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https://www.readbyqxmd.com/read/29331574/a-medicare-cost-analysis-of-mri-versus-ct-based-high-dose-rate-brachytherapy-of-the-cervix-can-mri-based-planning-be-less-costly
#1
Amishi Bajaj, Grant Harmon, John Weaver, Brendan Martin, Michael Mysz, Murat Surucu, John C Roeske, Andre A Konski, William Small, Matthew M Harkenrider
PURPOSE: While some institutions deliver multiple fractions per implant for MRI-based planning, it is common for only one fraction to be delivered per implant with CT-based cervical brachytherapy. The purpose of this study was to compare physician costs, hospital costs, and overall costs for cervical cancer patients treated with either CT-based or MRI-based high-dose-rate (HDR) cervical brachytherapy to determine if MRI-based brachytherapy as described can be financially feasible. METHODS AND MATERIALS: We identified 40 consecutive patients treated with curative intent cervical brachytherapy...
January 10, 2018: Brachytherapy
https://www.readbyqxmd.com/read/29298366/getting-it-rite-impact-of-a-dedicated-hospital-medicine-curriculum-for-residents
#2
Doris Lin, Chirayu Shah, Steffanie Campbell, Jeffrey T Bates, Erica Lescinskas
OBJECTIVE: The goal of this study was to improve resident confidence in inpatient care and knowledge in hospital medicine topics with a newly developed rotation and curriculum called the Resident Inpatient Training Experience. METHODS: This study was a prospective observational study completed by postgraduate year-2 (PGY-2) internal medicine residents in two affiliated hospitals. Forty-six PGY-2 residents each rotated on the Resident Inpatient Training Experience service for 1 month and completed a pre- and postrotation confidential online survey...
January 2018: Southern Medical Journal
https://www.readbyqxmd.com/read/29297896/-let-s-go-forward-but-wisely%C3%A2
#3
Massimo Di Maio
In recent years, the oncologic community has been widely debating the high costs of new anti-cancer drugs, that put at risk the sustainability of the health care system. In a study published in BMJ in October 2017, Davis and colleagues analyzed clinical trials conducted with anti-cancer drugs approved by the European Medicines Agency between 2009 and 2013. The authors emphasized that most anti-cancer drugs have been approved without any evidence of an improvement in overall survival and/or in quality of life...
December 2017: Recenti Progressi in Medicina
https://www.readbyqxmd.com/read/29296627/single-session-communication-with-a-locked-in-patient-by-functional-near-infrared-spectroscopy
#4
Androu Abdalmalak, Daniel Milej, Loretta Norton, Derek B Debicki, Teneille Gofton, Mamadou Diop, Adrian M Owen, Keith St Lawrence
There is a growing interest in the possibility of using functional neuroimaging techniques to aid in detecting covert awareness in patients who are thought to be suffering from a disorder of consciousness. Immerging optical techniques such as time-resolved functional near-infrared spectroscopy (TR-fNIRS) are ideal for such applications due to their low-cost, portability, and enhanced sensitivity to brain activity. The aim of this case study was to investigate for the first time the ability of TR-fNIRS to detect command driven motor imagery (MI) activity in a functionally locked-in patient suffering from Guillain-Barré syndrome...
October 2017: Neurophotonics
https://www.readbyqxmd.com/read/29279428/-thermoregulatory-behavior-and-its-central-circuit-mechanism-what-thermosensory-pathway-drives-it
#5
Kazuhiro Nakamura
Thermoregulatory behavior in homeothermic animals is an instinctive behavior to reduce the cost of their homeothermy, such as warm-seeking behavior to reduce metabolic energy for heat production in cold environments. A recent study identified the central neural pathway that transmits cutaneous thermosensory information on environmental temperature to drive thermoregulatory behavior. This study proposed that the brain mechanism that drives thermoregulatory behavior does not require conscious"feeling"(i.e., perception)of skin temperature mediated by the spinothalamocortical pathway, whereas thermosensory information that ascends through the spinal cord and the lateral parabrachial nucleus of the pons generates thermal comfort and discomfort that drive thermoregulatory behavior...
