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https://www.readbyqxmd.com/read/28324319/white-matter-measures-are-near-normal-in-controlled-hiv-infection-except-in-those-with-cognitive-impairment-and-longer-hiv-duration
#1
Lucette A Cysique, James R Soares, Guangqiang Geng, Maia Scarpetta, Kirsten Moffat, Michael Green, Bruce J Brew, Roland G Henry, Caroline Rae
The objective of the current study was to quantify the degree of white matter (WM) abnormalities in chronic and virally suppressed HIV-infected (HIV+) persons while carefully taking into account demographic and disease factors. Diffusion tensor imaging (DTI) was conducted in 40 HIV- and 82 HIV+ men with comparable demographics and life style factors. The HIV+ sample was clinically stable with successful viral control. Diffusion was measured across 32 non-colinear directions with a b-value of 1000 s/mm(2); fractional anisotropy (FA) and mean diffusivity (MD) maps were quantified with Itrack IDL...
March 21, 2017: Journal of Neurovirology
https://www.readbyqxmd.com/read/28324286/prolymphocytic-leukemia-new-insights-in-diagnosis-and-in-treatment
#2
REVIEW
Aude Collignon, Anne Wanquet, Elsa Maitre, Edouard Cornet, Xavier Troussard, Thérèse Aurran-Schleinitz
PURPOSE OF REVIEW: We aimed to produce a comprehensive update on clinical and biological data regarding two rare lymphoid neoplasms, B and T prolymphocytic leukemias, and assess therapeutic management in the light of new molecular insights and the advent of targeted therapies. RECENT FINDINGS: B cell prolymphocytic leukemia (B-PLL) diagnosis remains challenging in the absence of clear immunophenotypic or cytogenetic signature and overlap with mantle cell lymphoma...
April 2017: Current Oncology Reports
https://www.readbyqxmd.com/read/28324205/levels-of-intervention-how-are-they-used-in-quebec-hospitals
#3
Marjolaine Frenette, Jocelyne Saint-Arnaud, Karim Serri
In order to promote better practices and communication around end-of-life decision-making, several Canadian hospitals in the province of Quebec have developed a tool called "Levels of Intervention" (LOI). No work to date has been published demonstrating improvement since these forms were implemented. The purpose of the present study was to obtain information about the use of LOI forms across Quebec hospitals and to identify gaps in practice as well as areas for improvement. A retrospective study was undertaken of 299 charts of patients who had died in three Quebec hospitals with a LOI ordered...
March 21, 2017: Journal of Bioethical Inquiry
https://www.readbyqxmd.com/read/28324049/piloting-a-remission-strategy-in-type-2-diabetes-results-of-a-randomized-controlled-trial
#4
Natalia McInnes, Ada Smith, Rose Otto, Jeffrey Vandermey, Zubin Punthakee, Diana Sherifali, Kumar Balasubramanian, Stephanie Hall, Hertzel C Gerstein
Context: Medical strategies targeting remission of type 2 diabetes have not been systematically studied. Objective: This trial assessed the feasibility, safety and potential to induce remission of a short-term intensive metabolic strategy. Design: A randomized, parallel, open-label pilot trial in 83 participants followed for 52 weeks. Setting: Ambulatory care. Participants: Patients with type 2 diabetes of up to 3 years in duration...
March 15, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28323893/effect-of-supervised-exercise-training-during-pregnancy-on-neonatal-and-maternal-outcomes-among-overweight-and-obese-women-secondary-analyses-of-the-etip-trial-a-randomised-controlled-trial
#5
Kirsti Krohn Garnæs, Siri Ann Nyrnes, Kjell Åsmund Salvesen, Øyvind Salvesen, Siv Mørkved, Trine Moholdt
BACKGROUND: Maternal obesity associates with complications during pregnancy and childbirth. Our aim was to investigate if exercise during pregnancy in overweight/obese women could influence birth weight or other neonatal and maternal outcomes at delivery. MATERIAL AND METHODS: This is a secondary analysis of a randomised controlled trial of exercise training in pregnancy for women with body mass index (BMI) ≥ 28 kg/m2. Ninety-one women (31.3 ± 4.3 years, BMI 34...
