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https://www.readbyqxmd.com/read/27926555/avoiding-radical-surgery-in-elderly-patients-with-rectal-cancer-is-cost-effective
#1
Christopher Rao, Arthur Sun Myint, Thanos Athanasiou, Omar Faiz, Antony Paul Martin, Brendan Collins, Fraser McLean Smith
BACKGROUND: Radical surgery is associated with significant perioperative mortality in elderly and comorbid populations. Emerging data suggest for patients with a clinical complete response after neoadjuvant chemoradiotherapy that a watch-and-wait approach may provide equivalent survival and oncological outcomes. OBJECTIVE: The purpose of this study was to compare the cost-effectiveness of watch and wait and radical surgery for patients with rectal cancer after a clinical complete response following chemoradiotherapy...
January 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/27924187/evaluating-outcomes-in-patients-with-overactive-bladder-within-an-integrated-healthcare-delivery-system-using-a-treatment-patterns-analyzer
#2
Daniel B Ng, Melissa McCart, Christopher Klein, Chelsey Campbell, Robert Schoenhaus, Todd Berner
BACKGROUND: Overactive bladder (OAB) is a relatively common disease that has been linked to a variety of comorbidities, reductions in quality of life, and increased healthcare costs. Antimuscarinic agents are the standard of care among pharmacologic treatments for OAB, but these drugs are linked to high levels of anticholinergic burden, especially in the elderly. OBJECTIVE: To demonstrate how efficient data analysis can be used to identify gaps in care as a result of improvement strategies for OAB within an integrated healthcare delivery system setting...
September 2016: American Health & Drug Benefits
https://www.readbyqxmd.com/read/27923390/the-rapid-ctca-trial-rapid-assessment-of-potential-ischaemic-heart-disease-with-ctca-a-multicentre-parallel-group-randomised-trial-to-compare-early-computerised-tomography-coronary-angiography-versus-standard-care-in-patients-presenting-with-suspected-or-confirmed
#3
Alasdair J Gray, Carl Roobottom, Jason E Smith, Steve Goodacre, Katherine Oatey, Rachel O'Brien, Robert F Storey, Lumine Na, Steff C Lewis, Praveen Thokala, David E Newby
BACKGROUND: Emergency department attendances with chest pain requiring assessment for acute coronary syndrome (ACS) are a major global health issue. Standard assessment includes history, examination, electrocardiogram (ECG) and serial troponin testing. Computerised tomography coronary angiography (CTCA) enables additional anatomical assessment of patients for coronary artery disease (CAD) but has only been studied in very low-risk patients. This trial aims to investigate the effect of early CTCA upon interventions, event rates and health care costs in patients with suspected/confirmed ACS who are at intermediate risk...
December 7, 2016: Trials
https://www.readbyqxmd.com/read/27920246/beyond-utilization-measuring-effective-coverage-of-obstetric-care-along-the-quality-cascade
#4
Elysia Larson, Daniel Vail, Godfrey M Mbaruku, Redempta Mbatia, Margaret E Kruk
OBJECTIVE: To determine the effective coverage of obstetric care in a rural Tanzanian region and to assess differences in effective coverage by wealth. DESIGN: Cross-sectional structured interviews. SETTING: Pwani Region, Tanzania. PARTICIPANTS: The study includes 24 rural, government-managed, primary healthcare clinics and their catchment populations. From January-April 2016, we conducted a household survey of a census of women with recent deliveries, health worker knowledge surveys and facility audits...
December 4, 2016: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/27914729/operative-team-communication-during-simulated-emergencies-too-busy-to-respond
#5
W Austin Davis, Seth Jones, Adrianna M Crowell-Kuhnberg, Dara O'Keeffe, Kelly M Boyle, Suzanne B Klainer, Douglas S Smink, Steven Yule
BACKGROUND: Ineffective communication among members of a multidisciplinary team is associated with operative error and failure to rescue. We sought to measure operative team communication in a simulated emergency using an established communication framework called "closed loop communication." We hypothesized that communication directed at a specific recipient would be more likely to elicit a check back or closed loop response and that this relationship would vary with changes in patients' clinical status...