2018: Clinical Calcium
https://www.readbyqxmd.com/read/29223567/predictive-ability-of-the-evaruci-scale-and-comhon-index-for-pressure-injury-risk-in-critically-ill-patients-a-diagnostic-accuracy-study
#6
M de Los Ángeles Leal-Felipe, M Del Carmen Arroyo-López, M Del Cristo Robayna-Delgado, Ana Gómez-Espejo, Patricia Perera-Díaz, Carmen D Chinea-Rodríguez, Natalia García-Correa, Alejandro Jiménez-Sosa
BACKGROUND: Hospital-acquired pressure injuries are a costly and largely preventable complication occurring in a variety of acute care settings. Patients admitted to the intensive care unit are at greater risk of developing pressure injuries. OBJECTIVE: To determine whether the efficiency of scales to measure pressure injury risk increase when a continuously updated 3-day moving average method is used. METHODS: With a retrospective cohort design we recruited 3085 patients treated between June 2011 and February 2015 in the intensive care unit of a tertiary level university hospital...
December 6, 2017: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/29216780/using-cost-analyses-to-inform-health-professions-education-the-economic-cost-of-pre-clinical-failure
#7
Jonathan Foo, Dragan Ilic, George Rivers, Darrell J R Evans, Kieran Walsh, Terry P Haines, Sophie Paynter, Prue Morgan, Stephen Maloney
BACKGROUND: Student failure creates additional economic costs. Knowing the cost of failure helps to frame its economic burden relative to other educational issues, providing an evidence-base to guide priority setting and allocation of resources. The Ingredients Method is a cost-analysis approach which has been previously applied to health professions education research. In this study, the Ingredients Method is introduced, and applied to a case study, investigating the cost of pre-clinical student failure...
December 7, 2017: Medical Teacher
https://www.readbyqxmd.com/read/29192644/automated-centrifugal-therapeutic-plasma-exchange-option-for-guillain-barre-syndrome-a-report-from-calabar-nigeria
#8
O E Iheanacho, C Chimeziem, B S Sachais, P A Shi
Therapeutic plasma exchange (TPE) is performed frequently and effectively in developed countries, whereas the reverse is the case in developing countries. Guillain-Barre syndrome (GBS), synonymous with acute inflammatory demyelinating polyneuropathy, is an important indication for TPE, but this is rarely administered in the treatment of such patients in Nigeria due to lack of such automated facility, limited expertise, and high cost. This report therefore presents an uncommon case of GBS in which automated TPE was utilized in the management, with the aims of highlighting the current status and challenges of therapeutic apheresis services in Nigeria...
October 2017: Nigerian Journal of Clinical Practice
https://www.readbyqxmd.com/read/29180558/using-drug-prescribing-patterns-to-identify-stewards-of-cost-conscious-care
#9
Nicole Michele Gastala, Peter Wingrove, Winston Liaw, Stephen Petterson, Andrew Bazemore
PURPOSE: To characterize family physicians (FPs) who are stewards of care by consistently prescribing omeprazole over esomeprazole. METHODS: Cross-sectional analysis of physicians prescribing omeprazole or esomeprazole under Medicare Part D in 2014. RESULTS: There was a regional trend with 49% of Western FPs but only 6% of Southern FPs rarely prescribing esomeprazole. Physicians had increased odds of being a steward if they worked with a care coordinator (P < ...
November 2017: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29170334/37%C3%A2-routine-testing-of-salicylate-levels-in-overdose-patients-still-needed
#10
Elaine Hardy, Clare Toro, Susan Dorrian, Umesh Salanke
INTRODUCTION AND AIMS: Overdose is a common presentation in Emergency Departments (EDs) across the UK. Salicylate poisoning is potentially fatal; however it is becoming increasingly uncommon in the UK. This may be due to restriction of pack sizes in over the counter medicines as well as the use of aspirin as an analgesic being superseded by other NSAIDs, particularly ibuprofen.In conjunction with clinical features of salicylate toxicity, measurement of plasma salicylate concentration can help guide management...
