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https://www.readbyqxmd.com/read/28934596/features-and-outcomes-of-methamphetamine-associated-pulmonary-arterial-hypertension
#1
Roham T Zamanian, Haley Hedlin, Paul Greuenwald, David M Wilson, Joshua I Segal, Michelle Jorden, Kristina Kudelko, Juliana Liu, Andrew Hsi, Allyson Rupp, Andrew J Sweatt, Rubin Tuder, Gerald J Berry, Marlene Rabinovitch, Ramona L Doyle, Vinicio De Jesus Perez, Steven M Kawut
RATIONALE: While amphetamines are recognized as "likely" agents to cause drugs and toxins associated pulmonary arterial hypertension (PAH), (meth)amphetamine associated PAH (Meth-APAH) has not been well described. OBJECTIVES: To prospectively characterize the clinical presentation, histopathology, and outcomes of Meth-APAH compared to those of idiopathic PAH (iPAH). METHODS AND MEASUREMENTS: We performed a prospective cohort study of Meth-APAH and iPAH patients presenting to the Stanford University Pulmonary Hypertension Program between 2003-2015...
September 21, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28899233/differences-in-utility-elicitation-methods-in-cardiovascular-disease-a-systematic-review
#2
Marissa Blieden, Shravanthi R Gandra, Lung-I Cheng, Anna Szatkowski, Peter P Toth
AIMS: Utility values inform estimates of the cost-effectiveness of treatment for cardiovascular disease (CVD), but values can vary depending on the method used. The aim of this systematic literature review (SLR) was to explore how methods of elicitation impact utility values for CVD. MATERIALS AND METHODS: We identified English-language articles in Embase, MEDLINE, and the grey literature published between September 1992 and August 2015 using keywords for 'utilities' and 'stroke,' 'heart failure,' 'myocardial infarction,' or 'angina...
September 12, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28882333/trends-and-outcomes-of-aortic-valve-replacement-in-patients-with-end-stage-renal-disease-on-hemodialysis
#3
Sami Aljohani, Fahad Alqahtani, Ahmad Almustafa, Khaled Boobes, Sujal Modi, Mohamad Alkhouli
Hemodialysis (HD) patients with aortic stenosis are less likely to undergo aortic valve replacement (AVR) due to their excess perioperative mortality. We aimed to evaluate contemporary utilization and outcomes of combined and isolated AVR in HD patients. The Nationwide Inpatient Sample was used to identify 142,046 patients who underwent AVR in 2005 to 2014, of whom 2,264 (1.6%) were on HD. Crude and adjusted in-hospital outcomes and costs were assessed in unmatched and propensity-matched cohorts of HD and non-HD patients, respectively...
August 4, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28882175/strategies-to-improve-the-quality-of-life-of-persons-post-stroke-protocol-of-a-systematic-review
#4
Sarah E P Munce, Laure Perrier, Saeha Shin, Chamila Adhihetty, Kristen Pitzul, Michelle L A Nelson, Mark T Bayley
BACKGROUND: While many outcomes post-stroke (e.g., depression) have been previously investigated, there is no complete data on the impact of a variety of quality improvement strategies on the quality of life and physical and psychological well-being of individuals post-stroke. The current paper outlines a systematic review protocol on the impact of quality improvement strategies on quality of life as well as physical and psychological well-being of individuals with stroke. METHODS: MEDLINE, CINAHL, EMBASE, and PsycINFO databases will be searched...
September 7, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/28841249/assessing-physician-knowledge-regarding-indications-for-a-primary-prevention-implantable-defibrillator-and-potential-barriers-for-referral
#5
Rochelle Bernier, Satish R Raj, Dat Tran, Lucy Reyes, Michel Sauve, Glen L Sumner, Derek V Exner, Roopinder K Sandhu
BACKGROUND: Although there is clear evidence to demonstrate that primary prevention implantable defibrillators (ICDs) reduce mortality in high-risk patients, ICDs are underutilized. Limited data exist assessing referring physicians' knowledge about guideline indications and attitudes towards ICDs, which may influence decision for referral. METHODS AND RESULTS: The Arrhythmia Working Group from the Alberta Cardiovascular and Stroke Strategic Clinical Network developed a web-based survey consisting of case scenarios regarding primary prevention ICD indications and a list of barriers for referral to aid in the design of a complex device care pathway...
