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https://www.readbyqxmd.com/read/28433815/patterns-and-predictors-of-persistent-opioid-use-following-hip-or-knee-arthroplasty
#1
Seoyoung C Kim, Niteesh Choudhry, Jessica M Franklin, Katsiaryna Bykov, Matthias Eikermann, Joyce Lii, Michael A Fischer, Brian T Bateman
OBJECTIVE: The relationship between arthroplasty and long-term opioid use in patients with knee or hip osteoarthritis is not well studied. We examined the prevalence, patterns and predictors of persistent opioid use after hip or knee arthroplasty. METHOD: Using claims data (2004-2013) from a U.S. commercial health plan, we identified adults who underwent hip or knee arthroplasty and filled ≥1 opioid prescription within 30 days after the surgery. We defined persistent opioid users as patients who filled ≥1 opioid prescription every month during the 1-year postoperative period based on group-based trajectory models...
April 19, 2017: Osteoarthritis and Cartilage
https://www.readbyqxmd.com/read/28427987/trajectory-planning-and-guided-punctures-with-isocentric-navigation-in-posterolateral-endoscopic-lumbar-discectomy-technical-note
#2
Guoxin Fan, Chuanfeng Wang, Xin Gu, Hailong Zhang, Shisheng He
BACKGROUND: Posterolateral endoscopic trasforaminal discectomy (PELD) requires an ideal percutaneous puncture to place the working channel for endoscopic discectomy. The conventional blinded punctures relies on the surgeons' experience and repeated fluoroscopy, which may increase radiation exposure. The study aimed to introduce isocentric navigation to plan trajectory and guide punctures in PELD. METHODS: Technical note and clinical outcomes of patients undergoing PELD with isocentric navigation were recorded in this report...
April 17, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28420598/1-5-t-augmented-reality-navigated-interventional-mri-paravertebral-sympathetic-plexus-injections
#3
David R Marker, Paweena U Thainual, Tamas Ungi, Aaron J Flammang, Gabor Fichtinger, Iulian I Iordachita, John A Carrino, Jan Fritz
PURPOSE: The high contrast resolution and absent ionizing radiation of interventional magnetic resonance imaging (MRI) can be advantageous for paravertebral sympathetic nerve plexus injections. We assessed the feasibility and technical performance of MRI-guided paravertebral sympathetic injections utilizing augmented reality navigation and 1.5 T MRI scanner. METHODS: A total of 23 bilateral injections of the thoracic (8/23, 35%), lumbar (8/23, 35%) and hypogastric (7/23, 30%) paravertebral sympathetic plexus were prospectively planned in twelve human cadavers using a 1...
April 18, 2017: Diagnostic and Interventional Radiology: Official Journal of the Turkish Society of Radiology
https://www.readbyqxmd.com/read/28420191/designing-effective-interactions-for-concordance-around-end-of-life-care-decisions-lessons-from-hospice-admission-nurses
#4
Carey Candrian, Channing Tate, Kirsten Broadfoot, Alexandra Tsantes, Daniel Matlock, Jean Kutner
Near the end of life, hospice care reduces symptom-related distress and hospitalizations while improving caregiving outcomes. However, it takes time for a person to gain a sufficient understanding of hospice and decide to enroll. This decision is influenced by knowledge of hospice and its services, emotion and fear, cultural and religious beliefs, and an individual's acceptance of diagnosis. Hospice admission interactions, a key influence in shaping decisions regarding hospice care, happen particularly late in the illness trajectory and are often complex, unpredictable, and highly variable...
April 18, 2017: Behavioral Sciences
https://www.readbyqxmd.com/read/28419357/stereoelectroencephalography-using-magnetic-resonance-angiography-for-avascular-trajectory-planning-technical-report
#5
Krasimir Minkin, Kaloyan Gabrovski, Marin Penkov, Yuri Todorov, Rositsa Tanova, Yoana Milenova, Kiril Romansky, Petia Dimova
BACKGROUND: Stereoelectroencephalography (SEEG) requires high-quality angiographic studies because avascular trajectory planning is a prerequisite for the safety of this procedure. Some epilepsy surgery groups have begun to use computed tomography angiography and magnetic resonance T1-weighted sequence with contrast enhancement for this purpose. OBJECTIVE: To present the first series of patients with avascular trajectory planning of SEEG based on magnetic resonance angiography (MRA)...
