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Case management

C Buratti, F Fantozzi, M Barbanera, E Lascaro, M Chiorri, L Cecchini
Beef cattle production is a widespread activity in Italy in the agricultural field and determines an important impact on environment and resources consumption. Carbon footprint evaluation is thus necessary to evaluate the contributions of the different stages and the possible improvements of the production chain. In this study, two typical Italian beef production systems, a conventional and an organic one are investigated in order to evaluate the greenhouse gas emissions from "cradle to gate farm" by a Life Cycle Assessment (LCA) approach; the carbon footprint (CF) per 1kg of live weight meat is calculated...
October 23, 2016: Science of the Total Environment
Katharine Kripke, Jason Reed, Catherine Hankins, Gregory Smiley, Catey Laube, Emmanuel Njeuhmeli
BACKGROUND: The report of the Joint United Nations Programme on HIV/AIDS (UNAIDS) for World AIDS Day 2014 highlighted a Fast-Track Strategy that sets ambitious treatment and prevention targets to reduce global HIV incidence to manageable levels by 2020 and end the AIDS epidemic by 2030. The 90-90-90 treatment targets for 2020 call for 90% of people living with HIV to know their HIV status, 90% of people who know their status to receive treatment, and 90% of people on HIV treatment to be virally suppressed...
2016: PloS One
Jason Shafrin, Taylor T Schwartz, Darius N Lakdawalla, Felicia M Forma
BACKGROUND: Nonadherence to antipsychotic medication among patients with schizophrenia results in poor symptom management and increased health care and other costs. Despite its health impact, medication adherence remains difficult to accurately assess. New technologies offer the possibility of real-time patient monitoring data on adherence, which may in turn improve clinical decision making. However, the economic benefit of accurate patient drug adherence information (PDAI) has yet to be evaluated...
November 2016: Journal of Managed Care & Specialty Pharmacy
Saurabh Zanwar, Vikas Ostwal, Arvind Sahu, Deepak Jain, Anant Ramaswamy, Avanish Saklani, Mukta Ramadwar, Nitin Shetty, Shailesh V Shrikande
INTRODUCTION: There is scarce data relating to methods to improve sphincter preservation in rectal gastrointestinal stromal tumor (GIST). Increasing the duration of neoadjuvant (NA) imatinib resulting in improved sphincter preservation rate has not been established. This retrospective analysis looks at the rates of sphincter preservation in rectal GIST with NA imatinib and effect of duration of NA imatinib on the same to find out optimum duration of NA with respect to sphincter preservation in rectal GIST patients...
October 26, 2016: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
Maurizio Ponz de Leon, Monica Pedroni, Luca Roncucci, Federica Domati, Giuseppina Rossi, Giulia Magnani, Annalisa Pezzi, Rossella Fante, Luca Reggiani Bonetti
Attenuated polyposis could be defined as a variant of familial adenomatous polyposis (FAP) in which synchronous polyps of the large bowel range between 10 and 99. We analysed all cases of attenuated polyposis observed over the last 30 years with the objectives: (A) to classify the disease according to different type and proportion of polyps; (B) To ascertain the contribution of APC and MutYH genes; (C) to discover features which could arise the suspicion of mutations; (D) To obtain indications for management and follow-up...
October 25, 2016: Familial Cancer
Manigandan Subramanyam Thyagarajan, Khalid Sharif
Space occupying liver lesions usually present with abdominal pain or abnormal physical findings, such as a palpable abdominal mass or distention. Liver lesions identified in children include benign and malignant neoplasms, inflammatory masses, cysts and metastatic lesions. Two-thirds of liver lesions in children are malignant. Hepatoblastoma accounts for two-thirds of malignant liver tumors in children. Benign lesions of the liver in children include vascular lesions, hamartomas, adenomas, and focal nodular hyperplasia...
