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https://www.readbyqxmd.com/read/28719229/experiences-using-pre-exposure-prophylaxis-for-safer-conception-among-hiv-serodiscordant-heterosexual-couples-in-the-united-states
#1
Angela R Bazzi, Ashley A Leech, Dea L Biancarelli, Meg Sullivan, Mari-Lynn Drainoni
Antiretroviral pre-exposure prophylaxis (PrEP) is a promising HIV prevention strategy for HIV serodiscordant couples (HIV-infected male, uninfected female) seeking safer conception. However, most research on PrEP for safer conception has focused on couples in sub-Saharan Africa; little is known about the perspectives or experiences of heterosexual couples in the United States. We conducted qualitative interviews with six couples (six women and five of their male partners) receiving PrEP for conception services at an urban safety net hospital in the US Northeast...
July 18, 2017: AIDS Patient Care and STDs
https://www.readbyqxmd.com/read/28716797/a-pragmatic-phase-iii-multisite-double-blind-placebo-controlled-parallel-arm-dose-increment-randomised-trial-of-regular-low-dose-extended-release-morphine-for-chronic-breathlessness-breathlessness-exertion-and-morphine-sulfate-beams-study-protocol
#2
David Currow, Gareth John Watts, Miriam Johnson, Christine F McDonald, John O Miners, Andrew A Somogyi, Linda Denehy, Nicola McCaffrey, Danny J Eckert, Philip McCloud, Sandra Louw, Lawrence Lam, Aine Greene, Belinda Fazekas, Katherine C Clark, Kwun Fong, Meera R Agar, Rohit Joshi, Sharon Kilbreath, Diana Ferreira, Magnus Ekström
INTRODUCTION: Chronic breathlessness is highly prevalent and distressing to patients and families. No medication is registered for its symptomatic reduction. The strongest evidence is for regular, low-dose, extended- release (ER) oral morphine. A recent large phase III study suggests the subgroup most likely to benefit have chronic obstructive pulmonary disease (COPD) and modified Medical Research Council breathlessness scores of 3 or 4. This protocol is for an adequately powered, parallel-arm, placebo-controlled, multisite, factorial, block-randomised study evaluating regular ER morphine for chronic breathlessness in people with COPD...
July 17, 2017: BMJ Open
https://www.readbyqxmd.com/read/28715535/improving-adherence-to-long-term-opioid-therapy-guidelines-to-reduce-opioid-misuse-in-primary-care-a-cluster-randomized-clinical-trial
#3
Jane M Liebschutz, Ziming Xuan, Christopher W Shanahan, Marc LaRochelle, Julia Keosaian, Donna Beers, George Guara, Kristen O'Connor, Daniel P Alford, Victoria Parker, Roger D Weiss, Jeffrey H Samet, Julie Crosson, Phoebe A Cushman, Karen E Lasser
Importance: Prescription opioid misuse is a national crisis. Few interventions have improved adherence to opioid-prescribing guidelines. Objective: To determine whether a multicomponent intervention, Transforming Opioid Prescribing in Primary Care (TOPCARE; http://mytopcare.org/), improves guideline adherence while decreasing opioid misuse risk. Design, Setting, and Participants: Cluster-randomized clinical trial among 53 primary care clinicians (PCCs) and their 985 patients receiving long-term opioid therapy for pain...
July 17, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28711121/history-principles-and-policies-of-observation-medicine
#4
REVIEW
Michael A Ross, Michael Granovsky
The history of observation medicine has paralleled the rise of emergency medicine over the past 50 years to meet the needs of patients, emergency departments, hospitals, and the US health care system. Just as emergency departments are the safety net of the health system, observation units are the safety net of emergency departments. The growth of observation medicine has been driven by innovations in health care, an ongoing shift of patients from inpatient to outpatient settings, and changes in health policy...
