists in North Carolina that provide disease-specific management. The purpose of this retrospective cohort study was to compare the efficacy and charges from referrals to a Clinical Pharmacist Practitioner by the primary care provider, to those managed by a primary care provider alone. METHODS: Patients were separated into cohorts depending if they had at least two appointments with a Clinical Pharmacist Practitioner from November 2008 to November 2011...
October 21, 2016: BMC Health Services Research
Hanna F Skjåkødegård, Yngvild S Danielsen, Mette Morken, Sara-Rebekka F Linde, Rachel P Kolko, Katherine N Balantekin, Denise E Wilfley, Pétur B Júlíusson
BACKGROUND: The purpose of the FABO-study is to evaluate the effect of family-based behavioral social facilitation treatment (FBSFT), designed to target children's family and social support networks to enhance weight loss outcomes, compared to the standard treatment (treatment as usual, TAU) given to children and adolescents with obesity in a routine clinical practice. METHODS: Randomized controlled trial (RCT), in which families (n = 120) are recruited from the children and adolescents (ages 6-18 years) referred to the Obesity Outpatient Clinic (OOC), Haukeland University Hospital, Norway...
October 21, 2016: BMC Public Health
Kathryn Schnippel, Rebecca H Berhanu, Andrew Black, Cynthia Firnhaber, Norah Maitisa, Denise Evans, Edina Sinanovic
BACKGROUND: According to the World Health Organization, South Africa ranks as one of the highest burden of TB, TB/HIV co-infection, and drug-resistant TB (DR-TB) countries. DR-TB treatment is complicated to administer and relies on the use of multiple toxic drugs, with potential for severe adverse drug reactions. We report the occurrence of adverse events (AEs) during a standardised DR-TB treatment regimen at two outpatient, decentralized, public-sector sites in Johannesburg, South Africa...
October 21, 2016: BMC Infectious Diseases
Alessandro Mantovani, Lucia Mingolla, Riccardo Rigolon, Isabella Pichiri, Valentina Cavalieri, Giacomo Zoppini, Giuseppe Lippi, Enzo Bonora, Giovanni Targher
BACKGROUND: Recent studies suggested that nonalcoholic fatty liver disease (NAFLD) is associated with an increased prevalence of cardiovascular disease (CVD) in type 1 diabetes. We assessed whether NAFLD also predicts the risk of incident CVD events in type 1 diabetic adults. METHODS: We studied a retrospective cohort of 286 type 1 diabetic outpatients (mean age 43±14years; median duration of diabetes 17 [10-30] years) without secondary causes of chronic liver diseases, who were followed for a mean period of 5...
October 17, 2016: International Journal of Cardiology
Angela Brenton-Rule, Nicola Dalbeth, Hylton B Menz, Sandra Bassett, Keith Rome
OBJECTIVE: To determine whether foot and ankle characteristics are associated with falls in people with rheumatoid arthritis (RA). METHODS: Two hundred and one adults with RA were recruited from rheumatology outpatient clinics in Auckland, New Zealand. Clinical characteristics, common fall risk factors, and foot and ankle variables were measured. Participants were prospectively studied for 12 months, to record the occurrence of falls using falls diaries. Logistic regression analysis identified baseline variables which were independent predictors of falls over the 12 months...
October 21, 2016: Arthritis Care & Research
Klaus Kratochwill, Michael Boehm, Rebecca Herzog, Katharina Gruber, Anton Michael Lichtenauer, Lilian Kuster, Dagmar Csaicsich, Andreas Gleiss, Seth L Alper, Christoph Aufricht, Andreas Vychytil
BACKGROUND: Peritonitis and ultrafiltration failure remain serious complications of chronic peritoneal dialysis (PD). Dysfunctional cellular stress responses aggravate peritoneal injury associated with PD fluid exposure, potentially due to peritoneal glutamine depletion. In this randomized cross-over phase I/II trial we investigated cytoprotective effects of alanyl-glutamine (AlaGln) addition to glucose-based PDF. METHODS: In a prospective randomized cross-over design, 20 stable PD outpatients underwent paired peritoneal equilibration tests 4 weeks apart, using conventional acidic, single chamber 3...
2016: PloS One
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