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https://www.readbyqxmd.com/read/28806860/patient-caregiver-and-provider-perceptions-of-pain-and-pain-management-in-adolescents-and-young-adults-with-bleeding-disorders
#1
Angela Lambing, Cynthia D Nichols, James E Munn, Terry L Anderson, Bartholomew J Tortella, Michelle L Witkop
INTRODUCTION: Recurrent bleeding and associated pain are critical components in the management of bleeding disorders, yet scant data describe perceptions of pain in this patient population. OBJECTIVE: This study assessed perceptions of pain and pain management in adolescents and young adults (AYAs) with haemophilia or von Willebrand disease (VWD) to determine agreement/disagreement between patients, caregivers and health care providers. METHODS: Using an online questionnaire, AYA patients (N=89), their caregivers (N=77), and providers (N=54) reported on pain perception, pain treatment and pain control...
August 14, 2017: Haemophilia: the Official Journal of the World Federation of Hemophilia
https://www.readbyqxmd.com/read/28806858/the-haemtrack-home-therapy-reporting-system-design-implementation-strengths-and-weaknesses-a-report-from-uk-haemophilia-centre-doctors-organisation
#2
C R M Hay, H Xiang, M Scott, P W Collins, R Liesner, G Dolan, R Hollingsworth
INTRODUCTION: Haemtrack is an electronic home treatment diary for patients with inherited bleeding disorders, introduced in 2008. It aimed to improve the timeliness and completeness of patient-reported treatment records, to facilitate analysis of treatment and outcome trends. The system is easy to use, responsive and accessible. METHODS: The software uses Microsoft technologies with a SQL Server database and an ASP.net website front-end, running on personal computers, android and I-phones...
August 14, 2017: Haemophilia: the Official Journal of the World Federation of Hemophilia
https://www.readbyqxmd.com/read/28806842/clowns-in-paediatric-surgery-less-anxiety-and-more-oxytocin-a-pilot-study
#3
Tabea Scheel, Dorothea Hoeppner, Anne Grotevendt, Winfried Barthlen
Background Hospital stays and medical interventions are accompanied by worries and anxiety in children and parents. Recent studies show that hospital clowns may reduce anxiety and enhance well-being. However, so far studies are based solely on subjective measures and clowns are usually not integrated in medical routine. With this pilot study, we aim to provide both psychological and physiological evidence of positive effects of clowns' interventions in hospitalized children. Patients/Method In a consecutive randomized intervention-control group design with 31 children aged 4 to 13 years, 17 patients were accompanied by a clown prior to surgery or during ward round (intervention group) and 14 were not (control group)...
August 14, 2017: Klinische Pädiatrie
https://www.readbyqxmd.com/read/28806841/genetic-polymorphisms-as-predictive-markers-of-response-to-growth-hormone-therapy-in-children-with-growth-hormone-deficiency
#4
Anna Maria Jung, Martin Zenker, Christina Lißewski, Denny Schanze, Stefan Wagenpfeil, Tilman Robert Rohrer
Objective Growth hormone (GH) deficiency (GHD) is commonly treated with recombinant human GH (rhGH). Individual response to rhGH therapy varies widely and there is evidence that variations in growth-related genes, e. g. the GH receptor (GHR) gene, may impact treatment response. We aimed to identify genetic polymorphisms which could serve as predictive markers of response to rhGH therapy. Methods We conducted a genetic analysis of single nucleotide polymorphisms (SNPs) and the GHR exon 3 deletion in 101 paediatric GHD patients receiving rhGH...
August 14, 2017: Klinische Pädiatrie
https://www.readbyqxmd.com/read/28806794/benefits-and-harms-of-plant-based-cannabis-for-posttraumatic-stress-disorder-a-systematic-review
#5
Maya E O'Neil, Shannon M Nugent, Benjamin J Morasco, Michele Freeman, Allison Low, Karli Kondo, Bernadette Zakher, Camille Elven, Makalapua Motu'apuaka, Robin Paynter, Devan Kansagara
Background: Cannabis is available from medical dispensaries for treating posttraumatic stress disorder (PTSD) in many states of the union, yet its efficacy in treating PTSD symptoms remains uncertain. Purpose: To identify ongoing studies and review existing evidence regarding the benefits and harms of plant-based cannabis preparations in treating PTSD in adults. Data Sources: MEDLINE, the Cochrane Library, and other sources from database inception to March 2017...
