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https://www.readbyqxmd.com/read/29165737/management-of-hemostasis-for-pediatric-patients-on-ventricular-assist-devices
#1
Iki Adachi, Vadim Kostousov, Lisa Hensch, Martin A Chacon-Portillo, Jun Teruya
Ventricular-assist devices (VADs) have seen increased utilization in the pediatric population. Formerly, this therapeutic modality was limited to only the pulsatile VAD, EXCOR (Berlin Heart GmbH). However, the continuous flow VAD devices, HeartMate II (Abbott Inc.) and HeartWare (Medtronic Inc.), are now increasingly used in this population. Postoperatively, VAD patients are acutely anticoagulated using unfractionated heparin, often beginning 24 to 48 hours after VAD placement. Once the patient is stabilized and ready to transition to a lower acuity or outpatient setting, low-molecular-weight heparin or warfarin therapy may be instituted...
November 17, 2017: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/29164156/disseminated-mycobacterium-avium-intracellulare-complex-infection-presenting-with-disseminated-intravascular-coagulation-in-an-aids-patient
#2
Folusakin Ayoade, James Cotelingam, Andrew Stevenson Joel Chandranesan
Disseminated Mycobacterium avium-intracellulare complex (MAC) infection is one of the relatively common opportunistic infections seen in severely immunocompromised AIDS patients. A constellation of clinical, laboratory, and pathological features involving multiple organ systems are often present in disseminated MAC infection but disseminated intravascular coagulation (DIC) has not been previously described in association with this condition. To our knowledge, this is the first reported case of DIC complicating disseminated MAC infection in an AIDS patient...
October 2017: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/29160506/treatment-adherence-in-patients-living-with-hiv-aids-assisted-at-a-specialized-facility-in-brazil
#3
Simone Miyada, Artênio José Ísper Garbin, Renata Colturato Joaquim Gatto, Cléa Adas Saliba Garbin
INTRODUCTION: In the 1990s, Brazil adopted a public policy that allowed for universal, free access to antiretroviral therapy (ART). Since then, treatment adherence has become a new challenge for administrators of sexually transmitted disease/acquired immunodeficiency syndrome (STD/AIDS) policies. This study quantified adherence to ART and verified whether there is an association between sociodemographic variables and clinical/laboratory data in human immunodeficiency virus (HIV)-infected patients...
September 2017: Revista da Sociedade Brasileira de Medicina Tropical
https://www.readbyqxmd.com/read/29159788/the-fight-against-tuberculosis-in-the-mid-nineteenth-century-the-pivotal-contribution-of-edoardo-maragliano-1849-1940
#4
Mariano Martini, Ilaria Barberis, Nicola Luigi Bragazzi, Filippo Paluan
The second half of the nineteenth century saw the development of new medical "specialties", which, like the idea of constitutional disease, had a profound influence on medical practice. Against this lively "backdrop", Edoardo Maragliano played a central role in medicine's "renaissance" in Italy. Having graduated in medicine in 1870 at the University of Naples, he worked as an assistant in the University Medical Clinic. After beginning his academic career as professor of pathology at the Faculty of Medicine in Genoa in 1877, he became full professor of internal medicine in 1881...
November 21, 2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/29158887/medical-imaging-lesion-detection-based-on-unified-gravitational-fuzzy-clustering
#5
Jean Marie Vianney Kinani, Alberto Jorge Rosales Silva, Francisco Gallegos Funes, Dante Mújica Vargas, Eduardo Ramos Díaz, Alfonso Arellano
We develop a swift, robust, and practical tool for detecting brain lesions with minimal user intervention to assist clinicians and researchers in the diagnosis process, radiosurgery planning, and assessment of the patient's response to the therapy. We propose a unified gravitational fuzzy clustering-based segmentation algorithm, which integrates the Newtonian concept of gravity into fuzzy clustering. We first perform fuzzy rule-based image enhancement on our database which is comprised of T1/T2 weighted magnetic resonance (MR) and fluid-attenuated inversion recovery (FLAIR) images to facilitate a smoother segmentation...
