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https://www.readbyqxmd.com/read/28110382/economic-evaluations-alongside-efficient-study-designs-using-large-observational-datasets-the-pleasant-trial-case-study
#1
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
#2
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
#3
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
#4
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
https://www.readbyqxmd.com/read/28100979/late-cardiac-rupture-after-amplatzer-septal-occluder-implantation
#5
Ahmet Arnaz, Yasemin Turkekul, Yusuf Yalcinbas, Arda Saygili, Tayyar Sarioglu
Transcatheter device implantation has become an attractive alternative to surgery in the closure of atrial septal defects in selected patients. However, it can lead to early and late sequelae, some of them life threatening. For example, 79 days before her admission to our emergency department with sudden-onset respiratory distress and respiratory arrest (leading to cardiac tamponade and rupture), a 22-year-old woman had undergone percutaneous closure of an atrial septal defect. We describe the damage and its treatment...
December 2016: Texas Heart Institute Journal
https://www.readbyqxmd.com/read/28097793/living-with-cardiac-resynchronization-therapy-challenges-for-people-with-heart-failure
#6
Shadi Dehghanzadeh, Nahid Dehghan Nayeri, Shokoh Varaei, Jalal Kheirkhah
The number of people with heart failure requiring implantation of a cardiac resynchronization device is increasing in Iran. Although this intervention is an effective life-saving treatment, several challenges are associated with patients' lifestyle after insertion. This study identified the challenges and coping mechanisms of Iranians with heart failure living with cardiac resynchronization therapy. A qualitative approach using conventional content analysis was adopted. Seventeen people with heart failure and three nurses were recruited between December 2014 and November 2015 from a teaching hospital and a private clinic in Rasht, Iran...
January 18, 2017: Nursing & Health Sciences
https://www.readbyqxmd.com/read/28086975/a-qualitative-study-of-women-s-and-health-providers-attitudes-and-acceptability-of-mistreatment-during-childbirth-in-health-facilities-in-guinea
#7
Mamadou Diouldé Balde, Abou Bangoura, Boubacar Alpha Diallo, Oumar Sall, Habibata Balde, Aïssatou Sona Niakate, Joshua P Vogel, Meghan A Bohren
BACKGROUND: Reducing maternal morbidity and mortality remains a key health challenge in Guinea. Anecdotal evidence suggests that women in Guinea are subjected to mistreatment during childbirth in health facilities, but limited research exists on this topic. This study was conducted to better understand the social norms and the acceptability of four scenarios of mistreatment during childbirth, from the perspectives of women and service providers. METHODS: This study used qualitative methods including in-depth interviews (IDIs) and focus group discussions (FGDs) with women of reproductive age, midwives, nurses and doctors...
January 13, 2017: Reproductive Health
https://www.readbyqxmd.com/read/28075544/the-impact-of-type%C3%A2-2-diabetes-prevention-programmes-based-on-risk-identification-and-lifestyle-intervention-intensity-strategies-a-cost-effectiveness-analysis
#8
P R Breeze, C Thomas, H Squires, A Brennan, C Greaves, P J Diggle, E Brunner, A Tabak, L Preston, J Chilcott
AIMS: To develop a cost-effectiveness model to compare Type 2 diabetes prevention programmes targeting different at-risk population subgroups with a lifestyle intervention of varying intensity. METHODS: An individual patient simulation model was constructed to simulate the development of diabetes in a representative sample of adults without diabetes from the UK population. The model incorporates trajectories for HbA1c , 2-h glucose, fasting plasma glucose, BMI, systolic blood pressure, total cholesterol and HDL cholesterol...
January 11, 2017: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/28075507/labour-induction-near-term-for-women-aged-35-or-over-an-economic-evaluation
#9
Kate F Walker, Melina Dritsaki, George Bugg, Marion Macpherson, Carol McCormick, Nicky Grace, Chris Wildsmith, Lucy Bradshaw, Gordon Cs Smith, James G Thornton
OBJECTIVE: Induction of labour at 39 weeks for nulliparous women aged 35 years and over may prevent stillbirths and does not increase caesarean births, so it may be popular. But the overall costs and benefits of such a policy have not been compared. DESIGN: A cost-utility analysis alongside a randomised controlled trial (the 35/39 trial). SETTING: Obstetric departments of 38 UK National Health Service hospitals and one UK primary care trust...
