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Routine outcome monitoring

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https://www.readbyqxmd.com/read/29331656/effect-of-a-wearable-patient-sensor-on-care-delivery-for-preventing-pressure-injuries-in-acutely-ill-adults-a-pragmatic-randomized-clinical-trial-ls-hapi-study
#1
David Pickham, Nic Berte, Mike Pihulic, Andre Valdez, Barbara Mayer, Manisha Desai
IMPORTANCE: Though theoretically sound, studies have failed to demonstrate the benefit of routine repositioning of at-risk patients for the prevention of hospital acquired pressure injuries. OBJECTIVE: To assess the clinical effectiveness of a wearable patient sensor to improve care delivery and patient outcomes by increasing the total time with turning compliance and preventing pressure injuries in acutely ill patients. DESIGN: Pragmatic, investigator initiated, open label, single site, randomized clinical trial...
December 30, 2017: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/29329301/estimated-mortality-on-hiv-treatment-among-active-patients-and-patients-lost-to-follow-up-in-4-provinces-of-zambia-findings-from-a-multistage-sampling-based-survey
#2
Charles B Holmes, Izukanji Sikazwe, Kombatende Sikombe, Ingrid Eshun-Wilson, Nancy Czaicki, Laura K Beres, Njekwa Mukamba, Sandra Simbeza, Carolyn Bolton Moore, Cardinal Hantuba, Peter Mwaba, Caroline Phiri, Nancy Padian, David V Glidden, Elvin Geng
BACKGROUND: Survival represents the single most important indicator of successful HIV treatment. Routine monitoring fails to capture most deaths. As a result, both regional assessments of the impact of HIV services and identification of hotspots for improvement efforts are limited. We sought to assess true mortality on treatment, characterize the extent under-reporting of mortality in routine health information systems in Zambia, and identify drivers of mortality across sites and over time using a multistage, regionally representative sampling approach...
January 2018: PLoS Medicine
https://www.readbyqxmd.com/read/29326424/assessing-treatment-outcomes-in-multiple-sclerosis-trials-and-in-the-clinical-setting
#3
REVIEW
Carmen Tur, Marcello Moccia, Frederik Barkhof, Jeremy Chataway, Jaume Sastre-Garriga, Alan J Thompson, Olga Ciccarelli
Increasing numbers of drugs are being developed for the treatment of multiple sclerosis (MS). Measurement of relevant outcomes is key for assessing the efficacy of new drugs in clinical trials and for monitoring responses to disease-modifying drugs in individual patients. Most outcomes used in trial and clinical settings reflect either clinical or neuroimaging aspects of MS (such as relapse and accrual of disability or the presence of visible inflammation and brain tissue loss, respectively). However, most measures employed in clinical trials to assess treatment effects are not used in routine practice...
January 12, 2018: Nature Reviews. Neurology
https://www.readbyqxmd.com/read/29318355/an-enhanced-recovery-after-surgery-eras-protocol-for-ambulatory-anorectal-surgery-reduced-postoperative-pain-and-unplanned-returns-to-care-after-discharge
#4
Aaron B Parrish, Sean M O'Neill, Steven R Crain, Tara A Russell, Deepak K Sonthalia, Vu T Nguyen, Armen Aboulian
BACKGROUND: Ambulatory surgery for anorectal procedures has been proven to be safe and effective. Specific perioperative pathways combining multiple interventions have been shown to optimize recovery and outcomes associated with inpatient colorectal surgery. However, there are no major studies describing and evaluating a standardized protocol for ambulatory anorectal surgery. The purpose of this study was to evaluate the outcomes of a modified enhanced recovery after surgery (ERAS) protocol for ambulatory anorectal surgery...
January 9, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29315287/monitoring-multiple-myeloma
#5
Kyle A Udd, Tanya M Spektor, James R Berenson
Multiple myeloma (MM) is a B-cell malignancy characterized by the accumulation in bone marrow of terminally differentiated plasma cells. MM is a slowly growing, heterogeneous disease with no known cure. Patients with MM have a median survival of approximately 5 years, during which they may experience significant morbidity. More reliable and rapid determination of changes in the clinical status of patients with MM is becoming increasingly important because of the increasing number of available treatments for these patients...
