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https://www.readbyqxmd.com/read/28538795/neonatal-near-miss-and-mortality-factors-associated-with-life-threatening-conditions-in-newborns-at-six-public-maternity-hospitals-in-southeast-brazil
#1
Pauline Lorena Kale, Maria Helena Prado de Mello-Jorge, Kátia Silveira da Silva, Sandra Costa Fonseca
We aimed to evaluate factors associated with cases of neonatal near miss and neonatal deaths at six public maternity hospitals in São Paulo and Rio de Janeiro States, Brazil, in 2011. A prospective hospital-based birth cohort investigated these outcomes among live births with life-threatening conditions. Associations were tested using multinomial logistic regression models with hierarchical levels. High rates of near miss were observed for maternal syphilis (52.2‰ live births) and lack of prenatal care (80...
May 18, 2017: Cadernos de Saúde Pública
https://www.readbyqxmd.com/read/28538650/consequences-of-pediatric-undertriage-and-overtriage-in-a-statewide-trauma-system
#2
Hilary A Hewes, Mathew Christensen, Peter P Taillac, N Clay Mann, Kammy K Jacobsen, Stephen J Fenton
BACKGROUND: With increasing attention to the quality of health care delivery, evaluating trauma triage decisions in a large system of emergency care can help decision makers reduce mortality, morbidity, unnecessary transfers, and healthcare costs. OBJECTIVES: To quantify the magnitude of pediatric traumatic injury undertriage (hospital mortality risk) and overtriage (early trauma center discharge after transfer) in a statewide trauma system. METHODS: A statewide population-based evaluation of pediatric trauma outcomes and secondary triage (interfacility transfers) patterns from 2001-2013 among 45 hospitals in Utah's statewide trauma system...
May 22, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28538648/less-is-more-antibiotic-duration-and-outcomes-in-fournier-s-gangrene
#3
Margaret Lauerman, Olga Kolesnik, Kinjal Sethuraman, Ronald Rabinowitz, Manjari Joshi, Emily Clark, Deborah Stein, Thomas Scalea, Sharon Henry
BACKGROUND: Antibiotic management of Fournier's gangrene (FG) is without evidence-based guidelines, and is based on expert opinion. The effect of duration of antibiotic therapy on outcomes in FG is unknown. METHODS: A retrospective review was performed of FG patients from 2012-2015 at a single institution. Patients were managed by our institutional practice of complete primary wound closure as possible, with antibiotic duration according to physician judgement. Patients were stratified into multiple durations of antibiotic administration...
May 22, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28538598/the-need-for-multidimensional-stratification-of-chronic-low-back-pain-lbp
#4
Yoga Raja Rampersaud, Andrew Bidos, Caroline Fanti, Anthony V Perruccio
STUDY DESIGN: Cross-sectional study of Canadian LBP patients seeking primary care. OBJECTIVE: Determine which existing primary care LBP stratification schema is associated with distinct sub-populations as characterized by easily identifiable primary epidemiological factors. SUMMARY OF BACKGROUND DATA: Low back pain (LBP) is among the most frequent reasons for visits to primary care physicians and a leading cause of years lived with disability...
May 22, 2017: Spine
https://www.readbyqxmd.com/read/28538549/impact-of-evolving-radiation-therapy-techniques-on-implant-based-breast-reconstruction
#5
Horatiu Muresan, Gretl Lam, Benjamin T Cooper, Carmen A Perez, Alexes Hazen, Jamie P Levine, Pierre B Saadeh, Mihye Choi, Nolan S Karp, Daniel J Ceradini
BACKGROUND: Patients undergoing implant-based reconstruction in the setting of postmastectomy radiation therapy suffer from increased complications and inferior outcomes compared with those not irradiated, but advances in radiation delivery have allowed for more nuanced therapy. The authors investigated whether these advances impact patient outcomes in implant-based breast reconstruction. METHODS: Retrospective chart review identified all implant-based reconstructions performed at a single institution from November of 2010 to November of 2013...
