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https://www.readbyqxmd.com/read/28732315/total-and-ionized-magnesium-testing-in-the-surgical-intensive-care-unit-opportunities-for-improved-laboratory-and-pharmacy-utilization
#1
Daniel Dante Yeh, Nalin Chokengarmwong, Yuchiao Chang, Liyang Yu, Colleen Arsenault, Joseph Rudolf, Elizabeth Lee-Lewandrowski, Kent Lewandrowski
PURPOSE: Ionized fraction (iMg) is the physiologically active form of magnesium (Mg); total Mg may not accurately reflect iMg status. Erroneously "low" Mg levels may result in unnecessary repetitive testing. MATERIALS AND METHODS: From 11/2015 to 01/2016, patients ordered for Mg from a pilot ICU also had iMg tested. Weighted kappa statistic was used to assess agreement between Mg categories (low, normal, high). Predictors of unnecessary repeated Mg testing and repletion using data were explored through logistic regression models using GEE techniques to account for repeated measurements in both bivariate and multivariable analyses...
July 11, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28732192/cost-and-quality-issues-in-establishing-hematopoietic-cell-transplant-program-in-developing-countries
#2
REVIEW
Shahrukh K Hashmi, Alok Srivastava, Walid Rasheed, Salman Adil, Tong Wu, Madan Jagasia, Amr Nassar, William Y K Hwang, Amir Ali Hamidieh, Hildegard T Greinix, Marcelo C Pasquini, Jane F Apperley, Mahmoud Aljurf
The hematopoietic cell transplant (HCT) activity has grown significantly over the past two decades in both developing and developed countries. Many challenges arise in establishing new HCT programs in developing countries, due to scarcity of resources and manpower in expertise in HCT. While cost issues can potentially hinder establishment of new HCT programs in certain regions, the focus on quality and value should be included in the general vision of leadership before establishing an HCT program. The main challenge in most developing countries is the lack of trained/qualified personnel, enormous start-up costs for a tertiary care center, and quality maintenance...
July 14, 2017: Hematology/oncology and Stem Cell Therapy
https://www.readbyqxmd.com/read/28731382/external-validation-and-clinical-utility-of-a-prediction-model-for-6-month-mortality-in-patients-undergoing-hemodialysis-for-end-stage-kidney-disease
#3
Brian Forzley, Lee Er, Helen Hl Chiu, Ognjenka Djurdjev, Dan Martinusen, Rachel C Carson, Gaylene Hargrove, Adeera Levin, Mohamud Karim
BACKGROUND: End-stage kidney disease is associated with poor prognosis. Health care professionals must be prepared to address end-of-life issues and identify those at high risk for dying. A 6-month mortality prediction model for patients on dialysis derived in the United States is used but has not been externally validated. AIM: We aimed to assess the external validity and clinical utility in an independent cohort in Canada. DESIGN: We examined the performance of the published 6-month mortality prediction model, using discrimination, calibration, and decision curve analyses...
July 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28730987/evaluation-of-an-advanced-practice-physiotherapist-in-triaging-patients-with-lumbar-spine-pain-surgeon-physiotherapist-level-of-agreement-and-patient-satisfaction
#4
Susan Robarts, Paul Stratford, Deborah Kennedy, Barry Malcolm, Joel Finkelstein
BACKGROUND: Surgery for lumbar spine pain is indicated for specific etiologies. Given the majority of individuals referred to spine surgeons are not surgical candidates, care delivery is inefficient, with consultations being of limited value for most. Using specially trained physiotherapists in triage is a human resource strategy that may optimize surgeons' time and the patient experience. METHODS: An advanced-practice physiotherapist (APP) and a surgeon assessed consecutive patients with lumbar spine pain presenting at an academic health centre's spine surgery clinic...
August 2017: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/28730736/the-importance-of-moral-emotions-for-effective-collaboration-in-culturally-diverse-healthcare-teams
#5
Catherine Cook, Margaret Brunton
Moral emotions shape the effectiveness of culturally diverse teams. However, these emotions, which are integral to determining ethically responsive patient care and team relationships, typically go unrecognised. The contribution of emotions to moral deliberation is subjugated within the technorational environment of healthcare decision-making. Contemporary healthcare organisations rely on a multicultural workforce charged with the ethical care of vulnerable people. Limited extant literature examines the role of moral emotions in ethical decision-making among culturally diverse healthcare teams...