August 25, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28832867/cost-effectiveness-of-evolocumab-therapy-for-reducing-cardiovascular-events-in-patients-with-atherosclerotic-cardiovascular-disease
#6
Gregg C Fonarow, Anthony C Keech, Terje R Pedersen, Robert P Giugliano, Peter S Sever, Peter Lindgren, Ben van Hout, Guillermo Villa, Yi Qian, Ransi Somaratne, Marc S Sabatine
Importance: The proprotein convertase subtilisin/kexin type 9 inhibitor evolocumab has been demonstrated to reduce the composite of myocardial infarction, stroke, or cardiovascular death in patients with established atherosclerotic cardiovascular disease. To our knowledge, long-term cost-effectiveness of this therapy has not been evaluated using clinical trial efficacy data. Objective: To evaluate the cost-effectiveness of evolocumab in patients with atherosclerotic cardiovascular disease when added to standard background therapy...
August 23, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28806592/validation-of-simplified-centre-of-mass-models-during-gait-in-individuals-with-chronic-stroke
#7
Andrew H Huntley, Alison Schinkel-Ivy, Anthony Aqui, Avril Mansfield
BACKGROUND: The feasibility of using a multiple segment (full-body) kinematic model in clinical gait assessment is difficult when considering obstacles such as time and cost constraints. While simplified gait models have been explored in healthy individuals, no such work to date has been conducted in a stroke population. The aim of this study was to quantify the errors of simplified kinematic models for chronic stroke gait assessment. METHODS: Sixteen individuals with chronic stroke (>6months), outfitted with full body kinematic markers, performed a series of gait trials...
October 2017: Clinical Biomechanics
https://www.readbyqxmd.com/read/28801954/an-analysis-of-inpatient-pediatric-sickle-cell-disease-incidence-costs-and-outcomes
#8
Laura M Bou-Maroun, Fabien Meta, Curtis J Hanba, Andrew D Campbell, Gregory A Yanik
OBJECTIVE: To identify characteristics of pediatric sickle cell disease (SCD) hospitalizations and to examine admission demographics and medical expenditures. METHODS: Admissions with SCD were identified from the 2009 and 2012 releases of the Healthcare and Cost Utilization Project's Kids Inpatient Database. Disease-specific secondary diagnoses including acute chest syndrome (ACS), vaso-occlusive pain crisis (VOC), splenic sequestration, and stroke/transient ischemic attack were analyzed for patient and hospital demographics...
August 12, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28750695/cost-effectiveness-of-long-term%C3%A2-ticagrelor-in-patients-with-prior-myocardial-infarction-results-from-the-pegasus-timi-54-trial
#9
RANDOMIZED CONTROLLED TRIAL
Elizabeth A Magnuson, Haiyan Li, Kaijun Wang, Katherine Vilain, Ali Shafiq, Marc P Bonaca, Deepak L Bhatt, Marc Cohen, Philippe Gabriel Steg, Robert F Storey, Eugene Braunwald, Marc S Sabatine, David J Cohen
BACKGROUND: In patients with a myocardial infarction (MI) 1 to 3 years earlier, treatment with ticagrelor + low-dose aspirin (ASA) reduces the risk of cardiovascular (CV) death, MI, or stroke compared with low-dose aspirin alone, but at an increased risk of major bleeding. OBJECTIVES: The authors evaluated cost-effectiveness of ticagrelor + low-dose ASA in patients with prior MI within the prior 3 years. METHODS: The authors performed a prospective economic substudy alongside the PEGASUS-TIMI 54 (Prevention of Cardiovascular Events in Patients With Prior Heart Attack Using Ticagrelor Compared to Placebo on a Background of Aspirin-Thrombolysis In Myocardial Infarction 54) trial, which randomized 21,162 patients to ASA alone, ticagrelor 60 mg twice daily + low-dose ASA, or ticagrelor 90 mg twice daily + low-dose ASA...
