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https://www.readbyqxmd.com/read/29777782/financial-analysis-of-pediatric-resident-physician-primary-care-longitudinal-outpatient-experience
#1
Carole H Stipelman, Brad Poss, Laura Anne Stetson, Luca Boi, Michael Rogers, Caleb Puzey, Sri Koduri, Robert Kaplan, Vivian S Lee, Edward B Clark
PURPOSE: To determine whether residency training represents a net positive or negative cost to academic medical centers, we analyzed the cost of a residency program and clinical productivity of residents and faculty in outpatient primary care practice with or without residents. METHOD: Patient volume and revenue data (Current Procedural Terminology codes) from an academic primary care general pediatric clinic were evaluated for faculty clinics (faculty only) and resident teaching clinics (Longitudinal Outpatient Experience [LOE]) with 1-4 residents/faculty...
May 16, 2018: Academic Pediatrics
https://www.readbyqxmd.com/read/29777740/rapid-response-systems
#2
REVIEW
Patrick G Lyons, Dana P Edelson, Matthew M Churpek
INTRODUCTION: Rapid response systems are commonly employed by hospitals to identify and respond to deteriorating patients outside of the intensive care unit. Controversy exists about the benefits of rapid response systems. AIMS: We aimed to review the current state of the rapid response literature, including evolving aspects of afferent (risk detection) and efferent (intervention) arms, outcome measurement, process improvement, and implementation. DATA SOURCES: Articles written in English and published in PubMed...
May 16, 2018: Resuscitation
https://www.readbyqxmd.com/read/29777729/pharmacogenetic-tests-to-guide-drug-treatment-in-depression-comparison-of-the-available-testing-kits-and-clinical-trials
#3
REVIEW
Chiara Fabbri, Joseph Zohar, Alessandro Serretti
The empirical approach to drug choice and dosing in depression often results into inadequate response and side effects. Pharmacogenetic (PGx) testing appears a promising way to implement personalized treatments. A systematic review was performed to identify available PGx tests, compare the genes they include with clinical guidelines and drug labels, and assess the quality of published clinical studies. ~40 commercial PGx tests are available and potential benefits were estimated for nine of them by clinical studies...
May 16, 2018: Progress in Neuro-psychopharmacology & Biological Psychiatry
https://www.readbyqxmd.com/read/29777504/implementation-and-validation-of-constitutive-relations-for-human-dermis-mechanical-response
#4
Alessandra Aldieri, Mara Terzini, Cristina Bignardi, Elisabetta M Zanetti, Alberto L Audenino
Finite element models in conjunction with adequate constitutive relations are pivotal in several physiological and medical applications related to both native and engineered tissues, allowing to predict the tissue response under various loading states. In order to get reliable results, however, the validation of the constitutive models is crucial. Therefore, the main purpose of this work is to provide an experimental-computational approach to the biomechanical investigation of soft tissues such as the dermis...
May 19, 2018: Medical & Biological Engineering & Computing
https://www.readbyqxmd.com/read/29777464/the-key-features-approach-to-assess-clinical-decisions-validity-evidence-to-date
#5
REVIEW
G Bordage, G Page
The key-features (KFs) approach to assessment was initially proposed during the First Cambridge Conference on Medical Education in 1984 as a more efficient and effective means of assessing clinical decision-making skills. Over three decades later, we conducted a comprehensive, systematic review of the validity evidence gathered since then. The evidence was compiled according to the Standards for Educational and Psychological Testing's five sources of validity evidence, namely, Content, Response process, Internal structure, Relations to other variables, and Consequences, to which we added two other types related to Cost-feasibility and Acceptability...
May 17, 2018: Advances in Health Sciences Education: Theory and Practice
https://www.readbyqxmd.com/read/29776473/surgeons-experience-and-perceived-barriers-with-outpatient-shoulder-arthroplasty
#6
Tyler J Brolin, Ryan M Cox, Benjamin M Zmistowski, Surena Namdari, Gerald R Williams, Joseph A Abboud
BACKGROUND: Recently, outpatient total shoulder arthroplasty (TSA) has been proposed as a safe and cost-effective alternative to the inpatient setting. This study evaluated the expert shoulder surgeon's experience with and perceived barriers to outpatient TSA. METHODS: A secure web application was used to perform an online survey of 484 active American Shoulder and Elbow Surgeons members. The survey assessed surgeon practice demographics, experience with TSA/outpatient TSA, and perceived barriers to successful outpatient TSA...
