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Emergency medical response

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https://www.readbyqxmd.com/read/28650248/health-services-utilization-among-fee-for-service-medicare-and-medicaid-patients-under-age-65-with-behavioral-health-illness-at-an-urban-safety-net-hospital
#1
Ramon S Cancino, Brian W Jack, John Jarvis, Alice Kate Cummings, Ellie Cooper, Pierre-Yves Cremieux, James F Burgess
BACKGROUND: In 2011, fee-for-service patients with both Medicare and Medicaid (dual eligible) sustained $319.5 billion in health care costs. OBJECTIVE: To describe the emergency department (ED) use and hospital admissions of adult dual eligible patients aged under 65 years who used an urban safety net hospital. METHODS: This was a retrospective database analysis of patients aged between 18 and 65 years with Medicare and Medicaid, who used an urban safety net academic health center between January 1, 2011, and December 31, 2011...
July 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28648732/-adoptive-transfer-of-t-lymphocytes
#2
H Vié, B Clémenceau
Within a few years, the success of treatments based on the use of T-cells armed with a chimeric T-receptor for the CD19 molecule (CAR-T CD19) has revolutionized the perception of adoptive transfer approaches. The levels of responses observed in acute leukemias, of the order of 70-90 % are indeed unprecedented. The medical and financial enthusiasm aroused by these results has led to the current situation where more than 300 clinical trials are under way, against some thirty different antigens. This enthusiasm, well justified by the first successes, must however be tempered by the difficulties associated with the use of these cells...
June 22, 2017: Transfusion Clinique et Biologique: Journal de la Société Française de Transfusion Sanguine
https://www.readbyqxmd.com/read/28648313/cost-of-osteoporotic-fractures-in-singapore
#3
Charmaine Shuyu Ng, Tang Ching Lau, Yu Ko
OBJECTIVES: To estimate the 3-month direct and indirect costs associated with osteoporotic fractures from both the hospital's and patient's perspectives in Singapore and to compare the cost between acute and prevalent osteoporotic fractures. METHODS: Resource use and expenditure data were collected using interviewer-administered questionnaires at baseline and at a 3-month follow-up between July 2013 and January 2014. Estimated osteoporotic fracture-related costs included hospitalizations, accident and emergency room visits, outpatient physician visits, laboratory tests, medications, transportation, health care and community services, special equipment and home/car modifications, and productivity loss...
May 2017: Value in Health Regional Issues
https://www.readbyqxmd.com/read/28648218/innovative-information-technology-powered-population-health-care-management-improves-outcomes-and-reduces-hospital-readmissions-and-emergency-department-visits
#4
Sharon Anderson, Michele Campbell, Donna Mahoney, Ann Kathryn Muther, Janice Nevin, Patricia Resnik, Tabassum Salam, Terri Steinberg
BACKGROUND: Patients with chronic conditions are often the most frequent users of health care. Moreover, adapting to developments in one's illness, understanding how to self-manage a chronic illness, and sharing information between primary care and specialty providers, can be a full-time job for someone with a chronic illness. In response to these challenges, Christiana Care Health System (Wilmington, Delaware) developed Care Link, an information technology (IT)-enhanced care management support to enable populations of patients to achieve better clinical outcomes at lower cost...
July 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28646584/prehospital-advanced-cardiac-life-support-for-out-of-hospital-cardiac-arrest-a-cohort-study
#5
Alexis Cournoyer, Eric Notebaert, Massimiliano Iseppon, Sylvie Cossette, Luc Londei-Leduc, Yoan Lamarche, Judy Morris, Éric Piette, Raoul Daoust, Jean-Marc Chauny, Catalina Sokoloff, Yiorgos Alexandros Cavayas, Jean Paquet, André Denault
OBJECTIVES: Out-of-hospital advanced cardiac life support (ACLS) has not consistently shown a positive impact on survival. Extracorporeal cardiopulmonary resuscitation (E-CPR) could render prolonged on-site resuscitation (ACLS or basic cardiac life support [BCLS]) undesirable in selected cases. The objectives of this study were to evaluate, in patients suffering from out-of-hospital cardiac arrest (OHCA) and in a subgroup of potential E-CPR candidates, the association between the addition of prehospital ACLS to BCLS and survival to hospital discharge, prehospital return of spontaneous circulation (ROSC) and delay from call to hospital arrival...
