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patient centered research

Hatim A AlSulaim, R Sterling Haring, Anthony O Asemota, Blair J Smart, Joseph K Canner, Aslam Ejaz, David T Efron, Catherine G Velopulos, Elliott R Haut, Eric B Schneider
OBJECTIVE: To assess the relationship between The International Classification of Diseases, Ninth Revision, Clinical Modification-derived conscious status and mortality rates in trauma centres (TC) vs. non-trauma centres (NTC). METHODS: Patients in the 2006-2011 Nationwide Emergency Department Sample meeting, The Centers for Disease Control and Prevention criteria for traumatic brain injury (TBI), with head/neck Abbreviated Injury Scale (AIS) scores ≥3 were included...
March 21, 2018: Brain Injury: [BI]
Adolph J Yates
The Center for Disease Control and Prevention recently released their 2017 Guideline for the Prevention of Surgical Site Infection. One of their recommendations is the ordering of a single dose of preoperative prophylactic antibiotics with no subsequent postoperative dosing; this recommendation includes perioperative antibiotics for patients undergoing total joint arthroplasty. At this time, the American Association of Hip and Knee Surgeons (AAHKS) does not agree with this recommendation vis-a-vis total joint arthroplasty because it contradicts current international standards of care with limited evidence and study...
March 2018: Arthroplasty Today
Maryam Hassanzad, Azam Orooji, Ali Valinejadi, Aliakbar Velayati
Background: Finding a valid diagnosis is mostly a prolonged process. Current advances in the sector of artificial intelligence have led to the appearance of expert systems that enrich the experiences and capabilities of doctors for making decisions for their patients. Objective: The objective of this research was developing a fuzzy expert system for diagnosing Cystic Fibrosis (CF). Methods: Defining the risk factors and then, designing the fuzzy expert system for diagnosis of CF were carried out in this cross-sectional study...
December 2017: Electronic Physician
Matteo Chiappedi, Martina Mensi, Eliana Antonaci, Elena Zavani, Livio Tronconi, Cristiano Termine, Umberto Balottin
There are few literature evidences about the intellectual profile of adolescents with headache and no study has used the fourth edition of the Wechsler Intelligence Scale for Children (WISC-IV) in patients with a diagnosis of headache according to the ICHD-III-beta. We recruited 30 patients (age 11-14 years; male:female = 1:2) seen for headache in a tertiary center in Northern Italy and 30 healthy controls matched for age and sex, recruited in a public school from the same geographic area. The diagnosis of headache was done according to the ICHD-III criteria (beta version): the case group was composed of 16 patients with migraine and 14 with tension-type headache...
2018: Frontiers in Neurology
Thiago M P Fernandes, Michael J Oliveira de Andrade, Jessica B Santana, Renata M Toscano Barreto Lyra Nogueira, Natanael A Dos Santos
Smoking prevalence in patients who are diagnosed with schizophrenia (SCZ) is higher than in the general population. Chronic tobacco use in SCZ patients may reduce the side effects of antipsychotic drugs, thus serving as a self-medication for such side effects. Understanding the ways in which chronic tobacco use influences visual sensitivity has clinical implications, which may serve as a tool for non-invasively diagnosing early-stage visual processing deficits. The present study evaluated the effects of chronic tobacco use on visual sensitivity in SCZ patients...
2018: Frontiers in Psychology
Paloma Ruiz-Rodríguez, Antonio Cano-Vindel, Roger Muñoz-Navarro, Cristina M Wood, Leonardo A Medrano, Luciana Sofía Moretti
Introduction: In the primary care (PC) setting in Spain, the prevalence of emotional disorders (EDs) such as anxiety, depression and somatoform disorder is high. In PC patients, these disorders are not always managed in accordance with the recommendations provided by clinical practice guidelines, resulting in major direct and indirect economic costs and suboptimal treatment outcomes. The aim is to analyze and compare the cost-effectiveness and cost-utility of group-based psychological therapy versus treatment as usual (TAU)...
2018: Frontiers in Psychology
Linda B Mongero, Eric A Tesdahl, Alfred H Stammers, Andrew J Stasko, Samuel Weinstein
Myocardial protection during cardiac surgery is a multifaceted process that is structured to limit injury and preserve function. Evolving techniques use solutions with varying constituents that enter the systemic circulation and alter intrinsic systemic concentrations. This study compared two distinct cardioplegia solutions on affecting intraoperative glucose levels. Data were abstracted from a multi-institutional perfusion registry, including a total of 1,188 propensity-matched cases performed from January through October 2016, at 17 cardiac surgical centers across the United States in which both del Nido and 4:1 cardioplegia were used during the study period...