December 2017: Clinical Advances in Hematology & Oncology: H&O
https://www.readbyqxmd.com/read/29313186/multisystemic-therapy-and-functional-family-therapy-compared-on-their-effectiveness-using-the-propensity-score-method
#6
Hester V Eeren, Lucas M A Goossens, Ron H J Scholte, Jan J V Busschbach, Rachel E A van der Rijken
Multisystemic Therapy (MST) and Functional Family Therapy (FFT) have overlapping target populations and treatment goals. In this study, these interventions were compared on their effectiveness using a quasi-experimental design. Between October, 2009 and June, 2014, outcome data were collected from 697 adolescents (mean age 15.3 (SD 1.48), 61.9% male) assigned to either MST or FFT (422 MST; 275 FFT). Data were gathered during Routine Outcome Monitoring. The primary outcome was externalizing problem behavior (Child Behavior Checklist and Youth Self Report)...
January 9, 2018: Journal of Abnormal Child Psychology
https://www.readbyqxmd.com/read/29310367/should-roux-en-y-gastric-bypass-biliopancreatic-limb-length-be-tailored-to-achieve-improved-diabetes-outcomes
#7
Mário Nora, Tiago Morais, Rui Almeida, Marta Guimarães, Mariana P Monteiro
The objective is to access the role of Roux-en-Y gastric bypass (RYGB) biliopancreatic limb (BPL) length in type 2 diabetes (T2D) outcomes.RYGB is more effective than medical intervention for T2D treatment in obese patients. Despite the scarcity of available data, previous reports suggest that modifications of the RYGB limb lengths could improve the antidiabetic effects of the surgery.A cohort of obese T2D patients (n = 114) were submitted to laparoscopic RYGB, either with a standard BPL (SBPL) (n = 41; BPL 84 ± 2 cm) or long BPL (LBPL) (n = 73; BPL = 200 cm) and routinely monitored for weight loss and diabetic status up to 5 years after surgery...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29309990/ex-vivo-generation-of-drug-eluting-islets-improves-transplant-outcomes-by-inhibiting-tlr4-mediated-nfkb-upregulation
#8
Charles A Chang, Babatope Akinbobuyi, Jeremy M Quintana, Gumpei Yoshimatsu, Bashoo Naziruddin, Robert R Kane
The systemic administration of immunosuppressive and anti-inflammatory drugs is routinely employed in organ transplantation to minimize graft rejection and improve graft survival. Localized drug delivery has the potential to improve transplant outcomes by providing sustained exposure to efficacious drug concentrations while avoiding systemic immunosuppression and off-target effects. Here, we describe the synthesis of a novel prodrug and its direct covalent conjugation to pancreatic islets via a cleavable linker...
December 28, 2017: Biomaterials
https://www.readbyqxmd.com/read/29309641/congress-of-neurological-surgeons-systematic-review-and-evidence-based-guidelines-on-intraoperative-cranial-nerve-monitoring-in-vestibular-schwannoma-surgery
#9
Esther X Vivas, Matthew L Carlson, Brian A Neff, Neil T Shepard, D Jay McCracken, Alex D Sweeney, Jeffrey J Olson
Question 1: Does intraoperative facial nerve monitoring during vestibular schwannoma surgery lead to better long-term facial nerve function? Target Population: This recommendation applies to adult patients undergoing vestibular schwannoma surgery regardless of tumor characteristics. Recommendation: Level 3: It is recommended that intraoperative facial nerve monitoring be routinely utilized during vestibular schwannoma surgery to improve long-term facial nerve function...
December 20, 2017: Neurosurgery
https://www.readbyqxmd.com/read/29306043/safety-and-effectiveness-of-ledipasvir-and-sofosbuvir-with-or-without-ribavirin-in-treatment-experienced-patients-with-genotype-1-hepatitis-c-virus-infection-and-cirrhosis
#10
Joseph K Lim, Ann Marie Liapakis, Mitchell L Shiffman, Anna S Lok, Stefan Zeuzem, Norah A Terrault, James S Park, Charles S Landis, Mohamed Hassan, Joel Gallant, Alexander Kuo, Paul J Pockros, Monika Vainorius, Lucy Akushevich, Larry Michael, Michael W Fried, David R Nelson, Ziv Ben-Ari
BACKGROUND & AIMS: We aimed to evaluate the safety and effectiveness of 12 or 24 weeks treatment with ledipasvir and sofosbuvir, with or without ribavirin, in treatment-experienced patients with hepatitis C virus (HCV) genotype 1 infection and cirrhosis in routine clinical practice. Patients were followed in a multi-center, prospective, observational cohort study (HCV-TARGET). METHODS: We collected data from 667 treatment-experienced adults with chronic genotype 1 HCV infection who began treatment with ledipasvir and sofosbuvir, with or without ribavirin, from 2011 through September 15, 2016, according to the regional standards of care, at academic (n=39) and community (n=18) centers in the United States, Canada, Germany, and Israel...
