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Value-based medicine

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https://www.readbyqxmd.com/read/28346622/future-of-family-medicine-faculty-development-in-sub-saharan-africa
#1
Paul R Larson, Patrick Chege, Bruce Dahlman, Christine Gibson, Ann Evensen, Maria C Colon-Gonzalez, Stephanie Onguka, Roberta Lamptey, William E Cayley, Bich-May Nguyen, Brian Johnson, Sawra Getnet, Memoona Hasnain
BACKGROUND AND OBJECTIVES: High-quality family medicine education is needed in sub-Saharan Africa to facilitate the future growth of primary care health systems. Current faculty educators recognize the value of dedicated teacher training and ongoing faculty development. However, they are constrained by inadequate faculty development program availability and institutional support. METHODS: A cross-sectional study design was used to conduct a qualitative needs assessment comprised of 37 in-depth, semi-structured interviews of individual faculty trainers from postgraduate family medicine training programs in eight sub-Saharan African countries...
March 2017: Family Medicine
https://www.readbyqxmd.com/read/28345431/collaterals-2016-translating-the-collaterome-around-the-globe
#2
David S Liebeskind, Graham W Woolf, Ashfaq Shuaib
Collaterals 2016 (third International Symposium on Collaterals to the Brain) was a multidisciplinary scientific conference focused on collateral circulation in acute ischemic stroke. Decisive challenges include generalizability of optimal triage and selection paradigms based on collateral status for definitive treatment of acute ischemic stroke, rapid dissemination of expert methods, and the urgent need to leverage networking opportunities for stroke science related to the hemodynamics of collaterals. The collaterome, or individual capacity to offset ischemia in the brain, and determination of a favorable collateral profile have become pivotal factors in consideration of the precision medicine of stroke decision-making...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28345371/ewma-document-negative-pressure-wound-therapy
#3
Jan Apelqvist, Christian Willy, Ann-Mari Fagerdahl, Marco Fraccalvieri, Malin Malmsjö, Alberto Piaggesi, Astrid Probst, Peter Vowden
1. Introduction Since its introduction in clinical practice in the early 1990's negative pressure wounds therapy (NPWT) has become widely used in the management of complex wounds in both inpatient and outpatient care.(1) NPWT has been described as a effective treatment for wounds of many different aetiologies(2,3) and suggested as a gold standard for treatment of wounds such as open abdominal wounds,(4-6) dehisced sternal wounds following cardiac surgery(7,8) and as a valuable agent in complex non-healing wounds...
March 1, 2017: Journal of Wound Care
https://www.readbyqxmd.com/read/28345067/utility-of-360-degree-assessment-of-residents-in-a-turkish-academic-emergency-medicine-residency-program
#4
Cem Oktay, Yesim Senol, Stephan Rinnert, Yildiray Cete
OBJECTIVES: This study was designed to test a 360-degree assessment tool for four of the emergency medicine resident competencies as outlined by the Council of Residency Directors in Emergency Medicine on patient care, communication skills, professionalism and system based practice in an academic Emergency Department. MATERIAL AND METHODS: Using the competency framework of the American Accreditation Council for Graduate Medical Education, a 57 item-containing assessment tool was created...
March 2017: Turkish Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28344600/staged-reconstruction-brachytherapy-has-lower-overall-cost-in-recurrent-soft-tissue-sarcoma
#5
Arash O Naghavi, Ricardo J Gonzalez, Jacob G Scott, Youngchul Kim, Yazan A Abuodeh, Tobin J Strom, Michelle Echevarria, John E Mullinax, Kamran A Ahmed, Louis B Harrison, Daniel C Fernandez
PURPOSE: Adjuvant brachytherapy (AB) with immediate (IR) and staged reconstruction (SR) are distinct treatment modalities available for patients with recurrent soft tissue sarcoma (STS). Although SR may offer local control and toxicity benefit, it requires additional upfront procedures, and there is no evidence that it improves overall survival. With the importance of value-based care, our goal is to identify which technique is more cost effective. MATERIAL AND METHODS: A retrospective review of 22 patients with recurrent extremity STS treated with resection followed by AB alone...
