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https://www.readbyqxmd.com/read/29786953/iatrogenic-botulism-outbreak-in-egypt-due-to-a-counterfeit-botulinum-toxin-a-preparation-a-descriptive-series-of-patient-features-and-outcome
#1
Eman Abdel Monaem Abdel Rashid, Nashwa Mohamed El-Mahdy, Huda Shehata Kharoub, Ahmed Salah Gouda, Naglaa Ahmed ElNabarawy, Bruno Mégarbane
Iatrogenic botulism resulting from the substantial increase in use of botulinum neurotoxin type-A (BoNT-A) treatment is rarely reported. We aimed to describe a large iatrogenic botulism outbreak in Egypt in June-July 2017. Nine patients developed botulism after receiving intramuscular injections of BoNT-A (dose: 200-300 IU) to treat cerebral palsy (N=7), spastic dystonia (N=1), and hyperhidrosis (N=1). Detailed findings were available in 5/9 cases. Patients were admitted to the hospital 5-10 days after the BoNT-A injection...
May 22, 2018: Basic & Clinical Pharmacology & Toxicology
https://www.readbyqxmd.com/read/29786536/percutaneous-coronary-and-structural-interventions-in-women-a-position-statement-from-the-eapci-women-committee
#2
Alaide Chieffo, Gill Louise Buchanan, Julinda Mehilli, Davide Capodanno, Vijay Kunadian, Anna Sonia Petronio, Ghada W Mikhail, Piera Capranzano, Nieves Gonzal, Nicole Karam, Stéphane Manzo-Silberman, Stefanie Schüpke, Robert A Byrne, Giuliana Capretti, Yolande Appelman, Marie-Claude Morice, Patrizia Presbitero, Maria Radu, Josepa Mauri
Several expert documents on sex-based differences in interventional outcomes are now available, however this is the first position paper from the EAPCI Women Committee discussing the potential influence of sex in the percutaneous treatment of coronary and structural heart disease. Despite the misconception that coronary artery disease is a 'man's disease', contemporary data shows a growing incidence in women. However, women are under-represented in randomised coronary clinical trials (~25%). The generalisation of such studies is therefore problematic in decision-making for females undergoing coronary intervention...
May 22, 2018: EuroIntervention
https://www.readbyqxmd.com/read/29786503/relationships-between-theoretically-derived-short-term-outcomes-and-support-for-policy-among-the-public-and-decision-makers
#3
Carol L Schmitt, Laurel Curry, Vanessa Boudewyns, Pamela A Williams, LaShawn Glasgow, Deanna Van Hersh, Jeffrey Willett, Todd Rogers
PURPOSE AND OBJECTIVES: Policy change is a lengthy and complex process. Thus, it is important to articulate hypothesized causal pathways between advocacy activities and policy change outcomes and to identify and monitor early indicators of progress toward policy change. INTERVENTION APPROACH: The Kansas Health Foundation supports grantee efforts to address the public health effects of obesity through evidence-based policy, systems, and environmental change interventions...
May 17, 2018: Preventing Chronic Disease
https://www.readbyqxmd.com/read/29786128/long-term-oncologic-outcomes-of-laparoscopic-sentinel-node-navigation-surgery-in-early-gastric-cancer-a-single-center-single-arm-phase-ii-trial
#4
Do Joong Park, Young Suk Park, Sang Yong Son, Ju-Hee Lee, Hye Seung Lee, Young Soo Park, Kyoung Ho Lee, Young Hoon Kim, Kyoung Un Park, Won Woo Lee, Soyeon Ahn, Sang-Hoon Ahn, Hyung-Ho Kim
BACKGROUND: Sentinel node navigation surgery (SNNS) in early gastric cancer (EGC) is technically feasible according to previous literature, however its long-term oncologic safety has not been reported. METHODS: A single-center, single-arm, phase II trial was conducted to determine the oncologic outcomes of laparoscopic sentinel node (SN) biopsy in clinical stage T1N0M0 gastric cancer patients. Cases with positive SNs on intraoperative pathologic examination underwent conventional gastrectomy with radical lymphadenectomy (SN-positive group), whereas those with negative SNs underwent laparoendoscopic-limited gastric resections without further lymph node dissections (SN-negative group)...
