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https://www.readbyqxmd.com/read/28720619/predictors-of-emergency-department-use-by-adolescents-and-adults-with-autism-spectrum-disorder-a-prospective-cohort-study
#1
Yona Lunsky, Jonathan A Weiss, Melissa Paquette-Smith, Anna Durbin, Ami Tint, Anna M Palucka, Elspeth Bradley
OBJECTIVES: To determine predictors of emergency department (ED) visits in a cohort of adolescents and adults with autism spectrum disorder (ASD). DESIGN: Prospective cohort study. SETTING: Community-based study from Ontario, Canada. PARTICIPANTS: Parents reported on their adult sons and daughters with ASD living in the community (n=284). MAIN OUTCOME MEASURES: ED visits for any reason, ED visits for medical reasons and ED visits for psychiatric reasons over 1 year...
July 18, 2017: BMJ Open
https://www.readbyqxmd.com/read/28718253/psychological-adjustment-to-amputation-variations-on-the-bases-of-sex-age-and-cause-of-limb-loss
#2
Shaista Ali, Syeda Kaniz Fatima Haider
BACKGROUND: Amputation is the removal of a limb or part of a limb by a surgical procedure in order to save the life of a person. The underlying reasons behind the occurrence of this tragic incidence may be varied. However, irrespective of its cause limb loss is associated with wide range of life challenges. The study was done to investigate the psychological sequel of an individual after losing a limb and to know the level of strain and pressure they experience after this traumatic event...
April 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/28696992/triathlon-medical-coverage-a-guide-for-medical-directors
#3
Chad A Asplund, Thomas K Miller, Lawrence Creswell, Andrew Getzin, Andrew Hunt, John Martinez, Jason Diehl, William D Hiller, Paul Berlin
Interest and participation in triathlon has grown rapidly over the past 20 yr and with this growth, there has been an increase in the number of new events. To maximize the safety of participation, triathlons require medical directors to plan and oversee medical care associated with event participation. Provision of proper medical care requires knowledge of staffing requirements, common triathlon medical conditions, impact of course design, communication skill, and a familiarity of administrative requirements...
July 2017: Current Sports Medicine Reports
https://www.readbyqxmd.com/read/28693998/long-term-treatment-adherence-to-the-proprotein-convertase-subtilisin-kexin-type-9-inhibitor-alirocumab-in-6-odyssey-phase-iii-clinical-studies-with-treatment-duration-of-1-to-2%C3%A2-years
#4
Michel Farnier, Helen M Colhoun, William J Sasiela, Jay M Edelberg, Gaëlle Asset, Jennifer G Robinson
BACKGROUND: Nonadherence to cardiovascular medications, including daily, oral statin therapy, negatively impacts outcomes in patients requiring low-density lipoprotein cholesterol (LDL-C)-lowering therapy. The proprotein convertase subtilisin/kexin type 9 inhibitor alirocumab also reduces LDL-C, but has a different mode of administration (subcutaneous injection). OBJECTIVE: The objective of the study was to assess long-term adherence to alirocumab 75 or 150 mg, given every 2 weeks, in phase III trials of patients with sub-optimally controlled hypercholesterolemia...
June 8, 2017: Journal of Clinical Lipidology
https://www.readbyqxmd.com/read/28690039/retained-antibiotic-spacers-after-total-hip-and-knee-arthroplasty-resections-high-complication-rates
#5
Stephen M Petis, Kevin I Perry, Mark W Pagnano, Daniel J Berry, Arlen D Hanssen, Matthew P Abdel
BACKGROUND: Prolonged retention of an antibiotic spacer is occasionally chosen during treatment of periprosthetic joint infections after total hip arthroplasty (THA) and total knee arthroplasty (TKA). The purpose of our study was to evaluate the outcome of extended spacer retention. METHODS: We reviewed 1106 cases of periprosthetic joint infection after THA (n = 308) and TKA (n = 798) and identified 17 (5.5%) retained hip and 34 (4.3%) retained knee spacers. Most patients (35 of 51, 69%) underwent spacer retention because they were medically unfit for further surgery...