November 30, 2016: Surgery
https://www.readbyqxmd.com/read/27913561/hospitals-and-patients-working-in-unity-how-r-u-protocol-for-a-prospective-feasibility-study-of-telephone-peer-support-to-improve-older-patients-quality-of-life-after-emergency-department-discharge
#6
Judy A Lowthian, Alyse Lennox, Andrea Curtis, Jeremy Dale, Colette Browning, De Villiers Smit, Gillian Wilson, Debra O'Brien, Cate Rosewarne, Lee Boyd, Cath Garner, Peter Cameron
INTRODUCTION: Older people presenting to an emergency department (ED) have a higher likelihood of social isolation, loneliness and depression; which are all associated with negative health outcomes and increased health service use, including higher rates of ED attendance. The HOW R U? study aims to ascertain the feasibility and acceptability of a postdischarge telephone support programme for older ED patients following discharge. The intervention, which aims to improve quality of life, will be delivered by hospital-based volunteers...
December 2, 2016: BMJ Open
https://www.readbyqxmd.com/read/27912950/a-randomized-placebo-controlled-trial-of-traditional-chinese-medicine-as-an-add-on-therapy-to-oral-montelukast-in-the-treatment-of-mild-persistent-asthma-in-children
#7
Pak-Hong Chan, Ching-Yee To, Eric Yat-Tung Chan, Handong Li, Xiuxia Zhang, Pok-Yu Chow, Po-Ling Liu, Shuk-Yu Leung, Chung-Hong Chan, Ka-Yan Chan, Johnny Yick-Chun Chan, Jonathan Pak-Heng Ng, Daniel Kwok-Keung Ng
OBJECTIVES: Traditional Chinese medicine are commonly used for treatment of asthma. However, there are only very limited data about its efficacy in children. Therefore, we aimed to determine the efficacy of augmented Yu Ping Feng San (aYPFS) as an add-on to oral montelukast compared with montelukast alone for treatment of mild persistent asthma in children. DESIGN: A single centre, placebo-controlled, double-blinded, randomized control trial was carried out. Participants with age 6-18 years who had mild persistent asthma were randomized according to random number list to receive either aYPFS plus montelukast for 24 weeks or placebo plus montelukast for 24 weeks...
December 2016: Complementary Therapies in Medicine
https://www.readbyqxmd.com/read/27908900/democratic-therapeutic-community-treatment-for-personality-disorder-randomised-controlled-trial
#8
Steve Pearce, Lisle Scott, Gillian Attwood, Kate Saunders, Madeleine Dean, Ritz De Ridder, David Galea, Haroula Konstantinidou, Mike Crawford
BACKGROUND: Democratic therapeutic community (DTC) treatment has been used for many years in an effort to help people with personality disorder. High-quality evidence from randomised controlled trials (RCTs) is absent. AIMS: To test whether DTC treatment reduces use of in-patient services and improves the mental health of people with personality disorder. METHOD: An RCT of 70 people meeting DSM-IV criteria for personality disorder (trial registration: ISRCTN57363317)...
December 1, 2016: British Journal of Psychiatry: the Journal of Mental Science
https://www.readbyqxmd.com/read/27908846/the-effectiveness-of-web-based-asthma-self-management-system-my-asthma-portal-map-a-pilot-randomized-controlled-trial
#9
Sara Ahmed, Pierre Ernst, Susan J Bartlett, Marie-France Valois, Tasneem Zaihra, Guy Paré, Roland Grad, Owis Eilayyan, Robert Perreault, Robyn Tamblyn
BACKGROUND: Whether Web-based technologies can improve disease self-management is uncertain. My Asthma Portal (MAP) is a Web-based self-management support system that couples evidence-based behavioral change components (self-monitoring of symptoms, physical activity, and medication adherence) with real-time monitoring, feedback, and support from a nurse case manager. OBJECTIVE: The aim of this study was to compare the impact of access to a Web-based asthma self-management patient portal linked to a case-management system (MAP) over 6 months compared with usual care on asthma control and quality of life...
December 1, 2016: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/27908624/a-review-of-biomass-burning-emissions-and-impacts-on-air-quality-health-and-climate-in-china
#10
REVIEW
Jianmin Chen, Chunlin Li, Zoran Ristovski, Andelija Milic, Yuantong Gu, Mohammad S Islam, Shuxiao Wang, Jiming Hao, Hefeng Zhang, Congrong He, Hai Guo, Hongbo Fu, Branka Miljevic, Lidia Morawska, Phong Thai, Yun Fat Lam, Gavin Pereira, Aijun Ding, Xin Huang, Umesh C Dumka
Biomass burning (BB) is a significant air pollution source, with global, regional and local impacts on air quality, public health and climate. Worldwide an extensive range of studies has been conducted on almost all the aspects of BB, including its specific types, on quantification of emissions and on assessing its various impacts. China is one of the countries where the significance of BB has been recognized, and a lot of research efforts devoted to investigate it, however, so far no systematic reviews were conducted to synthesize the information which has been emerging...
