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https://www.readbyqxmd.com/read/27926548/liver-transplantation-for-hepatocellular-carcinoma-current-update-on-treatment-and-allocation
#1
Leigh Anne Dageforde, Kathryn J Fowler, William C Chapman
PURPOSE OF REVIEW: This review discusses the current imaging modalities and criteria used to diagnose, and the role of liver transplantation as well as nonsurgical hepatic-directed therapies to treat hepatocellular carcinoma in the setting of chronic liver disease. RECENT FINDINGS: There has been continual evolution of guidelines, policies, and algorithms for the imaging diagnosis of hepatocellular carcinoma, particularly the Liver Imaging Reporting and Data System...
December 6, 2016: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/27924347/preprocessing-structured-clinical-data-for-predictive-modeling-and-decision-support-a-roadmap-to-tackle-the-challenges
#2
José Carlos Ferrão, Mónica Duarte Oliveira, Filipe Janela, Henrique M G Martins
BACKGROUND: EHR systems have high potential to improve healthcare delivery and management. Although structured EHR data generates information in machine-readable formats, their use for decision support still poses technical challenges for researchers due to the need to preprocess and convert data into a matrix format. During our research, we observed that clinical informatics literature does not provide guidance for researchers on how to build this matrix while avoiding potential pitfalls...
December 7, 2016: Applied Clinical Informatics
https://www.readbyqxmd.com/read/27923909/mating-system-of-caiman-yacare-reptilia-alligatoridae-described-from-microsatellite-genotypes
#3
Guillermo N Ojeda, Eva C Rueda, Pablo A Siroski, Alejandro Larriera, Patricia S Amavet
The yacare caiman (Caiman yacare) is a reptile from South America and one of the two crocodilian species present in Argentina. The degradation of their natural habitat and strong hunting pressure led to a sharp numerical decline of wild populations. Nowadays C. yacare is included in the Appendix II of CITES, and at the same time it has been subjected to ranching practices in some areas in Argentina. In this context, it is important to better understand the population structure and mating system of the species...
December 6, 2016: Journal of Heredity
https://www.readbyqxmd.com/read/27922466/smartphone-based-electrocardiographic-and-cardiac-implantable-electronic-device-monitoring
#4
Suneet Mittal
The field of arrhythmia monitoring is changing rapidly. The rapid advent of technology in combination with marked improvements in cellular communication and an increased desire by patients to be actively engaged in their care has ushered in a new era of clinical care. Today, physicians need to think about their patients outside the traditional in-office setting. Two technologies that embody this changing landscape are smartphone-based electrocardiographic (ECG) monitors and remote monitoring of cardiac implantable electronic devices (CIEDs)...
January 2017: Cardiology in Review
https://www.readbyqxmd.com/read/27922462/fostering-evidence-based-quality-improvement-for-patient-centered-medical-homes-initiating-local-quality-councils-to-transform-primary-care
#5
Susan E Stockdale, Jessica Zuchowski, Lisa V Rubenstein, Negar Sapir, Elizabeth M Yano, Lisa Altman, Jacqueline J Fickel, Skye McDougall, Timothy Dresselhaus, Alison B Hamilton
BACKGROUND: Although the patient-centered medical home endorses quality improvement principles, methods for supporting ongoing, systematic primary care quality improvement have not been evaluated. We introduced primary care quality councils at six Veterans Health Administration sites as an organizational intervention with three key design elements: (a) fostering interdisciplinary quality improvement leadership, (b) establishing a structured quality improvement process, and (c) facilitating organizationally aligned frontline quality improvement innovation...
