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https://www.readbyqxmd.com/read/28107451/effect-of-nocturnal-hemodialysis-versus-conventional-hemodialysis-on-end-stage-renal-disease-a-meta-analysis-and-systematic-review
#1
Fangjie Liu, Yiting Sun, Tianhua Xu, Li Sun, Linlin Liu, Wei Sun, Xin Feng, Jianfei Ma, Lining Wang, Li Yao
OBJECTIVES: The purpose of this study is to assess the efficacy and safety of nocturnal hemodialysis on end-stage renal disease (ESRD) patients. METHODS: We searched Medline, EmBase, and the Cochrance Central Register of Controlled Trials for studies up to January 2016. Analysis was done to compare variant outcomes of different hemodialysis schedules, including mortality, cardiovascular-associated variables, uremia-associated variables, quality of life (QOL), side-effects, and drug usage...
2017: PloS One
https://www.readbyqxmd.com/read/28107397/efficacy-and-safety-of-everolimus-for-maintenance-immunosuppression-of-kidney-transplantation-a-meta-analysis-of-randomized-controlled-trials
#2
Jinyu Liu, Dong Liu, Juan Li, Lan Zhu, Chengliang Zhang, Kai Lei, Qiling Xu, Ruxu You
BACKGROUND: Conversion to everolimus is often used in kidney transplantation to overcome calcineurin inhibitor (CNI) nephrotoxicity but there is conflicting evidence for this approach. OBJECTIVES: To investigate the benefits and harm from randomized clinical trials (RCTs) involving the conversion from CNI to everolimus after kidney transplantation. METHODS: Databases were searched up to March 2016. Two reviewers independently assessed trials for eligibility and quality, and extracted data...
2017: PloS One
https://www.readbyqxmd.com/read/28107394/quality-of-documentation-as-a-surrogate-marker-for-awareness-and-training-effectiveness-of-phtls-courses-part-of-the-prospective-longitudinal-mixed-methods-epptc-trial
#3
David Häske, Stefan K Beckers, Marzellus Hofmann, Rolf Lefering, Bernhard Gliwitzky, Christoph C Wölfl, Paul Grützner, Ulrich Stöckle, Marc Dieroff, Matthias Münzberg
OBJECTIVE: Care for severely injured patients requires multidisciplinary teamwork. A decrease in the number of accident victims ultimately affects the routine and skills. PHTLS ("Pre-Hospital Trauma Life Support") courses are established two-day courses for medical and non-medical rescue service personnel, aimed at improving the pre-hospital care of trauma patients worldwide. The study aims the examination of the quality of documentation before and after PHTLS courses as a surrogate endpoint of training effectiveness and awareness...
2017: PloS One
https://www.readbyqxmd.com/read/28105882/quality-improvement-in-hospitals-barriers-and-facilitators
#4
Dick E Zoutman, B Douglas Ford
Purpose The purpose of this paper is to examine quality improvement (QI) initiatives in acute care hospitals, the factors associated with success, and the impacts on patient care and safety. Design/methodology/approach An extensive online survey was completed by senior managers responsible for QI. The survey assessed QI project types, QI methods, staff engagement, and barriers and factors in the success of QI initiatives. Findings The response rate was 37 percent, 46 surveys were completed from 125 acute care hospitals...
February 13, 2017: International Journal of Health Care Quality Assurance
https://www.readbyqxmd.com/read/28104490/increasing-trainee-reporting-of-adverse-events-with-monthly-trainee-directed-review-of-adverse-events
#5
Alla Smith, Jonathan Hatoun, James Moses
OBJECTIVE: Underreporting of adverse events by physicians is a barrier to improving patient safety. In an effort to increase resident and medical student (hereafter "trainee") reporting of adverse events, trainees developed and led a monthly conference during which they reviewed adverse-event reports, identified system vulnerabilities and designed solutions to those vulnerabilities. METHODS: Monthly conferences over the 22-month study period were led by pediatric trainees, and attended by fellow trainees, departmental leadership, and members of the hospital's quality improvement team...
