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Quality and patient safety

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https://www.readbyqxmd.com/read/28635368/efficacy-and-safety-of-autologous-cell-therapies-for-knee-cartilage-defects-autologous-stem-cells-chondrocytes-or-the-two-randomized-controlled-trial-design
#1
James B Richardson, Karina T Wright, Johanna Wales, Jan Herman Kuiper, Helen S McCarthy, Peter Gallacher, Paul E Harrison, Sally Roberts
AIM: The main aim of this trial is to test the safety and efficacy of autologous stromal/stem cells, chondrocytes or the two combined in the treatment of knee cartilage defects. PATIENTS & METHODS: Patients with symptomatic chondral/osteochondral defects will be randomized to cell therapy treatment with one of three cell populations (1:1:1). The primary efficacy outcome is a functional knee score (Lysholm) at 15 months post-treatment and the primary safety outcome is the incidence of adverse events...
June 21, 2017: Regenerative Medicine
https://www.readbyqxmd.com/read/28634619/implementation-of-li-rads-into-a-radiological-practice
#2
REVIEW
Stefan T Siedlikowski, Ania Z Kielar, Eleanor L Ormsby, Bijan Bijan, Christopher Kagay
Since its introduction in 2011, Liver Imaging Reporting and Data System (LI-RADS) has become an increasingly utilized method for radiologists to categorize lesions for hepatocellular carcinoma (HCC) in patients at risk (American College of Radiology, www.acr.org/quality-safety/resources/lirads 2016). This overview article presents insight into methods of incorporating LI-RADS into an existing clinical practice, highlighting concrete ways to establish this system as a mainstay in any radiologist's evidence-based armamentarium...
June 20, 2017: Abdominal Radiology
https://www.readbyqxmd.com/read/28633675/acupuncture-treatment-on-the-motor-area-of-the-scalp-for-motor-dysfunction-in-patients-with-ischemic-stroke-study-protocol-for-a-randomized-controlled-trial
#3
Jun Wang, Jian Pei, Dhiaedin Khiati, Qinhui Fu, Xiao Cui, Yi Song, Minghang Yan, Lijun Shi, Yiwen Cai, Yuhong Ma
BACKGROUND: Scalp acupuncture has shown a remarkable treatment efficacy on motor dysfunction in patients with stroke in China, especially the motor area of Jiao's scalp acupuncture, which is the most widely used treatment. However, previous studies have summarized that the clinical curative effect of acupuncture treatment for stroke remains uncertain. Meanwhile, no randomized controlled trials on Jiao's scalp acupuncture have been performed. The aim of this study is to evaluate the efficacy and safety of Jiao's scalp acupuncture for motor dysfunction in ischemic stroke...
June 20, 2017: Trials
https://www.readbyqxmd.com/read/28633657/patient-safety-culture-in-norwegian-nursing-homes
#4
Gunnar Tschudi Bondevik, Dag Hofoss, Bettina Sandgathe Husebø, Ellen Catharina Tveter Deilkås
BACKGROUND: Patient safety culture concerns leader and staff interaction, attitudes, routines, awareness and practices that impinge on the risk of patient-adverse events. Due to their complex multiple diseases, nursing home patients are at particularly high risk of adverse events. Studies have found an association between patient safety culture and the risk of adverse events. This study aimed to investigate safety attitudes among healthcare providers in Norwegian nursing homes, using the Safety Attitudes Questionnaire - Ambulatory Version (SAQ-AV)...
June 20, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28631903/-solitary-stones-of-the-lower-renal-calyx-how-to-treat
#5
A G Martov, D V Ergakov, A S Andronov, S V Dutov, R A Takhaev, Z I Kil'chukov, S A Moskalenko
INTRODUCTION: The choice of treatment for the stones of the lower renal calyx is one of the challenging issues of modern urology. The aim of this retrospective and prospective study was to investigate the clinical effectiveness and safety of 3 modern minimally invasive techniques for treating renal stones: percutaneous (PNL) and transurethral (TNL) nephrolithotripsy and extracorporeal shock wave lithotripsy (ESWL) in patients with solitary lower calyx stones sized from 10 to 15 mm. MATERIALS AND METHODS: The study included 136 patients with symptomatic stones of the lower calyces, who underwent ESWL, PNL and TNL from November 2010 to the present day...
