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https://www.readbyqxmd.com/read/28329620/acitretin-amelioration-of-acrokeratosis-paraneoplastica-bazex-syndrome-in-cases-of-incurable-squamous-cell-carcinoma-of-the-hypopharynx
#1
Polina M Vaynshtok, Frances Tian, Benjamin H Kaffenberger
BACKGROUNDAcrokeratosis paraneoplastica (Bazex Syndrome) is a rare paraneoplastic syndrome and dermatosis that only arises in patients with underlying malignancy and uncommonly resolves with systemic therapy.OBJECTIVE/METHODSWe present a patient with acrokeratosis paraneoplastica that improved significantly with acitretin. We present evidence to justify costs of therapy for insurance purposes. Additionally, there is a single report of acitretin use for Bazex syndrome in the French language.RESULTSWe present a case of acrokeratosis paraneoplastica in a patient with incurable stage IV squamous cell carcinoma of the hypopharynx that significantly improved on acitretin...
September 15, 2016: Dermatology Online Journal
https://www.readbyqxmd.com/read/28329208/differentiated-hiv-rna-viral-load-monitoring-in-resource-limited-settings-an-economic-analysis
#2
Diana M Negoescu, Zhenhuan Zhang, Heiner C Bucher, Eran Bendavid
Background: Viral load (VL) monitoring for patients receiving antiretroviral therapy (ART) is recommended worldwide. However, the costs of frequent monitoring are a barrier to implementation in resource-limited settings. The extent to which personalized monitoring frequencies may be cost-effective is unknown. Methods: We created a simulation model parameterized using person-level longitudinal data to assess the benefits of flexible monitoring frequencies. Our data-driven model tracked HIV+ individuals for 10 years following ART initiation...
March 1, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28328942/the-value-of-theory-in-programmes-to-implement-clinical-guidelines-insights-from-a-retrospective-mixed-methods-evaluation-of-a-programme-to-increase-adherence-to-national-guidelines-for-chronic-disease-in-primary-care
#3
Jessica Sheringham, Francesca Solmi, Cono Ariti, Abigail Baim-Lance, Steve Morris, Naomi J Fulop
BACKGROUND: Programmes have had limited success in improving guideline adherence for chronic disease. Use of theory is recommended but is often absent in programmes conducted in 'real-world' rather than research settings. MATERIALS AND METHODS: This mixed-methods study tested a retrospective theory-based approach to evaluate a 'real-world' programme in primary care to improve adherence to national guidelines for chronic obstructive pulmonary disease (COPD). Qualitative data, comprising analysis of documents generated throughout the programme (n>300), in-depth interviews with planners (clinicians, managers and improvement experts involved in devising, planning, and implementing the programme, n = 14) and providers (practice clinicians, n = 14) were used to construct programme theories, experiences of implementation and contextual factors influencing care...
2017: PloS One
https://www.readbyqxmd.com/read/28328935/intra-articular-hyaluronic-acid-in-the-management-of-knee-osteoarthritis-pharmaco-economic-study-from-the-perspective-of-the-national-health-insurance-system
#4
Thierry Thomas, Françoise Amouroux, Patrice Vincent
INTRODUCTION: Pharmaco-economic data on the management of knee osteoarthritis (OA) with intra articular hyaluronic acid (IA HA) viscosupplementation is limited. We contrasted IA HA with non-steroidal anti-inflammatory drugs (NSAIDs). METHODS: Observational, prospective and multicenter study comparing treatments of knee OA costs and efficacy with either NSAIDs alone, or hyaluronic acid (Arthrum H 2%®), during a 6-month follow-up period. The investigators were pharmacists who recorded data on disease, drug consumption and healthcare circuit...
2017: PloS One
https://www.readbyqxmd.com/read/28328885/introducing-therioepistemology-the-study-of-how-knowledge-is-gained-from-animal-research
#5
REVIEW
Joseph P Garner, Brianna N Gaskill, Elin M Weber, Jamie Ahloy-Dallaire, Kathleen R Pritchett-Corning
This focus issue of Lab Animal coincides with a tipping point in biomedical research. For the first time, the scale of the reproducibility and translatability crisis is widely understood beyond the small cadre of researchers who have been studying it and the pharmaceutical and biotech companies who have been living it. Here we argue that an emerging literature, including the papers in this focus issue, has begun to congeal around a set of recurring themes, which themselves represent a paradigm shift. This paradigm shift can be characterized at the micro level as a shift from asking "what have we controlled for in this model?" to asking "what have we chosen to ignore in this model, and at what cost?" At the macro level, it is a shift from viewing animals as tools (the furry test tube), to viewing them as patients in an equivalent human medical study...
