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https://www.readbyqxmd.com/read/29166305/botulinum-toxin-therapy-is-syringe-type-related-to-cost-effectiveness
#1
Mark Anthony Foglietti, Lauren Wright, Alanna Foglietti-Fostyk
INTRODUCTION: Clostridium botulinum toxin is effective through cleaving presynaptic proteins at the neuromuscular junction, which prevents the release of acetylcholine and inhibits muscle contraction. Several serotypes of botulinum toxin (BT) exist; however, only 2 types have been approved by the US Food and Drug Administration for commercial and medical use, A and B. Both types of BT must be administered intramuscularly with a syringe, but the type of syringe is the injector's preference...
November 21, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29165600/missed-opportunities-to-identify-occupational-asthma-in-acute-secondary-care
#2
P R Ellis, G I Walters
Background: Occupational asthma (OA) accounts for one in six cases of new-onset adult asthma. Despite this it remains under-recognized in the UK. Delayed and missed diagnoses of OA lead to poor health outcomes for workers at significant cost to the UK economy. The burden of occupational aetiology on hospital admissions with asthma is not known. Aims: To measure how frequently medical professionals consider occupational aetiology in patients presenting to secondary care with acute asthma symptoms...
November 18, 2017: Occupational Medicine
https://www.readbyqxmd.com/read/29165101/therapeutic-potentials-and-cytochrome-p450-mediated-interactions-involving-herbal-products-indicated-for-diabetes-mellitus
#3
Cyprian Ogbonna Onyeji, Sharon I Igbinoba, Gbola Olayiwola
There has been an increase in the use of herbal products to complement conventional drugs in the treatment of various diseases especially in developing countries. This may be attributable to the relatively cost-effectiveness and ease of accessibility of these products as well as the perception of their safety profiles. However, there are numerous literature reports on herbs altering the pharmacokinetics and pharmacodynamics of other co-administered drugs thereby modulating the therapeutic outcomes. The prevalence of diabetes is on a steady increase worldwide and it is now identified as one of the main threats to human health...
November 20, 2017: Drug Metabolism Letters
https://www.readbyqxmd.com/read/29164650/market-share-and-costs-of-biologic-therapies-for-inflammatory-bowel-disease-in-the-usa
#4
H Yu, D MacIsaac, J J Wong, Z M Sellers, A A Wren, R Bensen, C Kin, K T Park
BACKGROUND: Real-world data quantifying the costs of increasing use of biologics in inflammatory bowel disease (IBD) are unknown. AIM: To determine the outpatient IBD drug utilization trends, relative market share, and costs in the USA during a 9-year period. METHODS: The Truven MarketScan(®) Database was analysed for patients with Crohn's disease (CD) and ulcerative colitis (UC) during 2007-2015. National drug codes were used to identify prescription drugs; Healthcare Common Procedure Coding System J-codes were used to capture biologic out-patient infusions...
November 22, 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/29164542/-vr-and-ar-applications-in-medical-practice-and-education
#5
Min-Chai Hsieh, Yu-Hsuan Lin
As technology advances, mobile devices have gradually turned into wearable devices. Furthermore, virtual reality (VR), augmented reality (AR), and mixed reality (MR) are being increasingly applied in medical fields such as medical education and training, surgical simulation, neurological rehabilitation, psychotherapy, and telemedicine. Research results demonstrate the ability of VR, AR, and MR to ameliorate the inconveniences that are often associated with traditional medical care, reduce incidents of medical malpractice caused by unskilled operations, and reduce the cost of medical education and training...