April 13, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28419160/an-empirically-grounded-agent-based-model-for-modeling-directs-conflict-detection-and-resolution-operations-in-air-traffic-management
#6
Christian Bongiorno, Salvatore Miccichè, Rosario N Mantegna
We present an agent based model of the Air Traffic Management socio-technical complex system aiming at modeling the interactions between aircraft and air traffic controllers at a tactical level. The core of the model is given by the conflict detection and resolution module and by the directs module. Directs are flight shortcuts that are given by air controllers to speed up the passage of an aircraft within a certain airspace and therefore to facilitate airline operations. Conflicts between flight trajectories can occur for two main reasons: either the planning of the flight trajectory was not sufficiently detailed to rule out all potential conflicts or unforeseen events during the flight require modifications of the flight plan that can conflict with other flight trajectories...
2017: PloS One
https://www.readbyqxmd.com/read/28416224/post-discharge-kidney-function-is-associated-with-subsequent-ten-year-renal-progression-risk-among-survivors-of-acute-kidney-injury
#7
Simon Sawhney, Angharad Marks, Nick Fluck, Adeera Levin, David McLernon, Gordon Prescott, Corri Black
The extent to which renal progression after acute kidney injury (AKI) arises from an initial step drop in kidney function (incomplete recovery), or from a long-term trajectory of subsequent decline, is unclear. This makes it challenging to plan or time post-discharge follow-up. This study of 14651 hospital survivors in 2003 (1966 with AKI, 12685 no AKI) separates incomplete recovery from subsequent renal decline by using the post-discharge estimated glomerular filtration rate (eGFR) rather than the pre-admission as a new reference point for determining subsequent renal outcomes...
April 14, 2017: Kidney International
https://www.readbyqxmd.com/read/28412641/the-gap-between-entitlement-and-access-to-healthcare-an-analysis-of-candidacy-in-the-help-seeking-trajectories-of-asylum-seekers-in-montreal
#8
Liana E Chase, Janet Cleveland, Jesse Beatson, Cécile Rousseau
In 2012 the Canadian government made significant cuts to its historically strong federal refugee health coverage plan. While this policy had negligible effects on the level of coverage provided to asylum seekers in Quebec, there is evidence that this group nonetheless experienced reduced healthcare access during the period of polarized national debate that ensued. This study engaged the "candidacy" model of healthcare access to illuminate factors contributing to the observed gap between entitlement and access...
March 21, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28410647/disease-trajectories-before-esrd-implications-for-clinical-management
#9
REVIEW
Keiichi Sumida, Csaba P Kovesdy
One of the biggest challenges nephrologists face is to predict complex clinical pathways of kidney disease progression that do not follow a steady linear decline. This unpredictability often becomes a barrier to timely shared decision making between patients and physicians and could lead to adverse patient outcomes. By using numerous analytic approaches to characterize the longitudinal changes in kidney function, emerging evidence has disclosed the heterogeneous trajectories of kidney disease progression, particularly in late-stage chronic kidney disease (CKD) nearing end-stage renal disease (ESRD), and showed their independent associations with various clinical outcomes...
March 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28408262/optimization-of-microelectrode-recording-in-dbs-surgery-using-intraoperative-ct
#10
Ryan B Kochanski, Sander Bus, Gian Pal, Leo Verhagen Metman, Sepehr Sani
BACKGROUND: Microelectrode recording (MER) is used to confirm targeting accuracy during deep brain stimulation (DBS) surgery. We describe a technique using intraoperative CT extrapolation (iCTE) to predetermine and adjust the trajectory of the guide tube in order to improve microelectrode targeting accuracy. We hypothesized that this technique would decrease the number of MER tracks and operative time, while increasing the recorded length of subthalamic nucleus (STN). METHODS: Thirty-nine patients with Parkinson's disease who underwent STN DBS before the iCTE method were compared to 33 patients undergoing STN DBS using iCTE...