2017: PloS One
https://www.readbyqxmd.com/read/28323807/the-trauma-collaborative-care-study-tccs
#6
Stephen T Wegener, Andrew N Pollak, Katherine P Frey, Robert A Hymes, Kristin R Archer, Clifford B Jones, Rachel B Seymour, Robert V OʼToole, Renan C Castillo, Yanjie Huang, Daniel O Scharfstein, Ellen J MacKenzie
Previous research suggests that the care provided to trauma patients could be improved by including early screening and management of emotional distress and psychological comorbidity. The Trauma Collaborative Care (TCC) program, which is based on the principles of well-established models of collaborative care, was designed to address this gap in trauma center care. This article describes the TCC program and the design of a multicenter study to evaluate its effectiveness for improving patient outcomes after major, high-energy orthopaedic trauma at level 1 trauma centers...
April 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28323799/a-prospective-randomized-trial-to-assess-oral-versus-intravenous-antibiotics-for-the-treatment-of-postoperative-wound-infection-after-extremity-fractures-poviv-study
#7
William T Obremskey, Andrew H Schmidt, Robert V OʼToole, Jennifer DeSanto, Saam Morshed, Paul Tornetta, Clinton K Murray, Clifford B Jones, Daniel O Scharfstein, Tara J Taylor, Anthony R Carlini, Renan C Castillo
Patients surgically treated for infection after extremity fractures are typically discharged with a 6- to 12-week antibiotic regimen. Intravenous (IV) antibiotics are associated with significant cost and potential complications of deep vein thrombosis, line clotting, and sepsis. Many of the pathogens that cause musculoskeletal infection have both oral (PO) and IV antibiotic options with adequate bioavailability and antibacterial effect, yet IV antibiotics remain the standard of care absent evidence that PO options are clinically as efficacious...
April 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28323797/local-antibiotic-therapy-to-reduce-infection-after-operative-treatment-of-fractures-at-high-risk-of-infection-a-multicenter-randomized-controlled-trial-vanco-study
#8
Robert V OʼToole, Manjari Joshi, Anthony R Carlini, Clinton K Murray, Lauren E Allen, Daniel O Scharfstein, Joshua L Gary, Michael J Bosse, Renan C Castillo
A number of clinical studies in the spine literature suggest that the use of local vancomycin powder may substantially reduce surgical site infections (SSIs). These studies are primarily retrospective and observational and few focus on orthopaedic trauma patients. This study is a phase III, prospective, randomized, clinical trial to assess the efficacy of locally administered vancomycin powder in the prevention of SSI after fracture surgery. The primary goal of the VANCO Study is to compare the proportion of deep SSI 6 months after fracture fixation surgery...
April 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28323688/challenges-of-inpatient-glycemic-control
#9
Sally O Gerard, Josephine Ritchie
Hyperglycemia occurs in more than 30% of hospitalized patients. The condition has been associated with higher mortality and poor outcomes. Systems to effectively treat dysglycemia have been put into place, although many focus on critical care areas. The purpose of this article is to provide an overview of the challenges for glycemic control in non-critical care areas. Standardized order sets, critical pathways, professional education, and collaborative systems can support improved control.
March 20, 2017: Journal of Nursing Care Quality
https://www.readbyqxmd.com/read/28323659/stimulus-induced-rhythmic-periodic-or-ictal-discharges-in-coma-incidence-and-interrater-reliability-of-continuous-eeg-after-a-standard-stimulation-protocol-a-prospective-study
#10
Khalid A Alsherbini, Joao Mc-OʼNeil Plancher, David M Ficker, Brandon P Foreman, Opeolu M Adeoye, Jun Ying, Michael D Privitera
PURPOSE: Stimulus-induced rhythmic, periodic, or ictal discharges (SIRPIDs) are often seen during continuous electroencephalographic (cEEG) monitoring in coma. Given their uncertain clinical significance, our prospective study evaluated incidence of SIRPIDs in comatose patients in the neuroscience intensive care unit (NSICU) who underwent a standard stimulation protocol and defined interreader reliability for cEEG. METHODS: Of 146 patients prospectively screened who underwent cEEG during a 6-month period, 53 patients were included and 93 patients were excluded...