July 20, 2017: Nursing Inquiry
https://www.readbyqxmd.com/read/28730699/elevated-cardiac-troponin-t-in-cirrhotic-patients-with-emergency-care-admissions-is-associated-with-mortality
#6
Mayada Elnegouly, Katrin Umgelter, Wajima Safi, Alexander Hapfelmeier, Roland M Schmid, Andreas Umgelter
BACKGROUND & AIMS: Mortality of cirrhotic patients after emergency care admission is high and prognostic factors can help in prioritizing patients. The aim of our study was to assess the association between levels of cardiac Troponin T (cTnT) and one-year mortality in patients with liver cirrhosis without known cardiac disease, who were admitted to the emergency department (ED). METHODS: All patients with cirrhosis presented to the ED from October 2009 until August 2015 who had an initial cTnT value measured with the first lab-panel were retrospectively analyzed with a follow-up of 365 days...
July 20, 2017: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28730501/the-pseudo-sah-sign-an-imaging-pitfall-in-postmortem-computed-tomography
#7
Go Shirota, Wataru Gonoi, Masako Ikemura, Masanori Ishida, Yukako Shintani, Hiroyuki Abe, Masashi Fukayama, Tomohiko Higashida, Hidemi Okuma, Osamu Abe
Postmortem computed tomography (PMCT) of the brain has an important role in detection of subarachnoid hemorrhage (SAH), which has a high mortality rate. However, a phenomenon known as "pseudo-SAH," or high-attenuation areas along the cisterns mimicking SAH, may be seen on CT. The aim of this study was to evaluate the diagnostic accuracy of brain PMCT for SAH and to identify the characteristics of pseudo-SAH. Findings on PMCT (sulcal effacement, asymmetry, maximum thickness of SAH signs, presence of acute/subacute intraventricular/intraparenchymal hemorrhage) and clinical history (left ventricular assist device [LVAD] implantation, anticoagulation therapy/coagulation disorder, global ischemia) were compared between subjects with true SAH and those with pseudo-SAH...
July 20, 2017: International Journal of Legal Medicine
https://www.readbyqxmd.com/read/28729309/the-role-of-a-decision-support-smartphone-application-in-enhancing-community-health-volunteers-effectiveness-to-improve-maternal-and-newborn-outcomes-in-nairobi-kenya-quasi-experimental-research-protocol
#8
Pauline Bakibinga, Eva Kamande, Milka Omuya, Abdhalah K Ziraba, Catherine Kyobutungi
INTRODUCTION: Improving maternal and newborn survival remains major aspirations for many countries in the Global South. Slum settlements, a result of rapid urbanisation in many developing countries including Kenya, exhibit high levels of maternal and neonatal mortality. There are limited referral mechanisms for sick neonates and their mothers from the community to healthcare facilities with ability to provide adequate care. In this study, we specifically plan to develop and assess the added value of having community health volunteers (CHVs) use smartphones to identify and track mothers and children in a bid to reduce pregnancy-related complications and newborn deaths in the urban slums of Kamukunji subcounty in Nairobi, Kenya...
July 20, 2017: BMJ Open
https://www.readbyqxmd.com/read/28728882/variation-in-the-cost-of-5-common-operations-in-the-united-states
#9
Elliot Wakeam, George Molina, Neel Shah, Stuart R Lipsitz, David C Chang, Atul A Gawande, Alex B Haynes
BACKGROUND: Health care costs are an important policy focus in the United States. The magnitude and drivers of variation in the costs of common operative procedures are not well understood. We sought to characterize variation in costs across hospitals. METHODS: We used data from the Nationwide Inpatient Sample from 2001-2011 for 5 elective operations: colectomy, coronary artery bypass graft, total knee arthroplasty, cesarean section, and lung resection. Hospitals were benchmarked for each using hierarchical risk- and reliability-adjustment methods to generate an observed-to-expected cost ratio, which was adjusted for patient demographics, comorbidity, wage index, and procedure complexity...