March 2018: Journal of Extra-corporeal Technology
Agnes Bosch, Johannes B Scheppach, Joanna M Harazny, Ulrike Raff, Kai-Uwe Eckardt, Roland E Schmieder, Markus P Schneider
RATIONALE: Premature cardiovascular disease is a leading cause of death in patients with chronic kidney disease (CKD). In animal models CKD has been shown to cause renal and extrarenal vascular remodeling and capillary rarefaction, but data in humans with CKD are sparse. Retinal arteriolar wall-to-lumen ratio (WLR) is an established marker of early end-organ damage and there is evidence that arteriolar and capillary changes in the retinal circulation mirror those in the general and in particular the cerebrovascular microcirculation...
March 17, 2018: Microvascular Research
D'Andrea K Joseph, Daniel Daman, Rae Lynne Kinler, Karyl Burns, Lenworth Jacobs
The aim of this study was to describe the management of severe blunt renal injuries at a Level I trauma hospital. Data were collected through a record review of patients admitted from January 1, 2000, to December 31, 2011. These data were compiled as part of our hospital's participation in the Nonoperative Management of Grade IV and V Blunt Renal Injuries: A Research Consortium of New England Centers for Trauma Study. Thirty-six patients with severe blunt renal injuries were identified. Twenty-nine (80.6%) underwent nonoperative management (NOM) for their injuries...
March 1, 2018: American Surgeon
Anya Romanoff, Hank Schmidt, Matthew McMurray, Christina Weltz, Monica Schwartzman, Kathryn Friedman, Laurie Margolies, Elisa Port
The role of MRI in the workup of newly diagnosed breast cancer patients remains controversial. Breast MRI detects additional disease, but this has not translated into improved outcomes. In light of a dramatic rise in MRI use, we investigated patterns of MRI ordering for newly diagnosed breast cancer. All newly diagnosed breast cancer cases presenting for surgical management to a specialized breast center from 2011 to 2013 were reviewed. Patients who had an MRI ordered by their operating surgeon were compared with those who had an MRI completed previously...
March 1, 2018: American Surgeon
Jennifer Bido, Roya Ghazinouri, Jamie E Collins, Desirée Diez Portela, Luis Alcantara, Thomas S Thornhill, Jeffrey N Katz
BACKGROUND: Medical missions to low and middle-income countries are increasingly frequent, with an estimated 6,000 trips sponsored by U.S. organizations accounting for approximately 200,000 surgical cases and $250 million in costs annually. However, these missions have received little critical evaluation. This paper describes the research program Operation Walk (Op-Walk) Boston, and proposes an evaluation model for similar surgical missions. METHODS: We propose an evaluation model, borrowing from the work of Donabedian and enriched by evidence from our research program...
March 21, 2018: Journal of Bone and Joint Surgery. American Volume
Luciano Rossetti
Luciano Rossetti, MD, Executive Vice President, Global Head of R&D at Merck KGaA, Darmstadt, Germany speaks to Laura Dormer, Commissioning Editor Luciano Rossetti, MD, is Executive Vice President, Global Head of R&D at Merck KGaA, Darmstadt, Germany, and a member of the Healthcare Executive Committee. As Global Head of R&D, Rossetti leads the strategy for Merck KGaA, Darmstadt, Germany's discovery and development efforts in healthcare. He joined Merck KGaA in July 2014, and has since led the acceleration of several key programs through the pipeline and advanced the innovation of Merck KGaA's discovery teams into development...
March 20, 2018: Neurodegenerative Disease Management
Miran Brvar, Ming Yin Chan, Andrew H Dawson, Richard R Ribchester, Michael Eddleston
INTRODUCTION: Treatment of acute organophosphorus or carbamate insecticide self-poisoning is often ineffective, with tens of thousands of deaths occurring every year. Researchers have recommended the addition of magnesium sulfate or calcium channel blocking drugs to standard care to reduce acetylcholine release at cholinergic synapses. OBJECTIVE: We aimed to review systematically the evidence from preclinical studies in animals exposed to organophosphorus or carbamate insecticides concerning the efficacy of magnesium sulfate and calcium channel blocking drugs as therapy compared with placebo in reducing mortality or clinical features of poisoning...
