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https://www.readbyqxmd.com/read/28434458/relationship-between-state-malpractice-environment-and-quality-of-health-care-in-the-united-states
#1
Karl Y Bilimoria, Jeanette W Chung, Christina A Minami, Min-Woong Sohn, Emily S Pavey, Jane L Holl, Michelle M Mello
BACKGROUND: One major intent of the medical malpractice system in the United States is to deter negligent care and to create incentives for delivering high-quality health care. A study was conducted to assess whether state-level measures of malpractice risk were associated with hospital quality and patient safety. METHODS: In an observational study of short-term, acute-care general hospitals in the United States that publicly reported in the Centers for Medicaid & Medicare Services Hospital Compare in 2011, hierarchical regression models were used to estimate associations between state-specific malpractice environment measures (rates of paid claims, average Medicare Malpractice Geographic Practice Cost Index [MGPCI], absence of tort reform laws, and a composite measure) and measures of hospital quality (processes of care, imaging utilization, 30-day mortality and readmission, Agency for Healthcare Research and Quality Patient Safety Indicators, and patient experience from the Hospital Consumer Assessment of Healthcare Providers and Systems [HCAHPS])...
May 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28421999/use-and-withdrawal-of-immunosuppressors-in-primary-sj%C3%A3-gren-s-syndrome
#2
Jiram Torres-Ruiz, David Faz-Muñoz, Nora Hernández-Díaz, Gabriela Hernandez-Molina
OBJECTIVES: To assess the use and causes of withdrawal of glucocorticoids and immunosuppressors among patients with primary Sjögren's syndrome (pSS) in the clinical setting. METHODS: We retrospectively reviewed the medical records of 155 pSS patients and registered demographics, glandular/extraglandular features, serological data, cumulative ESSDAI and SSDDI. A single rheumatologist attributed the indication and cause of withdrawal of glucocorticoids and immunosuppressors...
April 18, 2017: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/28402417/grandmaternal-smoke-exposure-reduces-female-fertility-in-a-murine-model-with-great-grandmaternal-smoke-exposure-unlikely-to-have-an-effect
#3
N J Camlin, A G Jarnicki, R L Vanders, K A Walters, P M Hansbro, E A McLaughlin, J E Holt
STUDY QUESTION: What effect does multigenerational (F2) and transgenerational (F3) cigarette smoke exposure have on female fertility in mice? SUMMARY ANSWER: Cigarette smoking has a multigenerational effect on female fertility. WHAT IS KNOWN ALREADY: It has been well established that cigarette smoking decreases female fertility. Furthermore, a growing body of evidence suggests that smoking during pregnancy decreases the fertility of daughters and increases cancer and asthma incidence in grandchildren and great-grandchildren...
April 10, 2017: Human Reproduction
https://www.readbyqxmd.com/read/28397881/a-promising-biodegradable-magnesium-alloy-suitable-for-clinical-vascular-stent-application
#4
Lin Mao, Li Shen, Jiahui Chen, Xiaobo Zhang, Minsuk Kwak, Yu Wu, Rong Fan, Lei Zhang, Jia Pei, Guangyin Yuan, Chengli Song, Junbo Ge, Wenjiang Ding
We report a Mg alloy Mg-2.2Nd-0.1Zn-0.4Zr (wt.%, denoted as JDBM-2) showing great potential in clinical vascular stent application by integrating the advantages of traditional medical stainless steel and polymer. This alloy exhibits high yield strength and elongation of 276 ± 6 MPa and 34.3 ± 3.4% respectively. The JDBM-2 with a stable degradation surface results in a highly homogeneous degradation mechanism and long-term structural and mechanical durability. In vitro cytotoxicity test of the Mg extract via human vascular endothelial cells (HUVECs) indicates that the corrosion products are well tolerated by the tested cells and potentially negligible toxic effect on arterial vessel walls...
April 11, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28350752/the-yield-of-endoscopic-investigation-for-unintentional-weight-loss
#5
Naim Abu-Freha, Yotam Lior, Shira Shoher, Victor Novack, Alexander Fich, Alexander Rosenthal, Ohad Etzion
AIM: The aim of this study was to assess the yield of endoscopic evaluation in isolated unintentional weight loss (UWL) patients compared with patients with weight loss and additional symptoms or signs. PATIENTS AND METHODS: A retrospective review of all patients who underwent an endoscopic evaluation for the investigation of UWL at Soroka University Medical Center between 2006 and 2012. Data on clinical indication, endoscopic, and laboratory finding were retrieved...
