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https://www.readbyqxmd.com/read/29160909/revisiting-chronic-rejection-following-living-donor-liver-transplantation-in-the-tacrolimus-era-a-single-centre-experience
#1
Narendra Singh Choudhary, Neeraj Saraf, Sanjiv Saigal, Dheeraj Gautam, Amit Rastogi, Sanjay Goja, Prashant Bhangui, Thiagrajan Srinivasan, Sanjay Kumar Yadav, Arvinder Soin
BACKGROUND AND AIMS: Chronic rejection (CR) is an uncommon but important cause of graft dysfunction, leading to graft loss and often requires re-transplantation. This study evaluates the incidence and outcome of patients with CR at a large living donor liver transplant (LDLT) centre. METHODS: Data of patients with CR was retrospectively analyzed in 1232 adult (age >18 years) LDLT on Tacrolimus (mainly) based immunosuppression. Sirolimus/Everolimus (mTOR inhibitors) were added to baseline immunosuppression as rescue therapy in patients with CR...
November 21, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/29157898/radiologic-and-clinical-evaluation-of-a-bioabsorbable-collagen-implant-to-treat-partial-thickness-tears-a-prospective-multicenter-study
#2
Theodore F Schlegel, Jeffrey S Abrams, Brandon D Bushnell, J Logan Brock, Charles P Ho
BACKGROUND: Treatment of partial-thickness cuff tears remains controversial. Although conservative therapy may treat symptoms, these defects do not spontaneously heal and conversion to a full-thickness lesion with subsequent repair may alter the tendon footprint. The ability to induce new tissue formation and limit tear progression in intermediate- and high-grade partial-thickness tears without surgical repair may represent a significant advancement in the treatment paradigm for these lesions...
November 17, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/29155232/refusal-of-cervical-spine-immobilization-after-blunt-trauma-implications-for-initial-evaluation-and-management-a-retrospective-cohort-study
#3
James M Tatum, Navpreet K Dhillon, Ara Ko, Eric J T Smith, Nicolas Melo, Galinos Barmparas, Eric J Ley
INTRODUCTION: Rigid cervical collars are routinely placed in the pre-hospital setting after significant blunt trauma. Patients who are deemed competent by field personnel (Glasgow Coma Scale (GCS) ≥13, no major distracting injury and not grossly intoxicated) may refuse cervical collar placement. MATERIAL AND METHODS: A retrospective review was conducted of all adult trauma patients presenting to a Level 1 trauma center after blunt trauma with a GCS≥13 and no distracting injury or gross intoxication from January 2014 to December 2014...
November 15, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/29153127/enforcement-associated-with-higher-school-reported-immunization-rates
#4
Kylie J Hall, Molly A Howell, Rick J Jansen, Paul J Carson
INTRODUCTION: North Dakota's school-reported kindergarten immunization rates were among the lowest in the U.S. during the 2015-2016 school year. Ninety percent of kindergartners were fully immunized in accordance with state requirements, 3% had an exemption, and as many as 7% were noncompliant. School enforcement of immunization requirements has been noted as variable. This study sought to better understand the relationship between school-reported immunization rates and the enforcement of immunization requirements...
December 2017: American Journal of Preventive Medicine
https://www.readbyqxmd.com/read/29126537/a-47-year-old-man-with-recurrent-unilateral-pleural-effusion
#5
Alexandra Haw, Ronald Kotler, Kevin Steinberg
A 47-year-old man with a medical history of hypertension, diabetes, hyperlipidemia, and OSA presented with a 7- to 10-day history of progressively worsening dyspnea on exertion, with a walking distance of 60 feet. He had bilateral lower-extremity swelling and was prescribed furosemide without clinical improvement. At baseline, he used three pillows for sleeping. The patient was noncompliant with his CPAP treatment. He had no smoking history and was retired from working in technology sales. On review of systems, he denied cough, chest pain, hemoptysis, fevers, chills, or weight loss...
