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https://www.readbyqxmd.com/read/28738327/updated-concepts-on-treatment-outcomes-for-obstructive-sleep-apnea
#1
Victor Certal, Robson Capasso
Obstructive sleep apnea is a highly prevalent and poorly understood condition that not only leads to significant individual patient health damage, but carries a large societal cost secondary to excessive healthcare utilization, motor-vehicle accidents, and work absenteeism. While a significant fund of knowledge about its damaging effects on the cardiovascular system and neural pathways has been gathered over the past few decades, the translation to direct patient care still presents numerous challenges. With the exception of clear issues such as socially unacceptable snoring and breathing irregularities, the exact cause and effect relationship between airway narrowing, hypoxemia, and sleep fragmentation with subjective sleep-related complaints and neurocognitive symptoms is less clear...
2017: Advances in Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28738035/palliative-care-and-phase-1-trials-intervention-to-improve-quality-of-life-and-provide-education%C3%A2
#2
Betty R Ferrell, Vincent Chung, Marianna Koczywas, Anna Cathy Williams, Denise Gallagher, Patricia Fischer, Thomas J Smith
BACKGROUND: Patients in phase 1 clinical trials often have significant symptom burdens and quality-of-life concerns that increase as they progress along the cancer trajectory and experience drug toxicities from the clinical trial. 
. OBJECTIVES: The interdisciplinary intervention described is aimed at providing optimum palliative care to support patients with solid tumors participating in a phase 1 clinical trial.
. METHODS: The intervention includes a baseline evaluation using quantitative surveys, a comprehensive palliative care assessment by a research nurse based on patient baseline evaluation, and a goals-of-care discussion by the treating oncologist...
August 1, 2017: Clinical Journal of Oncology Nursing
https://www.readbyqxmd.com/read/28737990/cost-effectiveness-of-novel-agents-in-medicare-patients-with-multiple-myeloma-findings-from-a-u-s-payer-s-perspective
#3
Ying Chen, David R Lairson, Wenyaw Chan, Jinhai Huo, Xianglin L Du
BACKGROUND: Since multiple myeloma (MM) incurs a substantial economic burden in care management, more and more discussion has been generated in recent years about the costs of novel antimyeloma drugs and their associated value. Because of these costs, economic assessment that quantifies value of care over the long-term is essential. OBJECTIVE: To determine the cost-effectiveness (measured as cost per life-year saved) of front-line novel agent-based therapy use among a cohort of elderly patients with MM in a real-world setting...
August 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28737983/advancing-patient-care-through-specialty-pharmacy-services-in-an-academic-health-system
#4
Autumn Bagwell, Tara Kelley, Alicia Carver, Jennifer B Lee, Brandon Newman
BACKGROUND: With the rapid growth of specialty pharmacies, including those within academic health systems, pharmacists have the opportunity to improve patient care through the management of specialty medications. Specialty pharmacists within academic health systems are uniquely positioned to overcome restrictions to medication access, financial constraints, and provider burdens that often lead to obstacles for patients to start and maintain necessary treatments. The Vanderbilt Specialty Pharmacy (VSP) model at Vanderbilt University Medical Center (VUMC) provides an example of a patient-centered, collaborative care prototype that places pharmacists directly into specialty clinics to assist with comprehensive management of patients on specialty medications...
August 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28737301/vaccine-preventable-admissions-to-an-irish-paediatric-intensive-care
#5
Y Doyle, M Healy, C McMahon, S Crowe
In the Republic of Ireland, the schedule of state-funded immunisation for children is comprehensive and includes diphtheria, pertussis, tetanus, pneumococcus, hepatitis B, meningococcus C, haemophilus B, polio, measles, rubella and mumps. Varicella and meningococcal B vaccines are commercially available but are not currently funded by the government. Each of the illnesses preventable by these vaccines can cause substantial morbidity, and rarely mortality, in infants and children. Our PICU continues to see serious illness due to avoidable infection...
