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https://www.readbyqxmd.com/read/28938291/feasibility-and-safety-of-controlled-active-hypothermia-treatment-during-transport-in-neonates-with-hypoxic-ischemic-encephalopathy
#1
Eniko Szakmar, Kata Kovacs, Unoke Meder, Agnes Nagy, Andras Szell, Bojan Bundzsity, Zsolt Somogyvari, Attila J Szabo, Miklos Szabo, Agnes Jermendy
OBJECTIVES: To evaluate the feasibility and safety of controlled active hypothermia versus standard intensive care during neonatal transport in patients with hypoxic-ischemic encephalopathy. DESIGN: Cohort study with a historic control group. SETTING: All infants were transported by Neonatal Emergency & Transport Services to a Level-III neonatal ICU. PATIENTS: Two hundred fourteen term newborns with moderate-to-severe hypoxic-ischemic encephalopathy...
September 21, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28938046/the-value-that-infectious-diseases-physicians-bring-to-the-healthcare-system
#2
Daniel P McQuillen, Ann T MacIntyre
While a career in infectious diseases (ID) has always been challenging and exciting, recognition of the value that ID physicians provide to the healthcare system as a whole, over and above the value they provide to individual patients, has been poor in this system. In response to this disparity, the Infectious Diseases Society of America Clinical Affairs Committee has long endeavored to quantify the value of ID physicians to the system, which is challenging in part because of the many avenues through which they influence healthcare...
September 15, 2017: Journal of Infectious Diseases
https://www.readbyqxmd.com/read/28937870/student-led-screening-of-school-children-for-refractive-error-correction
#3
Dipesh Bhattarai, Subodh Gnyawali, Arpan Silwal, Sudan Puri, Anita Shrestha, Man Bahadur Kunwar, Madan Prasad Upadhyay
PURPOSE: Detection and correction of uncorrected refractive errors among 12 million children is an overwhelming task for the 500 currently available eye-care professionals in Nepal. A mid-term review of VISION 2020 goals in Nepal has recommended utilizing alternative human resources that could screen children for visual impairment. This study was conducted to assess the validity of vision screening of school children by trained high school students when compared to optometrist testing as the gold standard...
September 22, 2017: Ophthalmic Epidemiology
https://www.readbyqxmd.com/read/28937572/obstetric-care-consensus-no-6-periviable-birth
#4
(no author information available yet)
Approximately 0.5% of all births occur before the third trimester of pregnancy, and these very early deliveries result in the majority of neonatal deaths and more than 40% of infant deaths. A recent executive summary of proceedings from a joint workshop defined periviable birth as delivery occurring from 20 0/7 weeks to 25 6/7 weeks of gestation. When delivery is anticipated near the limit of viability, families and health care teams are faced with complex and ethically challenging decisions. Multiple factors have been found to be associated with short-term and long-term outcomes of periviable births in addition to gestational age at birth...
October 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28937567/obstetric-care-consensus-no-6-summary-periviable-birth
#5
(no author information available yet)
Approximately 0.5% of all births occur before the third trimester of pregnancy, and these very early deliveries result in the majority of neonatal deaths and more than 40% of infant deaths. A recent executive summary of proceedings from a joint workshop defined periviable birth as delivery occurring from 20 0/7 weeks to 25 6/7 weeks of gestation. When delivery is anticipated near the limit of viability, families and health care teams are faced with complex and ethically challenging decisions. Multiple factors have been found to be associated with short-term and long-term outcomes of periviable births in addition to gestational age at birth...
October 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28937535/validation-of-a-commercial-assay-and-decision-support-tool-for-routine-paclitaxel-therapeutic-drug-monitoring-tdm
#6
Markus Joerger, Stefanie Kraff, Ulrich Jaehde, Ralf A Hilger, Jodi B Courtney, Daniel J Cline, Sonali Jog, Irina Baburina, M C Miller, Salvatore J Salamone
BACKGROUND: The value of therapeutic drug monitoring (TDM) for paclitaxel was recently demonstrated in the largest TDM trial ever conducted in oncology. The trial demonstrated significant reduction in neuropathy when using TDM. Dose adjustment for paclitaxel was based on time above a threshold concentration (Tc>0.05). Tc>0.05 must be calculated with a pharmacokinetic model and complex non-linear mixed effects (NLME) software. The use of the software and chromatographic methods to measure paclitaxel require specialized expertise...