August 1, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28716014/the-comprehensive-post-acute-stroke-services-compass-study-design-and-methods-for-a-cluster-randomized-pragmatic-trial
#10
Pamela W Duncan, Cheryl D Bushnell, Wayne D Rosamond, Sara B Jones Berkeley, Sabina B Gesell, Ralph B D'Agostino, Walter T Ambrosius, Blair Barton-Percival, Janet Prvu Bettger, Sylvia W Coleman, Doyle M Cummings, Janet K Freburger, Jacqueline Halladay, Anna M Johnson, Anna M Kucharska-Newton, Gladys Lundy-Lamm, Barbara J Lutz, Laurie H Mettam, Amy M Pastva, Mysha E Sissine, Betsy Vetter
BACKGROUND: Patients discharged home after stroke face significant challenges managing residual neurological deficits, secondary prevention, and pre-existing chronic conditions. Post-discharge care is often fragmented leading to increased healthcare costs, readmissions, and sub-optimal utilization of rehabilitation and community services. The COMprehensive Post-Acute Stroke Services (COMPASS) Study is an ongoing cluster-randomized pragmatic trial to assess the effectiveness of a comprehensive, evidence-based, post-acute care model on patient-centered outcomes...
July 17, 2017: BMC Neurology
https://www.readbyqxmd.com/read/28693742/impact-of-cirrhosis-in-patients-who-underwent-surgical-aortic-valve-replacement
#11
MULTICENTER STUDY
Robert J Steffen, Faisal G Bakaeen, Patrick R Vargo, Bogdan A Kindzelski, Douglas R Johnston, Eric E Roselli, A Marc Gillinov, Lars G Svensson, Edward G Soltesz
Cirrhosis is known to adversely affect cardiac surgery outcomes. Our objective was to quantify the morbidity, mortality, and cost that cirrhosis adds to surgical aortic valve replacement. From 1998 to 2011, 423,789 patients in the Nationwide Inpatient Sample Healthcare Cost Utilization Project underwent isolated aortic valve replacement; 2,769 (0.7%) had cirrhosis. Multivariable linear regression and 1:1 propensity matching were used to determine the effect of cirrhosis on postsurgical outcomes. The number of patients with cirrhosis who underwent surgical aortic valve replacement per year more than tripled during the 13-year study period...
August 15, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28689940/carotid-body-tumor-resection-just-as-safe-without-preoperative-embolization
#12
Adrienne N Cobb, Adel Barkat, Witawat Daungjaiboon, Pegge Halandras, Paul Crisostomo, Paul C Kuo, Bernadette Aulivola
BACKGROUND: Carotid body tumors (CBT) are rare entities for which surgical resection remains the gold standard. Given their hypervascularity, preoperative embolization is often used, however, controversy exists over whether a benefit is associated. Proponents of embolization argue it minimizes blood loss and complications. Critics argue cost and stroke outweigh benefits. This study aimed to investigate the impact of embolization on outcomes following CBT resection. METHODS: Patients undergoing CBT resection were identified using the Healthcare Cost and Utilization Project State Inpatient Database (HCUP-SID) for 5 states 2006-2013...
July 6, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28683732/chinese-acute-ischemic-stroke-treatment-outcome-registry-castor-protocol-for-a-prospective-registry-study-on-patterns-of-real-world-treatment-of-acute-ischemic-stroke-in-china
#13
MULTICENTER STUDY
Weiping Sun, Qianhua Ou, Zhijun Zhang, Jiazhi Qu, Yining Huang
RATIONALE: Stroke presents a serious health problem in China. Despite progresses made in recent years, there is still a lack of effective treatments for acute ischemic stroke (AIS) in clinical practices. AIMS: The Chinese Acute Ischemic Stroke Treatment Outcome Registry (CASTOR) is designed to evaluate the patterns and cost-effectiveness of current treatments for AIS in real-world settings in China. DESIGN: CASTOR is a prospective, multi-center study registered with ClinicalTrials...
July 6, 2017: BMC Complementary and Alternative Medicine
https://www.readbyqxmd.com/read/28657348/comparing-the-economic-burden-of-ischemic-stroke-patients-with-and-without-atrial-fibrillation-a-retrospective-study-in-beijing-china
#14
Liankui Wen, Jingjing Wu, Lin Feng, Li Yang, Feng Qian
BACKGROUND: Little is known about the economic burden for ischemic stroke (IS) patients with atrial fibrillation (AF) in China. AIM: We aimed to compare the economic burden of treatment-related costs in IS patients with AF vs. without AF in China. METHODS: This retrospective analysis used economic burden data from the Beijing urban health insurance database. Using a random sampling method, 10% of the patients diagnosed with IS from 1 January through 31 December 2012 were enrolled...
