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Severity related outcome

Poul Jennum, Anne Sabers, Jakob Christensen, Rikke Ibsen, Jakob Kjellberg
PURPOSE: Epilepsy surgery has been a standard treatment for refractory epilepsies that cannot be controlled by standard medical treatment. We aimed to evaluate the health and social consequences of resective surgery relative to controls from a study of national data. METHODS: Using the Danish National Patient Registry we identified all subjects with an epilepsy diagnosis between 1996 and 2009 and compared them with a group of patients with an epilepsy diagnosis who had had neither epilepsy surgery nor a vagus stimulation diagnosis by the index date, and who were matched by gender, index year for epilepsy diagnosis, and index year for epilepsy surgery...
October 6, 2016: Seizure: the Journal of the British Epilepsy Association
Peiling Zhou, Sue C Grady
Doctor-patient conflicts in contemporary China are increasing in numbers and severity. This health geographic study shows how hospitals as a type of therapeutic landscape can shape doctor-patient relationships. First, the comprehensive nature of therapeutic landscapes with an emphasis on power operation within symbolic environments is provided as a framework for this study. Second, the results from participant observation and interviews with patients and doctors previously involved in conflicts are reported from Internal Medicine and Surgery Departments, within four hospitals in Anhui Province, Eastern China...
October 19, 2016: Health & Place
Anika Wranke, Beatriz Calle Serrano, Benjamin Heidrich, Janina Kirschner, Birgit Bremer, Patrick Lehmann, Svenja Hardtke, Katja Deterding, Kerstin Port, Max Westphal, Michael P Manns, Markus Cornberg, Heiner Wedemeyer
BACKGROUND: Hepatitis delta is the most severe form of viral hepatitis. Pegylated interferon alfa (PEG- IFNα) is effective in only 25-30% of patients and is associated with frequent side effects. The aim of this study was to analyze the clinical long-term outcome of hepatitis delta in relation to different antiviral treatment strategies. METHODS: We studied 136 anti-HDV-positive patients who were followed for at least 6 months in a retrospective single-center cohort (mean time of follow up 5...
October 22, 2016: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
G Kamkamidze, M Butsashvili, K Gendzekhadze
Hepatitis C virus (HCV) infection remains one of the most important blood-borne diseases worldwide with about 130-170 million people chronically infected with hepatitis C virus, and more than 350 000 people die from hepatitis C-related liver diseases each year. Infection with HCV becomes chronic in approximately 80% of cases, while in up to 20% of cases hepatitis C virus is cleared from the human organism. Chronic infections of hepatitis C often leads to the end-stage liver diseases such as cirrhosis and hepatocellular carcinoma...
September 2016: Georgian Medical News
Nibal R Chamoun, Rony Zeenny, Hanine Mansour
Background Pharmacists' involvement in patient care has improved the quality of care and reduced medication errors. However, this has required a lot of work that could not have been accomplished without documentation of interventions. Several means of documenting errors have been proposed in the literature but without a consistent comprehensive process. Recently, the American College of Clinical Pharmacy (ACCP) recognized that pharmacy practice lacks a consistent process for direct patient care and discussed several options for a pharmaceutical care plan, essentially encompassing medication therapy assessment, development and implementation of a pharmaceutical care plan and finally evaluation of the outcome...
October 21, 2016: International Journal of Clinical Pharmacy
Rodrigo Antonio Rocha da Cruz Adry, Lucas Crociati Meguins, Sebastião Carlos da Silva Júnior, Carlos Umberto Pereira, Gerardo Maria de Araújo Filho, Lúcia Helena Neves Marques
BACKGROUND: Mesial temporal sclerosis (MTS) is the most common disease found in an epilepsy surgery series. Early age of onset, a history of febrile convulsions, epileptiform discharges on EEG, duration of epilepsy, number of generalized seizures and severity of psychiatric disorders are possible prognostic factors in patients with MTS. OBJECTIVE: The aim of this study is to review the clinical, semiotic, psychological, electrophysiological and neuroradiological researches and relate their findings to the prognosis of patients with MTS who underwent anteromedial temporal lobectomy (ATL)...
October 21, 2016: Acta Neurochirurgica
Heather Adams, Pascal Thibault, Tamra Ellis, Emily Moore, Michael Sullivan
Background Catastrophic thinking has been associated with occupational disability in individuals with debilitating pain conditions. The relation between catastrophic thinking and occupational disability has not been previously examined in individuals with debilitating mental health conditions. The present study examined the relation between catastrophic thinking and occupational disability in individuals with major depression. Methods The study sample consisted of 80 work-disabled individuals with major depressive disorder (MDD) who were referred to an occupational rehabilitation service...
