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https://www.readbyqxmd.com/read/28437749/epilepsy-awareness-and-emergency-rescue-training-ignorance-is-bliss
#1
Rohit Shankar, Caryn Jory, Brendan McLean, Phil Tittensor, Matthew Walker
Status epilepticus (SE) has a high mortality rate and is associated with complications such as neurological deficit and cognitive decline. Buccal midazolam is the recommended emergency rescue medication in the UK to reduce the duration of a seizure and SE. It should be administered by an appropriately trained person. There are agreed guidelines on training standards for its administration in the UK produced by the Joint Epilepsy Council of the United Kingdom and Ireland. Training should provide an overview of epilepsy to facilitate safe, person-centered care and appropriate administration of rescue medication to people with epilepsy (PWE)...
April 19, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28437620/american-association-of-clinical-endocrinologists-and-american-college-of-endocrinology-guidelines-for-management-of-dyslipidemia-and-prevention-of-cardiovascular-disease
#2
Paul S Jellinger, Yehuda Handelsman, Paul D Rosenblit, Zachary T Bloomgarden, Vivian A Fonseca, Alan J Garber, George Grunberger, Chris K Guerin, David S H Bell, Jeffrey I Mechanick, Rachel Pessah-Pollack, Kathleen Wyne, Donald Smith, Eliot A Brinton, Sergio Fazio, Michael Davidson
OBJECTIVE: The development of these guidelines is mandated by the American Association of Clinical Endocrinologists (AACE) Board of Directors and American College of Endocrinology (ACE) Board of Trustees and adheres with published AACE protocols for the standardized production of clinical practice guidelines (CPGs). METHODS: Recommendations are based on diligent reviews of the clinical evidence with transparent incorporation of subjective factors, according to established AACE/ACE guidelines for guidelines protocols...
April 2017: Endocrine Practice
https://www.readbyqxmd.com/read/28437321/medical-expenditures-associated-with-diabetes-among-youth-with-medicaid-coverage
#3
Sundar S Shrestha, Ping Zhang, Theodore J Thompson, Edward W Gregg, Ann Albright, Giuseppina Imperatore
BACKGROUND: Information on diabetes-related excess medical expenditures for youth is important to understand the magnitude of financial burden and to plan the health care resources needed for managing diabetes. However, diabetes-related excess medical expenditures for youth covered by Medicaid program have not been investigated recently. OBJECTIVE: To estimate excess diabetes-related medical expenditures among youth aged below 20 years enrolled in Medicaid programs in the United States...
April 21, 2017: Medical Care
https://www.readbyqxmd.com/read/28437317/dementia-comorbidity-and-physical-function-in-the-program-of-all-inclusive-care-for-the-elderly
#4
Jason R Falvey, Allison M Gustavson, Lisa Price, Lucine Papazian, Jennifer E Stevens-Lapsley
BACKGROUND: Participants in the Program of All-Inclusive Care for the Elderly (PACE) are a unique clinical population of medically complex and highly disabled older adults who qualify for nursing home level care but receive services in the community. A main goal of PACE programs is to prevent further declines in physical function that may necessitate costly institutionalization. This study evaluates how multimorbidity and dementia impact both self-selected gait speed and Timed Up and Go (TUG) in this population...
April 21, 2017: Journal of Geriatric Physical Therapy
https://www.readbyqxmd.com/read/28437195/home-health-chains-and-practice-patterns-evidence-of-2008-medicare-reimbursement-revision
#5
Sean Shenghsiu Huang, Hyunjee Kim
Home health agencies (HHAs) are known to exploit the Medicare reimbursement schedule by targeting a specific number of therapy visits. These targeting behaviors cause unnecessary medical spending. The Centers for Medicare & Medicaid Services estimates that during fiscal year 2015, Medicare made more than $10 billion in improper payments to HHAs. Better understanding of heterogeneous gaming behaviors among HHAs can inform policy makers to more effectively oversee the home health care industry. This article aims to study how home health chains adjust and adopt new targeting behaviors as compared to independent agencies under the new reimbursement schedule...