December 3, 2016: Health Care Management Review
https://www.readbyqxmd.com/read/27921218/from-problem-solving-to-problem-definition-scrutinizing-the-complex-nature-of-clinical-practice
#6
Sayra Cristancho, Lorelei Lingard, Glenn Regehr
In medical education, we have tended to present problems as being singular, stable, and solvable. Problem solving has, therefore, drawn much of medical education researchers' attention. This focus has been important but it is limited in terms of preparing clinicians to deal with the complexity of the 21st century healthcare system in which they will provide team-based care for patients with complex medical illness. In this paper, we use the Soft Systems Engineering principles to introduce the idea that in complex, team-based situations, problems usually involve divergent views and evolve with multiple solution iterations...
December 5, 2016: Perspectives on Medical Education
https://www.readbyqxmd.com/read/27919586/practical-management-of-adverse-events-related-to-apomorphine-therapy
#7
Roongroj Bhidayasiri, Pedro J Garcia Ruiz, Tove Henriksen
The potential for adverse events is often cited as a barrier to the use of subcutaneous apomorphine therapy (intermittent injections and continuous infusion) in the management of Parkinson's disease. However, with proactive management most adverse effects are manageable if reported and tackled early enough. As such, proper clinician and patient awareness of the potential adverse effects is important to minimize their impact on the overall clinical utility of this efficacious antiparkinsonian agent. In this paper, we review the key local and systemic adverse effects reported during apomorphine titration, initiation and long-term treatment, and discuss practical management strategies...
November 27, 2016: Parkinsonism & related Disorders
https://www.readbyqxmd.com/read/27919250/the-impact-of-health-information-technologies-on-quality-improvement-methodologies-efficiency-throughput-and-financial-outcomes-a-retrospective-observational-study
#8
Raed H AlHazme, Syed S Haque, Hal Wiggin, Arif M Rana
BACKGROUND: To evaluate whether or not the utilization of Health Information Technologies (HITs) in Quality Improvement Methodologies (QIMs) has impacts on QIMs' efficiency, throughput and financial outcomes at healthcare organizations and physician practices in the United States. METHODS: This is a retrospective observational study that was conducted between the years of 2014 and 2015 and relied on two data sources: the Dorenfest Institute dataset and the Healthcare Information and Management Systems Society (HIMSS) Analytics data source...
December 5, 2016: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/27919163/isotopes-to-assess-sustainability-of-overexploited-groundwater-in-the-souss-massa-system-morocco
#9
Mohammed Hssaisoune, Lhoussaine Bouchaou, Baudelaire N'da, Mouna Malki, Houria Abahous, Alan E Fryar
Groundwater depletion and changes in isotopic and chemical contents constitute the main indicators of overexploitation, recharge, and flow paths in the Souss-Massa aquifer. These indicators highlight processes concerning sustainability of water resources in the aquifer (e.g. surface/groundwater interaction, recharge processes, and marine intrusion). The spatial variation of stable and radioactive isotopic contents indicates a mixing of modern and old water within the system. Recent recharge was observed mainly along the Souss River (the major surface-water drainage in the study area) and in the irrigated areas...
December 5, 2016: Isotopes in Environmental and Health Studies
https://www.readbyqxmd.com/read/27918873/loperamide-the-poor-man-s-methadone-brief-review
#10
Cornel N Stanciu, Samantha A Gnanasegaram
Loperamide is widely available as an inexpensive, over-the-counter remedy commonly used for management of diarrhea. Although an opioid, at therapeutic doses it acts primarily on the gastrointestinal tissues; however, larger than recommended amounts facilitate central nervous system (CNS) penetration. Such high doses of loperamide have recently gained popularity among users of opioids to manage withdrawal symptomatology and, less frequently, to achieve psychoactive effects. Chronic loperamide use can result in development of tolerance and, upon abrupt cessation of use, withdrawal...
December 5, 2016: Journal of Psychoactive Drugs
https://www.readbyqxmd.com/read/27918336/resident-physicians-improve-nontechnical-skills-when-on-operating-room-management-and-leadership-rotation
#11
Devon C Cole, Christopher R Giordano, Terrie Vasilopoulos, Brenda G Fahy
BACKGROUND: Anesthesiology residency primarily emphasizes the development of medical knowledge and technical skills. Yet, nontechnical skills (NTS) are also vital to successful clinical practice. Elements of NTS are communication, teamwork, situational awareness, and decision making. METHODS: The first 10 consecutive senior residents who chose to participate in this 2-week elective rotation of operating room (OR) management and leadership training were enrolled in this study, which spanned from March 2013 to March 2015...
