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https://www.readbyqxmd.com/read/28453826/unplanned-readmissions-within-30-days-after-discharge-improving-quality-through-easy-prediction
#1
Francesca Casalini, Susanna Salvetti, Silvia Memmini, Elena Lucaccini, Gabriele Massimetti, Pier Luigi Lopalco, Gaetano Pierpaolo Privitera
Objective: To propose an easy predictive model for the risk of rehospitalization, built from hospital administrative data, in order to prevent repeated admissions and to improve transitional care. Design: Retrospective cohort study. Setting: Azienda Ospedaliero Universitaria Pisana (Pisa University Hospital). Participants: Patients residing in the territory of the province of Pisa (Tuscany Region) with at least one unplanned hospital admission leading to a medical Diagnosis-Related Group (DRG) in the calendar year 2012...
April 1, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28449097/creating-a-culture-of-collaboration-a-brief-history-of-academic-neurosurgery-in-washington-dc
#2
Alan Siu, Christopher J Neal, Hasan R Syed, Daniel R Felbaum, M Nathan Nair, Kevin M McGrail, Anthony J Caputy, Donald C Shields
Clinical neurosurgery has been practiced in the US capital for just over 100 years. As former residents and fellows of Drs. Harvey Cushing and Walter Dandy moved to the region, hospitals at Georgetown and George Washington Universities became early adopters of this new surgical discipline. Later academic neurosurgery programs were established at the National Institutes of Health, Walter Reed Medical Center, and Children's National Medical Center. Neurosurgical pioneers at these institutions developed new technologies and diagnostic procedures which continue to inform our current practice...
April 25, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28448812/effect-of-exposure-to-p-p%C3%A2-dde-during-the-first-half-of-pregnancy-in-the-maternal-thyroid-profile-of-female-residents-in-a-mexican-floriculture-area
#3
José Ángel Hernández-Mariano, Luisa Torres-Sánchez, Susana Bassol-Mayagoitia, Maria Consuelo Escamilla-Nuñez, Mariano E Cebrian, Érika Adriana Villeda-Gutiérrez, Guadalupe López-Rodríguez, Eunice Elizabeth Félix-Arellano, Julia Blanco-Muñoz
BACKGROUND: Dichlorodiphenyldichloroethene (p,p´-DDE), the main metabolite of dichlorodiphenyltrichloroethane (DDT), has been associated with changes in human thyroid hormone levels. Maternal thyroid hormones are essential for adequate fetal neurodevelopment during the first half of pregnancy. OBJECTIVE: To evaluate the association between maternal p,p´-DDE concentration and the maternal thyroid profile during the first half of pregnancy. MATERIALS AND METHODS: We analyzed the information of 430 pregnant women from a Mexican floriculture area, with a gestational age ≤16 weeks...
April 24, 2017: Environmental Research
https://www.readbyqxmd.com/read/28448783/effectiveness-of-a-clinical-pharmacist-medication-therapy-management-program-in-discontinuation-of-drugs-to-avoid-in-the-elderly
#4
Nicole Caffiero, Thomas Delate, Mercy D Ehizuelen, Kris Vogel
BACKGROUND: Despite evidence of fall risk associated with some drugs to avoid in the elderly (DAEs), many aged patients continue to receive them. OBJECTIVE: To assess the effectiveness of a clinical pharmacist medication therapy management program (MTM) on discontinuation of prescribed DAEs. METHODS: This was a retrospective cohort study conducted at an integrated health care delivery system. Kaiser Permanente Colorado beneficiaries aged ≥65 years who were MTM-eligible and targeted for a DAE dispensing between 01/01/2015 and 09/30/2015 were included in the observation group...
May 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28448781/assessment-of-clinical-pharmacy-interventions-to-reduce-outpatient-use-of-high-risk-medications-in-the-elderly
#5
Sarah C Weddle, A Shaun Rowe, Julie W Jeter, Rachel C Renwick, Shaunta' M Chamberlin, Andrea S Franks
BACKGROUND: Use of high-risk medications in the elderly (HRME) and drug-disease (Rx-DIS) interactions in the elderly, as defined by the Healthcare Effectiveness Data and Information Set (HEDIS) Measures, are significantly associated with mortality, hospital admission, and need for emergency care. No published studies to date evaluate interventions to reduce the use of HEDIS-defined HRME, although many studies have postulated a beneficial effect of such interventions. OBJECTIVE: To evaluate the effect of pharmacist interventions on use of HRME and Rx-DIS interactions in the outpatient elderly population...
