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Medical innovation

Andrew McDowell, Neeraj Raizada, Sunil D Khaparde, Raghuram Rao, Sanjay Sarin, Aakshi Kalra, Virender Singh Salhotra, Sreenivas Achuthan Nair, Catharina Boehme, Claudia M Denkinger
BACKGROUND: Diagnosing tuberculosis (TB) in children presents considerable challenges. Upfront testing on Xpert® MTB/RIF ('Xpert')-a rapid molecular assay with high sensitivity and specificity-for pediatric presumptive TB patients, as recommended by India's Revised National Tuberculosis Control Program (RNTCP), can pave the way for early TB diagnosis. As part of an ongoing project implemented by Foundation for Innovative New Diagnostics (FIND) dedicated to providing upfront free-of-cost (FOC) Xpert testing to children seeking care in the public and private sectors, a qualitative assessment was designed to understand how national guidelines on TB diagnosis and Xpert technology have been integrated into the pediatric TB care practices of different health providers...
2018: PloS One
Pavani Rangachari
In 1999, the Institute of Medicine reported that 98,000 people die each year due to medical errors. In the following years, the focus on hospital quality was intensified nationally, with policymakers providing evidence-based practice guidelines for improving health care quality. However, these innovations (evidence-based guidelines) that were being produced at policy levels were not translating to clinical practice at the hospital organizational level easily, and stark variations continued to persist, in the quality of health care...
2018: Innov Entrep Health
Sandrine Loubière, Alexandre Drezet, Michèle Beau-Faller, Denis Moro-Sibilot, Sylvie Friard, Marie Wislez, Hélène Blons, Catherine Daniel, Virginie Westeel, Anne Madroszyk, Hervé Léna, Patrick Merle, Julien Mazières, Gérard Zalcman, Roger Lacave, Martine Antoine, Franck Morin, Pascale Missy, Fabrice Barlesi, Pascal Auquier, Jacques Cadranel
ALK rearrangement and EGFR / KRAS mutations constitute the primary biomarkers tested to provide targeted or nontargeted therapies in advanced nonsmall cell lung cancer (NSCLC) patients. Our objective was to assess the cost-effectiveness of biomarker testing for NSCLC.Between 2013 and 2014, 843 treatment-naive patients were prospectively recruited at 19 French hospitals into a longitudinal observational cohort study. Two testing strategies were compared, i.e. with "at least one biomarker status known" and "at least KRAS status known", in addition to "no biomarker testing" as the reference strategy...
March 2018: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
James A McClintic, Clifford L Snyder, Kimberly M Brown
OBJECTIVE: Although key clinical skills have been defined in the Core Entrustable Professional Activities, there is a need to improve medical school curricula with standardized training opportunities and assessments of these skills. Thus, we aimed to develop an innovative curriculum that emphasized critical thinking and clinical skills. We hypothesized that we would be able to observe measurable improvement on assessments of students' critical thinking and clinical skills after the implementation of the new curriculum...
March 12, 2018: Journal of Surgical Education
Ryan P Donahue, Andrew W Stamm, Robert P Gibbons, Christopher R Porter, Kathleen C Kobashi, John M Corman, Una J Lee
INTRODUCTION: The ureteral stent is engrained in the fabric of urologic practice. Virginia Mason Medical Center had a unique role in its development through the pioneering work of Dr. Robert Gibbons. Here, we review his contribution to the evolution of the modern ureteral stent. METHODS: We reviewed Dr. Gibbons' extensive work through primary sources, including interviews, projector slides, radiology images, stent prototypes, his personal writings and archived documents...
March 12, 2018: Urology
Sara Moccia, Elena De Momi, Sara El Hadji, Leonardo S Mattos
BACKGROUND: Blood vessel segmentation is a topic of high interest in medical image analysis since the analysis of vessels is crucial for diagnosis, treatment planning and execution, and evaluation of clinical outcomes in different fields, including laryngology, neurosurgery and ophthalmology. Automatic or semi-automatic vessel segmentation can support clinicians in performing these tasks. Different medical imaging techniques are currently used in clinical practice and an appropriate choice of the segmentation algorithm is mandatory to deal with the adopted imaging technique characteristics (e...
