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https://www.readbyqxmd.com/read/29452401/understanding-communication-breakdown-in-the-outpatient-referral-process-in-latin-america-a-cross-sectional-study-on-the-use-of-clinical-correspondence-in-public-healthcare-networks-of-six-countries
#1
Ingrid Vargas, Irene Garcia-Subirats, Amparo-Susana Mogollón-Pérez, Marina Ferreira-de-Medeiros-Mendes, Pamela Eguiguren, Angelica-Ivonne Cisneros, María-Cecilia Muruaga, Fernando Bertolotto, María-Luisa Vázquez
An adequate use of referral and reply letters-the main form of communication between primary care (PC) and out-patient secondary care (SC)-helps to avoid medical errors, test duplications and delays in diagnosis. However, it has been little studied to date in Latin America. The aim is to determine the level and characteristics of PC and SC doctors' use of referral and reply letters and to explore influencing factors in public healthcare networks of Argentina, Brazil, Chile, Colombia, Mexico and Uruguay. A cross-sectional study was conducted through a survey of PC and SC doctors working in public healthcare networks (348 doctors per country)...
February 14, 2018: Health Policy and Planning
https://www.readbyqxmd.com/read/29452361/iui-review-and-systematic-assessment-of-the-evidence-that-supports-global-recommendations
#2
Ben Cohlen, Aartjan Bijkerk, Sheryl Van der Poel, Willem Ombelet
BACKGROUND: IUI with or without ovarian stimulation (OS) has become a first-line treatment option for many infertile couples, worldwide. The appropriate treatment modality for couples and their clinical management through IUI or IUI/OS cycles must consider maternal and perinatal outcomes, most notably the clinical complication of higher-order multiple pregnancies associated with IUI-OS. With a current global emphasis to continue to decrease maternal and perinatal mortality and morbidity, the World Health Organization (WHO) had established a multi-year project to review the evidence for the establishment of normative guidance for the implementation of IUI as a treatment to address fertility problems, and to consider its cost-effectiveness for lower resource settings...
February 14, 2018: Human Reproduction Update
https://www.readbyqxmd.com/read/29451944/total-hip-arthroplasty-in-patients-with-avascular-necrosis-after-hematopoietic-stem-cell-transplantation
#3
Anita Vijapura, Harlan B Levine, Michele Donato, Mark A Hartzband, Melissa Baker, Gregg R Klein
The immunosuppressive regimens required for hematopoietic stem cell transplantation predispose recipients to complications, including avascular necrosis. Cancer-related comorbidities, immunosuppression, and poor bone quality theoretically increase the risk for perioperative medical complications, infection, and implant-related complications in total joint arthroplasty. This study reviewed 20 primary total hip arthroplasties for avascular necrosis in 14 patients. Outcomes were assessed at routine clinical visits and Harris hip scores were calculated...
February 16, 2018: Orthopedics
https://www.readbyqxmd.com/read/29451875/linkage-to-hiv-care-following-diagnosis-in-the-who-european-region-a-systematic-review-and-meta-analysis-2006-2017
#4
Sara Croxford, Zheng Yin, Fiona Burns, Andrew Copas, Katy Town, Sarika Desai, Andrew Skingsley, Valerie Delpech
BACKGROUND: Timely linkage to care after HIV diagnosis is crucial as delayed access can result in poor patient outcomes. The aim of this systematic review was to synthesise the evidence to achieve a better understanding of what proportion of patients are linked to care and what factors impact linkage. METHODS: Systematic searches were run in six databases up to the end of February 2017. The grey literature was also reviewed. Inclusion criteria were: sample size ≥50 people (aged ≥15), from the WHO European Region, published 2006-2017 and in English...
2018: PloS One
https://www.readbyqxmd.com/read/29451859/harmonization-of-pcr-based-detection-of-intestinal-pathogens-experiences-from-the-dutch-external-quality-assessment-scheme-on-molecular-diagnosis-of-protozoa-in-stool-samples
#5
Theo A Schuurs, Rob Koelewijn, Eric A T Brienen, Titia Kortbeek, Theo G Mank, Bert Mulder, Foekje F Stelma, Lisette van Lieshout, Jaap J van Hellemond
BACKGROUND: Real-time PCR methods are increasingly used in routine patient care settings not only to determine the presence or absence of pathogens in patient materials, but also to obtain semiquantitative results to estimate the pathogen load. However, it is so far unknown how well these methods are harmonized among different laboratories. METHODS: Sets of stool samples were distributed three to four times per year to ca. 25-40 participating laboratories within the European Union as part of an external quality assessment scheme (EQAS) for the detection of gastrointestinal protozoa...
