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https://www.readbyqxmd.com/read/29166348/the-economics-of-prepectoral-breast-reconstruction
#1
Scot Bradley Glasberg
The world of breast reconstruction over the last several years has seen a dramatic shift in focus to discussion and the application of placing tissue expanders and implants back into the prepectoral space. Although this technique failed during the early advent of breast reconstruction, newer technologies such as advances in fat grafting, improved acellular dermal matrices, better methods of assessing breast flap viability, and enhanced implants appear to have set the stage for the resurgence and positive early results seen with this technique...
December 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29166338/use-of-organs-from-hepatitis-c-virus-positive-donors-for-uninfected-recipients-a-potential-cost-effective-approach-to-save-lives
#2
Patrick B Trotter, Dominic M Summers, Ines Ushiro-Lumb, Matthew Robb, J Andrew Bradley, James Powell, Christopher J E Watson, James Neuberger
BACKGROUND: Organs from hepatitis C virus (HCV) seropositive (HCVpos) individuals are seldom used for transplantation because of the risk of disease transmission. Because transmitted HCV is now amenable to effective treatment we estimated the potential impact of using HCVpos deceased donor organs for transplantation. METHODS: The Potential Donor Audit (PDA) of patients (<80years) dying in UK critical care units and the UK Transplant Registry (UKTR) was searched to identify HCVpos potential and proceeding deceased donors...
November 22, 2017: Transplantation
https://www.readbyqxmd.com/read/29165984/on-chip-lipid-extraction-using-super-absorbent-polymers-for-mass-spectrometry
#3
Geul Bang, Young Hwan Kim, Junghyo Yoon, Yeong Jun Yu, Seok Chung, Jeong Ah Kim
Pre-treatment of samples is the one of most important steps in analytical methods for efficient and accurate results. Typically, an extraction method used for lipid analysis with mass spectrometry is accompanied by complex liquid-liquid extraction. We have devised a simple, rapid, and efficient lipid extraction method using super absorbent polymers (SAPs) and developed a high-throughput lipid extraction platform based on a microfluidic system. Since SAPs can rapidly absorb an aqueous solution from a raw sample and convert it into the gel, the lipid extraction process can be remarkably simplified...
November 22, 2017: Analytical Chemistry
https://www.readbyqxmd.com/read/29165789/medicaid-cost-savings-of-a-preventive-home-visit-program-for-disabled-older-adults
#4
Sarah L Szanton, Y Natalia Alfonso, Bruce Leff, Jack Guralnik, Jennifer L Wolff, Ian Stockwell, Laura N Gitlin, David Bishai
BACKGROUND/OBJECTIVES: Little is known about cost savings of programs that reduce disability in older adults. The objective was to determine whether the Community Aging in Place, Advancing Better Living for Elders (CAPABLE) program saves Medicaid more money than it costs to provide. DESIGN: Single-arm clinical trial (N = 204) with a comparison group of individuals (N = 2,013) dually eligible for Medicaid and Medicare matched on baseline geographic and demographic characteristics, chronic conditions, and healthcare use...
November 22, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29164374/fixed-dose-4-factor-prothrombin-complex-concentrate-for-the-emergent-reversal-of-warfarin-a-retrospective-analysis
#5
Greta Astrup, Preeyaporn Sarangarm, Allison Burnett
Published literature suggests that a fixed-dose 4-factor prothrombin complex concentrate (4FPCC) may be efficacious in managing warfarin-associated hemorrhage, however the ideal dose is still unclear. The purpose of this evaluation was to determine the efficacy of fixed-dose 4FPCC in reducing the International Normalized Ratio (INR) to ≤ 1.5 among warfarin patients with need for urgent or emergent anticoagulation reversal. Starting October 2016, our institution changed from standard 4FPCC FDA-labeled dosing based on the patient's presenting INR and weight, to a fixed-dose of 1500 units for all patients requiring urgent or emergent warfarin reversal...
