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https://www.readbyqxmd.com/read/29350380/patients-treated-with-bivalirudin-still-at-higher-risk-of-stent-thrombosis-a-comprehensive-meta-analysis-of-randomized-clinical-trials-of-bivalirudin-and-heparin-for-percutaneous-coronary-interventions
#1
Stefan Grajek, Michał Michlak, Adrian Gwizdała, Aleksander Araszkiewicz, Marek Grygier, Jarosław Hiczkiewicz, Maciej Lesiak
BACKGROUND: Although the current practice guidelines recommend using both heparin and bivalirudin for percutaneous coronary interventions (PCI), the research data are ambiguous. AIM: To compare the impact of bivalirudin- and heparin on major clinical endpoints in PCI patients with particular emphasis on periprocedural stent thrombosis. METHODS: Total of 18 randomised clinical trials involving 41752 subjects were included. The endpoints comprised: net adverse clinical event (NACE: death, myocardial infarction [MI], unscheduled revascularisation, major bleeding [MB]), major adverse cardiovascular event (MACE: death, MI or stroke), acute/subacute stent thrombosis (ST)...
January 19, 2018: Kardiologia Polska
https://www.readbyqxmd.com/read/29349201/factors-affecting-the-physical-and-mental-health-of-older-adults-in-china-the-importance-of-marital-status-child-proximity-and-gender
#2
Lindy Williams, Renling Zhang, Kevin C Packard
Evidence is accumulating about the association between strong family ties and the emotional and physical welfare of older adults, and researchers have identified negative consequences of being unmarried, being childless, and/or living alone. These associations have been recognized in multiple contexts, including in Asia where living with a spouse and/or grown children has been shown in some studies to improve elderly well-being. Social support, especially family support, is expected to continue to be important where populations are aging and social safety nets are weak...
December 2017: SSM—Population Health
https://www.readbyqxmd.com/read/29346063/linking-data-from-health-surveys-and-electronic-health-records-a-demonstration-project-in-two-chicago-health-center-clinics
#3
Fikirte Wagaw, Catherine A Okoro, Sunkyung Kim, Jessica Park, Fred Rachman
INTRODUCTION: Monitoring and understanding population health requires conducting health-related surveys and surveillance. The objective of our study was to assess whether data from self-administered surveys could be collected electronically from patients in urban, primary-care, safety-net clinics and subsequently linked and compared with the same patients' electronic health records (EHRs). METHODS: Data from self-administered surveys were collected electronically from a convenience sample of 527 patients at 2 Chicago health centers from September through November, 2014...
January 18, 2018: Preventing Chronic Disease
https://www.readbyqxmd.com/read/29345591/should-antithrombotic-treatment-strategies-in-east-asians-differ-from-caucasians-focused-on-acs-or-pci-treated-patients
#4
Jae Seok Bae, Jong-Hwa Ahn, Udaya Tantry, Paul A Gurbel, Young-Hoon Jeong
With over 1.5 billion people, East Asians are the most populous race in the world. Health status in this population is an important global issue. In the contemporary trials of antithrombotic treatment, East Asian patients have a lower risk for atherothrombotic diseases (especially, coronary artery disease [CAD]) and a higher risk for bleeding (especially, gastrointestinal bleeding and hemorrhagic stroke). Despite these observations, antithrombotic treatment strategies in East Asian patients are mainly based on the American or European guidelines that are derived from randomized, controlled trials including mostly Caucasians...
January 16, 2018: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/29344571/underwater-endoscopic-mucosal-resection-a-new-endoscopic-method-for-resection-of-rectal-neuroendocrine-tumor-grade-1-carcinoid-%C3%A2-%C3%A2-10%C3%A2-mm-in-diameter
#5
Takeshi Yamashina, Takehiko Tumura, Takanori Maruo, Takayuki Matsumae, Hiroyuki Yoshida, Gensho Tanke, Mio Taki, Manabu Fukuhara, Yoshito Kimura, Azusa Sakamoto, Shinichiro Henmi, Yugo Sawai, Sumio Saito, Norihiro Nishijima, Akihiro Nasu, Hideyuki Komekado, Masanori Asada, Ryuichi Kita, Toru Kimura, Yukio Osaki
Background and study aims  Rectal neuroendocrine tumors grade 1 (NET G1; carcinoid) ≤ 10 mm in diameter often extend into the submucosa, making their complete histological resection difficult using endoscopic techniques. Endoscopic submucosal resection with a ligation device (ESMR-L) and endoscopic submucosal dissection (ESD) are commonly used to overcome these difficulties. We also previously reported that underwater endoscopic mucosal resection (UEMR) could facilitate resection of rectal NET G1...
