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https://www.readbyqxmd.com/read/29144543/primary-thromboprophylaxis-in-individuals-without-cancer-admitted-to-a-geriatric-palliative-care-unit
#1
Adam J Gurau, Anna Berall, Jurgis Karuza, Giulia-Anna Perri
BACKGROUND/OBJECTIVES: The prevalence of individuals with advanced noncancer disease is increasing on palliative care units (PCUs), but there are no current guidelines to direct venous thromboembolism (VTE) prophylaxis decisions in these individuals. The aim of this study was to compare primary VTE prophylaxis in elderly adults with advanced noncancer diagnoses with that of those with advanced cancer on a dedicated geriatric PCU. DESIGN: Single-center retrospective chart review...
November 16, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29143673/the-heptestcontest-a-global-innovation-contest-to-identify-approaches-to-hepatitis-b-and-c-testing
#2
Joseph D Tucker, Kathrine Meyers, John Best, Karyn Kaplan, Razia Pendse, Kevin A Fenton, Isabelle Andrieux-Meyer, Carmen Figueroa, Pedro Goicochea, Charles Gore, Azumi Ishizaki, Giten Khwairakpam, Veronica Miller, Antons Mozalevskis, Michael Ninburg, Ponsiano Ocama, Rosanna Peeling, Nick Walsh, Massimo G Colombo, Philippa Easterbrook
BACKGROUND: Innovation contests are a novel approach to elicit good ideas and innovative practices in various areas of public health. There remains limited published literature on approaches to deliver hepatitis testing. The purpose of this innovation contest was to identify examples of different hepatitis B and C approaches to support countries in their scale-up of hepatitis testing and to supplement development of formal recommendations on service delivery in the 2017 World Health Organization hepatitis B and C testing guidelines...
November 1, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/29141040/medical-therapy-versus-radiofrequency-endometrial-ablation-in-the-initial-treatment-of-heavy-menstrual-bleeding-itom-trial-a-clinical-and-economic-analysis
#3
Abimbola O Famuyide, Shannon K Laughlin-Tommaso, Sherif A Shazly, Kirsten Hall Long, Daniel M Breitkopf, Amy L Weaver, Michaela E McGree, Sherif A El-Nashar, Maureen A Lemens, Matthew R Hopkins
BACKGROUND: Radiofrequency endometrial ablation (REA) is currently a second line treatment in women with heavy menstrual bleeding (MHB) if medical therapy (MTP) is contraindicated or unsatisfactory. Our objective is to compare the effectiveness and cost burden of MTP and REA in the initial treatment of HMB. METHODS: We performed a randomized trial at Mayo Clinic Rochester, Minnesota. The planned sample size was 60 patients per arm. A total of 67 women with HMB were randomly allocated to receive oral contraceptive pills (Nordette ®) or Naproxen (Naprosyn®) (n = 33) or REA (n = 34)...
2017: PloS One
https://www.readbyqxmd.com/read/29140112/a-2017-review-of-pharmacotherapy-for-treating-focal-epilepsy-where-are-we-now-and-how-will-treatment-develop
#4
Andreas Schulze-Bonhage
Focal epilepsy is the most common type of epilepsy with approximately 30 million patients affected worldwide. There is a major challenge to develop new antiepileptic treatments as currently approximately one third of patients remain uncontrolled under our best standards of care. Areas covered: An overview is given on first- and second generation antiepileptic drugs and their mechanisms of action, and on recent new strategies for antiepileptic targets, including drugs aiming at disease modification. Expert opinion: Newer antiepileptic drugs have enabled a better tolerated and individualized treatment for many patients...
November 15, 2017: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/29139337/do-people-with-severe-traumatic-brain-injury-benefit-from-making-errors-a-randomized-controlled-trial-of-error-based-and-errorless-learning
#5
Tamara Ownsworth, Jennifer Fleming, Robyn Tate, Elizabeth Beadle, Janelle Griffin, Melissa Kendall, Julia Schmidt, Amanda Lane-Brown, Mathilde Chevignard, David H K Shum
BACKGROUND: Errorless learning (ELL) and error-based learning (EBL) are commonly used approaches to rehabilitation for people with traumatic brain injury (TBI). However, it is unknown whether making errors is beneficial in the learning process to promote skills generalization after severe TBI. OBJECTIVE: To compare the efficacy of ELL and EBL for improving skills generalization, self-awareness, behavioral competency, and psychosocial functioning after severe TBI...