June 2017: Urologii︠a︡
https://www.readbyqxmd.com/read/28631387/umeclidinium-bromide-versus-placebo-for-people-with-chronic-obstructive-pulmonary-disease-copd
#6
REVIEW
Han Ni, Aung Htet, Soe Moe
BACKGROUND: People with chronic obstructive pulmonary disease (COPD) have poor quality of life, reduced survival, and accelerated decline in lung function, especially associated with acute exacerbations, leading to high healthcare costs. Long-acting bronchodilators are the mainstay of treatment for symptomatic improvement, and umeclidinium is one of the new long-acting muscarinic antagonists approved for treatment of patients with stable COPD. OBJECTIVES: To assess the efficacy and safety of umeclidinium bromide versus placebo for people with stable COPD...
June 20, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28631003/yoga-physical-therapy-or-education-for-chronic-low-back-pain-a-randomized-noninferiority-trial
#7
Robert B Saper, Chelsey Lemaster, Anthony Delitto, Karen J Sherman, Patricia M Herman, Ekaterina Sadikova, Joel Stevans, Julia E Keosaian, Christian J Cerrada, Alexandra L Femia, Eric J Roseen, Paula Gardiner, Katherine Gergen Barnett, Carol Faulkner, Janice Weinberg
Background: Yoga is effective for mild to moderate chronic low back pain (cLBP), but its comparative effectiveness with physical therapy (PT) is unknown. Moreover, little is known about yoga's effectiveness in underserved patients with more severe functional disability and pain. Objective: To determine whether yoga is noninferior to PT for cLBP. Design: 12-week, single-blind, 3-group randomized noninferiority trial and subsequent 40-week maintenance phase...
June 20, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28629729/a-multicenter-study-of-routine-versus-selective-intraoperative-leak-testing-for-sleeve-gastrectomy
#8
Jason Bingham, Jedediah Kaufman, Kai Hata, James Dickerson, Alec Beekley, Gordon Wisbach, Jacob Swann, Eric Ahnfeldt, Devon Hawkins, Yong Choi, Robert Lim, Matthew Martin
BACKGROUND: Staple line leaks after sleeve gastrectomy are dreaded complications. Many surgeons routinely perform an intraoperative leak test (IOLT) despite little evidence to validate the reliability, clinical benefit, and safety of this procedure. OBJECTIVES: To determine the efficacy of IOLT and if routine use has any benefit over selective use. SETTING: Eight teaching hospitals, including private, university, and military facilities. METHODS: A multicenter, retrospective analysis over a 5-year period...
May 25, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28629705/nursing-involvement-in-risk-and-patient-safety-management-in-primary-care
#9
Valle Coronado-Vázquez, Ana García-López, Susana López-Sauras, José María Turón Alcaine
Patient safety and quality of care in a highly complex healthcare system depends not only on the actions of professionals at an individual level, but also on interaction with the environment. Proactive risk management in the system to prevent incidents and activities targeting healthcare teams is crucial in establishing a culture of safety in centres. Nurses commonly lead these safety strategies. Even though safety incidents are relatively infrequent in primary care, since the majority are preventable, actions at this level of care are highly effective...
June 16, 2017: Enfermería Clínica
https://www.readbyqxmd.com/read/28629581/impact-of-a-teamstepps-trauma-nurse-academy-at-a-level-1-trauma-center
#10
V Kristen Peters, Ellen M Harvey, Andi Wright, Jennifer Bath, Dan Freeman, Bryan Collier
PROBLEM: Nurses are crucial members of the team caring for the acutely injured trauma patient. Until recently, nurses and physicians gained an understanding of leadership and supportive roles separately. With the advent of a multidisciplinary team approach to trauma care, formal team training and simulation has transpired. METHODS: Since 2007, our Level I trauma system has integrated TeamSTEPPS (Team Strategies & Tools to Enhance Performance & Patient Safety; Agency for Healthcare Research and Quality, Rockville, MD) into our clinical care, joint training of nurses and physicians, using simulations with participation of all health care providers...