November 2017: Chest
https://www.readbyqxmd.com/read/29122392/differences-in-psychosocial-determinants-of-hand-hygiene-between-health-care-professional-groups-insights-from-a-mixed-methods-analysis
#6
Muhamad Alif Bin Ibrahim, Chengzi Chow, Bee Fong Poh, Brenda Ang, Angela Chow
BACKGROUND: Good hand hygiene (HH) prevents health care-associated infections. We compared psychosocial and organizational factors associated with HH compliance and perceived need for improvement among physicians, nurses, and allied health professionals (AHPs). METHODS: We conducted a mixed-methods study in a 1,600-bed adult tertiary-care hospital in Singapore. Seven focus group discussions were conducted and data were analyzed using thematic analysis. The subsequent cross-sectional survey involved 1,064 staff members...
November 6, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/29118540/total-endoscopic-and-anal-irrigation-management-approach-to-noncompliant-neuropathic-bladder-and-bowel-in-children-a-long-term-follow-up
#7
Naif Alqarni, Hamdan Alhazmi, Ossamah Alsowayan, Tamer Eweda, Khalid Fouda Neel
Purpose: To evaluate the long-term efficacy and durability of combined intradetrusor botulinum-A toxin (BTX-A), endoscopic treatment of vesicouerteral reflux and anal irrigation for stool incontinence (SI) via a total endoscopic and anal irrigation management (TEAM(®)) approach in patients with myelomeningocele and neuropathic bladder and bowel who did not respond to conservative measures. Materials and Methods: Fourteen myelomeningocele patients with at least 3 years follow-up were included in the study...
October 2017: Urology Annals
https://www.readbyqxmd.com/read/29116661/complying-with-the-emergency-medical-treatment-and-labor-act-emtala-challenges-and-solutions
#8
Charleen Hsuan, Jill R Horwitz, Ninez A Ponce, Renee Y Hsia, Jack Needleman
The Emergency Medical Treatment and Labor Act (EMTALA), which requires Medicare-participating hospitals to provide emergency care to patients regardless of their ability to pay, plays an important role in protecting the uninsured. Yet many hospitals do not comply. This study examines the reasons for noncompliance and proposes solutions. We conducted 11 semistructured key informant interviews with hospitals, hospital associations, and patient safety organizations in the Centers for Medicare and Medicaid Services region with the highest number of EMTALA complaints filed...
November 8, 2017: Journal of Healthcare Risk Management: the Journal of the American Society for Healthcare Risk Management
https://www.readbyqxmd.com/read/29112459/atomoxetine-parent-training-and-their-effects-on-sleep-in-youth-with-autism-spectrum-disorder-and-attention-deficit-hyperactivity-disorder
#9
Jill A Hollway, Marrisa Mendoza-Burcham, Rebecca Andridge, Michael G Aman, Benjamin Handen, L Eugene Arnold, Luc Lecavalier, Craig Williams, Laura Silverman, Tristram Smith
OBJECTIVE: Sleep disturbance is often a problem for children with either autism spectrum disorder (ASD) or attention-deficit/hyperactivity disorder (ADHD). Psychostimulant medications used to treat ADHD symptoms can exacerbate this problem. For children with ASD and ADHD, atomoxetine (ATX) is a viable alternative to psychostimulants. We investigated the effects of ATX and a manualized parent training (PT) program targeting noncompliance, on the sleep quality of children with ASD and ADHD...
November 7, 2017: Journal of Child and Adolescent Psychopharmacology
https://www.readbyqxmd.com/read/29111501/understanding-variability-in-driving-recommendations-for-patients-with-seizures
#10
Sidrah Mahmud, Sean T Hwang
BACKGROUND: There is lack of consensus regarding driving restrictions for patients with epilepsy. Regulations vary by state. New York State (NYS) recommends driving restrictions for one year in a person with an episode of loss of consciousness (LOC), with physician discretion. Often, providers make recommendations to permit their patients to drive after a shorter seizure-free period than proposed guidelines. The prevalence and reasons behind more lenient recommendations have not been elucidated...
October 27, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/29109851/safety-and-efficacy-of-ledipasvir-sofosbuvir-on-hepatitis-c-eradication-in-hepatitis-c-virus-human-immunodeficiency-virus-co-infected-patients
#11
Xiaoping He, Lynne Hopkins, George Everett, Willie M Carter, Cynthia SchroppDyce, Khalid Abusaada, Vincent Hsu
AIM: To evaluate the safety and efficacy of ledipasvir/sofosbuvir on hepatitis C eradication in patients with hepatitis C virus (HCV)/human immunodeficiency virus (HIV) co-infection in an urban HIV clinic. METHODS: A retrospective cohort study of 40 subjects co-infected with HIV-1 and HCV treated with the fixed-dose combination of ledipasvir and sofosbuvir for 12 wk from 2014 to 2016. All patients included were receiving antiretroviral therapy (ART) with HIV RNA values of 100 copies/mL or fewer regardless of baseline HCV RNA level...
