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https://www.readbyqxmd.com/read/28108978/treatment-of-complicated-urinary-tract-infection-and-acute-pyelonephritis-by-short-course-intravenous-levofloxacin-750%C3%A2-mg-day-or-conventional-intravenous-oral-levofloxacin-500%C3%A2-mg-day-prospective-open-label-randomized-controlled-multicenter-non-inferiority
#1
Hong Ren, Xiao Li, Zhao-Hui Ni, Jian-Ying Niu, Bin Cao, Jie Xu, Hong Cheng, Xiao-Wen Tu, Ai-Min Ren, Ying Hu, Chang-Ying Xing, Ying-Hong Liu, Yan-Feng Li, Jun Cen, Rong Zhou, Xu-Dong Xu, Xiao-Hui Qiu, Nan Chen
OBJECTIVE: To compare the efficacy and safety of short-course intravenous levofloxacin (LVFX) 750 mg with a conventional intravenous/oral regimen of LVFX 500 mg in patients from China with complicated urinary tract infections (cUTIs) and acute pyelonephritis (APN). METHODS: This was a prospective, open-label, randomized, controlled, multicenter, non-inferiority clinical trial. Patients with cUTI and APN were randomly assigned to a short-course therapy group (intravenous LVFX at750 mg/day for 5 days) or a conventional therapy group (intravenous/oral regimen of LVFX at 500 mg/day for 7-14 days)...
January 20, 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/28108669/developmental-differences-in-dynamic-muscle-tendon-behavior-implications-for-movement-efficiency
#2
C M Waugh, T Korff, A J Blazevich
Children perform cyclic motor tasks less efficiently than adults, however the mechanisms underlying such differences are not fully understood. One mechanism that may contribute these age-related differences is a differential contribution of muscles and tendons to a given muscle tendon unit (MTU) excursion. The aims of this study were to a) compare muscle and tendon excursion between children and adults performing vertical hopping, and b) determine if children and adults choose a hopping frequency that maximizes movement efficiency, based on the utilization of energy-saving mechanisms...
January 20, 2017: Journal of Experimental Biology
https://www.readbyqxmd.com/read/28107785/blood-management-strategies-to-reduce-transfusions-after-elective-lower-extremity-joint-arthroplasty-surgeries
#3
Ankit Kansagra, Chester Andrzejewski, Robert Krushell, Andrew Lehman, Jordan Greenbaum, Paul Visintainer, Joan McGirr, Kathleen Mahoney, Darlene Cloutier, Alice Ehresman, Mihaela S Stefan
Blood loss associated with lower-extremity total joint arthroplasty (TJA) often results in anemia and the need for red blood cell transfusions (RBCTs). This article reports on a quality improvement initiative aimed at improving blood management strategies in patients undergoing TJA. A multifaceted intervention (preoperative anemia assessment, use of tranexamic acid, discouragement of autologous preoperative blood collection, restrictive RBCT protocols) was implemented. The results were stratified into 3 intervention periods: 1, pre; 2, peri; and 3, post...
January 1, 2017: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/28106518/a-case-report-cornerstone-health-care-reduced-the-total-cost-of-care-through-population-segmentation-and-care-model-redesign
#4
Dale E Green, Bruce H Hamory, Grace E Terrell, Jasmine O'Connell
Over the course of a single year, Cornerstone Health Care, a multispecialty group practice in North Carolina, redesigned the underlying care models for 5 of its highest-risk populations-late-stage congestive heart failure, oncology, Medicare-Medicaid dual eligibles, those with 5 or more chronic conditions, and the most complex patients with multiple late-stage chronic conditions. At the 1-year mark, the results of the program were analyzed. Overall costs for the patients studied were reduced by 12.7% compared to the year before enrollment...
January 20, 2017: Population Health Management
https://www.readbyqxmd.com/read/28102937/re-implementation-of-an-evidence-based-acute-tonsillitis-protocol-our-experience-in-one-hundred-and-twenty-six-patients
#5
Guled M Jama, Mahmoud Nosseir, Julian Danino, James Barraclough
The 'Portsmouth Tonsillitis Protocol' by Bird et al. (October 2013 issue)([1]) provides the first published treatment algorithm for use in patients with acute tonsillitis presenting to secondary care. Following introduction of the protocol at their centre the authors demonstrate an improved delivery of tonsillitis treatment as well as a reduction in hospital admission rates and inpatient services leading to significant cost savings. The financial implications are particularly relevant to health services facing economic pressures...