May 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28324800/breast-textiloma-an-unending-medico-legal-issue-about-a-case-report
#6
Marwa Boussaid, Med Amin Mesrati, Rania Jouirou, Nouha Abdejlil, Abdelfeteh Zakhama, Ali Chadly, Abir Aissaoui
INTRODUCTION: Textiloma is a mass composed of retained surgical textile foreign body. It is a rare iatrogenic complication that can engage the doctor's responsibility. The aim of this manuscript is to report an unusual case of breast Textiloma mimicking a recurrent tumor and to highlight its medico-legal implications. PRESENTATION OF CASE: A 47-year-old lady, without past medical history, was diagnosed with a breast infiltring intraductal carcinoma. She was treated with mastectomy...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28320115/reversible-cerebral-vasoconstriction-syndrome-in-puerperium-a-prospective-study
#7
Gian Paolo Anzola, Renato Brighenti, Milena Cobelli, Alessia Giossi, Sara Mazzucco, Silvia Olivato, Elisa Pari, Maria Paola Piras, Alessandro Padovani, Fabrizio Rinaldi, Giulia Turri
BACKGROUND AND AIM OF THE STUDY: Reversible cerebral vasoconstriction syndrome (RCVS) is characterized by severe "thunderclap" headache, with or without associated neurological symptoms and neuroimaging findings of reversible vasoconstriction of cerebral arteries. Puerperium is a recognized precipitant, but the incidence of puerperal RCVS is unknown. We conducted a prospective study to assess incidence, risk factors and clinical features of RCVS. MATERIAL AND METHOD: Nine-hundred consecutive puerperae were prospectively enrolled within three days of delivery...
April 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28295312/young-adult-outcomes-in-the-follow-up-of-the-multimodal-treatment-study-of-attention-deficit-hyperactivity-disorder-symptom-persistence-source-discrepancy-and-height-suppression
#8
James M Swanson, L Eugene Arnold, Brooke S G Molina, Margaret H Sibley, Lily T Hechtman, Stephen P Hinshaw, Howard B Abikoff, Annamarie Stehli, Elizabeth B Owens, John T Mitchell, Quyen Nichols, Andrea Howard, Laurence L Greenhill, Betsy Hoza, Jeffrey H Newcorn, Peter S Jensen, Benedetto Vitiello, Timothy Wigal, Jeffery N Epstein, Leanne Tamm, Kimberly D Lakes, James Waxmonsky, Marc Lerner, Joy Etcovitch, Desiree W Murray, Maximilian Muenke, Maria T Acosta, Mauricio Arcos-Burgos, William E Pelham, Helena C Kraemer
BACKGROUND: The Multimodal Treatment Study (MTA) began as a 14-month randomized clinical trial of behavioral and pharmacological treatments of 579 children (7-10 years of age) diagnosed with attention-deficit/hyperactivity disorder (ADHD)-combined type. It transitioned into an observational long-term follow-up of 515 cases consented for continuation and 289 classmates (258 without ADHD) added as a local normative comparison group (LNCG), with assessments 2-16 years after baseline. METHODS: Primary (symptom severity) and secondary (adult height) outcomes in adulthood were specified...
March 10, 2017: Journal of Child Psychology and Psychiatry, and Allied Disciplines
https://www.readbyqxmd.com/read/28279497/hyperoxia-at-what-level-of-spo2-is-a-patient-safe-a-study-in-mechanically-ventilated-icu-patients
#9
E M J Durlinger, A M E Spoelstra-de Man, B Smit, H J de Grooth, A R J Girbes, H M Oudemans-van Straaten, Y M Smulders
BACKGROUND: Concerns have been expressed regarding a possible association between arterial hyperoxia and adverse outcomes in critically ill patients. Oxygen status is commonly monitored noninvasively by peripheral saturation monitoring (SpO2). However, the risk of hyperoxia above specific SpO2 levels in critically ill patients is unknown. The purpose of this study was to determine a threshold value of SpO2 above which the prevalence of arterial hyperoxia distinctly increases. METHODS: This is a cross-sectional study in adult mechanically ventilated intensive care patients in a tertiary referral center...
