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https://www.readbyqxmd.com/read/28647917/novel-endpoints-for-heart-failure-clinical-trials
#1
REVIEW
Carine E Hamo, Mihai Gheorghiade, Javed Butler
PURPOSE OF REVIEW: With the growing prevalence of heart failure, there is a particular need to develop new pharmacologic treatments that can improve outcomes. While there are several approved therapies for heart failure with reduced ejection fraction, there is currently no approved agent for those with preserved ejection fraction. The current review aimed to explore the utility of alternate endpoints to mortality and hospitalization. RECENT FINDINGS: There is increased interest in the use of alternative endpoints such as functional status and quality of life for heart failure drug development to focus on patients feeling better in addition to improving outcomes...
June 24, 2017: Current Heart Failure Reports
https://www.readbyqxmd.com/read/28647737/trends-in-the-management-of-acute-appendicitis-in-a-single-center-quality-register-cohort-of-5-614-patients
#2
Martin J A Dahlberg, Emil H A Pieniowski, Lennart Å S Boström
Acute appendicitis is one of the most common reasons for emergency surgery. At Stockholm South General Hospital, information on all patients - 15 years or older - undergoing surgery for acute appendicitis is included in a quality register. Data on surgical method, preoperative imaging, hospital stay, intraoperative findings, and 30-day complications were recorded for each patient. From January 2004 to December 2014, 5,614 consecutive patients were registered. The percentage of patients examined with preoperative imaging increased from 30% in 2004 to 93% in 2014...
June 24, 2017: Digestive Surgery
https://www.readbyqxmd.com/read/28647465/french-registry-on-acute-st-elevation-and-non-st-elevation-myocardial-infarction-2015-fast-mi-2015-design-and-baseline-data
#3
Loïc Belle, Guillaume Cayla, Yves Cottin, Pierre Coste, Khalife Khalife, Jean-Noël Labèque, Bruno Farah, Thibaut Perret, Patrick Goldstein, Pierre-Yves Gueugniaud, François Braun, Jacques Gauthier, Martine Gilard, Jean-Yves Le Heuzey, Nicolas Naccache, Elodie Drouet, Vincent Bataille, Jean Ferrières, Etienne Puymirat, François Schiele, Tabassome Simon, Nicolas Danchin
BACKGROUND: The FAST-MI programme, consisting of 1-month surveys of patients admitted to hospital for acute myocardial infarction (AMI) in France, has run since 2005. AIM: To gather data on the characteristics, management and outcomes of patients hospitalized for AMI at the end of 2015 in France and to provide comparisons with the previous surveys. METHODS: Consecutive adults with ST-segment elevation myocardial infarction (STEMI) or non-ST-segment-elevation myocardial infarction (NSTEMI) with symptom onset≤48hours were included over a 1-month period, with a possible extension of recruitment for 1 additional month...
June 21, 2017: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/28647442/the-impact-of-the-transition-from-volume-to-value-on-heart-failure-care-implications-of-novel-payment-models-and-quality-improvement-initiatives
#4
REVIEW
Dushyanth Srinivasan, Nihar R Desai
In response to wide variation in quality and outcomes as well as escalating health care costs, the U.S. health care system is transitioning away from a volume based payment system to a quality- and value-based system. Medicare, the largest insurer and payer of healthcare, has accelerated the movement towards value-based care with the development and implementation of myriad alternative payment models and pay for performance programs as part of the Affordable Care Act. Given that heart failure affects a significant number of Medicare patients and these patients account for a disproportionate amount of healthcare utilization and spending, heart failure has become a focal point for these initiatives...
June 21, 2017: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/28647340/a-simulator-for-training-in-endovascular-aneurysm-repair-the-use-of-three-dimensional-printers
#5
I O Torres, N De Luccia
OBJECTIVES: To develop an endovascular aneurysm repair (EVAR) simulation system using three dimensional (3D) printed aneurysms, and to evaluate the impact of patient specific training prior to EVAR on the surgical performance of vascular surgery residents in a university hospital in Brazil. METHODS: This was a prospective, controlled, single centre study. During 2015, the aneurysms of patients undergoing elective EVAR at São Paulo University Medical School were 3D printed and used in training sessions with vascular surgery residents...