August 15, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28806793/holding-providers-accountable-for-health-care-outcomes
#6
David W Baker, Mark R Chassin
Federal public reporting and payment programs have increasingly emphasized the measurement of outcomes (such as readmission, health care-associated infections, and mortality). Yet, the criteria for assessing whether outcome measures are accurate and valid enough to use for public reporting, payment, and accreditation are not well-defined. An outcome measure should be used only if the outcome can be influenced substantially by providers (that is, a strong process-outcome link exists) and statistical adjustment can be made for differences in patient populations across providers so that differences in outcomes are truly attributable to differences in the care provided...
August 15, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28806783/the-utilization-of-critical-care-ultrasound-to-assess-hemodynamics-and-lung-pathology-on-icu-admission-and-the-potential-for-predicting-outcome
#7
Wanhong Yin, Yi Li, Xueying Zeng, Yao Qin, Dong Wang, Tongjuan Zou, Ling Su, Yan Kang
AIM: Critical care ultrasound (CCUS) has been used by many Intensive Care Units(ICUs) worldwide, so as to guiding the diagnosis and the treatment. However, none of the publications currently systematically describe the utilization of CCUS to analyze the characteristics of hemodynamics and lung pathology upon the new admission to ICU and its potential role in patients' prognosis prediction. In this retrospective clinical study, we have demonstrated and analyzed the characteristics of hemodynamics and lung pathology assessed by CCUS and investigated its potential to predict patient outcome...
2017: PloS One
https://www.readbyqxmd.com/read/28806761/transcriptome-analysis-of-pdgfr%C3%AE-cells-identifies-t-type-ca2-channel-cacna1g-as-a-new-pathological-marker-for-pdgfr%C3%AE-cell-hyperplasia
#8
Se Eun Ha, Moon Young Lee, Masaaki Kurahashi, Lai Wei, Brian G Jorgensen, Chanjae Park, Paul J Park, Doug Redelman, Kent C Sasse, Laren S Becker, Kenton M Sanders, Seungil Ro
Platelet-derived growth factor receptor alpha (PDGFRα)+ cells are distributed into distinct morphological groups within the serosal, muscular, and submucosal layers as well as the myenteric and deep muscular plexi. PDGFRα+ cells directly interact with interstitial cells of Cajal (ICC) and smooth muscle cells (SMC) in gastrointestinal smooth muscle tissue. These three cell types, SMC, ICC, and PDGFRα+ cells (SIP cells), form an electrical syncytium, which dynamically regulates gastrointestinal motility. We have previously reported the transcriptomes of SMC and ICC...
2017: PloS One
https://www.readbyqxmd.com/read/28806738/partial-igf-1-deficiency-is-sufficient-to-reduce-heart-contractibility-angiotensin-ii-sensibility-and-alter-gene-expression-of-structural-and-functional-cardiac-proteins
#9
José Luis González-Guerra, Inma Castilla-Cortazar, Gabriel A Aguirre, Úrsula Muñoz, Irene Martín-Estal, Elena Ávila-Gallego, Miriam Granado, Juan E Puche, Ángel Luis García-Villalón
Circulating levels of IGF-1 may decrease under several circumstances like ageing, metabolic syndrome, and advanced cirrhosis. This reduction is associated with insulin resistance, dyslipidemia, progression to type 2 diabetes, and increased risk for cardiovascular diseases. However, underlying mechanisms between IGF-1 deficiency and cardiovascular disease remain elusive. The specific aim of the present work was to study whether the partial IGF-1 deficiency influences heart and/or coronary circulation, comparing vasoactive factors before and after of ischemia-reperfusion (I/R)...
2017: PloS One
https://www.readbyqxmd.com/read/28806638/patient-preferences-and-extended-release-naltrexone-a-new-opportunity-to-treat-opioid-use-disorders-in-ukraine
#10
Ruthanne Marcus, Iuliia Makarenko, Alyona Mazhnaya, Alexei Zelenev, Maxim Polonsky, Lynn Madden, Sergii Filippovych, Sergii Dvoriak, Sandra A Springer, Frederick L Altice
BACKGROUND: Scaling up HIV prevention for people who inject drugs (PWID) using opioid agonist therapies (OAT) in Ukraine has been restricted by individual and structural factors. Extended-release naltrexone (XR-NTX), however, provides new opportunities for treating opioid use disorders (OUDs) in this region, where both HIV incidence and mortality continue to increase. METHODS: Survey results from 1613 randomly selected PWID from 5 regions in Ukraine who were currently, previously or never on OAT were analyzed for their preference of pharmacological therapies for treating OUDs...