June 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28254765/biological-therapies-in-nonsmall-cell-lung-cancer
#10
REVIEW
Jon Zugazagoitia, Sonia Molina-Pinelo, Fernando Lopez-Rios, Luis Paz-Ares
Biological therapies have improved survival outcomes of advanced-stage nonsmall cell lung cancer (NSCLC). Genotype-directed therapies have changed treatment paradigms of patients with EGFR-mutant and ALK/ROS1-rearranged lung adenocarcinomas, and the list of druggable targets with demonstrated clinical actionability (BRAF, MET, RET, NTRK1 and HER2) continues to expand. Furthermore, we have incrementally understood the mechanisms of cancer immune evasion and foresee ways to effectively circumvent them, particularly at the immune checkpoint level...
March 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/28249621/association-between-routine-laboratory-tests-and-long-term-mortality-among-acutely-admitted-older-medical-patients-a-cohort-study
#11
Henrik Hedegaard Klausen, Janne Petersen, Thomas Bandholm, Helle Gybel Juul-Larsen, Juliette Tavenier, Jesper Eugen-Olsen, Ove Andersen
BACKGROUND: Older people have the highest incidence of acute medical admissions. Old age and acute hospital admissions are associated with a high risk of adverse health outcomes after discharge, such as reduced physical performance, readmissions and mortality. Hospitalisations in this population are often by acute admission and through the emergency department. This, along with the rapidly increasing proportion of older people, warrants the need for clinically feasible tools that can systematically assess vulnerability in older medical patients upon acute hospital admission...
March 1, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28214968/piloting-the-use-of-patient-specific-cardiac-models-as-a-novel-tool-to-facilitate-communication-during-cinical-consultations
#12
Giovanni Biglino, Despina Koniordou, Marisa Gasparini, Claudio Capelli, Lindsay-Kay Leaver, Sachin Khambadkone, Silvia Schievano, Andrew M Taylor, Jo Wray
This pilot study aimed to assess the impact of using patient-specific three-dimensional (3D) models of congenital heart disease (CHD) during consultations with adolescent patients. Adolescent CHD patients (n = 20, age 15-18 years, 15 male) were asked to complete two questionnaires during a cardiology transition clinic at a specialist centre. The first questionnaire was completed just before routine consultation with the cardiologist, the second just after the consultation. During the consultation, each patient was presented with a 3D full heart model realised from their medical imaging data...
February 18, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28210286/bilastine-in-allergic-rhinoconjunctivitis-and-urticaria-a-practical-approach-to-treatment-decisions-based-on-queries-received-by-the-medical-information-department
#13
REVIEW
Amalia Leceta, Ander Sologuren, Román Valiente, Cristina Campo, Luis Labeaga
BACKGROUND: Bilastine is a safe and effective commonly prescribed non-sedating H1-antihistamine approved for symptomatic treatment in patients with allergic disorders such as rhinoconjunctivitis and urticaria. It was evaluated in many patients throughout the clinical development required for its approval, but clinical trials generally exclude many patients who will benefit in everyday clinical practice (especially those with coexisting diseases and/or being treated with concomitant drugs)...
2017: Drugs in Context
https://www.readbyqxmd.com/read/28196544/diagnostic-error-in-the-emergency-department-follow-up-of-patients-with-minor-trauma-in-the-outpatient-clinic
#14
Pieter-Jan Moonen, Luc Mercelina, Willem Boer, Tom Fret
BACKGROUND: The Emergency Department (ED) is prone to diagnostic error. Most frequent diagnostic errors involved "minor" trauma. Our goal was to determine how frequently a missed diagnosis was detected during follow up and to determine the frequency and causes of primary missed diagnosis and diagnostic error. METHODS: A retrospective single centre study review, during 6 months including all patients presenting to the outpatient clinic after ED admission with a minor trauma...
February 14, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28196503/validation-of-the-generic-medical-interview-satisfaction-scale-the-g-miss-questionnaire
#15
MULTICENTER STUDY
Axel Maurice-Szamburski, Pierre Michel, Anderson Loundou, Pascal Auquier
BACKGROUND: Patients have about seven medical consultations a year. Despite the importance of medical interviews in the healthcare process, there is no generic instrument to assess patients' experiences in general practices, medical specialties, and surgical specialties. The main objective was to validate a questionnaire assessing patients' experiences with medical consultations in various practices. METHOD: The G-MISS study was a prospective multi-center trial that enrolled patients from May to July 2016...