November 21, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/29163458/molecular-biology-can-change-the-classic-laboratory-approach-for-intestinal-protozoan-infections
#6
Fabio Formenti, Matteo Valerio, Massimo Guerriero, Francesca Perandin, Barbara Pajola, Manuela Mistretta, Stefano Tais, Monica Degani, Zeno Bisoffi
For many years microscopy has been considered the mainstay of the diagnosis of parasitic infections. In our laboratory, before the advent of molecular biology, the approach for the identification of parasitic infections in stools was the microscopic exam of three samples. Once we adopted molecular biology, a real-time PCR on one single sample was added to the classical coproparasitological exam of three samples. Given the high sensitivity of real-time PCR (Rt-PCR), we then decided to evaluate if a change of our routine was justified...
2017: Frontiers in Microbiology
https://www.readbyqxmd.com/read/29162647/a-unifying-biology-of-sex-steroid-induced-apoptosis-in-prostate-and-breast-cancers
#7
Philipp Y Maximov, Balkees Abderrahman, Ramona F Curpan, Yousef A Hawsawi, Ping Fan, V Craig Jordan
Prostate and breast cancer are the two cancers with the highest incidence in men and women, respectively. Here we focus on the known biology of acquired resistance to antihormone therapy of prostate and breast cancer and compare laboratory and clinical similarities in the evolution of the disease. Laboratory studies and clinical observations in prostate and breast cancer demonstrate that cell selection pathways occur during acquired resistance to antihormonal therapy. Following sex steroid deprivation, both prostate and breast cancer models show an initial increased acquired sensitivity to the growth potential of sex steroids...
November 21, 2017: Endocrine-related Cancer
https://www.readbyqxmd.com/read/29162320/controlled-human-infections-a-report-from-the-controlled-human-infection-models-workshop-leiden-university-medical-centre-4-6-may-2016
#8
Meta Roestenberg, Annie Mo, Peter G Kremsner, Maria Yazdanbakhsh
The principle of deliberately infecting humans with infectious agents in a controlled setting, so-called controlled human infections (CHI), is not novel. Many CHI models have a long history and were established decades ago such as the intentional exposure to yellow fever and dengue performed in the 1900's (Reed, 1902) [2]. In these times bioethics and scientific reasoning were in their infancy. Nowadays, clinical trials are highly regulated and CHI are executed worldwide. Controlled human malaria infections and influenza infections are the two most frequently practiced...
November 18, 2017: Vaccine
https://www.readbyqxmd.com/read/29162290/reduction-of-pharmaceutical-expenditure-by-a-drug-appropriateness-intervention-in-polymedicated-elderly-subjects-in-catalonia-spain
#9
Lluís Campins, Mateu Serra-Prat, Elisabet Palomera, Ignasi Bolibar, Miquel Àngel Martínez, Pedro Gallo
OBJECTIVE: To assess the monetary savings resulting from a pharmacist intervention on the appropriateness of prescribed drugs in community-dwelling polymedicated (≥8 drugs) elderly people (≥70 years). METHOD: An evaluation of pharmaceutical expenditure reduction was performed within a randomised, multicentre clinical trial. The study intervention consisted of a pharmacist evaluation of all drugs prescribed to each patient using the "Good Palliative-Geriatric Practice" algorithm and the "Screening Tool of Older Persons Prescriptions/Screening Tool to Alert doctors to Right Treatment" criteria (STOPP/START)...
November 18, 2017: Gaceta Sanitaria
https://www.readbyqxmd.com/read/29162145/reducing-hospital-admissions-in-remote-australia-through-the-establishment-of-a-palliative-and-chronic-disease-respite-facility
#10
Timothy A Carey, Mick Arundell, Kellie Schouten, John S Humphreys, Fred Miegel, Simon Murphy, John Wakerman
BACKGROUND: There are limited respite services for palliative care patients and their families in the Northern Territory (NT). The high prevalence of complex chronic diseases, limited access to primary care services, and the poor living situations of many Aboriginal and Torres Strait Islander Australians result in high hospitalisation rates and pressure on tertiary health services. Palliative Care NT identified a need for a flexible, community based, culturally appropriate respite service in Alice Springs...
