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Katherine Lincoln, Jessica Hyde
BACKGROUND: In recent years, a new technology for autologous epidermal harvesting has been developed to produce epidermal skin grafts (ESGs) for use over wounds. This technology employs negative pressure and heat to raise the epidermal skin layer, allowing for consistent and reproducible epidermal harvesting. The aim of this case series is to present the authors' experience using an automated, epidermal harvesting system to produce ESGs to treat wounds of patients with multiple comorbidities...
October 2016: Wounds: a Compendium of Clinical Research and Practice
Karina A F S Miller, Luciana S Branco-de-Almeida, Sandra Wolf, Nicole Hovencamp, Tina Treloar, Peter Harrison, Ikramuddin Aukhil, Yan Gong, Luciana M Shaddox
AIM: To evaluate long-term clinical response to periodontal therapy and maintenance in localized aggressive periodontitis (LAP). MATERIALS AND METHODS: One hundred forty-one African-Americans diagnosed with LAP, aged 5-25 years, were enrolled. Patients underwent periodontal mechanical debridement plus one week of amoxicillin/metronidazole. Mechanical therapy was repeated as needed and clinical parameters were recorded at baseline, 3, 6, 12, 18, and 24 months, and 2 additional annual follow-up visits after treatment...
October 21, 2016: Journal of Clinical Periodontology
Mahlet Fikreyesus, Matiwos Soboka, Garumma Tolu Feyissa
BACKGROUND: Psychotic relapse leads to repeated hospitalization and negatively affects the clinical prognosis of the patients. Information on prevalence of relapse among patients with psychotic disorders in Ethiopian setting is scarce. This study aimed to assess the prevalence of relapse among patients with psychotic disorders attending services in Jimma University Specialized Hospital (JUSH). METHODS: Data were collected using interviewer administered questionnaire...
October 20, 2016: BMC Psychiatry
Eirini Lioudaki, Martin Whyte
Patients with higher liver iron stores are likely to have a worse cardiac outcome following noncompliance with chelation. Cardiovascular magnetic resonance identifies myocardial siderosis allowing optimization of iron chelation regimes. Diabetes puts thalassemic patients at increased risk of myocardial fibrosis. Dual chelation therapy with deferoxamine and deferiprone offers improved cardiac outcomes.
October 2016: Clinical Case Reports
Lee N Newcomer, Richard Weininger, Robert W Carlson
PURPOSE: To evaluate a computer-based prior authorization system that was designed to include and test two new concepts for physician review: (1) the tool would minimize denials by providing real-time decision support with alternative options if the original request was noncompliant, and (2) the tool would collect sufficient information to create a patient registry. METHODS: A new prior authorization tool incorporating real-time decision support was tested with a large national payer...
October 18, 2016: Journal of Oncology Practice
Jitendra Meena, Pankaja Raghav, Neeti Rustagi
OBJECTIVE: To study the treatment compliance and adverse effects among hypertensive patients receiving treatment at Hypertension clinic, UHTC Pratap Nagar, Jodhpur, India. DESIGN AND METHOD: A longitudinal study was conducted on 1036 hypertensive patients enrolled at Hypertension clinic, Pratap Nagar, Jodhpur, India. Patients attendees to the clinic during inception (Nov 2013) were selected for study purpose and quarterly follow-ups were done. The participants were asked about their socio-demographic status, therapy, side effects, and compliance with physicians' instructions...
September 2016: Journal of Hypertension
Jinho Shin
Arterial pulsation which had long been studied for estimation of blood pressure or mean blood pressure was replaced by the measurement of systolic and diastolic blood pressure using Korotkoff sound detected by stethoscope in the beginning of the previous century. In the meantime, vast of modern knowledge of human hypertension from epidemiology to randomized clinical trial had been built on the Korotkoff sound and stethoscope methodology. Hypertension is very special clinical entity in terms of the diagnosis is solely dependent on the manual blood pressure measurement by a physician or nurse...
