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https://www.readbyqxmd.com/read/28106608/a-perioperative-systems-design-to-improve-intraoperative-glucose-monitoring-is-associated-with-a-reduction-in-surgical-site-infections-in-a-diabetic-patient-population
#1
Jesse M Ehrenfeld, Jonathan P Wanderer, Maxim Terekhov, Brian S Rothman, Warren S Sandberg
BACKGROUND: Diabetic patients receiving insulin should have periodic intraoperative glucose measurement. The authors conducted a care redesign effort to improve intraoperative glucose monitoring. METHODS: With approval from Vanderbilt University Human Research Protection Program (Nashville, Tennessee), the authors created an automatic system to identify diabetic patients, detect insulin administration, check for recent glucose measurement, and remind clinicians to check intraoperative glucose...
January 19, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28099686/the-clinical-implementation-of-primary-hpv-screening
#2
REVIEW
Luciano Mariani, Sarah Igidbashian, Maria Teresa Sandri, Patrizia Vici, Fabio Landoni
OBJECTIVE: To evaluate, from a gynecology perspective, the transition from cytology-based HPV screening to primary HPV screening. METHOD: Studies examining switching from cytology-based screening to primary HPV-DNA testing with triaging of patients with positive test results were retrieved and reviewed, with a particular focus on screening in an Italian setting. RESULTS: The increased complexity of patient-management decisions when implementing HPV-based screening was a critical issue discussed in the literature...
November 21, 2016: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28097725/increased-cortical-porosity-in-women-with-hip-fracture
#3
D Sundh, A G Nilsson, M Nilsson, L Johansson, D Mellström, M Lorentzon
BACKGROUND: Hip fractures cause increased mortality and disability and consume enormous healthcare resources. Only 46% of hip fracture patients have osteoporosis at the total hip according to dual-energy X-ray absorptiometry (DXA) measurement. Cortical porosity increases with ageing and is believed to be important for bone strength. OBJECTIVE: To investigate whether older women with hip fracture have higher cortical porosity than controls, and if so whether this difference is independent of clinical risk factors and areal bone mineral density (aBMD)...
January 18, 2017: Journal of Internal Medicine
https://www.readbyqxmd.com/read/28097445/pregnancy-outcomes-in-hiv-positive-women-a-retrospective-cohort-study
#4
Kholoud Arab, Andrea R Spence, Nicholas Czuzoj-Shulman, Haim A Abenhaim
PURPOSE: In the United States, an estimated 8500 HIV (human immunodeficiency virus) positive women gave birth in 2014. This rate appears to be increasing annually. Our objective is to examine obstetrical outcomes of pregnancy among HIV-positive women. METHODS: A population-based cohort study was conducted using the Nationwide Inpatient Sample database (2003-2011) from the United States. Pregnant HIV-positive women were identified and compared to pregnant women without HIV...
January 17, 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/28094189/medicaid-payer-status-is-linked-to-increased-rates-of-complications-after-treatment-of-proximal-humerus-fractures
#5
Vani J Sabesan, Graysen Petersen-Fitts, Daniel Lombardo, Daniel Briggs, James Whaley
BACKGROUND: Low socioeconomic status and Medicaid insurance as a primary payer have been associated with major disparities in resource utilization and risk-adjusted outcomes for patients undergoing total joint arthroplasty. With the expansion of Medicaid through the Affordable Care Act in 2014, examination of these disparities has become increasingly relevant for the treatment of proximal humerus fracture (PHF). METHODS: The Healthcare Cost and Utilization Project Nationwide Inpatient Sample database was used to identify patients who were treated for PHF from 2002 to 2012...
January 13, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28092930/prevalence-of-latent-tuberculosis-among-laboratory-healthcare-workers-in-iran-a-cross-sectional-study
#6
Mahshid Nasehi, Abdolrazagh Hashemi-Shahraki, Amin Doosti-Irani, Saeed Sharafi, Ehsan Mostafavi
Objectives: The risk of transmission of Mycobacterium tuberculosis from patients to health-care workers (HCWs) is a neglected problem in many countries including Iran. The aim of this study was to estimate the prevalence of latent tuberculosis infection (LTBI), and related risk factors among TB laboratory staff in Iran. Methods: All TB laboratory staff (689 individual) who were working in TB laboratories of 50 Iranian Universities of Medical Sciences and a random sample consisted of 317 participants from low risk HCWs, were included in this cross sectional study...
