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https://www.readbyqxmd.com/read/28325090/using-stents-in-the-management-of-malignant-bowel-obstruction-the-current-situation-and-future-progress
#1
Alessandro Fugazza, Piera Alessia Galtieri, Alessandro Repici
The use of self-expanding metal stents (SEMS) has been considered an effective and safe alternative to emergency surgery as bridge to surgery or for palliation in advanced colorectal cancer even though more recent data have raised concerns on both early and long-term outcomes when patients are treated with bridge to surgery indications. Areas covered: A comprehensive literature review of articles on endoscopic management of malignant bowel obstruction was performed. Indication, technique, outcomes, benefits and risks of these treatments in acute malignant colonic obstruction were reviewed...
March 22, 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28323624/conventional-or-natural-pharmacotherapy-and-the-prevalence-of-anxiety-and-depression-during-menopause
#2
Dorota Kopciuch, Anna Paczkowska, Tomasz Zaprutko, Michał Michalak, Elżbieta Nowakowska
Context • Psychoneurological symptoms are present in nearly all women in the perimenopausal period. Key elements of care in the period may include hormone replacement therapy (HRT). Alternatively, phytoestrogens, antidepressant pharmacotherapy, or a combination of hormonal and antidepressant therapies may be recommended. Objective • The study intended to verify whether women who are menopausal believe that a reduction in their symptoms of anxiety and depression depends on the type of pharmacotherapy used...
March 2017: Alternative Therapies in Health and Medicine
https://www.readbyqxmd.com/read/28322415/association-between-us-norepinephrine-shortage-and-mortality-among-patients-with-septic-shock
#3
Emily Vail, Hayley B Gershengorn, May Hua, Allan J Walkey, Gordon Rubenfeld, Hannah Wunsch
Importance: Drug shortages in the United States are common, but their effect on patient care and outcomes has rarely been reported. Objective: To assess changes to patient care and outcomes associated with a 2011 national shortage of norepinephrine, the first-line vasopressor for septic shock. Design, Setting, and Participants: Retrospective cohort study of 26 US hospitals in the Premier Healthcare Database with a baseline rate of norepinephrine use of at least 60% for patients with septic shock...
March 21, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28317402/glycemic-variability-and-its-association-with-demographics-and-lifestyles-in-a-general-adult-population
#4
Francisco Gude, Pablo Díaz-Vidal, Cintia Rúa-Pérez, Manuela Alonso-Sampedro, Carmen Fernández-Merino, Jesús Rey-García, Carmen Cadarso-Suárez, Marcos Pazos-Couselo, José Manuel García-López, Arturo Gonzalez-Quintela
OBJECTIVE: The objective was to investigate glycemic variability indices in relation to demographic factors and common environmental lifestyles in a general adult population. METHODS: The A Estrada Glycation and Inflammation Study is a cross-sectional study covering 1516 participants selected by sampling of the population aged 18 years and over. A subsample of 622 individuals participated in the Glycation project, which included continuous glucose monitoring procedures...
December 1, 2016: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28317382/effects-on-photovoltaic-performance-of-dialkyloxy-benzothiadiazole-copolymers-by-varying-the-thienoacene-donor
#5
Gururaj P Kini, Sora Oh, Zaheer Abbas, Shafket Rasool, Muhammad Jahandar, Chang Eun Song, Sang Kyu Lee, Won Suk Shin, Won-Wook So, Jong-Cheol Lee
A series of four donor-acceptor alternating copolymers based on dialkyloxy-benzothiadiazole (ROBT) as an acceptor and thienoacenes as a donor units were synthesized and tested for polymer solar cells (PSCs). These new polymers had different donor units with varied electron-donating ability (thieno[3,2-b]thiophene (TT), dithieno[3,2-b:2',3'-d]thiophene (DTT), benzo[1,2-b:4,5-b']dithiophene (BDT) and naphtha[1,2-b:5,6-b']dithiophene (NDT)) in the polymer backbone. To understand the effect of these thienoacenes on the optoelectronic and photovoltaic properties of the copolymers, we systematically analyzed and compared energy levels, crystallinity, morphology, charge recombination and charge carrier mobility in the resulting polymers...