August 2017: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/28710698/health-social-and-economic-outcomes-experienced-by-families-as-a-result-of-receiving-assistance-from-a-community-based-diaper-bank
#5
Kelley E C Massengale, Jennifer Toller Erausquin, Michelle Old
Objectives This paper aims to describe low-income recipients of a community-based diaper bank and the multiple daily challenges they face. Our paper seeks to document the health, social, and financial outcomes recipients experienced after receiving assistance. Methods We surveyed families (n = 150) about their experiences receiving diapers from a diaper bank in the southeastern United States. Additionally, we conducted short, focused interviews with families (n = 15) about outcomes after receiving diapers...
July 14, 2017: Maternal and Child Health Journal
https://www.readbyqxmd.com/read/28710596/patterns-of-and-reasons-for-electronic-cigarette-use-in-primary-care-patients
#6
Sara Kalkhoran, Nicholas Alvarado, Maya Vijayaraghavan, Paula J Lum, Patrick Yuan, Jason M Satterfield
BACKGROUND: Electronic cigarette (e-cigarette) use is rising in both the general and clinical populations. Little is known about e-cigarette use in primary care, where physicians report discussing e-cigarette use with patients. OBJECTIVE: Identify how and why smokers in primary care use e-cigarettes. DESIGN: Cross-sectional secondary data analysis from a randomized controlled trial of a tablet intervention to deliver the 5As for smoking cessation in primary care...
July 14, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28710221/trends-in-readmission-rates-for-safety-net-hospitals-and-non-safety-net-hospitals-in-the-era-of-the-us-hospital-readmission-reduction-program-a-retrospective-time-series-analysis-using-medicare-administrative-claims-data-from-2008-to-2015
#7
Amy M Salerno, Leora I Horwitz, Ji Young Kwon, Jeph Herrin, Jacqueline N Grady, Zhenqiu Lin, Joseph S Ross, Susannah M Bernheim
OBJECTIVE: To compare trends in readmission rates among safety net and non-safety net hospitals under the US Hospital Readmission Reduction Program (HRRP). DESIGN: A retrospective time series analysis using Medicare administrative claims data from January 2008 to June 2015. SETTING: We examined 3254 US hospitals eligible for penalties under the HRRP, categorised as safety net or non-safety net hospitals based on the hospital's proportion of patients with low socioeconomic status...
July 13, 2017: BMJ Open
https://www.readbyqxmd.com/read/28705916/biodistribution-and-dosimetry-of-18-f-meta-fluorobenzyl-guanidine-mfbg-a-first-in-human-pet-ct-imaging-study-of-patients-with-neuroendocrine-malignancies
#8
Neeta Pandit-Taskar, Pat B Zanzonico, Kevin D Staton, Jorge A Carrasquillo, Diane Reidy-Lagunes, Serge K Lyashchenko, Eva Burnazi, Hanwen Zhang, Jason S Lewis, Ronald Blasberg, Steven M Larson, Wolfgang Andreas Weber, Shakeel Modak
Introduction: Iodine-123-meta-iodobenzylguanidine ((123)I-MIBG) imaging is currently a mainstay in the evaluation of many neuroendocrine tumors, especially neuroblastoma. (123)I-MIBG imaging has several limitations that can be overcome by the use of a PET agent. (18)F-MFBG is a positron emission tomography (PET) analog of MIBG that may allow for single-day, high-resolution quantitative imaging. We conducted a first-in-human study of (18)F-MFBG PET imaging to evaluate the safety, feasibility, pharmacokinetics, and dosimetry of (18)F-MFBG in neuroendocrine tumors (NETs)...