January 2018: Endoscopy International Open
https://www.readbyqxmd.com/read/29338539/primary-care-provider-experience-with-breast-density-legislation-in-massachusetts
#6
Christine M Gunn, Nancy R Kressin, Kristina Cooper, Cinthya Marturano, Karen M Freund, Tracy A Battaglia
BACKGROUND: Dense breasts on mammography independently increases breast cancer risk and decreases mammography sensitivity. Thirty-two states have adopted notification laws to raise awareness among women with dense breasts about supplemental screening. Little is known about these policies' impact on clinical practice among primary care providers (PCPs). MATERIALS AND METHODS: This study explores PCP attitudes, knowledge, and the impact of the Massachusetts dense breast notification legislation on clinical practice after its enactment in 2015...
January 17, 2018: Journal of Women's Health
https://www.readbyqxmd.com/read/29338335/diabetic-retinopathy-and-the-cascade-into-vision-loss
#7
Carolyn Smith-Morris, George H Bresnick, Jorge Cuadros, Kathryn E Bouskill, Elin Rønby Pedersen
Vision loss from diabetic retinopathy should be unnecessary for patients with access to diabetic retinopathy screening, yet it still occurs at high rates and in varied contexts. Precisely because vision loss is only one of many late-stage complications of diabetes, interfering with the management of diabetes and making self-care more difficult, Vision Threatening Diabetic Retinopathy (VTDR) is considered a "high stakes" diagnosis. Our mixed-methods research addressed the contexts of care and treatment seeking in a sample of people with VTDR using safety-net clinic services and eye specialist referrals...
January 17, 2018: Medical Anthropology
https://www.readbyqxmd.com/read/29329520/effects-of-primary-care-clinician-beliefs-and-perceived-organizational-facilitators-on-the-delivery-of-preventive-care-to-individuals-with-mental-illnesses
#8
Bobbi Jo H Yarborough, Scott P Stumbo, Nancy A Perrin, Ginger C Hanson, John Muench, Carla A Green
BACKGROUND: Although many studies have documented patient-, clinician-, and organizational barriers/facilitators of primary care among people with mental illnesses, few have examined whether these factors predict actual rates of preventive service use. We assessed whether clinician behaviors, beliefs, characteristics, and clinician-reported organizational characteristics, predicted delivery of preventive services in this population. METHODS: Primary care clinicians (n = 247) at Kaiser Permanente Northwest (KPNW) or community health centers and safety-net clinics (CHCs), in six states, completed clinician surveys in 2014...
January 12, 2018: BMC Family Practice
https://www.readbyqxmd.com/read/29326964/transportation-and-other-nonfinancial-barriers-among-uninsured-primary-care-patients
#9
Akiko Kamimura, Samin Panahi, Zobayer Ahmmad, Mu Pye, Jeanie Ashby
Introduction: Nonfinancial barriers are frequent causes of unmet need in health-care services. The significance of transportation barriers can weigh more than the issues of access to care. The purpose of this cross-sectional study was to examine transportation and other nonfinancial barriers among low-income uninsured patients of a safety net health-care facility (free clinic). Methods: The survey data were collected from patients aged 18 years and older who spoke English or Spanish at a free clinic, which served uninsured individuals in poverty in the United States...
January 2018: Health Services Research and Managerial Epidemiology
https://www.readbyqxmd.com/read/29320892/the-effect-of-the-global-financial-crisis-on-preventable-hospitalizations-among-the-homeless-in-new-york-state
#10
Brandi White, Charles Ellis, Walter Jones, William Moran, Kit Simpson
Objective Periods of economic instability may increase preventable hospitalizations because of increased barriers to accessing primary care. For underserved populations such as the homeless, these barriers may be more pronounced due to limited resources in the health care safety net. This study examined the impact of the global financial crisis of 2007-2008 on access to care for the homeless in New York State. Methods Hospitalizations for ambulatory care sensitive conditions (ACSCs) were used as a proxy measure for primary care access...