2017: Journal of Healthcare Engineering
https://www.readbyqxmd.com/read/29154501/challenges-to-laser-assisted-drug-delivery-applying-theory-to-clinical-practice
#6
Omer Ibrahim, Emily Wenande, Sara Hogan, Kenneth A Arndt, Merete Haedersdal, Jeffrey S Dover
BACKGROUND: The percutaneous penetration of topically applied compounds can be enhanced using external chemical or physical sources and thus laser-assisted drug delivery is a burgeoning area of interest within the field of dermatology. OBJECTIVES: This article briefly discusses the mechanism of laser-assisted drug delivery and expands upon the challenges and safety issues that may arise in the clinical implementation of this modality. RESULTS: The existing literature demonstrates that investigators and clinicians in dermatology have successfully delivered anti-inflammatory, anti-neoplastic, and anti-oxidative medications transdermally for the treatment of a variety of conditions including scarring, photoageing, and cutaneous neoplasia...
November 20, 2017: Lasers in Surgery and Medicine
https://www.readbyqxmd.com/read/29154019/local-specialty-pharmacy-and-specialty-clinic-collaboration-assists-access-to-hepatitis-c-direct-acting-antivirals
#7
Julia Zhu, Ronald J Hazen, Cara Joyce, Ambrose Delpino, Heather S Kirkham, Carson Dietrich Strickland, Shauna Markes-Wilson, Tomeka Kim, Meen Kang, Raymond A Rubin, Lance L Stein
OBJECTIVES: To measure prescribed time to therapy (TtT) and sustained virologic response (SVR). Secondary objectives were to assess insurance appeals and copay assistance amount facilitated by a local specialty pharmacy (LSP). METHODS: This descriptive, retrospective study used a joint clinical and pharmacy database of patients who were prescribed direct-acting antivirals (DAAs) at a single-center liver specialty clinic and received LSP services from December 2013 to December 2015...
November 16, 2017: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/29154018/improving-patient-access-to-hepatitis-c-virus-treatment
#8
Milena M McLaughlin, Kevin T Marx, Colleen Terriff
OBJECTIVES: To discuss the current barriers to hepatitis C virus (HCV) treatment; to provide information and resources to assist health care providers with the prior authorization process; to provide resources for potential access to medications if a patient's third-party payer may not be an option; and to discuss the pharmacist's vital role as a patient advocate and considerations once medications are approved. SUMMARY: Access to HCV medications is often restricted by third-party payers...
November 16, 2017: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/29153636/early-intervention-for-lactate-dehydrogenase-elevation-improves-clinical-outcomes-in-patients-with-the-heartmate-ii-left-ventricular-assist-device-insights-from-the-prevent-study
#9
Thenappan Thenappan, John M Stulak, Richa Agarwal, Simon Maltais, Palak Shah, Peter Eckman, Sitaramesh Emani, Jason N Katz, Igor Gregoric, Mary E Keebler, Nir Uriel, Eric Adler, Joyce Chuang, David J Farrar, Kartik S Sundareswaran, Ranjit John
BACKGROUND: Hemolysis, assessed by elevated serum lactate dehydrogenase (LDH), is strongly associated with HeartMate II pump thrombosis (PT). However, it is unknown whether early intervention for elevated LDH circumvents the risk of serious PT requiring pump exchange. We sought to evaluate the relationship between elevated LDH and clinical outcomes, the effectiveness of early medical intervention, and risk factors for elevated LDH. METHODS: We studied 268 patients in the prospective, multicenter PREVENT study who had 2 or more LDH measurements at ≥30 days post-implant...
October 24, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/29153214/-psychological-support-for-patients-with-a-ventricular-assist-device
#10
Laurence Le Helias
In the case of end-stage heart failure, the medical-surgical team can suggest the use of an external circulatory assist device as a definitive therapy. Living with this assistance requires a certain amount of adaptation on the part of the patients and their family, but can significantly improve quality of life. Support groups give them the opportunity to talk about their new life and receive psychological support.
