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https://www.readbyqxmd.com/read/29454124/brainstem-dose-constraints-in-non-isometric-radiosurgical-treatment-planning-of-trigeminal-neuralgia-a-single-institution-experience
#1
Michael Zhang, Layton A Lamsam, Matthew K Schoen, Swapnil S Mehta, Geoffrey Appelboom, John K Adler, Scott G Soltys, Steven D Chang
INTRODUCTION: CyberKnife stereotactic radiosurgery (SRS) for trigeminal neuralgia (TGN) administers non-isometric, conformational high-dose radiation to the trigeminal nerve with risk of subsequent hypoesthesia. METHODS: We performed a retrospective, single-institution review of 66 TGN patients, treated by CyberKnife, to compare outcomes from two distinct treatment periods (standard dosing, N = 38 and reduced dosing, N = 28). Standard and reduced dosing permitted a maximum brainstem dose of 45 Gy and 25 Gy, respectively, each with a prescription dose of 60 Gy...
February 14, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29453838/from-cba-to-precautionary-appraisal-practical-responses-to-intractable-problems
#2
Andrew Stirling, Josie Coburn
The purpose of this essay is to critically review the design of methods for ethically robust forms of technology appraisal in the regulation of research and innovation in synthetic biology. It will focus, in particular, on the extent to which cost-benefit analysis offers a basis for informing decisions about which technological pathways to pursue and which to discourage. A further goal is to consider what (if anything) the precautionary principle might offer in enabling better decisions. And this, in turn, raises questions about why mention of precaution can excite accusations of unscientific bias or irrational, "anti-innovation" extremism...
January 2018: Hastings Center Report
https://www.readbyqxmd.com/read/29453677/changes-in-medicine-prescription-following-a-medication-review-in-older-high-risk-patients-with-polypharmacy
#3
Marian Z M Hurmuz, Sarah I M Janus, Jeannette G van Manen
Background The more (inappropriate) drugs a patient uses, the higher the risk of drug related problems. To reduce these risks, medication reviews can be performed. Objective To report changes in the prescribed number of (potentially inappropriate) drugs before and after performing a medication review in high-risk polypharmacy patients. A secondary objective was to study reasons for continuing potentially inappropriate drugs (PIDs). Setting Dutch community pharmacy and general medical practice. Methods A retrospective longitudinal intervention study with a pre-test/post-test design and follow-up of 1 week and 3 months was performed...
February 17, 2018: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/29453393/adherence-to-antiretroviral-therapy-and-factors-affecting-low-medication-adherence-among-incident-hiv-infected-individuals-during-2009-2016-a-nationwide-study
#4
Jungmee Kim, Eunyoung Lee, Byung-Joo Park, Ji Hwan Bang, Jin Yong Lee
For ideal clinical benefit, human immunodeficiency virus (HIV)-infected individuals should receive continuous medication. This is the first nationwide antiretroviral therapy (ART) adherence study in Asia, where medication monitoring at national level is systemically available. We estimated the ART adherence of incident HIV-infected individuals and investigated factors affecting low medication adherence using the national health insurance (NHI) claims data from 2007 to 2016. Medication possession ratio (MPR) was used to measure medication adherence and risk factors were identified by multivariable logistic regression analysis...
February 16, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29453287/adoption-of-sacubitril-valsartan-for-the-management-of-patients-with-heart-failure
#5
Lindsey R Sangaralingham, S Jeson Sangaralingham, Nilay D Shah, Xiaoxi Yao, Shannon M Dunlay
BACKGROUND: The US Food and Drug Administration approved the use of sacubitril/valsartan in patients with heart failure with reduced ejection fraction in July 2015. We aimed to assess the adoption and prescription drug costs of sacubitril/valsartan in its first 18 months after Food and Drug Administration approval. METHODS AND RESULTS: Using a large US insurance database, we identified privately insured and Medicare Advantage beneficiaries who filled a first prescription for sacubitril/valsartan between July 1, 2015, and December 31, 2016...