June 24, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28643399/distributed-health-literacy-among-people-living-with-type-2-diabetes-in-portugal-defining-levels-of-awareness-and-support
#6
Liliana Abreu, João Arriscado Nunes, Peter Taylor, Susana Silva
This study embraces a patient-centred and narrative-oriented notion of health literacy, exploring how social networks and personal experiences constitute distributed health literacy (DHL) by mapping out health literacy mediators of each individual and how they enable self-management skills and knowledge of health conditions. Semi-structured interviews with 26 patients with type 2 diabetes were conducted in a Primary Care Center of Porto (Portugal) from October 2014 to December 2015. Data were collected based on McGill Illness Narrative Interview (MINI)...
June 22, 2017: Health & Social Care in the Community
https://www.readbyqxmd.com/read/28641984/bi-objective-approach-for-placing-ground-and-air-ambulance-base-and-helipad-locations-in-order-to-optimize-ems-response
#7
Milad Shahriari, Ali Bozorgi-Amiri, Shayan Tavakoli, Abolghasem Yousefi-Babadi
Shortening the travel time of patient transfer has clinical implications for many conditions such as cardiac arrest, trauma, stroke and STEMI. As resources are often limited precise calculations are needed. In this paper we consider the location problem for both ground and aerial emergency medical services. Given the uncertainty of when patients are in need of prompt medical attention we consider these demand points to be uncertain. We consider various ways in which ground and helicopter ambulances can work together to make the whole process go faster...
June 15, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28641522/advances-on-ppar%C3%AE-research-in-the-emerging-era-of-precision-medicine
#8
Pinyi Lu, Zhongming Zhao
BACKGROUND: Peroxisome proliferator-activated receptor gamma (PPARγ) is a member of the nuclear receptor superfamily that functions as a ligand-inducible transcription factor. It regulates glucose and lipid metabolism, immunity, and cellular growth and differentiation. Thiazolidinediones (TZDs) are potent insulin sensitizers that function by activating PPARs, with a high specificity for PPARγ. Due to their ability to preserve pancreatic beta cell function and reduce insulin resistance, TZDs have become one of the most prescribed classes of medications for type 2 diabetes (T2D) since their approval by the US Food and Drug Administration (FDA) and initial use in 1997...
June 21, 2017: Current Drug Targets
https://www.readbyqxmd.com/read/28640889/contrasting-academic-and-lay-press-print-coverage-of-the-2013-2016-ebola-virus-disease-outbreak
#9
Mark D Kieh, Elim M Cho, Ian A Myles
Under a traditional paradigm, only those with the expected background knowledge consume academic literature. The lay press, as well as government and non-government agencies, play a complementary role of extracting findings of high interest or importance and translating them for general viewing. The need for accurate reporting and public advising is paramount when attempting to tackle epidemic outbreaks through behavior change. Yet, public trust in media outlets is at a historic low. The Crisis and Emergency Risk Communication (CERC) model for media reporting on public health emergencies was established in 2005 and has subsequently been used to analyze media reporting on outbreaks of influenza and measles as well as smoking habits and medication compliance...
2017: PloS One
https://www.readbyqxmd.com/read/28640812/challenges-in-preparing-and-implementing-a-clinical-trial-at-field-level-in-an-ebola-emergency-a-case-study-in-guinea-west-africa
#10
Sara Carazo Perez, Elin Folkesson, Xavier Anglaret, Abdoul-Habib Beavogui, Emmanuel Berbain, Alseny-Modet Camara, Evelyn Depoortere, Annabelle Lefevre, Piet Maes, Kristian Nødtvedt Malme, Jean-Marie Denis Malvy, Sien Ombelet, Geertrui Poelaert, Daouda Sissoko, Alexis Tounkara, Pierre Trbovic, Pascal Piguet, Annick Antierens
During the large Ebola outbreak that affected West Africa in 2014 and 2015, studies were launched to evaluate potential treatments for the disease. A clinical trial to evaluate the effectiveness of the antiviral drug favipiravir was conducted in Guinea. This paper describes the main challenges of the implementation of the trial in the Ebola treatment center of Guéckédou. Following the principles of the Good Clinical Research Practices, we explored the aspects of the community's communication and engagement, ethical conduct, trial protocol compliance, informed consent of participants, ongoing benefit/risk assessment, record keeping, confidentiality of patients and study data, and roles and responsibilities of the actors involved...