September 18, 2017: Therapeutic Drug Monitoring
https://www.readbyqxmd.com/read/28936475/surgical-data-science-the-new-knowledge-domain
#7
S Swaroop Vedula, Gregory D Hager
Healthcare in general, and surgery/interventional care in particular, is evolving through rapid advances in technology and increasing complexity of care with the goal of maximizing quality and value of care. While innovations in diagnostic and therapeutic technologies have driven past improvements in quality of surgical care, future transformation in care will be enabled by data. Conventional methodologies, such as registry studies, are limited in their scope for discovery and research, extent and complexity of data, breadth of analytic techniques, and translation or integration of research findings into patient care...
April 2017: Innov Surg Sci
https://www.readbyqxmd.com/read/28935832/an-electronic-trigger-based-on-care-escalation-to-identify-preventable-adverse-events-in-hospitalised-patients
#8
Viraj Bhise, Dean F Sittig, Viralkumar Vaghani, Li Wei, Jessica Baldwin, Hardeep Singh
BACKGROUND: Methods to identify preventable adverse events typically have low yield and efficiency. We refined the methods of Institute of Healthcare Improvement's Global Trigger Tool (GTT) application and leveraged electronic health record (EHR) data to improve detection of preventable adverse events, including diagnostic errors. METHODS: We queried the EHR data repository of a large health system to identify an 'index hospitalization' associated with care escalation (defined as transfer to the intensive care unit (ICU) or initiation of rapid response team (RRT) within 15 days of admission) between March 2010 and August 2015...
September 21, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/28935458/-value-based-health-care-vbhc-whence-and-wither
#9
Heiner Raspe
Since about 2005 VbHC has become a prominent movement on the border between population medicine and health economics. The "value" it is aiming at is defined as health care "outcomes per dollar spent". The text focuses on the work of two prominent proponents: M.E. Porter and J.A.M. Gray. It considers background and central elements of VbHC and discusses similarities and differences between the two authors. Especially the differences raise questions that will hopefully play a role in the German discussion that is still in its infancy...
September 18, 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/28935163/optimising-the-diagnosis-of-prostate-cancer-in-the-era-of-multiparametric-magnetic-resonance-imaging-a-cost-effectiveness-analysis-based-on-the-prostate-mr-imaging-study-promis
#10
Rita Faria, Marta O Soares, Eldon Spackman, Hashim U Ahmed, Louise C Brown, Richard Kaplan, Mark Emberton, Mark J Sculpher
BACKGROUND: The current recommendation of using transrectal ultrasound-guided biopsy (TRUSB) to diagnose prostate cancer misses clinically significant (CS) cancers. More sensitive biopsies (eg, template prostate mapping biopsy [TPMB]) are too resource intensive for routine use, and there is little evidence on multiparametric magnetic resonance imaging (MPMRI). OBJECTIVE: To identify the most effective and cost-effective way of using these tests to detect CS prostate cancer...
September 18, 2017: European Urology
https://www.readbyqxmd.com/read/28935130/determining-palliative-care-penetration-rates-in-the-acute-care-setting
#11
Heidi Gruhler, April Krutka, Hannah Luetke-Stahlman, Emmie Gardner
CONTEXT: Intermountain Healthcare, in collaboration with Cerner Corporation, developed a hospital-based electronic palliative care algorithm to improve identification of patients who would benefit from palliative care services. METHODS: This study used a mixed-methods non-randomized retrospective study design. Three 30-day iterations of clinical data were analyzed for patients identified by the electronic algorithm. During the second and third 30-day iteration, palliative care clinicians conducted weekly chart reviews for identified patients and determined whether the patients were appropriate for a palliative care consult...