January 1, 2018: Journal of Health Services Research & Policy
https://www.readbyqxmd.com/read/29319643/burnout-perceived-stress-and-job-satisfaction-among-trauma-nurses-at-a-level-i-safety-net-trauma-center
#11
Swapna Munnangi, Lynore Dupiton, Anthony Boutin, L D George Angus
Nurses are at the forefront of our health care delivery system and have been reported to exhibit a high level of burnout. Burnout and stress in trauma nurses at a safety-net hospital can negatively impact patient care. Safety-net hospitals are confronted with unique social, financial, as well as resource problems that can potentially make the work environment frustrating. The purpose of this study was to explore the levels of burnout, stress, and job satisfaction in nurses providing care to trauma patients at a Level I safety-net trauma center...
January 2018: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/29319249/stroke-prevention-in-atrial-fibrillation-which-is-the-best-balanced-in-efficacy-and-safety-as-a-thromboprophylactic
#12
Viraj Suvarna
Stroke prevention in atrial fibrillation (AF) has reached an exciting phase with a plethora of newer, potentially more efficacious and safer agents being introduced for physicians to select from. Dabigatran belongs to a class of anticoagulants called direct thrombin inhibitors, while rivaroxaban, apixaban, and edoxaban are direct Factor Xa inhibitors. Purely from a therapeutic endpoint perspective-based on the action of anticoagulants in reducing cardioembolic stroke-in clinical trials, one should look at whether a new anticoagulant in patients with AF prevents ischemic stroke...
October 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/29316742/design-and-engineering-of-antimicrobial-peptide-based-on-lpcin-yk3-an-antimicrobial-peptide-derivative-frombovine-milk
#13
Ji-Sun Kim, Ji-Ho Jeong, Yongae Kim
We have previously derived a novel antimicrobial peptide, LPcin-YK3(YK3), based on lactophoricin and have successfully studied and reported on the relationship between structure and function.In this study, antimicrobial peptides with improved antimicrobial activity, less cytotoxicity and shorter length were devised and characterized based on YK3, and named YK5, YK8, YK11.The peptide design was based on a variety of knowledge, and a total of nine analog peptides consist of one to three amino acid substitutions and C-terminal deletions...
January 11, 2018: Journal of Microbiology and Biotechnology
https://www.readbyqxmd.com/read/29315323/developing-a-theoretical-model-and-questionnaire-survey-instrument-to-measure-the-success-of-electronic-health-records-in-residential-aged-care
#14
Ping Yu, Siyu Qian
Electronic health records (EHR) are introduced into healthcare organizations worldwide to improve patient safety, healthcare quality and efficiency. A rigorous evaluation of this technology is important to reduce potential negative effects on patient and staff, to provide decision makers with accurate information for system improvement and to ensure return on investment. Therefore, this study develops a theoretical model and questionnaire survey instrument to assess the success of organizational EHR in routine use from the viewpoint of nursing staff in residential aged care homes...
2018: PloS One
https://www.readbyqxmd.com/read/29309781/technical-feasibility-diagnostic-yield-and-safety-of-micro-forceps-biopsies-during-eus-evaluation-of-pancreatic-cystic-lesions-with-video
#15
Chetan Mittal, Joshua C Obuch, Hazem Hammad, Steven A Edmundowicz, Sachin Wani, Raj J Shah, Brian C Brauer, Augustin R Attwell, Jeffrey B Kaplan, Mihir S Wagh
BACKGROUND AND AIMS: Through-the-needle micro forceps are a recent addition to the EUS armamentarium for evaluation of pancreatic cystic lesions (PCLs). The main aim of this study was to assess the technical feasibility, diagnostic yield and safety of EUS-guided micro forceps biopsy for PCLs. METHODS: Our electronic endoscopy database was queried to identify patients who underwent EUS-FNA of PCLs and micro forceps biopsies, during the same procedure. The wall of the cyst was biopsied with the micro forceps through the 19-gauge needle and cyst fluid was collected for cytology, and CEA levels...
