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https://www.readbyqxmd.com/read/28737304/investigation-and-diagnostic-formulation-in-patients-admitted-with-transient-loss-of-consciousness
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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...
June 29, 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
#9
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...
June 27, 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
#10
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
#11
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
#12
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
#13
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
https://www.readbyqxmd.com/read/28593867/-diagnosis-therapy-and-prophylactic-measures-of-parturient-paresis-in-dairy-cattle-results-of-an-online-survey-for-swiss-veterinarians
#14
T Perruchoud, A Maeschli, H Bachmann, M Walkenhorst, G Schüpbach, M Mevissen, P Zanolari
The aim of this study was to obtain the diagnostic, therapeutic and prophylactic approach among Swiss veterinary practitioners in cows with parturient hypocalcemia. All members of the Association for Ruminant Health were contacted per e-mail. The survey was completed by 108 (28%) of 393 that were contacted. According to the questionnaire responses, the typical presentation of a parturient paresis cow is a pluriparous middle-yielding dairy cow one day post-partum in sternal recumbency with normal consciousness...
June 2017: Schweizer Archiv Für Tierheilkunde
https://www.readbyqxmd.com/read/28589229/-stroke-in-children-and-adolescents
#15
REVIEW
S Meyer, M Poryo, M Flotats-Bastardas, D Ebrahimi-Fakhari, U Yilmaz
The occurrence of a stroke in children and adolescents constitutes a rare, critical event that is associated with substantial morbidity and mortality. In addition to the individual suffering for the young patient and the medical burden for the affected family, a stroke is also associated with high follow-up costs for the health system because of the necessary long-term rehabilitative treatment. Establishing an early and prompt diagnosis is of great therapeutic importance. Because of the rarity of the illness and the plethora of clinical manifestations, diagnosis is often delayed...
June 6, 2017: Der Radiologe
https://www.readbyqxmd.com/read/28545873/reveal-linq-versus-reveal-xt-implantable-loop-recorders-intra-and-post-procedural-comparison
#16
Hoang H Nguyen, Ian H Law, Michael W Rudokas, Jennifer Lampe, Tammy M Bowman, George F Van Hare, Jennifer N Avari Silva
OBJECTIVES: To compare the procedure, recovery, hospitalization times, and costs along with patient/parent satisfaction after newer-generation cardiac implantable loop recorder (Reveal LINQ; Medtronic Inc, Minneapolis, Minnesota) and previous-generation implantable loop recorder (Reveal XT; Medtronic Inc). STUDY DESIGN: A prospective study of patients undergoing LINQ implantations between April 2014 and October 2015 was performed. Retrospective chart review of patients undergoing XT implantations was performed for comparison...
May 22, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28542578/illness-experiences-of-diabetes-in-the-context-of-malaria-in-settings-experiencing-double-burden-of-disease-in-southeastern-tanzania
#17
Emmy Metta, Ajay Bailey, Flora Kessy, Eveline Geubbels, Hinke Haisma
BACKGROUND: Tanzania is doubly burdened with both non-communicable and infectious diseases, but information on how Tanzanians experience the co-existence of these conditions is limited. Using Kleinman's eight prompting questions the study synthesizes explanatory models from patients to describe common illness experiences of diabetes in a rural setting where malaria is the predominant health threat. METHODS: We conducted 17 focus group discussions with adult members of the general community, diabetes patients, neighbours and relatives of diabetes patients to gain insight into shared experiences...
2017: PloS One
https://www.readbyqxmd.com/read/28490967/comparative-study-of-fatty-acid-composition-of-table-eggs-from-the-jeddah-food-market-and-effect-of-value-addition-in-omega-3-bio-fortified-eggs
#18
Shahida Aziz Khan, Aziz Khan, Sarah A Khan, Mohd Amin Beg, Ashraf Ali, Ghazi Damanhouri
Health consciousness has increased the desire of people around the world to consume functional foods. Omega-3 essential fatty acids are one among these beneficial and important health supplements without which a general predisposition to degenerative and stress related disorders can occur. Saudi Arabia has shown an alarming increase in obesity (Al-Nozha et al., 2005), diabetes (Alqurashi et al., 2011), and cardiovascular disease (Al-Nozha et al., 2004) in the last few decades mainly due to nutritional transitions and lifestyle alterations (Amuna and Zotor, 2008)...
May 2017: Saudi Journal of Biological Sciences
https://www.readbyqxmd.com/read/28460273/eye-movements-provide-insights-into-the-conscious-use-of-context-in-prospective-memory
#19
Vanessa K Bowden, Rebekah E Smith, Shayne Loft
Prior research examining the impact of context on prospective memory (PM) has produced mixed results. Our study aimed to determine whether providing progressive context information could increase PM accuracy and reduce costs to ongoing tasks. Seventy-two participants made ongoing true/false judgements for simple sentences while maintaining a PM intention to respond differently to four memorised words. The context condition were informed of the trial numbers where PM targets could appear, and eye-tracking recorded trial number fixation frequency...
April 28, 2017: Consciousness and Cognition
https://www.readbyqxmd.com/read/28460271/transcranial-parenchymal-sonography-in-patients-with-chronic-disorders-of-consciousness-association-with-neuroimaging-data-and-beyond
#20
Antonino Chillura, Antonino Naro, Alberto Cacciola, Alessia Bramanti, Placido Bramanti, Rocco Salvatore Calabrò
Differential diagnosis of patients with Chronic Disorders of Consciousness (DoC) is rather challenging, owing to the lack of objective approaches highlighting residual awareness. Sophisticated functional neuroimaging have provided high diagnostic value, but their application in the clinical setting is limited due to their relative complexity, cost, availability and poor collaboration of persons with DoC. By using a specific ultrasound-based methodology, namely Transcranial B-mode Parenchymal Sonography (TCS), it is possible to obtain images of the main parenchymal brain structures...
July 2017: Consciousness and Cognition
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