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https://www.readbyqxmd.com/read/28829788/estimating-the-cost-per-result-of-a-national-reflexed-cryptococcal-antigenaemia-screening-program-forecasting-the-impact-of-potential-hiv-guideline-changes-and-treatment-goals
#1
Naseem Cassim, Lindi Marie Coetzee, Kathryn Schnippel, Deborah Kim Glencross
INTRODUCTION: During 2016, the National Health Laboratory Service (NHLS) introduced laboratory-based reflexed Cryptococcal antigen (CrAg) screening to detect early Cryptococcal disease in immunosuppressed HIV+ patients with a confirmed CD4 count of 100 cells/μl or less. OBJECTIVE: The aim of this study was to assess cost-per-result of a national screening program across different tiers of laboratory service, with variable daily CrAg test volumes. The impact of potential ART treatment guideline and treatment target changes on CrAg volumes, platform choice and laboratory workflow are considered...
2017: PloS One
https://www.readbyqxmd.com/read/28829626/transitioning-from-methadone-to-buprenorphine-maintenance-in-management-of-opioid-use-disorder-during-pregnancy
#2
Shakevia Johnson, Peter R Martin
BACKGROUND: Opioid use disorder during pregnancy is a growing health concern. Methadone maintenance is the treatment of choice but emerging data indicate buprenorphine is a viable alternative. Due to costs and limited accessibility of methadone, pregnant women may require transition from methadone to buprenorphine for maintenance treatment. OBJECTIVES: To assess safety and effectiveness of transitioning from methadone to buprenorphine when necessary during pregnancy...
August 22, 2017: American Journal of Drug and Alcohol Abuse
https://www.readbyqxmd.com/read/28829518/cost-of-opioid-treated-chronic-low-back-pain-findings-from-a-pilot-randomized-controlled-trial-of-mindfulness-meditation-based-intervention
#3
Aleksandra E Zgierska, James Ircink, Cindy A Burzinski, Marlon P Mundt
OBJECTIVE: Opioid-treated chronic low back pain (CLBP) is debilitating, costly, and often refractory to existing treatments. This secondary analysis aims to pilot-test the hypothesis that mindfulness meditation (MM) can reduce economic burden related to opioid-treated CLBP. DESIGN: Twenty-six-week unblinded pilot randomized controlled trial, comparing MM, adjunctive to usual-care, to usual care alone. SETTING: Outpatient. PARTICIPANTS: Thirty-five adults with opioid-treated CLBP (≥30 morphine-equivalent mg/day) for 3 + months enrolled; none withdrew...
May 2017: Journal of Opioid Management
https://www.readbyqxmd.com/read/28829161/cost-and-cost-effectiveness-of-donor-human-milk-to-prevent-necrotizing-enterocolitis-systematic-review
#4
Abigail Buckle, Celia Taylor
BACKGROUND: Necrotizing enterocolitis (NEC) is a costly gastrointestinal disorder that mainly affects preterm and low-birth-weight infants and can lead to considerable morbidity and mortality. Mother's own milk is protective against NEC but is not always available. In such cases, donor human milk has also been shown to be protective (although to a lesser extent) compared with formula milk, but it is more expensive. This systematic review aimed at evaluating the cost of donor milk, the cost of treating NEC, and the cost-effectiveness of exclusive donor milk versus formula milk feeding to reduce the short-term health and treatment costs of NEC...
August 22, 2017: Breastfeeding Medicine: the Official Journal of the Academy of Breastfeeding Medicine
https://www.readbyqxmd.com/read/28828943/from-a-global-crisis-to-the-end-of-aids-new-epidemics-of-signification
#5
Nora Kenworthy, Matthew Thomann, Richard Parker
In the past decade, discourses about AIDS have taken a remarkable, and largely unquestioned, turn. Whereas mobilisations for treatment scale-up during the 2000s were premised on perceptions of an 'epidemic out of control', we have repeatedly been informed in more recent years that an end to AIDS is immanent. This new discourse and its resulting policies are motivated by post-recession financial pressures, a changing field of global institutions, and shifting health and development priorities. These shifts also reflect a biomedical triumphalism in HIV prevention and treatment, whereby shorter term, privatised, technological, and 'cost-effective' interventions are promoted over long-term support for antiretroviral treatment...