July 17, 2017: Surgery
https://www.readbyqxmd.com/read/28728789/evaluation-of-the-environmental-sustainability-of-different-waste-to-energy-plant-configurations
#10
Lidia Lombardi, Ennio A Carnevale
Residual municipal solid waste (MSW) has an average lower heating value higher than 10GJ/Mg in the EU, and can be recovered in modern Waste-to-Energy (WtE) plants, producing combined heat and power (CHP) and reaching high levels of energy recovery. CHP is pinpointed as the best technique for energy recovery from waste. However, in some cases, heat recovery is not technically feasible - due to the absence of a thermal user (industrial plant or district heating) in the vicinity of the WtE plant - and power production remains the sole possibility...
July 17, 2017: Waste Management
https://www.readbyqxmd.com/read/28728773/psychometric-properties-of-the-turkish-version-of-caregiver-burden-index-cbi-for-parents-of-children-with-allergies
#11
Ayfer Ekim, Melis Hecan, Serkan Oren
Childhood chronic diseases have a great impact, including physiological, social and financial burdens, on parents. The concept of "caregiver burden" is gaining importance to understand the effects of allergic diseases and plan family-centered strategies. PURPOSE: The purpose of this study was to examine the psychometric properties of the Caregiver Burden Index (CBI) in Turkish mothers of children with allergies. METHOD: The participants of this methodological study were 213 mothers of children with allergies between 6 and 12years...
July 2017: Journal of Pediatric Nursing
https://www.readbyqxmd.com/read/28728718/cardiothoracic-critical-care
#12
REVIEW
Kevin W Lobdell, Douglas W Haden, Kshitij P Mistry
High-value CCC is rapidly evolving to meet the demands of increased patient acuity and to incorporate advances in technology. The high-performing CCC system and culture should aim to learn quickly and continuously improve. CCC demands a proactive, interactive, precise, an expert team, and continuity.
August 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/28728515/the-prevalence-of-constipation-at-admission-and-after-one-week-of-palliative-care-a-multicenter-study
#13
Sebastiano Mercadante, Francesco Masedu, Marco Maltoni, Daniela De Giovanni, Luigi Montanari, Cristina Pittureri, Raffaella Bertè, Laura Ursini, Franco Marinangeli, Federica Aielli
AIM: To assess the prevalence and intensity of constipation in advanced-cancer patients referred to palliative care, and to assess changes after one week of specialist palliative care. METHODS: Prospective multicenter study in advanced patients for a period of one year. At admission (T0), age, gender, primary tumor, concomitant diseases, Karnofsky status, Palliative prognostic score (PaP) Edmonton Symptom Assessment scale (ESAS), MDAS (Memorial Delirium Assessment Scale), and bowel function index (BFI) were collected...
July 20, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28727871/biosimilars-in-oncology-in-the-united-states-a-review
#14
Chadi Nabhan, Sandeep Parsad, Anthony R Mato, Bruce A Feinberg
Importance: Biosimilars are biological medicines that contain a highly similar version of the active substance of an already approved biologic reference product. The availability of biosimilars might provide an opportunity to lower health care expenditures as a result of the inherent price competition with their reference product. Understanding how biosimilar cancer drugs are regulated, approved, and paid for, as well as their impact in a value-based care environment, is essential for physicians and other stakeholders in oncology...
July 20, 2017: JAMA Oncology
https://www.readbyqxmd.com/read/28726744/future-protein-supply-and-demand-strategies-and-factors-influencing-a-sustainable-equilibrium
#15
REVIEW
Maeve Henchion, Maria Hayes, Anne Maria Mullen, Mark Fenelon, Brijesh Tiwari
A growing global population, combined with factors such as changing socio-demographics, will place increased pressure on the world's resources to provide not only more but also different types of food. Increased demand for animal-based protein in particular is expected to have a negative environmental impact, generating greenhouse gas emissions, requiring more water and more land. Addressing this "perfect storm" will necessitate more sustainable production of existing sources of protein as well as alternative sources for direct human consumption...