April 10, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28407108/realizing-the-promise-of-the-partnership-for-maternal-newborn-and-child-health
#11
Hareya Fassil, John Borrazzo, Richard Greene, Troy Jacobs, Maureen Norton, Mary Ellen Stanton, Nana Taona Kuo, K Rogers, Luwei Pearson, Ted Chaiban, Anshu Banerjee, Shyama Kuruvilla, Marta Seaone, Ann Starrs, Betsy McCallon, Stefan Germann, Anshu Mohan, Flavia Bustreo, Helga Fogstad, C K Mishra
Reflecting on Storeng and Béhague ("Lives in the balance": the politics of integration in the Partnership for Maternal, Newborn and Child Health. Health Policy and Planning Storeng and Béhague (2016).) historical ethnography of the Partnership for Maternal, Newborn and Child Health (PMNCH), this commentary provides a more current account of PMNCH's trajectory since its inception in 2005. It highlights PMNCH's distinct characteristics and how it is positioned to play an instrumental role in the current global health landscape...
April 12, 2017: Health Policy and Planning
https://www.readbyqxmd.com/read/28405725/the-posterolateral-approach-for-fluoroscopy-guided-tibiotalar-joint-injection
#12
Vanja Varenika, Jacob Harter, Edwin Chu, Lynne Steinbach
OBJECTIVE: To report a novel technique for tibiotalar joint injection that utilizes a posterolateral approach, including indications and technical considerations. METHODS: The posterolateral approach for tibiotalar injection is similar to that used in posterior subtalar joint injections. Using this technique, the tibiotalar joint space is accessed by directing the needle anterosuperiorly beneath the fibula until the posterior aspect of the talar dome has been reached...
April 12, 2017: Skeletal Radiology
https://www.readbyqxmd.com/read/28399022/palliative-and-end-of-life-care-in-nephrology-moving-from-observations-to-interventions
#13
Nwamaka D Eneanya, Michael K Paasche-Orlow, Angelo Volandes
PURPOSE OF REVIEW: In comparison with patients who have other serious illnesses, patients with advanced kidney disease have a higher rate of intensive care utilization at the end of life and receive palliative care less frequently. Consensus and clinical practice guidelines have therefore recommended the incorporation of palliative care earlier in the disease trajectory. This review summarizes recent literature on this aspect of care and will highlight future directions for patient-centered care within palliative nephrology...
April 8, 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/28397968/trajectory-optimization-in-radiotherapy-using-sectioning-torus
#14
Christopher Barry Locke, Karl Kenneth Bush
PURPOSE: A challenging problem in trajectory optimization for radiotherapy is properly handling the synchronization of the medical accelerators dynamic delivery. The initial coarse sampling of control points implemented in a Progressive Resolution Optimization type approach (VMAT) routinely results in MLC aperture forming contention issues as the sampling resolution increases. This work presents an approach to optimize continuous, beam-on radiation trajectories through exploration of the anatomical topology present in the patient and formation of a novel dual-metric graph optimization problem...
April 11, 2017: Medical Physics
https://www.readbyqxmd.com/read/28391021/implantation-of-responsive-neurostimulation-for-epilepsy-using-intraoperative-ct-technical-nuances-and-accuracy-assessment
#15
Mena G Kerolus, Ryan B Kochanski, Marvin Rossi, Michael Stein, Richard W Byrne, Sepehr Sani
INTRODUCTION: Implantation of responsive neurostimulation (RNS) system has been previously discussed in the literature but there is a paucity of data on target accuracy and the use of intraoperative imaging. We describe our experience with eight patients using intraoperative computed tomography (iCT) during implantation of the NeuroPace(®) RNS system. METHODS: A frame based system was used. CT images were obtained and merged with preoperative MRI and metabolic imaging studies to calculate target coordinates...