December 30, 2016: Epidemiology and Health
https://www.readbyqxmd.com/read/28091336/who-are-the-patients-that-default-tuberculosis-treatment-space-matters
#7
C Nunes, R Duarte, A M Veiga, B Taylor
The goals of this article are: (i) to understand how individual characteristics affect the likelihood of patients defaulting their pulmonary tuberculosis (PTB) treatment regimens; (ii) to quantify the predictive capacity of these risk factors; and (iii) to quantify and map spatial variation in the risk of defaulting. We used logistic regression models and generalized additive models with a spatial component to determine the odds of default across continental Portugal. We focused on new PTB cases, diagnosed between 2000 and 2013, and included some individual information (sex, age, residence area, alcohol abuse, intravenous drug use, homelessness, HIV, imprisonment status)...
January 16, 2017: Epidemiology and Infection
https://www.readbyqxmd.com/read/28089799/positive-airway-pressure-therapies-and-hospitalization-in-chronic-obstructive-pulmonary-disease
#8
Monica M Vasquez, Leslie A McClure, Duane L Sherrill, Sanjay R Patel, Jerry Krishnan, Stefano Guerra, Sairam Parthasarathy
BACKGROUND: Hospitalization of patients with chronic obstructive pulmonary disease (COPD) places a huge healthcare burden. Positive airway pressure (PAP) therapy is sometimes used in COPD patients, but the possible impact on hospitalization risk remains controversial. We studied the hospitalization risk of COPD patients before and after initiation of various PAP therapies in a "real-world" bioinformatics study. METHODS: We performed a retrospective analysis of administrative claims data of hospitalizations in patients with COPD who received or did not receive PAP therapy - continuous PAP, bilevel PAP, and non-invasive positive pressure ventilation using a home ventilator (NIPPV)...
January 12, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28079673/differences-in-use-of-high-quality-and-low-quality-hospitals-among-working-age-individuals-by-insurance-type
#9
Ioana Popescu, Kevin C Heslin, Rosanna M Coffey, Raynard E Washington, Marguerite L Barrett, Lucy H Karnell, José J Escarce
BACKGROUND: Research suggests that individuals with Medicaid or no insurance receive fewer evidence-based treatments and have worse outcomes than those with private insurance for a broad range of conditions. These differences may be due to patients' receiving care in hospitals of different quality. RESEARCH DESIGN: We used the Healthcare Cost and Utilization Project State Inpatient Databases 2009-2010 data to identify patients aged 18-64 years with private insurance, Medicaid, or no insurance who were hospitalized with acute myocardial infarction, heart failure, pneumonia, stroke, or gastrointestinal hemorrhage...
February 2017: Medical Care
https://www.readbyqxmd.com/read/28078998/lipoprotein-a-management-pharmacological-and-apheretic-treatment
#10
Ruth Hanssen, Ioanna Gouni-Berthold
Lipoprotein (a) [Lp(a)] is an low-density lipoprotein (LDL)-like particle with an additional apolipoprotein, apolipoprotein (a), [apo(a)] attached to apolipoprotein B. Recent epidemiologic and Mendelian randomization studies have provided evidence that Lp(a) is causally related to the pathogenesis of atherosclerosis and cardiovascular disease (CVD). The risk association between Lp(a) concentrations and CVD is still controversial but seems to be continuous and without an obvious threshold Lp(a) level. Circulating concentrations of Lp(a) are genetically determined; desirable levels are amplt; 50 mg/dl...