June 8, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28687554/innovative-models-for-providing-clinical-pharmacy-services-to-remote-locations-using-clinical-video-telehealth
#6
Cassie Perdew, Katie Erickson, Jessica Litke
PURPOSE: The use of videoconferencing and other telehealth technologies to expand access to clinical pharmacy services at multiple Veterans Affairs (VA) clinics in rural areas of Alaska and the northwestern United States is described. SUMMARY: Beginning in 2014, clinical pharmacy specialists at a regional VA Telehealth Hub based at Boise VA Medical Center in Idaho have provided telehealth services for 16 clinics. In one telehealth model, a pharmacist and other remotely located primary care team members (a medical provider, a medical support assistant, a social worker, and a psychologist) conduct telehealth visits with veterans located at VA clinics, with support provided by clinic-based nursing staff; this model has been used to improve medication management services for veterans in sparsely populated areas...
July 15, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28686484/nursing-and-medical-students-teaming-up-results-of-an-interprofessional-project
#7
Rebecca A Feather, Douglas E Carr, Derrick M Garletts, Deanna L Reising
Health professions programmes are increasing the number of interprofessional events in their curricula. Many of these programmes are grounded in case study or simulation events in order to prepare students for eventual practice. We designed an interprofessional education collaborative practice (IPECP) that provides direct interprofessional practice experience while students are still in their health profession programmes. In our programme, teams of senior baccalaureate nursing and third-year medical students provided health coaching to patients in need of chronic disease management...
July 7, 2017: Journal of Interprofessional Care
https://www.readbyqxmd.com/read/28685464/hemoglobin-based-oxygen-carrier-hboc-development-in-trauma-previous-regulatory-challenges-lessons-learned-and-a-path-forward
#8
Peter E Keipert
Historically, hemoglobin-based oxygen carriers (HBOCs) were being developed as "blood substitutes," despite their transient circulatory half-life (~ 24 h) vs. transfused red blood cells (RBCs). More recently, HBOC commercial development focused on "oxygen therapeutic" indications to provide a temporary oxygenation bridge until medical or surgical interventions (including RBC transfusion, if required) can be initiated. This included the early trauma trials with HemAssist (®) (BAXTER), Hemopure (®) (BIOPURE) and PolyHeme (®) (NORTHFIELD) for resuscitating hypotensive shock...
2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/28680470/a-case-of-successfully-managed-pregnancy-in-a-patient-with-complex-cyanotic-congenital-heart-disease
#9
J Y Liu, W K Tan, E L Tan, J L Tan, L K Tan
Medical advances have increased survival of patients with congenital heart disease. However, cardiac disease in pregnancy carries significant maternal and fetal risks, posing enormous challenges to obstetricians. Cyanotic congenital heart disease is associated with maternal complications such as arrhythmias, thromboembolic events and death. Fetal complications include small for gestational age, miscarriage and prematurity. Cyanotic congenital heart disease patients who continue their pregnancies require holistic multidisciplinary team care with early and coordinated planning for delivery...
June 2017: Obstetric Medicine
https://www.readbyqxmd.com/read/28678849/community-health-promotion-and-medical-provision-for-neonatal-health-champion-cluster-randomised-trial-in-nagarkurnool-district-telangana-formerly-andhra-pradesh-india
#10
RANDOMIZED CONTROLLED TRIAL
Peter Boone, Alex Eble, Diana Elbourne, Chris Frost, Chitra Jayanty, Rashmi Lakshminarayana, Vera Mann, Rohini Mukherjee, Gilda Piaggio, Padmanabh Reddy
BACKGROUND: In the mid-2000s, neonatal mortality accounted for almost 40% of deaths of children under 5 years worldwide, and constituted 65% of infant deaths in India. The neonatal mortality rate in Andhra Pradesh was 44 per 1,000 live births, and was higher in the rural areas and tribal regions, such as the Nagarkurnool division of Mahabubnagar district (which became Nagarkurnool district in Telangana in 2014). The aim of the CHAMPION trial was to investigate whether a package of interventions comprising community health promotion and provision of health services (including outreach and facility-based care) could lead to a reduction of the order of 25% in neonatal mortality...
