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"Standardized management"

Ya-Qi Wang, Jiao-Jiao Jiao, Zhen-Feng Wu, Qin Zheng, Ming Yang
"High quality, safety and effectiveness" are the primary principles for the pharmaceutical research and development process in China. The quality of products relies not only on the inspection method, but also on the design and development, process control and standardized management. The quality depends on the process control level. In this paper, the history and current development of quality control of traditional Chinese medicine (TCM) preparations are reviewed systematically. Based on the development model of international drug quality control and the misunderstanding of quality control of TCM preparations, the reasons for impacting the homogeneity of TCM preparations are analyzed and summarized...
January 2018: Zhongguo Zhong Yao za Zhi, Zhongguo Zhongyao Zazhi, China Journal of Chinese Materia Medica
Anikó Maráz, Adrienn Cserháti, Gabriella Uhercsák, Éva Szilágyi, Zoltán Varga, János Révész, Renáta Kószó, Linda Varga, Zsuzsanna Kahán
BACKGROUND: In patients with metastatic renal cell cancer, based on limited evidence, increased sunitinib exposure is associated with better outcome. The survival and toxicity data of patients receiving individualized dose escalated sunitinib therapy as compared to standard management were analyzed in this study. METHODS: From July 2013, the data of metastatic renal cell cancer patients with slight progression but still a stable disease according to RECIST 1.1 criteria treated with an escalated dose of sunitinib (first level: 62...
March 15, 2018: BMC Cancer
Marie-Laure Amram, Pierre-Yves Dietrich, Florence Rochon, Mylène Bolmont, Francesco Bianchi-Demicheli
Cancer itself and its treatments can result in physical and/or psychological adverse events which include disorders of sexual health. Both clinicians and patients are reluctant to talk about sexual issues, body image or intimacy between partners. Barriers from the clinician's perspective include feeling inadequately trained, lack of time or privacy. On the patients' side, embarrassment or belief that their sexual health are an untreatable complication of their disease and its treatment are the main barriers...
March 14, 2018: Revue Médicale Suisse
Gianni Belcaro, Mark Dugall, Roberta Luzzi, Morio Hosoi, Andrea Ledda, Beatrice Feragalli, Shu Hu, Apurba Ganguly, Roberto Eggenhoffner, Ambra Corti, Luca Giacomelli
BACKGROUND: Curcumin is a powerful anti-oxidant that can be used to treat inflammation and pain in chronic conditions such as osteoarthrosis (OA). Phytoproflex® is characterized by an innovative delivery system that improves bioavailability of curcuminoids and could be useful in the management of OA. METHODS: This 4-week registry included 56 patients with knee OA treated according to the best standard management for symptomatic OA. On top of that, 24 patients used Phytoproflex® supplement preparation (an extract containing boswellic acid 90%, curcumin 20% and valeric acid 0...
April 2018: Minerva Medica
Jocasta Ball, Maja-Lisa Løchen, Melinda J Carrington, Joshua F Wiley, Simon Stewart
Objective: Mild cognitive impairment (MCI) is prevalent in atrial fibrillation (AF) and has the potential to contribute to poor outcomes. We investigated the influence of MCI on survival and rehospitalisation in patients with chronic forms of AF undergoing a home-based, AF-specific disease management intervention (home-based intervention (HBI)) or standard management (SM). Methods: The Montreal Cognitive Assessment tool was administered at baseline (a score of <26/30 indicated MCI) in patients with AF randomised to HBI versus SM...
2018: Open Heart
Roberta Rossini, Giuseppe Tarantini, Giuseppe Musumeci, Giulia Masiero, Emanuele Barbato, Paolo Calabrò, Davide Capodanno, Sergio Leonardi, Maddalena Lettino, Ugo Limbruno, Alberto Menozzi, U O Alfredo Marchese, Francesco Saia, Marco Valgimigli, Walter Ageno, Anna Falanga, Antonio Corcione, Alessandro Locatelli, Marco Montorsi, Diego Piazza, Andrea Stella, Antonio Bozzani, Alessandro Parolari, Roberto Carone, Dominick J Angiolillo
Perioperative management of antithrombotic therapy in patients treated with coronary stents undergoing surgery remains poorly defined. Importantly, surgery represents a common reason for premature treatment discontinuation, which is associated with an increased risk in mortality and major adverse cardiac events. However, maintaining antithrombotic therapy to minimize the incidence of perioperative ischemic complications may increase the risk of bleeding complications. Although guidelines provide some recommendations with respect to the perioperative management of antithrombotic therapy, these have been largely developed according to the thrombotic risk of the patient and a definition of the hemorrhagic risk specific to each surgical procedure, key to defining the trade-off between ischemia and bleeding, is not provided...