November 21, 2017: BMC Palliative Care
https://www.readbyqxmd.com/read/29161972/impacts-of-initial-transformation-to-a-patient-centered-medical-home-on-diabetes-outcomes-in-federally-qualified-health-centers-in-florida
#11
Heidi S Kinsell, Allyson G Hall, Jeffrey S Harman, Sweta Tewary, Andrew Brickman
OBJECTIVE: Federally qualified health centers (FQHCs) in Florida see large numbers of vulnerable patients with diabetes. Patient-centered medical home (PCMH) models can lead to improvements in health for patients with chronic conditions and cost savings for providers. Therefore, FQHCs are increasingly moving to PCMH models of care. The study objective was to examine the effects of initial transformation to a level 3 National Committee for Quality Assurance (NCQA) certified PCMH in 2011, on clinical diabetes outcomes among 27 clinic sites from a network of FQHCs in Florida...
November 1, 2017: Journal of Primary Care & Community Health
https://www.readbyqxmd.com/read/29161521/lessons-from-the-camden-coalition-of-healthcare-providers-first-medicaid-shared-savings-performance-evaluation
#12
Aaron Truchil, Natasha Dravid, Stephen Singer, Zachary Martinez, Teagan Kuruna, Scott Waulters
Accountable Care Organizations (ACOs) aim to reduce health care costs while improving patient outcomes. Camden Coalition of Healthcare Providers' (Camden Coalition) work already aligned with this aim before receiving state approval to operate a certified Medicaid ACO in New Jersey. Upon its formation, the Camden Coalition ACO partnered with UnitedHealthcare and, through state legislation, Rutgers Center for State Health Policy (CSHP) was established as its external evaluator. In evaluating the Camden Coalition ACO, Rutgers CSHP built on the Medicare Shared Savings model, but modified it based on the understanding that the Medicaid population differs from the Medicare population...
November 21, 2017: Population Health Management
https://www.readbyqxmd.com/read/29161388/critical-care-at-the-end-of-life-balancing-technology-with-compassion-and-agreeing-when-to-stop
#13
H Montgomery, M Grocott, M Mythen
Modern intensive care saves lives. However, the substantial related financial costs are, for many, married to substantial costs in terms of suffering. In the most sick, the experience of intensive care is commonly associated with the development of profound physical debility, which may last years after discharge. Likewise, the negative psychological impact commonly experienced by such patients during their care is now widely recognized, as is the persistence of psychological morbidity. Such issues become increasingly important as the population of the frail elderly increases, and the health and social care services face budgetary restriction...
December 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29161262/the-value-of-confirmatory-testing-in-early-infant-hiv-diagnosis-programmes-in-south-africa-a-cost-effectiveness-analysis
#14
Lorna Dunning, Jordan A Francke, Divya Mallampati, Rachel L MacLean, Martina Penazzato, Taige Hou, Landon Myer, Elaine J Abrams, Rochelle P Walensky, Valériane Leroy, Kenneth A Freedberg, Andrea Ciaranello
BACKGROUND: The specificity of nucleic acid amplification tests (NAATs) used for early infant diagnosis (EID) of HIV infection is <100%, leading some HIV-uninfected infants to be incorrectly identified as HIV-infected. The World Health Organization recommends that infants undergo a second NAAT to confirm any positive test result, but implementation is limited. Our objective was to determine the impact and cost-effectiveness of confirmatory HIV testing for EID programmes in South Africa...
November 2017: PLoS Medicine
https://www.readbyqxmd.com/read/29161259/the-us-president-s-malaria-initiative-plasmodium-falciparum-transmission-and-mortality-a-modelling-study
#15
Peter Winskill, Hannah C Slater, Jamie T Griffin, Azra C Ghani, Patrick G T Walker
BACKGROUND: Although significant progress has been made in reducing malaria transmission globally in recent years, a large number of people remain at risk and hence the gains made are fragile. Funding lags well behind amounts needed to protect all those at risk and ongoing contributions from major donors, such as the President's Malaria Initiative (PMI), are vital to maintain progress and pursue further reductions in burden. We use a mathematical modelling approach to estimate the impact of PMI investments to date in reducing malaria burden and to explore the potential negative impact on malaria burden should a proposed 44% reduction in PMI funding occur...