August 5, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/28806603/cancer-vaccines-in-the-era-of-checkpoint-blockade-the-magic-is-in-the-adjuvant
#11
REVIEW
Willem W Overwijk
While T cell checkpoint blockade therapy of various cancers yields impressive clinical benefits, most patients are not cured. This is thought to result from insufficient spontaneous tumor-specific T cell responses, a situation that could be remedied with cancer-specific vaccination. Much work is underway to identify cancer-specific antigens, leaving open the question of how to formulate these antigens in a manner that provokes potent cancer-specific T cell responses. In this review I discuss paradigms guiding adjuvant development, and consider what may constitutes a clinically relevant T cell response...
August 11, 2017: Current Opinion in Immunology
https://www.readbyqxmd.com/read/28806590/how-multi-segmental-patterns-deviate-in-spastic-diplegia-from-typical-developed
#12
Matteo Zago, Chiarella Sforza, Alessia Bona, Veronica Cimolin, Pier Francesco Costici, Claudia Condoluci, Manuela Galli
BACKGROUND: The relationship between gait features and coordination in children with Cerebral Palsy is not sufficiently analyzed yet. Principal Component Analysis can help in understanding motion patterns decomposing movement into its fundamental components (Principal Movements). This study aims at quantitatively characterizing the functional connections between multi-joint gait patterns in Cerebral Palsy. METHODS: 65 children with spastic diplegia aged 10.6 (SD 3...
August 8, 2017: Clinical Biomechanics
https://www.readbyqxmd.com/read/28806586/the-new-frontier-of-strategic-alliances-in-health-care-new-partnerships-under-accountable-care-organizations
#13
Valerie A Lewis, Katherine I Tierney, Carrie H Colla, Stephen M Shortell
Accountable care organizations (ACOs) and similar reforms aim to improve coordination between health care providers; however, due to the fragmented nature of the US health care system, successful coordination will hinge in large part on the ability of health care organizations to successfully partner across organizational boundaries. Little is known about new partnerships formed under the ACO model. We use mixed methods data from the National Survey of ACOs, Medicare ACO performance data and interviews with executive leaders across 31 ACOs to examine the prevalence, characteristics, and capabilities of partnership ACOs and why and how ACO partnerships form...
May 2, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28806562/zika-virus-induced-neurological-critical-illness-in-latin-america-severe-guillain-barre-syndrome-and-encephalitis
#14
Sebastián U Ugarte, Angel Ricardo V Arenas, Bruno C Alvarez, Angela Cubides, Angélica F Luna, Max Arroyo-Parejo, Cayri E Acuña, Agamenón V Quintero, Orlando Ch Villareal, Oscar S Pinillos, Elías Vieda, Manuel Bello, Susana Peña, Carmelo Dueñas-Castell, Gloria M V Rodriguez, Jorge L M Ranero, Rosa L M López, Sandra G Olaya, José C Vergara, Ana Tandazo, Juan P S Ospina, Igor M Leyton Soto, R A Fowler, John C Marshall
Zika virus (ZIKAV) is classically described as causing minor symptoms in adult patients, however neurologic complications have been recognized. The recent outbreak in Central and South America has resulted in serious illness in some adult patients. We report adult patients in Latin America diagnosed with ZIKAV infection admitted to Intensive Care Units (ICUs). METHODS: Multicenter, prospective case series of adult patients with laboratory diagnosis of ZIKAV in 16 ICUs in 8 countries. RESULTS: Between December 1st 2015 and April 2nd 2016, 16 ICUs in 8 countries enrolled 49 critically ill patients with diagnosis of ZIKAV infection...
August 9, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28806490/challenges-and-resources-for-nurses-participating-in-a-hurricane-sandy-hospital-evacuation
#15
Nancy VanDevanter, Victoria H Raveis, Christine T Kovner, Meriel McCollum, Ronald Keller
PURPOSE: Weather-related disasters have increased dramatically in recent years. In 2012, severe flooding as a result of Hurricane Sandy necessitated the mid-storm patient evacuation of New York University Langone Medical Center. The purpose of this study was to explore, from the nurses' perspective, what the challenges and resources were to carrying out their responsibilities, and what the implications are for nursing education and preparation for disaster. DESIGN: This mixed-methods study included qualitative interviews with a purposive sample of nurses and an online survey of nurses who participated in the evacuation...