May 10, 2017: Irish Medical Journal
https://www.readbyqxmd.com/read/28737244/hypoxia-animal-experiments-and-clinical-implications
#6
Yasuyuki Kawagoe, Hiroshi Sameshima
The developing fetus has some unique physiological properties that differ from properties in extra-uterine life. The fetus exists in a hypoxemic condition as a result of the presence of the placenta, which serves as a limiting interface between maternal and fetal circulation. In addition, the fetus is prone to be exposed to uterine contractions, which place it under a further hypoxic burden. Thus, the fetal response to hypoxic insults is important. There has been marked progression in the understanding of fetal physiology since the introduction of the 'chronic preparation model'...
July 24, 2017: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/28736759/forecasted-trends-in-disability-and-life-expectancy-in-england-and-wales-up-to-2025-a-modelling-study
#7
Maria Guzman-Castillo, Sara Ahmadi-Abhari, Piotr Bandosz, Simon Capewell, Andrew Steptoe, Archana Singh-Manoux, Mika Kivimaki, Martin J Shipley, Eric J Brunner, Martin O'Flaherty
BACKGROUND: Reliable estimation of future trends in life expectancy and the burden of disability is crucial for ageing societies. Previous forecasts have not considered the potential impact of trends in disease incidence. The present prediction model combines population trends in cardiovascular disease, dementia, disability, and mortality to forecast trends in life expectancy and the burden of disability in England and Wales up to 2025. METHODS: We developed and validated the IMPACT-Better Ageing Model-a probabilistic model that tracks the population aged 35-100 years through ten health states characterised by the presence or absence of cardiovascular disease, dementia, disability (difficulty with one or more activities of daily living) or death up to 2025, by use of evidence-based age-specific, sex-specific, and year-specific transition probabilities...
July 2017: Lancet. Public Health
https://www.readbyqxmd.com/read/28736236/patients-with-hidradenitis-suppurativa-have-a-high-psychiatric-disease-burden-a-finnish-nationwide-registry-study
#8
Laura Huilaja, Hannu Tiri, Jari Jokelainen, Markku Timonen, Kaisa Tasanen
Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease of hair follicles which is associated with various comorbidities. In order further to clarify the associations between HS and psychiatric disorders, we conducted a nationwide retrospective study that included 4381 patients with HS and 39554 psoriasis and 43248 melanocytic nevi patients as controls. Patient data were obtained from the statutory Finnish Care Register for Health Care. The incidence of HS was 2.7/100,000 persons/year. At least one psychiatric diagnosis was found in 24...
July 20, 2017: Journal of Investigative Dermatology
https://www.readbyqxmd.com/read/28736010/predictors-of-mortality-in-living-donor-liver-transplantation
#9
S Elkholy, S Mogawer, A Hosny, M El-Shazli, U M Al-Jarhi, S Abdel-Hamed, A Salah, N El-Garem, A Sholkamy, M El-Amir, M S Abdel-Aziz, A Mukhtar, A El-Sharawy, A Nabil
BACKGROUND: Egypt has the highest prevalence of the world hepatitis C virus (HCV) load. Hence, the problem of end-stage liver disease (ESLD) is considered a huge burden on the community. Living donor liver transplantation (LDLT) is the only source of donation in Egypt till now. Survival rates had shown significant improvement in the past decades. This study provides analysis of the mortality rates and possible predictors of mortality following LDLT. It also aids in developing a practical and easy-to-apply risk index for prediction of early mortality...
July 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28735450/prescription-drug-price-paradox-cost-analysis-of-canadian-online-pharmacies-versus-us-medicare-beneficiaries-for-the-top-100-drugs
#10
Sean Hyungwoo Kim, Young Joo Ryu, Na-Eun Cho, Andy Eunwoo Kim, Jongwha Chang
BACKGROUND AND OBJECTIVES: Despite the introduction of Medicare Part D (MPD) and 2012 Affordable Care Act (ACA), patients have a cost burden due to increases in drug prices. To overcome cost barriers, some patients purchase their medications from Canadian online pharmacies as Canadian prescription drug prices are believed to be lower than US prescription drug prices. The objective of this study was to determine which top 100 Medicare drugs can be imported to the USA legally, and to determine which type of prescription drug would be more beneficial to be purchased from Canadian online pharmacies...