May 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28448757/prevalence-and-types-of-gender-affirming-surgery-among-a-sample-of-transgender-endocrinology-patients-prior-to-state-expansion-of-insurance-coverage
#6
Maya Kailas, Hsun Ming Simon Lu, Emily F Rothman, Joshua D Safer
OBJECTIVE: Transgender individuals now have many options for medical intervention, including gender affirmation surgeries. However, it is unknown how common it is for transgender individuals to undergo these surgeries. The purpose of this cross-sectional study was to assess the prevalence of gender affirming surgeries among transgender patients in 2015, which was immediately prior to insurance changes that made gender affirming surgery more affordable for Massachusetts residents. DESIGN: A retrospective chart review of 99 transgender patients was performed at the Endocrinology Clinic at Boston Medical Center, an urban safety net hospital...
April 27, 2017: Endocrine Practice
https://www.readbyqxmd.com/read/28447624/wireless-power-transfer-to-millimeter-sized-gastrointestinal-electronics-validated-in-a-swine-model
#7
Abubakar Abid, Jonathan M O'Brien, Taylor Bensel, Cody Cleveland, Lucas Booth, Brian R Smith, Robert Langer, Giovanni Traverso
Electronic devices placed in the gastrointestinal (GI) tract for prolonged periods have the potential to transform clinical evaluation and treatment. One challenge to the deployment of such gastroresident electronics is the difficulty in powering millimeter-sized electronics devices without using batteries, which compromise biocompatibility and long-term residence. We examined the feasibility of leveraging mid-field wireless powering to transfer power from outside of the body to electronics at various locations along the GI tract...
April 27, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28447053/deciphering-the-pathophysiology-of-irritable-bowel-syndrome-and-functional-gastrointestinal-disorders-an-alternative-model-for-pathogenesis-cytokine-controlled-transepithelial-multi-feedback-loop
#8
REVIEW
Ricky McCullough, Jeremiah McCullough
A working theoretical model for irritable bowel syndrome (IBS) and other functional gastrointestinal disorders (FGIDs) does not exist, hampered by the lack of any clear cut invention that address all symptom and signs of the disease. Reports of cessation of symptom and signs of both major types of IBS have been published using a non-systemic, topically active agent-high potency polymerized cross-linked sucralfate (HPPCLS). The unique clinical effect of this non-systemic agent restricted to the luminal surface of the gut provides opportunity to elaborate on an alternative working model for the pathogenesis of IBS and FGIDs...
2017: Translational Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28446983/thoracic-sympathectomy-for-hyperhidrosis-from-surgical-indications-to-clinical-results
#9
REVIEW
Fernando Vannucci, José Augusto Araújo
Sympathectomy and its variations have been performed in thoracic surgery for more than 100 years. However, its indications have undergone profound modifications in this period. Likewise, since then the surgical technique has also evolved dramatically up to the minimally invasive techniques worldwide accessible in present days. Currently, primary hyperhidrosis is, by far, the main indication for thoracic sympathectomy and this procedure is usually carried out thoracoscopically with excellent results. However, until today, hyperhidrosis is a part of thoracic surgery still surrounded by controversy, persisting as an open field over which some confusion still resides regarding its pathophysiology, terms definitions and operative approaches...
April 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28445235/recent-trends-in-the-epidemiology-of-hepatocellular-carcinoma-in-olmsted-county-minnesota-a-us-population-based-study
#10
Ju Dong Yang, Hager Ahmed Mohammed, William S Harmsen, Felicity Enders, Gregory J Gores, Lewis R Roberts
BACKGROUND/AIM: The epidemiology of hepatocellular carcinoma (HCC) has changed in the United States recently. The aim of this study is to evaluate the recent trends of HCC epidemiology in Olmsted County, MN. METHODS: Residents aged over 20 with newly diagnosed HCC were identified using the Rochester Epidemiology Project database. Clinical information was compared among patients diagnosed between 2000 and 2009 (era 1) and 2010 to 2014 (era 2). RESULTS: Over 1...