January 19, 2017: Clinical Otolaryngology
https://www.readbyqxmd.com/read/28100807/cost-minimisation-analysis-of-thermometry-in-two-different-hospital-systems
#6
Kenneth Hayes, Amanda Shepard, August Cesarec, Robert Likić
INTRODUCTION: Temperature monitoring can be accomplished by various methods, including oral (OT), rectal (RT), axillary (AT), tympanic membrane (TMT) and temporal artery (TAT) thermometry, with varying amounts of cost incurred by healthcare systems. METHODS: The potential thermometry cost savings in two hospital systems-University Hospital Centre Zagreb (UHCZ), which uses TMT (device Covidien Genius 2) and University of Michigan Hospitals (UMH), which relies on OT, RT and AT (device Welch Allyn suretemp plus 692)-were analysed to evaluate institution-wide TAT (device Exergen TAT-5000) implementation...
January 18, 2017: Postgraduate Medical Journal
https://www.readbyqxmd.com/read/28100215/a-discrete-event-simulation-model-to-evaluate-the-use-of-community-services-in-the-treatment-of-patients-with-parkinson-s-disease-in-the-united-kingdom
#7
Reda Lebcir, Eren Demir, Raheelah Ahmad, Christos Vasilakis, David Southern
BACKGROUND: The number of people affected by Parkinson's disease (PD) is increasing in the United Kingdom driven by population ageing. The treatment of the disease is complex, resource intensive and currently there is no known cure to PD. The National Health Service (NHS), the public organisation delivering healthcare in the UK, is under financial pressures. There is a need to find innovative ways to improve the operational and financial performance of treating PD patients. The use of community services is a new and promising way of providing treatment and care to PD patients at reduced cost than hospital care...
January 18, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28100142/reduction-in-jail-emergency-department-visits-and-closure-after-implementation-of-on-site-urgent-care
#8
Erick Eiting, Carrie S Korn, Erin Wilkes, Glenn Ault, Sean O Henderson
This descriptive study evaluates the impact of implementation of full service on-site urgent care services at the Los Angeles County Jail (LACJ) by examining the number of patients seen at the referral hospital, Los Angeles County + University of Southern California Medical Center (LAC+USC), and the number of hours that the referral hospital was closed to transfers in the periods before and after the development of the LACJ Urgent Care. The appropriate utilization of public resources is a critical priority for an overburdened county medical health care system...
January 2017: Journal of Correctional Health Care
https://www.readbyqxmd.com/read/28099724/costs-of-integrating-cervical-cancer-screening-at-an-hiv-clinic-in-kenya
#9
Elisabeth L Vodicka, Joseph B Babigumira, Marita R Mann, Rose J Kosgei, Fan Lee, Nelly R Mugo, Timothy C Okech, Samah R Sakr, Louis P Garrison, Michael H Chung
OBJECTIVE: To estimate the societal-level costs of integrating cervical cancer screening into HIV clinics in Nairobi, Kenya. METHODS: A cross-sectional micro-costing study was performed at Coptic Hope Center for Infectious Diseases and Kenyatta National Hospital, Kenya, between July 1 and October 31, 2014. To estimate direct medical, non-medical, and indirect costs associated with screening, a time-and-motion study was performed, and semi-structured interviews were conducted with women aged at least 18 years attending the clinic for screening during the study period and with clinic staff who had experience relevant to cervical cancer screening...
February 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28097927/assessment-and-comparison-of-three-high-aluminum-fly-ash-utilization-scenarios-in-inner-mongolia-china-using-an-eco-efficiency-indicator
#10
Shuo Yang, Ling Lin, Shao Peng Li, Qiang Li, Xiu Teng Wang, Liang Sun
Utilization of fly ash is of great importance in China in the context of resource and environmental crises. Different fly ash utilization processes are proposed, and some have been practically applied. However, none of these fly ash utilization pathways has been evaluated comprehensively by integrating both environmental and economic perspectives. In this study, three high-aluminum fly ash utilization methods in Mongolia were assessed and compared based on the concept of eco-efficiency. The environmental assessment was conducted in accordance with life-cycle assessment principles, and a monetization-weighting approach was applied to obtain social willingness-to-pay as a reflection of environmental impact...