May 21, 2018: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/29786024/needs-assessment-of-ophthalmology-education-for-undergraduate-medical-students-a-study-from-a-medical-college-in-south-india
#5
Karuppannasamy Divya, Kannappan Suvetha, Alo Sen, Devisundaram Sundar
Background: Adequate ophthalmic diagnostic and clinical skills are essential for practitioners in primary care settings as well as specialty care physicians. The objectives of this study were to assess the adequacy of ophthalmology teaching in undergraduate medical education and to evaluate the comfort of medical students in diagnosing common eye problems and performing ophthalmic skills. Methods: A questionnaire based, cross-sectional survey was conducted among third-year undergraduate students from a medical college in South India at the end of ophthalmology training from February 2014 to December 2014...
September 2017: Education for Health: Change in Training & Practice
https://www.readbyqxmd.com/read/29785866/impact-of-personality-disorder-cluster-on-depression-outcomes-within-collaborative-care-management-model-of-care
#6
Merit P George, Gregory M Garrison, Zachary Merten, Dagoberto Heredia, Cesar Gonzales, Kurt B Angstman
BACKGROUND: Previous studies have suggested that having a comorbid personality disorder (PD) along with major depression is associated with poorer depression outcomes relative to those without comorbid PD. However, few studies have examined the influence of specific PD cluster types. The purpose of the current study is to compare depression outcomes between cluster A, cluster B, and cluster C PD patients treated within a collaborative care management (CCM), relative to CCM patients without a PD diagnosis...
January 2018: Journal of Primary Care & Community Health
https://www.readbyqxmd.com/read/29785772/getting-the-picture-visual-interpretation-in-ophthalmology-residency-training
#7
Adam D Baim
OBJECTIVES: Visual interpretation is essential in many fields of health care. Although diagnostic competency can be measured as an educational outcome, few accounts have addressed tacit aspects of visual interpretation in clinical training; these include the disciplining of the trainee's attentions and the trainee's acculturation into expected styles of communicating visual interpretations to others. This paper describes values and dispositions that are taught to ophthalmology trainees as they learn to reason through visual information, and explores how these qualities are evaluated during residency training...
May 21, 2018: Medical Education
https://www.readbyqxmd.com/read/29785662/the-timing-and-circumstances-of-the-implementation-of-pediatric-palliative-care-in-hungarian-pediatric-oncology
#8
Judit Nyirő, Szilvia Zörgő, Földesi Enikő, Katalin Hegedűs, Péter Hauser
Despite the continuous improvement of pediatric palliative care, medical professionals still face various barriers regarding its implementation; our aim was to investigate this question in Hungarian pediatric oncology practice. Structured interviews were carried out in person with physicians from the Hungarian Pediatric Oncology Group (n = 22). Codes were generated inductively with the aid of Atlas.ti 6.0 software. Most physicians placed the palliative care discussion at the end of curative treatment (n = 21) and preferred to conduct it in a team setting (n = 18), mainly in the presence of a psychologist...
May 21, 2018: European Journal of Pediatrics
https://www.readbyqxmd.com/read/29785455/robotic-assisted-laparoscopic-median-arcuate-ligament-release-7-year-experience-from-a-single-tertiary-care-center
#9
Usah Khrucharoen, Yen-Yi Juo, Yas Sanaiha, Yijun Chen, Juan C Jimenez, Erik P Dutson
BACKGROUND: Despite previous reports of robotic-assisted laparoscopic release for median arcuate ligament syndrome (MALS), the safety and efficacy profile of this approach has been difficult to establish due to the rarity of this diagnostic entity. We aim to present our experience from a tertiary minimally invasive surgery referral center. METHODS: A case series was performed whereby all patients who underwent robotic-assisted MAL release from July 2010 to July 2017 at our institution were included...
May 21, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29785170/cost-effectiveness-of-olaratumab-in-combination-with-doxorubicin-for-patients-with-soft-tissue-sarcoma-in-the-united-states
#10
Santiago Zuluaga-Sanchez, Lisa M Hess, Sorrel E Wolowacz, Yulia D'yachkova, Emma Hawe, Adrian D Vickers, James A Kaye, David Bertwistle
Background: Standard first-line treatments for advanced soft tissue sarcoma (STS) have changed little for 40 years, and outcomes have been poor. Recently, the United States (US) Food and Drug Administration conditionally approved olaratumab in combination with doxorubicin (Olara + Dox) based on a randomized phase II trial that reported a significant 11.8-month improvement in median survival versus single-agent doxorubicin (Dox). The present study investigated the cost-effectiveness of Olara + Dox compared with Dox and five other standard-of-care regimens from the US payer perspective...