December 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29135765/the-effects-of-price-and-health-consciousness-and-satisfaction-on-the-medical-tourism-experience
#11
JungKun Park, Jiseon Ahn, Weon Sang Yoo
The objective of this study was to analyze the effects of price and health consciousness on medical tourism. Accordingly, we explore the utility of the theory of planned behavior for assessing the relationships between several variables and explain consumers' intentions to be repeat medical tourists. A 26-item questionnaire was developed, and data were collected from 407 patients who visited South Korea for medical purposes. Structural equation modeling was used to analyze the data. The results indicate that medical tourists' price consciousness was significant with respect to their satisfaction with medical and travel services...
November 2017: Journal of Healthcare Management / American College of Healthcare Executives
https://www.readbyqxmd.com/read/29131286/conscious-sedation-for-transcatheter-implantation-of-atrial-septal-occluders-with-the-2d-and-3d-transesophageal-echocardiography-guidance-the-feasibility-and-safety-study
#12
Piotr Lipiec, Dawid Miśkowiec, Jan Z Peruga, Michał Plewka, Ewa Szymczyk, Paulina Wejner-Mik, Karolina Kupczyńska, Jarosław D Kasprzak
BACKGROUND: General anesthesia may have negative impact on patients mortality and morbidity, as well as overall procedure costs in atrial septal occluders (ASO) implantation. AIM: We sought to evaluate the safety, efficacy and feasibility of conscious sedation for transcatheter implantation of ASO. METHODS: 122 patients (pts) referred for transcatheter implantation of ASO were included. Mean patients' age was 51±15 years, 43 patients were male (35%)...
November 13, 2017: Kardiologia Polska
https://www.readbyqxmd.com/read/29078678/uniportal-non-intubated-lung-metastasectomy
#13
Tommaso Claudio Mineo, Francesco Sellitri, Eleonora Fabbi, Vincenzo Ambrogi
BACKGROUND: More than 15 years ago, we started a program of uniportal video-assisted thoracoscopies (VATS) lung metastasectomy in non-intubated local anesthesia. Hereby we present the short and long-term results of this combined surgical-anesthesiological technique. METHODS: Between 2005 and 2015, 71 patients (37 men and 34 women) with pulmonary oligometastases, at the first episode, underwent uniportal VATS metastasectomy under non-intubated anesthesia. RESULTS: Four patients (5...
2017: Journal of Visualized Surgery
https://www.readbyqxmd.com/read/29072063/conscious-sedation-during-cryoballoon-ablation-of-atrial-fibrillation-the-feasibility-and-safety-study
#14
Dawid Miśkowiec, Jarosław D Kasprzak, Paulina Wejner-Mik, Ewa Szymczyk, Haval D Qawoq, Paweł Życiński, Tomasz Wcisło, Piotr Pagórek, Karolina Kupczyńska, Piotr Lipiec
BACKGROUND: Cryoballoon ablation for atrial fibrillation (cryoAF) is relatively simple, cost-effective and easy procedure. However, general anesthesia during this procedure may have negative impact on patients mortality and morbidity, as well as procedure costs. AIM: We sought to assess the feasibility and safety of conscious sedation during cryoAF. METHODS: Patients (pts) with paroxysmal or persistent, drug-refractory AF who underwent a first procedure of cryoAF were included in our single-center, retrospective study...
October 25, 2017: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/29059444/increases-in-cigarette-consumption-and-decreases-in-smoking-intensity-when-non-daily-smokers-are-provided-with-free-cigarettes
#15
Saul Shiffman, Sarah Scholl
Introduction: Studies testing novel tobacco products often provide participants with free product and assess consumption. Some, but not all, studies find that providing fee cigarettes increases smoking. We tested changes in smoking when free cigarettes were provided to non-daily, intermittent smokers (ITS), who constitute one third of US adult smokers. Methods: Cigarette consumption was assessed by Time-line Follow-back in 235 ITS for two two-week periods: when providing their own cigarettes, and when provided own-brand cigarettes for free...