August 9, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28650086/systemic-thrombolysis-catheter-directed-thrombolysis-and-anticoagulation-for-intermediate-risk-pulmonary-embolism-a-simulation-modeling-analysis
#15
Christopher Kabrhel, Ayman Ali, Jin G Choi, Chin Hur
OBJECTIVES: Decision making around the use of thrombolysis for patients with intermediate-risk (submassive) pulmonary embolism (PE) remains challenging. Studies indicate favorable clinical outcomes with systemic thrombolytics (intravenous tissue plasminogen activator [IV tPA]), but the risk of major bleeding and hemorrhagic stroke is a deterrent. Catheter-directed thrombolysis (CDT) may be a preferable strategy, as it has been shown to have a lower risk of bleeding than systemic thrombolysis...
June 26, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28643129/magnetohydrodynamic-voltage-recorder-for-comparing-peripheral-blood-flow
#16
Kevin J Wu, T Stan Gregory, Michael C Lastinger, Jonathan R Murrow, Zion Tsz Ho Tse
Blood flow is a clinical metric for monitoring of cardiovascular diseases but current measurements methods are costly or uncomfortable for patients. It was shown that the interaction of the magnetic field (B 0) during MRI and blood flow in the body, through the magnetohydrodynamic (MHD) effect, produce voltages (V MHD) observable through intra-MRI electrocardiography (ECG), which are correlated with regional blood flow. This study shows the reproducibility of V MHD outside the MRI and its application in a portable flow monitoring device...
June 22, 2017: Annals of Biomedical Engineering
https://www.readbyqxmd.com/read/28641023/cardiovascular-event-incidence-and-cost-in-type-2-diabetes-mellitus-a-medicare-claims-based-actuarial-analysis
#17
Kathryn Fitch, Tyler Engel, Stephen Sander, Effie Kuti, Helen Blumen
OBJECTIVE: To assess the economic burden of cardiovascular events in Medicare beneficiaries with type 2 diabetes mellitus (T2DM). METHODS: This claims-based actuarial analysis queried 2013 and 2014 Medicare 5% samples, defining a denominator of fee-for-service beneficiaries. Average per patient per month allowed cost ($PPPM) was calculated for T2DM, demographically adjusted non-T2DM, and denominator. Per member per month allowed cost ($PMPM) was calculated by dividing total population cost by member months in the denominator...
July 17, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28637460/healthcare-utilization-and-costs-for-patients-initiating-dabigatran-or-warfarin
#18
Shannon L Reynolds, Sameer R Ghate, Richard Sheer, Pranav K Gandhi, Chad Moretz, Cheng Wang, Stephen Sander, Mary E Costantino, Srinivas Annavarapu, George Andrews
BACKGROUND: Novel oral anticoagulants (NOAC) such as dabigatran, when compared to warfarin, have been shown to potentially reduce the risk of stroke in patients with non-valvular atrial fibrillation (NVAF) together with lower healthcare resource utilization (HCRU) and similar total costs. This study expands on previous work by comparing HCRU and costs for patients newly diagnosed with NVAF and newly initiated on dabigatran or warfarin, and is the first study specifically in a Medicare population...
June 21, 2017: Health and Quality of Life Outcomes
https://www.readbyqxmd.com/read/28635339/methods-for-estimating-costs-in-patients-with-hyperlipidemia-experiencing-their-first-cardiovascular-event-in-the-united-kingdom
#19
Mark D Danese, Michelle Gleeson, Robert I Griffiths, David Catterick, Lucie Kutikova
AIMS: Methods for integrating external costs into clinical databases are not well-characterized. The purpose of this research was to describe and implement methods for estimating the cost of hospitalizations, prescriptions, and general practitioner and specialist visits used to manage hyperlipidemia patients experiencing cardiovascular (CV) events in the United Kingdom (UK). METHODS: This study was a retrospective cohort study using the Clinical Practice Research Datalink and Hospital Episode Statistics data...
September 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28627034/brief-mindfulness-meditation-group-training-in-aphasia-exploring-attention-language-and-psychophysiological-outcomes
#20
Rebecca Shisler Marshall, Jacqueline Laures-Gore, Kim Love
BACKGROUND: Stroke is currently the leading cause of long-term disability in adults in the United States. There is a need for accessible, low-cost treatments of stroke-related disabilities such as aphasia. AIMS: To explore an intervention for aphasia utilizing mindfulness meditation (MM). This preliminary study examines the feasibility of teaching MM to individuals with aphasia. Since physiological measures have not been collected for those with aphasia, the study was also an exploration of the potential attention, language and physiological changes after MM in adults with aphasia during a brief, daily group training...
June 19, 2017: International Journal of Language & Communication Disorders
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