March 20, 2017: ACS Applied Materials & Interfaces
https://www.readbyqxmd.com/read/28302179/balanced-crystalloids-versus-saline-in-the-intensive-care-unit-study-protocol-for-a-cluster-randomized-multiple-crossover-trial
#6
Matthew W Semler, Wesley H Self, Li Wang, Daniel W Byrne, Jonathan P Wanderer, Jesse M Ehrenfeld, Joanna L Stollings, Avinash B Kumar, Antonio Hernandez, Oscar D Guillamondegui, Addison K May, Edward D Siew, Andrew D Shaw, Gordon R Bernard, Todd W Rice
BACKGROUND: Saline, the intravenous fluid most commonly administered to critically ill adults, contains a high chloride content, which may be associated with acute kidney injury and death. Whether using balanced crystalloids rather than saline decreases the risk of acute kidney injury and death among critically ill adults remains unknown. METHODS: The Isotonic Solutions and Major Adverse Renal Events Trial (SMART) is a pragmatic, cluster-level allocation, cluster-level crossover trial being conducted between 1 June 2015 and 30 April 2017 in five intensive care units at Vanderbilt University Medical Center in Nashville, TN, USA...
March 16, 2017: Trials
https://www.readbyqxmd.com/read/28301996/management-of-hepatocellular-carcinoma-prevention-surveillance-diagnosis-and-staging
#7
Digdem Ozer Etik, Nurettin Suna, Ahmet Sedat Boyacioglu
More than 600 000 people die from hepatocellular carcinoma each year. Worldwide, research on the disease needs to be intensified in both the medical and pharmaceutical fields, with a focus on providing help to geographic areas where resources are limited. Treatment approaches depend on the stage of the disease at diagnosis and on access to complex treatment regimens. However, advanced disease is not curable, and treating these patients is expensive and only marginally effective for increasing quality-adjusted life-years...
March 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28296662/iv-versus-subcutaneous-enoxaparin-in-critically-ill-infants-and-children-comparison-of-dosing-anticoagulation-quality-efficacy-and-safety-outcomes
#8
Yaser A Diab, Karthik Ramakrishnan, Brandon Ferrell, Reginald Chounoune, Fahad A Alfares, Kendal M Endicott, Sara Rooney, Jason Corcoran, David Zurakowski, John T Berger, Venkat Shankar, Dilip S Nath
OBJECTIVE: Subcutaneous enoxaparin is the mainstay anticoagulant in critically ill pediatric patients although it poses several challenges in this patient population. Enoxaparin infused IV over 30 minutes represents an attractive alternative, but there is limited experience with this route of administration in children. In this study, we assess dosing, anticoagulation quality, safety, and clinical efficacy of IV enoxaparin compared to subcutaneous enoxaparin in critically ill infants and children...
March 14, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28292289/at-first-glance-informal-payments-experience-on-track-why-accept-or-refuse-patients-perceive-in-cardiac-surgery-department-of-public-hospitals-northeast-of-iran-2013
#9
Ali Vafaei Najar, Hossein Ebrahimipour, Arefeh Pourtaleb, Habibollah Esmaily, Mehdi Jafari, Zohre Nejatzadegan, Yasamin Molavi Taleghani
BACKGROUND: Patient's Informal payments is among the main source of health care financing in some countries. This paper aimed at determining the patient informal payments and relative factors in Cardiac Surgery Departments (CSD) in hospitals affiliated to Mashhad University of Medical Sciences (MUMS) in 2013. METHODS: In this cross-sectional study, 316 discharged patients were selected using multi-stage sampling. Data gathering tool was a questionnaire which was filled by structured telephone interviews...
March 14, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28291598/identifying-radiology-s-place-in-the-expanding-landscape-of-episode-payment%C3%A2-models
#10
Andrew B Rosenkrantz, Joshua A Hirsch, Bibb Allen, H Benjamin Harvey, Gregory N Nicola
The current fee-for-service system for health care reimbursement in the United Stated is argued to encourage fragmented care delivery and a lack of accountability that predisposes to insufficient focus on quality as well as unnecessary or duplicative resource utilization. Episode payment models (EPMs) seek to improve coordination by linking payments for all services related to a patient's condition or procedure, thereby improving quality and efficiency of care. The CMS Innovation Center has implemented a broadening array of EPMs...
