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https://www.readbyqxmd.com/read/29137585/association-of-positive-fluid-balance-and-mortality-in-sepsis-and-septic-shock-in-an-australian-cohort
#1
M G Pittard, S J Huang, A S McLean, S R Orde
In patients with septic shock, a correlation between positive fluid balance and worsened outcomes has been reported in multiple observational studies worldwide. No published data exists in an Australasian cohort. We set out to explore this association in our institution. We conducted a retrospective audit of patient records from August 2012 to May 2015 in a single-centre, 24-bed surgical and medical intensive care unit (ICU) in Sydney, Australia. All patients with septic shock were included. Exclusion criteria included length of stay less than 24 hours or vasopressors needed for less than six hours...
November 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/29130601/scaling-up-hiv-viral-load-lessons-from-the-large-scale-implementation-of-hiv-early-infant-diagnosis-and-cd4-testing
#2
Trevor Peter, Clement Zeh, Zachary Katz, Ali Elbireer, Bereket Alemayehu, Lara Vojnov, Alex Costa, Naoko Doi, Ilesh Jani
INTRODUCTION: The scale-up of effective HIV viral load (VL) testing is an urgent public health priority. Implementation of testing is supported by the availability of accurate, nucleic acid based laboratory and point-of-care (POC) VL technologies and strong WHO guidance recommending routine testing to identify treatment failure. However, test implementation faces challenges related to the developing health systems in many low-resource countries. The purpose of this commentary is to review the challenges and solutions from the large-scale implementation of other diagnostic tests, namely nucleic-acid based early infant HIV diagnosis (EID) and CD4 testing, and identify key lessons to inform the scale-up of VL...
November 2017: Journal of the International AIDS Society
https://www.readbyqxmd.com/read/29126909/-demographic-analysis-of-a-congenital-heart-disease-clinic-of-the-mexican-institute-of-social-security-with-special-interest-in-the-adult
#3
Horacio Márquez-González, Lucelli Yáñez-Gutiérrez, Jimena Lucely Rivera-May, Diana López-Gallegos, Eduardo Almeida-Gutiérrez
INTRODUCTION: Congenital heart disease (CHD) has an incidence of 8-10 cases per 1000 live births. In Mexico, there are 18,000-20,000 new cases per year. Most tertiary care centers for CHD attend only pediatric population; the Mexican Institute of Social Security (IMSS) has a clinic that attends pediatric and adult population. OBJECTIVE: To analyze the demographic aspects of the CHD clinic of IMSS. METHODS: From 2011 to 2016 a cross-sectional study of the CC clinic of a third level hospital of the IMSS, including all patients with confirmed structural heart disease of recent diagnosis was carried out...
November 7, 2017: Archivos de Cardiología de México
https://www.readbyqxmd.com/read/29100870/rationing-potentially-inappropriate-treatment-in-newborn-intensive-care-in-developed-countries
#4
REVIEW
Dominic Wilkinson, Stavros Petrou, Julian Savulescu
In newborn intensive care, parents sometimes request treatment that professionals regard as 'futile' or 'potentially inappropriate'. One reason not to provide potentially inappropriate treatment is because it would be excessively costly relative to its benefit. Some public health systems around the world assess the cost-effectiveness of treatments and selectively fund those treatments that fall within a set threshold. This article explores the application of such thresholds to questions in newborn intensive care: (i) when a newborn infant's chance of survival is too small; (ii) how long treatment should continue; (iii) when quality of life is too low; and (iv) when newborn infants are too premature for cost-effective intensive care...
October 31, 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29096701/assessment-of-utilization-pattern-of-fixed-dose-drug-combinations-in-primary-secondary-and-tertiary-healthcare-centers-in-nepal-a-cross-sectional-study
#5
Arjun Poudel, Mohamed Izham Mohamed Ibrahim, Pranaya Mishra, Subish Palaian
BACKGROUND: Prescription practices, especially in South Asian countries, have come under investigation for quality. Although there have been no studies in Nepal that have analyzed the prescription pattern of FDCs for different levels of health care centers, several studies from Nepal and other countries in the region have revealed poor medicine use practices, including irrational use of fixed-dose drug combinations (FDCs). This research aimed at assessing the utilization pattern of FDCs among primary (PHC), secondary (SHC) and tertiary health care (THC) centers in Western region of Nepal...
November 2, 2017: BMC Pharmacology & Toxicology
https://www.readbyqxmd.com/read/29082158/using-sperm-testing-to-improve-patient-and-offspring-health-rational-evidence-based-care-of-the-infertile-male-in-the-art-clinic
#6
COMMENT
Douglas T Carrell, James Hotaling
No abstract text is available yet for this article.