July 13, 2017: Journal of Nuclear Medicine: Official Publication, Society of Nuclear Medicine
https://www.readbyqxmd.com/read/28700781/efficacy-and-safety-of-spironolactone-in-acute-heart-failure-the-athena-hf-randomized-clinical-trial
#9
Javed Butler, Kevin J Anstrom, G Michael Felker, Michael M Givertz, Andreas P Kalogeropoulos, Marvin A Konstam, Douglas L Mann, Kenneth B Margulies, Steven E McNulty, Robert J Mentz, Margaret M Redfield, W H Wilson Tang, David J Whellan, Monica Shah, Patrice Desvigne-Nickens, Adrian F Hernandez, Eugene Braunwald
Importance: Persistent congestion is associated with worse outcomes in acute heart failure (AHF). Mineralocorticoid receptor antagonists administered at high doses may relieve congestion, overcome diuretic resistance, and mitigate the effects of adverse neurohormonal activation in AHF. Objective: To assess the effect of high-dose spironolactone and usual care on N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels compared with usual care alone. Design, Setting, and Participants: This double-blind and placebo (or low-dose)-controlled randomized clinical trial was conducted in 22 US acute care hospitals among patients with AHF who were previously receiving no or low-dose (12...
July 12, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28700194/california-public-hospitals-improved-quality-of-care-under-medicaid-waiver-program
#10
Nederah Pourat
California has 12 county-owned and operated hospital systems and 5 University of California hospitals designated as public hospitals. These organizations deliver the majority of inpatient care and a significant amount of outpatient care to Medicaid patients in the state. In 2010, California was the first state in the nation to implement a five-year Delivery System Reform Incentive Payment (DSRIP) program under the Section §1115 Medicaid "Bridge to Reform" waiver to improve the capacity of these hospitals to deliver high quality and more efficient care...
June 2017: Policy Brief
https://www.readbyqxmd.com/read/28699083/a-therapy-system-for-post-traumatic-stress-disorder-using-a-virtual-agent-and-virtual-storytelling-to-reconstruct-traumatic-memories
#11
Myrthe L Tielman, Mark A Neerincx, Rafael Bidarra, Ben Kybartas, Willem-Paul Brinkman
Although post-traumatic stress disorder (PTSD) is well treatable, many people do not get the desired treatment due to barriers to care (such as stigma and cost). This paper presents a system that bridges this gap by enabling patients to follow therapy at home. A therapist is only involved remotely, to monitor progress and serve as a safety net. With this system, patients can recollect their memories in a digital diary and recreate them in a 3D WorldBuilder. Throughout the therapy, a virtual agent is present to inform and guide patients through the sessions, employing an ontology-based question module for recollecting traumatic memories to further elicit a detailed memory recollection...
August 2017: Journal of Medical Systems
https://www.readbyqxmd.com/read/28698258/comparison-of-fatal-or-irreversible-events-with-extended-duration-betrixaban-versus-standard-dose-enoxaparin-in-acutely-ill-medical-patients-an-apex-trial-substudy
#12
C Michael Gibson, Serge Korjian, Gerald Chi, Yazan Daaboul, Purva Jain, Douglas Arbetter, Samuel Z Goldhaber, Russel Hull, Adrian F Hernandez, Renato D Lopes, Alex Gold, Alexander T Cohen, Robert A Harrington
BACKGROUND: Extended-duration betrixaban showed a significant reduction in venous thromboembolism in the APEX trial (Acute Medically Ill VTE Prevention With Extended Duration Betrixaban Study). Given the variable clinical impact of different efficacy and safety events, one approach to assess net clinical outcomes is to include only those events that are either fatal or cause irreversible harm. METHODS AND RESULTS: This was a post hoc analysis of the APEX trial-a multicenter, double-blind, randomized controlled trial comparing extended-duration betrixaban versus standard-of-care enoxaparin...