March 17, 2017: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
https://www.readbyqxmd.com/read/28323642/a-bayesian-approach-for-three-dimensional-markerless-tumor-tracking-using-kv-imaging-during-lung-radiotherapy
#11
Chun-Chien Shieh, Vincent Caillet, Michelle Dunbar, Paul J Keall, Jeremy T Booth, Nicholas Hardcastle, Carol Haddad, Thomas Eade, Ilana Feain
The ability to monitor tumor motion without implanted markers can potentially enable broad access to more accurate and precise lung radiotherapy. A major challenge is that kilovoltage (kV) imaging based methods are rarely able to continuously track the tumor due to the inferior tumor visibility on 2D kV images. Another challenge is the estimation of 3D tumor position based on only 2D imaging information. The aim of this work is to address both challenges by proposing a Bayesian approach for markerless tumor tracking for the first time...
March 21, 2017: Physics in Medicine and Biology
https://www.readbyqxmd.com/read/28323612/from-particularities-to-context-refining-our-thinking-on-illness-narratives
#12
Annie Le, Kara Miller, Juliet McMullin
This paper examines how illness narratives are used in medical education and their implications for clinicians' thinking and care of patients. Ideally, collecting and reading illness narratives can enhance clinicians' sensitivity and contextual thinking. And yet these narratives have become part of institutionalizing cultural competency requirements in ways that tend to favor standardization. Stereotyping and reductionistic thinking can result from these pedagogic approaches and obscure structural inequities...
March 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/28323605/clinicians-obligations-to-use-qualified-medical-interpreters-when-caring-for-patients-with-limited-english-proficiency
#13
Gaurab Basu, Vonessa Phillips Costa, Priyank Jain
Access to language services is a required and foundational component of care for patients with limited English proficiency (LEP). National standards for medical interpreting set by the US Department of Health and Human Services and by the National Council on Interpreting in Health Care establish the role of qualified medical interpreters in the provision of care in the United States. In the vignette, the attending physician infringes upon the patient's right to appropriate language services and renders unethical care...
March 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/28319979/patient-experience-a-critical-indicator-of-healthcare-performance
#14
Pamela H Guler
Patient experience has become a critical differentiator for healthcare organizations, and it will only grow in importance as transparency and consumerism dominate the healthcare landscape. Creating and sustaining a consistently exceptional experience that promotes patient engagement and the best outcomes is far more than just "satisfying" patients, going well beyond amenities that may be provided.Perception of care experience is often shaped by methods we use to address the biopsychosocial needs of patients...
April 2017: Frontiers of Health Services Management
https://www.readbyqxmd.com/read/28319947/effects-of-capsaicin-on-older-patients-with-oropharyngeal-dysphagia-a-double-blind-placebo-controlled-crossover-study
#15
Rui Nakato, Noriaki Manabe, Sayako Shimizu, Kozo Hanayama, Akiko Shiotani, Jiro Hata, Ken Haruma
BACKGROUND/AIMS: The standard of care for older patients with oropharyngeal dysphagia (OD) is poor. Stimulation of transient receptor potential vanilloid 1 might become a pharmacological strategy for these patients. This study aimed to compare the therapeutic effect of film food containing 0.75 µg of capsaicin in these patients. METHODS: In a crossover, randomized trial, 49 patients with OD were provided capsaicin or identical placebo at least 7 days apart. Patients' reported symptoms during repeated swallowing, the volume, pH and substance P (SP) concentrations in saliva, and cervical esophageal wall motion evaluated by ultrasonographic tissue Doppler imaging were obtained before and after capsaicin or placebo administration...
