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https://www.readbyqxmd.com/read/28534432/gastrointestinal-microphysiological-systems
#1
Sarah E Blutt, James R Broughman, Winnie Zou, Xi-Lei Zeng, Umesh C Karandikar, Julie In, Nicholas C Zachos, Olga Kovbasnjuk, Mark Donowitz, Mary K Estes
Gastrointestinal diseases are a significant health care and economic burden. Prevention and treatment of these diseases have been limited by the available human biologic models. Microphysiological systems comprise organ-specific human cultures that recapitulate many structural, biological, and functional properties of the organ in smaller scale including aspects of flow, shear stress and chemical gradients. The development of intestinal microphysiological system platforms represents a critical component in improving our understanding, prevention, and treatment of gastrointestinal diseases...
January 1, 2017: Experimental Biology and Medicine
https://www.readbyqxmd.com/read/28534080/pathologic-complete-response-rates-after-neoadjuvant-treatment-in-rectal-cancer-an-analysis-of-the-national-cancer-database
#2
Patrick D Lorimer, Benjamin M Motz, Russell C Kirks, Danielle M Boselli, Kendall K Walsh, Roshan S Prabhu, Joshua S Hill, Jonathan C Salo
BACKGROUND: Pathologic complete response (pCR) of rectal cancer following neoadjuvant therapy is associated with decreased local recurrence and increased overall survival. This study utilizes a national dataset to identify predictors of pCR in patients with rectal cancer. METHODS: The National Cancer Database was queried for patients with nonmetastatic rectal cancer (2004-2014) who underwent neoadjuvant therapy and surgical resection. Unadjusted associations were assessed using rank-sum tests and χ (2) tests where appropriate...
May 22, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28532462/is-quality-of-care-a-key-predictor-of-perinatal-health-care-utilization-and-patient-satisfaction-in-malawi
#3
Andreea A Creanga, Sara Gullo, Anne K Sebert Kuhlmann, Thumbiko W Msiska, Christine Galavotti
BACKGROUND: The Malawi government encourages early antenatal care, delivery in health facilities, and timely postnatal care. Efforts to sustain or increase current levels of perinatal service utilization may not achieve desired gains if the quality of care provided is neglected. This study examined predictors of perinatal service utilization and patients' satisfaction with these services with a focus on quality of care. METHODS: We used baseline, two-stage cluster sampling household survey data collected between November and December, 2012 before implementation of CARE's Community Score Card© intervention in Ntcheu district, Malawi...
May 22, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28531268/implementation-of-an-integrated-approach-to-the-national-hiv-aids-strategy-for-improving-human-immunodeficiency-virus-care-for-youths
#4
J Dennis Fortenberry, Linda J Koenig, Bill G Kapogiannis, Carrie L Jeffries, Jonathan M Ellen, Craig M Wilson
Importance: Youths aged 13 to 24 years old living with human immunodeficiency virus (HIV) are less likely than adults to receive the health and prevention benefits of HIV treatments, with only a small proportion having achieved sustained viral suppression. These age-related disparities in HIV continuum of care are owing in part to the unique developmental issues of adolescents and young adults as well as the complexity and fragmentation of HIV care and related services. This article summarizes a national, multiagency, and multilevel approach to HIV care for newly diagnosed youths designed to bridge some of these fragmentations by addressing National HIV/AIDS Strategy goals for people living with HIV...
May 22, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28530525/cost-effectiveness-of-nivolumab-ipilimumab-combination-therapy-compared-with-monotherapy-for-first-line-treatment-of-metastatic-melanoma-in-the-united-states
#5
Anna Oh, Dang M Tran, Leann C McDowell, Dor Keyvani, Jay Andrew Barcelon, Oscar Merino, Leslie Wilson
BACKGROUND: The approval of new immunotherapies has dramatically changed the treatment landscape of metastatic melanoma. These survival gains come with trade-offs in side effects and costs, as well as important considerations for third-party payer systems, physicians, and patients. OBJECTIVE: To develop a Markov model to determine the cost-effectiveness of nivolumab, ipilimumab, and nivolumab-ipilimumab combination as firstline therapy in metastatic melanoma, while accounting for differential effectiveness in programmed death-ligand 1 (PD-L1) positive and negative patients...