September 2016: Journal of Hypertension
Jannet Labidi, Yosra Ben Ariba, Abdelkader Ben Gabsia, Faida Ajili, Riadh Battikh, Bassem Louzir, Nadia Ben Abdelhafidh, Saleh I Othman
Tissue calcification is a common complication in patients on continuous hemodialysis (HD) for chronic renal failure; however, severe calcification is unusual. Three distinct clinical types of extraosseous calcifications are found in uremic patients: vascular calcification, periarticular (tumoral) calcification, and visceral calcification (heart, lung, and kidney). We report a case of a young chronic HD patient who presented with extensive metastatic calcifi cations both vascular, visceral specially localized in the lungs, and periarticular with progressively increasing multiple subcutaneous swellings...
September 2016: Saudi Journal of Kidney Diseases and Transplantation
Joel Scholten, Ellen Danford, Azadeh Leland, Heather Malecki, Douglas Bidelspach, Brent Taylor, Nina Sayer
PURPOSE OF STUDY: Individualized interdisciplinary care is the hallmark for rehabilitation following traumatic brain injury (TBI). Veterans Health Administration (VHA) utilizes an electronic note template to document Interdisciplinary Rehabilitation and Community Reintegration (IRCR) care plans for Veterans with TBI requiring rehabilitation. All Veterans with a TBI diagnosis, receiving skilled therapy for TBI-related issues, and followed by a case manager must receive a care plan. The purpose of this study was to determine the level of compliance with the IRCR care plan requirements used to identify Veterans with TBI in need of the care plan and to evaluate the reasons for inconsistent compliance...
November 2016: Professional Case Management
Allison E Curry, Melissa R Pfeiffer, Michael R Elliott
INTRODUCTION: Graduated Driver Licensing (GDL) is the most effective strategy to reduce the burden of young driver crashes, but the extent to which young intermediate (newly licensed) drivers comply with, and police enforce, important GDL passenger and night-time restrictions is largely unknown. Population-level rates of intermediate drivers' compliance were estimated as well as police enforcement among crash-involved drivers who were noncompliant. METHODS: New Jersey's statewide driver licensing and crash databases were individually linked...
October 5, 2016: American Journal of Preventive Medicine
Yanchuan Zhao, Silvia V Rocha, Timothy M Swager
Iptycenes are intriguing compounds receiving considerable attention as a result of their rigid noncompliant three-dimensional architecture. The preparation of larger iptycenes is often problematic, as a result of their limited solubility and synthetic procedures involving multiple Diels-Alder reactions under harsh extended reaction conditions. We report a mechanochemical synthesis of structurally well-defined iptycenes through an iterative reaction sequence, wherein Diels-Alder reactions and a subsequent aromatization afford higher order iptycenes...
October 14, 2016: Journal of the American Chemical Society
Emel Oğuz-Akarsu, Zeynep Aydin-Özemir, Nerses Bebek, Candan Gürses, Ayşen Gökyiğit, Betül Baykan
Status epilepticus (SE) is rarely described in patients with juvenile myoclonic epilepsy (JME), and little is known about its frequency, subtypes, and predictors and the prognosis of these patients. In this retrospective study, we aimed to analyze the incidence of SE in patients with JME and emphasize the risk factors and long-term outcome of SE in an epilepsy outpatient-based cohort. We included patients with JME with a history of predominant myoclonic seizures and at least one diagnostic EEG with normal background activity and bursts of typical ≥3-Hz generalized spike-polyspike and waves...
October 10, 2016: Epilepsy & Behavior: E&B
Vidhi V Shah, Marshall B Kapp, Stephen E Wolverton
Malpractice risk is a common source of concern for the practicing physician. Dermatologists experience fewer lawsuits than most other specialists in medicine, but the risk is not negligible. All physicians should familiarize themselves with areas of potential risk and avoid medico-legal pitfalls. We present Part I of a two-part series addressing medico-legal questions common to most practitioners that cause a great deal of anxiety. Part I will focus upon risk management and prevention of future malpractice lawsuits, and Part II deals with suggestions and guidance once a lawsuit occurs...
October 12, 2016: American Journal of Clinical Dermatology
Bradley C Johnston, Gordon H Guyatt
Among clinical trials of adequate size, randomization balances both known and unknown prognostic factors between trial arms, thus allowing an unbiased comparison of intervention and control. To preserve this benefit, all randomly assigned participants should be followed to study termination and analyzed in the arm to which they were allocated. There are 2 potential limitations in study implementation: 1) patients are nonadherent and continue with follow-up visits, or 2) patients are lost to follow-up and their outcome data are missing...
