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https://www.readbyqxmd.com/read/29779180/the-impact-of-an-adolescent-depressive-disorders-clinical-pathway-on-healthcare-utilization
#1
Brooke Lifland, Davene R Wright, Rita Mangione-Smith, Arti D Desai
Clinical pathways are known to improve the value of health care in medical and surgical settings but have been rarely studied in the psychiatric setting. This study examined the association between level of adherence to an adolescent depressive disorders inpatient clinical pathway and length of stay (LOS), cost, and readmissions. Patients in the high adherence category had significantly longer LOS and higher costs compared to the low adherence category. There was no difference in the odds of 30-day emergency department return visits or readmissions...
May 19, 2018: Administration and Policy in Mental Health
https://www.readbyqxmd.com/read/29778017/the-preconception-care-experiences-of-women-with-epilepsy-on-sodium-valproate
#2
Lorna Lawther, Helen Dolk, Marlene Sinclair, Jim Morrow
PURPOSE: To understand the preconception experiences of women with epilepsy who have been taking the teratogenic drug valproate. METHODS: Seven women were recruited, three from a preconception clinic and four from an antenatal clinic in a region of the UK. All had taken valproate preconceptionally. Three preconception clinic encounters were observed and audio-recorded. Interviews with all women were analysed using Interpretative Phenomenological Analysis (IPA). RESULTS: Women experienced a "trajectory of balance"...
May 16, 2018: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/29777635/reducing-the-number-of-obstetrical-beds-by-challenging-traditions
#3
Camilla Dalby Salvig, Marie Højriis Storkholm, Jannie Dalby Salvig, Niels Uldbjerg
The aim of this commentary is to describe changes in women care at an obstetric department that made it possible to reduce the number of beds from 40 to 29. Patient pathways were reviewed and revised using lean methodology. The mean length of stay was reduced from 70 to 59 hours and the mean numbers of hospitalizations per woman from 1.26 to 1.20. At the organizational level, we introduced a Family Department, home management of newborns, home monitoring of the women with cardiotocography and blood samples, and intrapartum Group B Streptococcus-PCR...
May 19, 2018: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/29777566/care-provider-allocation-on-admissions-to-acute-mental-health-wards-the-development-and-validation-of-the-admission-team-score-list
#4
Sjobha R N van den Berg, Barbara Stringer, Roland van de Sande, Stasja Draisma
Currently, support tools are lacking to prioritize steps in the care coordination process to enable safe practice and effective clinical pathways in the first phase of acute psychiatric admissions. This study describes the development, validity, and reliability of an acute care coordination support tool, the Admission Team Score List (ATSL). The ATSL assists in care provider allocation during admissions. Face validity and feasibility of the ATSL were tested in 77 acute admissions. Endscores of filled out ATSL's were translated to recommended team compositions...
May 18, 2018: International Journal of Mental Health Nursing
https://www.readbyqxmd.com/read/29771791/a-successful-model-of-expedited-antiretroviral-therapy-for-clinically-stable-patients-living-with-hiv-in-haiti
#5
Colette Guiteau Moise, Vanessa R Rivera, Kelly A Hennessey, Clovy Bellot, Chris Nicholas, Anna P Fang, Rose Irène Verdier, Patrice Severe, Alix Sainvil, Benedict Charles, Derothy Dorval, Juseline St Amour, Jean W Pape, Serena P Koenig
BACKGROUND: Recommendations for universal antiretroviral therapy (ART) have greatly increased the number of HIV-infected patients who qualify for treatment, particularly with early clinical disease. Less intensive models of care are needed for clinically stable patients. SETTING: A Rapid Pathway (RP) model of expedited outpatient care for clinically stable patients was implemented at the Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO) Center, Port-au-Prince, Haiti...