December 2017: Hu Li za Zhi the Journal of Nursing
https://www.readbyqxmd.com/read/29164489/antimicrobial-stewardship-opportunities-in-critically-ill-patients-with-gram-negative-lower-respiratory-tract-infections-a-multicenter-cross-sectional-analysis
#6
Kimberly C Claeys, Evan J Zasowski, Trang D Trinh, Abdalhamid M Lagnf, Susan L Davis, Michael J Rybak
INTRODUCTION: Lower respiratory tract infections (LRTIs) are a major cause of morbidity and death. Because of changes in how LRTIs are defined coupled with the increasing prevalence of drug resistance, there is a gap in knowledge regarding the current burden of antimicrobial use for Centers for Disease Control and Prevention (CDC)-defined LRTIs. We describe the infection characteristics, antibiotic consumption, and clinical and economic outcomes of patients with Gram-negative (GN) LRTIs treated in intensive care units (ICUs)...
November 21, 2017: Infectious Diseases and Therapy
https://www.readbyqxmd.com/read/29164374/fixed-dose-4-factor-prothrombin-complex-concentrate-for-the-emergent-reversal-of-warfarin-a-retrospective-analysis
#7
Greta Astrup, Preeyaporn Sarangarm, Allison Burnett
Published literature suggests that a fixed-dose 4-factor prothrombin complex concentrate (4FPCC) may be efficacious in managing warfarin-associated hemorrhage, however the ideal dose is still unclear. The purpose of this evaluation was to determine the efficacy of fixed-dose 4FPCC in reducing the International Normalized Ratio (INR) to ≤ 1.5 among warfarin patients with need for urgent or emergent anticoagulation reversal. Starting October 2016, our institution changed from standard 4FPCC FDA-labeled dosing based on the patient's presenting INR and weight, to a fixed-dose of 1500 units for all patients requiring urgent or emergent warfarin reversal...
November 21, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/29164295/the-economic-and-social-burden-of-traumatic-injuries-evidence-from-a-trauma-hospital-in-port-au-prince-haiti
#8
Christopher Zuraik, John Sampalis, Alexa Brierre
INTRODUCTION: The cost of traumatic injury is unknown in Haiti. This study aims to examine the burden of traumatic injury of patients treated and evaluated at a trauma hospital in the capital city of Port-au-Prince. METHODS: A retrospective cross-sectional chart review study was conducted at the Hospital Bernard Mevs Project Medishare for all patients evaluated for traumatic injury from December 2015 to January 2016, as described elsewhere (Zuraik and Sampalis in World J Surg, https://doi...
November 21, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29164265/the-power-and-pitfalls-of-big-data-research-in-obstetrics-and-gynecology-a-consumer-s-guide
#9
Amie Goodin, Chris Delcher, Chelsea Valenzuela, Xi Wang, Yanmin Zhu, Dikea Roussos-Ross, Joshua D Brown
Importance: Research in obstetrics and gynecology (OB/GYN) increasingly relies on "big data" and observational study designs. There is a gap in practitioner-relevant guides to interpret and critique such research. Objective: This guide is an introduction to interpreting research using observational data and provides explanations and context for related terminology. In addition, it serves as a guide for critiquing OB/GYN studies that use observational data by outlining how to assess common pitfalls of experimental and observational study designs...
November 2017: Obstetrical & Gynecological Survey
https://www.readbyqxmd.com/read/29163935/the-cost-of-diabetes-in-latin-america-and-the-caribbean-in-2015-evidence-for-decision-and-policy-makers
#10
Alberto Barcelo, Armando Arredondo, Amparo Gordillo-Tobar, Johanna Segovia, Anthony Qiang
BACKGROUND: The financial implications of the increase in the prevalence of diabetes in middle-income countries represents one of the main challenges to health system financing and to the society as a whole. The objective of this study was to estimate the economic cost of diabetes in Latin America and the Caribbean (LAC) in 2015. METHODS: The study used a prevalence-based approach to estimate the direct and indirect costs related to diabetes in 29 LAC countries in 2015...