October 12, 2016: American Journal of Clinical Nutrition
Zubin J Daruwalla, Jing L Loh, Chaoyan Dong
BACKGROUND: The Personal Data Protection Act (PDPA) of Singapore was first passed in 2012, with subsequent enforcement regulations effective in 2014. Although medical education via digital platforms is not often used in medical schools in Singapore as of yet, many current means of communication at all levels in the medical community from medical schools to clinics to hospitals are unsecure and noncompliant with the PDPA. OBJECTIVE: This pilot study will assess the effectiveness of MyDoc, a secure, mobile telehealth application and messaging platform, as an educational tool, secure communications tool, and a tool to raise awareness of the PDPA...
August 9, 2016: JMIR Med Educ
Sin Gon Kim, Nam Hoon Kim, Bon Jeong Ku, Ho Sang Shon, Doo Man Kim, Tae Sun Park, Yong-Seong Kim, In Joo Kim, Dong Seop Choi
AIMS/INTRODUCTION: To assess the time to initiation of insulin therapy and concurrently investigate both patient- and physician-related factors associated with delaying insulin therapy in Korean patients with type 2 diabetes (T2D) uncontrolled on oral hypoglycemic agents (OHAs). MATERIALS AND METHODS: This prospective, observational disease registry study was conducted across 69 centers in Korea. T2D patients who had received two or more OHAs within the last 5 years, had a glycated hemoglobin (HbA1c) ≥8% in the last 6 months, and had not received insulin were included...
October 6, 2016: Journal of Diabetes Investigation
Lina M Majdalany, David A Wilder, Jesse Allgood, Latasha Sturkie
We evaluated a preliminary method for examining the antecedent and consequent contributions to noncompliance exhibited by two children with disabilities. In Phase 1, we assessed whether noncompliance was a result of a skill deficit. For one participant, we then conducted a functional analysis to determine the variables maintaining noncompliance in Phase 2. In Phase 3, we conducted a treatment evaluation to increase compliance for each participant. We identified the antecedent and consequent variables responsible for noncompliance and developed an effective intervention for both participants...
October 4, 2016: Journal of Applied Behavior Analysis
Carlos Roncero, Néstor Szerman, Antonio Terán, Carlos Pino, José María Vázquez, Elena Velasco, Marta García-Dorado, Miguel Casas
BACKGROUND: There is a need to evaluate the professionals' perception about the consequences of the lack of therapeutic adherence in the evolution of patients with co-occurring disorders. METHODS: An online survey, released on the Socidrogalcohol [Spanish Scientific Society for Research on Alcohol, Alcoholism and other Drug Addictions] and Sociedad Española de Patología Dual [the Spanish Society of Dual Pathology] web pages, was answered by 250 professionals who work in different types of Spanish health centers where dual diagnosis patients are assisted...
2016: Patient Preference and Adherence
Priya Kathpalia, Alexander Smith, Jennifer C Lai
AIM: To evaluate use of palliative care services in patients with end-stage liver disease who do not have access to liver transplant. METHODS: Evaluated were end-stage liver disease patients who were removed from the liver transplant wait-list or died prior to transplant at a single transplant center over a 2-year period. Those who were removed due to noncompliance or ultimately transplanted elsewhere were excluded from this study. Patient characteristics associated with palliative care consultation were assessed using logistic regression analysis...
September 24, 2016: World Journal of Transplantation
Bethany Coyne, Patricia J Hollen, Guofen Yan, Kenneth Brayman
BACKGROUND: Improvements in transplantation have increased the survival of children after kidney transplantation. These patients have complex needs, and the current medical system is not prepared to effectively transfer the care of these individuals from pediatric to adult health-care systems. Too often, transfer occurs during moments of crisis and is associated with poor outcomes. OBJECTIVE: The aim of this study was to use a national database, the Scientific Registry of Transplant Recipients, to test the hypothesis that the increased risk of graft loss after transfer of care (from pediatric to adult services) for young adult kidney transplant recipients over a 2- to 3-year posttransfer follow-up period was related to these posttransfer risk factors (medication noncompliance, acute rejection, insurance status)...
September 28, 2016: Progress in Transplantation
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