July 22, 2017: Clinical Drug Investigation
https://www.readbyqxmd.com/read/28735347/the-impact-of-eldercare-on-adult-children-s-health-and-employment-in-transitional-china
#11
Xiaomei Pei, Hao Luo, Zhiyong Lin, Norah Keating, Janet Fast
This paper explores the content and extent of the burden of caregiving for Chinese families in transition. It sets out to understand how Chinese families manage to balance family caregiving responsibilities with employment, the impact of the existing social institutions on family caregiving practices, and the risks that caregivers have to face. Data were collected from a sample of 214 workers from 14 manufacturing companies in an industrialized city in central China in 2013. Analysis revealed that common types of eldercare were assisting with activities of daily living and medical related care; middle aged employed respondents were most likely to be the caregivers to older family members; financial and time demands of care were challenging for caregivers, but women with more education and a secure job responded to the pressure of care giving better than those with less education and insecure jobs...
July 22, 2017: Journal of Cross-cultural Gerontology
https://www.readbyqxmd.com/read/28734709/worldwide-fracture-prediction
#12
Ghada El-Hajj Fuleihan, Marlene Chakhtoura, Jane A Cauley, Nariman Chamoun
The substantial increase in the burden of non-communicable diseases in general and osteoporosis in particular, necessitates the establishment of efficient and targeted diagnosis and treatment strategies. This chapter reviews and compares different tools for osteoporosis screening and diagnosis; it also provides an overview of different treatment guidelines adopted by countries worldwide. While access to dual-energy X-ray absorptiometry to measure bone mineral density (BMD) is limited in most areas in the world, the introduction of risk calculators that combine risk factors, with or without BMD, have resulted in a paradigm shift in osteoporosis screening and management...
July 19, 2017: Journal of Clinical Densitometry
https://www.readbyqxmd.com/read/28734682/how-have-systematic-priority-setting-approaches-influenced-policy-making-a-synthesis-of-the-current-literature
#13
REVIEW
Lydia Kapiriri, Donya Razavi
BACKGROUND: There is a growing body of literature on systematic approaches to healthcare priority setting from various countries and different levels of decision making. This paper synthesizes the current literature in order to assess the extent to which program budgeting and marginal analysis (PBMA), burden of disease & cost-effectiveness analysis (BOD/CEA), multi-criteria decision analysis (MCDA), and accountability for reasonableness (A4R), are reported to have been institutionalized and influenced policy making and practice...
July 12, 2017: Health Policy
https://www.readbyqxmd.com/read/28734109/the-cost-of-oropharyngeal-cancer-in-england-a-retrospective-hospital-data-analysis
#14
Sam T Keeping, Michael J Tempest, Stephanie J Stephens, Stuart M Carroll, Richard Simcock, Terence M Jones, Richard Shaw
OBJECTIVES: To estimate the total costs of treating head and neck cancers, specifically oropharyngeal, laryngeal and oral cavity cancer, in secondary care facilities in England during the period 2006/2007 to 2010/2011. DESIGN: Patient records were extracted from an English hospital database to estimate the number of patients treated for oropharyngeal, laryngeal and oral cavity cancer in England. Identified resource use was linked to published United Kingdom cost estimates to quantify the reimbursement of treatment through the Payment by Results system...
July 22, 2017: Clinical Otolaryngology
https://www.readbyqxmd.com/read/28733759/management-of-gait-changes-and-fall-risk-in-mci-and-dementia
#15
REVIEW
Gilles Allali, Joe Verghese
Gait disorders and falls are very prevalent in aging, especially in older adults with cognitive impairment: older adults with dementia are 2-3 times more likely to fall than their non-demented counterparts. The management of gait disorders and falls in older adults with mild cognitive impairment (MCI) or dementia begins by their identification with the use of specific screening tools, such as measuring gait speed, use of dual-task gait tests, or diagnosing motoric cognitive risk syndrome, a newly described pre-dementia syndrome...
September 2017: Current Treatment Options in Neurology
https://www.readbyqxmd.com/read/28733718/antimicrobial-resistance-in-the-next-30%C3%A2-years-humankind-bugs-and-drugs-a-visionary-approach
#16
REVIEW
Matteo Bassetti, Garyphallia Poulakou, Etienne Ruppe, Emilio Bouza, Sebastian J Van Hal, Adrian Brink
PURPOSE: To describe the current standards of care and major recent advances with regard to antimicrobial resistance (AMR) and to give a prospective overview for the next 30 years in this field. METHODS: Review of medical literature and expert opinion were used in the development of this review. RESULTS: There is undoubtedly a large clinical and public health burden associated with AMR in ICU, but it is challenging to quantify the associated excess morbidity and mortality...