November 28, 2016: Science of the Total Environment
https://www.readbyqxmd.com/read/27908335/the-past-present-and-future-of-the-centers-for-medicare-and-medicaid-services-quality-measure-sep-1-the-early-management-bundle-for-severe-sepsis-septic-shock
#11
REVIEW
Jeremy S Faust, Scott D Weingart
SEP-1, the new national quality measure on sepsis, resulted from an undertaking to standardize care for severe sepsis and septic shock regardless of the size of the emergency department where the patient is being treated. SEP-1 does not necessarily follow the best current evidence available. Nevertheless, a thorough understanding of SEP-1 is crucial because all hospitals and emergency providers will be accountable for meeting the requirements of this measure. SEP-1 is the first national quality measure on early management of sepsis care...
February 2017: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/27906976/a-laboratory-critical-incident-and-error-reporting-system-for-experimental-biomedicine
#12
Ulrich Dirnagl, Ingo Przesdzing, Claudia Kurreck, Sebastian Major
We here propose the implementation of a simple and effective method to enhance the quality of basic and preclinical academic research: critical incident reporting (CIR). CIR has become a standard in clinical medicine but to our knowledge has never been implemented in the context of academic basic research. We provide a simple, free, open-source software tool for implementing a CIR system in research groups, laboratories, or large institutions (LabCIRS). LabCIRS was developed, tested, and implemented in our multidisciplinary and multiprofessional neuroscience research department...
December 2016: PLoS Biology
https://www.readbyqxmd.com/read/27906602/meta-analysis-of-pre-clinical-trials-of-therapeutic-hypothermia-for-intracerebral-hemorrhage
#13
Kara R Melmed, Patrick D Lyden
Therapeutic hypothermia (TH) is a potent neuroprotectant for experimental ischemic stroke, but studies of TH for intracerebral hemorrhage (ICH) are emerging. We systematically reviewed the experimental literature to assess TH efficacy for ICH. We found 18 suitable papers; quality scores were moderately good. Compared with normothermia, TH reduced measures of edema (mean effect size (95% CI) -1.6873 (-2.3640, -1.0106), p < 0.0001) or blood-brain barrier leakage (p < 0.0001) and improved behavioral outcomes (p < 0...
December 1, 2016: Therapeutic Hypothermia and Temperature Management
https://www.readbyqxmd.com/read/27905620/-the-water-supply-of-a-pediatric-hospital-as-a-possible-source-of-an-outbreak-of-diarrhea-due-to-microsporidium-spp-in-immunocompromised-patients
#14
Paulina Coria, Claudia Urízar, Andrea Alba, Isabel Noemí, Anita Pino, José Luis Cerva
INTRODUCTION: The hospital water supply is a reservoir of a variety of potentially pathogenic microorganisms that can particularly affect children and immunocompromised patients. Potentially pathogenic Microsporidium spp. have been identified in water. Microsporidiosis is an emerging parasitic and opportunistic infection in immunocompromised patients. OBJECTIVE AND METHOD: to describe an outbreak of nosocomial diarrhea due to Microsporidium, species Encephalitozoon intestinalis...
August 2016: Revista Chilena de Infectología: órgano Oficial de la Sociedad Chilena de Infectología
https://www.readbyqxmd.com/read/27900532/mir-148a-the-epigenetic-regulator-of-bone-homeostasis-is-increased-in-plasma-of-osteoporotic-postmenopausal-women
#15
Ajda Bedene, Simona Mencej Bedrač, Lea Ješe, Janja Marc, Peter Vrtačnik, Janez Preželj, Tomaž Kocjan, Tilen Kranjc, Barbara Ostanek
BACKGROUND: Osteoporosis is a prevalent skeletal disorder characterized by reduced bone mineral density and microarchitectural deterioration of bone tissue, resulting in bone fragility and low-trauma fractures. Imaging techniques are routinely used to detect low bone mass; however, they are unable to identify deterioration of bone quality. Recently, microRNAs have emerged as regulators of bone remodelling and potentially also as a new class of sensitive biomarkers of bone health to aid in diagnosis and treatment monitoring of osteoporosis...