January 11, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28073749/cost-effectiveness-of-a-government-supported-policy-strategy-to-decrease-sodium-intake-global-analysis-across-183-nations
#10
Michael Webb, Saman Fahimi, Gitanjali M Singh, Shahab Khatibzadeh, Renata Micha, John Powles, Dariush Mozaffarian
OBJECTIVE:  To quantify the cost effectiveness of a government policy combining targeted industry agreements and public education to reduce sodium intake in 183 countries worldwide. DESIGN:  Global modeling study. SETTING:  183 countries. POPULATION:  Full adult population in each country. INTERVENTION:  A "soft regulation" national policy that combines targeted industry agreements, government monitoring, and public education to reduce population sodium intake, modeled on the recent successful UK program...
January 10, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28068945/why-women-bleed-and-how-they-are-saved-a-cross-sectional-study-of-caesarean-section-near-miss-morbidity
#11
S Maswime, E J Buchmann
BACKGROUND: Maternal deaths from 'bleeding during and after caesarean section' (BDACS) have increased in South Africa, and have now become the largest sub-cause of deaths from obstetric haemorrhage. The aim of this study was to describe risk factors and causes of near-miss related to BDACS and interventions used to arrest haemorrhage and treat its effects. METHODS: Cross-sectional prospective study in 13 urban public hospitals in South Africa, from July to December 2014...
January 9, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28064212/impact-of-a-critical-health-workforce-shortage-on-child-health-in-zimbabwe-a-country-case-study-on-progress-in-child-survival-2000-2013
#12
Connie A Haley, Sten H Vermund, Precious Moyo, Aaron M Kipp, Bernard Madzima, Trevor Kanyowa, Teshome Desta, Kasonde Mwinga, Marie A Brault
Despite notable progress reducing global under-five mortality rates, insufficient progress in most sub-Saharan African nations has prevented the achievement of Millennium Development Goal four (MDG#4) to reduce under-five mortality by two-thirds between 1990 and 2015. Country-level assessments of factors underlying why some African countries have not been able to achieve MDG#4 have not been published. Zimbabwe was included in a four-country study examining barriers and facilitators of under-five survival between 2000 and 2013 due to its comparatively slow progress towards MDG#4...
January 7, 2017: Health Policy and Planning
https://www.readbyqxmd.com/read/28058487/fetal-surgery-a-critical-review
#13
REVIEW
H Kitagawa, K C Pringle
Therapeutic fetal surgical procedures are predicated upon the ability to make an accurate fetal diagnosis. The earliest open fetal surgical procedures were introduced in the 1960s to treat Rh isoimmunisation. They were introduced when it became possible to predict impending fetal demise. Open procedures were abandoned when percutaneous approaches proved superior. The introduction of fetal ultrasound allowed the diagnosis of other congenital anomalies, some being amenable to fetal interventions. Open fetal surgical procedures were initially utilised, with significant maternal morbidity...
January 5, 2017: Pediatric Surgery International
https://www.readbyqxmd.com/read/28057111/-health-economic-evaluation-of-a-23-value-pneumococcal-polysaccharide-vaccination-pilot-programme-among-elderly-chronic-obstructive-pulmonary-disease-patients-in-china
#14
Y P Qiu, K Zhao, X Li, L W Shi, W D Guo, X R Qi, B Y Sui, R M Zhou
Objective: From the perspective of health economics, to evaluate 23 pneumococcal polysaccharide vaccination programme among chronic obstructive pulmonary disease (COPD) patient. Methods: In the pilot counties of the project of integrated care pathway for COPD patient (Hanbin district of Hanzhong city in Shanxi Province, Qianjian district of Qingqing city, Huandao district of Qindao city in Shangdong Province, Wen county of Jiaozuo city in Henan Province), information of insurance participants of New Rural Cooperative Medical System (NRCS) was collected by local NRCM information system, which included general information as well as records of medical care and medical fee...
