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https://www.readbyqxmd.com/read/28749593/developing-better-practices-at-the-institutional-level-leads-to-better-outcomes-after-pancreaticoduodenectomy-in-3-378-patients-domestic-audit-of-the-japanese-society-of-pancreatic-surgery
#1
Sohei Satoi, Tomohisa Yamamoto, Hideyuki Yoshitomi, Fuyuhiko Motoi, Manabu Kawai, Tsutomu Fujii, Keita Wada, Hidehito Arimitsu, Masayuki Sho, Ippei Matsumoto, Satoshi Hirano, Hiroaki Yanagimoto, Masayuki Ohtsuka, Michiaki Unno, Hiroki Yamaue, Masanori Kon
PURPOSE: To assess recent trends in pancreaticoduodenectomy (PD) and the role of institutional standardization on the development of post-operative complications in 3,378 patients who underwent PD in Japan. METHODS: Data were collected from 3,378 patients who underwent PD in 2006, 2010, and 2014 at 53 institutions. A standardized institution (SI) was defined as one that implements ≥7 of 13 quality initiatives according to departmental policy. There were 1,223 patients in the SI group and 2,155 in the non-SI group...
July 27, 2017: Journal of Hepato-biliary-pancreatic Sciences
https://www.readbyqxmd.com/read/28749065/concise-review-the-high-cost-of-high-tech-medicine-planning-ahead-for-market-access
#2
REVIEW
Dawn Driscoll, Stephanie Farnia, Panos Kefalas, Richard T Maziarz
Cellular therapies and other regenerative medicines are emerging as potentially transformative additions to modern medicine, but likely at a staggering financial cost. Public health care systems' budgets are already strained by growing and aging populations, and many private insurer's budgets are equally stretched. The current systems that most payers employ to manage their cash flow are not structured to absorb a sudden onslaught of very expensive prescriptions for a large portion of their covered population...
August 2017: Stem Cells Translational Medicine
https://www.readbyqxmd.com/read/28748673/neurological-complications-during-treatment-of-middle-east-respiratory-syndrome
#3
Jee Eun Kim, Jae Hyeok Heo, Hye Ok Kim, Sook Hee Song, Sang Soon Park, Tai Hwan Park, Jin Young Ahn, Min Ky Kim, Jae Phil Choi
BACKGROUND AND PURPOSE: Middle East respiratory syndrome (MERS) has a high mortality rate and pandemic potential. However, the neurological manifestations of MERS have rarely been reported since it first emerged in 2012. METHODS: We evaluated four patients with laboratory-confirmed MERS coronavirus (CoV) infections who showed neurological complications during MERS treatment. These 4 patients were from a cohort of 23 patients who were treated at a single designated hospital during the 2015 outbreak in the Republic of Korea...
July 2017: Journal of Clinical Neurology
https://www.readbyqxmd.com/read/28748574/delayed-postoperative-diet-is-associated-with-a-greater-incidence-of-prolonged-postoperative-ileus-and-longer-stay-in-hospital-for-patients-undergoing-gastrointestinal-surgery
#4
Joanna Rees, Kelly Bobridge, Catherine Cash, Philippa Lyons-Wall, Rebecca Allan, Jacqui Coombes
AIM: Recent evidence favours a move away from delaying postoperative nutrition towards early feeding practices for better patient outcomes after gastrointestinal surgery. The aim of the present study was to investigate postoperative diet progression and patient outcomes in a secondary hospital with a view to inform future practice. METHODS: This was a retrospective study of gastrointestinal surgery patients (n = 69) at a Western Australian general hospital. Demographic data and outcomes were collected from patient records and included presence or absence of prolonged postoperative ileus, length of stay in hospital, days on minimal nutrition and days until first flatus or stool...
July 26, 2017: Nutrition & Dietetics: the Journal of the Dietitians Association of Australia
https://www.readbyqxmd.com/read/28748366/clinical-features-of-psoriatic-arthritis-a-comprehensive-review-of-unmet-clinical-needs
#5
REVIEW
Angela McArdle, Stephen Pennington, Oliver FitzGerald
Psoriatic arthritis (PsA) is a form of inflammatory arthritis (IA) affecting approximately 0.25% of the population. It is a heterogeneous disorder associated with joint damage, disability, disfiguring skin disease and in severe cases, premature mortality. Inherently irreversible and frequently progressive, the process of joint damage begins at, or before, the clinical onset of disease. Early recognition and intervention is thus crucial to patient outcome. At disease onset, however, PsA often resembles other forms of arthritis-especially rheumatoid arthritis (RA)...
