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https://www.readbyqxmd.com/read/28209216/hypertrophic-cardiomyopathy-with-left%C3%A2-ventricular-apical-aneurysm-implications-for-risk-stratification-and-management
#1
Ethan J Rowin, Barry J Maron, Tammy S Haas, Ross F Garberich, Weijia Wang, Mark S Link, Martin S Maron
BACKGROUND: A previously under-recognized subset of hypertrophic cardiomyopathy (HCM) patients with left ventricular (LV) apical aneurysms is being identified with increasing frequency. However, risks associated with this subgroup are unknown. OBJECTIVES: The authors aimed to clarify clinical course and prognosis of a large cohort of HCM patients with LV apical aneurysms over long-term follow-up. METHODS: The authors retrospectively analyzed 1,940 consecutive HCM patients at 2 centers, 93 of which (4...
February 21, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28196089/taxes-and-subsidies-for-improving-diet-and-population-health-in-australia-a-cost-effectiveness-modelling-study
#2
Linda J Cobiac, King Tam, Lennert Veerman, Tony Blakely
BACKGROUND: An increasing number of countries are implementing taxes on unhealthy foods and drinks to address the growing burden of dietary-related disease, but the cost-effectiveness of combining taxes on unhealthy foods and subsidies on healthy foods is not well understood. METHODS AND FINDINGS: Using a population model of dietary-related diseases and health care costs and food price elasticities, we simulated the effect of taxes on saturated fat, salt, sugar, and sugar-sweetened beverages and a subsidy on fruits and vegetables, over the lifetime of the Australian population...
February 2017: PLoS Medicine
https://www.readbyqxmd.com/read/28181137/portoenterostomy-as-a-salvage-procedure-for-major-biliary-complications-following-hepaticojejunostomy
#3
Amit Sharma, John S Hammond, Emmanouil Psaltis, W Keith Dunn, Dileep N Lobo
Major biliary complications that require surgical intervention after hepaticojejunostomy are rare and technically challenging. While the hepaticojejunostomy can be refashioned in most patients requiring surgical reexploration after anastomotic dehiscence, a selected few may require a portoenterostomy, which involves anastomosis of the jejunum to a decapsulated area of the liver to establish a conduit from the intrahepatic bile ducts to the intestine. Herein, we describe the technique where a portoenterostomy has been used to restore bilioenteric continuity in three patients where reconstruction with a hepaticojejunostomy was not feasible...
February 8, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28174659/making-an-impakt-improving-care-of-chronic-kidney-disease-patients-in-the-community-through-collaborative-working-and-utilizing-information-technology
#4
Gang Xu, Rupert Major, David Shepherd, Nigel Brunskill
Chronic kidney disease (CKD) is a serious long-term condition, which if left untreated causes significant cardiovascular sequele. It is well recognized management of modifiable risk factors, such as blood pressure (BP), can lead to improved long-term outcomes. A novel information technology (IT) solution presents a possible solution to help clinicians in the community identify and manage at risk patients more efficiently. The IMproving Patient care and Awareness of Kidney disease progression Together (IMPAKT) IT tool was used to identify patients with CKD and uncontrolled hypertension in the community...
2017: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/28168139/video-laryngoscopy-vs-direct-laryngoscopy-in-teaching-neonatal-endotracheal-intubation-a-simulation-based-study
#5
Srikumar Nair, Eric J Thomas, Lakshmi Katakam
BACKGROUND: Neonatal endotracheal intubation is a life-saving procedural skill where best practices have been developed from expert opinion. Few empirical studies have examined how this skill should be taught. OBJECTIVE: To determine whether a video laryngoscope (VL) assisted intubation training curriculum compared to a traditional direct laryngoscope (DL) assisted curriculum improves neonatal intubation performance of novice intubators in a simulated setting. METHODS: A randomized trial of novice intubators was conducted at the University of Texas-Houston from 6/2013-8/2013...