February 14, 2017: Health and Quality of Life Outcomes
https://www.readbyqxmd.com/read/28185680/recurrent-pericarditis
#16
M Imazio, A Battaglia, L Gaido, F Gaita
Recurrent pericarditis is the most troublesome complication of pericarditis occurring in 15 to 30% of cases. The pathogenesis is often presumed to be immune-mediated although a specific rheumatologic diagnosis is commonly difficult to find. The clinical diagnosis is based on recurrent pericarditis chest pain and additional objective evidence of disease activity (e.g. pericardial rub, ECG changes, pericardial effusion, elevation of markers of inflammation, and/or imaging evidence of pericardial inflammation by CT or cardiac MR)...
May 2017: La Revue de Médecine Interne
https://www.readbyqxmd.com/read/28185463/-lymphoedema-following-regional-lymph-node-surgery-for-breast-cancer
#17
P Vrtělová, O Coufal, V Fait, L Gabrielová, O Zapletal
BACKGROUND: The treatment of breast cancer is based on the multimodal principle and surgery of regional lymph nodes is an inseparable part of this. Indication criteria are changing constantly folowing advances in other modalities. It is necessary to consider not only the diagnostic or therapeutic benefit but also to take into account adverse effects. Previous studies have demonstrated that axillary dissection (ALND) is burdened by a high frequency of chronic lymphoedema of the arm or chest wall; however, a considerable percentage of patients may also suffer from lymphoedema after sentinel lymph node biopsy (SLNB)...
2017: Klinická Onkologie: Casopis Ceské a Slovenské Onkologické Spolecnosti
https://www.readbyqxmd.com/read/28163146/the-subcutaneous-icd-as-an-alternative-to-the-conventional-icd-system-initial-experience-in-greece-and-review-of-the-literature
#18
REVIEW
Skevos Sideris, Stefanos Archontakis, Konstantinos A Gatzoulis, Aristotelis Anastasakis, Ilias Sotiropoulos, Petros Arsenos, Alexandros Kasiakogias, Dimitrios Terentes, Konstantinos Trachanas, Eleftherios Paschalidis, Dimitrios Tousoulis, Ioannis Kallikazaros
The introduction of the implantable cardioverter defibrillator (ICD) in clinical practice has revolutionized our therapeutic approach for sudden cardiac death (SCD) both in the context of primary and secondary prevention, since it has proven to be superior to medical therapy in treating potentially life-threatening ventricular arrhythmias, resulting in reduced mortality rates. However, conventional ICDs' implantation carries a not negligible risk of periprocedural and long-term complications associated with the transvenous ICD leads...
February 2, 2017: Hellenic Journal of Cardiology: HJC, Hellēnikē Kardiologikē Epitheōrēsē
https://www.readbyqxmd.com/read/28065953/self-evaluation-of-ethical-review-committees-functioning-at-foundation-university-medical-college-fumc-through-structured-constitution-practice-outcome-cpo-assessment-model
#19
Sadia Ahsin, Gul E Naghma Saeed
OBJECTIVE: To assess the operational efficiency of the ethical review committee of a medical college. METHODS: This study was conducted at the Foundation University Medical College, Islamabad, Pakistan, from 2012 to 2014. On the basis of literature review, methods for assessment of various features of ethical review committee were studied. A constitution-practice-outcome measurement model for evaluation of ethical review committee assessment process was developed...
January 2017: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/28051973/legal-blood-alcohol-testing-in-the-u-s-military
#20
Peter L Platteborze, Kelly W Wilhelms
OBJECTIVE: To retrospectively analyze multiple years of legal blood alcohol test (LBAT) results as part of a laboratory process improvement plan. METHODS: We analyzed the LBAT requests received by the Brooke Army Medical Center during calendar years 2013 and 2014. RESULTS: We received 365 samples from 11 installations; 351 were tested and 14 were rejected. Nearly one-third of the tested samples had negligible ethanol levels. One installation was responsible for submitting 10 rejected samples which prompted laboratory intervention...
January 2017: Military Medicine
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