July 20, 2017: Foods (Basel, Switzerland)
https://www.readbyqxmd.com/read/28726468/longitudinal-trajectories-of-benefit-finding-in-adolescents-with-type-1-diabetes
#16
Jessica Rassart, Koen Luyckx, Cynthia A Berg, Leen Oris, Deborah J Wiebe
OBJECTIVES: Benefit finding, which refers to perceiving positive life changes resulting from adversity, has been associated with better psychosocial well-being in different chronic illnesses. However, little research to date has examined how benefit finding develops in the context of Type 1 diabetes (T1D). The present study aimed to identify trajectories of benefit finding across adolescence and to investigate prospective associations with depressive symptoms, self-care, and metabolic control...
July 20, 2017: Health Psychology: Official Journal of the Division of Health Psychology, American Psychological Association
https://www.readbyqxmd.com/read/28725842/understanding-patients-process-to-use-medical-marijuana-a-southern-new-jersey-community-engagement-project
#17
Tara L Crowell
Given the necessity to better understand the process patients need to go through in order to seek treatment via medical marijuana, this study investigates this process to better understand this phenomenon. Specifically, Compassion Care Foundation (CCF) and Stockton University worked together to identify a solution to this problem. Specifically, 240 new patients at CCF were asked to complete a 1-page survey regarding various aspects associated with their experience prior to their use of medicinal marijuana-diagnosis, what prompted them to seek treatment, level of satisfaction with specific stages in the process, total length of time the process took, and patient's level of pain...
September 2016: Journal of patient experience
https://www.readbyqxmd.com/read/28725640/risk-factors-for-impaired-fasting-glucose-or-diabetes-among-hiv-infected-patients-on-art-in-the-copperbelt-province-of-zambia
#18
Perfect Shankalala, Choolwe Jacobs, Samuel Bosomprah, Michael Vinikoor, Patrick Katayamoyo, Charles Michelo
BACKGROUND: Africa has a high prevalence of both Human Immunodeficiency Virus and Non Communicable Diseases (NCDs) but in Zambia there are few data on co-morbid NCDs like Diabetes Mellitus (DM) among HIV-infected individuals. We aimed to identify risk factors for impaired fasting glucose or diabetes among HIV-infected Zambians on long-term Combined Antiretroviral Treatment (cART). METHODS: This was a cross sectional study of adult HIV patients in five health facilities of Copperbelt Province in Zambia...
2017: Journal of Diabetes and Metabolic Disorders
https://www.readbyqxmd.com/read/28725145/hiv-pharmaceutical-care-in-primary-healthcare-improvement-in-cd4-count-and-reduction-in-drug-related-problems
#19
C G R C Molino, Renata Cavalcanti Carnevale, Aline Teotonio Rodrigues, Patricia Moriel, Priscila Gava Mazzola
Background: Highly active antiretroviral therapy (HAART) is complex and many factors contribute to a patient's response to initial therapy including adherence, drug effectiveness, and tolerance. Close HAART follow-up is needed, particularly when there are concurrent therapies such as prophylactic antibiotics and medications for the treatment of comorbidities. Objective: To assess the effectiveness of pharmacist intervention in reducing drug related problems in HIV/AIDS outpatients (intervention group) and in improving clinical parameters in the intervention group compared to the control group...
July 2017: Saudi Pharmaceutical Journal: SPJ: the Official Publication of the Saudi Pharmaceutical Society
https://www.readbyqxmd.com/read/28724184/treatment-of-gestational-diabetes-mellitus-with-myo-inositol-analyzing-the-cutting-edge-starting-from-a-peculiar-case
#20
L Costabile, V Unfer
OBJECTIVE: The robust data about myo-inositol (Myo-Ins) safety profile and effectiveness opened a new scenario for the treatment and prevention of Gestational Diabetes Mellitus (GDM). We report our experience about a case of GDM successfully treated with Myo-Ins. PATIENTS AND METHODS: An overweight 29-year-old Caucasian pregnant woman, nulliparous, affected by GDM, according to the National Institute for Health and Care Excellence (NICE) Guideline. After diagnosis, the patient underwent regular glycemia checks: mean fasting blood glucose value was 103...
June 2017: European Review for Medical and Pharmacological Sciences
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