September 2017: Translational Andrology and Urology
https://www.readbyqxmd.com/read/29073324/is-it-rational-to-pursue-zero-suicides-among-patients-in-health-care
#7
Jan K Mokkenstorm, Ad J F M Kerkhof, Johannes H Smit, Aartjan T F Beekman
Suicide prevention is a major health care responsibility in need of new perspectives. This study reviews Zero Suicide, an emerging approach to suicide prevention that embraces the aspirational goal of zero suicides among patients treated in health care systems or organizations. Zero Suicide is gaining international momentum while at the same time evoking objections and concerns. Fundamental to Zero Suicide is a multilevel system view on suicide prevention, with three core elements: a direct approach to suicidal behaviors; continual improvement of the quality and safety of care processes; and an organizational commitment to the aspirational goal of zero suicides...
October 26, 2017: Suicide & Life-threatening Behavior
https://www.readbyqxmd.com/read/29071767/communicating-value-in-simulation-cost-benefit-analysis-and-return-on-investment
#8
Carl V Asche, Minchul Kim, Alisha Brown, Antoinette Golden, Torrey A Laack, Javier Rosario, Christopher Strother, Vicken Y Totten, Yasuharu Okuda
Value-based health care requires a balancing of medical outcomes with economic value. Administrators need to understand both the clinical and economic effects of potentially expensive simulation programs to rationalize the costs. Given the often-disparate priorities of clinical educators relative to health care administrators, justifying the value of simulation requires the use of economic analyses few physicians have been trained to conduct. Clinical educators need to be able to present thorough economic analyses demonstrating returns on investment and cost effectiveness to effectively communicate with administrators...
October 26, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29063673/theoretical-development-in-the-context-of-nursing-the-hidden-epistemology-of-nursing-theory
#9
Bente Hoeck, Charlotte Delmar
This article is about nursing theories, the development of nursing knowledge and the underlying, hidden epistemology. The current technical-economical rationality in society and health care calls for a specific kind of knowledge based on a traditional Western, Socratic view of science. This has an immense influence on the development of nursing knowledge. The purpose of the article was therefore to discuss the hidden epistemology of nursing knowledge and theories seen in a broad historical context and point to an alternative epistemology for a future context...
October 24, 2017: Nursing Philosophy: An International Journal for Healthcare Professionals
https://www.readbyqxmd.com/read/29062977/expansion-mini-microscopy-an-enabling-alternative-in-point-of-care-diagnostics
#10
Yu Shrike Zhang, Grissel Trujillo-de Santiago, Mario Moisés Alvarez, Steven J Schiff, Edward S Boyden, Ali Khademhosseini
Diagnostics play a significant role in health care. In the developing world and low-resource regions the utility for point-of-care (POC) diagnostics becomes even greater. This need has long been recognized, and diagnostic technology has seen tremendous progress with the development of portable instrumentation such as miniature imagers featuring low complexity and cost. However, such inexpensive devices have not been able to achieve a resolution sufficient for POC detection of pathogens at very small scales, such as single-cell parasites, bacteria, fungi, and viruses...
March 2017: Curr Opin Biomed Eng
https://www.readbyqxmd.com/read/29055811/access-to-treatment-with-controlled-medicines-rationale-and-recommendations-for-neutral-precise-and-respectful-language
#11
REVIEW
W Scholten, O Simon, I Maremmani, C Wells, J F Kelly, R Hämmig, L Radbruch
The European Pain Federation EFIC, the International Association for Hospice and Palliative Care, International Doctors for Healthier Drug Policies, the Swiss Romandy College for Addiction Medicine, the Swiss Society of Addiction Medicine, and the World Federation for the Treatment of Opioid Dependence called on medical journals to ensure that authors always use terminology that is neutral, precise, and respectful in relation to the use of psychoactive substances. It has been shown that language can propagate stigma, and that stigma can prevent people from seeking help and influence the effectiveness of social and public-health policies...
October 19, 2017: Public Health
https://www.readbyqxmd.com/read/29046989/epilepsy-and-psychiatric-comorbidities-drug-selection
#12
REVIEW
Marco Mula
Purpose of review The pharmacological treatment of patients with epilepsy and psychiatric comorbidities may sometimes represent a therapeutic challenge. This review is focused on the pharmacological management of patients with epilepsy and psychiatric problems in terms of rationalization of the antiepileptic drug (AED) treatment and the pharmacological management of the most clinically relevant psychiatric comorbidities, namely mood and anxiety disorders, psychoses, and attention deficit hyperactivity disorder (ADHD)...
October 19, 2017: Current Treatment Options in Neurology
https://www.readbyqxmd.com/read/29046768/smartphones-and-e-tablets-in-perioperative-medicine
#13
REVIEW
Frederic Michard
Smartphones and electronic tablets (e-tablets) have become ubiquitous devices. Their ease of use, smartness, accessibility, mobility and connectivity create unique opportunities to improve quality of surgical care from prehabilitation to rehabilitation. Before surgery, digital applications (Apps), serious games and text messaging may help for a better control of risk factors (hypertension, overweight), for smoking cessation, and for optimizing adherence to preoperative recommendations (e.g., regarding anticoagulation or antihypertensive treatments)...