2018: Sarcoma
https://www.readbyqxmd.com/read/29784755/intergenerational-associations-of-parent-adverse-childhood-experiences-and-child-health-outcomes
#11
Félice Lê-Scherban, Xi Wang, Kathryn H Boyle-Steed, Lee M Pachter
BACKGROUND: Adverse childhood experiences (ACEs) robustly predict future morbidity and mortality. Researchers are just beginning to investigate intergenerational effects. We hypothesize there are intergenerational associations between parent ACE exposure and worse child health, health behaviors, and health care access and use. METHODS: We linked data from 2 population-based cross-sectional telephone surveys in Philadelphia, Pennsylvania, that were used to ask parents about their past exposure to ACEs and their child's health, respectively...
May 21, 2018: Pediatrics
https://www.readbyqxmd.com/read/29784698/aspects-of-multicomponent-integrated-care-promote-sustained-improvement-in-surrogate-clinical-outcomes-a-systematic-review-and-meta-analysis
#12
REVIEW
Lee Ling Lim, Eric S H Lau, Alice P S Kong, Melanie J Davies, Naomi S Levitt, Björn Eliasson, Carlos A Aguilar-Salinas, Guang Ning, Yutaka Seino, Wing Yee So, Margaret McGill, Graham D Ogle, Trevor J Orchard, Philip Clarke, Rury R Holman, Edward W Gregg, Juan José Gagliardino, Juliana C N Chan
OBJECTIVE: The implementation of the Chronic Care Model (CCM) improves health care quality. We examined the sustained effectiveness of multicomponent integrated care in type 2 diabetes. RESEARCH DESIGN AND METHODS: We searched PubMed and Ovid MEDLINE (January 2000-August 2016) and identified randomized controlled trials comprising two or more quality improvement strategies from two or more domains (health system, health care providers, or patients) lasting ≥12 months with one or more clinical outcomes...
June 2018: Diabetes Care
https://www.readbyqxmd.com/read/29784628/why-physics-in-medicine
#13
Ehsan Samei, Thomas M Grist
Despite its crucial role in the development of new medical imaging technologies, in clinical practice, physics has primarily been involved in the technical evaluation of technologies. However, this narrow role is no longer adequate. New trajectories in medicine call for a stronger role for physics in the clinic. The movement toward evidence-based, quantitative, and value-based medicine requires physicists to play a more integral role in delivering innovative precision care through the intentional clinical application of physical sciences...
May 18, 2018: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/29784592/short-term-resource-utilization-and-cost-effectiveness-of-comprehensive-geriatric-assessment-in-acute-hospital-care-for-severely-frail-elderly-patients
#14
Niklas Ekerstad, Björn W Karlson, David Andersson, Magnus Husberg, Per Carlsson, Emelie Heintz, Jenny Alwin
OBJECTIVE: The objective of this study was to estimate the 3-month within-trial cost-effectiveness of comprehensive geriatric assessment (CGA) in acute medical care for frail elderly patients compared to usual medical care, by estimating health-related quality of life and costs from a societal perspective. DESIGN: Clinical, prospective, controlled, 1-center intervention trial with 2 parallel groups. INTERVENTION: Structured, systematic interdisciplinary CGA-based care in an acute elderly care unit...
May 18, 2018: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/29784570/research-gaps-in-wilderness-medicine
#15
Daniel Tritz, Kody Dormire, Travis Brachtenbach, Joshua Gordon, Donald Sanders, David Gearheart, Julia Crawford, Matt Vassar
INTRODUCTION: Wilderness medicine involves the treatment of individuals in remote, austere environments. Given the high potential for injuries as well as the unique treatment modalities required in wilderness medicine, evidence-based clinical practice guidelines are necessary to provide optimal care. In this study, we identify evidence gaps from low-quality recommendations in wilderness medicine clinical practice guidelines and identify new/ongoing research addressing them. METHODS: We included relevant clinical practice guidelines from the Wilderness Medical Society and obtained all 1C or 2C level recommendations...
