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https://www.readbyqxmd.com/read/28918680/transcranial-direct-current-stimulation-in-disorders-of-consciousness-a-review
#1
Ye Zhang, Weiqun Song
It is a challenge to evaluate and treat the patients with disorders of consciousness (DOC) in the clinic. Due to the huge costs of prolonged intensive care, the management of these patients raises great financial strain on families and important ethical questions. To date, several studies have attempted to specifically detect pharmacologic or non-pharmacologic effectiveness, until now there were no evidence-based guidelines about the treatment of patients with DOC. Recently, because of ethical and procedural limitations on the use of invasive stimulation techniques, non-invasive brain stimulation, such as the transcranial direct current stimulation (tDCS), has been investigated for improving the level of consciousness in patients with DOC...
September 18, 2017: International Journal of Neuroscience
https://www.readbyqxmd.com/read/28901969/disorders-of-consciousness-after-severe-brain-injury-therapeutic-options
#2
Caroline Schnakers, Martin M Monti
PURPOSE OF REVIEW: Very few options exist for patients who survive severe traumatic brain injury but fail to fully recover and develop a disorder of consciousness (e.g. vegetative state, minimally conscious state). RECENT FINDINGS: Among pharmacological approaches, Amantadine has shown the ability to accelerate functional recovery. Although with very low frequency, Zolpidem has shown the ability to improve the level of consciousness transiently and, possibly, also in a sustained fashion...
September 9, 2017: Current Opinion in Neurology
https://www.readbyqxmd.com/read/28872596/survey-of-veterinarians-using-a-novel-physical-compression-squeeze-procedure-in-the-management-of-neonatal-maladjustment-syndrome-in-foals
#3
Monica Aleman, Kalie M Weich, John E Madigan
Horses are a precocious species that must accomplish several milestones that are critical to survival in the immediate post-birth period for their survival. One essential milestone is the successful transition from the intrauterine unconsciousness to an extrauterine state of consciousness or awareness. This transition involves a complex withdrawal of consciousness inhibitors and an increase in neuroactivating factors that support awareness. This process involves neuroactive hormones as well as inputs related to factors such as cold, visual, olfactory, and auditory stimuli...
September 5, 2017: Animals: An Open Access Journal From MDPI
https://www.readbyqxmd.com/read/28838948/pediatric-training-faculty-and-resident-perceptions-on-teaching-high-value-cost-conscious-care-a-multi-institutional-study
#4
Brian C King, Jennifer DiPace, Monique Naifeh, Hoda Hammad, Linda M Gerber, Erika Abramson
BACKGROUND AND OBJECTIVES: High-value, cost-conscious care (HVCCC) is care that promotes optimal patient outcomes while reducing unnecessary costs. Teaching to promote HVCCC is essential, yet little research has assessed the dual perspectives of residents and faculty on this topic. Our aim was to investigate pediatric resident and faculty perspectives of HVCCC training and role modeling to more effectively promote curriculum and faculty development on this subject. METHODS: Pediatric residents and teaching faculty in 2 academic medical centers were surveyed during the 2015-2016 academic year...
August 24, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28789699/oral-pyridoxine-can-substitute-for-intravenous-pyridoxine-in-managing-patients-with-severe-poisoning-with-isoniazid-and-rifampicin-fixed-dose-combination-tablets-a-case-report
#5
M D S A Dilrukshi, C A P Ratnayake, C A Gnanathasan
BACKGROUND: Fixed drug combination of isoniazid and rifampicin is a rare cause of poisoning even in endemic countries for tuberculosis infection. Severe poisoning can cause severe morbidity and mortality if not treated promptly. Though intravenous pyridoxine is the preferred antidote for severe standard isoniazid poisoning it is not freely available even in best of care centers. We describe a case of severe poisoning with fixed drug combination of isoniazid and rifampicin successfully managed with oral pyridoxine at national hospital of Sri Lanka...
August 8, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28777822/quantifying-gaze-and-mouse-interactions-on-spatial-visual-interfaces-with-a-new-movement-analytics-methodology
#6
Urška Demšar, Arzu Çöltekin
Eye movements provide insights into what people pay attention to, and therefore are commonly included in a variety of human-computer interaction studies. Eye movement recording devices (eye trackers) produce gaze trajectories, that is, sequences of gaze location on the screen. Despite recent technological developments that enabled more affordable hardware, gaze data are still costly and time consuming to collect, therefore some propose using mouse movements instead. These are easy to collect automatically and on a large scale...