June 21, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28647107/-justification-of-off-label-antibiotics-uses-in-hospitalized-children
#6
Christelle Berthod, Behrouz Kassaï, Remy Boussageon, Léopold Adelaide, Matthias Jacquet-Lagrèze, Audrey Lajoinie
Unlicensed and off-label (UL/OL) drugs are commonly used in pediatrics wards, especially the antibiotics. It remains unclear if this strategy is justified by randomized controlled trials of good quality? OBJECTIVE: The aim of this study was to compare the level of evidence of UL/OL antibiotics prescription in hospitalized children. The initial hypothesis was that the UL/OL antibiotics prescriptions had a lower level of evidence than licensed antibiotics. METHOD: This observational study assessed the antibiotics prescription in the children mother and women hospital of Lyon...
May 26, 2017: Thérapie
https://www.readbyqxmd.com/read/28647073/quality-and-cost-in-thoracic-surgery
#7
REVIEW
Rachel L Medbery, Seth D Force
The value of health care is defined as health outcomes (quality) achieved per dollars spent (cost). The current national health care landscape is focused on minimizing spending while optimizing patient outcomes. With the introduction of minimally invasive thoracic surgery, there has been concern about added cost relative to improved outcomes. Moreover, differences in postoperative hospital care further drive patient outcomes and health care costs. This article presents a comprehensive literature review on quality and cost in thoracic surgery and aims to investigate current challenges with regard to achieving the greatest value for our patients...
August 2017: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/28647072/failure-to-rescue-in-thoracic-surgery
#8
REVIEW
Farhood Farjah
Variability in outcomes not attributable to case mix or chance is an indicator of low-quality care. Failure-to-rescue is an outcome measure defined as death during a hospitalization among patients who experience a complication. Researchers have used this measure to better understand the determinants of an untimely death-preventing complications, rescue, or both. Studies repeatedly find that complication rates vary little, if at all, across hospitals ranked by risk-adjusted mortality rates, suggesting that hospitals are equally capable (or incapable) of preventing complications...
August 2017: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/28647071/volume-outcome-relationships-in-thoracic-surgery
#9
REVIEW
Benjamin D Kozower, George J Stukenborg
Most thoracic surgery studies indicate that hospital and surgeon procedure volume are inversely associated with mortality. However, controversy exists regarding the strength and validity of this volume-outcome association. Because thresholds of procedure volume are used to recommend the regionalization of care, investigation of the volume-outcome relationship is imperative. This article examines the methodology used in the volume-outcome relationship literature and highlights important areas of concern. Careful examination of the literature demonstrates that lung and esophageal cancer resection volume is not strongly associated with mortality and should not be used as a proxy measure for quality...
August 2017: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/28647046/assessment-of-emergency-general-surgery-care-based-on-formally-developed-quality-indicators
#10
Angela Ingraham, Avery Nathens, Andrew Peitzman, Allison Bode, Gina Dorlac, Warren Dorlac, Preston Miller, Mahsa Sadeghi, Deena D Wasserman, Karl Bilimoria
BACKGROUND: Emergency general surgery outcomes vary widely across the United States. The utilization of quality indicators can reduce variation and assist providers in administering care aligned with established recommendations. Previous quality indicators have not focused on emergency general surgery patients. We identified indicators of high-quality emergency general surgery care and assessed patient- and hospital-level compliance with these indicators. METHODS: We utilized a modified Delphi technique (RAND Appropriateness Methodology) to develop quality indicators...