September 27, 2017: Nicotine & Tobacco Research: Official Journal of the Society for Research on Nicotine and Tobacco
https://www.readbyqxmd.com/read/29026493/an-uncommon-side-effect-of-a-commonly-used-antibiotic-amoxicillin-clavulanic-acid-induced-hepatitis
#16
Vinay Mathew Thomas, Neena Thomas-Eapen
Amoxicillin-Clavulanic acid continues to be one of the most commonly used antibiotic combinations. Hepatic injury due to this antibiotic is rare. We report a case of amoxicillin-clavulanic acid induced hepatitis causing painless jaundice to bring to attention this rare side effect of this commonly used antibiotic. This is a case of a 62-year-old Caucasian female, who presented with acute onset severe painless jaundice, nausea, vomiting, and pruritus of less than 1-week duration. She had completed a course of amoxicillin-clavulanic acid 3 weeks prior to presentation...
September 2017: Korean Journal of Family Medicine
https://www.readbyqxmd.com/read/29024871/brain-energetics-during-the-sleep-wake-cycle
#17
REVIEW
Mauro DiNuzzo, Maiken Nedergaard
Brain activity during wakefulness is associated with high metabolic rates that are believed to support information processing and memory encoding. In spite of loss of consciousness, sleep still carries a substantial energy cost. Experimental evidence supports a cerebral metabolic shift taking place during sleep that suppresses aerobic glycolysis, a hallmark of environment-oriented waking behavior and synaptic plasticity. Recent studies reveal that glial astrocytes respond to the reduction of wake-promoting neuromodulators by regulating volume, composition and glymphatic drainage of interstitial fluid...
October 9, 2017: Current Opinion in Neurobiology
https://www.readbyqxmd.com/read/28967732/endobronchial-ultrasound-guided-transbronchial-needle-aspiration-under-conscious-sedation-with-meperidine-and-midazolam
#18
Lorenzo Agostini, Nicola Facciolongo, Mirco Lusuardi, Eleonora Casalini, Carla Galeone, Luciano Lasagni, Luigi Zucchi
Endobronchial Ultrasound guided transbronchial needle aspiration (EBUS-TBNA) is usually performed under general anesthesia or deep sedation with drugs such as Propofol that, at least in Italy, can be administered only by an anesthesiologist. Aim of the study was to assess conscious sedation feasibility, safety and tolerability using Meperidine and Midazolam as administered by Pulmonologist and relevant impact on the efficiency of the sampling procedures.All patients undergoing EBUS-TBNA from February 2013 to July 2014 were examined retrospectively...
July 18, 2017: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
https://www.readbyqxmd.com/read/28955295/a-review-of-resting-state-electroencephalography-analysis-in-disorders-of-consciousness
#19
REVIEW
Yang Bai, Xiaoyu Xia, Xiaoli Li
Recently, neuroimaging technologies have been developed as important methods for assessing the brain condition of patients with disorders of consciousness (DOC). Among these technologies, resting-state electroencephalography (EEG) recording and analysis has been widely applied by clinicians due to its relatively low cost and convenience. EEG reflects the electrical activity of the underlying neurons, and it contains information regarding neuronal population oscillations, the information flow pathway, and neural activity networks...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28951662/safety-and-performance-characteristics-of-outpatient-medical-thoracoscopy-and-indwelling-pleural-catheter-insertion-for-evaluation-and-diagnosis-of-pleural-disease-at-a-tertiary-center-in-canada
#20
Robert Kyskan, Pen Li, Sunita Mulpuru, Carolina Souza, Kayvan Amjadi
BACKGROUND: Many centers performing medical thoracoscopy (MT) to diagnose pleural disease will insert a chest tube and admit patients to hospital after the procedure, which is inconvenient for patients and contributes to healthcare costs. We report the data on the safety, outcomes, and performance characteristics of outpatient MT with indwelling pleural catheter (IPC) insertion in a large Canadian cohort. METHODS: This retrospective cohort study reviewed patients who underwent outpatient MT and IPC insertion under conscious sedation...
2017: Canadian Respiratory Journal: Journal of the Canadian Thoracic Society
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