February 2018: Circulation. Heart Failure
https://www.readbyqxmd.com/read/29453016/metabolic-profiling-of-gegenqinlian-decoction-in-rat-plasma-urine-bile-and-feces-after-oral-administration-by-ultra-high-performance-liquid-chromatography-coupled-with-fourier-transform-ion-cyclotron-resonance-mass-spectrometry
#6
Ting Liu, Xiumin Tian, Zhaoqin Li, Fei Han, Bin Ji, Yunli Zhao, Zhiguo Yu
Gegenqinlian decoction (GQLD) as a traditional Chinese medical (TCM) prescription is made from four Chinese herbs and has been used for centuries to treat pyrexia and diarrhea. In this work, an ultra-high performance liquid chromatography coupled with Fourier transform ion cyclotron resonance mass spectrometry (UHPLC-FT-ICR-MS) method was established to profile the metabolic fate of GQLD in rat plasma, urine, bile and feces. The analysis was performed on a Waters Acquity UPLC HSS T3 column (2.1 mm × 100 mm, 1...
February 6, 2018: Journal of Chromatography. B, Analytical Technologies in the Biomedical and Life Sciences
https://www.readbyqxmd.com/read/29453006/illicit-and-prescription-drug-misuse-as-reported-to-the-maine-diversion-alert-program
#7
Brian J Piper, Michael J Suarez, John P Piserchio, Dipam T Shah, Olapeju M Simoyan, Kenneth L McCall, Clare E Desrosiers, Stephanie D Nichols
BACKGROUND: The opioid epidemic is rapidly evolving and new tools are needed to combat drug abuse. The Maine Diversion Alert Program (DAP) is an informational resource that facilitates communication about drug arrests between the criminal justice and healthcare fields. The objectives of this report were to: (1) describe the illegal and prescription pharmaceuticals reported to the DAP; (2) determine if the drugs implicated in arrests changed from the first to latter half of 2016; (3) identify the demographic and other characteristics of arrestees; and (4) outline the strengths and limitations of the DAP for other areas considering implementing similar programs...
February 6, 2018: Forensic Science International
https://www.readbyqxmd.com/read/29452972/does-preoperative-opioid-use-increase-the-risk-of-early-revision-total-hip-arthroplasty
#8
Nicholas A Bedard, David E DeMik, S Blake Dowdle, Jessell M Owens, Steve S Liu, John J Callaghan
BACKGROUND: The purpose of this study is to evaluate the impact of preoperative opioid use on the risk of subsequent revison after primary total hip arthroplasty (THA). METHODS: The Humana database was queried for unilateral THA between 2007-2015. Patients were tracked for the occurrence of an ipsilateral revision THA for 2. Factors analyzed included preoperative opioid use (defined as a history of opioid prescription filled within 3 months preceding primary THA), age, sex, diabetes, anxiety/depression, chronic kidney disease, and obesity (body mass index > 30 kg/m 2 )...
February 13, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29452865/stereotactic-radiosurgery-for-multiple-brain-metastases-results-of-multicenter-benchmark-planning-studies
#9
David J Eaton, Jonathan Lee, Ian Paddick
PURPOSE: Stereotactic radiosurgery is indicated for treatment of multiple brain metastases. Various treatment platforms are available, but most comparisons are limited to single-center studies. As part of a national commissioning program, benchmark planning cases were completed by 21 clinical centers, providing a unique dataset of current practice across a large number of providers and equipment platforms. METHODS AND MATERIALS: Two brain metastases cases were provided, with images and structures predrawn, involving 3 and 7 lesions...
December 30, 2017: Practical Radiation Oncology
https://www.readbyqxmd.com/read/29452743/medication-wasted-contents-and-costs-of-medicines-ending-up-in-household-garbage
#10
Sabine Vogler, Roger H P F de Rooij
BACKGROUND: Despite potentially considerable implications for public health, the environment and public funds, medicine waste is an under-researched topic. This study aims to analyse medicines drawn from household garbage in Vienna (Austria) and to assess possible financial implications for public payers. METHODS: Four pharmaceutical waste samples collected by the Vienna Municipal Waste Department between April 2015 and January 2016 were investigated with regard to their content...
February 10, 2018: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/29452704/substance-use-disorder-among-current-cancer-patients-rates-and-correlates-nationally-in-the-department-of-veterans-affairs
#11
Pochu Ho, Robert Rosenheck
BACKGROUND: Substance use disorders (SUDs) are known to cause or complicate treatment of many types of cancers. OBJECTIVES: We sought to systematically assess rates of current SUDs among patients currently in treatment for cancer. METHODS: The National Veteran Health Administration administrative data from fiscal year 2012 were used to compare veterans with both cancer and comorbid SUDs to veterans with cancer but no SUDs and those with a SUD but no cancer...