June 2018: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/29776436/rates-and-causes-of-30-day-readmission-and-emergency-room-utilization-following-head-and-neck-surgery
#7
Vincent Wu, Stephen F Hall
BACKGROUND: Unplanned returns to hospital are common, costly, and potentially avoidable. We aimed to investigate and characterize reasons for all-cause readmissions to hospital as in-patients (IPs) and visits to the Emergency Department (ED) within 30-days following patient discharge post head and neck surgery (HNS). METHODS: Retrospective case series with chart review. All patients within the Department of Otolaryngology - Head and Neck Surgery who underwent HNS for benign and malignant disease from January 1, 2010 to May 31, 2015 were identified...
May 18, 2018: Journal of Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/29776349/randomised-controlled-trial-rct-of-cannabinoid-replacement-therapy-nabiximols-for-the-management-of-treatment-resistant-cannabis-dependent-patients-a-study-protocol
#8
Anjali K Bhardwaj, David J Allsop, Jan Copeland, Iain S McGregor, Adrian Dunlop, Marian Shanahan, Raimondo Bruno, Nghi Phung, Mark Montebello, Craig Sadler, Jessica Gugusheff, Melissa Jackson, Jennifer Luksza, Nicholas Lintzeris
BACKGROUND: The cannabis extract nabiximols (Sativex®) effectively supresses withdrawal symptoms and cravings in treatment resistant cannabis dependent individuals, who have high relapse rates following conventional withdrawal treatments. This study examines the efficacy, safety and cost-effectiveness of longer-term nabiximols treatment for outpatient cannabis dependent patients who have not responded to previous conventional treatment approaches. METHODS/DESIGN: A phase III multi-site outpatient, randomised, double-blinded, placebo controlled parallel design, comparing a 12-week course of nabiximols to placebo, with follow up at 24 weeks after enrolment...
May 18, 2018: BMC Psychiatry
https://www.readbyqxmd.com/read/29775958/a-systematic-review-of-community-based-interventions-to-improve-oral-chronic-disease-medication-regimen-adherence-among-individuals-with-substance-use-disorder
#9
REVIEW
Karen M Clements, Tasmina Hydery, Mark A Tesell, Bonnie C Greenwood, Michael C Angelini
BACKGROUND: Poor medication adherence has been shown to cause medical complications, death, and increased healthcare costs and may be of particular importance in patients with substance use disorder (SUD). Concerns regarding adherence in this population may influence a healthcare provider's decision to prescribe a medication requiring high adherence. Guidance defining best practices that promote adherence among individuals with SUD is lacking. METHODS: A review of English articles in Medline and PsycINFO databases, published between October 1, 1994 and October 31, 2017, was conducted in order to identify studies of interventions intended to improve adherence to oral chronic disease medication regimens among patients with SUD...
May 1, 2018: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/29775206/prospective-determination-of-aspirin-sensitivity-in-patients-resistant-to-low-dose-aspirin-a-proof-of-concept-study
#10
Erica S Westphal, Michelle Rainka, Michelle Amsler, Traci Aladeen, Caitlin Wisniewski, Vernice Bates, Fran M Gengo
This study tested the capability of an assay to predict aspirin response and reduce ischemic events, and healthcare costs, and delays to optimal treatment. Patients who needed aspirin in the course of normal medical care were included. Patients were excluded if they had disorders affecting platelet function, alcohol use within 24 hours of a test, or NSAID use. Dose escalation of chewable aspirin from 81 mg, to 162 mg, to 325 mg daily occurred based on the results of whole blood impedance aggregation testing to the agonists, collagen (1ug/mL, 5 ug/mL) and arachidonate (0...