November 1, 2017: Neurorehabilitation and Neural Repair
https://www.readbyqxmd.com/read/29137903/implementation-of-alere-i-influenza-a-b-point-of-care-test-for-the-diagnosis-of-influenza-in-an-emergency-department
#6
E Trabattoni, V Le, B Pilmis, G Pean de Ponfilly, C Caisso, C Couzigou, B Vidal, A Mizrahi, O Ganansia, A Le Monnier, B Lina, J C Nguyen Van
STUDY OBJECTIVE: This study aimed to evaluate the impact of implementing rapid point-of-care testing (POCT) with the Alere i Influenza A & B in an emergency department (ED) during an influenza epidemic. METHODS: Direct nasal swabs were prospectively collected following the physical examination of patients aged >18years who presented to the ED of a tertiary hospital in France with influenza-like illness (ILI) symptoms (N=301) between February 1st and March 31st, 2016, which coincided with an influenza epidemic...
October 18, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29136003/longitudinal-acquisition-of-endotracheal-intubation-skills-in-novice-physicians
#7
Shinya Takeuchi, Takashi Shiga, Yasuaki Koyama, Taizo Nakanishi, Yosuke Honma, Hiroshi Morita, Tadahiro Goto
Little is known about the acquisition of intubation skills among novice physicians during their one-year clinical training. Our primary objective was to determine the changes in the intubation skills of novice physicians between prior to the clinical training and after completion of the clinical training. We used data of a prospective longitudinal multicenter data registry developed to investigate factors associated with the improvement of intubation skills among novice physicians. The study participants included 90 postgraduate year 1 physicians in 2015-2016...
2017: PloS One
https://www.readbyqxmd.com/read/29133284/the-association-of-health-literacy-and-electronic-health-literacy-with-self-efficacy-coping-and-caregiving-perceptions-among-carers-of-people-with-dementia-research-protocol-for-a-descriptive-correlational-study
#8
Areti Efthymiou, Nicos Middleton, Andreas Charalambous, Evridiki Papastavrou
BACKGROUND: In the last decade, electronic health (eHealth) literacy has attracted the attention of the scientific community, as it is associated with the self-management of patients with chronic diseases and the quality and cost of care. It is estimated that 80% of people with chronic diseases are cared for at home by a family member, friend, or relative. Informal carers are susceptible to physical and mental health problems, as well as social and financial hardships. Nevertheless, there seems to be a research gap in terms of carers' needs, skills, and available resources in the age of new technologies, with the vital role of eHealth literacy of the carers remaining unexplored...
November 13, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/29133262/911-emergency-medical-services-and-re-triage-to-level-i-trauma-centers
#9
Eric Kuncir, Dean Spencer, Kelly Feldman, Cristobal Barrios, Kenneth Miller, Stephanie Lush, Matthew Dolich, Michael Lekawa
BACKGROUND: Interfacility transfer of under-triaged patients to higher level trauma centers has been found to result in a delay of appropriate care and increase in mortality. To address this, for the last 10 years, our region has utilized 911 EMS paramedics for rapid re-triage of under-triaged patients to our institution's Level I trauma center. We sought to determine if utilizing 911 EMS for re-triage (911-RT) to our institution was associated with worse outcomes-with mortality as the primary outcome-compared to direct EMS transport from point of injury...
September 27, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29132630/evaluating-e-consultation-implementations-based-on-use-and-time-line-across-various-specialties
#10
Pratik J Parikh, Corinne Mowrey, Jennie Gallimore, Stephen Harrell, Brian Burke
BACKGROUND: Electronic Consultation (e-consults) can provide improved access, enhance patient and provider satisfaction, and reduce beneficiary travel expenses. We explored how e-consults were implemented across three specialty areas, diabetes (Diab), gastroenterology (GI), and neurosurgery (Neuro), at two Veterans Affairs hospitals in terms of strategies for use and time-lines. METHODS: We conducted observations and electronically shadowed patient e-consultations submitted to a specialty care service by primary care provider(s) at the two sites during a thirteen-month period...