January 6, 2017: Curēus
https://www.readbyqxmd.com/read/28168038/echocardiography-for-patients-undergoing-extracorporeal-cardiopulmonary-resuscitation-a-primer-for-intensive-care-physicians
#6
REVIEW
Zhongheng Zhang
Echocardiography is an invaluable tool in the management of patients with extracorporeal cardiopulmonary resuscitation (ECPR) and subsequent extracorporeal membrane oxygenation (ECMO) support and weaning. At the very beginning, echocardiography can identify the etiology of cardiac arrest, such as massive pulmonary embolism and cardiac tamponade. Eliminating these culprits saves life and may avoid the initiation of extracorporeal cardiopulmonary resuscitation. If the underlying causes are not identified or intrinsic to the heart (e...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28156490/the-impact-of-very-early-referral-on-the-effectiveness-of-specialty-cancer-care-management-services-for-oncology-patients-in-active-treatment
#7
Melissa Lindholm, Arthur H Rossof, Richard B Weininger, Margaret Rausa, Pamela Schumacker, Steven Hartley, Diane Richards, David Spangler, Debra Stern, J Scott Reid
: 157 Background: Many patients receiving treatment for cancer experience high levels of morbidity and reduction in quality of life. Proactive specialty cancer care management programs can be offered to patients experiencing these challenges. These patients are most often self-identified, referred by a physician, or identified by claims from a commercial or government insurer or vendor. While earlier intervention of case management or palliative care services has been shown to improve outcomes for cancer patients, a variety of logistic challenges frequently interfere with early referral...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152833/understanding-total-cost-of-cancer-care-to-determine-strategic-interventions-to-improve-value
#8
Salimah Velji, Kavita Patel, Basit Chaudhry, Sonia Grizzle, Catherine A Lyons, Rogerio Lilenbaum
: 3 Background: Cancer centers across the country are largely unprepared to move toward value-based payment. Total cost of care data is not readily available and centers do not know how much of their patients' care is received at other hospitals, when in the trajectory of illness greatest cost is incurred, or the elements of care that present the greatest opportunity for savings. A previous examination of practice patterns Smilow Cancer Hospital (SCH) demonstrated that our patients had high rates of ED visits, hospital admissions and ICU use in their last month of life...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152200/population-based-cost-offset-analyses-for-disorder-specific-treatment-of-anorexia-nervosa-and-bulimia-nervosa-in-germany
#9
Katharina Bode, Nina Maria Götz von Olenhusen, Eva-Maria Wunsch, Sören Kliem, Christoph Kröger
Previous research has shown that anorexia nervosa (AN) and bulimia nervosa (BN) are expensive illnesses to treat. To reduce their economic burden, adequate interventions need to be established. Our objective was to conduct cost-offset analyses for evidence-based treatment of eating disorders using outcome data from a psychotherapy trial involving cognitive behavioral therapy (CBT) and focal psychodynamic therapy (FPT) for AN and a trial involving CBT for BN. Assuming a currently running, ideal healthcare system using a 12-month, prevalence-based approach and varying the willingness to participate in treatment, we investigated whether the potential financial benefits of AN- and BN-related treatment outweigh the therapy costs at the population level...
February 2, 2017: International Journal of Eating Disorders
https://www.readbyqxmd.com/read/28135290/global-proteome-changes-in-the-rat-diaphragm-induced-by-endurance-exercise-training
#10
Kurt J Sollanek, Jatin G Burniston, Andreas N Kavazis, Aaron B Morton, Michael P Wiggs, Bumsoo Ahn, Ashley J Smuder, Scott K Powers
Mechanical ventilation (MV) is a life-saving intervention for many critically ill patients. Unfortunately, prolonged MV results in the rapid development of diaphragmatic atrophy and weakness. Importantly, endurance exercise training results in a diaphragmatic phenotype that is protected against ventilator-induced diaphragmatic atrophy and weakness. The mechanisms responsible for this exercise-induced protection against ventilator-induced diaphragmatic atrophy remain unknown. Therefore, to investigate exercise-induced changes in diaphragm muscle proteins, we compared the diaphragmatic proteome from sedentary and exercise-trained rats...
