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https://www.readbyqxmd.com/read/28939397/national-survey-of-emergency-physicians-concerning-home-based-care-options-as-alternatives-to-emergency-department-based-hospital-admissions
#1
Amy R Stuck, Christopher Crowley, James Killeen, Edward M Castillo
BACKGROUND: Emergency departments (EDs) in the United States play a prominent role in hospital admissions, especially for the growing population of older adults. Home-based care, rather than hospital admission from the ED, provides an important alternative, especially for older adults who have a greater risk of adverse events, such as hospital-acquired infections, falls, and delirium. OBJECTIVE: The objective of the survey was to understand emergency physicians' (EPs) perspectives on home-based care alternatives to hospitalization from the ED...
September 19, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28938728/modeling-of-live-birth-rates-and-cost-effectiveness-of-oocyte-cryopreservation-for-cancer-patients-prior-to-high-and-low-risk-gonadotoxic-chemotherapy
#2
B Lyttle Schumacher, N Grover, T Mesen, A Steiner, J Mersereau
STUDY QUESTION: What is the live-birth rate (LBR) and cost-effectiveness of fertility preservation with oocyte cryopreservation (FP-OC) compared to expectant management in cancer patients age 25-40 based on estimated gonadotoxicity of treatments 5 years after cancer diagnosis? SUMMARY ANSWER: Oocyte cryopreservation prior to cancer treatment is more costly, yet more effective (producing more live births), than not undergoing oocyte cryopreservation but it is most beneficial for patients undergoing high-risk chemotherapy (HRC)...
October 1, 2017: Human Reproduction
https://www.readbyqxmd.com/read/28927389/follow-up-care-after-treatment-for-prostate-cancer-protocol-for-an-evaluation-of-a-nurse-led-supported-self-management-and-remote-surveillance-programme
#3
Jane Frankland, Hazel Brodie, Deborah Cooke, Claire Foster, Rebecca Foster, Heather Gage, Jake Jordan, Ines Mesa-Eguiagaray, Ruth Pickering, Alison Richardson
BACKGROUND: As more men survive a diagnosis of prostate cancer, alternative models of follow-up care that address men's enduring unmet needs and are economical to deliver are needed. This paper describes the protocol for an ongoing evaluation of a nurse-led supported self-management and remote surveillance programme implemented within the secondary care setting. METHODS/DESIGN: The evaluation is taking place within a real clinical setting, comparing the outcomes of men enrolled in the Programme with the outcomes of a pre-service change cohort of men, using a repeated measures design...
September 19, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28923179/drugs-and-hyperglycemia-a-practical-guide
#4
REVIEW
Vandana Jain, Ronak Kumar Patel, Zaureen Kapadia, Sneha Galiveeti, Maryann Banerji, Lisel Hope
Drug-induced diabetes is one of the factors contributing to the increasing incidence of diabetes worldwide. This review considers the frequency, pathogenesis and treatment of drug-induced diabetes. Drugs that induce diabetes include hormonal therapy, especially glucocorticoids and androgen blockers, cardiovascular drugs, especially statins, beta-blockers and diuretics, antipsychotics, especially clozapine, olanzapine and quetiapine, antiretrovirals (protease inhibitors and non-reverse transcriptase inhibitors - NRTIs) and other drugs (mechanistic target of rapamycin inhibitors -mTORs, post organ transplantation drugs, tyrosine kinase inhibitors and interferon-alpha)...
October 2017: Maturitas
https://www.readbyqxmd.com/read/28901831/collaboration-between-biomedical-and-complementary-and-alternative-care-providers-barriers-and-pathways
#5
Alberta S J van der Watt, Gareth Nortje, Lola Kola, John Appiah-Poku, Caleb Othieno, Benjamin Harris, Bibilola D Oladeji, Oluyomi Esan, Victor Makanjuola, LeShawndra N Price, Soraya Seedat, Oye Gureje
We examined the scope of collaborative care for persons with mental illness as implemented by traditional healers, faith healers, and biomedical care providers. We conducted semistructured focus group discussions in Ghana, Kenya, and Nigeria with traditional healers, faith healers, biomedical care providers, patients, and their caregivers. Transcribed data were thematically analyzed. A barrier to collaboration was distrust, influenced by factionalism, charlatanism, perceptions of superiority, limited roles, and responsibilities...