January 16, 2017: Academic Pediatrics
https://www.readbyqxmd.com/read/28104022/-immune-checkpoint-inhibitor-therapy-in-advanced-head-and-neck-cancer
#6
W Hang, Z X Xu, Q Zhang, X Lu, G Liu
Immune checkpoint inhibitor therapy, which targets regulatory pathways in T cells to enhance antitumor immune responses, improves the life quality of cancer patients and has joined the ranks of surgery, radiation, and chemotherapy to become a major choice for cancer therapy. Over the past few years, multiple exciting results have been obtained on checkpoint inhibitor therapy in advanced head and neck cancer. However, questions such as patient selection and biomarkers for assessing the therapy are largely unsolved...
January 7, 2017: Zhonghua Er Bi Yan Hou Tou Jing Wai Ke za Zhi, Chinese Journal of Otorhinolaryngology Head and Neck Surgery
https://www.readbyqxmd.com/read/28103925/protocol-for-a-realist-review-of-workplace-learning-in-postgraduate-medical-education-and-training
#7
Anel Wiese, Caroline Kilty, Colm Bergin, Patrick Flood, Na Fu, Mary Horgan, Agnes Higgins, Bridget Maher, Grainne O'Kane, Lucia Prihodova, Dubhfeasa Slattery, Deirdre Bennett
BACKGROUND: Postgraduate medical education and training (PGMET) is a complex social process which happens predominantly during the delivery of patient care. The clinical learning environment (CLE), the context for PGMET, shapes the development of the doctors who learn and work within it, ultimately impacting the quality and safety of patient care. Clinical workplaces are complex, dynamic systems in which learning emerges from non-linear interactions within a network of related factors and activities...
January 19, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/28103397/the-economic-burden-of-nurse-sensitive-adverse-events-in-22-medical-surgical-units-retrospective-and-matching-analysis
#8
Eric Tchouaket, Carl-Ardy Dubois, Danielle D'Amour
AIMS: To assess the economic burden of nurse-sensitive adverse events (NSAEs) in 22 acute care units in Quebec by estimating excess hospital-related costs and calculating resulting additional hospital days. BACKGROUND: Recent changes in the worldwide economic and financial contexts have made the cost of patient safety a topical issue. Yet our knowledge about the economic burden of safety of nursing care is quite limited in Canada in general and Quebec in particular...
January 19, 2017: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/28101765/tolerability-and-safety-of-commonly-used-antiepileptic-drugs-in-adolescents-and-adults-a-clinician-s-overview
#9
REVIEW
Martin J Brodie
This paper discusses the issues surrounding the tolerability and safety of the commonly used antiepileptic drugs (AEDs) in adolescents and adults. The content includes dose-related adverse effects, idiosyncratic reactions, behavioural and psychiatric comorbidities, chronic problems, enzyme induction and teratogenesis. Twenty-one AEDs are discussed in chronological order of their introduction into the UK, starting with phenobarbital and ending with brivaracetam. Wherever possible, advice is given on anticipating, recognising and managing these issues and thereby improving the lives of people with epilepsy, most of whom will need to take one or more of these agents for life...
January 18, 2017: CNS Drugs
https://www.readbyqxmd.com/read/28101753/effect-and-safety-of-paroxetine-combined-with-zolpidem-in-treatment-of-primary-insomnia
#10
Z H Yu, X H Xu, S D Wang, M F Song, Y Liu, Y Yin, H J Mao, G Z Tang
PURPOSE: Primary insomnia is a persistent and recurrent disorder as well as a risk factor for depression. The aim of this study was to determine whether the zolpidem combined with paroxetine would be effective in the treatment of patients with primary insomnia. METHODS: Ninety patients meeting DSM-IV criteria for primary insomnia were randomly assigned to 8 weeks of treatment with zolpidem combined with paroxetine (the combined treatment group, n = 45) or zolpidem combined with placebo (the control group, n = 45)...
