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https://www.readbyqxmd.com/read/29783275/assessment-of-likelihood-ratio-for-four-contact-dermatitis-symptoms-of-vinca-minor
#1
Suman Bagchi, Chaturbhuja Nayak, Lex Rutten, Munmun Koley, Subhranil Saha, Mousumi Roy, Sk Jahir Abbas, Simantini Ghosh, Suman Halder, Ghulam Nabi Wani, Anaitulah Ahmad Mir, Showket Ahmad Bhat
BACKGROUND:  Contact dermatitis (CD) is a frequently occurring medical condition, for which Vinca minor (VM) is one of the recommended homeopathic medicines. However, the symptoms indicating this medicine have not yet been assessed systematically. Likelihood ratio (LR), based on Bayesian statistics, may yield better estimation of a medicine's indication than the existing method of entry of symptoms into materia medica and repertories. METHODS:  We investigated LRs of four CD symptoms of VM: (1) great sensitiveness of skin, with redness and soreness from slightest rubbing; (2) weeping eczema with foul, thick crusts; (3) itching amelioration in open air; and (4) CD of scalp...
May 21, 2018: Homeopathy: the Journal of the Faculty of Homeopathy
https://www.readbyqxmd.com/read/29783270/reducing-alarm-fatigue-in-two-neonatal-intensive-care-units-through-a-quality-improvement-collaboration
#2
Kendall R Johnson, James I Hagadorn, David W Sink
OBJECTIVE:  To reduce nonactionable oximeter alarms by 80% without increasing time infants were hypoxemic (oxygen saturation [SpO2 ] ≤ 80%) or hyperoxemic (SpO2  > 95% while on supplemental oxygen). STUDY DESIGN:  In 2015, a multidisciplinary team at Connecticut Children's Medical Center initiated a quality improvement project to reduce nonactionable oximeter alarms in two referral neonatal intensive care units (NICUs). Changes made through improvement cycles included reduction of the low oximeter alarm limit for specific populations, increased low alarm delay, development of postmenstrual age-based alarm profiles, and updated bedside visual reminders...
May 21, 2018: American Journal of Perinatology
https://www.readbyqxmd.com/read/29783258/-theoretical-grounds-of-a-structural-and-functional-model-for-quality-assurance-of-radiation-diagnostics-under-conditions-of-development-of-the-modern-health-care-system-in-ukraine
#3
Oleg A Korop, Sergiy V Lenskykh
OBJECTIVE: Introduction: Modern changes in the health care system of Ukraine are focused on financial support in providing medical and diagnostic care to the population and are based on deep and consistent structural and functional transformations. They are aimed at providing adequate quality care, which is the main target function and a principal criterion for operation of health care system. The urgency of this problem is increasing in the context of reforming the health care system and global changes in the governmental financial guarantees for the provision of medical services to the population...
2018: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/29783253/planning-of-effective-evaluation-of-the-activities-of-hospital-district-at-the-example-of-poltava-region
#4
Vyacheslav M Zhdan, Valentyn M Dvornyk, Viktor P Lysak, Igor M Skrypnyk, Valeriy I Pokhylko, Iryna A Holovanova, Inna V Bielikova, Maxim V Khorosh, Ludmila M Shylkina, Mariya M Tovstiak
OBJECTIVE: Introduction: Increasing of the availability and quality of health care in rural areas is one of the priority directions of public health and regional development policy. The need for reforming of the network of secondary health care facilities is due to the fact, that they are unable to meet the needs of the population in this specialized type of medical care in the conditions of the existing structure and funding system. The aim: to analyze the existing legislation regulating the establishment and operation of hospital districts; to determine the methodology for monitoring and evaluating of the activity of the hospital district on the example of the Poltava region...
2018: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/29783241/-assessment-of-the-life-quality-for-patients-with-chronic-pancreatitis
#5
Viktor A Ohniev, Pavlo O Trehub
OBJECTIVE: Introduction: The relevance of study, assessment and prediction of the life quality of patients with chronic pancreatitis to improve the provision of medical care and rehabilitation is high, since it allows to solve a number of important medical, social and economic problems of society. The aim: The aim: To study, evaluate and develop a model for the quality of life assessment in patients with chronic pancreatitis. PATIENTS AND METHODS: Materials and methods: The primary material was the results of a sociological study of patients with chronic pancreatitis conducted by the authors - 300 questionnaires...