March 12, 2018: JACC. Cardiovascular Interventions
Gianni Belcaro, Umberto Cornelli, Mark Dugall, Morio Hosoi, Roberto Cotellese, Beatrice Feragalli
BACKGROUND: This registry study evaluated the effects of Pycnogenol® on edema and thrombotic complications in long-haul flights; jet lag was also evaluated. METHODS: Four hundred and fifty subjects at different risk levels for thrombosis, flying in economy class twice a week for more than 8 hours, were included; 295 completed the registry study and were subdivided in 3 groups according to their risk level - low, moderate, or high. The high-risk group also received Aspirin®...
April 2018: Minerva Cardioangiologica
Candace Haddock, Al Ghalgya Al Maawali, Joseph Ting, Julie Bedford, Kourosh Afshar, Erik D Skarsgard
BACKGROUND/PURPOSE: Elimination of unnecessary practice variation through standardization creates opportunities for improved outcomes and cost-effectiveness. A quality improvement (QI) initiative at our institution used evidence and consensus to standardize management of gastroschisis (GS) from birth to discharge. METHODS: An interdisciplinary team utilized best practice evidence and expert opinion to standardize GS care. Following stakeholder engagement and education, care standardization was implemented in September 2014...
February 7, 2018: Journal of Pediatric Surgery
Ola S Ahmed, Ailín C Rogers, Jarlath C Bolger, Achille Mastrosimone, William B Robb
BACKGROUND: Enhanced recovery after surgery (ERAS) guidelines, fast-track protocols, and alternative clinical pathways have been widely promoted in a variety of disciplines leading to improved outcomes in post-operative morbidity and length of stay (LOS). This meta-analysis assesses the implications of standardized management protocols in bariatric surgery. METHODS: The PRISMA guidelines were adhered to. Databases were searched with the application of pre-defined inclusion and exclusion criteria...
February 27, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Yang Shen, Xin Wang, Zengwu Wang, Linfeng Zhang, Zuo Chen, Manlu Zhu, Chun Chang, Runlin Gao
We investigated the prevalence, awareness, treatment, and control of hypertension and the related risk factors among Chinese working population. From 2012 to 2013, a total of 37,856 employees aged 18-60 years from 61 workplaces were sampled. Standard questionnaire surveys and physical examinations were undertaken. Multilevel logistic regression models were performed to identify the risk factors. Overall, the age-standardized prevalence of hypertension was 23.3% (95% confidence interval [CI]: 22.9%-23.7%). Among the hypertensives, 47...
February 10, 2018: Journal of the American Society of Hypertension: JASH
François Olivier, Sophie Nadeau, Sylvie Bélanger, Anne-Sophie Julien, Edith Massé, Nabeel Ali, Georges Caouette, Bruno Piedboeuf
Background: Minimally invasive surfactant therapy (MIST) is a new strategy to avoid mechanical ventilation (MV) in respiratory distress syndrome. The primary aim of this study was to test MIST as a means of avoiding MV exposure and pneumothorax occurrence in moderate and late preterm infants (32 to 36 weeks' gestational age). Methods: This was a randomized controlled trial including three Canadian centres. Patients were randomized to standard management or to the intervention if they required nasal continuous positive airway pressure of 6 cm H2 O and 35% FiO2 in the first 24 hours of life...
June 2017: Paediatrics & Child Health
María Fernanda Escobar Vidarte, Daniela Montes, Alejandra Pérez, Sara Loaiza-Osorio, Albaro José Nieto Calvache
BACKGROUND: Hepatic rupture is a complication during pregnancy that, although rare, accounts for high morbidity and mortality rates. It is mainly associated with severe preeclampsia and HELLP syndrome. Incidence is estimated to be at one per 67 000 births or one per 2000 patients with preeclampsia/eclampsia/HELLP, mainly in multiparous women; women in their 40s; after 32 weeks of gestation; and during the first 15 hours postpartum Cases: This article exposes the institutional experience at Fundación Valle del Lili in Cali, Colombia, in managing and treating hepatic rupture associated with severe preeclampsia and HELLP syndrome in three patients in the 30th, 26th and 27th week of gestation, not resulting in maternal death...
February 25, 2018: Journal of Maternal-fetal & Neonatal Medicine
Gaku Uchino, Takeshi Yoshida, Bunpachi Kakii, Masato Furui
OBJECTIVE:  Thoracic prosthetic graft infection is a rare but serious complication with no standard management. We reported our surgical experience on graft-sparing strategy for thoracic prosthetic graft infection. METHODS:  This study included patients who underwent graft-sparing surgery for thoracic prosthetic graft infection at Matsubara Tokushukai Hospital in Japan from January 2000 to October 2017. RESULTS:  There were 17 patients included in the analyses, with a mean age at surgery of 71...