October 28, 2017: World Journal of Hepatology
https://www.readbyqxmd.com/read/29100704/effect-of-technique-on-outcomes-following-bioresorbable-vascular-scaffold%C3%A2-implantation-analysis-from-the-absorb-trials
#12
Gregg W Stone, Alexandre Abizaid, Yoshinobu Onuma, Ashok Seth, Runlin Gao, John Ormiston, Takeshi Kimura, Bernard Chevalier, Ori Ben-Yehuda, Ovidiu Dressler, Tom McAndrew, Stephen G Ellis, Dean J Kereiakes, Patrick W Serruys
BACKGROUND: Procedural technique may affect clinical outcomes after bioresorbable vascular scaffold (BVS) implantation. Prior studies suggesting such a relationship have not adjusted for baseline patient and lesion characteristics that may have influenced operator choice of technique and outcomes. OBJECTIVES: This study sought to determine whether target lesion failure (TLF) (cardiac death, target-vessel myocardial infarction, or ischemia-driven target lesion revascularization) and scaffold thrombosis (ScT) rates within 3 years of BVS implantation are affected by operator technique (vessel size selection and pre- and post-dilation parameters)...
October 20, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29096920/significance-of-noncompliance-when-treating-patients-with-epilepsy
#13
Rumyana Kuzmanova, Irina Stefanova, Katerina Stambolieva
INTRODUCTION: The absence of patient's cooperation when it comes to his/her treatment ("noncompliance") is typical to chronic diseases and it is significant problem in medical practice. The term "compliance" means patient's capability of strictly adhering to the recommendations concerning the prescribed treatment. The noncompliance with drug regime is frequent case in patients with epilepsy, it is related to increased risk of epileptic seizures' occurrence and other undesired consequences, including increased costs in the healthcare area...
October 23, 2017: Neurologia i Neurochirurgia Polska
https://www.readbyqxmd.com/read/29091125/noncompliance-in-people-living-with-hiv-accuracy-of-defining-characteristics-of-the-nursing-diagnosis1
#14
Richardson Augusto Rosendo da Silva, Mayara Mirna do Nascimento Costa, Vinicius Lino de Souza, Bárbara Coeli Oliveira da Silva, Cristiane da Silva Costa, Itaísa Fernandes Cardoso de Andrade
OBJECTIVE: to evaluate the accuracy of the defining characteristics of the NANDA International nursing diagnosis, noncompliance, in people with HIV. METHOD: study of diagnostic accuracy, performed in two stages. In the first stage, 113 people with HIV from a hospital of infectious diseases in the Northeast of Brazil were assessed for identification of clinical indicators of noncompliance. In the second, the defining characteristics were evaluated by six specialist nurses, analyzing the presence or absence of the diagnosis...
October 30, 2017: Revista Latino-americana de Enfermagem
https://www.readbyqxmd.com/read/29083529/evaluation-of-patient-nasal-saline-irrigation-practices-following-endoscopic-sinus-surgery
#15
Frederick Yoo, Elisabeth H Ference, Edward C Kuan, Jivianne T Lee, Marilene B Wang, Jeffrey D Suh
BACKGROUND: Functional endoscopic sinus surgery (FESS) is an effective treatment for chronic rhinosinusitis (CRS). Postoperative management strategies after FESS often vary from surgeon to surgeon. Recent data suggests that nasal saline irrigation following FESS is almost universally recommended; however, patient adherence has not been formally evaluated. The purpose of this study is to evaluate postoperative nasal irrigation practices and its effects on short-term outcomes in post-FESS patients...
