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USA health care

Andras P Durko, Ruben L Osnabrugge, Nicolas M Van Mieghem, Milan Milojevic, Darren Mylotte, Vuyisile T Nkomo, A Pieter Kappetein
Aims: The number of transcatheter aortic valve implantation (TAVI) procedures is rapidly increasing. This has a major impact on health care resource planning. However, the annual numbers of TAVI candidates per country are unknown. The aim of this study was to estimate current and future number of annual TAVI candidates in 27 European countries, the USA and Canada. Methods and results: Systematic literature searches and meta-analyses were performed on aortic stenosis (AS) epidemiology and decision-making in severe symptomatic AS...
March 12, 2018: European Heart Journal
Alain Bruno Tagne Nouemssi
Tuberculosis (TB) continues to represent an important public health challenge in the world and the USA, especially given its association with HIV infection and population migration. Cervical tuberculous lymphadenitis represents the most common extrapulmonary presentation of TB in the USA. Considerations for other causes of neck mass often contribute to delay in diagnosis. In this report, we describe the case of a 41-year-old man who presented with painful swelling of the neck and was diagnosed with tuberculous lymphadenitis, complicated by HIV therapy-associated immune reconstitution syndrome...
March 15, 2018: BMJ Case Reports
Sean Robison, Gauri Rani Karur, Rachel M Wald, Paaladinesh Thavendiranathan, Andrew M Crean, Kate Hanneman
BACKGROUND: Calculation of cardiovascular magnetic resonance (CMR) extracellular volume (ECV) requires input of hematocrit, which may not be readily available. The purpose of this study was to evaluate the diagnostic accuracy of ECV calculated using various noninvasive measures of hematocrit compared to ECV calculated with input of laboratory hematocrit as the reference standard. METHODS: One hundred twenty three subjects (47.7 ± 14.1 years; 42% male) were prospectively recruited for CMR T1 mapping between August 2016 and April 2017...
March 15, 2018: Journal of Cardiovascular Magnetic Resonance
David H Jang, Utsha G Khatri, Anita Mudan, Jennifer S Love, Shawn Owiredu, David M Eckmann
It is conservatively estimated that 5,000 deaths per year and 20,000 injuries in the USA are due to poisonings caused by chemical exposures (e.g., carbon monoxide, cyanide, hydrogen sulfide, phosphides) that are cellular inhibitors. These chemical agents result in mitochondrial inhibition resulting in cardiac arrest and/or shock. These cellular inhibitors have multi-organ effects, but cardiovascular collapse is the primary cause of death marked by hypotension, lactic acidosis, and cardiac arrest. The mitochondria play a central role in cellular metabolism where oxygen consumption through the electron transport system is tightly coupled to ATP production and regulated by metabolic demands...
March 13, 2018: Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology
Janelle Guirguis-Blake, Gina A Keppel, John Holmes, Rex W Force, William Kriegsman, Laura-Mae Baldwin
Background: Patients with chronic kidney disease (CKD) are at high risk for adverse drug events related to medication dosing errors and prescriptions for relatively contraindicated medications, such as non-steroidal anti-inflammatory drugs (NSAIDs). Objectives: To examine the scope of and variation in prescribing relatively contraindicated medications and medications above the recommended dose levels among patients with stage III/IV CKD in primary care practice...
February 26, 2018: Family Practice
Mary E Cooley, Hermine Poghosyan, Kim Sprunck-Harrild, Jonathan P Winickoff, Stephen B Edge, Karen M Emmons
Cancer survivors are a rapidly growing population and an important target for tobacco treatment interventions. Continued smoking after the diagnosis of cancer is associated with a higher risk of cancer recurrence and mortality. Systematic tobacco cessation programs are effective. This study surveyed American College of Surgeons Commission on Cancer (CoC) programs in the Northeast region of the USA regarding their tobacco control programs. Seventy percent of cancer survivors are treated within CoC programs. The purpose of this study was to describe the extent of implementation of tobacco treatment and determine the organizational delivery of tobacco treatment as measured by the presence of goals to address smoking, leadership support, and integration of tobacco treatment guidelines into care delivery...