January 18, 2017: Sleep & Breathing, Schlaf & Atmung
https://www.readbyqxmd.com/read/28101651/eslicarbazepine-acetate-its-effectiveness-as-adjunctive-therapy-in-clinical-trials-and-open-studies
#11
REVIEW
S D Shorvon, E Trinka, B J Steinhoff, M Holtkamp, V Villanueva, J Peltola, E Ben-Menachem
Eslicarbazepine acetate (ESL) is a once-daily antiepileptic drug that is approved as adjunctive therapy in adults with focal-onset seizures. Following oral administration, ESL is rapidly metabolized to its active metabolite, eslicarbazepine, which acts primarily by enhancing slow inactivation of voltage-gated sodium channels. The efficacy and safety/tolerability of ESL in the adjunctive setting were established in a comprehensive Phase III program (n = 1702 randomized patients) and this evidence has been supported by several open studies (n = 864)...
January 18, 2017: Journal of Neurology
https://www.readbyqxmd.com/read/28101567/influence-of-arm-crank-ergometry-on-development-of-lymphedema-in-breast-cancer-patients-after-axillary-dissection-a-randomized-controlled-trail
#12
Thorsten Schmidt, Jette Berner, Walter Jonat, Burkhard Weisser, Christioph Röcken, Marion van Mackelenbergh, Christoph Mundhenke
OBJECTIVE: To investigate the safety and efficacy of arm crank ergometry in breast cancer patients after axillary lymph node dissection, with regard to changes in bioelectrical impedance analysis, arm circumference, muscular strength, quality of life and fatigue. DESIGN: Randomized controlled clinical intervention trial. SUBJECTS: Forty-nine patients with breast cancer after axillary lymph node dissection. METHODS: Arm crank ergometer training twice-weekly was compared with usual care over 12 weeks...
January 19, 2017: Journal of Rehabilitation Medicine
https://www.readbyqxmd.com/read/28100544/oscillatory-whole-body-vibration-improves-exercise-capacity-and-physical-performance-in-pulmonary-arterial-hypertension-a-randomised-clinical-study
#13
Felix Gerhardt, Daniel Dumitrescu, Carina Gärtner, Ralf Beccard, Thomas Viethen, Tilmann Kramer, Stephan Baldus, Martin Hellmich, Eckhard Schönau, Stephan Rosenkranz
OBJECTIVE: In patients with pulmonary arterial hypertension (PAH), supportive therapies may be beneficial in addition to targeted medical treatment. Here, we evaluated the effectiveness and safety of oscillatory whole-body vibration (WBV) in patients on stable PAH therapy. METHODS: Twenty-two patients with PAH (mean PAP≥25 mm Hg and pulmonary arterial wedge pressure (PAWP)≤15 mm Hg) who were in world health organization (WHO)-Functional Class II or III and on stable PAH therapy for≥3 months, were randomised to receive WBV (16 sessions of 1-hour duration within 4 weeks) or to a control group, that subsequently received WBV...
January 18, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28100176/effect-of-training-and-structured-medication-review-on-medication-appropriateness-in-nursing-home-residents-and-on-cooperation-between-health-care-professionals-the-intherakt-study-protocol
#14
Angelika Mahlknecht, Nadja Nestler, Ulrike Bauer, Nadine Schüßler, Jochen Schuler, Sebastian Scharer, Ralf Becker, Isabel Waltering, Georg Hempel, Oliver Schwalbe, Maria Flamm, Jürgen Osterbrink
BACKGROUND: Pharmacotherapy in residents of nursing homes is critical due to the special vulnerability of this population. Medical care and interprofessional communication in nursing homes are often uncoordinated. As a consequence, polypharmacy and inappropriate medication use are common and may lead to hospitalizations and health hazards. The aim of this study is to optimize communication between the involved professional groups by specific training and by establishing a structured medication review process, and to improve medication appropriateness and patient-relevant health outcomes for residents of nursing homes...
January 18, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28099988/exercise-based-rehabilitation-programmes-for-pulmonary-hypertension
#15
REVIEW
Norman R Morris, Fiona D Kermeen, Anne E Holland
BACKGROUND: Individuals with pulmonary hypertension (PH) have reduced exercise capacity and quality of life. Despite initial concerns that exercise training may worsen symptoms in this group, several studies have reported improvements in functional capacity and well-being following exercise-based rehabilitation in PH. OBJECTIVES: To assess the efficacy and safety of exercise-based rehabilitation for people with PH. Primary outcomes were exercise capacity, adverse events during the intervention period and health-related quality of life (HRQoL)...