May 18, 2018: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/29784540/recommendations-for-the-use-of-electroencephalography-and-evoked-potentials-in-comatose-patients
#16
REVIEW
Nathalie André-Obadia, Julie Zyss, Martine Gavaret, Jean-Pascal Lefaucheur, Eric Azabou, Sébastien Boulogne, Jean-Michel Guérit, Aileen McGonigal, Philippe Merle, Véronique Mutschler, Lionel Naccache, Cécile Sabourdy, Agnès Trébuchon, Louise Tyvaert, Laurent Vercueil, Benjamin Rohaut, Arnaud Delval
Predicting the outcome of a comatose or poorly responsive patient is a major issue for intensive care unit teams, in order to give the most accurate information to the family and to choose the best therapeutic option. However, determining the level of cortical activity in patients with disorders of consciousness is a real challenge. Reliable criteria are required to help clinicians in the decision-making process, especially in the acute phase of coma. In this paper, we propose recommendations for recording and interpreting electroencephalography and evoked potentials in comatose patients based on the literature and the clinical experience of a group of neurophysiologists trained in the management of comatose patients...
May 18, 2018: Neurophysiologie Clinique, Clinical Neurophysiology
https://www.readbyqxmd.com/read/29784441/effect-of-methicillin-resistant-staphylococcus-aureus-in-japan
#17
Hironori Uematsu, Kazuto Yamashita, Seiko Mizuno, Susumu Kunisawa, Keigo Shibayama, Yuichi Imanaka
BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) is the most common antimicrobial-resistant organism identified in Japanese health care facilities. This study analyzed the clinical and economic burdens attributable to methicillin resistance in S aureus in Japanese hospitals. METHODS: We retrospectively investigated data from 14,905 inpatients of 57 hospitals combined with data from nosocomial infection surveillance and administrative claim databases...
May 18, 2018: American Journal of Infection Control
https://www.readbyqxmd.com/read/29784265/don-t-ignore-my-snore-reducing-perioperative-complications-of-obstructive-sleep-apnea
#18
Ludy P Lemus, Betty McMullin, Honorata Balinowski
PURPOSE: Obstructive sleep apnea (OSA), a condition associated with decreased muscle tone in the airway, has been linked to postoperative complications. The purpose of the initiative was to develop and implement a guideline for patients identified as high-risk for OSA to reduce complications related to OSA. DESIGN: A multidisciplinary team developed the guideline utilizing the Iowa Model of Evidence-Based Practice to Promote Quality Care. METHODS: PubMed literature search from 2006-2013 and critique of over 40 articles were completed...
June 2018: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/29784225/nursing-diagnoses-of-the-homeless-population-in-light-of-self-care-theory
#19
Felicialle Pereira da Silva, Francisco de Assis Siqueira Paiva, Carolina Pereira Guedes, Iracema da Silva Frazão, Selene Cordeiro Vasconcelos, Murilo Duarte da Costa Lima
BACKGROUND: A growing number of people find themselves in conditions of extreme poverty, which often makes living on the streets the only option. Living conditions in this setting exert a direct impact on health and self-care. Health care for the homeless population should be planned in an interdisciplinary and intersectoral manner. In this context, nursing diagnoses constitute an essential part of the systemization of care. OBJECTIVES: The aims of the present study were to identify nursing diagnoses of a homeless population and propose nursing interventions based on the findings in light of the Nursing Outcomes Classification and Nursing Interventions Classification...
June 2018: Archives of Psychiatric Nursing
https://www.readbyqxmd.com/read/29784113/identifying-barriers-to-access-and-utilization-of-preventive-health-care-services-by-young-adults-in-vermont
#20
Stephen G DeVoe, Linda L Roberts, Wendy S Davis, Rachel R Wallace-Brodeur
PURPOSE: The objective of this study was to examine barriers to accessing and utilizing routine preventive health-care checkups for Vermont young adults. METHODS: A population-based analysis was conducted using aggregated data from the 2011-2014 Behavioral Risk Factor Surveillance System (BRFSS) surveys of Vermont young adults aged 18-25 years (N = 1,329). Predictors analyzed as barriers were classified county of residence, health-care coverage, and annual household income level, as well as covariates, with the outcome of the length of time since the last routine checkup...
June 2018: Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine
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