12, 2017: Current Medicinal Chemistry
https://www.readbyqxmd.com/read/28077613/socioeconomic-deprivation-and-the-outcome-of-pulmonary-rehabilitation-in-england-and-wales
#11
Michael C Steiner, Derek Lowe, Katy Beckford, John Blakey, Charlotte E Bolton, Sarah Elkin, William D-C Man, C Michael Roberts, Louise Sewell, Paul Walker, Sally J Singh
BACKGROUND: Pulmonary rehabilitation (PR) improves exercise capacity and health status in patients with COPD, but many patients assessed for PR do not complete therapy. It is unknown whether socioeconomic deprivation associates with rates of completion of PR or the magnitude of clinical benefits bequeathed by PR. METHODS: PR services across England and Wales enrolled patients to the National PR audit in 2015. Deprivation was assessed using Index of Multiple Deprivation (IMD) derived from postcodes...
January 11, 2017: Thorax
https://www.readbyqxmd.com/read/28077602/diagnoses-of-sexual-abuse-and-their-common-registered-comorbidities-in-the-total-population-of-stockholm
#12
Gita Rajan, Gunnar Ljunggren, Per Wändell, Lars Wahlström, Carl-Göran Svedin, Axel C Carlsson
BACKGROUND: Prior research based on self-reports has proven sexual abuse to be a risk factor for pain and psychiatric disorders. However, less is known about how this is reflected within the healthcare system. The aim of this study was to study the 2-year prevalence of diagnosis of sexual abuse and concomitant conditions. METHODS: Using data from VAL, the study population included all living persons in Stockholm County, Sweden, between 1 January 2008 and 31 December 2014 (N=2 549 496)...
January 11, 2017: Journal of Epidemiology and Community Health
https://www.readbyqxmd.com/read/28073749/cost-effectiveness-of-a-government-supported-policy-strategy-to-decrease-sodium-intake-global-analysis-across-183-nations
#13
Michael Webb, Saman Fahimi, Gitanjali M Singh, Shahab Khatibzadeh, Renata Micha, John Powles, Dariush Mozaffarian
OBJECTIVE:  To quantify the cost effectiveness of a government policy combining targeted industry agreements and public education to reduce sodium intake in 183 countries worldwide. DESIGN:  Global modeling study. SETTING:  183 countries. POPULATION:  Full adult population in each country. INTERVENTION:  A "soft regulation" national policy that combines targeted industry agreements, government monitoring, and public education to reduce population sodium intake, modeled on the recent successful UK program...
January 10, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28068972/an-underlying-diagnosis-of-osteonecrosis-of-bone-is-associated-with-worse-outcomes-than-osteoarthritis-after-total-hip-arthroplasty
#14
Jasvinder A Singh, Jason Chen, Maria C S Inacio, Robert S Namba, Elizabeth W Paxton
BACKGROUND: Well-designed studies of complications and readmission rates in patients undergoing total hip arthroplasty (THA) with osteonecrosis are lacking. Our objective was to examine if a diagnosis of osteonecrosis was associated with complications, mortality and readmission rates after THA. METHODS: We analyzed prospectively collected data from an integrated healthcare system's Total Joint Replacement Registry of adults with osteonecrosis vs. osteoarthritis (OA) undergoing unilateral primary THA during 2001-2012, in an observational cohort study...
January 9, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28065185/predictors-of-immunodeficiency-related-death-in-a-cohort-of-low-income-people-living-with-hiv-a-competing-risks-survival-analysis
#15
M F P M Albuquerque, D N Alves, C C Bresani Salvi, J D L Batista, R A A Ximenes, D B Miranda-Filho, H R L Melo, M Maruza, U R Montarroyos
We conducted a survival analysis with competing risks to estimate the mortality rate and predictive factors for immunodeficiency-related death in people living with HIV/AIDS (PLWH) in northeast Brazil. A cohort with 2372 PLWH was enrolled between July 2007 and June 2010 and monitored until 31 December 2012 at two healthcare centres. The event of interest was immunodeficiency-related death, which was defined based on the Coding Causes of Death in HIV Protocol (CoDe). The predictor variables were: sociodemographic characteristics, illicit drugs, tobacco, alcohol, nutritional status, antiretroviral therapy, anaemia and CD4 cell count at baseline; and treatment or chemoprophylaxis for tuberculosis (TB) during follow-up...