January 3, 2018: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29305676/impact-of-3d-mapping-on-procedural-characteristics-and-outcomes-in-cryoballoon-pulmonary-vein-isolation-for-atrial-fibrillation
#11
Emily N Guhl, Evan Adelstein, Andrew Voigt, Norman C Wang, Samir Saba, Sandeep K Jain
PURPOSE: The use of 3D mapping during cryoballoon pulmonary vein isolation (PVI) is optional with added cost but potential benefit in aiding vein identification, reducing fluoroscopy, and post-ablation testing. Data are limited evaluating procedural characteristics and outcomes in patients undergoing cryoballoon PVI with mapping vs. no mapping. In the present study, we compare procedural characteristics and recurrence-free rates in patients undergoing cryoballoon PVI among patients using CARTO®, NavX™, or no mapping system...
January 5, 2018: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/29304910/benefits-and-harms-of-capnography-during-procedures-involving-moderate-sedation-a-rapid-review-and-meta-analysis
#12
William Parker, Cameron G Estrich, Elliot Abt, Alonso Carrasco-Labra, Jonathan B Waugh, Aaron Conway, Ruth D Lipman, Marcelo W B Araujo
BACKGROUND: Patient safety is a priority in dentistry. Evaluating the benefits and harms associated with the addition of capnography to standard monitoring during moderate sedation for adult patients in the dental practice setting is needed. TYPES OF STUDIES REVIEWED: The authors used rapid review methodology to identify relevant systematic reviews, which they updated through a systematic search by using the same search strategy as the identified reviews. The authors searched PubMed and Google Scholar and through the references of the identified systematic reviews, which yielded 2,892 studies...
January 2018: Journal of the American Dental Association
https://www.readbyqxmd.com/read/29300419/the-my-meal-intake-tool-m-mit-validity-of-a-patient-self-assessment-for-food-and-fluid-intake-at-a-single-meal
#13
J McCullough, H Keller
OBJECTIVES: Hospital malnutrition is an under-recognized issue that leads to a variety of adverse outcomes, especially for older adults. Food/fluid intake (FFI) monitoring in hospital can be used to identify those who are improving and those who need further treatment. Current monitoring practices such as calorie counts are impractical for all patients and a patient-completed tool, if valid, could support routine FFI monitoring. The aim of this research was to determine whether the patient-completed My Meal Intake Tool (M-MIT) can accurately represent FFI at a single meal...
2018: Journal of Nutrition, Health & Aging
https://www.readbyqxmd.com/read/29298736/multiple-frequency-bioimpedance-devices-for-fluid-management-in-people-with-chronic-kidney-disease-receiving-dialysis-a-systematic-review-and-economic-evaluation
#14
Graham Scotland, Moira Cruickshank, Elisabet Jacobsen, David Cooper, Cynthia Fraser, Michal Shimonovich, Angharad Marks, Miriam Brazzelli
BACKGROUND: Chronic kidney disease (CKD) is a long-term condition requiring treatment such as conservative management, kidney transplantation or dialysis. To optimise the volume of fluid removed during dialysis (to avoid underhydration or overhydration), people are assigned a 'target weight', which is commonly assessed using clinical methods, such as weight gain between dialysis sessions, pre- and post-dialysis blood pressure and patient-reported symptoms. However, these methods are not precise, and measurement devices based on bioimpedance technology are increasingly used in dialysis centres...
January 2018: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/29291254/supportive-periodontal-therapy-spt-for-maintaining-the-dentition-in-adults-treated-for-periodontitis
#15
REVIEW
Carolina Manresa, Elena C Sanz-Miralles, Joshua Twigg, Manuel Bravo
BACKGROUND: Periodontitis is a bacterially-induced, chronic inflammatory disease that destroys the connective tissues and bone that support teeth. Active periodontal treatment aims to reduce the inflammatory response, primarily through eradication of bacterial deposits. Following completion of treatment and arrest of inflammation, supportive periodontal therapy (SPT) is employed to reduce the probability of re-infection and progression of the disease; to maintain teeth without pain, excessive mobility or persistent infection in the long term, and to prevent related oral diseases...