June 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28530522/factors-associated-with-adherence-to-and-treatment-duration-of-erlotinib-among-patients-with-non-small-cell-lung-cancer
#6
Lisa M Hess, Anthony Louder, Katherine Winfree, Yajun E Zhu, Ana B Oton, Radhika Nair
BACKGROUND: In lung cancer, there is an increasing number of oral agents available for patients; however, little is known about the factors associated with adherence to and treatment duration on oral medications in non-small cell lung cancer (NSCLC). OBJECTIVE: To evaluate the clinical and demographic factors associated with adherence and treatment discontinuation, respectively, to oral oncolytics among patients with NSCLC. METHODS: A retrospective, claims-based analysis of the Humana Research Database supplemented with medical chart review was conducted among patients with NSCLC who started an oral oncolytic between January 1, 2008, and June 30, 2013...
June 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28529098/differences-in-the-economic-valuation-and-determining-factors-of-informal-care-over-time-the-case-of-blood-cancer
#7
Marta Ortega-Ortega, Roberto Montero-Granados, Juan de Dios Jiménez-Aguilera
OBJECTIVE: To estimate differences in the economic valuation and sociodemographic and clinical factors associated with informal care between phases of the treatment in the case of blood cancer patients. METHODS: 139 haematological cancer patients who underwent a stem cell transplantation completed a longitudinal questionnaire according to 3 phases of the treatment: short-term (pre-transplant), medium-term (1st year post-transplant) and long-term (2nd-6th year post-transplant)...
May 19, 2017: Gaceta Sanitaria
https://www.readbyqxmd.com/read/28528569/time-to-treatment-and-mortality-during-mandated-emergency-care-for-sepsis
#8
Christopher W Seymour, Foster Gesten, Hallie C Prescott, Marcus E Friedrich, Theodore J Iwashyna, Gary S Phillips, Stanley Lemeshow, Tiffany Osborn, Kathleen M Terry, Mitchell M Levy
Background In 2013, New York began requiring hospitals to follow protocols for the early identification and treatment of sepsis. However, there is controversy about whether more rapid treatment of sepsis improves outcomes in patients. Methods We studied data from patients with sepsis and septic shock that were reported to the New York State Department of Health from April 1, 2014, to June 30, 2016. Patients had a sepsis protocol initiated within 6 hours after arrival in the emergency department and had all items in a 3-hour bundle of care for patients with sepsis (i...
May 21, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28528347/discriminative-accuracy-of-physician-and-nurse-predictions-for-survival-and-functional-outcomes-6-months-after-an-icu-admission
#9
Michael E Detsky, Michael O Harhay, Dominique F Bayard, Aaron M Delman, Anna E Buehler, Saida A Kent, Isabella V Ciuffetelli, Elizabeth Cooney, Nicole B Gabler, Sarah J Ratcliffe, Mark E Mikkelsen, Scott D Halpern
Importance: Predictions of long-term survival and functional outcomes influence decision making for critically ill patients, yet little is known regarding their accuracy. Objective: To determine the discriminative accuracy of intensive care unit (ICU) physicians and nurses in predicting 6-month patient mortality and morbidity, including ambulation, toileting, and cognition. Design, Setting, and Participants: Prospective cohort study conducted in 5 ICUs in 3 hospitals in Philadelphia, Pennsylvania, and enrolling patients who spent at least 3 days in the ICU from October 2013 until May 2014 and required mechanical ventilation, vasopressors, or both...
May 21, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28527642/depressive-symptoms-and-perceptions-of-ed-care-in-patients-evaluated-for-acute-coronary-syndrome
#10
Tara St Onge, Donald Edmondson, Emily Cea, Syed Husain, Bernard P Chang
INTRODUCTION: Posttraumatic stress disorder (PTSD) develops in 1 out of 8 survivors of acute coronary syndrome (ACS) events, and these persons have a doubling of risk for recurrent ACS and mortality. Overcrowding in the emergency department during ACS evaluation has been associated with increased risk for PTSD, and depressed patients have been found to be particularly vulnerable. Little is known about the mechanisms by which overcrowding increases PTSD risk in depressed patients. Our aim was to evaluate one possible mechanism, patient perception of crowding and care, in depressed and nondepressed ED patients evaluated for ACS...