November 2017: PLoS Medicine
https://www.readbyqxmd.com/read/29161129/research-validity-of-measurements-when-reusing-icare-probes
#16
Michelle S Lee, Brad Barnett, Jing Tian, Scott McCabe, Eric L Singman
BACKGROUND: It has been reported that reusing Icare tonometer probes may not pose a considerable risk of transmission of infection, thereby supporting this practice under extraordinary circumstances, such as mass glaucoma screenings in developing countries. The present study sought to determine whether reusing the probes reduced the validity of pressure readings. METHODS: Thousands of measurements were made with the same Icare probe on a purpose-built calibration device...
November 2017: Biomedical Instrumentation & Technology
https://www.readbyqxmd.com/read/29160426/impact-assessment-of-an-automated-drug-dispensing-system-in-a-tertiary-hospital
#17
Débora de-Carvalho, José Luiz Alvim-Borges, Cristiana Maria Toscano
OBJECTIVE: To evaluate the costs and patient safety of a pilot implementation of an automated dispensing cabinet in a critical care unit of a private tertiary hospital in São Paulo/Brazil. METHODS: This study considered pre- (January-August 2013) and post- (October 2013-October 2014) intervention periods. We considered the time and cost of personnel, number of adverse events, audit adjustments to patient bills, and urgent requests and returns of medications to the central pharmacy...
October 2017: Clinics
https://www.readbyqxmd.com/read/29159398/cost-effectiveness-of-publicly-funded-treatment-of-opioid-use-disorder-in-california
#18
Emanuel Krebs, Benjamin Enns, Elizabeth Evans, Darren Urada, M Douglas Anglin, Richard A Rawson, Yih-Ing Hser, Bohdan Nosyk
Background: Only 1 in 5 of the nearly 2.4 million Americans with an opioid use disorder received treatment in 2015. Fewer than half of Californians who received treatment in 2014 received opioid agonist treatment (OAT), and regulations for admission to OAT in California are more stringent than federal regulations. Objective: To determine the cost-effectiveness of OAT for all treatment recipients compared with the observed standard of care for patients presenting with opioid use disorder to California's publicly funded treatment facilities...
November 21, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/29159273/a-health-economic-evaluation-of-needle-based-confocal-laser-endomicroscopy-for-the-diagnosis-of-pancreatic-cysts
#19
Claude Le Pen, Laurent Palazzo, Bertrand Napoléon
Background and study aims:  The low sensitivity of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA), especially for the diagnosis of serous cystadenomas (SCAs), can be associated with diagnostic uncertainty that can regularly lead to unnecessary surgical procedures. Needle-based confocal laser endomicroscopy (nCLE) used with EUS-FNA improves diagnostic accuracy, helping to reduce unnecessary surgery and patient follow-up. This study was conducted to evaluate the economic benefit of EUS-FNA + nCLE...
October 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/29157739/office-based-spirometry-a-new-model-of-care-in-preoperative-assessment-for-low-risk-lung-resections
#20
Jessica L Hudson, Jennifer M Bell, Traves D Crabtree, Daniel Kreisel, G Alexander Patterson, Bryan F Meyers, Varun Puri
BACKGROUND: Formal pulmonary function testing with laboratory spirometry (LS) is the standard of care for risk stratification before lung resection. LS and handheld office spirometry (OS) are clinically comparable for forced expiratory volume in 1 second and forced vital capacity. We investigated the safety of preoperative risk stratification based solely on OS. METHODS: Patients at low-risk for cardiopulmonary complications were enrolled in a single-center prospective study and underwent preoperative OS...
November 17, 2017: Annals of Thoracic Surgery
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