April 30, 2018: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/29771251/-ebm-guidelines-protocols-knowledge-attitudes-and-utilization-in-the-era-of-law-on-professional-responsibility-and-safety-of-health-care
#6
Silvia Minozzi, Francesca Ruggiero, Matteo Capobussi, Marien González-Lorenzo, Micaela La Regina, Alessandro Squizzato, Lorenzo Moja, Francesco Orlandini
INTRODUCTION: <AbstractText Label="INTRODUCTION" NlmCategory="BACKGROUND">The knowledge of principles and methods of Evidence Based Medicine (EBM) and the use of Clinical Practice Guidelines to inform clinical decisions are recognised as key instruments to improve the quality of care. In Italy the Parliament has revised the legal system that rules the responsibilities of health professionals and health care safety, prescribing health professionals to adhere to guidelines and good practice recommendations...
May 2018: Recenti Progressi in Medicina
https://www.readbyqxmd.com/read/29770995/adolescent-and-young-adult-oncology-patients-in-france-heterogeneity-in-pathways-of-care
#7
Emmanuel Desandes, Laurence Brugières, Florence Molinié, Gautier Defossez, Patricia Delafosse, Karine Jehannin-Ligier, Michel Velten, Brigitte Trétarre, Brice Amadéo, Emilie Marrer, Anne-Sophie Woronoff, Olivier Ganry, Alain Monnereau, Tania d'Almeida, Xavier Troussard, Laetitia Daubisse-Marliac, Simona Bara, Anne-Valérie Guizard, Isabelle Baldi, Guy Launoy, Jacqueline Clavel, Brigitte Lacour
BACKGROUND: In order to evaluate at the population level the impact of the actions developed in France since 2004 to organize the care of adolescents and young adults (AYAs) with cancer, we conducted the present study to provide an unbiased view of the pathway of care of these patients. METHODS: Using a population-based registry, we conducted a review of all cases of cancer diagnosed during 2012 and 2013 in 15- to 24-year-old patients living in nineteen French administrative areas...
May 17, 2018: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/29770715/enasidenib-for-the-treatment-of-acute-myeloid-leukemia
#8
James Dugan, Daniel Pollyea
In August 2017 the United States Federal Drug Administration (FDA) approved enasidenib (Idhifa, Celgene/Agios) for adults with relapsed and refractory acute myelogenous leukemia (AML) with an IDH2 mutation. Enasidenib targets cells with mutant copies of isocitrate dehydrogenase-2 (IDH2), inhibiting the oncometabolite 2-hydroxyglutarte (2-HG) formed by the mutant IDH2. Areas covered: We review the studies leading to enasidenib's approval, as well as common side effects and safety issues experienced during the clinical trials...
May 17, 2018: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/29769386/global-acceptance-of-biosimilars-importance-of-regulatory-consistency-education-and-trust
#9
REVIEW
Eduardo Cazap, Ira Jacobs, Ali McBride, Robert Popovian, Karol Sikora
Globally, biosimilars are expected to have a key role in improving patient access to biological therapies and addressing concerns regarding the escalating cost of health care. Indeed, in Europe, increased use of biologics and reduced drug prices have been observed after the introduction of biosimilars. Recently, several monoclonal antibody biosimilars of anticancer therapies have been approved, and numerous others are in various stages of clinical development. Biosimilars are authorized via a regulatory pathway separate from that used for generic drugs; they are also regulated separately from novel biologics...
May 16, 2018: Oncologist
https://www.readbyqxmd.com/read/29768451/intravitreal-ocriplasmin-for-the-treatment-of-vitreomacular-traction-and-macular-hole-a-study-of-efficacy-and-safety-based-on-nice-guidance
#10
Mahiul M K Muqit, Robin Hamilton, Jason Ho, Sally Tucker, Helen Buck
PURPOSE: To evaluate the real world clinical outcomes of intravitreal ocriplasmin in patients with vitreomacular traction (VMT) with and without full thickness macular holes (FTMH) treated according to NICE guidance. METHODS: Retrospective observational case series of 25 patients treated with a single intravitreal ocriplasmin injection between December 2013 and December 2015. Best corrected visual acuity and optical coherence tomography exams were performed to determine visual outcomes and anatomical VMT release and FTMH closure over time...