February 20, 2018: Thoracic and Cardiovascular Surgeon
S Mishra, J C Mohan, Tiny Nair, V K Chopra, S Harikrishnan, S Guha, S Ramakrishnan, S Ray, R Sethi, U C Samal, K Sarat Chandra, M S Hiremath, A K Banerjee, S Kumar, M K Das, P K Deb, V K Bahl
Heart failure is a common clinical syndrome and a global health priority. The burden of heart failure is increasing at an alarming rate worldwide as well as in India. Heart failure not only increases the risk of mortality, morbidity and worsens the patient's quality of life, but also puts a huge burden on the overall healthcare system. The management of heart failure has evolved over the years with the advent of new drugs and devices. This document has been developed with an objective to provide standard management guidance and simple heart failure algorithms to aid Indian clinicians in their daily practice...
January 2018: Indian Heart Journal
Jafar Sadegh Tabrizi, Ramin Rezapour, Mohammad Saadati, Samira Seifi, Behnam Amini, Farahnaz Varmazyar
Background: Non-standard management of medical waste leads to irreparable side effects. This issue is of double importance in health care centers in a city which are the most extensive system for providing Primary Health Care (PHC) across Iran cities. This study investigated the medical waste management standards observation in Tabriz community health care centers, northwestern Iran. Methods: In this triangulated cross-sectional study (qualitative-quantitative), data collecting tool was a valid checklist of waste management process developed based on Iranian medical waste management standards...
February 2018: Iranian Journal of Public Health
Behzad Damari, Abbas Vosoogh-Moghaddam, Sahand Riazi-Isfahani
Background: According to the general health policies issued in 2014, Health Impact Assessment (HIA) or Health Annex should be implemented in Iran. The present study provided a model for executing HIA in the Iranian context as a developing country. Methods: This is a system design study with the qualitative approach. The data on the system components were gathered via reviews of the literature, in-depth interviews and focused group discussions (FGDs) with experts...
February 2018: Iranian Journal of Public Health
A J MacNeill, W J Van Houdt, C J Swallow, A Gronchi
Introduction: Retroperitoneal sarcoma (RPS) is a rare disease accounting for 0.1-0.2% of all malignancies. Management of RPS is complex and requires multidisciplinary, tailored treatment strategies at all stages, but especially in the context of metastatic or multifocal recurrent disease. Due to the rarity and heterogeneity of this family of diseases, the literature to guide management is limited. Methods: The Trans-Atlantic Retroperitoneal Sarcoma Working Group (TARPSWG) is an international collaboration of sarcoma experts from all disciplines convened in an effort to overcome these limitations...
February 7, 2018: Annals of Oncology: Official Journal of the European Society for Medical Oncology
Howieda Fouly, Fayza Ahmed Abdou, Ahmed M Abbas, Ayat Masoud Omar
Maternal deaths remain high, numbers at the facility level are relatively low. AIM: To evaluate effect of management guidelines on occurrence of maternal near miss in Women's Health Hospital. DESIGN: A cross-sectional study. SETTING: ICU of Women's Health Hospital's at Assiut Main University Hospital and Al-fayoum University Hospital. SUBJECTS: Convenient sample of 93 maternal near-miss cases including (Pregnancy or postpartum complications)...
February 2018: Applied Nursing Research: ANR
Abdulwahid M Salih, Fahmi H Kakamad, Rawezh Q Salih, Shvan H Mohammed, Imad J Habibullah, Zuhair D Hammood, Masrur S Aziz, Hiwa O Baba
BACKGROUND: Pilonidal sinus disease is a common perianal inflammatory condition. Currently, operative therapy is the standard management strategy. The aim of this study is to investigate the efficacy of a preparation with antimicrobial, sclerosing, and wound-enhancing properties in the nonoperative management of pilonidal sinus disease. METHODS: A parallel randomized controlled trial was conducted between January 2013 and January 2017 to investigate the effect of a mixture of sclerosing agent and herbal product (Lawsonia inermis powder) in the management of sacrococcygeal pilonidal sinus disease...
February 2, 2018: Surgery
Ernesto De Leon, Lewei Duan, Ellen Rippenberger, Adam L Sharp
CONTEXT: There is substantial variation in the emergency treatment of atrial fibrillation with tachycardia. A standardized treatment approach at an academic center decreased admissions without adverse outcomes, but this approach has not been evaluated in a community Emergency Department (ED). OBJECTIVE: To evaluate the implementation of a standardized treatment guideline for patients with atrial fibrillation and a rapid heart rate in a community ED. DESIGN: An observational pre-/postimplementation (August 2013 to July 2014 and August 2014 to July 2015, respectively) study at a community ED...
2018: Permanente Journal
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