February 2017: Journal of Contemporary Brachytherapy
https://www.readbyqxmd.com/read/28344475/antiproliferative-and-apoptotic-effect-of-morus-nigra-extract-on-human-prostate-cancer-cells
#6
Ibrahim Turan, Selim Demir, Kagan Kilinc, Nesibe Arslan Burnaz, Serap Ozer Yaman, Kubra Akbulut, Ahmet Mentese, Yuksel Aliyazicioglu, Orhan Deger
Background: Morus nigra L. belongs to the family Moraceae and is frequently used in traditional medicine. Numerous studies have investigated the antiproliferative effects of various extracts of different Morus species, but studies involving the in vitro cytotoxic effect of M. nigra extract are very limited. The purpose of this study was to evaluate the phenolic composition and antioxidant activity of dimethyl sulfoxide extract of M. nigra (DEM) and to investigate, for the first time, the probable cytotoxic effect in human prostate adenocarcinoma (PC-3) cells together with the mechanism involved...
February 2017: Saudi Pharmaceutical Journal: SPJ: the Official Publication of the Saudi Pharmaceutical Society
https://www.readbyqxmd.com/read/28344446/prediction-of-tennis-performance-in-junior-elite-tennis-players
#7
Tamara Kramer, Barbara C H Huijgen, Marije T Elferink-Gemser, Chris Visscher
Predicting current and future tennis performance can lead to improving the development of junior tennis players. The aim of this study is to investigate whether age, maturation, or physical fitness in junior elite tennis players in U13 can explain current and future tennis performance. The value of current tennis performance for future tennis performance is also investigated. A total of 86 junior elite tennis players (boys, n = 44; girls, n = 42) U13 (aged: 12.5 ± 0.3 years), and followed to U16, took part in this study...
March 2017: Journal of Sports Science & Medicine
https://www.readbyqxmd.com/read/28344140/high-value-cost-conscious-care-iterative-systems-based-interventions-to-reduce-unnecessary-lab-testing
#8
Brett W Sadowski, Alison B Lane, Shannon M Wood, Sara L Robinson, Chin Hee Kim
BACKGROUND: Inappropriate testing contributes to soaring health care costs within the United States and teaching hospitals are vulnerable to providing care largely for academic development. Via its 'Choosing Wisely' campaign, the American Board of Internal Medicine recommends avoiding repetitive testing for stable inpatients. We designed systems-based interventions to reduce laboratory orders for patients admitted to the wards at an academic facility. METHODS: We identified the computer-based order entry system as an appropriate target for sustainable intervention...
March 23, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28343164/a-quantitative-concordance-measure-for-comparing-and-combining-treatment-selection-markers
#9
Zhiwei Zhang, Shujie Ma, Lei Nie, Guoxing Soon
Motivated by an HIV example, we consider how to compare and combine treatment selection markers, which are essential to the notion of precision medicine. The current literature on precision medicine is focused on evaluating and optimizing treatment regimes, which can be obtained by dichotomizing treatment selection markers. In practice, treatment decisions are based not only on efficacy but also on safety, cost and individual preference, making it difficult to choose a single cutoff value for all patients in all settings...
March 25, 2017: International Journal of Biostatistics
https://www.readbyqxmd.com/read/28342581/neurodevelopmental-outcomes-in-infants-undergoing-general-anesthesia
#10
Kelsey A Nestor, Michelle Zeidan, Erin Boncore, Aaron Richardson, Gijo Alex, Michael Weiss, Saleem Islam
PURPOSE: Preclinical data strongly suggest that all agents used for general anesthesia (GA) have detrimental effects on the developing brain. However, clinical data are unclear. The purpose of this study was to use a cohort of infants who underwent GA and understand their neurodevelopmental outcomes. METHODS: A cohort of infants who underwent GA was selected between 2010 and 2011, and a control group was created. Data regarding GA, procedures, and outcomes were collected in 2015...