July 11, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28697253/effect-of-antidepressant-switching-vs-augmentation-on-remission-among-patients-with-major-depressive-disorder-unresponsive-to-antidepressant-treatment-the-vast-d-randomized-clinical-trial
#13
Somaia Mohamed, Gary R Johnson, Peijun Chen, Paul B Hicks, Lori L Davis, Jean Yoon, Theresa C Gleason, Julia E Vertrees, Kimberly Weingart, Ilanit Tal, Alexandra Scrymgeour, David D Lawrence, Beata Planeta, Michael E Thase, Grant D Huang, Sidney Zisook, Sanjai D Rao, Patricia D Pilkinton, James A Wilcox, Ali Iranmanesh, Mamta Sapra, George Jurjus, James P Michalets, Muhammed Aslam, Thomas Beresford, Keith D Anderson, Ronald Fernando, Sriram Ramaswamy, John Kasckow, Joseph Westermeyer, Gihyun Yoon, D Cyril D'Souza, Gunnar Larson, William G Anderson, Mary Klatt, Ayman Fareed, Shabnam I Thompson, Carlos J Carrera, Solomon S Williams, Timothy M Juergens, Lawrence J Albers, Clifford S Nasdahl, Gerardo Villarreal, Julia L Winston, Cristobal A Nogues, K Ryan Connolly, Andre Tapp, Kari A Jones, Gauri Khatkhate, Sheetal Marri, Trisha Suppes, Joseph LaMotte, Robin Hurley, Aimee R Mayeda, Alexander B Niculescu, Bernard A Fischer, David J Loreck, Nicholas Rosenlicht, Steven Lieske, Mitchell S Finkel, John T Little
Importance: Less than one-third of patients with major depressive disorder (MDD) achieve remission with their first antidepressant. Objective: To determine the relative effectiveness and safety of 3 common alternate treatments for MDD. Design, Setting, and Participants: From December 2012 to May 2015, 1522 patients at 35 US Veterans Health Administration medical centers who were diagnosed with nonpsychotic MDD, unresponsive to at least 1 antidepressant course meeting minimal standards for treatment dose and duration, participated in the study...
July 11, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28697098/implementation-of-a-risk-based-heparin-protocol-for-postpartum-venous-thromboembolism-prevention
#14
Elizabeth Robison, Kent Heyborne, Amanda A Allshouse, Carolyn Valdez, Torri D Metz
OBJECTIVE: To evaluate the effect of a postpartum risk-based low-molecular-weight heparin protocol for venous thromboembolism prevention. METHODS: We conducted a retrospective cohort study of postpartum women at a safety net hospital before (2013), during (2014), and after (2015) implementation of a risk-based enoxaparin thromboembolism prevention protocol. The calculated sample size was based on a primary outcome of enoxaparin administration rate. Secondary outcomes included incidence of postpartum thromboembolism, wound complications, and 30-day readmission rates...
July 7, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28693085/-molecular-characterization-genetic-diversity-of-extended-spectrum-%C3%AE-lactamases-harboring-conjugative-plasmids-identified-in-multi-drug-resistant-escherichia-coli-isolated-from-food-in-china
#15
L Bai, Z Pan, J Xu, F Q Li
Objective: The purpose of this study was to investigate the molecular characteristics of ESBL-encoding conjugative plasmid identified in muti-drug resistant Escherichia coli isolated from food. Methods: 465 Escherichia coli isolates were collected from national foodborne disease surveillance net from 2013 to 2014 (salad, n=159; meat, n=102; processed meat, n=95; cakes/rice, n=46; cooked dish, n=63). ESBLs strain was detected by Mueller-Hinton agar plate, and then its drug resistance was tested by agar dilution method...
July 6, 2017: Zhonghua Yu Fang Yi Xue za Zhi [Chinese Journal of Preventive Medicine]
https://www.readbyqxmd.com/read/28691896/assessing-the-risk-of-cytomegalovirus-dnaaemia-in-allogeneic-stem-cell-transplant-recipients-by-monitoring-oxidative-stress-markers-in-plasma
#16
Alberto Talaya, Carlos Solano, Estela Giménez, José Luis García Giménez, Víctor Vinuesa, Juan Alberola, Federico V Pallardó, David Navarro
The level of antioxidants, such as thiol-containing tripeptide glutathione (GSH), in cytomegalovirus (CMV)-infected cells is notably increased. We previously showed that GSH levels in plasma, as measured by untargeted 1H nuclear magnetic resonance, are higher in allogeneic stem cell transplant (allo-SCT) recipients who subsequently develop CMV viraemia. We hypothesized that the net level of oxidative-stress markers present in plasma may be reduced in patients who develop CMV DNAaemia compared to those who do not...