June 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28538442/impact-of-moderate-hyperchloremia-on-clinical-outcomes-in-intracerebral-hemorrhage-patients-treated-with-continuous-infusion-hypertonic-saline-a-pilot-study
#6
Heidi M Riha, Michael J Erdman, Joseph E Vandigo, Lauren A Kimmons, Nitin Goyal, K Erin Davidson, Abhi Pandhi, G Morgan Jones
OBJECTIVES: Hyperchloremia has been associated with increased morbidity and mortality in critically ill patients. While previous research has demonstrated an association between hypertonic saline and hyperchloremia, limited data exist in neurocritical care patients. The objective of this study is to determine the impact of moderate hyperchloremia (chloride ≥ 115 mmol/L) on clinical outcomes in intracerebral hemorrhage patients treated with continuous IV infusion 3% hypertonic saline...
May 22, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28538110/the-effect-of-individual-movements-and-interventions-on-the-spread-of-influenza-in-long-term-care-facilities
#7
Mehdi Najafi, Marek Laskowski, Pieter T de Boer, Evelyn Williams, Ayman Chit, Seyed M Moghadas
BACKGROUND: Nosocomial influenza poses a serious risk among residents of long-term care facilities (LTCFs). OBJECTIVE: We sought to evaluate the effect of resident and staff movements and contact patterns on the outcomes of various intervention strategies for influenza control in an LTCF. METHODS: We collected contact frequency data in Canada's largest veterans' LTCF by enroling residents and staff into a study that tracked their movements through wireless tags and signal receivers...
May 1, 2017: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/28537970/neuraxial-and-combined-neuraxial-general-anesthesia-compared-to-general-anesthesia-for-major-truncal-and-lower-limb-surgery-a-systematic-review-and-meta-analysis
#8
Lauren M Smith, Crispiana Cozowicz, Yoshiaki Uda, Stavros G Memtsoudis, Michael J Barrington
Neuraxial anesthesia may improve perioperative outcomes when compared to general anesthesia; however, this is controversial. We performed a systematic review and meta-analysis using randomized controlled trials and population-based observational studies identified in MEDLINE, PubMed, and EMBASE from 2010 to May 31, 2016. Studies were included for adult patients undergoing major surgery of the trunk and lower extremity that reported: 30-day mortality (primary outcome), cardiopulmonary morbidity, surgical site infection, thromboembolic events, blood transfusion, and resource use...
May 19, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28537961/the-affordable-care-act-and-cancer-care-delivery
#9
Gabriel A Brooks, J Russell Hoverman, Carrie H Colla
The Affordable Care Act (ACA) has reformed US health care delivery through insurance coverage expansion, experiments in payment design, and funding for patient-centered clinical and health care delivery research. The impact on cancer care specifically has been far reaching, with new ACA-related programs that encourage coordinated, patient-centered, cost-effective care. Insurance expansions through private exchanges and Medicaid, along with preexisting condition clauses, have helped more than 20 million Americans gain health care coverage...
May 2017: Cancer Journal
https://www.readbyqxmd.com/read/28537957/testing-the-implementation-of-a-pain-self-management-support-intervention-for-oncology-patients-in-clinical-practice-a-randomized-controlled-pilot-study-antipain
#10
Antje Koller, Jan Gaertner, Sabina De Geest, Monika Hasemann, Gerhild Becker
BACKGROUND: In oncology, pain control is a persistent problem. Significant barriers to cancer pain management are patient related. Pain self-management support interventions have shown to reduce pain intensity and patient-related barriers. Comparative effectiveness research is a suitable approach to test whether effects are sustained in clinical practice. OBJECTIVE: In this pilot randomized controlled trial, the implementation of the ANtiPain intervention into clinical practice was tested to assess the effects on pain intensity, function-related outcomes, self-efficacy, and patient-related barriers to pain management to prepare a larger effectiveness trial...