March 20, 2018: Clinical Toxicology
Nazarii Kobyliak, Ludovico Abenavoli, Galyna Mykhalchyshyn, Liudmyla Kononenko, Luigi Boccuto, Dmytro Kyriienko, Oleg Dynnyk
BACKGROUND: Probiotics have a beneficial effect on nonalcoholic fatty liver disease (NAFLD) in animal models. Randomized placebo-controlled trials (RCTs) in NAFLD are still lacking in humans despite a large number of data from animal research. AIM: We performed a double-blind single center RCT of live multi-strain probiotic vs. placebo in type 2 diabetes patients with NAFLD. METHODS: A total of 58 patients met the criteria for inclusion. They were randomly assigned to receive the multi-probiotic "Symbiter" (concentrated biomass of 14 probiotic bacteria genera Bifidobacterium, Lactobacillus, Lactococcus, Propionibacterium) or placebo for 8-weeks administered as a sachet formulation in double-blind treatment...
March 2018: Journal of Gastrointestinal and Liver Diseases: JGLD
Ahmad Rezaeian
Objective Hyposmia is a sensorial disorder in which patients have a reduced sense of smell. However, there are no effective regimens for the management of this disorder. Therefore, the aim of this study is to evaluate the therapeutic effect of intranasal insulin on olfactory recovery in patients with hyposmia. Study Design This is a double-blinded, randomized controlled trial. Setting Intervention. Subjects and Methods This study was administered on 38 patients with hyposmia according to the inclusion and exclusion criteria...
March 1, 2018: Otolaryngology—Head and Neck Surgery
Marsha Reyngold, Joyce Niland, Anna Ter Veer, Tanios Bekaii-Saab, Lily Lai, Joshua E Meyer, Steven J Nurkin, Deborah Schrag, John M Skibber, Al B Benson, Martin R Weiser, Christopher H Crane, Karyn A Goodman
Purpose: Intensity modulated radiation therapy (IMRT) has been rapidly incorporated into clinical practice because of its technological advantages over 3-dimensional conformal radiation therapy (CRT). We characterized trends in IMRT utilization in trimodality treatment of locally advanced rectal cancer at National Comprehensive Cancer Network cancer centers between 2005 and 2011. Methods and materials: Using the prospective National Comprehensive Cancer Network Colorectal Cancer Database, we determined treatment patterns for 976 patients with stage II-III rectal cancer who received pelvic radiation therapy at contributing centers between 2005 and 2011...
January 2018: Advances in Radiation Oncology
Ying Liu, Brent Logan, Ning Liu, Zhiyuan Xu, Jian Tang, Yanzhi Wang
In this paper, we propose the first deep reinforcement learning framework to estimate the optimal Dynamic Treatment Regimes from observational medical data. This framework is more flexible and adaptive for high dimensional action and state spaces than existing reinforcement learning methods to model real life complexity in heterogeneous disease progression and treatment choices, with the goal to provide doctor and patients the data-driven personalized decision recommendations. The proposed deep reinforcement learning framework contains a supervised learning step to predict the most possible expert actions; and a deep reinforcement learning step to estimate the long term value function of Dynamic Treatment Regimes...
August 2017: Healthcare Informatics: the Business Magazine for Information and Communication Systems
Brandyn D Lau, Michael B Streiff, Peter J Pronovost, Elliott R Haut
Venous thromboembolism (VTE) is 1 of the most common causes of preventable harm for patients in hospitals. Consequently, the Joint Commission, the Centers for Medicare and Medicaid Services, the Agency for Healthcare Research and Quality, the United Kingdom Care Quality Commission, the Australian Commission on Safety and Quality in Health Care, the Maryland Health Services Cost Review Commission, and the American College of Surgeons have prioritized measuring and reporting VTE outcomes with the goal of reducing the incidence of and preventable harm from VTE...
March 20, 2018: Circulation
Prasad R Shankar, Matthew S Davenport, Sean A Woolen, Ruth C Carlos, Katerine E Maturen
Survey research is appealing to many clinical researchers, including radiologists. Emerging interest in patient preferences and patient-centered outcomes related to imaging likely will stimulate additional use of questionnaires in our field. However, like other quantitative methods, survey-based research requires meticulous planning, execution, and analysis to generate reliable results and support meaningful conclusions. The purpose of this review is to provide a guideline for radiologists embarking on this type of research, with attention to questionnaire design, sampling, survey administration, and analysis...
March 16, 2018: Academic Radiology
M M J Linszen, G A van Zanten, R J Teunisse, R M Brouwer, P Scheltens, I E Sommer
BACKGROUND: Similar to visual hallucinations in visually impaired patients, auditory hallucinations are often suggested to occur in adults with hearing impairment. However, research on this association is limited. This observational, cross-sectional study tested whether auditory hallucinations are associated with hearing impairment, by assessing their prevalence in an adult population with various degrees of objectified hearing impairment. METHODS: Hallucination presence was determined in 1007 subjects aged 18-92, who were referred for audiometric testing to the Department of ENT-Audiology, University Medical Center Utrecht, the Netherlands...
March 20, 2018: Psychological Medicine
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