2017: PloS One
https://www.readbyqxmd.com/read/28759314/enhanced-recovery-after-surgery-implementation-from-planning-to-success
#7
Didier Roulin, Peter Najjar, Nicolas Demartines
Enhanced Recovery After Surgery (ERAS(®)) is an evidence-based approach in perioperative care. The implementation and translation of ERAS pathways into clinical practice requires a certain investment in time and money. A multidisciplinary team must be gathered and should undergo training according to the ERAS Implementation Program. Close attention to financial aspects of implementation, including projecting return on investment, is necessary in today's cost-conscious healthcare environment. Despite frequently encountered barriers and resistance to change, the common objective of reducing complications should overcome these barriers, so that every patient benefits from the most appropriate perioperative care...
September 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28737304/investigation-and-diagnostic-formulation-in-patients-admitted-with-transient-loss-of-consciousness
#8
R Briggs, T Coughlan, J Doherty, D R Collins, D O'Neill, S P Kennelly
Several commonly completed tests have low diagnostic yield in the setting of transient loss of consciousness (T-LOC). We estimated the use and cost of inappropriate investigations in patients admitted with T-LOC and assessed if these patients were given a definitive diagnosis for their presentation. We identified 80 consecutive patients admitted with T-LOC to a university teaching hospital. Eighty-eight percent (70/80) had a computerized topography (CT) brain scan and 49% (34/70) of these scans were inappropriate based on standard guidelines...
May 10, 2017: Irish Medical Journal
https://www.readbyqxmd.com/read/28736662/can-time-resolved-nirs-provide-the-sensitivity-to-detect-brain-activity-during-motor-imagery-consistently
#9
Androu Abdalmalak, Daniel Milej, Mamadou Diop, Mahsa Shokouhi, Lorina Naci, Adrian M Owen, Keith St Lawrence
Previous functional magnetic resonance imaging (fMRI) studies have shown that a subgroup of patients diagnosed as being in a vegetative state are aware and able to communicate by performing a motor imagery task in response to commands. Due to the fMRI's cost and accessibility, there is a need for exploring different imaging modalities that can be used at the bedside. A promising technique is functional near infrared spectroscopy (fNIRS) that has been successfully applied to measure brain oxygenation in humans...
April 1, 2017: Biomedical Optics Express
https://www.readbyqxmd.com/read/28704302/botulinum-a-intramuscular-injection-in-an-orthopaedic-paediatric-patient-cohort-service-restructure-analysis
#10
Matthew Lee, Enda Kelly, Paula Kelly
Botulinum intramuscular injections are increasingly being used in the management of hypertonic musculature. Historically, injections were administered under general anaesthesia (GA), which has service and economic implications. Our delivery changed to outpatient conscious injections to improve service efficiency. A retrospective analysis of all patient injections from January 2010 to December 2015 analysed cost-benefit and efficiency of service remodelling. 472 patients were administered injections, 298 in theatre under GA and 174 without GA...
July 12, 2017: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/28702333/cough-syncope-induced-by-post-nasal-drip-successfully-managed-by-gabapentin
#11
Hussein Algahtani, Bader Shirah
Syncope is a common complaint in both neurology clinic and emergency department. It is defined as transient loss of consciousness with loss of postural tone, which is usually self-limited and followed by a spontaneous recovery. Our report describes a case of cough syncope resulting from chronic intractable cough caused by post nasal drip. Although his experience was debilitating, we were able to control his symptoms significantly using a small dose of Gabapentin. This dose is much lower when compared with the already established licensed indicated higher doses used for the treatment of neuropathic pain and epilepsy...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28701126/educating-general-practitioners-are-we-preparing-them-for-cost-conscious-care
#12
Justin J Beilby
No abstract text is available yet for this article.
July 17, 2017: Medical Journal of Australia
https://www.readbyqxmd.com/read/28699935/use-of-simulation-to-assess-incoming-interns-recognition-of-opportunities-to-choose-wisely
#13
Kathleen Wiest, Jeanne Farnan, Ellen Byrne, Lukas Matern, Melissa Cappaert, Kristen Hirsch, Vineet Arora
BACKGROUND: Despite increasing healthcare costs, training on cost-consciousness is lacking in graduate medical education (GME). Medical centers must consider how best to incorporate value-based training into their GME curricula. OBJECTIVE: To incorporate low-value principles into an existing GME simulation exercise and assess incoming interns' recognition of low-value care. METHODS: Choosing Wisely™ lists were reviewed to identify 4 low-value hazards to be embedded into a simulated hospital room in addition to the 8 patient safety hazards used previously...
July 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28677462/putting-a-price-on-care
#14
James Buchan
As a relatively expensive staffing solution, agency nursing is often in the spotlight in the cost-conscious NHS.