March 22, 2017: Lab Animal
https://www.readbyqxmd.com/read/28328840/osteopathic-manipulative-treatment-showed-reduction-of-length-of-stay-and-costs-in-preterm-infants-a-systematic-review-and-meta-analysis
#6
Diego Lanaro, Nuria Ruffini, Andrea Manzotti, Gianluca Lista
BACKGROUND: Osteopathic medicine is an emerging and complementary method used in neonatology. METHODS: Outcomes were the mean difference in length of stay (LOS) and costs between osteopathy and alternative treatment group. A comprehensive literature search of (quasi)- randomized controlled trials (RCTs), was conducted from journal inception to May, 2015. Eligible studies must have treated preterm infants directly in the crib or bed and Osteopathic Manipulative Treatment (OMT) must have been performed by osteopaths...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28328648/the-economic-and-clinical-impact-of-sustained-use-of-a-progressive-mobility-program-in-a-neuro-icu
#7
Jeannette M Hester, Peggy R Guin, Gale D Danek, Jaime R Thomas, William L Titsworth, Richard K Reed, Terrie Vasilopoulos, Brenda G Fahy
OBJECTIVE: To investigate a progressive mobility program in a neurocritical care population with the hypothesis that the benefits and outcomes of the program (e.g., decreased length of stay) would have a significant positive economic impact. DESIGN: Retrospective analysis of economic and clinical outcome data before, immediately following, and 2 years after implementation of the Progressive Upright Mobility Protocol Plus program (UF Health Shands Hospital, Gainesville, FL) involving a series of planned movements in a sequential manner with an additional six levels of rehabilitation in the neuro-ICU at UF Health Shands Hospital...
March 21, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28328635/a-systematic-review-of-the-use-of-telemedicine-in-plastic-and-reconstructive-surgery-and-dermatology
#8
Krishna S Vyas, H Rhodes Hambrick, Afaaf Shakir, Shane D Morrison, Duy C Tran, Keon Pearson, Henry C Vasconez, Samir Mardini, Amanda A Gosman, Marek Dobke, Mark S Granick
BACKGROUND: Telemedicine, the use of information technology and telecommunication to provide healthcare at a distance, is a burgeoning field with applications throughout medicine. Given the visual nature of plastic surgery and dermatology, telemedicine has a myriad of potential applications within the field. METHODS: A comprehensive literature review of articles published on telemedicine since January 2010 was performed. Articles were selected for their relevance to plastic and reconstructive surgery and dermatology, and then reviewed for their discussion of the applications, benefits, and limitations of telemedicine in practice...
March 21, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28328578/sustained-improvements-in-pain-mood-function-and-opioid-use-post-interdisciplinary-pain-rehabilitation-in-patients-weaned-from-high-and-low-dose-chronic-opioid-therapy
#9
Kelly L Huffman, Taylor E Rush, Youran Fan, Giries W Sweis, Brinder Vij, Edward C Covington, Judith Scheman, Manu Mathews
Increased prescribing of opioids for chronic non cancer pain is associated with significant social costs, including overdose and addiction. In this context, there is interest in interdisciplinary chronic pain rehabilitation programs (ICPRP) focusing on self-management and minimizing opioid use. This study examined outcomes of patients weaned from opioids in an ICPRP from 2007-2012. Participants included 413 patients on high dose (HD) chronic opioid therapy (COT; >100mg), 528 on low dose (LD) COT and 516 not on opioids (NO)...
March 21, 2017: Pain
https://www.readbyqxmd.com/read/28328576/chronic-pain-patients-perspectives-of-medical-cannabis
#10
Brian J Piper, Monica L Beals, Alexander T Abess, Stephanie D Nichols, Maurice Martin, Catherine M Cobb, Rebecca M DeKeuster
Medical cannabis (MC) is employed for a variety of conditions including chronic pain. The goal of this report was to provide an in-depth qualitative exploration of patient perspectives on the strengths and limitations of MC. Members of MC dispensaries (N = 984) in New England including two-thirds with a history of chronic pain completed an online survey. In response to "How effective is medical cannabis in treating your symptoms or conditions?", with options of 0% "no relief" to 100% "complete relief", the average was 74...