July 27, 2017: Clinical Reviews in Allergy & Immunology
https://www.readbyqxmd.com/read/28748197/incidence-long-term-outcomes-and-healthcare-utilization-of-patients-with-human-immunodeficiency-virus-acquired-immune-deficiency-syndrome-and-disseminated-mycobacterium-avium-complex-from-1992-2015
#6
Lauren F Collins, Meredith E Clement, Jason E Stout
BACKGROUND: Despite the advent of combination antiretroviral therapy (cART), patients with human immunodeficiency virus (HIV) continue to develop late-stage complications including acquired immune deficiency syndrome (AIDS), disseminated Mycobacterium avium complex (DMAC), and death. METHODS: We performed an observational retrospective cohort study of HIV-infected adults who developed DMAC in the Duke University Health System from 1992 to 2015 to determine the incidence, long-term outcomes, and healthcare utilization of this population at high risk for poor outcomes...
2017: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/28747161/factors-associated-with-perinatal-mortality-among-public-health-deliveries-in-addis-ababa-ethiopia-an-unmatched-case-control-study
#7
Yemisrach Getiye, Mesganaw Fantahun
BACKGROUND: perinatal mortality is the sum of still birth (fetal death) and early neonatal death (ENND) i.e. death of live newborn before the age of 7 completed days. Perinatal mortality accounts three fourth of the deaths of the neonatal period and is one of the major challenges for under-five mortality. Therefore this study was conducted to better understand the common and avoidable factors that affect perinatal mortality in Addis Ababa, Ethiopia. METHODS: An unmatched case control study design using secondary data as a source of information was conducted...
July 26, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28746269/transversus-abdominis-plane-blocks-with-single-dose-liposomal-bupivacaine-in-conjunction-with-a-nonnarcotic-pain-regimen-help-reduce-length-of-stay-following-abdominally-based-microsurgical-breast-reconstruction
#8
Eric M Jablonka, Andreas M Lamelas, Julie N Kim, Bianca Molina, Nathan Molina, Michelle Okwali, William Samson, Mark R Sultan, Joseph H Dayan, Mark L Smith
BACKGROUND: Side effects associated with use of postoperative narcotics for pain control can delay recovery after abdominally based microsurgical breast reconstruction. The authors evaluated a nonnarcotic pain control regimen in conjunction with bilateral transversus abdominis plane blocks on facilitating early hospital discharge. METHODS: A retrospective analysis was performed of consecutive patients who underwent breast reconstruction using abdominally based free flaps, with or without being included in a nonnarcotic protocol using intraoperative transversus abdominis plane blockade...
August 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28742815/il33-mediated-ilc2-activation-and-neutrophil-il5-production-in-the-lung-response-after-severe-trauma-a-reverse-translation-study-from-a-human-cohort-to-a-mouse-trauma-model
#9
Jing Xu, Jesse Guardado, Rosemary Hoffman, Hui Xu, Rami Namas, Yoram Vodovotz, Li Xu, Mostafa Ramadan, Joshua Brown, Heth R Turnquist, Timothy R Billiar
BACKGROUND: The immunosuppression and immune dysregulation that follows severe injury includes type 2 immune responses manifested by elevations in interleukin (IL) 4, IL5, and IL13 early after injury. We hypothesized that IL33, an alarmin released early after tissue injury and a known regulator of type 2 immunity, contributes to the early type 2 immune responses after systemic injury. METHODS AND FINDINGS: Blunt trauma patients admitted to the trauma intensive care unit of a level I trauma center were enrolled in an observational study that included frequent blood sampling...
July 2017: PLoS Medicine
https://www.readbyqxmd.com/read/28742637/is-intussusception-a-middle-of-the-night-emergency
#10
Brooke S Lampl, Jonathan Glaab, Rama S Ayyala, Rania Kanchi, Carrie B Ruzal-Shapiro
OBJECTIVES: Intussusception is the most common abdominal emergency in pediatric patients aged 6 months to 3 years. There is often a delay in diagnosis, as the presentation can be confused for viral gastroenteritis. Given this scenario, we questioned the practice of performing emergency reductions in children during the night when minimal support staff are available. Pneumatic reduction is not a benign procedure, with the most significant risk being bowel perforation. We performed this analysis to determine whether it would be safe to delay reduction in these patients until normal working hours when more support staff are available...