September 18, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28934249/variability-in-objective-and-subjective-measures-affects-baseline-values-in-studies-of-patients-with-copd
#12
Wayne H Anderson, Jae Wook Ha, David J Couper, Wanda K O'Neal, R Graham Barr, Eugene R Bleecker, Elizabeth E Carretta, Christopher B Cooper, Claire M Doerschuk, M Bradley Drummond, MeiLan K Han, Nadia N Hansel, Victor Kim, Eric C Kleerup, Fernando J Martinez, Stephen I Rennard, Donald Tashkin, Prescott G Woodruff, Robert Paine, Jeffrey L Curtis, Richard E Kanner
RATIONALE: Understanding the reliability and repeatability of clinical measurements used in the diagnosis, treatment and monitoring of disease progression is of critical importance across all disciplines of clinical practice and in clinical trials to assess therapeutic efficacy and safety. OBJECTIVES: Our goal is to understand normal variability for assessing true changes in health status and to more accurately utilize this data to differentiate disease characteristics and outcomes...
2017: PloS One
https://www.readbyqxmd.com/read/28934176/positron-emission-tomographic-imaging-elucidates-the-complex-relationship-between-glucose-uptake-and-tissue-blood-flow-mechanism-in-squamous-cell-oral-cancer-patients
#13
Ping Xu, Yan Li, Shuyong Yang, Mingzhe Li, Chenjun Li
BACKGROUND Through the clinical use of positron emission tomography, we aimed to elucidate the complex relationship between glucose uptake and squamous cell oral cancer (ScOC) growth, along with its mechanism with respect to tissue blood flow (tBF). MATERIAL AND METHODS We retrospectively reviewed a total of 69 newly diagnosed ScOC patients by Fluorine-18 fluorodeoxyglucose (18F-FDG) positron emission tomography (PET). Maximum and mean standard uptake values (SUV↑ and SUV) were recorded to assess glucose uptake...
September 21, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28933329/-mid-term-to-long-term-results-of-revision-total-hip-arthroplasty-using-the-oval-shaped-acetabular-cup-tc-type
#14
E Šťastný, T Trč, J Frýdl, Z Kopečný, T Philippou, J Lisý
INTRODUCTION The purpose of our paper is to evaluate the mid-term to long-term results and to confirm the basic criteria of a high-quality revision implant: safe bridging of bone defects, achievement of reliable primary fixation of revision acetabular cup, achievement of good secondary stability with documentable osteointegration of cup and demonstration of remodelling of transplanted bone tissue in the area of defects and in spaces between the implant ribs. MATERIAL AND METHODS Altogether 36 patients (38 cups) were evaluated who had undergone revision hip arthroplasty in the period from 2004 to 2010...
2017: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
https://www.readbyqxmd.com/read/28933010/economic-evaluation-of-dupilumab-for-the-treatment-of-moderate-to-severe-atopic-dermatitis-in-adults
#15
Andreas Kuznik, Gaëlle Bégo-Le-Bagousse, Laurent Eckert, Abhijit Gadkari, Eric Simpson, Christopher N Graham, LaStella Miles, Vera Mastey, Puneet Mahajan, Sean D Sullivan
INTRODUCTION: Dupilumab significantly improves signs and symptoms of atopic dermatitis (AD), including pruritus, symptoms of anxiety and depression, and health-related quality of life versus placebo in adults with moderate-to-severe AD. Since the cost-effectiveness of dupilumab has not been evaluated, the objective of this analysis was to estimate a value-based price range in which dupilumab would be considered cost-effective compared with supportive care (SC) for treatment of moderate-to-severe AD in an adult population...
September 20, 2017: Dermatology and Therapy
https://www.readbyqxmd.com/read/28932914/estimating-a-constant-wtp-for-a-qaly-a-mission-impossible
#16
Björn Sund, Mikael Svensson
Economic evaluations are an important input to decision-making and priority-setting in the health care sector. Measuring preferences for health improvements, as the demand-side value (willingness to pay) of gaining a quality-adjusted life year (QALY), is one relevant component in the interpretation of the results from health economic evaluations. Our article addresses whether willingness to pay for a QALY (WTP-Q) is sensitive to the size of the health differences and the probability for improvement. We use data from a contingent valuation survey based on 1400 respondents conducted in the spring of 2014...
