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https://www.readbyqxmd.com/read/28222472/telemedizin-chancen-in-der-schmerztherapie
#1
Carla Nau
Pain is generally undertreated and there is a need to differentiate and improve access to appropriate pain care. The growing Field of telehealth offers a novel opportunity for pain care, exploiting mainly communicative and pharmacological therapeutic principles. Rationale for telemedicine for the management of chronic pain are the potential to overcome timely, economical, and structural barriers for the access to specialized pain care as well as the general open mindedness of physicians and patients towards this technology...
February 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/28222014/verification-of-examination-procedures-in-clinical-laboratory-for-imprecision-trueness-and-diagnostic-accuracy-according-to-iso-15189-2012-a-pragmatic-approach
#2
Giorgia Antonelli, Andrea Padoan, Ada Aita, Laura Sciacovelli, Mario Plebani
Background The International Standard ISO 15189 is recognized as a valuable guide in ensuring high quality clinical laboratory services and promoting the harmonization of accreditation programmes in laboratory medicine. Examination procedures must be verified in order to guarantee that their performance characteristics are congruent with the intended scope of the test. The aim of the present study was to propose a practice model for implementing procedures employed for the verification of validated examination procedures already used for at least 2 years in our laboratory, in agreement with the ISO 15189 requirement at the Section 5...
February 21, 2017: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/28221865/cost-effectiveness-of-immune-checkpoint-inhibition-in-braf-wild-type-advanced-melanoma
#3
Christine G Kohn, Simon B Zeichner, Qiushi Chen, Alberto J Montero, Daniel A Goldstein, Christopher R Flowers
Purpose Patients who are diagnosed with stage IV metastatic melanoma have an estimated 5-year relative survival rate of only 17%. Randomized controlled trials of recent US Food and Drug Administration-approved immune checkpoint inhibitors-pembrolizumab (PEM), nivolumab (NIVO), and ipilumumab (IPI)-demonstrate improved patient outcomes, but the optimal treatment sequence in patients with BRAF wild-type metastatic melanoma remains unclear. To inform policy makers about the value of these treatments, we developed a Markov model to compare the cost-effectiveness of different strategies for sequencing novel agents for the treatment of advanced melanoma...
February 21, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28221676/key-factors-that-influence-government-policies-and-decision-making-about-healthcare-priorities-lessons-for-the-field-of-eating-disorders
#4
Harvey Whiteford, Ruth Striegel Weissman
Worldwide, the demand for healthcare exceeds what individuals and governments are able to afford. Priority setting is therefore inevitable, and mental health services have often been given low priority in the decision-making process. Drawing on established economic criteria, and specifically the work of Philip Musgrove, key factors which influence government decision-making about health priorities are reviewed. These factors include the size of the health burden, the availability of cost-effective interventions to reduce the burden, whether private markets can provide the necessary treatment efficiently, whether there are "catastrophic costs" incurred in accessing treatment, whether negative externalities arise from not providing care, and if the "rule of rescue" applies...
February 21, 2017: International Journal of Eating Disorders
https://www.readbyqxmd.com/read/28221176/value-based-insurance-design
#5
Alok D Sharan, Gregory D Schroeder, Michael E West, Alexander R Vaccaro
The increasing awareness of the scarcity of health care resources is forcing the health care industry to improve quality while lowering the cost. One method by which employers and insurance companies are attempting to do this is with value-based insurance design. In these plans, patients pay a lower amount for certain services that are considered high value and a higher amount for services that are considered low value.
February 17, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28220139/genome-wide-single-nucleotide-polymorphism-discovery-and-the-construction-of-a-high-density-genetic-map-for-melon-cucumis-melo-l-using-genotyping-by-sequencing
#6
Che-Wei Chang, Yu-Hua Wang, Chih-Wei Tung
Although genotyping-by-sequencing (GBS) enables the efficient and low-cost generation of large numbers of markers, the utility of resultant genotypes are limited, because they are enormously error-prone and contain high proportions of missing data. In this study, we generated single nucleotide polymorphism (SNP) markers for 109 recombinant inbred lines of melon (Cucumis melo L.) using the GBS approach and ordered them according to their physical position on the draft double haploid line DHL92 genome. Next, by investigating associations between these SNPs, we discovered that some segments on the physical map conflict with linkage relationships...
2017: Frontiers in Plant Science
https://www.readbyqxmd.com/read/28219992/a-new-handheld-device-for-the-detection-of-falsified-medicines-demonstration-on-falsified-artemisinin-based-therapies-from-the-field
#7
Benjamin K Wilson, Harparkash Kaur, Elizabeth Louise Allan, Anthony Lozama, David Bell
Poor-quality medicines are a major problem for health-care systems in resource-poor settings as identifying falsified medicines requires a complex laboratory infrastructure such as a Medicines Quality Control Laboratory. We report here an evaluation of a low-cost, handheld near-infrared spectrometer (NIRS) device by analyzing a library of artemisinin-based combination therapy (ACT) medicines to determine its usefulness as a drug-screening tool. The "SCiO" research prototype device was used to collect NIR spectra of a library of ACT and artesunate monotherapy medicine samples previously collected in Bioko Island and Equatorial Guinea and Kintampo, Ghana...