May 2018: Computer Methods and Programs in Biomedicine
Alexandra Wollum, Rose Gabert, Claire R McNellan, Jessica M Daly, Priscilla Reddy, Paurvi Bhatt, Miranda Bryant, Danny V Colombara, Pamela Naidoo, Belinda Ngongo, Anam Nyembezi, Zaino Petersen, Bryan Phillips, Shelley Wilson, Emmanuela Gakidou, Herbert C Duber
BACKGROUND: The HealthRise initiative seeks to implement and evaluate innovative community-based strategies for diabetes, hypertension and hypercholesterolemia along the entire continuum of care (CoC)-from awareness and diagnosis, through treatment and control. In this study, we present baseline findings from HealthRise South Africa, identifying gaps in the CoC, as well as key barriers to care for non-communicable diseases (NCDs). METHODS: This mixed-methods needs assessment utilized national household data, health facility surveys, focus group discussions, and key informant interviews in Umgungundlovu and Pixley ka Seme districts...
2018: PloS One
Carl D Stevens
The sudden, dramatic collapse of the seven-year struggle in Congress to repeal and replace the Affordable Care Act holds important lessons for all would-be reformers, including those advocating fundamental changes in medical education. In this Invited Commentary, the author draws parallels between reform initiatives in health policy and those in medical education, highlighting that, in both settings, stakeholders rarely support "repeal" in the absence of a superior replacement, even when they view the status quo as deeply flawed...
March 13, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
Matthew J Snyder, Dana R Nguyen, Jasmyne J Womack, Christopher W Bunt, Katie L Westerfield, Adriane E Bell, Christy J W Ledford
BACKGROUND AND OBJECTIVES: Collection of feedback regarding medical student clinical experiences for formative or summative purposes remains a challenge across clinical settings. The purpose of this study was to determine whether the use of a quick response (QR) code-linked online feedback form improves the frequency and efficiency of rater feedback. METHODS: In 2016, we compared paper-based feedback forms, an online feedback form, and a QR code-linked online feedback form at 15 family medicine clerkship sites across the United States...
March 2018: Family Medicine
Gianni Belcaro, Mark Dugall, Roberta Luzzi, Morio Hosoi, Andrea Ledda, Beatrice Feragalli, Shu Hu, Apurba Ganguly, Roberto Eggenhoffner, Ambra Corti, Luca Giacomelli
BACKGROUND: Curcumin is a powerful anti-oxidant that can be used to treat inflammation and pain in chronic conditions such as osteoarthrosis (OA). Phytoproflex® is characterized by an innovative delivery system that improves bioavailability of curcuminoids and could be useful in the management of OA. METHODS: This 4-week registry included 56 patients with knee OA treated according to the best standard management for symptomatic OA. On top of that, 24 patients used Phytoproflex® supplement preparation (an extract containing boswellic acid 90%, curcumin 20% and valeric acid 0...
April 2018: Minerva Medica
Dominik Zinsser, Roy Marcus, Ahmed E Othman, Fabian Bamberg, Konstantin Nikolaou, Thomas Flohr, Mike Notohamiprodjo
BACKGROUND:  For years, the number of performed CT examinations has been rising. At the same time, computed tomography became more dose efficient. The aim of this article is to give an overview about the state of the art in dose reduction in CT and to highlight currently available tools in dose management. METHOD:  By performing a literature research on Pubmed regarding dose reduction in CT, relevant articles were identified and analyzed. RESULTS AND CONCLUSION:  Technical innovations with individual adaptation of tube current and voltage as well as iterative image reconstruction enable a considerable dose reduction with preserved image quality...
March 13, 2018: RöFo: Fortschritte Auf Dem Gebiete der Röntgenstrahlen und der Nuklearmedizin
Lisa D DiMartino, Sarah A Birken, Laura C Hanson, Justin G Trogdon, Alecia S Clary, Morris Weinberger, Katherine Reeder-Hayes, Bryan J Weiner
BACKGROUND: The implementation science literature has contributed important insights regarding the influence of formal policies and practices on health care innovation implementation, whereas informal implementation policies and practices have garnered little attention. The broader literature suggests that informal implementation policies and practices could also influence innovation use. PURPOSE: We used the Organizational Theory of Innovation Implementation to further understand the role of formal and informal implementation policies and practices as determinants of implementation effectiveness...
March 12, 2018: Health Care Management Review
Katharina Wulf, Michael Teske, Claudia Matschegewski, Daniela Arbeiter, Dalibor Bajer, Thomas Eickner, Klaus-Peter Schmitz, Niels Grabow
The successive incorporation of several drugs into the polymeric bulk of implants mostly results in loss of considerable quantity of one drug, and/or the loss in quality of the coating and also in changes of drug release time points. A dual drug delivery system (DDDS) based on poly-L-lactide (PLLA) copolymers combining the effective inhibition of smooth muscle cell proliferation while simultaneously promoting re-endothelialization was successfully developed. To overcome possible antagonistic drug interactions and the limitation of the polymeric bulk material as release system for dual drugs, a novel concept which combines the bulk and surface drug immobilization for a DDDS was investigated...