February 16, 2018: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/29451830/quality-of-life-and-african-american-women-who-are-family-caregivers-a-literature-review-with-implications-for-psychiatric-mental-health-advanced-practice-registered-nurses
#6
Shaquita A Starks, Freida Outlaw, J Carolyn Graff, Wendy Likes, Shelley White-Means, Laura Melaro, Mona N Wicks
PURPOSE: To identify factors affecting the quality of life (QOL) of African American women (AAW) family caregivers of individuals with kidney failure. METHODS: Ferrans' Conceptual Model of QOL provided the framework for this literature review. Included studies were (a) peer- reviewed, (b) published within the last ten years, (c) written in English, and (d) examined QOL of AAW family caregivers. Using CINAHL© and PubMed©, we found 14 studies that described factors associated with these caregivers' QOL...
February 16, 2018: Issues in Mental Health Nursing
https://www.readbyqxmd.com/read/29451814/variability-in-asthma-quality-and-costs-in-children-with-different-medicaid-insurance-plans-in-maricopa-county
#7
Matthew Rank, Natalie Landman, Gevork Harootunian, Michelle Winscott, Neil Jain, Keith Frey, Gena Wilson, Rupali Drewek, Lilia Parra-Roide, Charlton Wilson, Robert Smoldt, Denis Cortese
OBJECTIVE: To describe the variation in asthma quality and costs among children with different Medicaid insurance plans. METHODS: We used 2013 data from the Center for Health Information and Research, which houses a database that includes individuals who have Medicaid insurance in Arizona. We analyzed children ages 2-17 years-old who lived in Maricopa County, Arizona. Asthma medication ratio (AMR, a measure of appropriate asthma medication use), outpatient follow-up within 2 weeks after asthma-related hospitalization (a measure of continuity of care), asthma-related hospitalizations, and all emergency department (ED) visits were the primary quality metrics...
February 16, 2018: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/29451694/children-with-facial-morphea-managing-everyday-life-a-qualitative-study
#8
E Stasiulis, B Gladstone, K Boydell, C O'Brien, E Pope, R Laxer
BACKGROUND: This study explores the everyday experiences of children with facial morphea by examining the psychosocial impact of living with facial morphea and how children and their families manage its impact. METHODS: We used a qualitative, social constructionist approach involving focus groups, in-depth interviews and drawing activities with 10 children with facial morphea 8-17 years of age and 13 parents. Interpretive thematic analysis was utilized to examine the data...
February 16, 2018: British Journal of Dermatology
https://www.readbyqxmd.com/read/29451670/-it-s-a-traumatic-illness-traumatic-to-witness-a-qualitative-study-of-the-experiences-of-bereaved-family-caregivers-of-patients-with-cutaneous-t-cell-lymphoma
#9
D Orlowska, L E Selman, T Beynon, E Radcliffe, S Whittaker, F Child, R Harding
BACKGROUND: Cutaneous T-cell lymphomas (CTCL) are rare cancers which can be difficult to diagnose, are incurable and adversely affect quality of life, particularly in advanced disease. Families often provide care, but little is known about their experiences or needs while caring for their relative with advanced disease or in bereavement. OBJECTIVES: To explore the experiences of bereaved family caregivers of patients with CTCL. METHODS: Single semi-structured qualitative interviews were conducted with bereaved family caregivers of patients with CTCL recruited via a supra-regional CTCL clinic...
February 16, 2018: British Journal of Dermatology
https://www.readbyqxmd.com/read/29451516/-evidence-based-medicine-vs-personalized-medicine
#10
Lucio Capurso
Evidence-based medicine (EBM) and personalized medicine (PM) are driven by two diverse modes of reasoning about «evidence making». EBM has been criticized since his quality mark has been misappropriated by vested interests, the benefits statistically significant may be marginal in clinical practice, rigid rules and technology may produce care that is management driven rather than patient centered. On the contrary PM (or "precision medicine") refers to the tailoring of medical treatment to the specific characteristics of each patient involving the ability to classify individuals into subpopulations that are uniquely susceptible to a specific treatment, sparing expense and side effects and is derived from doubts on the results of subgroup analyses and on non responders in clinical trials typical of EBM...