2018: PloS One
https://www.readbyqxmd.com/read/29767851/risk-factors-for-vitamin-d-deficiency-in-sickle-cell-disease
#11
Jin Han, Xu Zhang, Santosh L Saraf, Michel Gowhari, Robert E Molokie, Johara Hassan, Shivi Jain, Binal N Shah, Taimur Abbasi, Roberto F Machado, Victor R Gordeuk
Vitamin D deficiency (VDD), 25-OHD levels <20 ng/ml, is prevalent among patients with sickle cell disease (SCD) and is linked to acute and chronic pain and bone fracture in this population. There is limited literature regarding VDD-associated risk factors for SCD. We examined potential clinical and genomic parameters associated with VDD in 335 adults with SCD in a cross-sectional study. VDD was present in 65% of adult SCD patients, and 25-OHD levels independently and positively correlated with older age (P < 0·001) and vitamin D supplementation (P < 0·001)...
May 16, 2018: British Journal of Haematology
https://www.readbyqxmd.com/read/29766615/barriers-and-facilitators-to-smoking-cessation-in-pregnancy-and-in-the-post-partum-period-the-health-care-professionals-perspective
#12
Felix Naughton, Sarah Hopewell, Lesley Sinclair, Dorothy McCaughan, Jennifer McKell, Linda Bauld
OBJECTIVES: Health care professionals and the health care environment play a central role in protecting pregnant and post-partum women and their infants from smoking-related harms. This study aimed to better understand the health professional's perspective on how interactions between women, health care professionals, and the environment influence how smoking is managed. DESIGN: Semi-structured interviews and focus groups. METHODS: Data were from 48 health care staff involved in antenatal or post-partum care at two UK sites, including midwives, obstetricians, health visitors, GPs, pharmacists, service commissioners, and Stop Smoking Service (SSS) advisors and managers...
May 15, 2018: British Journal of Health Psychology
https://www.readbyqxmd.com/read/29766565/a-retrospective-observational-study-of-people-with-type-1-diabetes-with-self-reported-severe-hypoglycaemia-reveals-high-level-of-ambulance-attendance-but-low-levels-of-therapy-change-and-specialist-intervention
#13
B C T Field, R Nayar, A Kilvert, M Baxter, J Hickey, M Cummings, S C Bain
AIM: To evaluate the impact of severe hypoglycaemia on NHS resources and overall glycaemic control in adults with Type 1 diabetes. METHODS: An observational, retrospective study of adults (aged ≥ 18 years) with Type 1 diabetes reporting one or more episodes of severe hypoglycaemia during the preceding 24 months in 10 NHS hospital diabetes centres in England and Wales. The primary outcome was healthcare resource utilization associated with severe hypoglycaemia...
May 15, 2018: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/29766482/-fragile-x-syndrome-new-therapeutic-strategies
#14
S Zeidler, B Dierckx, K Lubbers, A M van Eeghen, C R Lincke, J A Kievit, R Willemsen, A Rietman
Fragile X syndrome (fxs) is the most common hereditary cause of intellectual disability and autism spectrum disorders. Targeted treatment is currently lacking. In the past decades an enormous amount of knowledge has been obtained concerning the involved molecular pathways, introducing potential targets for disease modifying therapy.<br/> AIM: To present an overview of the development of targeted treatment for fxs.<br/> METHOD: Several important publications were collected and indexed.<br/> RESULTS: While preclinical animal model studies with targeted interventions are promising, the translation to the clinic has been disappointing...
2018: Tijdschrift Voor Psychiatrie
https://www.readbyqxmd.com/read/29766275/implementing-cough-reflex-testing-in-a-clinical-pathway-for-acute-stroke-a-pragmatic-randomised-controlled-trial
#15
Makaela Field, Rachel Wenke, Arman Sabet, Melissa Lawrie, Elizabeth Cardell
Silent aspiration is common after stroke and can lead to subsequent pneumonia. While standard bedside dysphagia assessments are ineffective at predicting silent aspiration, cough reflex testing (CRT) has shown promise for identifying patients at risk of silent aspiration. We investigated the impact of CRT on patient and service outcomes when embedded into a clinical pathway. 488 acute stoke patients were randomly allocated to receive either CRT or standard care (i.e. bedside assessment). Primary outcomes included confirmed pneumonia within 3 months post stroke and length of acute inpatient stay...