January 10, 2018: Psychosomatics
https://www.readbyqxmd.com/read/29452691/recurrent-cardiovascular-events-in-survivors-of-myocardial-infarction-with-st-segment-elevation-from-the-ami-quebec-study
#12
Thao Huynh, Martine Montigny, Umair Iftikhar, Roxanne Gagnon, Mark Eisenberg, Claude Lauzon, Samer Mansour, Stephane Rinfret, Marc Afilalo, Michel Nguyen, Simon Kouz, Jean-Pierre Déry, Richard Harvey, Robert De LaRocheliere, Bernard Cantin, Eerick Schampaert, Jean-Claude Tardif
The characteristics and predictors of long-term recurrent ischemic cardiovascular events (RICEs) after myocardial infarction with ST-segment elevation (STEMI) have not yet been clarified. We aimed to characterize the 10-year incidence, types, and predictors of RICE. We obtained 10-year follow-up of STEMI survivors at 17 Quebec hospitals in Canada (the AMI-QUEBEC Study) in 2003. There were 858 patients; mean age was 60 years and 73% were male. The majority of patients receive reperfusion therapy; 53.3% and 39...
January 31, 2018: American Journal of Cardiology
https://www.readbyqxmd.com/read/29452560/health-care-efficiencies-consolidation-and-alternative-models-vs-health-care-and-antitrust-regulation-irreconcilable-differences
#13
Michael W King
Despite the U.S. substantially outspending peer high income nations with almost 18% of GDP dedicated to health care, on any number of statistical measurements from life expectancy to birth rates to chronic disease, 1 the U.S. achieves inferior health outcomes. In short, Americans receive a very disappointing return on investment on their health care dollars, causing economic and social strain. 2 Accordingly, the debates rage on: what is the top driver of health care spending? Among the culprits: poor communication and coordination among disparate providers, paperwork required by payors and regulations, well-intentioned physicians overprescribing treatments, drugs and devices, outright fraud and abuse, and medical malpractice litigation...
November 2017: American Journal of Law & Medicine
https://www.readbyqxmd.com/read/29452135/evidence-based-exercise-recommendations-to-reduce-hepatic-fat-content-in-youth-a-systematic-review-and-meta-analysis
#14
REVIEW
María Medrano, Cristina Cadenas-Sanchez, Celia Álvarez-Bueno, Iván Cavero-Redondo, Jonatan R Ruiz, Francisco B Ortega, Idoia Labayen
The main purposes of this study were to elucidate the effects of supervised-exercise training (ET) interventions on hepatic fat content and on non-alcoholic fatty liver disease (NAFLD) prevalence in children and adolescents and to provide information about the optimal ET prescription (type, intensity, volume, and frequency) needed to reduce hepatic fat content in youths. Supervised-ET interventions performed in children and adolescents (6-19 years) that provided results of exercise effects on hepatic fat content or NAFLD prevalence were included...
February 13, 2018: Progress in Cardiovascular Diseases
https://www.readbyqxmd.com/read/29452065/past-year-nonmedical-use-of-prescription-drugs-among-women-on-probation-and-parole-a-cross-sectional-study
#15
Martin T Hall, Diana Ball, Jeanelle Sears, George E Higgins, T K Logan, Seana Golder
BACKGROUND: Prescription drug-related overdose deaths have increased dramatically in recent years. Women in the justice system experience high rates of drug use, victimization, trauma symptoms, and other health problems, and would appear to be at high risk for nonmedical use of prescription drugs (NMUPD). This study will be among the first to describe prevalence and correlates of NMUPD among this population. METHODS: This cross-sectional study collected data from 406 victimized women on probation and parole between 2010 and 2012...
February 16, 2018: Substance Abuse
https://www.readbyqxmd.com/read/29451948/duration-of-maternal-mental-health-related-outcomes-after-an-infant-s-death-a-retrospective-matched-cohort-study-using-linkable-administrative-data
#16
Elizabeth Wall-Wieler, Leslie L Roos, James Bolton
BACKGROUND: Mothers have increased mental illness such as anxiety and depression after the death of a child. We examine the duration of this worsening of mental health. METHODS: The mental health of all mothers who experience the death of an infant (< 1 years old) in Manitoba, Canada between April 1, 1999 and March 31, 2011 (n = 534) is examined in the 4 years leading up to, and the 4 years following, the death of their child. Mental health-related outcomes of these mothers are compared with a matched (3:1) cohort of mothers who did not experience the death of a child (n = 1,602)...