September 1, 2017: Qualitative Health Research
https://www.readbyqxmd.com/read/28894635/topical-naltrexone-is-a-safe-and-effective-alternative-to-standard-treatment-of-diabetic-wounds
#6
Patricia J McLaughlin, Jarrett D Cain, Michelle B Titunick, Joseph W Sassani, Ian S Zagon
Objective: Diabetes affects more than 29 million individuals in the United States, resulting in healthcare costs approaching $245 billion. Approximately 15% of these individuals will develop a chronic, non-healing foot ulcer (diabetic foot ulcer [DFU]) that, if untreated, may lead to amputation. The current treatments for DFU are expensive, have significant side-effects, and often result in non-compliance. A new topical treatment is described that accelerates cutaneous wound repair and is disease modifying by targeting underlying aberrant diabetic pathways...
September 1, 2017: Advances in Wound Care
https://www.readbyqxmd.com/read/28875736/what-makes-extra-care-housing-an-appropriate-setting-for-people-with-dementia-an-exploration-of-staff-decision-making
#7
Hilde Verbeek, Sue Tucker And, Mark Wilberforce, Christian Brand, Michele Abendstern, David Challis
Extra care housing facilities in the UK are intended to offer a community-based alternative to care home placement. However, little is known about staff's views of the appropriateness of extra care housing for people with dementia. This paper describes a mixed-methods study which explored this issue using statistical modelling of frontline staff's recommendations of the best care setting for care home entrants; thematic analysis of transcripts from a simulated Resource Allocation Management Panel meeting; and content analysis of care coordinators' reasons for not considering extra care housing in actual care home applications...
January 1, 2017: Dementia
https://www.readbyqxmd.com/read/28871545/measurements-of-electron-partitioning-between-cytochrome-and-alternative-oxidase-pathways-in-plant-tissues
#8
Nestor Fernandez Del-Saz, Miquel Ribas-Carbo, Gabriel Martorell, Alisdair R Fernie, Igor Florez-Sarasa
Plant respiration is characterized by the existence of the alternative oxidase pathway (AOP) that competes with cytochrome oxidase pathway (COP) for the electrons of the ubiquinone pool of the mitochondrial electron transport chain, thus reducing ATP synthesis. The oxygen (O2) isotope fractionation technique is the only available to determine the electron partitioning between the two pathways and their in vivo activities in plant tissues. In this chapter, the basis of the O2 isotope fractionation technique and its derived calculations are carefully explained together with a detailed description of the dual-inlet isotope ratio mass spectrometry (DI-IRMS) system and the protocol developed at the University of Balearic Islands...
2017: Methods in Molecular Biology
https://www.readbyqxmd.com/read/28871541/procedures-of-mitochondria-purification-and-gene-expression-to-study-alternative-respiratory-and-uncoupling-pathways-in-fruits
#9
Jurandi Gonçalves de Oliveira, Luis Miguel Mazorra Morales, Gláucia Michelle Cosme Silva, Kátia Daniella da Cruz Saraiva, Diederson Bortolino Santana, Clesivan Pereira Dos Santos, Marcos Goes Oliveira, José Hélio Costa
We describe detailed procedures to get intact and well-coupled mitochondria from a variety of fruit species such as papaya (Carica papaya), guava (Psidium guajava), tomato (Solanum lycopersicum), and strawberry (Fragaria x ananassa) as well as the protocols to assess the capacities of AOX and UCP pathways in intact fruit mitochondria. The procedures presented here were tested for the species mentioned above; their use with other types of fruits must be tested for yield of intact and active mitochondria. This is possible from individual adjustments...
2017: Methods in Molecular Biology
https://www.readbyqxmd.com/read/28868786/effect-of-fa-cs-substitution-and-pbi2-on-the-long-term-stability-of-triple-cation-perovskites
#10
Shashwat Shukla, Sudhanshu Shukla, Lew Jia Haur, Harsha Satya Sai, Guifang Han, Anish Priyadarshi, Tom Baikie, Subodh Mhaisalkar, Nripan Mathews
Altering cation and anion ratios in perovskites has been an excellent avenue in tuning the perovskite properties and enhancing the performance. Recently, MA/FA/Cs triple cation mixed halide perovskites have demonstrated efficiencies reaching up to 22 %. Similar to the widely explored MAPbI3, excess PbI2 is added in these perovskite films to enhance the performance. Previous reports demonstrate that the excess PbI2 is beneficial for the performance. However, not much work has been conducted about its impact on stability...