January 5, 2018: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/29309216/the-war-on-poverty-s-health-legacy-what-it-was-and-why-it-matters
#16
Merlin Chowkwanyun
The movement to promote a culture of health bears many similarities to another large-scale and ambitious effort from more than fifty years ago: President Lyndon Johnson's War on Poverty. Long a target of critics of all ideological persuasions, the War on Poverty, through its heritage, offers an instructive precedent for champions of the culture of health movement. This essay examines two regional-level War on Poverty health endeavors, one each in New York City and Los Angeles. They show the influence the War on Poverty had on the ground in widening the health care safety net, implementing holistic models of care, and facilitating community involvement in the leadership of larger health care institutions...
January 2018: Health Affairs
https://www.readbyqxmd.com/read/29309214/dually-enrolled-beneficiaries-have-higher-episode-costs-on-the-medicare-spending-per-beneficiary-measure
#17
Lok Wong Samson, Lena M Chen, Arnold M Epstein, Karen E Joynt Maddox
Cost measures are a growing part of Medicare's value-based payment programs. Medicare Spending per Beneficiary (MSPB) is the cost measure included in Medicare's Hospital Value-Based Purchasing (VBP) Program. Beneficiaries who are dually enrolled in Medicare and Medicaid are known to have higher spending on care, but it is unknown whether spending on the MSPB measure varies based on dual enrollment and whether this has implications for the performance of safety-net hospitals. We found that after adjustment for comorbidities, dually enrolled beneficiaries had 4...
January 2018: Health Affairs
https://www.readbyqxmd.com/read/29305630/chronic-myeloid-leukemia-patients-in-tunisia-epidemiology-and-outcome-in-the-imatinib-era-a-multicentric-experience
#18
Raihane Ben Lakhal, Hela Ghedira, Hatem Bellaaj, Yosra Ben Youssef, Samia Menif, Zeineb Manai, Manel Bedoui, Amel Lakhal, Fehmi M'Sadek, Moez Elloumi, Abderrahmane Khélif, Neila Ben Romdhane, Mohamed Adnène Laatiri, Tarek Ben Othmen, Balkis Meddeb
Data are limited in developing countries regarding the clinicopathologic features and response to therapy of chronic myeloid leukemia (CML) in the era of imatinib (IM). The objective of this study is to report on the clinicoepidemiologic features of CML in Tunisia, to evaluate the long-term outcome of patients in chronic (CP) or accelerated phase (AP) treated with IM 400 mg daily as frontline therapy, and to determine imatinib's efficacy and safety. From October 2002 to December 2014, 410 CML patients were treated with IM in six Tunisian departments of hematology...
January 6, 2018: Annals of Hematology
https://www.readbyqxmd.com/read/29302881/could-pay-for-performance-worsen-health-disparities
#19
Mubeen Shakir, Katrina Armstrong, Jason H Wasfy
Pay-for-performance (P4P) has become a prominent component of health care funding in the Affordable Care Act (ACA) era. Although the ACA's future remains unclear, these programs receive bipartisan support and will likely continue to be a part of payment policies. At the same time, racial and class disparities remain among the most pressing of the many challenges facing the US health system. We review evidence of the effects of P4P on disparities at the population and individual levels. Providers caring for predominantly minority patients or those with lower socioeconomic status are known to have poorer quality metrics...
January 4, 2018: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/29301822/unstable-housing-and-diabetes-related-emergency-department-visits-and-hospitalization-a-nationally-representative-study-of-safety-net-clinic-patients
#20
Seth A Berkowitz, Sara Kalkhoran, Samuel T Edwards, Utibe R Essien, Travis P Baggett
OBJECTIVE: Homelessness is associated with worse diabetes outcomes, but the relationship between other forms of unstable housing and diabetes is not well studied. We assessed whether unstable housing was associated with increased risk for diabetes-related emergency department use or hospitalization. RESEARCH DESIGN AND METHODS: We used data from the 2014 Health Center Patient Survey, a cross-sectional, nationally representative survey of patients who receive care at federally funded safety-net health centers...
January 4, 2018: Diabetes Care
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