February 23, 2017: Population Health Management
https://www.readbyqxmd.com/read/28437150/cost-of-cancer-related-neutropenia-or-fever-hospitalizations-united-states-2012
#6
Eric Tai, Gery P Guy, Angela Dunbar, Lisa C Richardson
PURPOSE: Neutropenia and subsequent infections are life-threatening treatment-related toxicities of chemotherapy. Among patients with cancer, hospitalizations related to neutropenic complications result in substantial medical costs, morbidity, and mortality. Previous estimates for the cost of cancer-related neutropenia hospitalizations are based on older and limited data. This study provides nationally representative estimates of the cost of cancer-related neutropenia hospitalizations...
April 24, 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28436256/clinical-and-economic-impact-of-hyperkalemia-in-patients-with-chronic-kidney-disease-and-heart-failure
#7
Michael Polson, Todd C Lord, Anne Kangethe, Lindsay Speicher, Carolyn Farnum, Melanie Brenner, Nina Oestreicher, Paula Alvarez
BACKGROUND: Hyperkalemia (HK) is a concern for patients with chronic kidney disease (CKD) and heart failure (HF), and for those receiving treatments that inhibit the renin-angiotensin-aldosterone system (RAASi). An analysis of 1.7 million medical records of patients in the United States revealed that among individuals with more than 2 potassium values during 2007 to 2012, HK was detected in 34.6% of patients with CKD and 30.0% of patients with HF. OBJECTIVE: To evaluate the association of HK and use of RAASi therapies at optimal and suboptimal doses in patients with CKD and/or HF with health care resource utilization and overall cost of care in a diverse cohort of commercially insured patients...
April 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28435989/aggressive-medical-management-of-acute-traumatic-subdural-hematomas-before-emergency-craniotomy-in-patients-presenting-with-bilateral-unreactive-pupils-a-cohort-study
#8
Arturo Chieregato, Alessandra Venditto, Emanuele Russo, Costanza Martino, Giovanni Bini
BACKGROUND: The outcome of patients with severe traumatic brain injury (TBI) and acute traumatic subdural hematoma (aSDH) admitted to the emergency room with bilaterally dilated, unreactive pupils (bilateral mydriasis) is notoriously poor. METHODS: Of 2074 TBI patients consecutively admitted to our facility between 1997 and 2012, 115 had a first CT scan with aSDH, unreactive bilateral mydriasis, and a Glasgow Coma Score of 3 or 4. Sixty-two patients were unoperated and died within hours or a few days...
April 24, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28435820/costs-of-hospital-admission-on-primary-immunodeficiency-diseases
#9
Kheirollah Gholami, Elaheh Laali, Hassan Abolhassani, Alireza Ahmadvand, Niayesh Mohebbi, Mohammad Reza Javadi, Asghar Aghamohammadi, Nima Rezaei
BACKGROUND: Primary immunodeficiency diseases (PID) are heterogeneous group of inherited disorders mainly characterized by recurrent infections leading to several times hospital admissions. The economic impact of PID is a challenging issue; therefore, this study was designed to determine the medical costs of hospitalizations in this group of patients as an indicator of the direct cost of these diseases. METHODS: One hundred and ten children with PID hospitalized in the Children's Medical Center Hospital, Tehran, Iran were included in this study during Jan 2011 and Jan 2012...
March 2017: Iranian Journal of Public Health
https://www.readbyqxmd.com/read/28435754/establishing-successful-patient-centered-medical-homes-in-rural-hawai-i-three-strategies-to-consider
#10
Melissa Nelson Scribner, Kasey Kehoe
The challenges to healthcare delivery posed by Hawai'i's unique geography, physician shortages, and dispersed population are of particular importance in light of implementing the Affordable Care Act (ACA). This study draws on central goals laid out in the ACA - to decrease costs, increase access, and improve patient outcomes. The use of the Patient-Centered Medical Homes (PCMHs) is a care model that has the potential to meet all three goals. How to identify the most effective way to develop PCMHs in the specific context of Hawai'i is the focus of this study...