December 1, 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27918231/a-3d-assessment-and-feedback-tool-for-ankylosing-spondylitis-from-the-perspective-of-healthcare-professionals
#12
Shijuan Li, Stephen Kay, Stuart Porter
To investigate the utility of 3D visualization technology to augment assessment and feedback for Ankylosing Spondylitis (AS), a visualization prototype was developed, and both subjective and objective measures of current assessment instruments were compared. To verify and establish a base-line for the prototype's effectiveness, motion data and measurement data from a healthy adult in a laboratory environment were collected. To validate the prototype, a qualitative evaluation was undertaken using multiple methods including a pilot study, focus groups, and individual interviews...
December 5, 2016: Informatics for Health & Social Care
https://www.readbyqxmd.com/read/27917975/central-asia-kyrgyzstan-and-the-learning-experience-in-the-design-of-pastoral-institutions
#13
U Kasymov, A Undeland, A Dörre, A Mackinnon
The authors analyse the nature of policy development to understand the reasons for institutional change in pasture management in Kyrgyzstan. They use the concept of intentional institutional change, emphasising its incremental nature and the important relationship between belief systems and institutions. The paper explores the relationship between the perceptions and beliefs of policy-makers, the policy interventions they undertake, and the consequences for pastoral migration and practices. The study reveals the gap between the intentions behind such policies and their outcomes, the persistence and importance of pastoral migration, and the learning process that policy-makers undergo...
November 2016: Revue Scientifique et Technique
https://www.readbyqxmd.com/read/27917532/do-women-have-a-choice-care-providers-and-decision-makers-perspectives-on-barriers-to-access-of-health-services-for-birth-after-a-previous-cesarean
#14
Sarah Munro, Jude Kornelsen, Kitty Corbett, Elizabeth Wilcox, Nick Bansback, Patricia Janssen
BACKGROUND: Repeat cesarean delivery is the single largest contributor to the escalating cesarean rate worldwide. Approximately 80 percent of women with a past cesarean are candidates for vaginal birth after a cesarean (VBAC), but in Canada less than one-third plan VBAC. Emerging evidence suggests that these trends may be due in part to nonclinical factors, including care provider practice patterns and delays in access to surgical and anesthesia services. This study sought to explore maternity care providers' and decision makers' attitudes toward and experiences with providing and planning services for women with a previous cesarean...
December 5, 2016: Birth
https://www.readbyqxmd.com/read/27916252/knowledge-of-managing-avulsed-tooth-among-general-dental-practitioners-in-malaysia
#15
Dalia Abdullah, Suet Yeo Soo, Shalini Kanagasingam
BACKGROUND: Dental and maxillofacial injuries are one of the areas of concern highlighted in the Malaysian National Oral Health Plan 2011-2020. General dental practitioners (GDPs) have the responsibility of diagnosing and assessing dental trauma and determining the prognosis and outcomes of trauma along with its management. The purpose of this study was to evaluate the knowledge base and preferred methods of general dental practitioners regarding the management of avulsed tooth. METHODS: A random convenient sampling methodology was employed for sample selection...
December 2016: Singapore Dental Journal
https://www.readbyqxmd.com/read/27916174/management-of-para-aortic-lymph-node-metastasis-in-colorectal-patients-a-systemic-review
#16
REVIEW
J S M Wong, G H C Tan, M C C Teo
INTRODUCTION: Para-aortic lymph node (PALN) involvement occurs in up to 2% of colorectal cancer (CRC) patients. While resection for isolated hepatic and pulmonary metastases in colorectal cancer is standard practice, the role of PALN dissection (PALND) in CRC has not been established and remains a controversy. We aim to perform a systematic review of the literature to determine if extensive lymphadenectomy improves survival, and is an acceptable strategy for PALN metastasis (PALNM). MATERIALS AND METHODS: A systematic search of PubMed and Embase databases for studies reporting on patients with isolated PALNM in CRC was performed...