January 1, 2017: Waste Management & Research
https://www.readbyqxmd.com/read/28097913/cost-consequence-analysis-of-different-active-flowable-hemostatic-matrices-in-cardiac-surgical-procedures
#11
D Makhija, M Rock, Y Xiong, J D Epstein, M R Arnold, O M Lattouf, D Calcaterra
BACKGROUND: A recent retrospective comparative effectiveness study found that use of FLOSEAL® Hemostatic Matrix in cardiac surgery was associated with significantly lower risks of complications, blood transfusions, surgical revisions and shorter length of surgery than use of SURGIFLO(®) Hemostatic Matrix. These outcome improvements in cardiac surgery procedures may translate to economic savings for hospitals and payers. OBJECTIVE: The objective of this study was to estimate the cost-consequence of two flowable hemostatic matrices (FLOSEAL or SURGIFLO) in cardiac surgeries for US hospitals...
January 18, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28097305/enhanced-recovery-after-surgery-a-review
#12
Olle Ljungqvist, Michael Scott, Kenneth C Fearon
Importance: Enhanced Recovery After Surgery (ERAS) is a paradigm shift in perioperative care, resulting in substantial improvements in clinical outcomes and cost savings. Observations: Enhanced Recovery After Surgery is a multimodal, multidisciplinary approach to the care of the surgical patient. Enhanced Recovery After Surgery process implementation involves a team consisting of surgeons, anesthetists, an ERAS coordinator (often a nurse or a physician assistant), and staff from units that care for the surgical patient...
January 11, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28097246/three-year-follow-up-of-a-randomized-controlled-trial-comparing-preoperative-neuroscience-education-for-patients-undergoing-surgery-for-lumbar-radiculopathy
#13
Adriaan Louw, Ina Diener, Merrill R Landers, Kory Zimney, Emilio J Puentedura
BACKGROUND: Results from a previous multicenter randomized controlled trial (RCT) on preoperative pain neuroscience education (PNE) for lumbar radiculopathy found no significant difference in patient reported outcomes between groups. However, patients who received PNE viewed their surgical experience more favorably and utilized significantly less healthcare compared to those that did not. The purpose is to determine if the reduction in healthcare costs from 1-year would be continued at 3-year following surgery, and to explore differences (if any) in patient reported outcomes...
December 2016: Journal of Spine Surgery (Hong Kong)
https://www.readbyqxmd.com/read/28097244/minimising-costs-in-spinal-surgery-is-group-save-testing-justified-in-lumbar-decompression-surgery
#14
William T Wilson, Adam M H Young, Paul Fivey
BACKGROUND: Lumbar microdiscectomy and laminectomy are two of the most common neurosurgical procedures performed worldwide. Current practice still sees pre-operative group and save testing prior to this surgery. The aim of this study was to determine the need for pre-operative group and save and post-operative blood checks. METHODS: Patient archives were reviewed to identify those undergoing primary elective lumbar decompression surgery at the Institute of Neurological Sciences, Queen Elizabeth University Hospital, Glasgow, UK...
December 2016: Journal of Spine Surgery (Hong Kong)
https://www.readbyqxmd.com/read/28097100/hepatitis-c-virus-a-review-of-treatment-guidelines-cost-effectiveness-and-access-to-therapy
#15
REVIEW
Shaina M Lynch, George Y Wu
Hepatitis C virus (HCV) infection remains a significant medical concern in the United States and around the world. It is still one of the leading causes of chronic liver disease, and, for more than 20 years, there has been little progress in the treatment of HCV infection. The advent of direct-acting antivirals (DAAs) initiated the era of high efficacy and well-tolerated medications with high cure rates. The efficacy of these medications has prompted many professional societies around the world to update their treatment guidelines to include DAAs as first-line treatment...