September 3, 2017: ChemSusChem
https://www.readbyqxmd.com/read/28860178/can-more-appropriate-support-and-services-be-provided-for-people-who-attend-the-emergency-department-frequently-national-health-service-staff-views
#11
Suzanne Ablard, Elizabeth Coates, Cindy Cooper, Glenys Parry, Suzanne M Mason
BACKGROUND: Interventions designed to help Emergency Department (ED) staff manage frequent attenders are labour-intensive and only benefit a small sample of frequent attenders. We aimed to use the in-depth knowledge of health professionals with experience of working with ED frequent attenders to understand the challenges of managing this group of patients and their opinions on providing more appropriate support. METHODS: Semi-structured interviews were conducted with medical and nursing ED staff, mental health liaison nurses and general practitioners (GPs)...
August 31, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28845724/adding-insult-to-brain-injury-young-adults-experiences-of-residing-in-nursing-homes-following-acquired-brain-injury
#12
Aoife Dwyer, Caroline Heary, Marcia Ward, Pádraig MacNeela
PURPOSE: There is general consensus that adults under age 65 with acquired brain injury residing in nursing homes is inappropriate, however there is a limited evidence base on the issue. Previous research has relied heavily on third-party informants and qualitative studies have been of questionable methodological quality, with no known study adopting a phenomenological approach. This study explored the lived experiences of young adults with brain injury residing in aged care facilities...
August 28, 2017: Disability and Rehabilitation
https://www.readbyqxmd.com/read/28844979/tailoring-naringenin-conjugates-with-amplified-and-triple-antiplatelet-activity-profile-rational-design-synthesis-human-plasma-stability-and-in-vitro-evaluation
#13
Evgenios Stylos, Maria V Chatziathanasiadou, Antonis Tsiailanis, Tahsin F Kellici, Maria Tsoumani, Androniki D Kostagianni, Maria Deligianni, Alexandros D Tselepis, Andreas G Tzakos
BACKGROUND: The current standard-of-care antiplatelet therapy in cardiovascular disease patients is consisted of cyclooxygenase-1 (COX-1) inhibitor aspirin, along with a platelet receptor P2Y12 antagonist. Recently, the triple antiplatelet therapy with aspirin, a P2Y12 receptor antagonist and a protease activated receptor-1 (PAR-1) antagonist, has been suggested for the secondary prevention of atherothrombotic events, however presented an increased risk of bleeding. Therefore, the quest for novel antiplatelet agents simultaneously targeting the three pathways with improved efficacy/safety profile is of immense importance...
August 24, 2017: Biochimica et Biophysica Acta
https://www.readbyqxmd.com/read/28838647/from-nonclinical-research-to-clinical-trials-and-patient-registries-challenges-and-opportunities-in-biomedical-research
#14
José M de la Torre Hernández, Elazer R Edelman
The most important challenge faced by human beings is health. The only way to provide better solutions for health care is innovation, true innovation. The only source of true innovation is research, good research indeed. The pathway from a basic science study to a randomized clinical trial is long and not free of bumps and even landmines. These are all the obstacles and barriers that limit the availability of resources, entangle administrative-regulatory processes, and restrain investigators' initiatives. There is increasing demand for evidence to guide clinical practice but, paradoxically, biomedical research has become increasingly complex, expensive, and difficult to integrate into clinical care with increased barriers to performing the practical aspects of investigation...
August 21, 2017: Revista Española de Cardiología
https://www.readbyqxmd.com/read/28834162/whither-the-genotype-phenotype-relationship-an-historical-and-methodological-appraisal
#15
Gene S Fisch
More than a century ago, Wilhelm Johannsen proposed the terms "genotype" and "phenotype" to study heredity. Much of what we know about genetics and behavior has evolved since then, especially how causality from genotypes can be inferred from observational studies of phenotypes. Unfortunately, there are genotypes that produce complex clinical-behavioral phenotypes-pleiotropy. In addition, there are often many genotypes that produce the same phenotype, adding a layer of complexity in establishing valid genotype-phenotype relationships...