February 16, 2018: Depression and Anxiety
https://www.readbyqxmd.com/read/29451672/predictors-of-persistent-prescription-opioid-analgesic-use-among-people-without-cancer-in-australia
#17
Samanta Lalic, Natasa Gisev, J Simon Bell, Maarit Jaana Korhonen, Jenni Ilomäki
AIMS: To identify patterns of opioid analgesic use and determine predictors of persistent opioid use among people without cancer. METHODS: A population-based cohort study of Australians initiating prescription opioids from July 2013 to December 2015 was conducted using data from a random 10% sample of people who accessed medicines through Australia's Pharmaceutical Benefits Scheme. A 12-month look-back period was used to define opioid initiation, exclude people with cancer, and determine comorbidities...
February 16, 2018: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29451507/-appropriateness-in-cardiology-a-statement-of-the-anmco-veneto-region
#18
Guerrino Zuin, Gianfranco Frigo, Loris Roncon, Aldo Bonso, Emanuele Carbonieri, Fabio Chirillo, Fabio De Conti, Pietro Delise, Alessandro Desideri, Daniele D'Este, Loredano Milani, Roberto Valle, Claudio Bilato
Inappropriate tests are responsible for longer waiting lists, higher economical costs for the National Health System and major clinical risks due to radiation exposure from prescription abuse of diagnostic testing. Clinical inappropriateness frequently derives from poor knowledge of guidelines, "defensive medicine" approach and/or repeat requests of patients and family members. About one third of non-invasive imaging tests are considered inappropriate.In order to define the most appropriate instruments for the follow-up of the most common cardiovascular diseases with the highest risk of inappropriateness, all the cardiologists of the Veneto Region (Italy), along with the local chapters of the main national cardiology societies and general practitioners have been involved by the Regional Section of the Italian Association of Hospital Cardiologists (ANMCO) in several scientific meetings on the following topics: hypertension, chronic ischemic heart disease, valvular heart disease, heart failure, and atrial fibrillation...
January 2018: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/29451116/population-tailored-care-for-homeless-veterans-and-acute-care-use-cost-and-satisfaction-a-prospective-quasi-experimental-trial
#19
Thomas P O'Toole, Erin E Johnson, Matthew Borgia, Amy Noack, Jean Yoon, Elizabeth Gehlert, Jeanie Lo
INTRODUCTION: Although traditional patient-centered medical homes (PCMHs) are effective for patients with complex needs, it is unclear whether homeless-tailored PCMHs work better for homeless veterans. We examined the impact of enrollment in a Veterans Health Administration (VHA) homeless-tailored PCMH on health services use, cost, and satisfaction compared with enrollment in a traditional, nontailored PCMH. METHODS: We conducted a prospective, multicenter, quasi-experimental, single-blinded study at 2 VHA medical centers to assess health services use, cost, and satisfaction during 12 months among 2 groups of homeless veterans: 1) veterans receiving VHA homeless-tailored primary care (Homeless-Patient Aligned Care Team [H-PACT]) and 2) veterans receiving traditional primary care services (PACT)...
February 15, 2018: Preventing Chronic Disease
https://www.readbyqxmd.com/read/29451077/intravitreal-aflibercept-versus-ranibizumab-for-wet-age-related-macular-degeneration-a-cost-effectiveness-analysis
#20
Luis Hernandez, Tereza Lanitis, Clifford Cele, Hector Toro-Diaz, Andrea Gibson, Andreas Kuznik
BACKGROUND: Age-related macular degeneration (AMD) is the leading cause of vision loss in the United States. The most severe vision loss occurs in patients with neovascular AMD, known as wet AMD (wAMD). The most commonly used antivascular endothelial growth factor (VEGF) therapies approved by the FDA to treat patients with wAMD are ranibizumab, 0.5 mg administered by intravitreal injection once a month (approximately every 28 days), and intravitreal aflibercept injection (IAI), 2 mg every 4 weeks (monthly) for the first 12 weeks (3 months), followed by IAI 2 mg once every 8 weeks (2 months)...
February 16, 2018: Journal of Managed Care & Specialty Pharmacy
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