2017: PloS One
https://www.readbyqxmd.com/read/28134923/transforming-growth-factor-%C3%AE-1-functional-polymorphisms-in-myeloablative-sibling-hematopoietic-stem-cell-transplantation
#11
M Berro, M V Palau Nagore, M M Rivas, P Longo, C Foncuberta, A Vitriú, G Remaggi, J Martínez Rolon, G Jaimovich, A Requejo, L Feldman, K Padros, M B Rodríguez, B E Shaw, I Larripa, C B Belli, G D Kusminsky
Hematopoietic stem cell transplantation (HSCT) with sibling donors (s.d.) is a life-saving intervention for patients with hematological malignancies. Numerous genetic factors have a role in transplant outcome. Several functional polymorphisms have been identified in TGF-β1 gene, such as single-nucleotide polymorphism (SNP) at +29C>T within exon 1. Two hundred and forty five patient/donor pairs who underwent a s.d. HSCT in our centers were genotyped for this SNP. In the myeloablative cohort, +29CC donors were associated with an increase in severe chronic GvHD (32% vs 16%, hazard ratio (HR) 9...
January 30, 2017: Bone Marrow Transplantation
https://www.readbyqxmd.com/read/28131484/major-incident-triage-derivation-and-comparative-analysis-of-the-modified-physiological-triage-tool-mptt
#12
James Vassallo, John Beavis, Jason E Smith, Lee A Wallis
BACKGROUND: Triage is a key principle in the effective management at a major incident. There are at least three different triage systems in use worldwide and previous attempts to validate them, have revealed limited sensitivity. Within a civilian adult population, there has been no work to develop an improved system. METHODS: A retrospective database review of the UK Joint Theatre Trauma Registry was performed for all adult patients (>18years) presenting to a deployed Military Treatment Facility between 2006 and 2013...
January 23, 2017: Injury
https://www.readbyqxmd.com/read/28127941/multidisciplinary-managed-care-networks-life-saving-interventions-for-hepatitis-c-patients
#13
J M Tait, H Wang, B P Stephens, M Miller, P G McIntyre, S Cleary, J F Dillon
Successful hepatitis C virus (HCV) therapy depends on effective pathways of care. Over two decades, we have developed four sequential models of care latterly using a multidisciplinary managed care network to improve HCV testing, care and treatment. This was a cohort study to evaluate the effectiveness of care pathways, carried out using all HCV antibody-positive individuals tested in a geographical region between 1994 and 2014. The study involved 3122 HCV-positive patients. They were divided into four subgroups representing different care pathways defined by their date of HCV antibody diagnosis...
March 2017: Journal of Viral Hepatitis
https://www.readbyqxmd.com/read/28127487/spontaneous-rupture-of-a-leiomyoma-causing-life-threatening-intra-abdominal-hemorrhage
#14
Melissa Schwartz, Kristin Powell
Background. Uterine fibroids are common benign tumors in women. Clinical manifestations are well known. Acute complications necessitating emergent surgical intervention are rare. Case. We report a case of a 53-year-old woman with a history of uterine fibroids presenting with acute-onset severe abdominal pain. Imaging indicated massive free fluid and a large partially solid uterine mass. Vitals were consistent with hypovolemic shock. Examination revealed a surgical abdomen. She underwent an emergent laparotomy and total hysterectomy...
2017: Case Reports in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28122592/barriers-and-enablers-of-health-system-adoption-of-kangaroo-mother-care-a-systematic-review-of-caregiver-perspectives
#15
Emily R Smith, Ilana Bergelson, Stacie Constantian, Bina Valsangkar, Grace J Chan
BACKGROUND: Despite improvements in child survival in the past four decades, an estimated 6.3 million children under the age of five die each year, and more than 40% of these deaths occur in the neonatal period. Interventions to reduce neonatal mortality are needed. Kangaroo mother care (KMC) is one such life-saving intervention; however it has not yet been fully integrated into health systems around the world. Utilizing a conceptual framework for integration of targeted health interventions into health systems, we hypothesize that caregivers play a critical role in the adoption, diffusion, and assimilation of KMC...