September 2017: American Journal of Medical Genetics. Part C, Seminars in Medical Genetics
https://www.readbyqxmd.com/read/28808901/the-utility-of-routine-intensive-care-admission-for-patients-undergoing-intracranial-neurosurgical-procedures-a-systematic-review
#16
Cesar Cimonari de Almeida, M Dustin Boone, Yosef Laviv, Burkhard S Kasper, Clark C Chen, Ekkehard M Kasper
BACKGROUND: Patients who have undergone intracranial neurosurgical procedures have traditionally been admitted to an intensive care unit (ICU) for close postoperative neurological observation. The purpose of this study was to systematically review the evidence for routine ICU admission in patients undergoing intracranial neurosurgical procedures and to evaluate the safety of alternative postoperative pathways. METHODS: We were interested in identifying studies that examined selected patients who presented for elective, non-emergent intracranial surgery whose postoperative outcomes were compared as a function of ICU versus non-ICU admission...
August 14, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28794660/a-renal-colic-fast-track-pathway-to-improve-waiting-times-and-outcomes-for-patients-presenting-to-the-emergency-department
#17
Omar Al Kadhi, Kate Manley, Madhavi Natarajan, Valmiki Lutchmedial, Abbi Forsyth, Kate Tabrett, Jonathan Betteridge, William Finch, Heinrich Hollis
INTRODUCTION: Renal colic is commonly encountered in the emergency department (ED). We validated a fast track renal colic (FTRC) initiative to decrease patient waiting times and streamline patient flow. METHOD: The FTRC pathway was devised according to the National Institute for Health and Care Excellence clinical summary criteria for the management of patients with suspected renal colic. ED triage nurses use the pathway to identify patients with likely renal colic suitable for fast track to analgesia, investigation and management...
2017: Open Access Emergency Medicine: OAEM
https://www.readbyqxmd.com/read/28777197/elabela-improves-cardio-renal-outcome-in-fatal-experimental-septic-shock
#18
David Coquerel, Frédéric Chagnon, Xavier Sainsily, Lauralyne Dumont, Alexandre Murza, Jérôme Côté, Robert Dumaine, Philippe Sarret, Éric Marsault, Dany Salvail, Mannix Auger-Messier, Olivier Lesur
OBJECTIVES: Apelin-13 was recently proposed as an alternative to the recommended β-adrenergic drugs for supporting endotoxin-induced myocardial dysfunction. Since Apelin-13 signals through its receptor (Apelin peptide jejunum) to exert singular inotropic/vasotropic actions and to optimize body fluid balance, this candidate pathway might benefit septic shock management. Whether the newly discovered ELABELA (ELA), a second endogenous ligand of the Apelin peptide jejunum receptor highly expressed in the kidney, further improves cardio-renal impairment remains unknown...
August 2, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28764868/modeling-new-immunoregulatory-therapeutics-as-antimicrobial-alternatives-for-treating-clostridium-difficile-infection
#19
Andrew Leber, Raquel Hontecillas, Vida Abedi, Nuria Tubau-Juni, Victoria Zoccoli-Rodriguez, Caroline Stewart, Josep Bassaganya-Riera
The current treatment paradigm in Clostridium difficile infection is the administration of antibiotics contributing to the high rates of recurrent infections. Recent alternative strategies, such as fecal microbiome transplantation and anti-toxin antibodies, have shown similar efficacy in the treatment of C. difficile associated disease (CDAD). However, barriers exist for either treatment or other novel treatments to displace antibiotics as the standard of care. To aid in the comparison of these and future treatments in CDAD, we developed an in silico pipeline to predict clinical efficacy with nonclinical results...
May 2017: Artificial Intelligence in Medicine
https://www.readbyqxmd.com/read/28757175/-main-novelties-of-the-last-set-of-european-guidelines-for-the-management-of-heart-failure
#20
Richard Isnard, Nadjib Hammoudi, Lise Legrand, Françoise Pousset
Heart failure is the main chronic disease in cardiology. Its prognosis remains poor despite improvements in its management that allow patients to live increasingly longer with this disease, alternating periods of stability and episodes of decompensation. Treatment guidelines are regularly updated to integrate new results of recent trials that are likely to influence routine care. These guidelines are proposed with different classes of recommendations and difference levels of evidence. It is of paramount importance to summarize the guidelines to make them accessible to the vast majority of cardiologists and easier to read to promote their application...
July 2017: La Presse Médicale
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