June 16, 2017: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
https://www.readbyqxmd.com/read/28629447/transcranial-direct-current-stimulation-for-depression-in-alzheimer-s-disease-study-protocol-for-a-randomized-controlled-trial
#11
Zui Narita, Yuma Yokoi
BACKGROUND: Patients with Alzheimer's disease frequently elicit neuropsychiatric symptoms as well as cognitive deficits. Above all, depression is one of the most common neuropsychiatric symptoms in Alzheimer's disease but antidepressant drugs have not shown significant beneficial effects on it. Moreover, electroconvulsive therapy has not ensured its safety for potential severe adverse events although it does show beneficial clinical effect. Transcranial direct current stimulation can be the safe alternative of neuromodulation, which applies weak direct electrical current to the brain...
June 19, 2017: Trials
https://www.readbyqxmd.com/read/28629376/radiation-therapy-for-older-patients-with-brain-tumors
#12
REVIEW
Giuseppe Minniti, Andrea Riccardo Filippi, Mattia Falchetto Osti, Umberto Ricardi
The incidence of brain tumors in the elderly population has increased over the last few decades. Current treatment includes surgery, radiotherapy and chemotherapy, but the optimal management of older patients with brain tumors remains a matter of debate, since aggressive radiation treatments in this population may be associated with high risks of neurological toxicity and deterioration of quality of life. For such patients, a careful clinical status assessment is mandatory both for clinical decision making and for designing randomized trials to adequately evaluate the optimal combination of radiotherapy and chemotherapy...
June 19, 2017: Radiation Oncology
https://www.readbyqxmd.com/read/28628522/patient-experiences-of-partnering-with-healthcare-professionals-for-hand-hygiene-compliance-a-systematic-review
#13
Samantha Butenko, Craig Lockwood, Alexa McArthur
BACKGROUND: Healthcare-associated infections pose a significant risk to patients in acute healthcare settings such as hospitals. Increasingly, patients are encouraged to be active participants and partner with healthcare professionals to positively influence their own safety and overall experience throughout their healthcare journey. Patient-focused safety initiatives include the empowerment of patients to be active partners with healthcare professionals in order to influence the hand hygiene behaviors and compliance of the healthcare professionals providing care to them...
June 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/28628003/clinical-effectiveness-and-cost-effectiveness-results-from-the-randomised-phase-iib-trial-in-previously-untreated-patients-with-chronic-lymphocytic-leukaemia-to-compare-fludarabine-cyclophosphamide-and-rituximab-with-fludarabine-cyclophosphamide-mitoxantrone
#14
Dena R Howard, Talha Munir, Lucy McParland, Andy C Rawstron, Anna Chalmers, Walter M Gregory, John L O'Dwyer, Alison Smith, Roberta Longo, Abraham Varghese, Alexandra Smith, Peter Hillmen
BACKGROUND: The conventional frontline therapy for fit patients with chronic lymphocytic leukaemia (CLL) is fludarabine, cyclophosphamide and rituximab (FCR). Rituximab (Mabthera(®), Roche Products Ltd) targets the CD20 antigen, which is expressed at low levels in CLL. The standard dose of rituximab in CLL (375 mg/m(2) in cycle 1 and 500 mg/m(2) in cycles 2-6) was selected based on toxicity data only. Small doses of rituximab (as low as 20 mg) have biological activity in CLL, with an immediate reduction in circulating CLL cells and down-regulation of CD20...
May 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28627150/-applying-a-set-of-indicators-to-evaluate-the-primary-health-care
#15
Antonio Giampietro Russo, Maria Teresa Greco
OBJECTIVES: to develop a system of indicators to monitor the quality of health care, in terms of safety, effectiveness, and appropriateness to allow the integrated promotion of the welfare of the effectiveness and quality. DESIGN: retrospective study. SETTING AND PARTICIPANTS: all general practitioners (GPs) with at least 100 patients in loading at 1.1.2015 were included. The setting chosen is the Primary Care of the Agency for Health Protection of the Province of Milan (Northern Italy)...