June 2017: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/28639869/economic-burden-of-inpatient-admission-of-ankle-fractures
#11
Justin D Stull, Suneel B Bhat, Justin M Kane, Steven M Raikin
BACKGROUND: Ankle fractures are among the most prevalent traumatic orthopaedic injuries. A large proportion of patients sustaining operative ankle fractures are admitted directly from the emergency department prior to operative management. In the authors' experience, however, many closed ankle injuries may be safely and effectively managed on an outpatient basis. The aim of this study was to characterize the economic impact of routine inpatient admission of ankle fractures. METHODS: A retrospective review of all outpatient ankle fracture surgery performed by a single foot and ankle fellowship-trained surgeon at a tertiary level academic center in 2012 was conducted to identify any patients requiring postoperative inpatient admission...
June 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28637082/positive-aspects-of-having-had-cancer-a-mixed-methods-analysis-of-responses-from-the-american-cancer-society-survivors-of-cancer-ii-studies
#12
Gail Adorno, Ellen Lopez, Mary Ann Burg, Victoria Loerzel, Michael Killian, Amy B Dailey, Joanne D Iennaco, Cara Wallace, Dinghy Kristine B Sharma, Kevin Stein
PURPOSE: This study focused on understanding positive aspects of cancer amongst a large, national sample of survivors, two, five, and ten years' post-cancer diagnosis, who responded to the American Cancer Society Survivors of Cancer-II survey question "Please tell us about any positive aspects of having cancer." METHODS: A sequential mixed methods approach examined 1) thematic categories of positive aspects from cancer survivors (n = 5149) and 2) variation in themes by sociodemographics, cancer type, stage of disease, and length of survivorship...
June 21, 2017: Psycho-oncology
https://www.readbyqxmd.com/read/28636895/neurocognitive-characteristics-of-youth-with-noncomorbid-and-comorbid-forms-of-conduct-disorder-and-attention-deficit-hyperactivity-disorder
#13
Andrea L Glenn, Rheanna J Remmel, Min Yee Ong, Nikki S J Lim, Rebecca P Ang, A Hunter Threadgill, Nicole Ryerson, Adrian Raine, Daniel Fung, Yoon Phaik Ooi
OBJECTIVE: Studies investigating neurocognitive deficits in youth with conduct disorder (CD) and attention deficit hyperactivity disorder (ADHD) are often confounded by the high rates of comorbidity between the two. METHOD: Neurocognitive functioning was examined in three diagnostic groups (ADHD only, CD only, comorbid ADHD and CD) matched by age, sex, IQ, and medication status (n=28-32 per group). RESULTS: No significant differences emerged between the diagnostic groups on measures of risk-taking or response inhibition...
June 8, 2017: Comprehensive Psychiatry
https://www.readbyqxmd.com/read/28634909/categorical-risk-perception-drives-variability-in-antibiotic-prescribing-in-the-emergency-department-a-mixed-methods-observational-study
#14
Eili Y Klein, Elena M Martinez, Larissa May, Mustapha Saheed, Valerie Reyna, David A Broniatowski
BACKGROUND: Adherence to evidence-based antibiotic therapy guidelines for treatment of upper respiratory tract infections (URIs) varies widely among clinicians. Understanding this variability is key for reducing inappropriate prescribing. OBJECTIVE: To measure how emergency department (ED) clinicians' perceptions of antibiotic prescribing risks affect their decision-making. DESIGN: Clinician survey based on fuzzy-trace theory, a theory of medical decision-making, combined with retrospective data on prescribing outcomes for URI/pneumonia visits in two EDs...
June 20, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28633604/a-two-stage-approach-to-the-joint-analysis-of-longitudinal-and-survival-data-utilising-the-coxian-phase-type-distribution
#15
Conor Donnelly, Lisa M McFetridge, Adele H Marshall, Hannah J Mitchell
The Coxian phase-type distribution is a special type of Markov model which can be utilised both to uncover underlying stages of a survival process and to make inferences regarding the rates of flow of individuals through these latent stages before an event of interest occurs. Such models can be utilised, for example, to identify individuals who are likely to deteriorate faster through a series of disease states and thus require more aggressive medical intervention. Within this paper, a two-stage approach to the analysis of longitudinal and survival data is presented...