December 2016: Surgical Oncology
https://www.readbyqxmd.com/read/27915100/synergistic-effect-of-biogenic-fe-3-coupled-to-s%C3%A2-oxidation-on-simultaneous-bioleaching-of-cu-co-zn-and-as-from-hazardous-pyrite-ash-waste
#17
Sandeep Panda, Ata Akcil, Srabani Mishra, Ceren Erust
Pyrite ash, a waste by-product formed during roasting of pyrite ores, is a good source of valuable metals. The waste is associated with several environmental issues due to its dumping in sea and/or land filling. Although several other management practices are available for its utilization, the waste still awaits and calls for an eco-friendly biotechnological application for metal recovery. In the present study, chemolithotrophic meso-acidophilic iron and sulphur oxidisers were evaluated for the first time towards simultaneous mutli-metal recovery from pyrite ash...
November 19, 2016: Journal of Hazardous Materials
https://www.readbyqxmd.com/read/27914816/clinical-approach-used-in-medical-consultations-for-allergic-like-events-following-immunization-case-series-report-in-relation-to-practice-guidelines
#18
Joseline G Zafack, Gaston De Serres, Isabelle Rouleau, Marie-Claude Gariépy, Rémi Gagnon, Jean-Philippe Drolet, Danuta M Skowronski
BACKGROUND: The Joint Task Force on Practice Parameters (JTFPP) guidelines for the investigation and reimmunization of patients who experienced allergic-like events (ALEs) after immunization are predicated on the likelihood of anaphylaxis, assessed through the time to symptom onset (≤ or >4 hours) and number of systems involved. OBJECTIVE: The objectives of this study were to compare the management of a series of patients with ALE in actual practice relative to JTFPP guidelines and to discuss key concepts and considerations in their use...
November 30, 2016: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/27914632/the-us-food-and-drug-administration-s-risk-evaluation-and-mitigation-strategy-rems-program-current-status-and-future-direction
#19
Jasmanda Wu, Juhaeri Juhaeri
The US Food and Drug Administration (FDA) Amendments Act of 2007 granted the FDA new authorities to enhance drug safety by requiring application holders to submit a proposed Risk Evaluation and Mitigation Strategy (REMS). A REMS is a required risk management plan that uses tools beyond the package insert. REMS elements may include a medication guide and patient package insert for patients and a communication plan focused on health care professionals. Elements to assure safe use (ETASUs) are put in place to mitigate a specific known serious risk when other less restrictive elements of a REMS are not sufficient to mitigate such risk...
November 30, 2016: Clinical Therapeutics
https://www.readbyqxmd.com/read/27912776/improving-stroke-prevention-therapy-for-patients-with-atrial-fibrillation-in-primary-care-protocol-for-a-pragmatic-cluster-randomized-trial
#20
Theresa M Lee, Noah M Ivers, Sacha Bhatia, Debra A Butt, Paul Dorian, Liisa Jaakkimainen, Kori Leblanc, Dan Legge, Dante Morra, Alissia Valentinis, Laura Wing, Jacqueline Young, Karen Tu
BACKGROUND: The prevalence of atrial fibrillation (AF) is growing as the population ages, and at least 15% of ischemic strokes are attributed to AF. However, many high-risk AF patients are not offered guideline-recommended stroke prevention therapy due to a variety of system, provider, and patient-level barriers. METHODS: We will conduct a pragmatic, cluster-randomized controlled trial randomizing primary care clinics to test a "toolkit" of quality improvement interventions in primary care...
December 3, 2016: Implementation Science: IS
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