December 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/29132445/physician-remuneration-for-remote-consults-an-overview-of-approaches-across-canada
#11
Kelly Stanistreet, Jenn Verma, Kirby Kirvan, Neil Drimer, Clare Liddy
While lengthy waits for medical specialists remains a persistent problem across Canada, remote consult presents a strategy to address this issue. Connecting primary healthcare providers to specialists via electronic (eConsult) or telephone consult enables care providers to deliver appropriate, speciality-informed care for their patients in the primary care setting, reducing the time spent waiting for specialists and potentially preventing unnecessary referrals to specialty care. These remote consult models are the focus of a new pan-Canadian quality improvement collaborative delivered by the Canadian Foundation for Healthcare Improvement in partnership with Canada Health Infoway, the College of Family Physicians of Canada and the Royal College of Physicians and Surgeons of Canada...
2017: Healthcare Quarterly
https://www.readbyqxmd.com/read/29131328/headache-education-active-waiting-directive-a-program-to-enhance-well-being-during-long-referral-wait-times
#12
Ana Marissa Lagman-Bartolome, Valerie Lawler, Christine Lay
OBJECTIVE: The aim of this initiative was to evaluate the clinical impact, patient acceptability, and sustainability of implementing a newly developed evidence-guided migraine education program in an academic headache center. BACKGROUND: Headache is the fifth most common reason for emergency department (ED) visits and accounts for more than 10 million physician visits annually. Successful management of headaches presents a challenge to both primary care providers and neurologists...
November 12, 2017: Headache
https://www.readbyqxmd.com/read/29130236/-occurrence-diagnosis-and-treatment-of-de-novo-gastrointestinal-malignancies-after-organ-transplantation
#13
Linhua Ji, Gang Zhao
With the continuous use of immunosuppressive agents routinely, the long-term survival rate of organ transplant recipients has been incessantly improved. However, the risk of de novo malignancies is also increasing, which has become the second cause of death after organ transplantation. De novo gastrointestinal malignancies are common after liver or kidney transplantation, mostly with advanced stage when diagnosed and poor prognosis. There is a significant trend in the development of de novo malignancies in transplant recipients, which is probably related to factors, including direct or indirect effects of immunosuppressive agents, precancerosis and survival time of transplanted grafts and recipients...
October 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/29127230/primary-care-management-of-headaches-and-how-direct-access-mri-fits-a-qualitative-study-of-uk-general-practitioners-views
#14
Raphael Underwood, Rachael Kilner, Leone Ridsdale
OBJECTIVES: To develop a better understanding of general practitioners' (GPs) views and experiences of the management of patients with headaches and use of direct-access MRI scans, and observe outcomes of an educational session offered by a GP with a special interest (GPwSI) to GPs. DESIGN: A qualitative study using semistructured interviews, analysed using thematic analysis. A GPwSI in headaches visited practices delivering a talk on headache medication, diagnosis and management...
November 9, 2017: BMJ Open
https://www.readbyqxmd.com/read/29126894/developments-in-pre-hospital-patient-transport-in-st-elevation-myocardial-infarction
#15
Maria Inês da Costa Silveira, Maria João Monteiro Sousa, Patrícia Fernandes Dias de Madureira Rodrigues, Bruno Miguel Fernandes Brochado, Raquel Bachen Guimarães Santos, Maria Ana Meixa Alves Burbach Trêpa, André Miguel Coimbra Luz, João Antonio Brum da Silveira, Aníbal António Braga de Albuquerque, Henrique José Cyrne de Castro Machado Carvalho, Severo Barreiro Torres
INTRODUCTION: ST-elevation myocardial infarction (STEMI) is a medical emergency that benefits from rapid access to specialized care. The objective of this study was to describe developments in patient transport via the pre-hospital emergency medical system (EMS) and its impact on clinical outcomes. METHODS: We retrospectively studied STEMI patients who underwent primary percutaneous coronary intervention between January 2008 and July 2015. Patients were divided according to type of admission...