March 10, 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28286376/high-mobility-group-box-1-protein-and-outcomes-in-critically-ill-surgical-patients-requiring-open-abdominal-management
#11
Michelle S Malig, Craig N Jenne, Chad G Ball, Derek J Roberts, Zhengwen Xiao, Andrew W Kirkpatrick
Background. Previous studies assessing various cytokines in the critically ill/injured have been uninformative in terms of translating to clinical care management. Animal abdominal sepsis work suggests that enhanced intraperitoneal (IP) clearance of Damage-Associated Molecular Patterns (DAMPs) improves outcome. Thus measuring the responses of DAMPs offers alternate potential insights and a representative DAMP, High Mobility Group Box-1 protein (HMGB-1), was considered. While IP biomediators are being recognized in critical illness/trauma, HMGB-1 behaviour has not been examined in open abdomen (OA) management...
2017: Mediators of Inflammation
https://www.readbyqxmd.com/read/28285574/virtual-reality-exercise-on-a-home-based-phase-iii-cardiac-rehabilitation-program-effect-on-executive-function-quality-of-life-and-depression-anxiety-and-stress-a-randomized-controlled-trial
#12
Ágata Vieira, Cristina Melo, Jorge Machado, Joaquim Gabriel
PURPOSE: To analyse the effect of a six-month home-based phase III cardiac rehabilitation (CR) specific exercise program, performed in a virtual reality (Kinect) or conventional (booklet) environment, on executive function, quality of life and depression, anxiety and stress of subjects with coronary artery disease. METHODS: A randomized controlled trial was conducted with subjects, who had completed phase II, randomly assigned to intervention group 1 (IG1), whose program encompassed the use of Kinect (n = 11); or intervention group 2 (IG2), a paper booklet (n = 11); or a control group (CG), only subjected to the usual care (n = 11)...
March 13, 2017: Disability and Rehabilitation. Assistive Technology
https://www.readbyqxmd.com/read/28285117/acute-heart-failure-alternatives-to-hospitalization
#13
REVIEW
Reka Zsilinszka, Robert J Mentz, Adam D DeVore, Zubin J Eapen, Peter S Pang, Adrian F Hernandez
Acute heart failure (HF) is a major public health problem with substantial associated economic costs. Because most patients who present to hospitals are admitted irrespective of their level of risk, novel approaches to manage acute HF are needed, such as the use of same-day access clinics for outpatient diuresis and observation units from the emergency department. Current published data lacks a comprehensive overview of the present state of acute HF management in various clinical settings. This review summarizes the strengths and limitations of acute HF care in the outpatient and emergency department settings...
March 4, 2017: JACC. Heart Failure
https://www.readbyqxmd.com/read/28277487/a-randomized-controlled-trial-of-an-intervention-to-maintain-suppression-of-hiv-viremia-following-prison-release-the-impact-trial
#14
David Alain Wohl, Carol E Golin, Kevin Knight, Michele Gould, Jessica Carda-Auten, Jennifer S Groves, Sonia Napravnik, Stephen R Cole, Becky L White, Cathie Fogel, David L Rosen, Michael J Mugavaro, Brian W Pence, Patrick M Flynn
BACKGROUND: HIV-infected individuals transitioning from incarceration to the community are at risk for loss of viral suppression. We compared the effects of imPACT, a multi-dimensional intervention to promote care engagement after release, to standard care on sustaining viral suppression after community re-entry. METHODS: This trial randomized 405 HIV-infected inmates being released from prisons in Texas and North Carolina with HIV-1 RNA levels <400 copies/mL to imPACT versus standard care...
March 8, 2017: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/28277114/interdisciplinary-consensus-on-management-of-premenstrual-disorders-in-switzerland
#15
Petra Stute, Christine Bodmer, Ulrike Ehlert, Roger Eltbogen, Ankica Ging, Isabelle Streuli, Michael von Wolff
Premenstrual disorders (PMD) can affect women throughout their entire reproductive years. In 2016, an interdisciplinary expert meeting of general gynecologists, gynecological endocrinologists, psychiatrists and psychologists from Switzerland was held to provide an interdisciplinary algorithm on PMD management taking reproductive stages into account. The Swiss PMD algorithm differentiates between primary and secondary PMD care providers incorporating different levels of diagnostic and treatment. Treatment options include cognitive behavioral therapy, alternative therapy, antidepressants, ovulation suppression and diuretics...