July 24, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28742381/systemic-error-in-radiology
#11
Stephen Waite, Jinel Moore Scott, Alan Legasto, Srinivas Kolla, Brian Gale, Elizabeth A Krupinski
OBJECTIVE: Interpretive errors in diagnostic imaging result in significant patient morbidity and mortality, but the importance of errors and process failures in the imaging cycle other than during image interpretation is underappreciated. In this article, we describe these errors and potential solutions, providing a framework to improve patient safety and understand the changing roles of radiologists beyond image interpretation. CONCLUSION: For comprehensive improvements to health care delivery, other failures in the cycle besides diagnostic interpretive error-such as ordering inappropriate studies, PACS failures, and a lack of accurate clinician contact information (with resultant communication failure)-should be recognized as contributors to patient harm because they lead to wasted resources and delayed care...
July 25, 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28742377/reducing-delay-in-diagnosis-multistage-recommendation-tracking
#12
Ben Wandtke, Sarah Gallagher
OBJECTIVE: The purpose of this study was to determine whether a multistage tracking system could improve communication between health care providers, reducing the risk of delay in diagnosis related to inconsistent communication and tracking of radiology follow-up recommendations. MATERIALS AND METHODS: Unconditional recommendations for imaging follow-up of all diagnostic imaging modalities excluding mammography (n = 589) were entered into a database and tracked through a multistage tracking system for 13 months...
July 25, 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28742309/knowledge-of-rare-diseases-among-health-care-students-%C3%A2-the-effect-of-targeted-education
#13
Kamil Jonas, Marcin Waligóra, Mateusz Hołda, Joanna Sulicka-Grodzicka, Magdalena Strach, Piotr Podolec, Grzegorz Kopeć
BACKGROUND: Poor knowledge on rare diseases (RD) results in a significant delay in their diagnosis and treatment. So far there are no standards of university education in RD. We assessed knowledge on RD among healthcare students and the effectiveness of targeted education. METHODS: We conducted an internet-based survey among students of the faculty of medicine, pharmacy and health sciences. Questions regarded personal information, definition and epidemic data on RD...
2017: Przegla̧d Epidemiologiczny
https://www.readbyqxmd.com/read/28741307/modelling-cost-effectiveness-and-health-gains-of-a-universal-vs-prioritized-hcv-treatment-policy-in-a-real-life-cohort
#14
Loreta A Kondili, Federica Romano, Francesca Romana Rolli, Matteo Ruggeri, Stefano Rosato, Maurizia Rossana Brunetto, Anna Linda Zignego, Alessia Ciancio, Alfredo Di Leo, Giovanni Raimondo, Carlo Ferrari, Gloria Taliani, Guglielmo Borgia, Teresa Antonia Santantonio, Pierluigi Blanc, Giovanni Battista Gaeta, Antonio Gasbarrini, Luchino Chessa, Elke Maria Erne, Erica Villa, Donatella Ieluzzi, Francesco Paolo Russo, Pietro Andreone, Maria Vinci, Carmine Coppola, Liliana Chemello, Salvatore Madonia, Gabriella Verucchi, Marcello Persico, Massimo Zuin, Massimo Puoti, Alfredo Alberti, Gerardo Nardone, Marco Massari, Giuseppe Montalto, Giuseppe Foti, Maria Grazia Rumi, Maria Giovanna Quaranta, Americo Cicchetti, Antonio Craxì, Stefano Vella
We evaluated the cost-effectiveness of two alternative DAA treatment policies in a real-life cohort of HCV-infected patients: Policy 1 - "universal": treat all patients, regardless of the fibrosis stage; Policy 2 - treat only "prioritized" patients, delay treatment of the remaining patients until reaching stage F3. A liver disease progression Markov model, which used a lifetime horizon and healthcare system perspective, was applied to the PITER cohort (representative of Italian HCV-infected patients in care)...