March 16, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28341955/osteoplasty-in-crooked-nose-deformity-a-novel-approach
#11
Ilker Koçak, Erol Senturk
BACKGROUND: Crooked nose deformity is one of the most difficult issues to correct by rhinoplasty, as it can result in undesired late sequelae. Revision rates are often high, and numerous operational techniques have been tested. This study describes a crooked nose rhinoplasty technique that reduces the need for a double osteotomy in the long nasal bone. METHODS: This study included 26 patients with an I-shaped crooked nose deformity. In the surgical correction of the crooked nose deformity, previously defined techniques were applied to the cartilage identically...
March 24, 2017: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28341581/the-graham-jackson-memorial-lecture-issm-2016-the-man-who-knew-too-much-time-to-recognize-erectile-dysfunction-and-low-testosterone-as-independent-risk-factors-for-cardiovascular-disease
#12
REVIEW
Geoffrey Hackett
INTRODUCTION: Graham Jackson introduced the concept that erectile dysfunction (ED) is a marker for undiagnosed cardiovascular (CV) disease and future events. In the Princeton 3 guidelines, he recognized the important impact of testosterone deficiency (TD) on all-cause and CV mortality. Recent evidence suggests that testosterone therapy to target levels and for sufficient duration decreases CV events. Unfortunately, this had a modest impact on CV disease management because ED is not incorporated into current risk calculators...
March 21, 2017: Sexual Medicine Reviews
https://www.readbyqxmd.com/read/28341247/toxicological-evaluation-of-oviductus-ranae-acute-sub-acute-and-genotoxicity-studies-in-mice-and-rats
#13
Yang Zhang, Kun Zhu, Hao Cui, Yang Liu, Ye-Fang Lu, Hong-Wei Pan, He-Peng Zhao, Ling Qi, Xiu-Dong Yang, Hong-Li Zhou
ETHNOPHARMACOLOGICAL RELEVANCE: Oviductus ranae (OR) is a traditional animal-based Chinese medicine, which has been listed in the Chinese Pharmacopoeia since 1985 edition. Although its medicinal application has been widely acknowleged, there is little available information on its potential toxicity. AIM OF THE STUDY: The aim of this study was to investigate the acute, sub-acute, and genetic toxicities of OR. MATERIALS AND METHODS: In acute toxicity evaluation, OR was administered orally to mice at doses of 2...
March 21, 2017: Journal of Ethnopharmacology
https://www.readbyqxmd.com/read/28339766/higher-bioavailability-of-doxycycline-in-broiler-chickens-with-a-novel-in-feed-pharmaceutical-formulation
#14
Lilia Gutiérrez, Juan Zermeño, Yazmín Alcalá, Héctor Sumano
Bioavailability of a new, long-acting (LA) pharmaceutical preparation for administering doxycycline as in-feed medication to broiler chickens was compared to the standard in-feed administration of doxycycline. A commercial poultry house harboring Ross-308 broiler chickens, weighing 450 g, was divided into 7 sections as follows: doxy-FOLA group (n = 6,000 chickens divided into 3 replicates) medicated with 10% doxycyline, long-acting pellets at a dose of 400 g of doxycycline HCl/ton of food, resulting in a calculated dose of 48 mg/kg for 5 d; doxy-ref group (n = 6,000, divided into 3 replicates) medicated as for doxy-FOLA, but using a 20% commercial preparation of doxycycline...
February 23, 2017: Poultry Science
https://www.readbyqxmd.com/read/28338645/development-of-44-novel-polymorphic-ssr-markers-for-determination-of-shiitake-mushroom-lentinula-edodes-cultivars
#15
Hwa-Yong Lee, Suyun Moon, Donghwan Shim, Chang Pyo Hong, Yi Lee, Chang-Duck Koo, Jong-Wook Chung, Hojin Ryu
The shiitake mushroom (Lentinulaedodes) is one of the most popular edible mushrooms in the world and has attracted attention for its value in medicinal and pharmacological uses. With recent advanced research and techniques, the agricultural cultivation of the shiitake mushroom has been greatly increased, especially in East Asia. Additionally, demand for the development of new cultivars with good agricultural traits has been greatly enhanced, but the development processes are complicated and more challenging than for other edible mushrooms...