January 2018: Recenti Progressi in Medicina
https://www.readbyqxmd.com/read/29451446/improving-patient-safety-during-introduction-of-novel-medical-devices-through-cumulative-summation-analysis
#11
Vejay N Vakharia, Roman Rodionov, Andrew W McEvoy, Anna Miserocchi, Rachel Sparks, Aidan G O'Keeffe, Sebastien Ourselin, John S Duncan
OBJECTIVE The aim of this study was to implement cumulative summation (CUSUM) analysis as an early-warning detection and quality assurance system for preclinical testing of the iSYS1 novel robotic trajectory guidance system. METHODS Anatomically accurate 3D-printed skull phantoms were created for 3 patients who underwent implantation of 21 stereoelectroencephalography electrodes by surgeons using the current standard of care (frameless technique). Implantation schema were recreated using the iSYS1 system, and paired accuracy measures were compared with the previous frameless implantations...
February 16, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29451406/cancer-costs-and-outcomes-for-common-cancer-sites-in-the-finnish-population-between-2009-2014
#12
Paulus Torkki, Riikka-Leena Leskelä, Miika Linna, Suvi Mäklin, Jukka-Pekka Mecklin, Petri Bono, Vesa Kataja, Sakari Karjalainen
BACKGROUND: The cost of cancer and outcomes of cancer care have been discussed a lot since cancer represents 3-6% of total healthcare costs and cost estimations have indicated growing costs. There are studies considering the cost of all cancers, but studies focusing on the cost of disease and outcomes in most common cancer sites are limited. The objective of this study was to analyze the development of the costs and outcomes in Finland between 2009 and 2014 per cancer site. METHODS: The National cost, episode and outcomes data were obtained from the National register databases based on International Statistical Classification of Diseases (ICD)-10 diagnosis codes...
February 16, 2018: Acta Oncologica
https://www.readbyqxmd.com/read/29451185/early-versus-conventional-stoma-closure-following-bowel-surgery-a-randomized-controlled-trial
#13
Thirugnanasambandam Nelson, Amuda R Pranavi, Sathasivam Sureshkumar, Gubbi S Sreenath, Vikram Kate
Background/Aim: To compare early stoma closure with conventional stoma closure following defunctioning diversion stoma surgery with respect to the frequency of complications, health-related quality of life (QoL), and length of hospitalization (LoH). Patients and Methods: This study was designed as a prospective parallel-arm randomized controlled trial. Patients who underwent temporary stoma following bowel surgery between February 2014 and November 2015 were included...
January 2018: Saudi Journal of Gastroenterology: Official Journal of the Saudi Gastroenterology Association
https://www.readbyqxmd.com/read/29451114/molecular-tools-to-study-preharvest-food-safety-challenges
#14
Deepak Kumar, Siddhartha Thakur
Preharvest food safety research and activities have advanced over time with the recognition of the importance and complicated nature of the preharvest phase of food production. In developed nations, implementation of preharvest food safety procedures along with strict monitoring and containment at various postharvest stages such as slaughter, processing, storage, and distribution have remarkably reduced the burden of foodborne pathogens in humans. Early detection and adequate surveillance of pathogens at the preharvest stage is of the utmost importance to ensure a safe meat supply...
February 2018: Microbiology Spectrum
https://www.readbyqxmd.com/read/29451077/intravitreal-aflibercept-versus-ranibizumab-for-wet-age-related-macular-degeneration-a-cost-effectiveness-analysis
#15
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
https://www.readbyqxmd.com/read/29451066/psychometric-properties-of-mdhaq-rapid3-in-patients-with-systemic-lupus-erythematosus
#16
N Annapureddy, D Giangreco, H Devilliers, J A Block, M Jolly
Background The Multidimensional Health Assessment Questionnaire (MDHAQ) is a patient-reported outcome (PRO) tool that includes the Routine Assessment of Patient Index Data 3 (RAPID3), an index that can be calculated at the point of care. The objective of this study was to perform psychometric analyses of MDHAQ/RAPID3 to study its measurement properties in systemic lupus erythematosus (SLE). Methods The MDHAQ was completed by 161 SLE patients in routine care, along with LupusPRO (a disease-specific PRO). The SLE disease-specific activity index (SELENA-SLEDAI) and damage (SDI) were assessed...