January 1, 2017: Statistical Methods in Medical Research
https://www.readbyqxmd.com/read/28632149/association-between-air-pollution-and-emergency-room-visits-for-atrial-fibrillation
#16
Angelo G Solimini, Matteo Renzi
Despite the large prevalence in the population, possible factors responsible for the induction of atrial fibrillation (AF) events in susceptible individuals remain incompletely understood. We investigated the association between air pollution levels and emergency department admissions for AF in Rome. We conducted a 14 years' time-series study to evaluate the association between the daily levels of air pollution (particulate matter, PM10 and PM2.5, and nitrogen dioxide, NO₂) and the daily count of emergency accesses for AF (ICD-9 code: 427...
June 20, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/28630435/in-situ-electrical-and-thermal-monitoring-of-printed-electronics-by-two-photon-mapping
#17
Francesco Pastorelli, Nicolò Accanto, Mikkel Jørgensen, Niek F van Hulst, Frederik C Krebs
Printed electronics is emerging as a new, large scale and cost effective technology that will be disruptive in fields such as energy harvesting, consumer electronics and medical sensors. The performance of printed electronic devices relies principally on the carrier mobility and molecular packing of the polymer semiconductor material. Unfortunately, the analysis of such materials is generally performed with destructive techniques, which are hard to make compatible with in situ measurements, and pose a great obstacle for the mass production of printed electronics devices...
June 19, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28628463/operational-research-during-the-ebola-emergency
#18
Gabriel Fitzpatrick, Tom Decroo, Bertrand Draguez, Rosa Crestani, Axelle Ronsse, Rafael Van den Bergh, Michel Van Herp
Operational research aims to identify interventions, strategies, or tools that can enhance the quality, effectiveness, or coverage of programs where the research is taking place. Médecins Sans Frontières admitted ≈5,200 patients with confirmed Ebola virus disease during the Ebola outbreak in West Africa and from the beginning nested operational research within its emergency response. This research covered critical areas, such as understanding how the virus spreads, clinical trials, community perceptions, challenges within Ebola treatment centers, and negative effects on non-Ebola healthcare...
July 2017: Emerging Infectious Diseases
https://www.readbyqxmd.com/read/28627602/molecular-profiling-of-locally-advanced-rectal-adenocarcinoma-using-microrna-expression-review
#19
Cory Pettit, Steve Walston, Patrick Wald, Amy Webb, Terence M Williams
Treatment for locally-advanced rectal cancer (LARC) typically consists of neoadjuvant chemoradiation followed by total mesorectal excision. Recently, there has been growing interest in non-operative management for patients who are medically-inoperable or wish to avoid surgical morbidity and permanent colostomy. Approximately 50% of patients who receive pre-operative neoadjuvant chemoradiation develop some degree of pathologic response. Approximately 10-20% of patients are found to have a complete pathologic response, a finding which has frequently been shown to predict better clinical outcomes, including local-regional control, distant metastasis and survival...
June 14, 2017: International Journal of Oncology
https://www.readbyqxmd.com/read/28626833/the-lung-is-a-host-defense-niche-for-immediate-neutrophil-mediated-vascular-protection
#20
Bryan G Yipp, Jung Hwan Kim, Ronald Lima, Lori D Zbytnuik, Björn Petri, Nick Swanlund, May Ho, Vivian G Szeto, Tamar Tak, Leo Koenderman, Peter Pickkers, Anton T J Tool, Taco W Kuijpers, Timo K van den Berg, Mark R Looney, Matthew F Krummel, Paul Kubes
Bloodstream infection is a hallmark of sepsis, a medically emergent condition requiring rapid treatment. However, upregulation of host defense proteins through toll-like receptors and NFκB requires hours after endotoxin detection. Using confocal pulmonary intravital microscopy, we identified that the lung provides a TLR4-Myd88-and abl tyrosine kinase-dependent niche for immediate CD11b-dependent neutrophil responses to endotoxin and Gram-negative bloodstream pathogens. In an in vivo model of bacteremia, neutrophils crawled to and rapidly phagocytosed Escherichia coli sequestered to the lung endothelium...
April 28, 2017: Science Immunology
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