March 21, 2017: Pain
https://www.readbyqxmd.com/read/28328148/long-term-follow-up-study-of-community-based-patients-receiving-xr-ntx-for-opioid-use-disorders
#11
Arthur Robin Williams, Vincent Barbieri, Kaitlyn Mishlen, Frances R Levin, Edward V Nunes, John J Mariani, Adam Bisaga
BACKGROUND AND OBJECTIVES: Extended-release naltrexone (XR-NTX) is FDA-approved to prevent relapse in patients with Opioid Use Disorder. However little is known about long-term use among community-based outpatients. METHODS: Retrospective chart review and long-term follow-up survey among individuals (N = 168) who entered an outpatient XR-NTX trial between 2011 and 2015, during which participants were offered three monthly injections of XR-NTX at no cost. The survey consisted of 35 questions covering a total of four domains: (1) substance use; (2) treatment continuation; (3) barriers; and (4) attitudes...
March 22, 2017: American Journal on Addictions
https://www.readbyqxmd.com/read/28327993/stepwise-distributed-open-innovation-contests-for-software-development-acceleration-of-genome-wide-association-analysis
#12
Andrew Hill, Po-Ru Loh, Ragu B Bharadwaj, Pascal Pons, Jingbo Shang, Eva Guinan, Karim Lakhani, Iain Kilty, Scott A Jelinsky
BACKGROUND: The association of differing genotypes with disease related phenotypic traits offers great potential to both help identify new therapeutic targets and support stratification of patients who would gain the greatest benefit from specific drug classes. Development of low cost genotyping and sequencing has made collecting large scale genotyping data routine in population and therapeutic intervention studies. In addition, a range of new technologies are being used to capture numerous new and complex phenotypic descriptors...
February 28, 2017: GigaScience
https://www.readbyqxmd.com/read/28327833/-burden-of-smoking-related-disease-and-potential-impact-of-cigarette-price-increase-in-peru
#13
Ariel E Bardach, Joaquín E Caporale, Andrea Alcaraz, Federico Augustovski, Leandro Huayanay-Falconí, Cesar Loza-Munarriz, Akram Hernández-Vásquez, Andrés Pichon-Riviere
Objectives: . To calculate the burden of smoking-related disease and evaluate the potential economic and health impact of tax-induced cigarette price increase in Peru. Materials and methods.: A microsimulation model was used to estimate smoking-attributable impact on mortality, quality of life, and costs associated with heart and cerebrovascular disease, chronic obstructive pulmonary disease, pneumonia, lung cancer, and another nine cancers. Three scenarios, involving increased taxes, were evaluated...
October 2016: Revista Peruana de Medicina Experimental y Salud Pública
https://www.readbyqxmd.com/read/28327185/economic-evaluation-of-interventions-delivered-by-primary-care-providers-to-improve-neurodevelopment-in-children-aged-under-5%C3%A2-years-protocol-for-a-scoping-review
#14
Karen M Edmond, Natalie A Strobel, Kimberley McAuley, Elizabeth Geelhoed, Lisa Hurt
BACKGROUND: Frequently cited benefit-cost ratios suggest that interventions to improve neurodevelopment have high economic returns when implemented during pregnancy and early childhood. However, there are many challenges when primary care providers implement these interventions at scale, and it is unclear how many research studies or programmes have examined cost-effectiveness and which methods were used. There are no current scoping or systematic reviews which have assessed economic evaluations of interventions delivered by primary care providers to improve child neurodevelopment...
March 21, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/28327143/the-imperative-for-systems-thinking-to-promote-access-to-medicines-efficient-delivery-and-cost-effectiveness-when-implementing-health-financing-reforms-a-qualitative-study
#15
Tom Achoki, Abaleng Lesego
BACKGROUND: Health systems across Africa are faced with a multitude of competing priorities amidst pressing resource constraints. Expansion of health insurance coverage offers promise in the quest for sustainable healthcare financing for many of the health systems in the region. However, the broader policy implications of expanding health insurance coverage have not been fully investigated and contextualized to many African health systems. METHODS: We interviewed 37 key informants drawn from public, private and civil society organizations involved in health service delivery in Botswana...