August 22, 2017: Global Public Health
https://www.readbyqxmd.com/read/28828925/towards-ion-beam-therapy-based-on-laser-plasma-accelerators
#6
Leonhard Karsch, Elke Beyreuther, Wolfgang Enghardt, Malte Gotz, Umar Masood, Ulrich Schramm, Karl Zeil, Jörg Pawelke
Only few ten radiotherapy facilities worldwide provide ion beams, in spite of their physical advantage of better achievable tumor conformity of the dose compared to conventional photon beams. Since, mainly the large size and high costs hinder their wider spread, great efforts are ongoing to develop more compact ion therapy facilities. One promising approach for smaller facilities is the acceleration of ions on micrometre scale by high intensity lasers. Laser accelerators deliver pulsed beams with a low pulse repetition rate, but a high number of ions per pulse, broad energy spectra and high divergences...
August 22, 2017: Acta Oncologica
https://www.readbyqxmd.com/read/28828746/clinical-safety-of-renaming-encapsulated-follicular-variant-of-papillary-thyroid-carcinoma-is-niftp-truly-benign
#7
David N Parente, Wouter P Kluijfhout, Pim J Bongers, Raoul Verzijl, Karen M Devon, Lorne E Rotstein, David P Goldstein, Sylvia L Asa, Ozgur Mete, Jesse D Pasternak
BACKGROUND: Renaming encapsulated follicular variant of papillary thyroid carcinoma (EFVPTC) to noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) was recently suggested to prevent the overtreatment, cost and stigma associated with this low-risk entity. The purpose of this study is to document the incidence and further assess the clinical outcomes of reclassifying EFVPTC to NIFTP. METHODS: We searched synoptic pathologic reports from a high-volume academic endocrine surgery hospital from 2004 to 2013...
August 21, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28828180/multi-level-spine-endoscopy-a-review-of-available-evidence-and-case-report
#8
Scott D Middleton, Ralf Wagner, J N Alastair Gibson
In the last ten years, there has been an exponential increase in endoscopic spinal surgery practice.With improvements in equipment quality and the availability of high definition camera systems, cervical endoscopic disc resection is now a viable alternative to anterior cervical decompression and fusion (ACDF) or disc arthroplasty for the treatment of disc prolapse and low grade stenosis.Based on the current literature, there is now strong evidence to support the use of transforaminal endoscopic approaches for the treatment of thoracic disc prolapse...
July 2017: EFORT open reviews
https://www.readbyqxmd.com/read/28828167/outcomes-and-surgical-complications-in-kidney-transplantation
#9
F Reyna-Sepúlveda, A Ponce-Escobedo, A Guevara-Charles, M Escobedo-Villarreal, E Pérez-Rodríguez, G Muñoz-Maldonado, M Hernández-Guedea
BACKGROUND: Kidney transplantation is the most cost-effective therapy for end-stage renal disease. Post-operative complications account for 15%-17% of all cases and are associated with significant morbidity. Currently 4.8% of post-transplantation patients have returned to dialysis. Our center's main transplant origin is cadaveric donation. OBJECTIVE: To review surgical complications of kidney transplantation over the past 5 years. METHODS: This was an observational descriptive study that included all patients from 2011 to 2015...
2017: International Journal of Organ Transplantation Medicine
https://www.readbyqxmd.com/read/28828162/the-application-of-diode-laser-in-the-treatment-of-oral-soft-tissues-lesions-a-literature-review
#10
REVIEW
Daniel Ortega-Concepción, Jorge A Cano-Durán, Juan-Francisco Peña-Cardelles, Víctor-Manuel Paredes-Rodríguez, José González-Serrano, Juan López-Quiles
BACKGROUND: Since its appearance in the dental area, the laser has become a treatment of choice in the removal of lesions in the oral soft tissues, due to the numerous advantages they offer, being one of the most used currently the diode laser. The aim of this review was to determine the efficacy and predictability of diode laser as a treatment of soft tissue injuries compared to other surgical methods. MATERIAL AND METHODS: A literature review of articles published in PubMed/MEDLINE, Scopus and the Cochrane Library databases between 2007 and 2017 was performed...
July 2017: Journal of Clinical and Experimental Dentistry
https://www.readbyqxmd.com/read/28828064/increasing-rates-of-surgical-treatment-for-paediatric-diaphyseal-forearm-fractures-a-national-database-study-from-2000-to-2012
#11
A I Cruz, J E Kleiner, S F DeFroda, J A Gil, A H Daniels, C P Eberson
FOREARM: Purpose fractures are one of the most commonly sustained injuries in children and are often treated non-operatively. The purpose of this study was to estimate the rate of inpatient surgical treatment of paediatric forearm fractures over time using a large, publicly available, national database. METHODS: The Healthcare Cost and Utilization Project (HCUP) Kids' Inpatient Database (KID) was evaluated between 2000 and 2012. Forearm fractures and surgeries were identified using International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9 CM) diagnosis and procedure codes...