March 24, 2017: Genes
https://www.readbyqxmd.com/read/28335766/barriers-to-the-conduct-and-application-of-research-in-complementary-and-alternative-medicine-a-systematic-review
#16
Yasamin Veziari, Matthew J Leach, Saravana Kumar
BACKGROUND: The popularity of Complementary and alternative medicine (CAM) has grown considerably over the past few decades. This has been accompanied by increasing public pressure for CAM to be evidence-based. Notwithstanding, the conduct and application of research in CAM faces a number of obstacles. No systematic review has mapped these barriers to date. Therefore, this systematic literature review aimed to explore, identify and map the barriers to the conduct and application of research in CAM...
March 23, 2017: BMC Complementary and Alternative Medicine
https://www.readbyqxmd.com/read/28334910/evaluating-pharmacist-input-into-the-pharmaceutical-care-of-patients-in-dispensing-medical-practices-in-remote-and-rural-areas-of-scotland
#17
Derek Stewart, Breda Anthony, Clare Morrison, Yvonne MacRae, Lucy Dixon, Emer Friel, Evelyn Yoong, Scott Cunningham, Katie MacLure
Background.: The Highlands and the Western Isles are the two most remote and rural areas of Scotland, with many medical practices in areas where pharmacies would not be viable. Recent regulations state that that dispensing medical practices in these areas must receive pharmacist support for patients who would benefit. Objective.: This study aimed to evaluate pilot services, which centred on the provision of patient centred pharmaceutical care. Methods...
March 8, 2017: Family Practice
https://www.readbyqxmd.com/read/28334396/quantifying-circular-rna-expression-from-rna-seq-data-using-model-based-framework
#18
Musheng Li, Xueying Xie, Jing Zhou, Mengying Sheng, Xiaofeng Yin, Eun-A Ko, Tong Zhou, Wanjun Gu
Motivation: Circular RNAs (circRNAs) are a class of non-coding RNAs that are widely expressed in various cell lines and tissues of many organisms. Although the exact function of many circRNAs is largely unknown, the cell type- and tissue-specific circRNA expression has implicated their crucial functions in many biological processes. Hence, the quantification of circRNA expression from high-throughput RNA-seq data is becoming important to ascertain. Although many model-based methods have been developed to quantify linear RNA expression from RNA-seq data, these methods are not applicable to circRNA quantification...
March 8, 2017: Bioinformatics
https://www.readbyqxmd.com/read/28331118/reconsideration-of-secondary-risk-management-strategies-in-patients-with-ischemic-heart-disease
#19
Kuninobu Kashiyama, Shinjo Sonoda, Yutaka Otsuji
The main risk factors in ischemic heart diseases, including myocardial infarction, are hypertension, dyslipidemia, diabetes, obesity and smoking. The incidence of ischemic heart disease in Japan has been lower than that in Western countries because of differences in lifestyle and the anatomy of the coronary arteries, but the situation has been changing recently because of the westernization of lifestyle. Cardiovascular diseases have become the second most common cause of death in Japan, and 40% of those deaths are attributed to ischemic heart disease...
2017: Journal of UOEH
https://www.readbyqxmd.com/read/28327571/insights-from-early-experience-of-a-rare-disease-genomic-medicine-multidisciplinary-team-a-qualitative-study
#20
Elizabeth Ormondroyd, Michael P Mackley, Edward Blair, Jude Craft, Julian C Knight, John Taylor, Jenny C Taylor, Andrew Om Wilkie, Hugh Watkins
Whole-exome/whole-genome sequencing (WES/WGS) has the potential to enhance genetic diagnosis of rare disease, and is increasingly becoming part of routine clinical care in mainstream medicine. Effective translation will require ongoing efforts in a number of areas including: selection of appropriate patients, provision of effective consent, pre- and post-test genetic counselling, improving variant interpretation algorithms and practices, and management of secondary findings including those found incidentally and those actively sought...
March 22, 2017: European Journal of Human Genetics: EJHG
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