January 2017: Epidemiologia e Prevenzione
https://www.readbyqxmd.com/read/28626086/nursing-skill-mix-in-european-hospitals-cross-sectional-study-of-the-association-with-mortality-patient-ratings-and-quality-of-care
#16
Linda H Aiken, Douglas Sloane, Peter Griffiths, Anne Marie Rafferty, Luk Bruyneel, Matthew McHugh, Claudia B Maier, Teresa Moreno-Casbas, Jane E Ball, Dietmar Ausserhofer, Walter Sermeus
OBJECTIVES: To determine the association of hospital nursing skill mix with patient mortality, patient ratings of their care and indicators of quality of care. DESIGN: Cross-sectional patient discharge data, hospital characteristics and nurse and patient survey data were merged and analysed using generalised estimating equations (GEE) and logistic regression models. SETTING: Adult acute care hospitals in Belgium, England, Finland, Ireland, Spain and Switzerland...
July 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/28625740/comparative-proteomic-analysis-of-two-transgenic-low-gliadin-wheat-lines-and-non-transgenic-wheat-control
#17
María Dolores García-Molina, Vera Muccilli, Rosaria Saletti, Salvatore Foti, Stefania Masci, Francisco Barro
Gluten proteins are major determinants of the bread making quality of wheat, but also of important wheat-related disorders, including coeliac disease (CD), and allergies. We carried out a proteomic study using the total grain proteins from two low-gliadin wheat lines, obtained by RNAi, and the untransformed wild type as reference. The impact of silencing on both target and on non-target proteins was evaluated. Because of the great protein complexity, we performed separate analyses of four kernel protein fractions: gliadins and glutenin subunits, and metabolic and CM-like proteins, by using a classical 2D electrophoresis gel based approach followed by RP-HPLC/nESI-MS/MS...
June 15, 2017: Journal of Proteomics
https://www.readbyqxmd.com/read/28625506/long-term-cost-effectiveness-of-two-glp-1-receptor-agonists-for-the-treatment-of-type-2-diabetes-mellitus-in-the-italian-setting-liraglutide-versus-lixisenatide
#18
Barnaby Hunt, Nana Kragh, Ceilidh C McConnachie, William J Valentine, Maria C Rossi, Roberta Montagnoli
PURPOSE: Maintaining glycemic control is the key treatment target for patients with type 2 diabetes mellitus. In addition, the glucagon-like peptide-1 (GLP-1) receptor agonists may be associated with other favorable treatment characteristics, such as reduction in body weight and reduced risk of hypoglycemia compared with traditional diabetes interventions. The aim of the present analysis was to compare the long-term cost-effectiveness of 2 GLP-1 receptor agonists, liraglutide 1.8 mg and lixisenatide 20 μg (both administered once daily), in the treatment of patients with type 2 diabetes failing to achieve glycemic control with metformin monotherapy in the Italian setting...
June 15, 2017: Clinical Therapeutics
https://www.readbyqxmd.com/read/28625396/management-of-menopausal-symptoms-in-women-with-gynecologic-cancers
#19
REVIEW
Marcela G Del Carmen, Laurel W Rice
OBJECTIVE: Women with gynecologic malignancies will be cured or may become long-term survivors. Management of menopausal symptoms is important in addressing their quality of life. We review the benefit and safety of hormone therapy use in these patients. METHODS: MEDLINE was searched for studies on menopause management published in English through December of 2016. RESULTS: Available data suggest that short-term use of hormone therapy in gynecologic cancer patients who do not have an estrogen-dependent malignancy do not adversely impact oncologic outcome and results in improvement of menopausal vasomotor and genitourinary symptoms...
June 15, 2017: Gynecologic Oncology
https://www.readbyqxmd.com/read/28624717/management-of-venous-thromboembolism-in-patients-with-glioma
#20
Mosaad Al Megren, Carine De Wit, Mohammad Al Qahtani, Grégoire Le Gal, Marc Carrier
BACKGROUND: Venous thromboembolism (VTE) is a common complication among patients with glioma. However, data on the safety of therapeutic doses of anticoagulation is scarce in this patient population. OBJECTIVES: The purpose of this study is to evaluate the risk of intracranial hemorrhage (ICH) in glioma patients receiving therapeutic anticoagulation for VTE treatment. PATIENTS AND METHODS: We conducted a case-control study including glioma patients with and without acute VTE from Jan 2010 to March 2015...
June 8, 2017: Thrombosis Research
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