March 2017: Hawai'i Journal of Medicine & Public Health: a Journal of Asia Pacific Medicine & Public Health
https://www.readbyqxmd.com/read/28435690/the-complex-legal-and-ethical-issues-related-to-generic-medications-viral-hepatitis-a-case-study
#11
EDITORIAL
M Danta, N Ghinea
The economic impact of medications is significant, with many countries unable to afford the essential medicines listed by the WHO. Generic medications are one strategy to address this issue. Generic medications are similar to but not the same as originator medications. They have a significant cost advantage because they do not require the background research and development studies to support registration. Consequently, they are gaining increased market share in both the developed and developing world. Many new medications are now licensed to generic manufacturers in the developing world...
April 1, 2017: Journal of Virus Eradication
https://www.readbyqxmd.com/read/28435508/a-novel-collaboration-to-reduce-the-travel-related-cost-of-residency-interviewing
#12
Eric Shappell, Abra Fant, Benjamin Schnapp, Jill P Craig, James Ahn, Christine Babcock, Michael A Gisondi
INTRODUCTION: Interviewing for residency is a complicated and often expensive endeavor. Literature has estimated interview costs of $4,000 to $15,000 per applicant, mostly attributable to travel and lodging. The authors sought to reduce these costs and improve the applicant interview experience by coordinating interview dates between two residency programs in Chicago, Illinois. METHODS: Two emergency medicine residency programs scheduled contiguous interview dates for the 2015-2016 interview season...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28435495/areas-of-potential-impact-of-the-patient-protection-and-affordable-care-act-on-ems-a-synthesis-of-the-literature
#13
REVIEW
Daniel G Ostermayer, Charles A Brown, William G Fernandez, Emily Couvillon
INTRODUCTION: This comprehensive review synthesizes the existing literature on the Patient Protection and Affordable Care Act (ACA) as it relates to emergency medical services (EMS) in order to provide guidance for navigating current and future healthcare changes. METHODS: We conducted a comprehensive review to identify all existing literature related to the ACA and EMS and all sections within the federal law pertaining to EMS. RESULTS: Many changes enacted by the ACA directly affect emergency care with potential indirect effects on EMS systems...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28435492/applying-systems-engineering-reduces-radiology-transport-cycle-times-in-the-emergency-department
#14
Benjamin A White, Brian J Yun, Michael H Lev, Ali S Raja
INTRODUCTION: Emergency department (ED) crowding is widespread, and can result in care delays, medical errors, increased costs, and decreased patient satisfaction. Simultaneously, while capacity constraints on EDs are worsening, contributing factors such as patient volume and inpatient bed capacity are often outside the influence of ED administrators. Therefore, systems engineering approaches that improve throughput and reduce waste may hold the most readily available gains. Decreasing radiology turnaround times improves ED patient throughput and decreases patient waiting time...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28435294/patient-considerations-in-metastatic-colorectal-cancer-role-of-panitumumab
#15
REVIEW
Jane E Rogers
Epidermal growth factor receptor (EGFR) is overexpressed in many malignancies, including colorectal cancer (CRC), making EGFR an attractive treatment option. Panitumumab and cetuximab, monoclonal antibodies (mAbs) directed at EGFR, are both currently utilized in the management of metastatic CRC (mCRC). Through the development of these agents in mCRC, key issues surrounding each mAbs use have been revealed. These key issues include negative patient outcome avoidance when determining use, the economic burden with high-cost medication, predictive biomarkers, tumor location, patient geographic location, patient quality of life, and the prevention of debilitating adverse effects...
2017: OncoTargets and Therapy
https://www.readbyqxmd.com/read/28435229/medication-adherence-and-persistence-in-type-2-diabetes-mellitus-perspectives-of-patients-physicians-and-pharmacists-on-the-spanish-health-care-system
#16
Elena Labrador Barba, Marta Rodríguez de Miguel, Antonio Hernández-Mijares, Francisco Javier Alonso-Moreno, Maria Luisa Orera Peña, Susana Aceituno, María José Faus Dader
OBJECTIVE: A good relationship between diabetes patients and their health care team is crucial to ensure patients' medication adherence and self-management. To this end, we aimed to identify and compare the views of type 2 diabetes mellitus (T2DM) patients, physicians and pharmacists concerning the factors and strategies that may be associated with, or could improve, medication adherence and persistence. METHODS: An observational, cross-sectional study was conducted using an electronic self-administered questionnaire comprising 11 questions (5-point Likert scale) concerning factors and strategies related to medication adherence...