November 29, 2016: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/27896771/selective-reaction-monitoring-for-quantitation-of-cellular-proteins
#16
Vitor M Faça
Proteins and proteomes are dynamic and complex. The accurate identification and measurement of their properties such as abundance, location, and turnover are challenging tasks. Even though high-throughput proteomics has significantly evolved, the technique still lacks fully quantitative and reproducible qualities. A mass spectrometry-based targeted proteomic strategy called selective reaction monitoring (SRM) has emerged in recent years as an important multiplex platform to precisely quantify sets of proteins in multiple samples...
2017: Methods in Molecular Biology
https://www.readbyqxmd.com/read/27894349/-when-i-saw-walking-i-just-kind-of-took-it-as-wheeling-interpretations-of-mobility-related-items-in-generic-preference-based-health-state-instruments-in-the-context-of-spinal-cord-injury
#17
Yvonne Anne Michel, Lidia Engel, Kim Rand-Hendriksen, Liv Ariane Augestad, David Gt Whitehurst
BACKGROUND: In health economic analyses, health states are typically valued using instruments with few items per dimension. Due to the generic (and often reductionist) nature of such instruments, certain groups of respondents may experience challenges in describing their health state. This study is concerned with generic, preference-based health state instruments that provide information for decisions about the allocation of resources in health care. Unlike physical measurement instruments, preference-based health state instruments provide health state values that are dependent on how respondents interpret the items...
November 28, 2016: Health and Quality of Life Outcomes
https://www.readbyqxmd.com/read/27894265/long-term-condition-morbidity-in-english-general-practice-a-cross-sectional-study-using-three-composite-morbidity-measures
#18
Charlotte Weston, Alexander Gilkes, Stevo Durbaba, Peter Schofield, Patrick White, Mark Ashworth
BACKGROUND: The burden of morbidity represented by patients with long term conditions (LTCs) varies substantially between general practices. This study aimed to determine the characteristics of general practices with high morbidity burden. METHOD: Retrospective cross-sectional study; general practices in England, 2014/15. Three composite morbidity measures (MMs) were constructed to quantify LTC morbidity at practice level: a count of LTCs derived from the 20 LTCs included in the UK Quality and Outcomes Framework (QOF) disease registers, expressed as 'number of QOF LTCs per 100 registered patients'; the % of patients with one or more QOF LTCs; the % of patients with one or more of 15 broadly defined LTCs included in the GP Patient Survey (GPPS)...
November 29, 2016: BMC Family Practice
https://www.readbyqxmd.com/read/27893213/reliability-and-validity-of-data-obtained-from-alcohol-cannabis-and-gambling-populations-on-amazon-s-mechanical-turk
#19
Hyoun S Kim, David C Hodgins
Researchers recently have begun using Mechanical Turk (MTurk), an online crowdsourcing platform, to recruit addiction populations. However, whether the data obtained from substance users and gamblers on MTurk are reliable and valid is unknown. Herein, we assessed the internal and retest reliability of and concurrent and convergent validity of data obtained from addiction populations on MTurk. Current drinkers (N = 208), cannabis users (N = 200), and gamblers (N = 200) residing in the United States completed measures of alcohol, cannabis, and gambling severity, psychological constructs (e...
November 28, 2016: Psychology of Addictive Behaviors: Journal of the Society of Psychologists in Addictive Behaviors
https://www.readbyqxmd.com/read/27893012/surgeons-and-trauma-care-physicians-perception-of-the-impact-of-the-globalization-of-medical-education-on-quality-of-care-in-lima-peru
#20
Lacey N LaGrone, Leah N Isquith-Dicker, Eduardo Huaman Egoavil, Manuel J A Rodriguez Castro, Alfredo Allagual, Fernando Revoredo, Charles N Mock
Importance: The globalization of medical education-the process by which trainees in any region gain access to international training (electronic or in-person)-is a growing trend. More data are needed to inform next steps in the responsible stewardship of this process, from the perspective of trainees and institutions at all income levels, and for use by national and international policymakers. Objective: To describe the impact of the globalization of medical education on surgical care in Peru from the perspective of Peruvian surgeons who received international training...
November 23, 2016: JAMA Surgery
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