December 2017: Journal of Global Health
https://www.readbyqxmd.com/read/29163845/improved-medical-expenditure-and-survival-with-integration-of-traditional-chinese-medicine-treatment-in-patients-with-heart-failure-a-nationwide-population-based-cohort-study
#11
Ming-Yen Tsai, Wen-Long Hu, Jen-Huai Chiang, Yu-Chuen Huang, Shih-Yu Chen, Yu-Chiang Hung, Yung-Hsiang Chen
Background: No previous studies have evaluated the effects of traditional Chinese medicine (TCM) treatment on patients with heart failure (HF). Hence, in this study, we determined whether TCM treatment affects the healthcare burden and survival of HF patients. Methods: Samples were retrieved from the registry of catastrophic illness patients of the Taiwan National Health Insurance Research Database (NHIRD). Based on a frequency (1:1) matched case-control design, patients with HF between 2000 and 2010 were designated as cases (TCM users) and controls (non-TCM users)...
October 27, 2017: Oncotarget
https://www.readbyqxmd.com/read/29163728/results-of-a-quality-improvement-project-aimed-at-eliminating-healthcare-waste-by-changing-medical-resident-test-ordering-behavior
#12
Sushilkumar Satish Gupta, Radhika Voleti, Vimbai Nyemba, Selma Demir, Olaoluwatomi Lamikanra, Nomsa Musemwa, Angela Saverimuthu, Kamaldeen Agoro, Robert D Kalter, Peter Homel, Melvyn Hecht, Lawrence B Wolf, Edward K Chapnick, Michael G Kantrowitz, Stephan L Kamholz
Background: In light of rising healthcare costs and evidence of inefficient use of medical resources, there is growing interest in reducing healthcare waste by clinicians. Unwarranted lab tests may lead to further tests, prolonged hospital stays, unnecessary referrals and procedures, patient discomfort, and iatrogenic anemia, resulting in significant economic and clinical effects. Blood tests are essential in guiding medical decisions, but they are also associated with significant financial and clinical costs...
December 2017: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/29162757/low-fidelity-simulation-to-enhance-understanding-of-infection-control-among-undergraduate-medical-students
#13
Suman P Singh, Chirag M Modi, Chirag P Patel, Ajay G Pathak
BACKGROUND: Developing economies are stressing institutional care for better health outcomes but its advantages are dampened by healthcare-associated infections (HAIs). Besides other undesired complications, the economic cost of HAIs is enormous. Developing countries have higher HAI rates compared with Europe or the USA. The knowledge and practice of infection control is poor among medical students. Based on introspection of 'Infection Control Module' for undergraduates introduced in 2012, we tested emotional sensitization using low-fidelity techniques to enhance its effectiveness...
July 2017: National Medical Journal of India
https://www.readbyqxmd.com/read/29162728/evaluating-the-value-of-the-respiratory-therapist-where-is-the-evidence-focus-on-the-barnes-jewish-hospital-experience
#14
Marin H Kollef
Currently, >20 million people in the United States have asthma, and approximately 15 million adults have been diagnosed with COPD, with approximately the same number not yet having been diagnosed with this condition. Moreover, the overall burden of respiratory diseases is still increasing, in part due to environmental factors, such as air pollution. At the same time, the number of patients requiring hospitalization as well as the number of individuals admitted to ICUs from emergency departments has been on the rise over the last decade...
December 2017: Respiratory Care
https://www.readbyqxmd.com/read/29162640/outcomes-of-a-clinical-pathway-to-standardize-use-of-maintenance-intravenous-fluids
#15
Sahar N Rooholamini, Holly Clifton, Wren Haaland, Caitlin McGrath, Surabhi B Vora, Claudia S Crowell, Holly Romero, Jeffrey Foti
OBJECTIVES: Improper use of maintenance intravenous fluids (IVFs) may cause serious hospital-acquired harm. We created an evidence-based clinical pathway to guide providers on the indications for IVF, its preferred composition, and appropriate clinical monitoring. METHODS: Pathway implementation was supported by the creation of an electronic order set (PowerPlan) and hospital-wide education. Outcomes were measured among pathway-eligible patients for the years before (July 1, 2014-June 30, 2015) and after (July 1, 2015-June 30, 2016) implementation...