November 7, 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/29126415/cost-of-illness-of-atrial-fibrillation-a-nationwide-study-of-societal-impact
#16
Søren Paaske Johnsen, Lene Worsaae Dalby, Tomas Täckström, Jens Olsen, Anina Fraschke
BACKGROUND: The prevalence of atrial fibrillation is increasing rapidly; however, to date, population-based data are lacking on the attributable cost of illness of atrial fibrillation from a societal perspective, including both direct and indirect costs. METHODS: The study was an incidence-based cost-of-illness study based on national registries covering the entire population of Denmark. We identified all patients with a first-time hospital diagnosis of atrial fibrillation between 2001 and 2012...
November 10, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/29124976/rethinking-mercury-the-role-of-selenium-in-the-pathophysiology-of-mercury-toxicity
#17
Henry A Spiller
INTRODUCTION: There is increasing evidence that the pathophysiological target of mercury is in fact selenium, rather than the covalent binding of mercury to sulfur in the body's ubiquitous sulfhydryl groups. The role of selenium in mercury poisoning is multifaceted, bidirectional, and central to understanding the target organ toxicity of mercury. METHODS: An initial search was performed using Medline/PubMed, Toxline, Google Scholar, and Google for published work on mercury and selenium...
November 10, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/29123600/activities-performed-by-pharmacists-integrated-in-family-health-teams-results-from-a-web-based-survey
#18
Ulrika Gillespie, Lisa Dolovich, Simone Dahrouge
Objectives: Family health teams (FHTs), an interprofessional primary care practice model, were established in Ontario in 2005. As of October 2014, 191 FHT organizations were in operation, and 111 (58%) included one or several pharmacists. The objective of this study was to document the focus of pharmacist activities in FHTs. Approach: We invited all 155 known FHT pharmacists to a web-based survey. The survey was constructed using information obtained from previously done semi-structured telephone interviews with pharmacists working in FHTs...
November 2017: Canadian Pharmacists Journal: CPJ, Revue des Pharmaciens du Canada: RPC
https://www.readbyqxmd.com/read/29120385/hospital-audit-as-a-useful-tool-in-the-process-of-introducing-falsified-medicines-directive-fmd-into-hospital-pharmacy-settings-a-pilot-study
#19
Urszula Religioni, Damian Swieczkowski, Anna Gawrońska, Anna Kowalczuk, Mariola Drozd, Mikołaj Zerhau, Dariusz Smoliński, Stanisław Radomiński, Natalia Cwalina, David Brindley, Miłosz J Jaguszewski, Piotr Merks
BACKGROUND: Recently, the European Union has introduced the Falsified Medicines Directive (FMD). Additionally, in early 2016, a Delegated Act (DA) related to the FMD was published. The main objective of this study was to evaluate the usefulness of external audits in the context of implementing new regulations provided by the FMD in the secondary care environment. METHODS: The external, in-person workflow audits were performed by an authentication company in three Polish hospital pharmacies...
November 9, 2017: Pharmacy (Basel, Switzerland)
https://www.readbyqxmd.com/read/29118679/an-electronic-health-record-data-driven-model-for-identifying-older-adults-at-risk-of-unintentional-falls
#20
Adam Baus, Jeffrey Coben, Keith Zullig, Cecil Pollard, Charles Mullett, Henry Taylor, Jill Cochran, Traci Jarrett, Dustin Long
Screening for risk of unintentional falls remains low in the primary care setting because of the time constraints of brief office visits. National studies suggest that physicians caring for older adults provide recommended fall risk screening only 30 to 37 percent of the time. Given prior success in developing methods for repurposing electronic health record data for the identification of fall risk, this study involves building a model in which electronic health record data could be applied for use in clinical decision support to bolster screening by proactively identifying patients for whom screening would be beneficial and targeting efforts specifically to those patients...
2017: Perspectives in Health Information Management
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