February 20, 2017: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/28219957/evaluating-investment-in-quality-improvement-capacity-building-a-systematic-review
#8
Gustavo Mery, Mark J Dobrow, G Ross Baker, Jennifer Im, Adalsteinn Brown
PURPOSE: Leading health systems have invested in substantial quality improvement (QI) capacity building, but little is known about the aggregate effect of these investments at the health system level. We conducted a systematic review to identify key steps and elements that should be considered for system-level evaluations of investment in QI capacity building. METHODS: We searched for evaluations of QI capacity building and evaluations of QI training programmes...
February 20, 2017: BMJ Open
https://www.readbyqxmd.com/read/28219434/when-is-proton-pump-inhibitor-use-appropriate
#9
EDITORIAL
Rena Yadlapati, Peter J Kahrilas
Proton pump inhibitor (PPI) therapy is commonly used outside of Food and Drug Administration indication for a broad range of conditions such as extra-esophageal reflux and PPI-responsive esophageal eosinophilia. While this may be appropriate in some scenarios, it has also resulted in widespread inappropriate PPI use. At the same time, data suggesting adverse effects of long-term PPI therapy are multiplying, albeit mainly from low quality studies. The systematic review by Scarpignato et al. (BMC Med 14:179, 2016) addresses this dilemma with a comprehensive analysis of the risks and benefits of PPI use...
February 21, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28218972/views-of-oral-antibiotics-and-advice-seeking-about-acne-a-qualitative-study-of-online-discussion-forums
#10
M Santer, D Chandler, M Lown, N A Francis, I Muller
BACKGROUND: Acne vulgaris is common and can significantly impair quality of life, yet little is known about patients' understanding of acne and its treatments. Oral antibiotics are widely used for acne, despite concerns about antibiotic resistance. People are increasingly turning to online discussion forums for advice and information on these sites may influence health beliefs and treatment adherence. OBJECTIVE: To explore understandings about the use of oral antibiotics for acne and advice shared amongst messages posted on online forums...
February 20, 2017: British Journal of Dermatology
https://www.readbyqxmd.com/read/28218940/financial-and-time-burdens-for-medical-students-interviewing-for-residency
#11
Paul Callaway, Trisha Melhado, Anne Walling, Jordan Groskurth
BACKGROUND AND OBJECTIVES: Interviewing for residency positions is increasingly stressful for students and challenging for programs. Little information is available about the costs and time invested by students in interviewing or about the key factors in decisions to accept interview offers. Our objective was to assess the time and financial costs of residency interviewing for an entire class at a regional campus and explore factors influencing student decisions to accept interviews. METHODS: We used a 14-item survey administered electronically immediately following National Resident Matching Program results...
February 2017: Family Medicine
https://www.readbyqxmd.com/read/28218868/-diagnosis-and-treatment-of-chronic-hepatitis-b-and-d-national-consensus-guideline-in-hungary-from-15-october-2016
#12
Gábor Horváth, Zsuzsanna Gerlei, Judit Gervain, Gabriella Lengyel, Mihály Makara, Alajos Pár, László Rókusz, Ferenc Szalay, István Tornai, Klára Werling, Béla Hunyady
Diagnosis and treatment of HBV/HDV infection means for the patient to be able to maintain working capacity, to increase quality of life, to prevent cancer, and to prolong life expectancy, while society benefits from eliminating the chances of further transmission of the viruses, and decreasing the overall costs of serious complications. The guideline delineates the treatment algorithms for 2017 set by a consensus meeting of physicians involved in the treatment of these diseases. The prevalence of HBV infection in the Hungarian general population is 0...
February 2017: Orvosi Hetilap
https://www.readbyqxmd.com/read/28218470/maximizing-the-functional-lifetime-of-protein-a-resins
#13
Jennifer Zhang, Sethu Siva, Ryan Caple, Rob Gronke, Sanchayita Ghose
Protein A chromatography is currently the industry gold-standard for monoclonal antibody and Fc-fusion protein purification. The high cost of Protein A however makes resin lifetime and resin reuse an important factor for process economics. Typical resin lifetime studies performed in the industry usually examine the effect of resin re-use on binding capacity, yield, and product quality without answering the fundamental question of what is causing the decrease in performance. A two part mechanistic study was conducted in an attempt to decouple the effect of the two possible factors (resin hydrolysis and/or degradation vs...
February 20, 2017: Biotechnology Progress
https://www.readbyqxmd.com/read/28218404/topical-medication-instillation-techniques-for-glaucoma
#14
REVIEW
Li Xu, Xuemei Wang, Meijing Wu
BACKGROUND: Glaucoma is a leading cause of irreversible blindness worldwide and the second most common cause of blindness after cataracts. The primary treatment for glaucoma aims to lower intraocular pressure (IOP) with the use of topical medicines. Topical medication instillation techniques, such as eyelid closure and nasolacrimal occlusion when instilling drops, have been proposed as potential methods to increase ocular absorption and decrease systemic absorption of the drops. OBJECTIVES: To investigate the effectiveness of topical medication instillation techniques compared with usual care or another method of instillation of topical medication in the management of glaucoma or ocular hypertension...