June 1, 2017: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/28828019/chronic-pain-in-chronic-heart-failure-a-review-article
#12
REVIEW
Mohammad Javad Alemzadeh-Ansari, Mohammad Mostafa Ansari-Ramandi, Nasim Naderi
Heart failure (HF) is one of the main causes of death and disability in the world. The prevalence of HF in developed countries is between 1% and 2% of the adult population and approximately between 6% and 10% in the elderly, giving rise to high costs of care and treatment. Indeed, in the United States, the direct and indirect costs exceeded 23 billion dollars in 2002. HF is typically characterized by periods of acute symptoms followed by returns to nearly asymptomatic periods. As dyspnea and fatigue are considered the signature symptoms of HF, other symptoms such as pain go unnoticed...
April 2017: Journal of Tehran Heart Center
https://www.readbyqxmd.com/read/28827861/the-prospective-24-week-assessment-of-cost-efficacy-of-and-compliance-to-antidepressant-medications-in-a-rural-setting-pacecar-study
#13
T S Sathyanarayana Rao, J Shivanand Manohar, Rajesh Raman, M S Darshan, Abhinav Tandon, K N Karthik, N Saraswathi, Keya Das, G T Harsha, Swetha Patil Kunkeri, Chittaranjan Andrade
BACKGROUND: Anxiety and depression are common mental health disorders that are responsible for considerable societal burden. There are no data on cost-efficacy and medication compliance related to the treatment of these disorders in rural India. MATERIALS AND METHODS: All consenting adults (n = 455) diagnosed with generalized anxiety or (unipolar) depressive disorders in Suttur village, Karnataka, were treated with open-label fluoxetine (20-60 mg/day), sertraline (50-150 mg/day), escitalopram (10-20 mg/day), desvenlafaxine (50-150 mg/day), duloxetine (30-90 mg/day), amitriptyline (75-150 mg/day), or clomipramine (75-150 mg/day) in a structured, monotherapy dosing plan...
April 2017: Indian Journal of Psychiatry
https://www.readbyqxmd.com/read/28827854/immediate-loading-of-short-implants-in-posterior-maxillae-case-series
#14
Eduardo Anitua
BACKGROUND: There is an increasing number of scientific evidence supporting the clinical use of short dental implants. However, few studies have evaluated the long-term outcomes of immediate loading protocols in short implants. This study aims to evaluate immediate loading of short dental implants in the posterior regions of the maxillae. MATERIALS AND METHODS: Patients having short implants in maxillae posterior areas inserted before December, 2010 and immediately loaded were selected...
June 2017: Acta Stomatologica Croatica
https://www.readbyqxmd.com/read/28827796/host-population-structure-impedes-reversion-to-drug-sensitivity-after-discontinuation-of-treatment
#15
Jonas I Liechti, Gabriel E Leventhal, Sebastian Bonhoeffer
Intense use of antibiotics for the treatment of diseases such as tuberculosis, malaria, Staphylococcus aureus or gonorrhea has led to rapidly increasing population levels of drug resistance. This has generally necessitated a switch to new drugs and the discontinuation of older ones, after which resistance often only declines slowly or even persists indefinitely. These long-term effects are usually ascribed to low fitness costs of resistance in absence of the drug. Here we show that structure in the host population, in particular heterogeneity in number of contacts, also plays an important role in the reversion dynamics...
August 21, 2017: PLoS Computational Biology
https://www.readbyqxmd.com/read/28827495/the-north-wind-and-the-sun-pediatric-antimicrobial-stewardship-program-combining-restrictive-and-persuasive-approaches-in-hematology-oncology-ward-and-hematopoietic-stem-cell-transplant-unit
#16
Yuho Horikoshi, Tetsuji Kaneko, Yoshihiko Morikawa, Mihoko Isogai, Junichi Suwa, Hiroshi Higuchi, Yuki Yuza, Takayo Shoji, Kenta Ito
OBJECTIVE: The Japanese government's goal for the reduction of antimicrobial consumption is two-thirds of the 2013 rate by 2020. While the antimicrobial stewardship programs (ASP) are essential in health care facilities, ASP data on pediatric hematology-oncology and hematopoietic stem cell transplant (HSCT) patients are limited. Our aim was to evaluate the impact of restrictive and persuasive ASP on immunocompromised children. DESIGN: The ASP for hematology-oncology and HSCT patients at Tokyo Metropolitan Children's Medical Center was assessed...