April 25, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28445222/development-of-an-hiv-postexposure-prophylaxis-pep-protocol-for-trainees-engaging-in-academic-global-health-experiences
#11
Gitanjli Arora, Risa M Hoffman
PROBLEM: Global health (GH) education programs have become increasingly common in U.S. medical schools and graduate medical education programs, with growing numbers of medical students, residents, and fellows participating in clinical experiences in settings with high HIV prevalence and limited resources. However, there are no guidelines for provision of HIV postexposure prophylaxis (PEP) to trainees engaging in these academic GH experiences. APPROACH: Faculty of the Global Health Education Programs (GHEP) at the David Geffen School of Medicine at UCLA and GH partner institutions recognized the need for PEP access for trainees engaged in GH experiences...
April 25, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28444318/psychiatric-morbidity-in-children-with-hiv-aids-at-a-tertiary-health-institution-in-north-central-nigeria
#12
Mary Oluwatosin Adefalu, Mosunmola Florence Tunde-Ayinmode, Baba Awoye Issa, Adewole Adebola Adefalu, Seleemat Ajoke Adepoju
Introduction: Children with human immunodeficiency virus (HIV) infection are living longer with the infection and are at risk of different complications. We assessed for the prevalence of and associated factors for psychiatric morbidity among HIV-infected children in a tertiary facility in Ilorin, Nigeria. Methods: A descriptive cross-sectional, two-staged study involving 196 HIV-positive children (6-17 years). A semi-structured questionnaire and psychological instruments were used for the study...
April 20, 2017: Journal of Tropical Pediatrics
https://www.readbyqxmd.com/read/28444208/adverse-impacts-of-chronic-pain-on-health-related-quality-of-life-work-productivity-depression-and-anxiety-in-a-community-based-study
#13
Kosuke Kawai, Alison Tse Kawai, Peter Wollan, Barbara P Yawn
Background.: Chronic pain has major clinical and social consequences. Few studies have examined any variation in the extent of impairment on quality of life and work productivity by site and type of chronic pain. Objective.: The objective of our study is to examine adverse impacts of chronic pain on physical and psychological health and work productivity. Methods.: Our community-population study was based on a phone-interview of adults with chronic pain, residing in Olmsted County, MN...
April 22, 2017: Family Practice
https://www.readbyqxmd.com/read/28444111/pattern-recognition-receptors-immune-targets-to-enhance-cancer-immunotherapy
#14
T Shekarian, S Valsesia-Wittmann, J Brody, M C Michallet, S Depil, C Caux, A Marabelle
Durable tumor responses and significant levels of disease control rates have been described in more than 20 advanced/metastatic cancer types with B7-family immune checkpoint-targeted anti-CTLA-4, anti-PD-1, and anti-PD-L1 monoclonal antibodies. These results and the recent approvals of ipilimumab, pembrolizumab, nivolumab and atezolizumab are currently revolutionizing the way we envision the future of cancer care. However these clinical benefits are not observed in all cancer types and in every patient. Therefore, our clinical challenge is to identify therapeutic strategies which could overcome the primary and secondary resistances to these novel cancer immunotherapies...
April 21, 2017: Annals of Oncology: Official Journal of the European Society for Medical Oncology
https://www.readbyqxmd.com/read/28443222/analysis-of-hospital-volume-and-factors-influencing-economic-outcomes-in-cancer-surgery-results-from-a-population-based-study-in-korea
#15
Jung-A Lee, So-Young Kim, Keeho Park, Eun-Cheol Park, Jong-Hyock Park
OBJECTIVES: To evaluate associations between hospital volume, costs, and length of stay (LOS), and clinical and demographic outcome factors for five types of cancer resection. The main dependent variables were cost and LOS; the primary independent variable was volume. METHODS: Data were obtained from claims submitted to the Korean National Health Insurance scheme. We identified patients who underwent the following surgical procedures: pneumonectomy, colectomy, mastectomy, cystectomy, and esophagectomy...