March 8, 2018: Translational Behavioral Medicine
Hyun-Seok Park, Jae-Hyung Choi
OBJECTIVE: The beneficial effect of hypothermia after hemicraniectomy in malignant middle cerebral artery (MCA) infarction has been controversial. We aim to investigate the safety and clinical efficacy of hypothermia after hemicraniectomy in malignant MCA infarction. METHODS: From October 2012 to February 2016, 20 patients underwent hypothermia (Blanketrol III, Cincinnati Sub-Zero, Cincinnati, OH, USA) at 34°C after hemicraniectomy in malignant MCA infarction (hypothermia group)...
March 2018: Journal of Korean Neurosurgical Society
Isabelle Scholl, Allison LaRussa, Pola Hahlweg, Sarah Kobrin, Glyn Elwyn
BACKGROUND: Shared decision-making (SDM) is poorly implemented in routine care, despite being promoted by health policies. No reviews have solely focused on an in-depth synthesis of the literature around organizational- and system-level characteristics (i.e., characteristics of healthcare organizations and of healthcare systems) that may affect SDM implementation. A synthesis would allow exploration of interventions to address these characteristics. The study aim was to compile a comprehensive overview of organizational- and system-level characteristics that are likely to influence the implementation of SDM, and to describe strategies to address those characteristics described in the literature...
March 9, 2018: Implementation Science: IS
Iolanda Alves Braga, Paola Amaral de Campos, Paulo Pinto Gontijo Filho, Rosineide Marques Ribas
BACKGROUND: Healthcare-associated infection (HAI) represents a major problem for patient safety worldwide. AIM: To provide an up-to-date picture of the extent, aetiology, risk factors and patterns of infections in intensive care units (ICUs) in 28 Brazilian hospitals of different sizes. METHODS: A one-day point prevalence survey in 2016 enrolled the ICU of hospitals from the 12 meso regions located in the State of Minas Gerais, Southeast region of Brazil...
March 6, 2018: Journal of Hospital Infection
Stephen A Stanhope, Mary C Cooley, Linda F Ellington, Gregory P Gadbois, Andrew L Richardson, Timothy C Zeddes, Jay P LaBine
BACKGROUND: In the United States, home-based primary care (HBPC) is increasingly proposed as a means of enabling frail elders to remain at home for as long as possible, while still receiving needed medical care. However, there are relatively few studies of either the medical outcome effects or cost benefits of HBPC. In this paper, we examine medical cost and mortality outcomes for enrollees in the HBPC program offered by Spectrum Health/Priority Health (SH/PH), a not-for-profit integrated health care/health insurance system located in Grand Rapids, MI, USA...
March 7, 2018: BMC Health Services Research
Sara Barsanti, Manila Bonciani
Healthcare systems have followed several strategies aimed at integrating primary care services and professionals. Medical homes in the USA and Canada, and primary care centres across Europe have collocated general practitioners and other health and social professionals in the same building in order to boost coordination among services and the continuity of care for patients. However, in the literature, the impact of co-location on primary care has led to controversial results. This article analyses the possible benefits of the co-location of services in primary care focusing on the Italian model of primary care centres (Case della Salute) in terms of general practitioners' perception...
January 1, 2018: Health Services Management Research
Sabrina Roy, Fred H Hochberg, Pamela S Jones
This article aims to document the growth in extracellular vesicle (EV) research. Here, we report the growth in EV-related studies, patents, and grants as well as emerging companies with major intent on exosomes. Four different databases were utilized for electronic searches of published literature: two general databases - Scopus/Elsevier and Web of Science (WoS), as well as two specialized US government databases - the USA Patent and Trademark Office and National Institutes of Health (NIH) of the Department of Health and Human Services...
2018: Journal of Extracellular Vesicles
J Mullins, M N Lobato, K Bemis, L Sosa
SETTING: In the United States, tuberculosis (TB) control is increasingly focusing on the identification of persons with latent tuberculous infection (LTBI). OBJECTIVE: To characterize the local epidemiology of LTBI in Connecticut, USA. METHODS: We used spatial analyses 1) to identify census tract-level clusters of reported LTBI and TB disease in Connecticut, 2) to compare persons and populations in clusters with those not in clusters, and 3) to compare persons with LTBI to those with TB disease...
February 1, 2018: International Journal of Tuberculosis and Lung Disease
Gitanjali Srivastava, Caroline Apovian
PURPOSE OF REVIEW: Obesity is a global health crisis with detrimental effects on all organ systems leading to worsening disease state and rising costs of care. Persons with obesity failing lifestyle therapies need to be escalated to appropriate pharmacological treatment modalities, medical devices, and/or bariatric surgery if criteria are met and more aggressive intervention is needed. The progression of severe obesity in the patient population coupled with related co-morbidities necessitates the development of novel therapies for the treatment of obesity...