July 2017: PLoS Medicine
https://www.readbyqxmd.com/read/28677422/evaluation-of-a-standardized-perioperative-management-protocol-in-the-adult-hematology-anticoagulation-management-service
#11
Diane J Lum, Patricia A Ross, Martin A Bishop, Michelle L Caetano, Michael B Streiff
BACKGROUND: In North America, 250,000 patients on vitamin K antagonists require surgical procedures each year. Temporary interruption of oral anticoagulation and perioperative bridging therapy with unfractionated heparin or low-molecular-weight heparin are recommended by the American College of Chest Physicians 2012 for select patients. OBJECTIVES: The study objectives are to evaluate adherence and nonadherence to the Johns Hopkins clinic guidelines for perioperative management of anticoagulation and identify bleeding or thromboembolic events during perioperative management of anticoagulation...
July 1, 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28674617/an-ffrct-diagnostic-strategy-versus-usual-care-in-patients-with-suspected-coronary-artery-disease-planned-for-invasive-coronary-angiography-at-german-sites-one-year-results-of-a-subgroup-analysis-of-the-platform-prospective-longitudinal-trial-of-ffrct-outcome
#12
Roisin Colleran, Pamela S Douglas, Martin Hadamitzky, Matthias Gutberlet, Lukas Lehmkuhl, Borek Foldyna, Michael Woinke, Ulrich Hink, Jonathan Nadjiri, Alan Wilk, Furong Wang, Gianluca Pontone, Mark A Hlatky, Campbell Rogers, Robert A Byrne
AIM: Diagnostic evaluation practices for suspected coronary artery disease (CAD) may vary between countries. Our objective was to compare a CT-derived fractional flow reserve (FFRCT) diagnostic strategy with usual care in patients with planned invasive coronary angiography (ICA) enrolled in the PLATFORM (Prospective Longitudinal Trial of FFRCT: Outcome and Resource Impacts) study at German sites. METHODS: Patients were divided into two consecutive observational cohorts, receiving either usual care or CT angiography (CTA)/FFRCT...
2017: Open Heart
https://www.readbyqxmd.com/read/28668911/recognizing-the-ordinary-as-extraordinary-insight-into-the-way-we-work-to-improve-patient-safety-outcomes
#13
Elizabeth A Henneman
The Institute of Medicine (now National Academy of Medicine) reports "To Err is Human" and "Crossing the Chasm" made explicit 3 previously unappreciated realities: (1) Medical errors are common and result in serious, preventable adverse events; (2) The majority of medical errors are the result of system versus human failures; and (3) It would be impossible for any system to prevent all errors. With these realities, the role of the nurse in the "near miss" process and as the final safety net for the patient is of paramount importance...
July 2017: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
https://www.readbyqxmd.com/read/28665365/-difficulties-in-the-diagnosis-of-stroke-in-pregnant-women
#14
E V Eliseev, D A Doroshenko, O V Averkov, O V Konysheva, P R Kamchatnov, A R Zubarev
AIM: To study the features of the clinical picture of stroke and results of laboratory/instrumental study in pregnant women. MATERIAL AND METHODS: A study included 44 women at different periods of gestation (mean age 33.4±9.7 years) with clinical symptoms of stroke hospitalized within 4-11h after stroke. Neuroimaging, clinical/instrumental and laboratory examinations were carried out in the first 40 min after admission. RESULTS: A routine screening examination during the management of pregnancy in women's consultation clinics does not always reduce the risk of life threatening events...
2017: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
https://www.readbyqxmd.com/read/28658719/patient-education-in-the-management-of-coronary-heart-disease
#15
REVIEW
Lindsey Anderson, James Pr Brown, Alexander M Clark, Hasnain Dalal, Henriette K Rossau, Charlene Bridges, Rod S Taylor
BACKGROUND: Coronary heart disease (CHD) is the single most common cause of death globally. However, with falling CHD mortality rates, an increasing number of people live with CHD and may need support to manage their symptoms and improve prognosis. Cardiac rehabilitation is a complex multifaceted intervention which aims to improve the health outcomes of people with CHD. Cardiac rehabilitation consists of three core modalities: education, exercise training and psychological support. This is an update of a Cochrane systematic review previously published in 2011, which aims to investigate the specific impact of the educational component of cardiac rehabilitation...