February 2017: Osong Public Health and Research Perspectives
https://www.readbyqxmd.com/read/28442453/clickotine-a-personalized-smartphone-app-for-smoking-cessation-initial-evaluation
#16
Brian M Iacoviello, Joshua R Steinerman, David B Klein, Theodore L Silver, Adam G Berger, Sean X Luo, Nicholas J Schork
BACKGROUND: Tobacco smoking is the leading cause of preventable death in the United States, and the annual economic burden attributable to smoking exceeds US $300 billion. Obstacles to smoking cessation include limited access and adherence to effective cessation interventions. Technology can help overcome these obstacles; many smartphone apps have been developed to aid smoking cessation, but few that conform to the US clinical practice guideline (USCPG) have been rigorously tested and reported in the literature...
April 25, 2017: JMIR MHealth and UHealth
https://www.readbyqxmd.com/read/28442189/exploring-how-residents-who-partially-participate-in-family-planning-training-determine-their-level-of-participation
#17
Jema K Turk, Felisa Preskill, Alecia Fields, Uta Landy, Jody E Steinauer
OBJECTIVES: The Accreditation Council for Graduate Medical Education (ACGME) requires that obstetrics and gynecology residency programs provide access to abortion training, though residents may elect to opt out of participating due to religious or moral objections. While clinical benefits of partial participation have previously been explored, our study aimed to explore how residents navigate partial participation in abortion training and determine their limits. STUDY DESIGN: This study was qualitative in nature...
April 22, 2017: Women's Health Issues: Official Publication of the Jacobs Institute of Women's Health
https://www.readbyqxmd.com/read/28441678/the-addiction-recovery-clinic-a-novel-primary-care-based-approach-to-teaching-addiction-medicine
#18
Stephen R Holt, Nora Segar, Dana A Cavallo, Jeanette M Tetrault
PROBLEM: Substance use is highly prevalent in the United States, but little time in the curriculum is devoted to training internal medicine residents in addiction medicine. APPROACH: In 2014, the authors developed and launched the Addiction Recovery Clinic (ARC) to address this educational gap while also providing outpatient clinical services to patients with substance use disorders. The ARC is embedded within the residency primary care practice and is staffed by three to four internal medicine residents, two board-certified addiction medicine specialists, one chief resident, and one psychologist...
May 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28441675/teaching-today-in-the-practice-setting-of-the-future-implementing-innovations-in-graduate-medical-education
#19
Jung G Kim, Carl G Morris, Paul Ford
PROBLEM: Implementing an innovation, such as offering new types of patient-physician encounters through the patient-centered medical home (PCMH) model while maintaining Accreditation Council for Graduate Medical Education (ACGME) accreditation standards (e.g., patient encounter minimums for trainees), is challenging. APPROACH: In 2009, the Group Health Family Medicine Residency (GHFMR) received an ACGME Program Experimentation and Innovation Project (PEIP) exception that redefined the minimum Family Medicine Resident Review Committee requirement to 1,400 face-to-face visits and 250 electronic visits (1 electronic visit defined as 3 secure message or telephone encounters)...
May 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28441505/error-detection-based-model-to-assess-educational-outcomes-in-crisis-resource-management-training-a-pilot-study
#20
Sarah Bouhabel, Emily Kay-Rivest, Carol Nhan, Ilana Bank, Peter Nugus, Rachel Fisher, Lily Hp Nguyen
Otolaryngology-head and neck surgery (OTL-HNS) residents face a variety of difficult, high-stress situations, which may occur early in their training. Since these events occur infrequently, simulation-based learning has become an important part of residents' training and is already well established in fields such as anesthesia and emergency medicine. In the domain of OTL-HNS, it is gradually gaining in popularity. Crisis Resource Management (CRM), a program adapted from the aviation industry, aims to improve outcomes of crisis situations by attempting to mitigate human errors...
April 1, 2017: Otolaryngology—Head and Neck Surgery
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