March 2, 2017: Gynecological Endocrinology
https://www.readbyqxmd.com/read/28275943/inventory-management-of-reusable-surgical-supplies
#16
Adam Diamant, Joseph Milner, Fayez Quereshy, Bo Xu
We investigate the inventory management practices for reusable surgical instruments that must be sterilized between uses. We study a hospital that outsources their sterilization services and model the inventory process as a discrete-time Markov chain. We present two base-stock inventory models, one that considers stockout-based substitution and one that does not. We derive the optimal base-stock level for the number of reusable instruments to hold in inventory, the expected service level, and investigate the implied cost of a stockout...
March 8, 2017: Health Care Management Science
https://www.readbyqxmd.com/read/28270727/economic-evaluation-of-brentuximab-vedotin-for-persistent-hodgkin-lymphoma
#17
V Babashov, M A Begen, J Mangel, G S Zaric
BACKGROUND: We conducted a cost-effectiveness analysis of brentuximab vedotin for the treatment of relapsed and refractory Hodgkin lymphoma (hl) in the post-autologous stem-cell transplantation (asct) failure period, from the perspective of the Canadian health care payer. METHODS: We developed a decision-analytic model to simulate lifetime costs and benefits of brentuximab vedotin compared with best supportive care for the treatment of patients with hl after failure of asct...
February 2017: Current Oncology
https://www.readbyqxmd.com/read/28270122/implementation-of-integrated-geriatric-care-at-a-german-hospital-a-case-study-to-understand-when-and-why-beneficial-outcomes-can-be-achieved
#18
Loraine Busetto, Jörn Kiselev, Katrien Ger Luijkx, Elisabeth Steinhagen-Thiessen, Hubertus Johannes Maria Vrijhoef
BACKGROUND: Many health systems have implemented integrated care as an alternative approach to health care delivery that is more appropriate for patients with complex, long-term needs. The objective of this article was to analyse the implementation of integrated care at a German geriatric hospital and explore whether the use of a "context-mechanisms-outcomes"-based model provides insights into when and why beneficial outcomes can be achieved. METHODS: We conducted 15 semi-structured interviews with health professionals employed at the hospital...
March 7, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28267371/medicare-imaging-demonstration-assessing-attributes-of-appropriate-use-criteria-and-their-influence-on-ordering-behavior
#19
Ronilda Lacson, Ivan Ip, Keith D Hentel, Sameer Malhotra, Patricia Balthazar, Curtis P Langlotz, Ali S Raja, Ramin Khorasani
OBJECTIVE: Persistent concern exists about the variable and possibly inappropriate utilization of high-cost imaging tests. The purpose of this study is to assess the influence of appropriate use criteria attributes on altering ambulatory imaging orders deemed inappropriate. MATERIALS AND METHODS: This secondary analysis included Medicare Imaging Demonstration data collected from three health care systems in 2011-2013 via the use of clinical decision support (CDS) during ambulatory imaging order entry...
March 7, 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28265321/prepuce-health-and-childhood-circumcision-choices-in-canada
#20
REVIEW
Emmanuel O Abara
INTRODUCTION: Worldwide, almost 100% of boys are born with penises with a "hood" called prepuce or foreskin. In the course of the boy's life, the prepuce can be circumcised, can become affected by diseased (e.g., phimosis), or a can become infected and hurt the neonate (and his sexual partner) in adulthood. The objectives of this report are to: 1) review the state, function, fate, and care of the prepuce in childhood, with focus on the neonate, in Canada; 2) understand the current practice of childhood male circumcision in terms of age, indications, performers, techniques, outcomes, and education; and 3) consider ways to sustain a good healthcare professional-parental dialogue for safe practices that are accessible, acceptable, and culturally sensitive in the care of the prepuce...
January 2017: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
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