April 5, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28390401/a-process-evaluation-of-systematic-risk-and-needs-assessment-for-caregivers-in-specialised-palliative-care
#16
Kia Toft Thomsen, Mai-Britt Guldin, Mette Kjærgaard Nielsen, Chaitali Laura Ollars, Anders Bonde Jensen
BACKGROUND: Caregiving is strenuous and it may be associated with adverse psychological outcomes. During the palliative care trajectory, there are unique opportunities for providing support and preventing poor bereavement outcome. However, the tasks of palliative care staff in relation to caregivers are often unclear in the daily practice. Assessment is recommended to establish risk and needs and standards for caregiver support are available. Still, the feasibility of applying these standards among caregivers in everyday clinical practice has not been tested so far...
April 8, 2017: BMC Palliative Care
https://www.readbyqxmd.com/read/28389876/augmented-reality-in-intraventricular-neuroendoscopy
#17
T Finger, A Schaumann, M Schulz, Ulrich-W Thomale
BACKGROUND: Individual planning of the entry point and the use of navigation has become more relevant in intraventricular neuroendoscopy. Navigated neuroendoscopic solutions are continuously improving. OBJECTIVE: We describe experimentally measured accuracy and our first experience with augmented reality-enhanced navigated neuroendoscopy for intraventricular pathologies. PATIENTS AND METHODS: Augmented reality-enhanced navigated endoscopy was tested for accuracy in an experimental setting...
April 7, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28378847/developmental-origins-of-type-2-diabetes-a-perspective-from-china
#18
REVIEW
R C W Ma, K Y Tsoi, W H Tam, C K C Wong
There has been a marked increase in the prevalence of diabetes in Asia, including China, over the last few decades. While the increased prevalence of diabetes has often been attributed to the nutritional transition associated with recent economic development, emerging data suggest that early-life exposures also play a major role in shaping developmental trajectories, and contributes to alter an individual's susceptibility to diabetes and other non-communicable diseases (NCDs). Early-life exposures such as in utero exposure to undernutrition has been consistently linked with later risk of diabetes and obesity...
April 5, 2017: European Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/28371230/a-post-cardiac-surgery-intervention-to-manage-delirium-involving-families-a-randomized-pilot-study
#19
Tanya Mailhot, Sylvie Cossette, José Côté, Anne Bourbonnais, Marie-Claude Côté, Yoan Lamarche, André Denault
BACKGROUND: As many delirium manifestations (e.g., hallucinations or fears) are linked to patients' experiences and personality traits, it is suggested that interventions should be tailored to optimize its management. The inclusion of family members, as part of an intervention, has recently emerged as a solution to developing individualised patient care, but has never been assessed in post-cardiac surgery intensive care unit where almost half of patients will present with delirium. AIMS: To assess the feasibility, acceptability and preliminary efficacy of an nursing intervention involving family caregivers (FC) in delirium management following cardiac surgery...
March 31, 2017: Nursing in Critical Care
https://www.readbyqxmd.com/read/28363881/trajectories-of-depressive-symptoms-among-web-based-health-risk-assessment-participants
#20
Richard Bedrosian, Matt Hawrilenko, Heather Cole-Lewis
BACKGROUND: Health risk assessments (HRAs), which often screen for depressive symptoms, are administered to millions of employees and health plan members each year. HRA data provide an opportunity to examine longitudinal trends in depressive symptomatology, as researchers have done previously with other populations. OBJECTIVE: The primary research questions were: (1) Can we observe longitudinal trajectories in HRA populations like those observed in other study samples? (2) Do HRA variables, which primarily reflect modifiable health risks, help us to identify predictors associated with these trajectories? (3) Can we make meaningful recommendations for population health management, applicable to HRA participants, based on predictors we identify? METHODS: This study used growth mixture modeling (GMM) to examine longitudinal trends in depressive symptomatology among 22,963 participants in a Web-based HRA used by US employers and health plans...
March 31, 2017: Journal of Medical Internet Research
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