August 17, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28827422/antibacterial-resistance-in-ureaplasma-species-and-mycoplasma-hominis-isolates-from-urine-cultures-in-college-aged-females
#17
Marissa A Valentine-King, Mary B Brown
Urinary tract infections (UTIs) affect nearly 20% of women aged 15-29 and account for an estimated $3.5 billion in US costs. Antibiotic resistance prolongs UTI treatment and resistance profiles vary regionally. This regional variation is an important consideration in guiding empirical treatment selection. Regional studies in the US have identified tetracycline resistance in over a third of Ureaplasma spp. isolates, but no studies have evaluated antibiotic resistance levels in college-aged women with first-time UTI...
August 21, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28827377/clinical-practice-guideline-for-screening-and-management-of-high-blood-pressure-in-children-and-adolescents
#18
Joseph T Flynn, David C Kaelber, Carissa M Baker-Smith, Douglas Blowey, Aaron E Carroll, Stephen R Daniels, Sarah D de Ferranti, Janis M Dionne, Bonita Falkner, Susan K Flinn, Samuel S Gidding, Celeste Goodwin, Michael G Leu, Makia E Powers, Corinna Rea, Joshua Samuels, Madeline Simasek, Vidhu V Thaker, Elaine M Urbina
These pediatric hypertension guidelines are an update to the 2004 "Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents." Significant changes in these guidelines include (1) the replacement of the term "prehypertension" with the term "elevated blood pressure," (2) new normative pediatric blood pressure (BP) tables based on normal-weight children, (3) a simplified screening table for identifying BPs needing further evaluation, (4) a simplified BP classification in adolescents ≥13 years of age that aligns with the forthcoming American Heart Association and American College of Cardiology adult BP guidelines, (5) a more limited recommendation to perform screening BP measurements only at preventive care visits, (6) streamlined recommendations on the initial evaluation and management of abnormal BPs, (7) an expanded role for ambulatory BP monitoring in the diagnosis and management of pediatric hypertension, and (8) revised recommendations on when to perform echocardiography in the evaluation of newly diagnosed hypertensive pediatric patients (generally only before medication initiation), along with a revised definition of left ventricular hypertrophy...
August 21, 2017: Pediatrics
https://www.readbyqxmd.com/read/28827273/comparison-of-health-related-quality-of-life-in-patients-with-atrial-fibrillation-treated-with-catheter-ablation-or-antiarrhythmic-drug-therapy-a-systematic-review-and-meta-analysis-protocol
#19
Katherine S Allan, Shaunattonie Henry, Theresa Aves, Laura Banfield, J Charles Victor, Paul Dorian, Jeff S Healey, Jason Andrade, Sandra Carroll, Michael McGillion
INTRODUCTION: Atrial fibrillation (AF) is the most prevalent cardiac arrhythmia and causes patients considerable burden; symptoms such as palpitations and dyspnoea are common, leading to frequent emergency room visits. Patients with AF report reduced health-related quality of life (HQOL) compared with the general population; thus, treatments focus on the restoration of sinus rhythm to improve symptoms. Catheter ablation (CA) is a primary treatment strategy to treat AF-related burden in select patient populations; however, repeat procedures are often needed, there is a risk of major complications and the procedure is quite costly in comparison to medical therapy...
August 21, 2017: BMJ Open
https://www.readbyqxmd.com/read/28827260/extending-the-liaison-psychiatry-service-in-a-large-hospital-in-the-uk-a-before-and-after-evaluation-of-the-economic-impact-and-patient-care-following-ed-attendances-for-self-harm
#20
Brent C Opmeer, William Hollingworth, Elsa M R Marques, Ruta Margelyte, David Gunnell
OBJECTIVES: To evaluate the impact of an expansion of liaison psychiatry services (LPS) on patient management, outcomes and treatment costs for emergency department (ED) attendances for self-harm. DESIGN: Retrospective before and after cohort study using routinely collected Self-Harm Surveillance Register data. SETTING: A large hospital in South West England. SUBJECTS: Patients attending the ED for self-harm. INTERVENTIONS: Extension of the LPS' working hours from 9:00 to 17:00, Monday to Friday to 8:00 to 22:00, 7 days a week, following a £250 000 annual investment MAIN OUTCOME MEASURES: Number and characteristics of ED attendances for self-harm...
August 21, 2017: BMJ Open
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