November 2017: Soins; la Revue de Référence Infirmière
https://www.readbyqxmd.com/read/29141856/impact-of-diabetes-mellitus-on-outcomes-in-patients-supported-with-left-ventricular-assist-devices-a-single-institutional-9-year-experience
#11
Rabea Asleh, Alexandros Briasoulis, Sarah D Schettle, Vakhtang Tchantchaleishvili, Naveen L Pereira, Brooks S Edwards, Alfredo L Clavell, Simon Maltais, David L Joyce, Lyle D Joyce, Richard C Daly, Sudhir S Kushwaha, John M Stulak
BACKGROUND: Diabetes mellitus (DM) is a risk factor for morbidity and mortality in patients with heart failure. The effect of DM on post-left ventricular assist device (LVAD) implantation outcomes is unclear. This study sought to investigate whether patients with DM had worse outcomes than patients without DM after LVAD implantation and whether LVAD support resulted in a better control of DM. METHODS AND RESULTS: We retrospectively reviewed 341 consecutive adults who underwent implantation of LVAD from 2007 to 2016...
November 2017: Circulation. Heart Failure
https://www.readbyqxmd.com/read/29138593/intrathecal-pain-management-a-team-based-approach
#12
REVIEW
Jeremy A Adler, Neona M Lotz
Objective: Physician assistants (PAs), nurse practitioners (NPs), and registered nurses (RNs) provide professional services on pain management teams. This review provides an overview of the practical management of chronic pain with intrathecal (IT) therapy using an interprofessional approach (eg, physicians and other health care professionals), with a focus on the contributions of PAs, NPs, and RNs. Methods: Narrative review based on literature searches of the Medline database and treatment guidelines on the use of IT therapy in the management of patients with chronic pain...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/29135752/experiences-and-shared-meaning-of-teamwork-and-interprofessional-collaboration-among-health-care-professionals-in-primary-health-care-settings-a-systematic-review
#13
Carine Sangaleti, Mariana Cabral Schveitzer, Marina Peduzzi, Elma Lourdes Campos Pavone Zoboli, Cassia Baldini Soares
BACKGROUND: During the last decade, teamwork has been addressed under the rationale of interprofessional practice or collaboration, highlighted by the attributes of this practice such as: interdependence of professional actions, focus on user needs, negotiation between professionals, shared decision making, mutual respect and trust among professionals, and acknowledgment of the role and work of the different professional groups. Teamwork and interprofessional collaboration have been pointed out as astrategy for effective organization of health care services as the complexity of healthcare requires integration of knowledge and practices from differente professional groups...
November 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/29135431/intervention-to-improve-medication-management-qualitative-outcomes-from-a-phase-i-randomized-controlled-trial
#14
Jaclyn K Schwartz, Kimberly A Grogan, Melissa J Mutch, Emily B Nowicki, Elizabeth A Seidel, Stefanie A Woelfel, Roger O Smith
OBJECTIVES: We sought to define an occupational therapy intervention to promote medication management and to evaluate the acceptability and effectiveness of the intervention. METHOD: Nineteen adults with chronic health conditions and poor medication adherence participated in a two-group, blinded, randomized study. They received either an occupational therapy or a standard care intervention. We used a qualitative method to measure participants' changes in medication management through an interview regarding participants' perceptions and behaviors...
November 2017: American Journal of Occupational Therapy: Official Publication of the American Occupational Therapy Association
https://www.readbyqxmd.com/read/29135075/the-role-of-body-mind-and-environment-in-preterm-birth-mind-the-gap
#15
REVIEW
Shelby Yamamoto, Shahirose Premji
Preterm birth continues to be a problem affecting low-, middle-, and high-income countries, with rates increasing in some areas despite ongoing efforts to reduce the incidence. This emphasizes the need for more effective interventions, particularly if we aim to achieve the broad health targets of the Sustainable Development Goals (SDGs) by 2030. The current focus on medically-oriented interventions such as reducing nonmedically-indicated induction of labor, cesarean birth, and multiple embryo transfers associated with assisted reproductive technologies, as well as the application of cervical cerclage and use of progesterone therapy, though important, are likely only partial solutions to the complex phenomenon of preterm birth...