2018: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/29783091/mind-at-home-streamlined-study-protocol-for-a-randomized-trial-of-home-based-care-coordination-for-persons-with-dementia-and-their-caregivers
#6
Quincy M Samus, Betty Smith Black, Melissa Reuland, Jeannie-Marie S Leoutsakos, Laura Pizzi, Kevin D Frick, David L Roth, Laura N Gitlin, Constantine G Lyketsos, Deirdre Johnston
BACKGROUND: Dementia is associated with high health care costs, premature long-term care (LTC) placement, medical complications, reduced quality of life, and caregiver burden. Most health care providers and systems are not yet organized or equipped to provide comprehensive long-term care management for dementia, although a range of effective symptoms and supportive care approaches exist. The Maximizing Independence at Home-Streamlined (MIND-S) is a promising model of home-based dementia care coordination designed to efficiently improve person-centered outcomes, while reducing care costs...
May 18, 2018: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/29783012/decisional-conflict-among-patients-considering-treatment-options-for-lumbar-herniated-disc
#7
Hwang Richard, Lambrechts Sylvia, Liu Hui, Christopher S Saigal, Kwan Lorna, Cisneros Crystal, Langston T Holly, Duru O Kenrik
BACKGROUND: Lumbar herniated disc is a "preference-sensitive" condition, in which the optimal treatment choice is crucially dependent on an informed patient's goals and values. Little is known about decisional conflict, defined as an individual's level of uncertainty regarding a decision, in patients considering treatment for lumbar herniated discs. Our work aims to identify factors associated with decisional conflict and areas for improved shared decision-making. METHODS: We prospectively surveyed patients seeking treatment for a lumbar herniated disc at L4-L5 and/or L5-S1 with a physician at the UCLA Spine Center...
May 18, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29782617/patient-specific-neurosurgical-phantom-assessment-of-visual-quality-accuracy-and-scaling-effects
#8
Felipe Wilker Grillo, Victor Hugo Souza, Renan Hiroshi Matsuda, Carlo Rondinoni, Theo Zeferino Pavan, Oswaldo Baffa, Helio Rubens Machado, Antonio Adilton Oliveira Carneiro
Background: Training in medical education depends on the availability of standardized materials that can reliably mimic the human anatomy and physiology. One alternative to using cadavers or animal bodies is to employ phantoms or mimicking devices. Styrene-ethylene/butylene-styrene (SEBS) gels are biologically inert and present tunable properties, including mechanical properties that resemble the soft tissue. Therefore, SEBS is an alternative to develop a patient-specific phantom, that provides real visual and morphological experience during simulation-based neurosurgical training...
2018: 3D Print Med
https://www.readbyqxmd.com/read/29782615/feasibility-study-applying-a-parametric-model-as-the-design-generator-for-3d-printed-orthosis-for-fracture-immobilization
#9
Jianyou Li, Hiroya Tanaka
Background: Applying 3D printing technology for the fabrication of custom-made orthoses provides significant advantages, including increased ventilation and lighter weights. Currently, the design of such orthoses is most often performed in the CAD environment, but creating the orthosis model is a time-consuming process that requires significant CAD experience. This skill gap limits clinicians from applying this technology in fracture treatment. The purpose of this study is to develop a parametric model as the design generator for 3D-printed orthoses for an inexperienced CAD user and to evaluate its feasibility and ease of use via a training and design exercise...
2018: 3D Print Med
https://www.readbyqxmd.com/read/29782601/patient-centered-medical-home-status-and-preparedness-to-assess-resident-milestones-a-cera-study
#10
Thad Wilkins, Wonsuk Yoo, Ralph A Gillies, Julie Dahl-Smith, Jacqueline Dubose, Joseph Hobbs, Selina Smith, Dean A Seehusen
Purpose: The patient-centered medical home (PCMH) model has been proposed as the ideal model for delivering primary care and is focused on improving patient safety and quality, reducing costs, and enhancing patient satisfaction. The mandated Accreditation Council for Graduate Medical Education educational milestones for evaluation of resident competency represent the skills graduates will utilize after graduation. Many of these skills are reflected in the PCMH model. We sought to determine if residency programs whose main family medicine (FM) practice sites have achieved PCMH recognition are therefore more prepared to evaluate milestones...