June 21, 2017: Surgery
https://www.readbyqxmd.com/read/28646925/stress-ulcer-prophylaxis-versus-placebo-or-no-prophylaxis-in-adult-hospitalised-acutely-ill-patients-protocol-for-a-systematic-review-with-meta-analysis-and-trial-sequential-analysis
#11
Søren Marker, Anders Perner, Jørn Wetterslev, Marija Barbateskovic, Janus Christian Jakobsen, Mette Krag, Anders Granholm, Carl Thomas Anthon, Morten Hylander Møller
BACKGROUND: Stress ulcer prophylaxis is considered standard of care in many critically ill patients in the intensive care unit (ICU). However, the quality of evidence supporting this has recently been questioned, and clinical equipoise exists. Whether there is overall benefit or harm of stress ulcer prophylaxis in adult hospitalised acutely ill patients is unknown. Accordingly, we aim to assess patient-important benefits and harms of stress ulcer prophylaxis versus placebo or no treatment in adult hospitalised acutely ill patients with high risk of gastrointestinal bleeding irrespective of hospital setting...
June 24, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/28646857/overview-of-post-discharge-predictors-for-psychiatric-re-hospitalisations-a-systematic-review-of-the-literature
#12
R Sfetcu, S Musat, P Haaramo, M Ciutan, G Scintee, C Vladescu, K Wahlbeck, H Katschnig
BACKGROUND: High levels of hospital readmission (rehospitalisation rates) is widely used as indicator of a poor quality of care. This is sometimes also referred to as recidivism or heavy utilization. Previous studies have examined a number of factors likely to influence readmission, although a systematic review of research on post-discharge factors and readmissions has not been conducted so far. The main objective of this review was to identify frequently reported post-discharge factors and their effects on readmission rates...
June 24, 2017: BMC Psychiatry
https://www.readbyqxmd.com/read/28646811/alternative-therapy-for-patients-with-obstructive-sleep-apnea-hypopnea-syndrome-a-1-year-single-blind-randomized-trial-of-tui-na
#13
Cheng-Nan Lu, Michael Friedman, Hsin-Ching Lin, Kuo-Wei Bi, Tun-Pin Hsueh, Hsueh-Wen Chang, Mao-Chang Su, Meng-Chih Lin
Context • Obstructive sleep apnea/hypopnea syndrome (OSAHS) is among the most prevalent of sleep-related breathing disorders. No long-term follow-up studies have documented the continued success of lifestyle changes in treatment; oral appliances have an approximate 50% success rate; compliance with continuous positive airway pressure is poor, ranging from 50% to 89%; and the success rate of upper-airway surgery is only 66.4%. Therefore, some OSAHS patients seek alternative treatments. Objectives • The study intended to examine the efficacy of traditional Chinese therapeutic massage (tui na) for patients with OSAHS...
July 2017: Alternative Therapies in Health and Medicine
https://www.readbyqxmd.com/read/28646807/manual-therapy-with-cryotherapy-versus-manual-therapy-with-kinesio-taping-for-males-with-lumbar-discopathy-a-pilot-randomized-trial
#14
Pawel Lizis, Wojciech Kobza
Context • Numerous modalities of therapeutic interventions exist for lumbar discopathy. Manual therapy is one option, although its effectiveness remains controversial. The addition of cryotherapy to manual therapy may enhance the health benefits in patients with lumbar discopathy.  Objective • The study intended to evaluate the efficacy of manual therapy combined with cryotherapy vs manual therapy combined with Kinesio taping for males with lumbar discopathy. Design • The research team designed a pilot randomized trial with concealed allocation, assessor blinding, and intention-to-treat analysis...
June 23, 2017: Alternative Therapies in Health and Medicine
https://www.readbyqxmd.com/read/28646691/what-housing-features-should-inform-the-development-of-housing-solutions-for-adults-with-neurological-disability-a-systematic-review-of-the-literature
#15
REVIEW
Courtney J Wright, Heidi Zeeman, Elizabeth Kendall, Jennifer A Whitty
Despite the recent emphasis in Australian political, academic, and legislative narratives to more actively promote real housing choice for people with high healthcare and support needs, there is a lack of understanding regarding the specific housing features that might constitute better housing solutions for this population. Inclusive housing provision in Australia rightly emphasises safety and accessibility issues but often fails to incorporate factors related to broader psychosocial elements of housing such as dwelling location, neighbourhood quality, and overall design...