October 21, 2016: Journal of Occupational Rehabilitation
Jennifer C Cook, Richard H Tran, J Herbert Patterson, Jo E Rodgers
PURPOSE: The pharmacology, clinical efficacy, and safety profiles of evolving therapies for the management of chronic heart failure (HF) and acute decompensated heart failure (ADHF) are described. SUMMARY: HF confers a significant financial burden despite the widespread use of traditional guideline-directed medical therapies such as angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, β-blockers, and aldosterone receptor antagonists, and the rates of HF-related mortality and hospitalization have remained unacceptably high...
November 1, 2016: American Journal of Health-system Pharmacy: AJHP
Shara I Feld, Sarah E Tevis, Alexander G Cobian, Mark W Craven, Gregory D Kennedy
BACKGROUND: Many studies have evaluated predictors of postoperative complications, yet little is known about the development of multiple complications. The goal of this study was to assess complication timing in cascades of multiple complications and the risk of future complications given a patient's first complication. METHODS: This study includes 30-day, postoperative complications from the American College of Surgeons National Surgical Quality Improvement Program for all patients who underwent major inpatient and outpatient operative procedures from 2005-2013...
October 18, 2016: Surgery
C Franklin, E Livingstone, A Roesch, B Schilling, D Schadendorf
Malignant melanoma contributes the majority of skin cancer related deaths and shows an increasing incidence in the past years. Despite all efforts of early diagnosis, metastatic melanoma still has a poor prognosis and remains a challenge for treating physicians. In recent years, improved knowledge of the pathophysiology and a better understanding of the role of the immune system in tumour control have led to the development and approval of several immunotherapies. Monoclonal antibodies against different immune checkpoints have been revolutionizing the treatment of metastatic and unresectable melanoma...
September 2, 2016: European Journal of Surgical Oncology
Hanna F Skjåkødegård, Yngvild S Danielsen, Mette Morken, Sara-Rebekka F Linde, Rachel P Kolko, Katherine N Balantekin, Denise E Wilfley, Pétur B Júlíusson
BACKGROUND: The purpose of the FABO-study is to evaluate the effect of family-based behavioral social facilitation treatment (FBSFT), designed to target children's family and social support networks to enhance weight loss outcomes, compared to the standard treatment (treatment as usual, TAU) given to children and adolescents with obesity in a routine clinical practice. METHODS: Randomized controlled trial (RCT), in which families (n = 120) are recruited from the children and adolescents (ages 6-18 years) referred to the Obesity Outpatient Clinic (OOC), Haukeland University Hospital, Norway...
October 21, 2016: BMC Public Health
Samuele Zilioli, Ledina Imami, Richard B Slatcher
Social class is a robust predictor of health, with risk for disease and mortality increasing towards the lower end of the socioeconomic (SES) spectrum. While certain psychological characteristics, such as high sense of control, can protect low-SES individuals from adverse health outcomes, very few studies have investigated the biological mechanisms underlying these relationships. In this study, we tested whether sense of control mitigated the associations between SES and cortisol activity, and SES and physical health in daily life (i...
October 6, 2016: Psychoneuroendocrinology
Joseph K Maddry, Alejandra G Mora, Shelia Savell, Lauren K Reeves, Crystal A Perez, Vikhyat S Bebarta
BACKGROUND: Medical evacuation (MEDEVAC) is the movement and en route care of injured and medically compromised patients by medical care providers via helicopter. Military MEDEVAC platforms provide lifesaving interventions that improve survival in combat. There is limited evidence to support decision making related to en route care and allocation of resources. The association between provider type and en route care is not well understood. Our objective was to describe MEDEVAC providers and identify associations between provider type, procedures performed, and outcomes...
November 2016: Journal of Trauma and Acute Care Surgery
Ashleigh A McGirr, Kevin L Schwartz, Upton Allen, Melinda Solomon, Beate Sander
Background Children with cystic fibrosis (CF) are at higher risk of severe respiratory syncytial virus (RSV) infection, which can lead to a decline in lung function. A monoclonal antibody, palivizumab (PMB), effectively prevents RSV hospitalizations; however, the high cost of PMB, approximately C$10,000 per patient per RSV season, limits its widespread use. We assess the cost-effectiveness of PMB prophylaxis in CF children less than 2 years of age from the Canadian healthcare payer's perspective. Methods In 2014, a Markov cohort model of CF disease and infant RSV infections in the Canadian setting was developed based on literature data...