November 21, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/29162559/enhancing-the-usability-of-an-optical-reader-system-to-support-point-of-care-rapid-diagnostic-testing-an-iterative-design-approach
#16
Jess Hohenstein, Dakota O'Dell, Elizabeth L Murnane, Zhengda Lu, David Erickson, Geri Gay
BACKGROUND: In today's health care environment, increasing costs and inadequate medical resources have created a worldwide need for more affordable diagnostic tools that are also portable, fast, and easy to use. To address this issue, numerous research and commercial efforts have focused on developing rapid diagnostic technologies; however, the efficacy of existing systems has been hindered by usability problems or high production costs, making them infeasible for deployment in at-home, point-of-care (POC), or resource-limited settings...
November 21, 2017: JMIR Human Factors
https://www.readbyqxmd.com/read/29162428/can-mindfulness-training-improve-medication-adherence-integrative-review-of-the-current-evidence-and-proposed-conceptual-model
#17
Elena Salmoirago-Blotcher, Michael P Carey
Medication adherence is a complex, multi-determined behavior that is often influenced by system- (e.g., cost), drug- (e.g., regimen complexity), and patient-related (e.g., depression) factors. System-level approaches (e.g., making medications more affordable) are critically important but do not address patient-level factors that can undermine adherence. In this paper, we identify patient-level determinants of non-adherence and discuss whether mindfulness-training approaches that target these determinants can help to improve adherence to medical treatment...
October 23, 2017: Explore: the Journal of Science and Healing
https://www.readbyqxmd.com/read/29162320/controlled-human-infections-a-report-from-the-controlled-human-infection-models-workshop-leiden-university-medical-centre-4-6-may-2016
#18
Meta Roestenberg, Annie Mo, Peter G Kremsner, Maria Yazdanbakhsh
The principle of deliberately infecting humans with infectious agents in a controlled setting, so-called controlled human infections (CHI), is not novel. Many CHI models have a long history and were established decades ago such as the intentional exposure to yellow fever and dengue performed in the 1900's (Reed, 1902) [2]. In these times bioethics and scientific reasoning were in their infancy. Nowadays, clinical trials are highly regulated and CHI are executed worldwide. Controlled human malaria infections and influenza infections are the two most frequently practiced...
November 18, 2017: Vaccine
https://www.readbyqxmd.com/read/29162145/reducing-hospital-admissions-in-remote-australia-through-the-establishment-of-a-palliative-and-chronic-disease-respite-facility
#19
Timothy A Carey, Mick Arundell, Kellie Schouten, John S Humphreys, Fred Miegel, Simon Murphy, John Wakerman
BACKGROUND: There are limited respite services for palliative care patients and their families in the Northern Territory (NT). The high prevalence of complex chronic diseases, limited access to primary care services, and the poor living situations of many Aboriginal and Torres Strait Islander Australians result in high hospitalisation rates and pressure on tertiary health services. Palliative Care NT identified a need for a flexible, community based, culturally appropriate respite service in Alice Springs...
November 21, 2017: BMC Palliative Care
https://www.readbyqxmd.com/read/29162073/patient-navigation-to-improve-diabetes-outpatient-care-at-a-safety-net-hospital-a-retrospective-cohort-study
#20
Michal Horný, Wiljeana Glover, Gouri Gupte, Aruna Saraswat, Varsha Vimalananda, James Rosenzweig
BACKGROUND: Recent emphasis on value based care and population management, such as Accountable Care Organizations in the United States, promote patient navigation to improve the quality of care and reduce costs. Evidence supporting the efficacy of patient navigation for chronic disease care is limited. The objective of this study was to evaluate the effect of a patient navigation program on medical and administrative outcomes among patients with diabetes in an urban, safety-net hospital clinic setting...
November 21, 2017: BMC Health Services Research
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