August 14, 2017: Journal of Nursing Scholarship
https://www.readbyqxmd.com/read/28806455/association-of-state-access-standards-with-accessibility-to-specialists-for-medicaid-managed-care-enrollees
#16
Chima D Ndumele, Michael S Cohen, Paul D Cleary
Importance: Medicaid recipients have consistently reported less timely access to specialists than patients with other types of coverage. By 2018, state Medicaid agencies will be required by the Center for Medicare and Medicaid Services (CMS) to enact time and distance standards for managed care organizations to ensure an adequate supply of specialist physicians for enrollees; however, there have been no published studies of whether these policies have significant effects on access to specialty care...
August 14, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28806445/use-of-laboratory-markers-in-addition-to-symptoms-for-diagnosis-of-inflammatory-bowel-disease-in-children-a-meta-analysis-of-individual-patient-data
#17
Gea A Holtman, Yvonne Lisman-van Leeuwen, Andrew S Day, Ulrika L Fagerberg, Paul Henderson, Stevan T Leach, Gøri Perminow, David Mack, Patrick F van Rheenen, Els van de Vijver, David C Wilson, Johannes B Reitsma, Marjolein Y Berger
Importance: Blood markers and fecal calprotectin are used in the diagnostic workup for inflammatory bowel disease (IBD) in pediatric patients. Any added diagnostic value of these laboratory markers remains unclear. Objective: To determine whether adding laboratory markers to evaluation of signs and symptoms improves accuracy when diagnosing pediatric IBD. Data Sources: A literature search of MEDLINE and EMBASE from inception through September 26, 2016...
August 14, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28806444/eliminating-creatine-kinase-myocardial-band-testing-in-suspected-acute-coronary-syndrome-a-value-based-quality-improvement
#18
Matthew D Alvin, Allan S Jaffe, Roy C Ziegelstein, Jeffrey C Trost
Cardiac biomarker testing is estimated to occur in nearly 30 million emergency department visits nationwide each year in the United States. The American College of Cardiology/European Society of Cardiology indicate that cardiac troponin is the biomarker of choice owing to its nearly absolute myocardial tissue specificity and high clinical sensitivity for myocardial injury. Multiple academic medical centers have implemented interventions to eliminate the routine ordering of creatine kinase-myocardial band tests, with published patient safety outcomes data; however, creatine kinase-myocardial band testing is still ordered in many hospitals and emergency departments...
August 14, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28806407/low-fermentable-oligosaccharides-disaccharides-monosaccharides-and-polyols-fodmap-diet-improves-symptoms-in-adults-suffering-from-irritable-bowel-syndrome-ibs-compared-to-standard-ibs-diet-a-meta-analysis-of-clinical-studies
#19
Péter Varjú, Nelli Farkas, Péter Hegyi, András Garami, Imre Szabó, Anita Illés, Margit Solymár, Áron Vincze, Márta Balaskó, Gabriella Pár, Judit Bajor, Ákos Szűcs, Orsolya Huszár, Dániel Pécsi, József Czimmer
BACKGROUND: Irritable bowel syndrome (IBS) and functional digestive tract disorders, e.g. functional bloating, carbohydrate maldigestion and intolerances, are very common disorders frequently causing significant symptoms that challenge health care systems. A low Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols (FODMAP) diet is one of the possible therapeutic approaches for decreasing abdominal symptoms and improving quality of life. OBJECTIVES: We aimed to meta-analyze data on the therapeutic effect of a low-FODMAP diet on symptoms of IBS and quality of life and compare its effectiveness to a regular, standard IBS diet with high FODMAP content, using a common scoring system, the IBS Symptom Severity Score (IBS-SSS)...
2017: PloS One
https://www.readbyqxmd.com/read/28806399/lymph-node-status-have-a-prognostic-impact-in-breast-cancer-patients-with-distant-metastasis
#20
Chuangang Tang, Pei Wang, Xiaoxin Li, Bingqing Zhao, Haochang Yang, Haifeng Yu, Changwen Li
BACKGROUND: The objective of this retrospective study was to determine whether lymph node metastasis has a prognostic impact on patients with stage IV breast cancer. PATIENTS AND METHODS: Seven thousand three hundred and seventy-nine patients with de novo stage IV breast cancer diagnosed from 2004 to 2013 were identified. Kaplan-Meier estimate method was fitted to measure overall survival and breast cancer-specific survival (BCSS). Cox proportional hazard analysis was used to evaluate the association between N stage and BCSS after controlling variables such as other patient/tumor characteristics...
2017: PloS One
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