May 2018: PRiMER
https://www.readbyqxmd.com/read/29782517/importance-of-software-version-for-measurement-of-arterial-stiffness-arteriograph-as-an-example
#11
Margareta Ring, Maria J Eriksson, Gunnar Nyberg, Kenneth Caidahl
BACKGROUND: Current guidelines recommend the measurement of arterial stiffness in terms of aortic pulse wave velocity (PWV) as an important cardio-vascular risk marker. Both aortic PWV and the aortic augmentation index (AIxao) can be measured using different techniques, e.g., the Arteriograph and SphygmoCor. A new version of the software for the Arteriograph (v. 3.0.0.1, TensioMed, Budapest, Hungary; Arteriograph II) is now available. We wanted to determine whether this improved software differs from the previous version (Arteriograph v...
2018: PloS One
https://www.readbyqxmd.com/read/29782182/a-specifically-designed-multispecies-probiotic-supplement-relieves-seasonal-allergic-rhinitis-symptoms
#12
Annabelle M Watts, Amanda J Cox, Peter K Smith, Isolde Besseling-van der Vaart, Allan W Cripps, Nicholas P West
BACKGROUND: Probiotics are purported to reduce symptoms of allergic rhinitis. This study sought to determine the proportion of participants with an improvement in the mini Rhinoconjunctivitis Quality of Life Questionnaire (mRQLQ) in response to a multispecies probiotic supplement with a Simon Two-Stage design. METHODS: This study was based on a Simon Two-Stage Design for p1 -p0  = 0.18 to account for seasonal variation in symptoms. Under this design, ≥10 patients are required to exhibit an improvement in quality-of-life scores to determine that there was sufficient activity for the supplement to be considered effective...
May 21, 2018: Journal of Alternative and Complementary Medicine: Research on Paradigm, Practice, and Policy
https://www.readbyqxmd.com/read/29781838/a-new-dual-purpose-quality-control-dosimetry-protocol-for-diagnostic-reference-level-determination-in-computed-tomography
#13
Mehdi Sohrabi, Masoumeh Parsi, Sedigheh Sina
A diagnostic reference level is an advisory dose level set by a regulatory authority in a country as an efficient criterion for protection of patients from unwanted medical exposure. In computed tomography, the direct dose measurement and data collection methods are commonly applied for determination of diagnostic reference levels. Recently, a new quality-control-based dose survey method was proposed by the authors to simplify the diagnostic reference-level determination using a retrospective quality control database usually available at a regulatory authority in a country...
May 17, 2018: Health Physics
https://www.readbyqxmd.com/read/29781833/influence-of-socio-demographic-factors-on-disease-characteristics-and-vision-related-quality-of-life-in-primary-open-angle-glaucoma-patients-the-italian-primary-open-angle-glaucoma-study-ipoags
#14
Ivano Riva, Lorenzo Legramandi, Andreas Katsanos, Francesco Oddone, Eliana Rulli, Gloria Roberti, Luciano Quaranta
PURPOSE: To evaluate the potential association between socio-demographic factors with clinical characteristics, vision-related quality of life and glaucoma-related symptoms scores in a large cohort of primary open angle glaucoma (POAG) patients. MATERIAL AND METHODS: Multicenter, cross-sectional study involving academic and non-academic centers. Previously diagnosed POAG patients aged >18 years were enrolled. At baseline, information on demographic characteristics, social, medical and ocular history, clinical presentation and treatments was collected...
May 17, 2018: Journal of Glaucoma
https://www.readbyqxmd.com/read/29781467/comprehensive-geriatric-assessment-interprofessional-team-recommendations-for-older-adult-women-with-breast-cancer
#15
Janine Overcash
BACKGROUND: Geriatric oncology incorporates comprehensive geriatric assessment (CGA) and traditional oncology care. OBJECTIVES: The aims are to identify limitations reflected by mean scores on the CGA instruments and describe the CGA recommendations documented in the medical record. METHODS: CGA was administered and consisted of the Timed Up and Go Test, the Activities of Daily Living Scale, the Instrumental Activities of Daily Living Scale, grip strength, falls, pain, the Brief Fatigue Inventory, the Pittsburgh Sleep Quality Index, the Geriatric Depression Scale, the Mini-Cog, and the Mini Nutritional Assessment...