July 21, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28733686/comparison-of-the-proportion-and-healthcare-utilisation-of-adult-patients-with-uncontrolled-severe-asthma-versus-non-severe-asthma-seen-in-a-southeast-asian-hospital-based-respiratory-specialist-clinic
#17
Tunn Ren Tay, Hang Siang Wong, Rosna Ihsan, Hsiao Peng Toh, Xuening Choo, Augustine Kh Tee
INTRODUCTION: Understanding the burden of uncontrolled severe asthma is essential for disease-targeted healthcare planning. There is a scarcity of data regarding the proportion, healthcare utilisation and costs of patients with uncontrolled severe asthma in Asia. This study aimed to plug the knowledge gap in this area. MATERIALS AND METHODS: Consecutive patients with asthma managed in our respiratory specialist clinic were evaluated prospectively. Healthcare utilisation comprising unscheduled asthma-related primary care visits, emergency department (ED) visits and hospital admissions were obtained from the national health records system...
June 2017: Annals of the Academy of Medicine, Singapore
https://www.readbyqxmd.com/read/28733181/caring-for-a-person-with-dementia-on-the-margins-of-long-term-care-a-perspective-on-burden-from-8-european-countries
#18
Caroline Sutcliffe, Clarissa Giebel, Michel Bleijlevens, Connie Lethin, Minna Stolt, Kai Saks, Maria E Soto, Gabriele Meyer, Adelaida Zabalegui, Helen Chester, David Challis
OBJECTIVES: To explore associations between carer burden and characteristics of (1) the informal carer, (2) the person with dementia, and (3) the care support network in 8 European countries. DESIGN: Cross-sectional study. SETTING: People with dementia judged at risk of admission to long-term care (LTC) facilities in 8 European countries (Estonia, Finland, France, Germany, Netherlands, Spain, Sweden, United Kingdom). PARTICIPANTS: A total of 1223 people with dementia supported by community services at home or receiving day care or respite care and their informal carers...
July 18, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28733043/perioperative-hypotension-and-discharge-outcomes-in-non-critically-injured-trauma-patients-a-single-centre-retrospective-cohort-study
#19
Nadav Sheffy, Itay Bentov, Brianna Mills, Bala G Nair, G Alec Rooke, Monica S Vavilala
BACKGROUND: There is a lack of information on the effect of age on perioperative care and outcomes after minor trauma in the elderly. We examined the association between perioperative hypotension and discharge outcome among non-critically injured adult patients. METHODS: We conducted a retrospective study of non-critically ill patients (ISS <9 or discharged within less than 24h) who received anaesthesia care for surgery and Recovery Room care at a level-1 trauma centre between 5/1/2012 and 11/30/2013...
June 24, 2017: Injury
https://www.readbyqxmd.com/read/28732831/initiating-or-changing-to-a-fixed-dose-combination-of-fluticasone-propionate-formoterol-over-fluticasone-propionate-salmeterol-a-real-life-effectiveness-and-cost-impact-evaluation
#20
Simon Wan Yau Ming, John Haughney, Iain Small, Stephanie Wolfe, John Hamill, Kevin Gruffydd-Jones, Cathal Daly, Joan B Soriano, Elizabeth Gardener, Derek Skinner, Martina Stagno d'Alcontres, David B Price
OBJECTIVE: Asthma has a substantial impact on quality of life and health care resources. The identification of a more cost-effective, yet equally efficacious, treatment could positively influence the economic burden of this disease. Fluticasone propionate/Formoterol (FP/FOR) may be as effective as Fluticasone Salmeterol (FP/SAL). We evaluated non-inferiority of asthma control in terms of the proportion of patients free from exacerbations, and conducted a cost impact analysis. METHODS: This historical, matched cohort database study evaluated two treatment groups in the Optimum Patient Care Research Database in the UK: 1) an FP/FOR cohort of patients initiating treatment with FP/FOR or changing from FP/SAL to FP/FOR and; 2) an FP/SAL cohort comprising patients initiating, or remaining on FP/SAL pMDI combination therapy...
August 2017: Respiratory Medicine
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