March 21, 2017: International Journal for Equity in Health
https://www.readbyqxmd.com/read/28327122/midodrine-as-adjunctive-support-for-treatment-of-refractory-hypotension-in-the-intensive-care-unit-a-multicenter-randomized-placebo-controlled-trial-the-midas-trial
#16
Matthew H Anstey, Bradley Wibrow, Tharusan Thevathasan, Brigit Roberts, Khushi Chhangani, Pauline Yeung Ng, Alexander Levine, Alan DiBiasio, Todd Sarge, Matthias Eikermann
BACKGROUND: Patients admitted to intensive care units (ICU) are often treated with intravenous (IV) vasopressors. Persistent hypotension and dependence on IV vasopressors in otherwise resuscitated patients lead to delay in discharge from ICU. Midodrine is an oral alpha-1 adrenergic agonist approved for treatment of symptomatic orthostatic hypotension. This trial aims to evaluate whether oral administration of midodrine is an effective adjunct to standard therapy to reduce the duration of IV vasopressor treatment, and allow earlier discharge from ICU and hospital...
March 21, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28327120/where-s-the-evidence-a-systematic-review-of-economic-analyses-of-residential-aged-care-infrastructure
#17
Tiffany Easton, Rachel Milte, Maria Crotty, Julie Ratcliffe
BACKGROUND: Residential care infrastructure, in terms of the characteristics of the organisation (such as proprietary status, size, and location) and the physical environment, have been found to directly influence resident outcomes. This review aimed to summarise the existing literature of economic evaluations of residential care infrastructure. METHODS: A systematic review of English language articles using AgeLine, CINAHL, Econlit, Informit (databases in Health; Business and Law; Social Sciences), Medline, ProQuest, Scopus, and Web of Science with retrieval up to 14 December 2015...
March 21, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28326908/sublingual-immunotherapy-tablets-as-a-disease-modifying-add-on-treatment-option-to-pharmacotherapy-for-allergic-rhinitis-and-asthma
#18
Stephen Brunton, Harold S Nelson, David I Bernstein, Simon Lawton, Susan Lu, Hendrik Nolte
Allergic rhinitis (AR) with or without conjunctivitis (AR/C) is associated with a significant health and economic burden, and is often accompanied by asthma. Pharmacotherapies are the mainstay treatment options for AR and asthma, but guidelines also recommend allergy immunotherapy (AIT). Unlike pharmacotherapies, AIT has the ability to modify the underlying immunologic mechanisms of AR and asthma with the potential for long-term benefits after treatment is discontinued. Immunotherapy may also prevent progression of AR/C to asthma...
March 22, 2017: Postgraduate Medicine
https://www.readbyqxmd.com/read/28326868/a-longitudinal-study-assessing-the-maintenance-condition-of-cadres-of-four-types-of-wheelchairs-provided-in-low-resource-areas
#19
Karen Rispin, Kristofer Riseling, Joy Wee
Wheelchair breakdowns increase the risk of injury and limit the mobility of wheelchair users. In the endeavour to meet the enormous global need for wheelchairs, manufacturers of wheelchairs for low-resource settings face a cost-benefit tension between affordability and durability. Field studies are needed to provide feedback on durability. Four manufacturers provided cadres of wheelchairs to the organization providing rehabilitation to students at a boarding school for children with disabilities in a low-resource area...
March 22, 2017: Disability and Rehabilitation. Assistive Technology
https://www.readbyqxmd.com/read/28326146/effects-of-continuous-and-intermittent-renal-replacement-therapies-among-adult-patients-with-acute-kidney-injury
#20
Tonio Schoenfelder, Xiaoyu Chen, Hans-Holger Bleß
Background: Dialysis-dependent acute kidney injury (AKI) can be treated using continuous (CRRT) or intermittent renal replacement therapies (IRRT). Although some studies suggest that CRRT may have advantages over IRRT, study findings are inconsistent. This study assessed differences between CRRT and IRRT regarding important clinical outcomes (such as mortality and renal recovery) and cost-effectiveness. Additionally, ethical aspects that are linked to renal replacement therapies in the intensive care setting are considered...
2017: GMS Health Technology Assessment
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