October 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/29029668/the-de-pharm-project-a-pharmacist-driven-deprescribing-initiative-in-a-nursing-facility
#14
Jennifer Pruskowski, Steven M Handler
OBJECTIVE: Many residents with life-limiting illnesses are being prescribed and taking potentially inappropriate medications (PIMs) and questionably beneficial medications either near or at the end of life. These medications can contribute to adverse drug reactions, increase morbidity, and increase unnecessary burden and cost. It is crucial that the process of deprescribing be incorporated into the care of these residents. After developing a clinical pharmacist-driven deprescribing initiative in the nursing facility, the objective of this project was to reduce the number of PIMs via accepted recommendations from the clinical pharmacist to the primary team...
August 1, 2017: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
https://www.readbyqxmd.com/read/29029663/demystifying-probiotics-use-in-the-elderly
#15
Caren McHenry Martin, Gianna Bryan
Pharmacists and other health care professionals can be perplexed by the growing body of literature regarding the use of probiotics for a variety of symptoms and conditions and by an increasing number of probiotic products available to consumers. Understanding the functions of the intestinal microbiome, the possible mechanisms of actions of probiotics, the research supporting or refuting probiotic use, and criteria for selecting a probiotic product is essential to making a rational recommendation for patients...
August 1, 2017: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
https://www.readbyqxmd.com/read/29024890/a-systematic-review-of-economic-evaluation-in-pancreatic-ductal-adenocarcinoma
#16
REVIEW
Claire Gérard, Philippe Fagnoni, Angélique Vienot, Christophe Borg, Samuel Limat, Franck Daval, François Calais, Julie Vardanega, Marine Jary, Virginie Nerich
OBJECTIVES: The economic evaluation (EE) of healthcare interventions has become a necessity. However, high quality needs to be ensured in order to achieve validated results and help making informed decisions. Thus, the objective of the present study was to systematically identify and review published pancreatic ductal adenocarcinoma-related EEs and to assess their quality. METHODS: Systematic literature research was conducted in PubMed and Cochrane to identify published EEs between 2000 and 2015...
October 9, 2017: European Journal of Cancer
https://www.readbyqxmd.com/read/29017990/healthy-beyond-pregnancy-a-web-based-intervention-to-improve-adherence-to-postpartum-care-randomized-controlled-feasibility-trial
#17
Katherine Park Himes, Heidi Donovan, Stephanie Wang, Carrie Weaver, Jillian Rae Grove, Francesca Lucia Facco
BACKGROUND: During the postpartum visit, health care providers address issues with short- and long-term implications for maternal and child health. Women with Medicaid insurance are less likely to return for a postpartum visit compared with women with private insurance. Behavioral economics acknowledges that people do not make exclusively rational choices, rather immediate gratification, cognitive and psychological biases, and social norms influence decision making. Drawing on insights from decision science, behavioral economists have examined how these biases can be modulated through carefully designed interventions...
October 10, 2017: JMIR Human Factors
https://www.readbyqxmd.com/read/29017755/self-medication-and-non-prescription-drug-counseling-illustrating-profession-uncertainty-within-turkish-pharmacy-practice
#18
Afonso Miguel Cavaco, Bilge Sozen-Sahne, Elif Ulutas-Deniz, Selen Yegenoglu
BACKGROUND: Recommending effective minor ailment treatments and using non-prescription or over-the-counter (OTC) medicines is a pharmacist's duty. Although common in most European countries, self-medication counseling practices may differ from country to country. OBJECTIVES: This study explored Turkish community pharmacists' attitudes concerning the present self-medication market, professional responsibilities toward patients' self-care, and the usefulness of e-learning for patients' counseling education...
September 29, 2017: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/29016415/prognostications-in-health-care
#19
Suzanne K Powell
There are health care issues that have been around for decades, which may likely continue: rationed health care, rising costs, patient safety, ageing populations, and transitional care techniques. Current issues include these, plus their evolutionary variations such as new technologies, the changing health care landscape, and subsequent emerging ethical issues. Where will it all go? No one knows.
November 2017: Professional Case Management
https://www.readbyqxmd.com/read/28992541/pastoral-power-in-hiv-prevention-converging-rationalities-of-care-in-christian-and-medical-practices-in-papua-new-guinea
#20
P Shih, H Worth, J Travaglia, A Kelly-Hanku
In his conceptualisation of pastoral power, Michel Foucault argues that modern healthcare practices derive a specific power technique from pastors of the early Christian church. As experts in a position of authority, pastors practise the care of others through implicitly guiding them towards thoughts and actions that effect self-care, and towards a predefined realm of acceptable conduct, thus having a regulatory effect. This qualitative study of healthcare workers from two Christian faith-based organisations in Papua New Guinea examines the pastoral rationalities of HIV prevention practices which draw together globally circulated modern medical knowledge and Christian teachings in sexual morality for implicit social regulation...
November 2017: Social Science & Medicine
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