February 20, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28217938/impact-of-provider-competition-under-global-budgeting-on-the-use-of-cesarean-delivery
#15
Bradley Chen, Chin-Shyan Chen, Tsai-Ching Liu
OBJECTIVE: To examine the impact of provider competition under global budgeting on the use of cesarean delivery in Taiwan. DATA SOURCES/STUDY SETTING: (1) Quarterly inpatient claims data of all clinics and hospitals with birth-related expenses from 2000 to 2008; (2) file of health facilities' basic characteristics; and (3) regional quarterly point values (price conversion index) for clinics and hospitals, respectively, from the fourth quarter in 1999 to the third quarter in 2008, from the Statistics of the National Health Insurance Administration...
February 19, 2017: Health Services Research
https://www.readbyqxmd.com/read/28217432/cost-effectiveness-of-grass-pollen-scit-compared-with-slit-and-symptomatic-treatment
#16
Thomas Reinhold, Bernd Brüggenjürgen
BACKGROUND: Whereas specific immunotherapy (SIT) has already been shown to be cost-effective in the treatment of allergic rhinitis compared with symptomatic treatment, only a small number of investigations have compared sublingual (SLIT) and subcutaneous (SCIT) immunotherapeutic approaches. This analysis discusses the cost-effectiveness of SCIT compared with SLIT and a symptomatic treatment modality. At the same time, particular attention is paid to preparation-specific characteristics...
2017: Allergo Journal International
https://www.readbyqxmd.com/read/28217384/decreasing-hospital-length-of-stay-following-lumbar-fusion-utilizing-multidisciplinary-committee-meetings-involving-surgeons-and-other-caretakers
#17
Lisa B E Shields, Lisa Clark, Steven D Glassman, Christopher B Shields
BACKGROUND: Although hospital length of stay (LOS) following lumbar fusion has decreased for a variety of reasons, different institutions find their LOS over the benchmarks published by the national Agency for Healthcare Research and Quality (AHRQ). Over a 3-year period, this prospective study introduced utilization of multidisciplinary committee meetings between surgeons and other caretakers to decrease LOS following spinal fusion surgery without compromising the quality of care. METHODS: A multidisciplinary committee was established to assess factors and institute recommendations that influence hospital LOS following lumbar fusion compared to the national compared to the national AHRQ benchmark at baseline and at 1 and 2 years after adjusting our standard practice...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28217305/redesigning-care-delivery-with-patient-support-personnel-learning-from-accountable-care-organizations
#18
Ksenia O Gorbenko, Taressa Fraze, Valerie A Lewis
INTRODUCTION: Accountable care organizations (ACOs) are a value-based payment model in the United States rooted in holding groups of healthcare providers financially accountable for the quality and total cost of care of their attributed population. To succeed in reaching their quality and efficiency goals, ACOs implement a variety of care delivery changes, including workforce redesign. Patient support personnel (PSP)-non-physician staff such as care coordinators, community health workers, and others-are critical to restructuring care delivery...
September 2016: Int J Care Coord
https://www.readbyqxmd.com/read/28217049/effectiveness-of-sodium-thiopentone-propofol-and-etomidate-as-an-ideal-intravenous-anesthetic-agent-for-modified-electroconvulsive-therapy
#19
Altaf Hussain Mir, Nida Farooq Shah, Mehraj Ud Din, Shabir Ahmad Langoo, Fayaz Ahmad Reshi
INTRODUCTION: Electroconvulsive therapy (ECT) is a well-established psychiatric treatment in which seizures are electrically induced in patients for therapeutic effects. ECT can produce severe disturbances in the cardiovascular system and a marked increase in cerebral blood flow and intracranial pressure. These cardiovascular changes may be altered using various anesthetic drugs. AIM AND OBJECTIVES: This study was undertaken to compare the effects of intravenous (IV) sodium thiopentone, propofol, and etomidate, used as IV anesthetic agents in modified ECT as regards, induction time and quality of anesthesia, alteration of hemodynamics, seizure duration, and recovery time...
January 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28216856/feasibility-and-acceptability-of-implementing-the-integrated-care-plan-for-the-dying-in-the-indian-setting-survey-of-perspectives-of-indian-palliative-care-providers
#20
Naveen Salins, Jeremy Johnson, Stanley Macaden
INTRODUCTION: Capacity to provide end-of-life care in India is scored as 0.6/100, and very few people in India have access to palliative and end-of-life care. Lack of end-of-life care provision in India has led to a significant number of people receiving inappropriate medical treatment at the end of life, with no access to pain and symptom control and high treatment costs. The International Collaborative for the Best Care for the Dying Person is an initiative that offers the opportunity to apply international evidence on the key factors required to provide best care for the dying in the Indian context...
January 2017: Indian Journal of Palliative Care
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