May 18, 2018: Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29775086/healthcare-utilization-and-costs-of-multiple-sclerosis-patients-in-the-netherlands-a-healthcare-claims-database-study
#11
Servaas Buijs, Marieke Krol, Gert de Voer
AIM: To investigate the incidence and prevalence and healthcare costs of multiple sclerosis (MS) in the Netherlands by using healthcare claims data. MATERIALS & METHODS: A claims database was analyzed including 26% of the Dutch population. RESULTS: Average prevalence of MS in the Netherlands was 88 per 100,000 inhabitants (males 48, 127 females) and incidence nine per 100,000. Yearly per patient medication costs were highest in the year after the first MS claim and then decreased...
May 18, 2018: Journal of Comparative Effectiveness Research
https://www.readbyqxmd.com/read/29775079/improved-glycemic-control-with-minimal-change-in-medication-regimen-complexity-in-a-pharmacist-endocrinologist-diabetes-intense-medical-management-dimm-tune-up-clinic
#12
Candis M Morello, Taylor Rotunno, John Khoan, Jan D Hirsch
BACKGROUND: Gaining glycemic control in patients with type 2 diabetes (T2D) usually requires more complicated medication regimens. Increased medication regimen complexity (MRC) negatively impacts adherence and clinical outcomes. OBJECTIVE: Compare MRC change in patients with uncontrolled T2D referred to a collaborative pharmacist-endocrinologist Diabetes Intense Medical Management (DIMM) clinic "tune up" model versus similar patients receiving usual primary care provider (PCP) care over 6 months...
May 1, 2018: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/29774392/cost-effectiveness-of-ventricular-assist-device-destination-therapy-for-advanced-heart-failure-in-duchenne-muscular-dystrophy
#13
Defne A Magnetta, JaHyun Kang, Peter D Wearden, Kenneth J Smith, Brian Feingold
Destination ventricular assist device therapy (DT-VAD) is well accepted in select adults with medically refractory heart failure (HF) who are not transplant candidates; however, its use in younger patients with progressive diseases is unclear. We sought to evaluate the cost-effectiveness of DT-VAD in Duchenne muscular dystrophy (DMD) patients with advanced HF. We created a Markov-state transition model (5-year horizon) to compare survival, costs, and quality of life (QOL) between medical management and DT-VAD in DMD with advanced HF...
May 17, 2018: Pediatric Cardiology
https://www.readbyqxmd.com/read/29774184/a-systematic-review-of-clinical-value-of-three-dimensional-printing-in-renal-disease
#14
Zhonghua Sun, Dongting Liu
The aim of this systematic review is to analyse current literature related to the clinical value of three-dimensional (3D) printed models in renal disease. A literature search of PubMed and Scopus databases was performed to identify studies reporting the clinical application and usefulness of 3D printed models in renal disease. Fifteen studies were found to meet the selection criteria and were included in the analysis. Eight of them provided quantitative assessments with five studies focusing on dimensional accuracy of 3D printed models in replicating renal anatomy and tumour, and on measuring tumour volume between 3D printed models and original source images and surgical specimens, with mean difference less than 10%...
April 2018: Quantitative Imaging in Medicine and Surgery
https://www.readbyqxmd.com/read/29773763/initial-experience-with-endoscopic-sleeve-gastroplasty-in-poland
#15
Aleksander Sowier, Przemysław Pyda, Anna-Maria Borucka, Sebastian Sowier, Jacek Białecki, Joanna Kapturzak, Stanisław Wójtowicz
INTRODUCTION: Obesity is becoming one of the major public health problems. Bariatric procedures are considered the most effective methods of treating this condition but they are costly and entail a high risk of complications. Thus, there is a need to look for better bariatric treatment solutions. One of the newest, highly promising bariatric methods is endoscopic sleeve gastroplasty (ESG), which is comparably effective to other bariatric procedures in terms of weight loss but at the same time it is much less invasive...