March 12, 2018: Drug Delivery and Translational Research
Georgi Tchernev
BACKGROUND: We present to the attention of the medical, dermatological and oncosurgical community data that serves to indicate the indispensability of optimisation of the algorithm and recommendations for diagnosis and surgical treatment of cutaneous melanoma. These recommendations could be referred to different subgroups of patients in different clinical stages as well as to patients with different initial characterisation (histological morphology) of the primary tumours. One step surgery is not a myth, even more, it could prove to be one of the best solutions for some patient collectives with advanced stages of melanoma...
February 15, 2018: Open Access Macedonian Journal of Medical Sciences
Urvish Joshi, Sheetal Vyas
Background and Objectives: Current programs in medical education technology concentrate mainly upon "how-to-teach." The focus is needed on learner's memory retention too. An innovative strategy like concept mapping might be a way forward. The study was carried out to assess its effectiveness and to know students' perceptions. Materials and Methods: During community medicine classes, a student-group was sensitized on how to make and use concept maps out of taught contents...
January 2018: Indian Journal of Community Medicine
Teresa Seeman, Duncan Thomas, Sharon Stein Merkin, Kari Moore, Karol Watson, Arun Karlamangla
Longitudinal, individual-specific data from the Multi-Ethnic Study of Atherosclerosis (MESA) provide support for the hypothesis that the 2008 to 2010 Great Recession (GR) negatively impacted the health of US adults. Results further advance understanding of the relationship by ( i ) illuminating hypothesized greater negative impacts in population subgroups exposed to more severe impacts of the GR and ( ii ) explicitly controlling for confounding by individual differences in age-related changes in health over time...
March 12, 2018: Proceedings of the National Academy of Sciences of the United States of America
Mauricio Mandel, Carlo Emanuel Petito, Rafael Tutihashi, Wellingson Paiva, Suzana Abramovicz Mandel, Fernando Campos Gomes Pinto, Almir Ferreira de Andrade, Manoel Jacobsen Teixeira, Eberval Gadelha Figueiredo
OBJECTIVE Advances in video and fiber optics since the 1990s have led to the development of several commercially available high-definition neuroendoscopes. This technological improvement, however, has been surpassed by the smartphone revolution. With the increasing integration of smartphone technology into medical care, the introduction of these high-quality computerized communication devices with built-in digital cameras offers new possibilities in neuroendoscopy. The aim of this study was to investigate the usefulness of smartphone-endoscope integration in performing different types of minimally invasive neurosurgery...
March 13, 2018: Journal of Neurosurgery
Andrew N Claxton, Paul M Dark
Sepsis is a medical emergency, which requires the initiation of broad-spectrum antimicrobial agents as early as possible. In the absence of positive microbiological cultures providing targeted antimicrobial advice, broad-spectrum antibiotics are commonly continued until there is clinical evidence of infection resolution. With an absence of robust evidence to inform when it is safe to stop antimicrobial agents in sepsis, the duration of antimicrobial courses may be longer than is required. Prolonged courses of potent broad-spectrum antimicrobials increase the risk of adverse drug events and contribute to the growing emergence of multidrug resistant pathogens, which is a global public health emergency...
March 2, 2018: British Journal of Hospital Medicine
Miusi Shi, Ruiwen Yang, Qin Li, Kangle Lv, Richard J Miron, Jie Sun, Mei Li, Yufeng Zhang
Since the discovery of osteoinduction in the early 20th century, innovative biomaterials with osteoinductive potential have emerged as candidates for bone repair. Recently, artificial protocell models have demonstrated great potential for tissue regeneration. Herein, we developed artificial bioactive proto-osteocells by self-assembly of biodegradable biphasic-phosphate particles in the form of aqueous-bone morphogenetic protein 2 (BMP2)-containing pickering emulsions in corn oil to fulfill the release of BMP2 with controlled and local efficacy...
March 12, 2018: ACS Applied Materials & Interfaces
Marko Zdravković, Tamara Serdinšek, Monika Sobočan, Sebastjan Bevc, Radovan Hojs, Ivan Krajnc
BACKGROUND: Student engagement (SE) in the curriculum is a positive indicator in the development of students deeply involved in their learning. It also has several benefits for the schools' level of educational innovation and quality assurance. METHOD: In order to identify the most important pearls from the last decade of educational developments within the field of SE at the Faculty of Medicine University of Maribor, we searched through our school's archives, publications and research in the field of medical education...
March 11, 2018: Medical Teacher
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