December 6, 2016: Zhonghua Yu Fang Yi Xue za Zhi [Chinese Journal of Preventive Medicine]
https://www.readbyqxmd.com/read/28055117/confidentiality-and-the-role-of-the-addiction-specialist-team-in-liver-transplantation-procedures-commentary-on-donnadieu-rigole-et%C3%A2-al-2016-follow-up-of-alcohol-consumption-after-liver-transplantation-interest-of-an-addiction-team
#15
Geert Dom
For patients suffering from end-stage alcoholic liver disease (ALD), liver transplantation (LT) is often the only remaining, life-saving intervention. During the last two decades the number of transplantations that have been performed in the context of ALD has being growing steadily both in the United States and Europe. For example, 30-50% of all liver transplantations in Europe are currently done for this indication (Bruha et al., 2012). This article is protected by copyright. All rights reserved.
January 5, 2017: Alcoholism, Clinical and Experimental Research
https://www.readbyqxmd.com/read/28052886/intestinal-rehabilitation-for-children-with-intestinal-failure-is-cost-effective-a-simulation-study
#16
Henk Groen, Esther G Neelis, Marten J Poley, Joanne F Olieman, René Scheenstra, Paul Fm Krabbe, Gerard Dijkstra, Edmond Hhm Rings
BACKGROUND: Children with intestinal failure (IF) depend on parenteral nutrition (PN). The goal in the treatment of IF is to wean children off PN through intestinal rehabilitation (IR). Although the healthcare burden of IF is enormous, to our knowledge there has been no previous cost-effectiveness analysis in pediatric IF including IR. OBJECTIVE: We sought to determine the cost-effectiveness of IR in terms of costs and life-years. DESIGN: We simulated the treatment of IF in children in a discrete-event model...
January 4, 2017: American Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/28049746/the-global-agenda-for-the-prevention-of-type-2-diabetes
#17
William H Herman
Diabetes represents an enormous and growing clinical and public health problem. Its financial burden is huge and growing and likely to be unsustainable. Lifestyle interventions are safe and effective for preventing diabetes, are associated with improved quality of life, and are cost-effective. Metformin is effective, safe, and cost-effective, if not cost-saving. National and international efforts are needed to identify at-risk individuals and to systematically apply these interventions. Research must focus on how best to implement diabetes prevention in diverse populations and settings...
January 2017: Nutrition Reviews
https://www.readbyqxmd.com/read/28043442/sutureless-aortic-valves-combining-the-best-or-the-worst
#18
Kareem Bedeir, Michael Reardon, Lawrence H Cohn, Basel Ramlawi
Aortic valve replacement is a life saving intervention. Significant progress has been made toward reducing surgical trauma through minimally invasive surgery and transcatheter techniques. Each of these approaches has its advantages and limitations. Sutureless aortic valves have been proposed to overcome these limitations and have been in use in Europe. It is however less than clear whether these valves will prove advantageous and whether they will have a role in the future. We review the published literature for sutureless aortic valves and their performance against standard and transcatheter aortic valve replacements...
July 2016: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28027458/altered-level-of-consciousness-evidence-based-management-in-the-emergency-department
#19
Joo Lee Song, Vincent J Wang
A child who presents to the emergency department with an altered level of consciousness can be clinically unstable and can pose a great diagnostic challenge. The emergency clinician must quickly develop a wide differential of possible etiologies in order to administer potentially life-saving medications or interventions. The history, physical examination, and appropriate diagnostic tests can aid greatly in rapidly narrowing the differential diagnosis. Once initial stabilization, workup, and first-line interventions are completed, most patients who present with unresolved or unidentified altered level of consciousness should be admitted for further evaluation and close monitoring...
January 2017: Pediatric Emergency Medicine Practice
https://www.readbyqxmd.com/read/28027338/effect-of-an-intensive-outpatient-program-to-augment-primary-care-for-high-need-veterans-affairs-patients-a-randomized-clinical-trial
#20
Donna M Zulman, Christine Pal Chee, Stephen C Ezeji-Okoye, Jonathan G Shaw, Tyson H Holmes, James S Kahn, Steven M Asch
Importance: Many organizations are adopting intensive outpatient care programs for high-need patients, yet little is known about their effectiveness in integrated systems with established patient-centered medical homes. Objective: To evaluate how augmenting the Veterans Affairs (VA) medical home (Patient Aligned Care Teams [PACT]) with an Intensive Management program (ImPACT) influences high-need patients' costs, health care utilization, and experience. Design, Setting, and Participants: Randomized clinical trial at a single VA facility...
December 27, 2016: JAMA Internal Medicine
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