June 21, 2017: Health & Place
https://www.readbyqxmd.com/read/28646610/measuring-the-societal-impact-of-psoriasis-in-the-united-kingdom-through-a-non-interventional-study-of-patients
#16
C E Griffiths, R Williams, A C Halliday, J A Leman
This cross-sectional study aimed to measure total societal costs of moderate-to-severe, chronic plaque psoriasis in adults, and was conducted at 10 National Health Service hospitals in the United Kingdom between June-November 2014. Data capture was via hand-held electronic devices. Investigators at participating sites identified participants. Eligible patients were ≥18 years of age and diagnosed with moderate-to-severe plaque psoriasis for at least 6 months (Psoriasis Area and Severity Index (PASI) ≥10, and Dermatology Life Quality Index (DLQI) >10)...
June 24, 2017: Journal of the European Academy of Dermatology and Venereology: JEADV
https://www.readbyqxmd.com/read/28646519/the-association-of-health-literacy-with-preventable-ed-visits-a-cross-sectional-study
#17
Meenakshi P Balakrishnan, Jill Boylston Herndon, Jingnan Zhang, Thomas Payton, Jonathan Shuster, Donna L Carden
BACKGROUND: Policy-makers argue that emergency department (ED) visits for conditions preventable with high-quality outpatient care contribute to waste in the healthcare system. However, access to ambulatory care is uneven, especially for vulnerable populations like minorities, the poor and those with limited health literacy. The impact of limited health literacy on ED visits that are preventable with timely, high-quality ambulatory care is unknown. OBJECTIVE: To determine the association of health literacy and preventable ED visits...
June 24, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28646343/clinical-outcome-following-anterior-cervical-discectomy-and-fusion-with-and-without-anterior-cervical-plating-for-the-treatment-of-cervical-disc-herniation-a-25-year-follow-up-study
#18
Benedikt W Burkhardt, Moritz Brielmaier, Karsten Schwerdtfeger, Joachim M Oertel
Extreme long-term clinical outcome studies following anterior cervical discectomy and fusion (ACDF) with an autologous iliac crest with and without Caspar plating (ACDF + CP) for the treatment of radiculopathy caused by cervical disc herniation (CDH) are extremely rare. Hospital records of patients who underwent ACDF or ACDF + CP for the treatment of CDH at least 17 years ago were reviewed. Information about diagnosis, surgery, pre- and postoperative clinical process, and repeated procedure was analyzed...
June 23, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28646114/staphylococcus-aureus-strain-newman-photoinactivation-and-cellular-response-to-sunlight-exposure
#19
Jill S McClary, Lauren M Sassoubre, Alexandria B Boehm
Sunlight influences microbial water quality of surface waters. Previous studies have investigated photoinactivation mechanisms and cellular photostress responses of fecal indicator bacteria (FIB), including Escherichia coli and enterococci, but further work is needed to characterize photostress responses of bacterial pathogens. Here we investigate the photoinactivation of Staphylococcus aureus (strain Newman), a pigmented, waterborne pathogen of emerging concern. We measured photodecay using standard culture-based assays and cellular membrane integrity; and investigated photostress response by measuring the relative number of mRNA transcripts of select oxidative stress, DNA repair, and metabolism genes...
June 23, 2017: Applied and Environmental Microbiology
https://www.readbyqxmd.com/read/28645945/how-can-we-ensure-that-the-coroner-s-autopsy-is-not-an-invasion-of-human-rights
#20
Stephen Leadbeatter, Ryk James
BACKGROUND: Despite public inquiries, and some changes to legislation following high-profile multiple homicides that were not detected by autopsy, coroners continue to rely largely on the autopsy. Regardless of the extent of quality failings and excess deaths at some hospitals, not detected through the coroner system, the autopsy is scarcely used by hospitals to monitor standards and educate. OBJECTIVE: To explore when a compulsory medicolegal autopsy should, and should not, be used...
June 23, 2017: Journal of Clinical Pathology
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