July 5, 2017: Nursing Standard
https://www.readbyqxmd.com/read/28664644/barriers-to-sexually-transmitted-infection-testing-in-new-zealand-a-qualitative-study
#15
Hayley J Denison, Collette Bromhead, Rebecca Grainger, Elaine M Dennison, Annemarie Jutel
OBJECTIVE: To investigate the barriers that prevent or delay people seeking a sexually transmitted infection (STI) test. METHODS: Qualitative in-depth interviews were conducted with 24 university students, who are a group prone to behaviours putting them at risk of STIs, to understand the factors that had prevented or delayed them from going for an STI test in the past. Resulting data were thematically analysed employing a qualitative content analysis method, and a final set of themes identified...
August 2017: Australian and New Zealand Journal of Public Health
https://www.readbyqxmd.com/read/28658025/determinants-of-receiving-palliative-care-and-ventilator-withdrawal-among-patients-with-prolonged-mechanical-ventilation
#16
Yang-Ching Chen, Hsien-Yu Fan, J Randall Curtis, Oscar Kuang-Sheng Lee, Chih-Kuang Liu, Sheng-Jean Huang
OBJECTIVES: Increasing numbers of patients with prolonged mechanical ventilation generates a tremendous strain on healthcare systems. Patients with prolonged mechanical ventilation suffer from long-term poor quality of life. However, no study has ever explored the willingness to receive palliative care or terminal withdrawal and the factors influencing willingness. DESIGN: Cross-sectional study. SETTING: Five different hospitals of Taipei City Hospital system...
October 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28642208/assessing-the-efficacy-of-imagery-enhanced-cognitive-behavioral-group-therapy-for-social-anxiety-disorder-study-protocol-for-a-randomized-controlled-trial
#17
Peter M McEvoy, Michelle L Moulds, Jessica R Grisham, Emily A Holmes, David A Moscovitch, Delia Hendrie, Lisa M Saulsman, Ottmar V Lipp, Robert T Kane, Ronald M Rapee, Matthew P Hyett, David M Erceg-Hurn
Cognitive behavior group therapy (CBGT) is effective for social anxiety disorder (SAD), but a substantial proportion of patients do not typically achieve normative functioning. Cognitive behavioral models of SAD emphasize negative self-imagery as an important maintaining factor, and evidence suggests that imagery is a powerful cognitive mode for facilitating affective change. This study will compare two group CBGT interventions, one that predominantly uses verbally-based strategies (VB-CBGT) and another that predominantly uses imagery-enhanced strategies (IE-CBGT), in terms of (a) efficacy, (b) mechanisms of change, and (c) cost-effectiveness...
June 19, 2017: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/28641453/accuracy-of-limited-montage-electroencephalography-in-monitoring-postanoxic-comatose-patients
#18
Sandipan Pati, Lauren McClain, Lidia Moura, Yuan Fan, M Brandon Westover
BACKGROUND: Continuous EEG (cEEG) monitoring may help to identify the small percentage of adults with hypoxic-ischemic encephalopathy (HIE) who will regain consciousness if allowed sufficient time. However, the limited yield in this population has led some to question the cost-effectiveness cEEG monitoring in this population. We hypothesized that limited-montage cEEG could provide essentially the same neurophysiologic information at lower cost. In this proof of concept study, we aim to demonstrate the potentials of limited channel EEG in prognostication in postanoxic patients...
June 1, 2017: Clinical EEG and Neuroscience: Official Journal of the EEG and Clinical Neuroscience Society (ENCS)
https://www.readbyqxmd.com/read/28619298/alternative-medicine-worker-health-and-absenteeism-in-the-united-states
#19
Kate Rybczynski
Health related absenteeism costs an estimated $153 billion annually in the United States (Witters and Agrawal, 2011).(1) Chronic conditions (major contributors to absenteeism) are often successfully managed by Complementary and Alternative Medicine (CAM). As CAM becomes an increasingly visible component of healthcare, firms may wish to consider whether CAM therapies can help reduce illness-related absenteeism. This paper aims to extend the literature on healthcare utilization and absenteeism by exploring whether CAM treatment is associated with fewer workdays missed due to illness...
June 2017: Complementary Therapies in Medicine
https://www.readbyqxmd.com/read/28611921/adherence-of-self-monitoring-of-blood-glucose-in-persons-with-type-1-diabetes-in-sweden
#20
Peter Moström, Elsa Ahlén, Henrik Imberg, Per-Olof Hansson, Marcus Lind
OBJECTIVE: The primary aim was to evaluate the extent to which persons with type 1 diabetes perform self-monitoring of blood glucose (SMBG) according to guidelines. Secondary objectives were to investigate predictors for good SMBG adherence, reasons for non-adherence, and association between SMBG frequency and hemoglobin A1c (HbA1c). METHODS: This was a survey-based cross-sectional study. Questionnaires were sent out to 600 random patients at five sites. Patients were included if they were diagnosed with type 1 diabetes and ≥18 years old and excluded if they were currently using continuous glucose monitoring (CGM)...
2017: BMJ Open Diabetes Research & Care
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