May 17, 2017: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
https://www.readbyqxmd.com/read/28525558/electronic-clinical-quality-measure-reporting-challenges-findings-from-the-medicare-ehr-incentive-program-s-controlling-high-blood-pressure-measure
#11
Dawn M Heisey-Grove, Hilary K Wall, Janet S Wright
Objective: To identify physician and practice characteristics associated with high clinical and technical performance on the electronic clinical quality measure (eCQM) that calculates the proportion of patients with hypertension who have controlled blood pressure. Materials and Methods: The study included 268 602 physicians participating in the Medicare Electronic Health Record Incentive Program between 2011 and 2014. Independent variables included delivery reform participation and physician, practice level, and area characteristics...
May 19, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28525464/the-cardiac-rehabilitation-model-improves-fitness-quality-of-life-and-depression-in-breast-cancer-survivors
#12
Lianne B Dolan, Danielle Barry, Teresa Petrella, Lindsay Davey, Ann Minnes, Allison Yantzi, Susan Marzolini, Paul Oh
PURPOSE: Exercise is a demonstrated, therapeutic strategy for cancer survivors to minimize many treatment-induced side effects and may decrease risk of recurrence. Nonetheless, structured programs that combine exercise and education are not yet standardized within cancer care. The Health, Exercise, Active Living, Therapeutic lifestyle (HEALTh) program is a clinical exercise program based on the established cardiac rehabilitation model, but customized for female breast cancer survivors...
May 18, 2017: Journal of Cardiopulmonary Rehabilitation and Prevention
https://www.readbyqxmd.com/read/28525441/dance-your-heart-out-a-community-s-approach-to-addressing-cardiovascular-health-by-using-a-logic-model
#13
Karin L Becker
Cardiovascular health has been identified as a prioritized community health need according to recent community health needs assessment data. While the Affordable Care Act mandates that nonprofit hospitals conduct a community health needs assessment, little guidance exists on how to address the identified needs. Logic models provide systematic structure and necessary direction in how communities can start to address their identified health needs. Completing logic models in a nonlinear fashion is encouraged to employ a strengths-based approach and verify the logic...
July 2017: Family & Community Health
https://www.readbyqxmd.com/read/28523265/prevalence-and-associated-factors-of-erectile-dysfunction-among-married-men-in-vietnam
#14
Thang Van Vo, Hue Dinh Hoang, Nhan Phuc Thanh Nguyen
BACKGROUND: Sexuality is an essential part of life; however, erectile dysfunction (ED) has been one of the most common complaints among men with sexual health issues all over the world. ED includes dysfunction in erection and penile erectile pain. In Vietnam, ED is a subject a not readily discussed. Thus, relatively little is known about ED among Vietnamese men. AIMS: To identify the prevalence of ED and its associated variables and the need for treatment of ED among married men in Vietnam...
2017: Frontiers in Public Health
https://www.readbyqxmd.com/read/28522822/physical-activity-and-risk-of-comorbidities-in-patients-with-chronic-obstructive-pulmonary-disease-a-cohort-study
#15
Tsung Yu, Gerben Ter Riet, Milo A Puhan, Anja Frei
Multi-morbidity is common in patients with chronic obstructive pulmonary disease and low levels of physical activity are hypothesized to be an important risk factor. The current study aimed to assess the longitudinal association between physical activity and risk of seven categories of comorbidity in chronic obstructive pulmonary disease patients. The study included 409 patients from primary care practice in the Netherlands and Switzerland. We assessed physical activity using the Longitudinal Ageing Study Amsterdam Physical Activity Questionnaire at baseline and followed patients for up to 5 years...
May 18, 2017: NPJ Primary Care Respiratory Medicine
https://www.readbyqxmd.com/read/28521782/combining-alcohol-interventions-with-tobacco-addictions-treatment-in-primary-care-the-combat-study-a-pragmatic-cluster-randomized-trial
#16
Nadia Minian, Dolly Baliunas, Laurie Zawertailo, Aliya Noormohamed, Norman Giesbrecht, Christian S Hendershot, Bernard Le Foll, Jürgen Rehm, Andriy Samokhvalov, Peter L Selby
BACKGROUND: Tobacco and alcohol use present multiplicative risk for aerodigestive cancers. Reducing alcohol consumption improves smoking cessation outcomes and reduces cancer risk. Risky alcohol consumption and smoking are often treated separately despite concurrent treatment potentially leading to better outcomes for each. However, no rapidly scalable program exists for combined interventions in primary care clinics spread across wide geographic areas. This cluster randomized trial aims to report on the effects of a novel clinical decision support system (CDSS) on intervention rates by primary care practitioners addressing risky alcohol use in a smoking cessation program...