March 5, 2018: Current Obesity Reports
Lindsay H Dewa, Kevin Murray, Bethan Thibaut, Sonny Christian Ramtale, Sheila Adam, Ara Darzi, Stephanie Archer
OBJECTIVE: Physical healthcare has dominated the patient safety field; research in mental healthcare is not as extensive but findings from physical healthcare cannot be applied to mental healthcare because it delivers specialised care that faces unique challenges. Therefore, a clearer focus and recognition of patient safety in mental health as a distinct research area is still needed. The study aim is to identify future research priorities in the field of patient safety in mental health...
March 3, 2018: BMJ Open
William Levack, Kounosuke Tomori, Kayoko Takahashi, Aidan J Sherrington
OBJECTIVE: This study aimed to investigate the content of an English-language version of a Japanese iPad application designed to facilitate shared decision-making around goal setting in rehabilitation: Aid for Decision-making in Occupational Choice-English (ADOC-E). DESIGN: Phase 1: Delphi methods to reach consensus with an international group of expert occupational therapists on the text and images in ADOC-E. Phase 2: Testing correct recognition (unprompted and prompted) of images in ADOC-E by health service users in inpatient rehabilitation and residential care...
March 1, 2018: BMJ Open
Mohammed K Ali, Kai McKeever Bullard, Sharon Saydah, Giuseppina Imperatore, Edward W Gregg
BACKGROUND: There is controversy over the usefulness of prediabetes as a diagnostic label. Using data from US National Health and Nutrition Examination Surveys (NHANES) between 1988 and 2014, we examined the cardiovascular and renal burdens in adults with prediabetes over time and compared patterns with other glycaemic status groups. METHODS: We analysed cross-sectional survey data from non-pregnant adults aged 20 years and older from the NHANES survey periods 1988-94, 1999-2004, 2005-10, and 2011-14...
February 27, 2018: Lancet Diabetes & Endocrinology
Zibusiso Ndlovu, Emmanuel Fajardo, Elton Mbofana, Tatenda Maparo, Daniela Garone, Carol Metcalf, Helen Bygrave, Kekeletso Kao, Sekesai Zinyowera
BACKGROUND: HIV Viral Load and Early Infant Diagnosis technologies in many high burden settings are restricted to centralized laboratory testing, leading to long result turnaround times and patient attrition. GeneXpert (Cepheid, CA, USA) is a polyvalent near point-of-care platform and is widely implemented for Xpert MTB/RIF diagnosis. This study sought to evaluate the operational feasibility of integrated HIV VL, EID and MTB/RIF testing in new GeneXpert platforms. METHODS: Whole blood samples were collected from consenting patients due for routine HIV VL testing and DBS samples from infants due for EID testing, at three rural health facilities in Zimbabwe...
2018: PloS One
A Kumaran, A Chan, K Yong, S Shen
AIM: To describe differences in the deep lateral orbital wall (specifically, trigone) between Chinese, Malay, Indian and Caucasian subjects Methods: Single-centre retrospective Computed Tomogram (CT)-based study; 20 subjects of each ethnicity were used from existing databases, matched for gender, average age and laterality. Subjects below 16 years of age were excluded. DICOM image viewing software CARESTREAM Vue PACS (Carestream Health Inc., USA) and OsiriX version 7.5 (Pixmeo., Switzerland) were used to measure deep lateral wall length, thickness and volume, as well as orbital depth and statistical analyses performed using Statistical Package for Social Sciences version 21 (IBM, USA)...
February 26, 2018: Orbit
Nirupama Bonthala, Sunanda Kane
PURPOSE OF REVIEW: Inflammatory bowel disease affects approximately 800,000 women in the USA with the peak incidence between ages 15 to 40. Thus for many females, IBD can impact nearly every stage of their life from menarche to pregnancy, menopause, and beyond. This paper will review the most recent updates on the topics of sexual health, cervical cancer screening, menstruation, fertility, contraception, and menopause. RECENT FINDINGS: Menarche can be delayed in females especially those who are underweight, malnourished, or with active inflammatory bowel disease...
February 26, 2018: Current Treatment Options in Gastroenterology
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