May 23, 2017: Cancer Nursing
https://www.readbyqxmd.com/read/28535558/evaluation-of-depression-in-subacute-low-back-pain-a-case-control-study
#11
Daniel Lopez-Lopez, Juan M Vilar-Fernandez, Cesar Calvo-Lobo, Marta E Losa-Iglesias, David Rodriguez-Sanz, Ricardo Becerro-de-Bengoa-Vallejo
BACKGROUND: Low back pain (LBP) is the most common musculoskeletal disorder affecting the general population and it is believed to be associated with depression. OBJECTIVE: The study aim was to describe and compare the impact in a sample of people with subacute LBP (SLBP) and patients without LBP with normalized reference values in the light of the scores obtained with regard using the Beck Depression Inventory (BDI). STUDY DESIGN: This was a case-control study...
May 2017: Pain Physician
https://www.readbyqxmd.com/read/28535455/the-effectiveness-of-telemedicine-delivered-opioid-agonist-therapy-in-a-supervised-clinical-setting
#12
Joseph K Eibl, Graham Gauthier, David Pellegrini, Jeffery Daiter, Michael Varenbut, John C Hogenbirk, David C Marsh
OBJECTIVE: Opioid use disorder has been declared a public health crisis across North America and opioid agonist therapy (OAT) is the standard of care for these patients. Despite the increasing adoption of telemedicine as a delivery method for OAT, its effectiveness has not yet been evaluated against traditional in-person treatment. This study compared treatment outcomes for in-person versus telemedicine-delivered OAT. METHODS: We conducted a non-randomized cohort comparison study using an administrative database for patients who commenced OAT between 2011 and 2012 across 58 clinic sites in the province of Ontario, Canada...
May 17, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/28535331/computer-and-mobile-technology-interventions-for-self-management-in-chronic-obstructive-pulmonary-disease
#13
REVIEW
Catherine McCabe, Margaret McCann, Anne Marie Brady
BACKGROUND: Chronic obstructive pulmonary disease (COPD) is characterised by airflow obstruction due to an abnormal inflammatory response of the lungs to noxious particles or gases, for example, cigarette smoke. The pattern of care for people with moderate to very severe COPD often involves regular lengthy hospital admissions, which result in high healthcare costs and an undesirable effect on quality of life. Research over the past decade has focused on innovative methods for developing enabling and assistive technologies that facilitate patient self-management...
May 23, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28535109/intranasal-steroid-use-for-otitis-media-with-effusion-ongoing-opportunities-for-quality-improvement
#14
David E Wang, Derek J Lam, Angela M Bellmunt, Richard M Rosenfeld, Allison K Ikeda, Jennifer J Shin
Objectives Our objectives were (1) to assess patterns of intranasal steroid administration when otitis media with effusion (OME) has been diagnosed in children, (2) to investigate whether usage varies according to visit setting, and (3) to determine if practice gaps are such that quality improvement could be tracked. Study Design Cross-sectional analysis of an administrative database. Subjects and Methods National Ambulatory and Hospital Ambulatory Medical Care Surveys, 2005 to 2012; univariate, multivariate, and stratified analyses of intranasal steroid usage were performed...
May 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28535106/value-tools-in-managed-care-decision-making-current-hurdles-and-future-opportunities
#15
Jeremy Schafer, Dominic Galante, Jason Shafrin
BACKGROUND: Organizations such as the National Comprehensive Cancer Network, American Society of Clinical Oncology, Institute for Clinical and Economic Review, and Memorial Sloan Kettering have created distinct tools to help different stakeholders assess the value of oncology treatments. However, the oncology value tools were not necessarily created for payers, and it is unclear whether payers are using these tools as part of their drug management process. OBJECTIVE: To understand what value tools payers are using in oncology management and what benefits and shortcomings the tools may have from the payer perspective...