December 28, 2016: Journal of Clinical and Translational Hepatology
https://www.readbyqxmd.com/read/28096974/mortality-hospital-days-and-treatment-costs-of-current-and-reduced-sugar-consumption-in-israel
#16
Gary M Ginsberg
BACKGROUND: Consumption of sugar causes tooth decay, overweight and obesity related morbidities. This paper in response to the Minister of Health's request, provides estimates of the mortality, morbidity and health care costs attributable to sugar consumption in Israel along with the effects of reducing sugar consumption. METHODS: Gender specific relative risks of many diseases from overweight (25 < =BMI < 30) and obesity (BMI > =30) were applied to the national gender specific prevalence rates of overweight and obesity in order to calculate the population attributable fraction (PAF) from overweight and obesity...
2017: Israel Journal of Health Policy Research
https://www.readbyqxmd.com/read/28096064/evaluation-of-financial-burdens-following-complications-after-major-surgery-in-france-potential-returns-after-perioperative-goal-directed-therapy
#17
Alain Landais, Morgane Morel, Jacques Goldstein, Jerôme Loriau, Annie Fresnel, Corinne Chevalier, Gilles Rejasse, Pascal Alfonsi, Claude Ecoffey
OBJECTIVE: Perioperative goal directed therapy (PGDT) has been demonstrated to improve postoperative outcomes and reduce the length of hospital stays. The objective of our analysis was to evaluate the cost of complications, derived from French hospital payments, and calculate the potential cost savings and length of hospital stay reductions. METHODS: The billing of 2,388 patients who underwent scheduled high-risk surgery (i.e. major abdominal, gynaecologic, urological, vascular, and orthopaedic interventions) over three years was retrospectively collected from three French hospitals (one public - teaching, one public, and one private hospital)...
January 13, 2017: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/28095832/cost-effectiveness-of-using-a-motion-sensor-biofeedback-treatment-approach-for-the-management-of-sub-acute-or-chronic-low-back-pain-economic-evaluation-alongside-a-randomised-trial
#18
Terry Haines, Kelly-Ann Bowles
BACKGROUND: Low back pain is a common and costly condition internationally. There is high need to identify effective and economically efficient means for managing this problem. This study aimed to explore the cost-effectiveness of a novel motion-sensor biofeedback treatment approach in addition to guidelines-based care compared to guidelines-based care alone, from a societal perspective over a 12 month time horizon. METHOD: This was an incremental cost-effectiveness analysis conducted concurrently with a pilot, cluster randomized controlled trial...
January 17, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28095037/non-invasive-follicular-tumor-with-papillary-like-nuclear-features-niftp-not-a-tempest-in-a-teapot
#19
Nidhi Agrawal, Collette E Abbott, Cheng Liu, Stella Kang, Laura Tipton, Kepal Patel, Mark Persky, Lizabeth King, Fang-Ming Deng, Michael Bannan, Jennifer B Ogilvie, Keith Heller, Steven P Hodak
BACKGROUND: Encapsulated non-invasive follicular variant papillary thyroid cancer (ENIFVPTC) has recently been re-termed noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP). This designation specifically omits the word "cancer" to encourage conservative management since patients with NIFTP tumors have been shown to derive no benefit from completion thyroidectomy or adjuvant radioactive iodine (RAI) therapy. METHODS: IRB approved retrospective study of consecutive cases of tumors from 2007 to 2015 that met pathologic criteria for NIFTP...
January 17, 2017: Endocrine Practice
https://www.readbyqxmd.com/read/28094677/costs-of-formal-and-informal-care-in-the-last-year-of-life-for-patients-in-receipt-of-specialist-palliative-care
#20
Aoife Brick, Samantha Smith, Charles Normand, Sinéad O'Hara, Elsa Droog, Ella Tyrrell, Nathan Cunningham, Bridget Johnston
BACKGROUND: Economic evaluation of palliative care has been slow to develop and the evidence base remains small. AIM: This article estimates formal and informal care costs in the last year of life for a sample of patients who received specialist palliative care in three different areas in Ireland. DESIGN: Formal care costs are calculated for community, specialist palliative care, acute hospital and other services. Where possible, a bottom-up approach is used, multiplying service utilisation by unit cost...
January 1, 2017: Palliative Medicine
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