January 1, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29288559/omitting-cytogenetic-assessment-from-routine-treatment-response-monitoring-in-cml-is-safe
#16
Inge G P Geelen, Noortje Thielen, Jeroen J W M Janssen, Mels Hoogendoorn, Tanja J A Roosma, Peter J M Valk, Otto Visser, Jan J Cornelissen, Peter E Westerweel
OBJECTIVES: The monitoring of response in chronic myeloid leukemia (CML) is of great importance to identify patients failing their treatment in order to adjust TKI choice and thereby prevent progression to advanced stage disease. Cytogenetic monitoring has a lower sensitivity, is expensive, and requires invasive bone marrow sampling. Nevertheless, chronic myeloid leukemia guidelines continue to recommend performing routine cytogenetic response assessments, even when adequate molecular diagnostics are available...
December 29, 2017: European Journal of Haematology
https://www.readbyqxmd.com/read/29285019/consolidation-radiotherapy-for-advanced-stage-aggressive-b-cell-non-hodgkin-lymphoma-a-systematic-review-and-meta-analysis
#17
REVIEW
Ernie Yap, Zhe Kang Law, Nik Muhd Aslan Abdullah, S Fadilah Abdul Wahid
Patients with advanced aggressive B-cell non-Hodgkin lymphomas (NHL) are usually treated with rituximab in combination with chemotherapy. However, disease relapse rates are high. Radiotherapy (RT) has been shown to be efficacious in treating early-stage NHL but its role in advanced stage diseases is unclear. We performed a systematic review of randomized controlled trials (RCTs) comparing chemotherapy with RT to chemotherapy alone in patients with newly diagnosed advanced aggressive NHL. We searched online databases and pooled similar outcome estimates...
2017: EXCLI Journal
https://www.readbyqxmd.com/read/29284360/the-utility-of-routine-pre-chemotherapy-screening-with-cardiac-gated-blood-pool-scan-for-patients-at-low-risk-of-anthracycline-toxicity
#18
Puey Ling Chia, K Chiang, R Snyder, A Dowling
Background Anthracycline-based chemotherapy is used in many malignancies. Current recommendations by several groups suggest cardiac monitoring prior to and during anthracycline therapy. We aim to review the usefulness of baseline cardiac screening for left ventricular ejection fraction to assess if it had any impact on chemotherapy decisions in patients to be treated with anthracycline-based regimens or any beneficial effect upon outcomes. Methods We conducted a retrospective three-year audit of cancer patients who underwent GBPS prior to anthracycline (doxorubicin) chemotherapy...
January 1, 2017: Journal of Oncology Pharmacy Practice
https://www.readbyqxmd.com/read/29274727/antiplatelet-therapy-with-aspirin-clopidogrel-and-dipyridamole-versus-clopidogrel-alone-or-aspirin-and-dipyridamole-in-patients-with-acute-cerebral-ischaemia-tardis-a-randomised-open-label-phase-3-superiority-trial
#19
Philip M Bath, Lisa J Woodhouse, Jason P Appleton, Maia Beridze, Hanne Christensen, Robert A Dineen, Lelia Duley, Timothy J England, Katie Flaherty, Diane Havard, Stan Heptinstall, Marilyn James, Kailash Krishnan, Hugh S Markus, Alan A Montgomery, Stuart J Pocock, Marc Randall, Annemarei Ranta, Thompson G Robinson, Polly Scutt, Graham S Venables, Nikola Sprigg
BACKGROUND: Intensive antiplatelet therapy with three agents might be more effective than guideline treatment for preventing recurrent events in patients with acute cerebral ischaemia. We aimed to compare the safety and efficacy of intensive antiplatelet therapy (combined aspirin, clopidogrel, and dipyridamole) with that of guideline-based antiplatelet therapy. METHODS: We did an international, prospective, randomised, open-label, blinded-endpoint trial in adult participants with ischaemic stroke or transient ischaemic attack (TIA) within 48 h of onset...
December 20, 2017: Lancet
https://www.readbyqxmd.com/read/29250737/a-prospective-observational-study-of-problematic-oral-cannabinoid-use
#20
Mark A Ware, Marc O Martel, Roman Jovey, Mary E Lynch, Joel Singer
BACKGROUND: Despite evidence supporting the benefits of cannabinoids for symptom control across a wide range of medical conditions, concerns have been raised regarding the potential misuse and/or problematic use of cannabinoids (CBs). OBJECTIVE: The first objective of this study was to examine the incidence of problematic prescription cannabinoid use (PPCBU) over a 12-month period among patients initiating cannabinoid therapy. The second objective was to examine the factors associated with PPCBU...
December 17, 2017: Psychopharmacology
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