September 21, 2017: European Journal of Health Economics: HEPAC: Health Economics in Prevention and Care
https://www.readbyqxmd.com/read/28932501/development-and-validation-of-prediabetes-risk-score-for-predicting-prediabetes-among-indonesian-adults-in-primary-care-cross-sectional-diagnostic-study
#17
Isti Ilmiati Fujiati, Harun Alrasyid Damanik, Adang Bachtiar, Andi Armyn Nurdin, Paul Ward
OBJECTIVE: To develop and validate a risk score model for recognizing prediabetes among Indonesian adults in primary care. METHODS: This was a cross-sectional diagnostic study. After excluding subjects with diabetes from Indonesian National Basic Health Survey (INBHS) data set, 21,720 subjects who have completed fasting plasma glucose test and aged >18 years were selected for development stage. About 6,933 subjects were selected randomly from INBHS for validation stage in different diagnostic criteria of prediabetes-based random plasma glucose...
June 2017: Interventional Medicine & Applied Science
https://www.readbyqxmd.com/read/28931509/development-and-validation-of-qmortality-risk-prediction-algorithm-to-estimate-short-term-risk-of-death-and-assess-frailty-cohort-study
#18
Julia Hippisley-Cox, Carol Coupland
Objectives To derive and validate a risk prediction equation to estimate the short term risk of death, and to develop a classification method for frailty based on risk of death and risk of unplanned hospital admission.Design Prospective open cohort study.Participants Routinely collected data from 1436 general practices contributing data to QResearch in England between 2012 and 2016. 1079 practices were used to develop the scores and a separate set of 357 practices to validate the scores. 1.47 million patients aged 65-100 years were in the derivation cohort and 0...
September 20, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28931497/use-of-simulation-based-on-an-electronic-health-records-environment-to-evaluate-the-structure-and-accuracy-of-notes-generated-by-medical-scribes-proof-of-concept-study
#19
Robert Pranaat, Vishnu Mohan, Megan O'Reilly, Maxwell Hirsh, Karess McGrath, Gretchen Scholl, Deborah Woodcock, Jeffrey A Gold
BACKGROUND: The increasing adoption of electronic health records (EHRs) has been associated with a number of unintended negative consequences with provider efficiency and job satisfaction. To address this, there has been a dramatic increase in the use of medical scribes to perform many of the required EHR functions. Despite this rapid growth, little has been published on the training or assessment tools to appraise the safety and efficacy of scribe-related EHR activities. Given the number of reports documenting that other professional groups suffer from a number of performance errors in EHR interface and data gathering, scribes likely face similar challenges...
September 20, 2017: JMIR Medical Informatics
https://www.readbyqxmd.com/read/28931405/evaluating-a-preoperative-protocol-that-includes-magnetic-resonance-imaging-for-lymph-node-metastasis-in-the-cholangiocarcinoma-screening-and-care-program-cascap-in-thailand
#20
Metha Songthamwat, Nittaya Chamadol, Narong Khuntikeo, Jadsada Thinkhamrop, Supinda Koonmee, Nathaphop Chaichaya, Jeffrey Bethony, Bandit Thinkhamrop
BACKGROUND: Treatment planning especially liver resection in cholangiocarcinoma (CCA) depends on the extension of tumor and lymph node metastasis which is included as a key criterion for operability. Magnetic resonance imaging (MRI) offers a rapid and powerful tool for the detection of lymph node metastasis (LNM) and in the current manuscript is assessed as a critical tool in the preoperative protocol for liver resection for treatment of CCA. However, the accuracy of MRI to detect LNM from CCA had yet to be comprehensively evaluated...
September 20, 2017: World Journal of Surgical Oncology
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