October 25, 2016: Indian Journal of Pediatrics
Salem A Beshyah, Ibrahim H Sherif, Farida Chentli, Amir Hamrahian, Aly B Khalil, Hussein Raef, Mohamed El-Fikki, Selim Jambart
BACKGROUND: Prolactinomas are the commonest functional tumors of the pituitary gland. There are still controversies regarding medical therapy in specific clinical situations. Patients may be managed by different specialists in the Middle East and North Africa (MENA) region and no data exist on patterns of clinical management. OBJECTIVES: To ascertain the diagnostic and therapeutic approaches to prolactinomas among relevant professionals from the MENA region. METHODS: An online survey of a large sample of physicians was conducted...
October 25, 2016: Pituitary
J Schmolders, S Koob, P Schepers, P H Pennekamp, S Gravius, D C Wirtz, R Placzek, A C Strauss
PURPOSE AND OBJECTIVE: Bone resection regarding adequate surgical margins is the treatment of choice for malignant bone tumors. In the case of metastasis-related complications, so-called skeletal-related events, it is highly important to achieve pain relief and a stable joint situation to re-mobilize the patients immediately following surgery. To bridge the often large osseous defect zones after tumor resection, both cemented and uncemented modular endoprosthetic systems are widely used...
October 25, 2016: Archives of Orthopaedic and Trauma Surgery
Marina Aparicio-Soto, Marina Sánchez-Hidalgo, Ma Ángeles Rosillo, Ma Luisa Castejón, Catalina Alarcón-de-la-Lastra
Nowadays, it is clear that an unhealthy diet is one of the prime factors that contributes to the rise of inflammatory diseases and autoimmunity in the populations of both developed and developing countries. The Mediterranean diet has been associated with a reduced incidence of certain pathologies related to chronic inflammation and the immune system. Olive oil, the principal source of dietary lipids of the Mediterranean diet, possesses a high nutritional quality and a particular composition, which is especially relevant in the case of Extra Virgin Olive Oil (EVOO)...
October 26, 2016: Food & Function
Giovanni D Tebala, Sean Keane, Abdelsalam Osman, Mina Ip, Abdul Q Khan, Luciano Perrone
BACKGROUND: Enhanced recovery (ER) programs are policies and protocols meant to improve postoperative recovery after surgery. As a consequence of a smoother recovery, patients can be discharged early. This paper describes the impact of an ER program in colorectal surgery in a rural hospital. MATERIALS AND METHODS: In total, 132 patients had colorectal resection within the ER program. Data were collected prospectively. The ER pathway affects perioperative management in the following ways in order to: (1) improve patient's general condition before surgery, (2) minimize intraoperative surgical trauma by using a laparoscopic approach in all cases, and (3) facilitation of a quicker postoperative return of physiological function...
October 25, 2016: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
Jeffrey G Trost, Lawrence O Lin, Sarah Jane Clark, David Y Khechoyan, Larry H Hollier, Edward P Buchanan
BACKGROUND: Conjoined twins are a rare medical phenomenon that offers a unique challenge for medical professionals. The complex anatomy of conjoined twins dictates their survival and amenability to separation, making each case different in terms of medical management, surgical planning, and patient outcomes. Thoraco-omphalo-ischiopagus twins, joined from the thorax to the pelvis, are one of the rarest orientations recorded in the medical literature, and successful separation of this subset of conjoined twins has not been documented...
November 2016: Plastic and Reconstructive Surgery
Troy A Pittman, Kenneth L Fan, Megan A Rudolph
BACKGROUND: Although literature and case reports regarding anaplastic large cell lymphoma (ALCL) continue to increase, changes in plastic surgery practice patterns have not been assessed. METHODS: A 19-question survey was sent electronically to U.S. and international board-certified plastic surgeons. Data were analyzed using chi-square test and logistic regression analysis. RESULTS: A total of 1383 surgeons (U.S., 715; international, 668) responded, at a rate of 13...
November 2016: Plastic and Reconstructive Surgery
Torsten Oliver Salge, David Antons, Patrick Cichy, J Nils Foege, Julian Hannen, Antje S J Huetten
BACKGROUND: It is now widely established that health care organizations are well advised not only to identify and act upon the concerns of all patient groups but also to encourage and enable them to voice their concerns in the first place. That said, research has begun to reveal that patients differ substantially in their readiness to complain, with many deciding to remain silent even after experiencing severe adverse events. Little research has explored whether patients at the margins (e...