October 30, 2017: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/29083310/-pharmaceutical-care-at-the-primary-care-clinic-in-gar%C3%A3-ab%C3%A3-r-number-and-type-of-drug-therapy-problems-identified-among-elderly-clients
#16
Anna Bryndis Blondal, Anna Birna Almarsdottir, Jon Steinar Jonsson, Sveinbjorn Gizurarson
INTRODUCTION: Elderly people are a rising population in Iceland. With higher age the likelihood of drug consumption increases and thus drug therapy problems. Pharmaceutical care has been established abroad, where the pharmacist works in collaboration with other healthcare professionals to reduce patients' drug therapy problems. The aim of this research was to study the number and types of drug therapy problems of older individuals in primary care in Garðabær, by providing pharmacist-led pharmaceutical care in collaboration with general practitioners...
November 2017: Læknablađiđ
https://www.readbyqxmd.com/read/29083042/practitioner-review-current-best-practice-in-the-use-of-parent-training-and-other-behavioural-interventions-in-the-treatment-of-children-and-adolescents-with-attention-deficit-hyperactivity-disorder
#17
REVIEW
David Daley, Saskia Van Der Oord, Maite Ferrin, Samuele Cortese, Marina Danckaerts, Manfred Doepfner, Barbara J Van den Hoofdakker, David Coghill, Margaret Thompson, Philip Asherson, Tobias Banaschewski, Daniel Brandeis, Jan Buitelaar, Ralf W Dittmann, Chris Hollis, Martin Holtmann, Eric Konofal, Michel Lecendreux, Aribert Rothenberger, Paramala Santosh, Emily Simonoff, Cesar Soutullo, Hans Christoph Steinhausen, Argyris Stringaris, Eric Taylor, Ian C K Wong, Alessandro Zuddas, Edmund J Sonuga-Barke
BACKGROUND: Behavioural interventions are recommended for use with children and young people with attention deficit hyperactivity disorder (ADHD); however, specific guidance for their implementation based on the best available evidence is currently lacking. METHODS: This review used an explicit question and answer format to address issues of clinical concern, based on expert interpretation of the evidence with precedence given to meta-analyses of randomised controlled trials...
October 30, 2017: Journal of Child Psychology and Psychiatry, and Allied Disciplines
https://www.readbyqxmd.com/read/29079312/idiopathic-constipation-a-challenging-but-manageable-problem
#18
Andrea Bischoff, Giulia Brisighelli, Belinda Dickie, Jason Frischer, Marc A Levitt, Alberto Peña
PURPOSE: A protocol to treat idiopathic constipation is presented. METHODS: A contrast enema is performed in every patient and, when indicated, patients are initially submitted to a "clean out" protocol. All patients are started on a Senna-based laxative. The initial dosage is empirically determined and adjusted daily, during a one week period, based on history and abdominal radiographs, until the amount of Senna that empties the colon is reached. The management is considered successful when patients empty their colon daily and stop soiling...
October 10, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29077540/toward-reduction-in-antibiotic-use-for-pediatric-otitis-media-predicting-parental-compliance-with-watchful-waiting-advice
#19
Erina L MacGeorge, Rachel A Smith, Emily P Caldes, Nicole M Hackman
"Watchful waiting" (WW) can reduce unnecessary antibiotic use in the treatment of pediatric otitis media (ear infection), but the utility of the strategy is impaired by underutilization and noncompliance. Guided by advice response theory (ART), the current study examines how parental compliance with WW and trust in the prescribing physician is predicted by evaluative and affective responses to the advice. Parents (N = 134) of at least one child aged 5 years or younger completed questionnaires that assessed responses to WW advice they received for their youngest child...
November 2017: Journal of Health Communication
https://www.readbyqxmd.com/read/29074011/analysis-of-reasons-for-noncompliance-with-laser-treatment-in-patients-of-diabetic-retinopathy
#20
Wen Hua, Sijia Cao, Jing Cui, David Maberley, Joanne Matsubara
OBJECTIVE: To identify the underlying reasons for noncompliance among Chinese patients undergoing laser photocoagulation treatment for diabetic retinopathy (DR). DESIGN: Prospective cohort study. PARTICIPANTS: A total of 262 patients with DR with indications for panretinal photocoagulation and focal laser treatment were recruited. METHODS: Those who did not complete the prescribed laser treatment were categorized into 2 types of defaulters: Type 1 defaulters were those who did not initiate laser treatment as scheduled; type 2 defaulters were those who did not complete the entire laser sessions, including terminating midterm or defaulting prompt supplement of laser treatment...
November 2017: Canadian Journal of Ophthalmology. Journal Canadien D'ophtalmologie
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