May 18, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28521751/an-integrated-intervention-to-reduce-intimate-partner-violence-and-psychological-distress-with-refugees-in-low-resource-settings-study-protocol-for-the-nguvu-cluster-randomized-trial
#17
Wietse A Tol, M Claire Greene, Samuel Likindikoki, Lusia Misinzo, Peter Ventevogel, Ann G Bonz, Judith K Bass, Jessie K K Mbwambo
BACKGROUND: Intimate partner violence (IPV) is a critical public health and human rights concern globally, including for refugee women in low-resource settings. Little is known about effective interventions for this population. IPV and psychological distress have a bi-directional relationship, indicating the potential benefit of a structured psychological component as part of efforts to reduce IPV for women currently in violent relationships. METHODS: This protocol describes a cluster randomized controlled trial aimed at evaluating an 8-session integrated psychological and advocacy intervention (Nguvu) with female adult survivors of past-year IPV displaying moderate to severe psychological distress...
May 18, 2017: BMC Psychiatry
https://www.readbyqxmd.com/read/28516504/prognostic-potential-of-midregional-pro-adrenomedullin-following-decompensation-for-systolic-heart-failure-comparison-with-cardiac-natriuretic-peptides
#18
Caroline Morbach, Almuth Marx, Mathias Kaspar, Gülmisal Güder, Susanne Brenner, Carolin Feldmann, Stefan Störk, Jörn O Vollert, Georg Ertl, Christiane E Angermann
AIMS: Whereas guidelines recommend the routine use of natriuretic peptides (NPs) in heart failure (HF) care, the clinical relevance and prognostic potential of midregional pro-adrenomedullin (MR-proADM) is less well established. We aimed to compare the prognostic potential of MR-proADM after acute decompensation for systolic HF with that of N-terminal pro-B-type natriuretic peptide (NT-proBNP) and midregional pro-atrial NP (MR-proANP), to investigate the significance of high/rising MR-proADM, and to evaluate the incremental prognostic yield of repeat measurements...
May 17, 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/28515062/changes-in-total-energy-intake-and-macronutrient-composition-after-bariatric-surgery-predict-long-term-weight-outcome-findings-from-the-swedish-obese-subjects-sos-study
#19
Noora Kanerva, Ingrid Larsson, Markku Peltonen, Anna-Karin Lindroos, Lena M Carlsson
Background: Approximately 20-30% of obese patients do not achieve successful weight outcomes after bariatric surgery.Objective: We examined whether short-term changes (≤0.5 y postsurgery) in energy intake and macronutrient composition after bariatric surgery could predict 10-y weight change.Design: Participants were recruited from the Swedish Obese Subjects (SOS) study, which was a matched (nonrandomized) prospective trial that compared bariatric surgery with usual care for obese patients. A total of 2010 patients who underwent bariatric surgery were included in the study...
May 17, 2017: American Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/28514641/mapping-workforce-configuration-and-operational-models-in-australian-emergency-departments-a-national-survey
#20
Glenn Gardner, Anne Gardner, Sandy Middleton, Julie Considine, Gerard Fitzgerald, Luke Christofis, Anna Doubrovsky, Margaret Adams, Jane O'Connell
Objective Hospital emergency departments (ED) in Australia and internationally have been experiencing increased demand, resulting in reduced hospital quality, impaired access and adverse health outcomes. Effective evaluation of new ED service models and their effect on outcomes is reliant on baseline measures of the staffing configuration and organisational characteristics of the EDs being studied. The aim of the present study was to comprehensively measure these variables in Australian EDs.Methods Australian hospital EDs with 24-h medical and nursing cover were identified and invited to participate in the study...
May 18, 2017: Australian Health Review: a Publication of the Australian Hospital Association
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