January 9, 2017: Epidemiology and Infection
https://www.readbyqxmd.com/read/28063674/predictors-of-30-day-hospital-readmission-after-hip-fracture-a-systematic-review
#16
REVIEW
Adam M Ali, Charles E R Gibbons
BACKGROUND: Early readmission to hospital after hip fracture is associated with increased mortality and significant costs to the healthcare system. There is growing interest in the use of 30-day readmission rates as a metric of hospital performance. Identifying patients at increased risk of readmission after hip fracture may enable pre-emptive action to mitigate this risk and the development of effective methods of risk-adjustment to allow readmission to be used as a reliable measure of hospital performance...
January 3, 2017: Injury
https://www.readbyqxmd.com/read/28060226/barriers-to-care-and-1-year-mortality-among-newly-diagnosed-hiv-infected-people-in-durban-south-africa
#17
Ingrid V Bassett, Sharon M Coleman, Janet Giddy, MFamMed, Laura M Bogart, Christine E Chaisson, Douglas Ross, Moses J E Flash, Tessa Govender, Rochelle P Walensky, Kenneth A Freedberg, Elena Losina
BACKGROUND: Prompt entry into HIV care is often hindered by personal and structural barriers. Our objective was to evaluate the impact of self-perceived barriers to healthcare on 1-year mortality among newly diagnosed HIV-infected individuals in Durban, South Africa. METHODS: Prior to HIV testing at four outpatient sites, adults (≥18y) were surveyed regarding perceived barriers to care including: 1) service delivery; 2) financial; 3) personal health perception; 4) logistical; and 5) structural...
December 30, 2016: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/28057799/prospective-study-of-oral-anticoagulants-and-risk-of-liver-injury-in-patients-with-atrial-fibrillation
#18
Alvaro Alonso, Richard F MacLehose, Lin Y Chen, Lindsay Gs Bengtson, Alanna M Chamberlain, Faye L Norby, Pamela L Lutsey
OBJECTIVE: To assess the risk of liver injury hospitalisation in patients with atrial fibrillation (AF) after initiation of direct oral anticoagulants (DOACs) or warfarin and to determine predictors of liver injury hospitalisation in this population. METHODS: We studied 113 717 patients (mean age 70, 39% women) with AF included in the MarketScan Commercial and Medicare Supplemental databases with a first prescription for oral anticoagulation after 4 November 2011, followed through 31 December 2014...
January 5, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28057245/alcohol-abuse-and-cardiac-disease
#19
Isaac R Whitman, Vratika Agarwal, Gregory Nah, Jonathan W Dukes, Eric Vittinghoff, Thomas A Dewland, Gregory M Marcus
BACKGROUND: Understanding the relationship between alcohol abuse, a common and theoretically modifiable condition, and the most common cause of death in the world, cardiovascular disease, may inform potential prevention strategies. OBJECTIVES: The study sought to investigate the associations among alcohol abuse and atrial fibrillation (AF), myocardial infarction (MI), and congestive heart failure (CHF). METHODS: Using the Healthcare Cost and Utilization Project database, we performed a longitudinal analysis of California residents ≥21 years of age who received ambulatory surgery, emergency, or inpatient medical care in California between 2005 and 2009...
January 3, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28057183/immunoth%C3%A3-rapie-une-innovation-de-rupture-non-soutenable-%C3%A3-conomiquement
#20
Jean-Pierre Thierry
A NON-SUSTAINABLE BREAKTHROUGH?: The arrival of new immunotherapy anticancer drugs on the market marks a turning point. Their reference prices are fixed in the US and are positioned at the same level that the anticancer targeted therapies. They benefit from an accelerated approval process and often obtain the status of orphan drugs. The extensions of indications to many cancers and the likely combinations could significantly increase healthcare spending at a level that recently unveiled their non-sustainability, due to unrealistic prices approved by regulators...
November 2016: Bulletin du Cancer
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