July 10, 2017: Journal of General Virology
https://www.readbyqxmd.com/read/28689056/patient-navigation-for-lung-cancer-screening-in-an-urban-safety-net-system-protocol-for-a-pragmatic-randomized-clinical-trial
#17
David E Gerber, Heidi A Hamann, Noel O Santini, Suhny Abbara, Hsienchang Chiu, Molly McGuire, Lisa Quirk, Hong Zhu, Simon J Craddock Lee
The National Lung Screening Trial demonstrated improved lung cancer mortality with annual low-dose computed tomography (CT) screening, leading to lung cancer screening endorsement by the United States Preventive Services Task Force and coverage by the Centers for Medicare and Medicaid. Adherence to annual CT screens in that trial was 95%, which may not be representative of real-world, particularly medically underserved populations. This pragmatic trial will determine the effect of patient-focused, telephone-based patient navigation on adherence to CT-based lung cancer screening in an urban safety-net population...
July 5, 2017: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/28687120/safety-effects-of-dynamic-speed-limits-on-motorways
#18
Ellen De Pauw, Stijn Daniels, Laurent Franckx, Inge Mayeres
Dynamic speed limits (DSL) are limits that change according to real-time traffic, road or weather conditions. In DSL-schemes road users are typically informed of speed limit changes by electronic signs that are housed within gantries situated above lanes. Dynamic speed limit systems are increasingly applied worldwide, usually on motorways. One of the objectives of dynamic speed limits is to improve traffic safety through reductions in speed variations within and across lanes and between upstream and downstream flows...
July 4, 2017: Accident; Analysis and Prevention
https://www.readbyqxmd.com/read/28684922/emerging-use-of-everolimus-in-the-treatment-of-neuroendocrine-tumors
#19
REVIEW
Pablo Gajate, Olga Martínez-Sáez, Teresa Alonso-Gordoa, Enrique Grande
Neuroendocrine tumors (NETs) consist of a diverse family of malignancies, which are derived from neuroendocrine cells, most commonly originating from the gastroenteropancreatic (GEP) tract or the bronchopulmonary system. In general, NETs are more indolent than epithelial tumors, with median survival rates of longer than 30 months. The upregulation of mTOR pathway has been shown to play a pivotal role in NET pathogenesis. Inhibition of mTOR protein with everolimus represents a progress in the treatment of advanced NETs...
2017: Cancer Management and Research
https://www.readbyqxmd.com/read/28684357/promotora-assisted-depression-and-self-care-management-among-predominantly-latinos-with-concurrent-chronic-illness-safety-net-care-system-clinical-trial-results
#20
Kathleen Ell, María P Aranda, Shinyi Wu, Hyunsung Oh, Pey-Jiuan Lee, Jeffrey Guterman
The study evaluated depression and self-care management among patients with diabetes and/or heart disease in a 12-month randomized trial conducted in Los Angeles County Department of Health Services (LAC-DHS) community clinics. We compared LAC-DHS clinic usual care (UC) versus A-Helping-Hand (AHH) intervention in which bilingual promotoras, hired and supervised by the research project, provided 6 weekly psychoeducational sessions followed by boosters. Of 1957 screened, 348 depressed patients (PHQ-9 score≥10) were enrolled, randomized to AHH (n=178) or UC (n=170) after baseline interview assessing mental health, treatment receipt, co-morbid illness, self-care management, and environmental stressors...
July 3, 2017: Contemporary Clinical Trials
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