October 25, 2016: Health Care Management Review
Vivek S Chawathe, Anil K Gaur, Badrinath D Athani, Shefali Gupta
A 14-year-old boy reported with congenital deformity of the left lower limb, with gross shortening, hip and knee flexion deformities, ankle with equinus deformity, and polydactyly of the left foot. Radiologic examination showed proximal femoral focal deficiency, double fibula, and duplication of the tarsal bones, and a diagnosis of 'proximal femoral focal deficiency associated with fibular duplication and diplopodia with complete agenesis of tibia' was made. Such association of deformities is very rare and poses difficulties in rehabilitation of the case...
October 25, 2016: Journal of Pediatric Orthopedics. Part B
Seyoun Park, Todd McNutt, William Plishker, Harry Quon, John Wong, Raj Shekhar, Junghoon Lee
PURPOSE: Accurate tracking of anatomical changes and computation of actually delivered dose to the patient are critical for successful adaptive radiation therapy (ART). Additionally, efficient data management and fast processing are practically important for the adoption in clinic as ART involves a large amount of image and treatment data. The purpose of this study was to develop an accurate and efficient Software platform for CUmulative Dose Assessment (scuda) that can be seamlessly integrated into the clinical workflow...
October 2016: Medical Physics
Xindi Zhang, Jim Warren, Arden Corter, Felicity Goodyear-Smith
This paper describes development of a prototype data analytics portal for analysis of accumulated screening results from eCHAT (electronic Case-finding and Help Assessment Tool). eCHAT allows individuals to conduct a self-administered lifestyle and mental health screening assessment, with usage to date chiefly in the context of primary care waiting rooms. The intention is for wide roll-out to primary care clinics, including secondary school based clinics, resulting in the accumulation of population-level data...
2016: Studies in Health Technology and Informatics
Guy Hembroff
Healthcare systems globally continue to face challenges surrounding patient identification. Consequences of misidentification include incomplete and inaccurate electronic patient health records potentially jeopardizing patients' safety, a significant amount of cases of medical fraud because of inadequate identification mechanisms, and difficulties affiliated with the value of remote health self-management application data being aggregated accurately into the user's Electronic Health Record (EHR). We introduce a new technique of user identification in healthcare capable of establishing a global identifier...
2016: Studies in Health Technology and Informatics
Judith Born, Jürgen Albert, Elizabeth M Borycki, Norbert Butz, Kendall Ho, Josh Koczerginski, Andre W Kushniruk, Johannes Schenkel, Christian Juhra
BACKGROUND: In order to improve access to critical patient data in case of emergency, many countries have begun or intend to implement emergency datasets. In Germany, the German Medical Association developed a medical emergency dataset (MED), which provides the possibility to store information on prior diagnoses, medications, allergies and other emergency-relevant information on the German Electronic Health Card. OBJECTIVES: The aim of the study is to evaluate how the MED can be used internationally...
2016: Studies in Health Technology and Informatics
S Nayak, P K Lenka, A Equebal, A Biswas
Up to now, a cosmetic glove was the most common method for managing transmetacarpal (TMC) and carpometacarpal (CMC) amputations, but it is devoid of markings and body color. At this amputation level, it is very difficult to fit a functional prosthesis because of the short available length, unsightly shape, grafted skin, contracture and lack of functional prosthetic options. A 30-year-old male came to our clinic with amputation at the 1st to 4th carpometacarpal level and a 5th metacarpal that was projected laterally and fused with the carpal bone...
September 2016: Hand Surgery and Rehabilitation
J Roger, L Mathieu, F Mottier, F Vigouroux, F Chauvin, F Rongiéras
The authors report and discuss the management of a 25-year-old male patient with a trapeziometacarpal joint dislocation complicated by a trapezium fracture. This injury combination is rare with only reported 15 cases. After closed reduction resulted in dorsal instability, anatomical reduction of the trapezium fracture and internal screw fixation were performed using an open approach. This fixation stabilized the joint but was fragile due to the small fragment size. For this reason, ligament reconstruction using half of the flexor carpi radialis tendon was added...
September 2016: Hand Surgery and Rehabilitation
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