July 24, 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/28741035/biomarkers-of-hepatic-injury-and-function-in-neonatal-hypoxic-ischemic-encephalopathy-and-with-therapeutic-hypothermia
#15
Hemananda Muniraman, Danielle Gardner, Jane Skinner, Anna Paweletz, Anitha Vayalakkad, Ying Hui Chee, Clare Clifford, Sunil Sanka, Vidheya Venkatesh, Anna Curley, Suresh Victor, Mark A Turner, Paul Clarke
Therapeutic hypothermia (TH) is now provided as standard care to infants with moderate-severe hypoxic ischemic encephalopathy (HIE). The role of TH in limiting neuronal injury is well recognized, but its effect on hepatic injury which occurs frequently in neonatal HIE is not known. Our objective was to characterize biomarkers of liver injury and function in the setting of neonatal HIE and to describe whether HIE severity and provision of TH influence these hepatic biomarkers. We performed a multicenter retrospective study and compared hepatic biomarkers obtained during the first postnatal week, according to the severity of HIE and whether treated with TH...
July 24, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28740528/bone-health-in-menopausal-women-a-role-for-general-practitioners
#16
REVIEW
Raffaella Michieli, Martina Musto
General Practitioners (GPs) are in a prime location to assess patient health needs, knowing clinical history, living habits and risk factors. GPs can identify in healthy people those in which prevention could be useful, in order to avoid or delay some diseases. For this purpose GPs need to change their care model from a waiting model to a proactive model, in order to identify health needs before the development of diseases.
January 2017: Clinical Cases in Mineral and Bone Metabolism
https://www.readbyqxmd.com/read/28740482/both-low-blood-glucose-and-insufficient-treatment-confer-risk-of-neurodevelopmental-impairment-in-congenital-hyperinsulinism-a-multinational-cohort-study
#17
Annett Helleskov, Maria Melikyan, Evgenia Globa, Inna Shcherderkina, Fani Poertner, Anna-Maria Larsen, Karen Filipsen, Klaus Brusgaard, Charlotte Dahl Christiansen, Lars Kjaersgaard Hansen, Henrik T Christesen
BACKGROUND/AIMS: Congenital hyperinsulinism (CHI) is a heterogeneous disease most frequently caused by KATP-channel (ABCC8 and KCNJ11) mutations, with neonatal or later onset, variable severity, and with focal or diffuse pancreatic involvement as the two major histological types. CHI confers a high risk of neurological impairment; however, sparsely studied in larger patient series. We assessed the neurodevelopmental outcome in children with CHI at follow-up in a mixed international cohort...
2017: Frontiers in Endocrinology
https://www.readbyqxmd.com/read/28739142/radiation-therapy-for-oligorecurrence-in-prostate-cancer-preliminary-results-of-our-centre
#18
C González Ruiz de León, M Ramírez Backhaus, M Sobrón Bustamante, J Casaña, L Arribas, J Rubio-Briones
INTRODUCTION AND OBJECTIVE: There is growing interest in the use of more aggressive therapeutic modalities for treating metastatic prostate cancer. In this study, we examine the use of stereotactic body radiation therapy (SBRT) for patients with oligorecurrent prostate cancer. We analysed the biochemical response and toxicity of patients who underwent this therapy at our centre. MATERIAL AND METHOD: We selected patients who experienced oligorecurrence between January 2015 to December 2016 and were administered SBRT...
July 21, 2017: Actas Urologicas Españolas
https://www.readbyqxmd.com/read/28738886/failure-to-return-to-receive-hiv-test-results-the-cameroon-experience
#19
Defo Defo, Emmanuel Armand Kouotou, Jobert Richie Nansseu
BACKGROUND: To be acquainted of one's HIV serological status is an important strategy for the fight against HIV/AIDS, but many patients still miss the appointment to receive their HIV-test result. The aim of this study was to determine the epidemiological and serological profiles of patients not coming back to collect their HIV-test result in a tertiary health care facility in Yaoundé, Cameroon. METHODS: We undertook a retrospective analysis of data of patients who visited the HIV-day care unit of the Yaoundé Central Hospital (Yaoundé, Cameroon) from January to December 2009 in order to be screened for HIV, and who did not come back to retrieve their result...
July 24, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28738236/early-predictors-of-study-success-in-a-dutch-advanced-nurse-practitioner-education-program-a-retrospective-cohort-study
#20
Ercolie R Bossema, Tineke H J M Meijs, Jeroen W B Peters
BACKGROUND: Study delay and attrition are major concerns in higher education. They cost time and effort, and threaten the availability of higher qualified professionals. Knowing early what factors contribute to delay and attrition may help prevent this. OBJECTIVE: The aim of this study was to examine whether student characteristics, including a literature study report grade as a proxy of cognitive abilities, predicted study success in a dual advanced nurse practitioner education program...
July 15, 2017: Nurse Education Today
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