June 28, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28654972/effect-of-electronic-reminders-financial-incentives-and-social-support-on-outcomes-after-myocardial-infarction-the-heartstrong-randomized-clinical-trial
#16
Kevin G Volpp, Andrea B Troxel, Shivan J Mehta, Laurie Norton, Jingsan Zhu, Raymond Lim, Wenli Wang, Noora Marcus, Christian Terwiesch, Kristen Caldarella, Tova Levin, Mike Relish, Nathan Negin, Aaron Smith-McLallen, Richard Snyder, Claire M Spettell, Brian Drachman, Daniel Kolansky, David A Asch
Importance: Adherence to medications prescribed after acute myocardial infarction (AMI) is low. Wireless technology and behavioral economic approaches have shown promise in improving health behaviors. Objective: To determine whether a system of medication reminders using financial incentives and social support delays subsequent vascular events in patients following AMI compared with usual care. Design, Setting, and Participants: Two-arm, randomized clinical trial with a 12-month intervention conducted from 2013 through 2016...
June 26, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28652953/a-robust-and-affordable-table-indexing-approach-for-multi-isocenter-dosimetrically-matched-fields
#17
Amy Yu, Benjamin Fahimian, Lynn Million, Annie Hsu
Purpose  Radiotherapy treatment planning of extended volume typically necessitates the utilization of multiple field isocenters and abutting dosimetrically matched fields in order to enable coverage beyond the field size limits. A common example includes total lymphoid irradiation (TLI) treatments, which are conventionally planned using dosimetric matching of the mantle, para-aortic/spleen, and pelvic fields. Due to the large irradiated volume and system limitations, such as field size and couch extension, a combination of couch shifts and sliding of patients are necessary to be correctly executed for accurate delivery of the plan...
May 23, 2017: Curēus
https://www.readbyqxmd.com/read/28647541/response-tailored-protocol-versus-the-fixed-12weeks-course-of-dual-sofosbuvir-daclatasvir-treatment-in-egyptian-patients-with-chronic-hepatitis-c-genotype-4-infection-a-randomized-open-label-non-inferiority-trial
#18
Mostafa Yakoot, Alaa M Abdo, Siham Abdel-Rehim, Sherine Helmy
BACKGROUND: The most recent European Association for the Study of the Liver (EASL) 2016 Guidelines on treatment of hepatitis C (HCV), allowed for shortening the course of treatment for some subsets of patients with sofosbuvir/ledipasvir and with grazoprevir/elbasvir based on cutoff baseline HCV RNA values. We hypothesized that it would be prudent to also consider an objectively assuring very rapid, on-treatment, virologic response to therapy at week 2 (vRVR) before taking the decision of shortening the treatment duration...
May 17, 2017: EBioMedicine
https://www.readbyqxmd.com/read/28631809/anabolic-steroids-for-treating-pressure-ulcers
#19
REVIEW
Cho Naing, Maxine A Whittaker
BACKGROUND: Pressure ulcers, also known as bed sores, pressure sores or decubitus ulcers develop as a result of a localised injury to the skin or underlying tissue, or both. The ulcers usually arise over a bony prominence, and are recognised as a common medical problem affecting people confined to a bed or wheelchair for long periods of time. Anabolic steroids are used as off-label drugs (drugs which are used without regulatory approval) and have been used as adjuvants to usual treatment with dressings, debridement, nutritional supplements, systemic antibiotics and antiseptics, which are considered to be supportive in healing of pressure ulcers...
June 20, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28627221/management-and-family-burdens-endorsed-by-parents-of-youth-7-years-old-with-type-1-diabetes
#20
Kara Harrington, Claire T Boyle, Kellee M Miller, Marisa E Hilliard, Barbara J Anderson, Michelle Van Name, Linda A DiMeglio, Lori M Laffel
BACKGROUND: This study investigated unique burdens experienced by parents of young children with type 1 diabetes in the context of contemporary diabetes management. METHODS: Self-report surveys and medical record information from the T1D Exchange clinic registry were used. Parental burden and family impact scores were tabulated across demographic and clinical characteristics, overall and according to age group (<4, 4-<6, and 6-<7 years). RESULTS: The mean age of the 549 children was 5...
February 1, 2017: Journal of Diabetes Science and Technology
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