2017: Patient Preference and Adherence
https://www.readbyqxmd.com/read/28435128/randomized-trial-on-fast-track-care-in-colorectal-surgery-for-deep-infiltrating-endometriosis
#17
Marco Scioscia, Marcello Ceccaroni, Irene Gentile, Roberto Rossini, Roberto Clarizia, Davide Brunelli, Giacomo Ruffo
STUDY OBJECT: To study the application of a fast-track care protocol in colorectal surgery for deep infiltrating endometriosis. Bowel endometriosis is an infrequent but not rare condition that often needs intestinal surgery and imposes a high economic burden on society. DESIGN: Prospective randomized trial (Canadian Task Force I). SETTING: Tertiary referral center. PATIENTS: We randomly assigned 227 patients with preoperative evidence of bowel endometriosis to a fast-track (no preoperative bowel preparation, early restoration of diet, no postoperative antibiotics, and early post-operative mobilization) or conventional care for laparoscopic intestinal surgery...
April 18, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28435100/montreal-accord-on-patient-reported-outcomes-use-series-paper-5-patient-reported-outcomes-pro-can-be-linked-to-epidemiologic-measures-to-monitor-populations-and-inform-public-health-decisions
#18
Hiroshi Mamiya, Lisa M Lix, William Gardner, Susan J Bartlett, Sara Ahmed, David Buckeridge
BACKGROUND: Comprehensive picture of population health status can be captured by the incorporation of patient reported outcome measures into population health monitoring. OBJECTIVE: To identify current state, opportunities, and future research related to the utilization of patient reported outcome measures for population health monitoring in Canada. DISCUSSIONS: Patient reported outcome measures can help to identify community health needs in public health topics including injury, chronic disease, and communicable disease...
April 20, 2017: Journal of Clinical Epidemiology
https://www.readbyqxmd.com/read/28434936/defining-a-research-agenda-to-address-the-converging-epidemics-of-tuberculosis-and-diabetes-part-1-epidemiology-and-clinical-management
#19
REVIEW
Julia A Critchley, Blanca I Restrepo, Katharina Ronacher, Anil Kapur, Andrew A Bremer, Larry S Schlesinger, Randall Basaraba, Hardy Kornfeld, Reinout van Crevel
There is growing interest in the interaction between type 2 diabetes (DM) and tuberculosis (TB), but many research questions remain unanswered. Epidemiologists, basic scientists and clinical experts recently convened and identified priorities. This is the first of two reviews on this topic, summarising priority areas of research with regard to epidemiology, clinical management and public health. First, from an epidemiological point of view, more study is needed to determine the importance of transient hyperglycemia in TB patients, and on the importance of DM for the global epidemic of multi-drug resistant (MDR)-TB...
April 19, 2017: Chest
https://www.readbyqxmd.com/read/28434871/a-brief-psychological-intervention-to-reduce-repetition-of-self-harm-in-patients-admitted-to-hospital-following-a-suicide-attempt-a-randomised-controlled-trial
#20
Rory C O'Connor, Eamonn Ferguson, Fiona Scott, Roger Smyth, David McDaid, A-La Park, Annette Beautrais, Christopher J Armitage
BACKGROUND: We investigated whether a volitional helpsheet (VHS), a brief psychological intervention, could reduce repeat self-harm in the 6 months following a suicide attempt. METHODS: We did a prospective, single-site, randomised controlled trial. Patients admitted to a hospital in Edinburgh, UK, after a suicide attempt were deemed eligible for the study if they were over the age of 16 years, had a self-reported history of self-harm, were fluent in English, were medically fit to interview, and were not participating in other research studies within the hospital...
April 20, 2017: Lancet Psychiatry
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