June 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28535104/measuring-the-value-of-new-drugs-validity-and-reliability-of-4-value-assessment-frameworks-in-the-oncology-setting
#16
Tanya G K Bentley, Joshua T Cohen, Elena B Elkin, Julie Huynh, Arnab Mukherjea, Thanh H Neville, Matthew Mei, Ronda Copher, Russell Knoth, Ioana Popescu, Jackie Lee, Jenelle M Zambrano, Michael S Broder
BACKGROUND: Several organizations have developed frameworks to systematically assess the value of new drugs. OBJECTIVE: To evaluate the convergent validity and interrater reliability of 4 value frameworks to understand the extent to which these tools can facilitate value-based treatment decisions in oncology. METHODS: Eight panelists used the American Society of Clinical Oncology (ASCO), European Society for Medical Oncology (ESMO), Institute for Clinical and Economic Review (ICER), and National Comprehensive Cancer Network (NCCN) frameworks to conduct value assessments of 15 drugs for advanced lung and breast cancers and castration-refractory prostate cancer...
June 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28534712/benefit-of-adjunct-universal-rectal-screening-for-chlamydia-genital-infections-in-women-attending-canadian-sexually-transmitted-infection-clinics
#17
Nguyen X Thanh, Ilke Akpinar, Jennifer Gratrix, Sabrina Plitt, Petra Smyczek, Ron Read, Philip Jacobs, Tom Wong, Ameeta E Singh
Adding universal rectal screening to urogenital screening should positively impact rectal Chlamydia trachomatis (CT) incidence in affected populations. A dynamic Markov model was used to evaluate costs and outcomes of three rectal CT screening strategies among women attending sexually transmitted infection clinics in Alberta, Canada: universal urogenital-only screening (UG-only), additional selected (exposure-based) rectal screening (UG+SR), and additional universal rectal screening (UG+UR). The model included two mutually exclusive health states: infected and susceptible...
January 1, 2017: International Journal of STD & AIDS
https://www.readbyqxmd.com/read/28534543/-evolution-of-patient-safety-culture-in-a-medium-stay-hospital-monitoring-indicators
#18
M J Merino-Plaza, F J Carrera-Hueso, M Castillo-Blasco, A Martínez-Asensi, R Martínez-Capella, N Fikri-Benbrahim
BACKGROUND: Patient safety is a challenge for health care. The aim of this study is to identify the dimensions with the greatest impact on patient safety culture of healthcare staff in a medium-stay hospital; to asses its evolution over time and to check the sensitivity of monitoring indicators. METHODS: Two cross-sectional studies (2013 to 2015) were conducted. The safety culture assessment tool used was the Spanish version of the "Hospital Survey on Patient Safety" (AHRQ)...
April 30, 2017: Anales del Sistema Sanitario de Navarra
https://www.readbyqxmd.com/read/28534536/current-clinical-scoring-systems-of-percutaneous-nephrolithotomy-outcomes
#19
REVIEW
Wayland J Wu, Zeph Okeke
Percutaneous nephrolithotomy has become the preferred treatment modality for patients with large renal calculi. The technique provides excellent stone clearance, but complication rates are higher than those of minimally invasive techniques, such as ureteroscopy and shockwave lithotripsy. Guy's stone score, S.T.O.N.E. nephrolithometry, the CROES nomogram, and S-ReSC are contemporary scoring systems introduced to provide standardized grading of stone complexity and outcomes of percutaneous stone surgery. Guy's stone score is easy to apply and has been validated in multiple studies...
May 23, 2017: Nature Reviews. Urology
https://www.readbyqxmd.com/read/28534429/prevalence-and-costs-of-defensive-medicine-a-national-survey-of-italian-physicians
#20
Massimiliano Panella, Carmela Rinaldi, Fabrizio Leigheb, Sanita Knesse, Chiara Donnarumma, Seval Kul, Kris Vanhaecht, Francesco Di Stanislao
Objective To identify the prevalence of the practice of defensive medicine among Italian hospital physicians, its costs and the reasons for practising defensive medicine and possible solutions to reduce the practice of defensive medicine. Methods Cross-sectional web survey. Main outcome measures Number of physicians reporting having engaged in any defensive medicine behaviour in the previous year. Results A total of 1313 physicians completed the survey. Ninety-five per cent believed that defensive medicine would increase in the near future...
January 1, 2017: Journal of Health Services Research & Policy
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