October 21, 2016: Human Vaccines & Immunotherapeutics
Monique Vanaman Wilson, Sabrina Guillen Fabi, Ryan Greene
Importance: The pivotal approval trial for a smooth, highly cohesive, viscous, 20-mg/mL hyaluronic acid filler demonstrated sustained aesthetic improvement, with a mean injection volume of 6.65 mL. In daily practice, however, it is not often practical or necessary to use large injection volumes to achieve the desired cosmetic outcome. Objective: To assess the efficacy, longevity, and patient satisfaction associated with correction of age-related midface volume loss using the low volumes of hyaluronic acid filler more commonly used in day-to-day practice...
October 20, 2016: JAMA Facial Plastic Surgery
Michael D Cusimano, Iryna Pshonyak, Michael Y Lee, Gabriela Ilie
OBJECTIVE The 30-day readmission rate has emerged as an important marker of the quality of in-hospital care in several fields of medicine. This review aims to summarize available research reporting readmission rates after cranial procedures and to establish an association with demographic, clinical, and system-related factors and clinical outcomes. METHODS The authors conducted a systematic review of several databases; a manual search of the Journal of Neurosurgery, Neurosurgery, Acta Neurochirurgica, Canadian Journal of Neurological Sciences; and the cited references of the selected articles...
October 21, 2016: Journal of Neurosurgery
Emily Dalton, Natasha A Lannin, Kate Laver, Leo Ross, Stephen Ashford, Annie McCluskey, Anne Cusick
PURPOSE: The Disabilities of Arm, Shoulder and Hand (DASH) questionnaire is a patient reported outcome measure for evaluating upper limb function in people with musculoskeletal conditions. While the DASH has good psychometric properties when used with people with musculoskeletal conditions, it has not been tested with adults after stroke. METHODS: Data for n = 61 adults following stroke (aged 32-93 years, 44% male) were analyzed to test validity and reliability of the DASH for use with a stroke population...
October 21, 2016: Disability and Rehabilitation
Fernando J Martinez, Jørgen Vestbo, Julie A Anderson, Robert D Brook, Bartolome R Celli, Nicholas J Cowans, Courtney Crim, Mark Dransfield, Sally Kilbride, Julie Yates, David E Newby, Dennis Niewoehner, Peter Ma Calverley
BACKGROUND: Inhaled corticosteroids have been shown to decrease exacerbations in COPD patients with moderate to severe COPD. Their effect in patients with milder airflow obstruction remains unclear. OBJECTIVE: This was an analysis of exacerbations in the Study to Understand Mortality and MorbidITy (SUMMIT) study. DESIGN: In a double-blind randomized controlled trial, once daily inhaled placebo, fluticasone furoate (FF, 100 μg), vilanterol (VI, 25 μg) or the combination (FF/VI) was administered...
October 21, 2016: American Journal of Respiratory and Critical Care Medicine
Maria Elisabeth Moreira, Ana Paula Esteves Pereira, Saint Clair Gomes Junior, Ruth Guinsburg, Maria Fernanda Branco de Almeida, Silvana Granado Gama, Maria do Carmo Leal
BACKGROUND: Approximately 5-10 % of newborns require some form of resuscitationupon delivery; several factors, such as maternal abnormal conditions, gestational age and type of delivery could be responsible for this trend. This study aimed to describe the factors associated with the need for positive pressure ventilation (PPV) via a mask or endotracheal tube and the use of supplemental O2 in newborns with a gestational age greater than 34 weeks in Brazil. METHODS: We performed a cross-sectional study and obtained data from the Birth in Brazil Survey...
October 17, 2016: Reproductive Health
Peter T Theunissen, Sonia Beken, Bruce Beyer, William J Breslin, Gregg D Cappon, Connie L Chen, Gary Chmielewski, Luc de Schaepdrijver, Brian Enright, Jennifer E Foreman, Wafa Harrouk, Kok-Wah Hew, Alan M Hoberman, Julia Y Hui, Thomas B Knudsen, Susan B Laffan, Susan L Makris, Matthew Martin, Mary Ellen McNerney, Christine L Siezen, Dinesh J Stanislaus, Jane Stewart, Kary E Thompson, Belen Tornesi, Jan Willem Van der Laan, Gerhard F Weinbauer, Sandra Wood, Aldert H Piersma
A database of embryo-fetal developmental toxicity (EFDT) studies of 379 pharmaceutical compounds in rat and rabbit was analyzed for species differences based on toxicokinetic parameters of area under the curve (AUC) and maximum concentration (Cmax) at the developmental lowest adverse effect level (dLOAEL). For the vast majority of cases (83% based on AUC of n = 283), dLOAELs in rats and rabbits were within the same order of magnitude (less than 10-fold different) when compared based on available data on AUC and Cmax exposures...
October 21, 2016: Critical Reviews in Toxicology
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