March 21, 2017: Digestion
https://www.readbyqxmd.com/read/28319910/the-role-of-vasopressin-and-the-vasopressin-type-v1a-receptor-agonist-selepressin-in-septic-shock
#16
REVIEW
Antonio F Saad, Marc O Maybauer
Septic shock remains one of the major causes of morbidity and mortality in the critically ill. Despite early goal therapy and administration of cathecholaminergic agents, up to 30% of patients succumb to the disease. In this manuscript, we first summarize the standard of care of patients with septic shock and current guidelines. We review the physiologic role of vasopressin and its role in septic shock management. We then review the most up-to-date evidence on the potential role of V1a receptor agonists such as Selepressin, in septic shock...
March 15, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28319653/the-ecology-of-human-microbiota-dynamics-and-diversity-in-health-and-disease
#17
Antti Karkman, Jenni Lehtimäki, Lasse Ruokolainen
Social welfare, better health care, and urbanization have greatly improved human health and well-being. On the other hand, Western societies suffer from the downsides of the elevated standard of living. Among other factors, the Western diet (poor in dietary fiber), lack of contact with natural biodiversity, and excessive antibiotic use are known to be associated with the increase in chronic inflammatory disorders. Limited exposure to microbial biodiversity, in combination with severe lifestyle-related disturbances to commensal microbial communities, especially during early life, is changing the diversity and composition of human microbiota...
March 20, 2017: Annals of the New York Academy of Sciences
https://www.readbyqxmd.com/read/28319584/episode-of-care-characteristics-and-costs-for-hip-and-knee-replacement-surgery-in-hospitals-belonging-to-the-high-value-health-care-collaborative-compared-with-similar-hospitals-in-the-same-health-care-markets
#18
William B Weeks, William J Schoellkopf, David J Ballard, Gary S Kaplan, Brent James, James N Weinstein
BACKGROUND: To inform consumers and restrain health care cost growth, efforts to promote transparency and to reimburse for care episodes are accelerating in the United States. OBJECTIVE: To compare characteristics and costs of 30-day episode of care for hip and knee replacement occurring in High Value Healthcare Collaborative (HVHC)-member hospitals to those occurring in like non-HVHC-member hospitals in the same 15 health care markets before interventions by HVHC members to improve health care value for those interventions...
March 17, 2017: Medical Care
https://www.readbyqxmd.com/read/28319416/specifics-in-the-review-of-health-documentation
#19
K Kacalova, B Havelkova, D Farkasova
OBJECTIVES: The objective of the work was to identify if health documentation management is depending of actually current legislation. Also to review range and consistency records. The work described forms and content of documentation, relating to treat wounds and decubitus. METHODS: A content analysis of 139 health documentation of insurer of General Health Insurance Company, which were treated by 28 home care agencies (hereinafter "HCA") and in the HCA was done directly audit in 2012 and 2014...
2017: Bratislavské Lekárske Listy
https://www.readbyqxmd.com/read/28319164/modeling-the-potential-impact-on-the-us-blood-supply-of-transfusing-critically-ill-patients-with-fresher-stored-red-blood-cells
#20
Arianna Simonetti, Hussein Ezzeldin, Mikhail Menis, Stephen McKean, Hector Izurieta, Steven A Anderson, Richard A Forshee
BACKGROUND: Although some studies have suggested that transfusion recipients may have better medical outcomes if transfused with red blood cell units stored for a short time, the overall body of evidence shows mixed results. It is important to understand how using fresher stored red blood cell units for certain patient groups may affect blood availability. METHODS: Based on the Stock-and-Flow simulation model of the US blood supply developed by Simonetti et al. 2014, we evaluated a newly implemented allocation method of preferentially transfusing fresher stored red blood cell units to a subset of high-risk group of critically ill patients and its potential impact on supply...
2017: PloS One
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