May 15, 2018: Dysphagia
https://www.readbyqxmd.com/read/29765774/how-shall-we-treat-early-triple-negative-breast-cancer-tnbc-from-the-current-standard-to-upcoming-immuno-molecular-strategies
#16
REVIEW
Ji Hyun Park, Jin-Hee Ahn, Sung-Bae Kim
Triple-negative breast cancer (TNBC) is a long-lasting orphan disease in terms of little therapeutic progress during the past several decades and still the standard of care remains chemotherapy. Experimental discovery of molecular signatures including the 'BRCAness' highlighted the innate heterogeneity of TNBC, generating the diversity of TNBC phenotypes. As it contributes to enhancing genomic instability, it has widened the therapeutic spectrum of TNBC. In particular, unusual sensitivity to DNA damaging agents was denoted in patients with BRCA deficiency, suggesting therapeutic benefit from platinum and poly(ADP-ribose) polymerase inhibitors...
2018: ESMO Open
https://www.readbyqxmd.com/read/29765168/mucosal-delivery-systems-of-antihypertensive-drugs-a-practical-approach-in-general-practice
#17
Lukasz P Bialy, Cezary Wojcik, Izabela Mlynarczuk-Bialy
Patients who are unable to receive oral medication (p.o.) are a major problem in outpatient settings, especially in home health care systems. Mucosal administration of drugs offers an alternative to the oral route, especially when the parenteral mode cannot be used. There are three main pathways of mucosal administration: sublingual/buccal, intranasal and rectal. We discuss the possibility of mucosal delivery of antihypertensive drugs. Perindopril arginine and Amlodipine besylate are registered in the EU as orodispersible tablets for oromucosal delivery, however, they are not available in all countries...
May 15, 2018: Biomedical Papers of the Medical Faculty of the University Palacký, Olomouc, Czechoslovakia
https://www.readbyqxmd.com/read/29763344/from-the-valley-of-death-to-the-crossroads-of-opportunity-a-discussion-of-evolving-benefit-risk-evaluation-standards
#18
Peter J Pitts, Patrick Brady
A series of recent US Food and Drug Administration (FDA) approvals (such as Sarepta's Exondys 51, Merck's Keytruda, and Portola's Bevyxxa) has generated significant interest within the drug development ecosystem. Facilitated regulatory pathways aimed toward expediting medicines to patients suffering from serious and life-threatening conditions are a good thing, even if it raises curiosity and introduces some degree of uncertainty. Over the last 20 years, two key words in drug development have been speed and innovation...
January 1, 2018: Therapeutic Innovation & Regulatory Science
https://www.readbyqxmd.com/read/29759808/implementation-of-a-clinical-nursing-pathway-for-percutaneous-coronary-intervention-a-prospective-study
#19
Meng Li, Huimin Liu
This study is to evaluate the effect of a clinical nursing pathway (CNP) on the clinical outcomes of the transradial approach for emergency percutaneous coronary intervention (PCI). A total of 118 subjects diagnosed with acute myocardial infarction (AMI) were enrolled in the study. They were randomly divided into a control group receiving conventional nursing and a clinical nursing pathway group. The differences in door-to-balloon time, length of hospital stay, hospitalization cost, postoperative complications, and patient satisfaction with nursing care between the two groups were determined and analyzed statistically...
May 11, 2018: Geriatric Nursing
https://www.readbyqxmd.com/read/29759561/going-the-distance-are-we-losing-patients-along-the-multiple-myeloma-treatment-pathway
#20
REVIEW
Evangelos Terpos, Florence Suzan, Hartmut Goldschmidt
Despite data suggesting that individuals with multiple myeloma can benefit from receiving several lines of therapy, and guidelines recommending treatment after relapse, a recent European patient chart review found that only 61% of patients receive second-line treatment. The review found that factors such as old age and previous adverse events lead to physicians deciding not to treat after relapse. However, given the large number of regimens available, treatment can be tailored to individual patients' needs and supportive care measures can help with the management of adverse effects...
June 2018: Critical Reviews in Oncology/hematology
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