January 1, 2018: Lupus
https://www.readbyqxmd.com/read/29451059/-oncokompas-a-web-based-self-management-application-to-support-patient-activation-and-optimal-supportive-care-a-feasibility-study-among-breast-cancer-survivors
#17
Heleen C Melissant, Irma M Verdonck-de Leeuw, Birgit I Lissenberg-Witte, Inge R Konings, Pim Cuijpers, Cornelia F Van Uden-Kraan
BACKGROUND: Cancer survivors have to deal with symptoms related to cancer and its treatment. In Oncokompas, cancer survivors monitor their quality of life by completing patient reported outcome measures (PROMs), followed by personalized feedback, self-care advice, and supportive care options to stimulate patient activation. The aim of this study was to investigate feasibility and pretest-posttest differences of Oncokompas including a newly developed breast cancer (BC) module among BC survivors...
February 16, 2018: Acta Oncologica
https://www.readbyqxmd.com/read/29451026/the-tim-system-developing-a-novel-telehealth-service-to-improve-access-to-specialist-care-in-motor-neurone-disease-using-user-centered-design
#18
Esther V Hobson, Wendy O Baird, Rebecca Partridge, Cindy L Cooper, Susan Mawson, Ann Quinn, Pamela J Shaw, Theresa Walsh, Daniel Wolstenholme, Christopher J Mcdermott
OBJECTIVES: Attendance at a specialist multidisciplinary motor neurone disease (MND) clinic is associated with improved survival and may also improve quality of life and reduce hospital admissions. However, patients struggle to travel to clinic and may experience difficulties between clinic visits that may not be addressed in a timely manner. We wanted to explore how we could improve access to specialist MND care. METHODS: We adopted an iterative, user-centered co-design approach, collaborating with those with experience of providing and receiving MND care including patients, carers, clinicians, and technology developers...
February 16, 2018: Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration
https://www.readbyqxmd.com/read/29451006/different-indexes-of-glycemic-variability-as-identifiers-of-patients-with-risk-of-hypoglycemia-in-type-2-diabetes-mellitus
#19
Ana M Gómez, Oscar M Muñoz, Alejandro Marin, Maria Camila Fonseca, Martin Rondon, María Alejandra Robledo Gómez, Andrei Sanko, Dilcia Lujan, Maira García-Jaramillo, Fabian Mauricio León Vargas
INTRODUCTION: Recent publications frequently introduce new indexes to measure glycemic variability (GV), quality of glycemic control, or glycemic risk; however, there is a lack of evidence supporting the use of one particular parameter, especially in clinical practice. METHODS: A cohort of type 2 diabetes mellitus (T2DM) patients in ambulatory care were followed using continuous glucose monitoring sensors (CGM). Mean glucose (MG), standard deviation, coefficient of variation (CV), interquartile range, CONGA1, 2, and 4, MAGE, M value, J index, high blood glucose index, and low blood glucose index (LBGI) were estimated...
February 1, 2018: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/29450782/-is-the-refusal-of-invasive-or-noninvasive-ventilation-in-a-child-with-spinal-muscular-atrophy-ethically-justified
#20
Martina Radner, Annette Henry
We report about an infant who was diagnosed with spinal muscular atrophy type 1 (Werdnig-Hoffmann) at the age of 7 weeks. In a detailed discussion with the physicians the parents decided against mechanical ventilation in the event of either acute or chronical respiratory failure. During care at home all palliative actions were taken to optimize the quality of life for the child. The boy died at the age of 7 months at home. Whether continuous mechanical ventilation in a child with spinal muscular atrophy type 1 should be the individual decision of the parents or whether it should never be offered by the physicians is discussed controversially in the present medical literature...
February 15, 2018: Wiener Medizinische Wochenschrift
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