January 19, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28099325/intraoperative-clinical-decision-support-for-anesthesia-a-narrative-review-of-available-systems
#16
Bala G Nair, Eilon Gabel, Ira Hofer, Howard A Schwid, Maxime Cannesson
With increasing adoption of anesthesia information management systems (AIMS), there is growing interest in utilizing AIMS data for intraoperative clinical decision support (CDS). CDS for anesthesia has the potential for improving quality of care, patient safety, billing, and compliance. Intraoperative CDS can range from passive and post hoc systems to active real-time systems that can detect ongoing clinical issues and deviations from best practice care. Real-time CDS holds the most promise because real-time alerts and guidance can drive provider behavior toward evidence-based standardized care during the ongoing case...
February 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28099276/factors-in-the-efficacy-safety-and-impact-on-quality-of-life-for-treatment-of-drooling-with-botulinum-toxin-type-a-in-patients-with-cerebral-palsy
#17
Maria D Gonzalez-L, Carmen Martinez, Inma Bori Y Fortuny, Santiago Suso-Vergara
OBJECTIVE: To assess the efficacy and safety of botulinum toxin A (BoNT-A) injected in both submandibular and parotid versus only in parotid glands as a treatment for drooling in patients with spastic and dyskinetic cerebral palsy (CP), including an assessment of impact on quality of life (QoL) based on items from the International Classification of Functioning, Disability, and Health (ICF) core set. DESIGN: Forty patients with CP 18 years or older (mean, 21.8 years) participated in a prospective, single-center, randomized controlled interventional study...
February 2017: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/28097941/telemedicine-support-shortens-length-of-stay-after-fast-track-hip-replacement
#18
Martin Svoldgaard Vesterby, Preben Ulrich Pedersen, Malene Laursen, Søren Mikkelsen, Jens Larsen, Kjeld Søballe, Lene Bastrup Jørgensen
Background and purpose - Telemedicine could allow patients to be discharged more quickly after surgery and contribute to improve fast-track procedures without compromising quality, patient safety, functionality, anxiety, or other patient-perceived parameters. We investigated whether using telemedicine support (TMS) would permit hospital discharge after 1 day without loss of self-assessed quality of life, loss of functionality, increased anxiety, increased rates of re-admission, or increased rates of complications after hip replacement...
February 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28096194/autologous-cell-therapy-for-peripheral-arterial-disease-systematic-review-and-meta-analysis-of-randomized-non-randomized-and-non-controlled-studies
#19
Mauro Rigato, Matteo Monami, Gian Paolo Fadini
RATIONALE: Critical limb ischemia (CLI) is a life-threatening complication of peripheral arterial disease (PAD). In patients who are ineligible for revascularization procedures, there are few therapeutic alternatives, leading to amputations and death. OBJECTIVE: To provide a systematic review of the literature and a meta-analysis of studies evaluating safety and efficacy of autologous cell therapy for intractable PAD/CLI. METHODS AND RESULTS: We retrieved 19 randomized controlled trials (RCTs; 837 patients), 7 non-randomized trials (338 patients), and 41 non-controlled studies (1,177 patients)...
January 17, 2017: Circulation Research
https://www.readbyqxmd.com/read/28095408/patient-safety-incidents-involving-sick-children-in-primary-care-in-england-and-wales-a-mixed-methods-analysis
#20
Philippa Rees, Adrian Edwards, Colin Powell, Peter Hibbert, Huw Williams, Meredith Makeham, Ben Carter, Donna Luff, Gareth Parry, Anthony Avery, Aziz Sheikh, Liam Donaldson, Andrew Carson-Stevens
BACKGROUND: The UK performs poorly relative to other economically developed countries on numerous indicators of care quality for children. The contribution of iatrogenic harm to these outcomes is unclear. As primary care is the first point of healthcare contact for most children, we sought to investigate the safety of care provided to children in this setting. METHODS AND FINDINGS: We undertook a mixed methods investigation of reports of primary care patient safety incidents involving sick children from England and Wales' National Reporting and Learning System between 1 January 2005 and 1 December 2013...
January 2017: PLoS Medicine
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