April 30, 2018: Polski Przeglad Chirurgiczny
https://www.readbyqxmd.com/read/29773657/review-of-the-role-of-nice-in-promoting-the-adoption-of-innovative-cardiac-technologies
#16
REVIEW
Peter H Groves, Chris Pomfrett, Mirella Marlow
The National Institute for Health and Care Excellence (NICE) Medical Technologies Evaluation Programme (MTEP) promotes the adoption of innovative diagnostic and therapeutic technologies into National Health Service (NHS) clinical practice through the publication of guidance and briefing documents. Since the inception of the programme in 2009, there have been 7 medical technologiesguidance, 3 diagnostics guidance and 23 medtechinnovation briefing documents published that are relevant to the heart and circulation...
May 17, 2018: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29773527/acceptability-and-feasibility-of-real-time-antiretroviral-therapy-adherence-interventions-in-rural-uganda-mixed-method-pilot-randomized-controlled-trial
#17
Angella Musiimenta, Esther C Atukunda, Wilson Tumuhimbise, Emily E Pisarski, Melanie Tam, Monique A Wyatt, Norma C Ware, Jessica E Haberer
BACKGROUND: Wireless electronic adherence monitors can detect antiretroviral therapy (ART) adherence lapses and trigger interventions in real time, thus potentially avoiding unnecessary HIV viremia. Evidence about the acceptability and feasibility of these monitors and associated interventions, however, is limited. OBJECTIVE: The aim of this study was to assess the acceptability and feasibility of real-time adherence monitoring linked to text messaging (short message service, SMS) reminders and notifications to support adherence among individuals living with HIV who are taking ART in rural southwestern Uganda...
May 17, 2018: JMIR MHealth and UHealth
https://www.readbyqxmd.com/read/29773367/reduction-active-polymeric-prodrug-micelles-based-on-%C3%AE-cyclodextrin-polyrotaxanes-for-triggered-drug-release-and-enhanced-cancer-therapy
#18
Shuang Bai, Meili Hou, Xiaoxiao Shi, Jiucun Chen, Xiaoqian Ma, Yong-E Gao, Yajun Wang, Peng Xue, Yuejun Kang, Zhigang Xu
As one of the medical polymers approved by US Food and Drug Administration (FDA), poly(ethylene glycol) has low toxicity, high stability, good biocompatibility, unique physical and chemical properties. Cyclodextrin is an ideal candidate as a drug carrier due to its special structures and characteristics. These two materials were successfully assembled through chemosynthesis in combination with the hydrophilic poly(ethylene glycol) methyl ether methacrylate (OEGMA) chain and hydrophobic polymeric camptothecin (CPT) chain by atom transfer radical polymerization (ATRP)...
August 1, 2018: Carbohydrate Polymers
https://www.readbyqxmd.com/read/29772995/bilateral-spontaneous-quadriceps-tendon-ruptures-after-staged-bilateral-total-knee-arthroplasties-a-case-report
#19
Marine Coste, Jared M Newman, Neil V Shah, Ahmed M Eldib, Preston W Grieco, Aditya V Maheshwari
Quadriceps tendon ruptures are rare complications of total knee arthroplasty (TKA) and may be associated with preexisting tendon degeneration, vascular injuries during surgery, damage to the quadriceps tendon with over resection of the patella, or incomplete healing after a particular surgical approach. Moreover, postoperative causes include tissue necrosis due to component malalignment, trauma, and infection. Patient factors such as chronic systemic diseases, medications, increased body weight, and sedentary lifestyle could also be responsible...
2018: Journal of Long-term Effects of Medical Implants
https://www.readbyqxmd.com/read/29772991/reconstruction-plate-based-antibiotic-cement-spacers-clinical-outcomes-and-description-of-technique
#20
Aditya V Maheshwari, Robert Pivec, Roby Abraham, Qais Naziri
The standard of care for chronic deep peri-prosthetic hip infection is a two-stage exchange with placement of a temporary antibiotic cement spacer and treatment with intravenous antibiotics. Several commercially available cement spacer options exist. We report on a novel antibiotic spacer that may be an efficient, cost-effective alternative. Medical records of all patients treated for deep peri-prosthetic hip infection after total hip arthroplasty between 2004 and 2012 were reviewed. Each antibiotic spacer was constructed from a 12- to 16-hole recon plate bent to provide adequate soft tissue tension and a cement ball that matched the acetabulum...
2018: Journal of Long-term Effects of Medical Implants
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