January 25, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28114182/economic-evaluation-of-an-implementation-strategy-for-the-management-of-low-back-pain-in-general-practice
#16
Cathrine Elgaard Jensen, Allan Riis, Karin Dam Petersen, Martin Bach Jensen, Kjeld Møller Pedersen
In connection with the publication of a clinical practice guideline on the management of low back pain (LBP) in general practice in Denmark, a cluster randomised controlled trial was carried out. In this trial, a multifaceted guideline implementation strategy to improve general practitioners' treatment of LBP patients was compared with a usual implementation strategy. The aim was to determine whether the multifaceted strategy was cost-effective, as compared with the usual implementation strategy. The economic evaluation was conducted as a cost-utility analysis where cost collected from a societal perspective and quality-adjusted life years (QALY) were used as outcome measures...
January 18, 2017: Pain
https://www.readbyqxmd.com/read/28110382/economic-evaluations-alongside-efficient-study-designs-using-large-observational-datasets-the-pleasant-trial-case-study
#17
Matthew Franklin, Sarah Davis, Michelle Horspool, Wei Sun Kua, Steven Julious
BACKGROUND: Large observational datasets such as Clinical Practice Research Datalink (CPRD) provide opportunities to conduct clinical studies and economic evaluations with efficient designs. OBJECTIVES: Our objectives were to report the economic evaluation methodology for a cluster randomised controlled trial (RCT) of a UK NHS-delivered public health intervention for children with asthma that was evaluated using CPRD and describe the impact of this methodology on results...
January 21, 2017: PharmacoEconomics
https://www.readbyqxmd.com/read/28104273/physiologically-based-predictive-analytics-using-the-heart-rate-to-systolic-ratio-significantly-improves-the-timeliness-and-accuracy-of-sepsis-prediction-compared-to-sirs
#18
Omar K Danner, Sandra Hendren, Ethel Santiago, Brittany Nye, Prasad Abraham
BACKGROUND: Enhancing the efficiency of diagnosis and treatment of severe sepsis by using physiologically-based, predictive analytical strategies has not been fully explored. We hypothesize assessment of heart-rate-to-systolic-ratio significantly increases the timeliness and accuracy of sepsis prediction after emergency department (ED) presentation. METHODS: We evaluated the records of 53,313 ED patients from a large, urban teaching hospital between January and June 2015...
January 7, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28103836/rapid-reduction-of-maternal-mortality-in-uganda-and-zambia-through-the-saving-mothers-giving-life-initiative-results-of-year-1-evaluation
#19
Florina Serbanescu, Howard I Goldberg, Isabella Danel, Tadesse Wuhib, Lawrence Marum, Walter Obiero, James McAuley, Jane Aceng, Ewlyn Chomba, Paul W Stupp, Claudia Morrissey Conlon
BACKGROUND: Achieving maternal mortality reduction as a development goal remains a major challenge in most low-resource countries. Saving Mothers, Giving Life (SMGL) is a multi-partner initiative designed to reduce maternal mortality rapidly in high mortality settings through community and facility evidence-based interventions and district-wide health systems strengthening that could reduce delays to appropriate obstetric care. METHODS: An evaluation employing multiple studies and data collection methods was used to compare baseline maternal outcomes to those during Year 1 in SMGL pilot districts in Uganda and Zambia...
January 19, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28101360/successful-treatment-of-anti-nmda-receptor-encephalitis-with-a-prompt-ovarian-tumour-removal-and-prolonged-course-of-plasmapheresis-a-case-report
#20
Elzbieta Rypulak, Michal Borys, Pawel Piwowarczyk, Magdalena Fijalkowska, Beata Potrec, Justyna Sysiak, Janusz Spustek, Alicja Bartkowska-Sniatkowska, Jan Kotarski, Waldemar A Turski, Konrad Rejdak, Miroslaw Czuczwar
Anti-N-methyl-d-aspartate-receptor (NMDAR) encephalitis is an uncommon autoimmune disorder with a wide spectrum of neuropsychiatric symptoms. There is a great requirement to emphasize the importance of a multidisciplinary team approach in the process of diagnosis and treatment of the potentially fatal condition, including psychiatrists, neurologists, gynaecologists and intensivists. Physicians must be aware that psychiatric and neurological disorders, which are typical features for NMDAR encephalitis in young women with ovarian tumours, may progress into status epilepticus and respiratory insufficiency...
December 2016: Molecular and Clinical Oncology
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