November 14, 2017: Journal of Midwifery & Women's Health
https://www.readbyqxmd.com/read/29132918/the-first-in-human-experience-with-a-minimally-invasive-ambulatory-counterpulsation-heart-assist-system-for-advanced-congestive-heart-failure
#16
Valluvan Jeevanandam, Tae Song, David Onsager, Takeyoshi Ota, Colleen Juricek LaBuhn, Thomas Lammy, Gabriel Sayer, Gene Kim, Sonna Patel-Raman, Nir Uriel
BACKGROUND: The intravascular ventricular assist system (iVAS) is a new, minimally invasive, ambulatory counterpulsation heart assist system delivered via the subclavian artery and powered by a portable driver. It is designed for recovery, bridge to transplantation (BTT) or for prolonging medical therapy. We report the first-in-human (FIH) experience with iVAS. METHODS: This is a prospective, non-randomized single arm, U.S. Food and Drug Administration (FDA)-approved early feasibility trial in patients listed for cardiac transplantation...
November 10, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/29129193/experiences-of-three-states-implementing-the-medicaid-health-home-model-to-address-opioid-use-disorder-case-studies-in-maryland-rhode-island-and-vermont
#17
Lisa Clemans-Cope, Jane B Wishner, Eva H Allen, Nicole Lallemand, Marni Epstein, Brenda C Spillman
PURPOSE: The United States is facing an unprecedented opioid epidemic. The Affordable Care Act (ACA) included several provisions designed to increase care coordination in state Medicaid programs and improve outcomes for those with chronic conditions, including substance use disorders. Three states-Maryland, Rhode Island, and Vermont - adopted the ACA's optional Medicaid health home model for individuals with opioid use disorder. The model coordinates opioid use disorder treatment that features opioid agonist therapy provided at opioid treatment programs (OTPs) and Office-based Opioid Treatment (OBOT) with medical and behavioral health care and other services, including those addressing social determinants of health...
December 2017: Journal of Substance Abuse Treatment
https://www.readbyqxmd.com/read/29128439/robotic-splenectomy-for-isolated-splenic-recurrence-of-endometrial-adenocarcinoma
#18
Valerio Gallotta, Marco D'Indinosante, Camilla Nero, Maria Teresa Giudice, Carmine Conte, Claudio Lodoli, Gian Franco Zannoni, Anna Fagotti, Giovanni Scambia
OBJECTIVES: We present a rare case of an isolated intraparenchymal splenic metastasis of endometrial cancer managed with robotic-assisted surgery. METHODS: A 55-year-old patient with a history of endometrial cancer was found to have a splenic lesion during her follow-up exams. She underwent surgical staging (total hysterectomy, bilateral salpingo-oopherectomy, pelvic lymphadenectomy and peritoneal washing) in 2014 and the final pathologic findings showed an endometrioid endometrial adenocarcinoma, FIGO Stage IB G2...
November 8, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/29128237/medication-management-in-minnesota-schools-the-need-for-school-nurse-pharmacist-partnerships
#19
Meg M Little, Sara Eischens, Mary Jo Martin, Susan Nokleby, Laura C Palombi, Cynthia Van Kirk, Jayme van Risseghem, Ya-Feng Wen, Jennifer Koziol Wozniak, Erika Yoney, Randall Seifert
BACKGROUND: Pharmacist participation in school medication management (MM) is minimal. School nurses are responsible for increasingly complex medication administration and management in schools. OBJECTIVES: The purpose of this study was to 1) assess the MM needs of school nurses in Minnesota, and 2) determine if and how interprofessional partnerships between nurses and pharmacists might optimize MM for students. METHODS: Researchers from the University of Minnesota College of Pharmacy, School Nurse Organization of Minnesota, and Minnesota Department of Health conducted a 32-item online survey of school nurses...
November 8, 2017: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/29126911/why-mdma-therapy-for-alcohol-use-disorder-and-why-now
#20
REVIEW
Ben Sessa
Alcohol use disorder represents a serious clinical, social and personal burden on its sufferers and a significant financial strain on society. Current treatments, both psychological and pharmacological are poor, with high rates of relapse after medical detoxification and dedicated treatment programs. The earliest historical roots of psychedelic drug-assisted psychotherapy in the 1950s were associated with Lysergic acid diethylamide (LSD)-assisted psychotherapy to treat what was then called, alcoholism. But results were varied and psychedelic therapy with LSD and other 'classical' psychedelics fell out of favour in the wake of socio-political pressures and cultural changes...
November 7, 2017: Neuropharmacology
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