June 1, 2018: Clinical Journal of Oncology Nursing
https://www.readbyqxmd.com/read/29781395/judicialization-2-0-understanding-right-to-health-litigation-in-real-time
#16
João Biehl, Mariana P Socal, Varun Gauri, Debora Diniz, Marcelo Medeiros, Gabriela Rondon, Joseph J Amon
Over the past two decades, debate over the whys, the hows, and the effects of the ever-expanding phenomenon of right-to-health litigation ('judicialization') throughout Latin America have been marked by polarised arguments and limited information. In contrast to claims of judicialization as a positive or negative trend, less attention has been paid to ways to better understand the phenomenon in real time. In this article, we propose a new approach-Judicialization 2.0-that recognises judicialization as an integral part of democratic life...
May 21, 2018: Global Public Health
https://www.readbyqxmd.com/read/29781385/procalcitonin-guided-use-of-antibiotics-for-lower-respiratory-tract-infection
#17
David T Huang, Donald M Yealy, Michael R Filbin, Aaron M Brown, Chung-Chou H Chang, Yohei Doi, Michael W Donnino, Jonathan Fine, Michael J Fine, Michelle A Fischer, John M Holst, Peter C Hou, John A Kellum, Feras Khan, Michael C Kurz, Shahram Lotfipour, Frank LoVecchio, Octavia M Peck-Palmer, Francis Pike, Heather Prunty, Robert L Sherwin, Lauren Southerland, Thomas Terndrup, Lisa A Weissfeld, Jonathan Yabes, Derek C Angus
Background The effect of procalcitonin-guided use of antibiotics on treatment for suspected lower respiratory tract infection is unclear. Methods In 14 U.S. hospitals with high adherence to quality measures for the treatment of pneumonia, we provided guidance for clinicians about national clinical practice recommendations for the treatment of lower respiratory tract infections and the interpretation of procalcitonin assays. We then randomly assigned patients who presented to the emergency department with a suspected lower respiratory tract infection and for whom the treating physician was uncertain whether antibiotic therapy was indicated to one of two groups: the procalcitonin group, in which the treating clinicians were provided with real-time initial (and serial, if the patient was hospitalized) procalcitonin assay results and an antibiotic use guideline with graded recommendations based on four tiers of procalcitonin levels, or the usual-care group...
May 20, 2018: New England Journal of Medicine
https://www.readbyqxmd.com/read/29781384/how-to-uncover-sources-of-unwarranted-practice-variation-a-case-study-in-emergency-medicine
#18
Markus A Feufel
Forty years of statistical database analyses have demonstrated the existence of unwarranted practice variation in care delivery, that is, variations independent of medical need, evidence, or patient preference. Alas, little is known about the underlying mechanisms and thus finding interventions to reduce unwarranted variations remains difficult, hampering quality, equity, and efficiency of care. Whereas statistical analyses describe deviations from ideal patterns, ethnographically inspired analyses aim at understanding when, how, and why variations occur in practice...
May 1, 2018: Qualitative Health Research
https://www.readbyqxmd.com/read/29781334/surgical-treatment-of-dystonia
#19
Rubens G Cury, Suneil K Kalia, Binit B Shah, Joohi Jimenez-Shahed, L K Prashanth, Elena Moro
Treatment of dystonia should be individualized and tailored to the specific needs of patients. Surgical treatment is an important option in medically refractory cases. Several issues regarding type of the surgical intervention, targets, and predict factors of benefit are still under debate. Areas covered: To date, several clinical trials have proven the benefit and safety of deep brain stimulation (DBS) for inherited and idiopathic isolated dystonia, whereas there is still insufficient evidence in combined and acquired dystonia...
May 21, 2018: Expert Review of Neurotherapeutics
https://www.readbyqxmd.com/read/29781286/medical-therapy-versus-balloon-sinus-dilation-in-adults-with-chronic-rhinosinusitis-merlot-12-month-follow-up
#20
J Pablo Stolovitzky, Neelesh Mehendale, Keith E Matheny, William J Brown, Anthony A Rieder, Douglas R Liepert, Ewen Tseng, Andrew Gould
Background Chronic rhinosinusitis (CRS) is a devastating disease affecting nearly 30 million people in the United States. An interim analysis of data from the present study suggested that, in patients who had previously failed medical therapy, balloon sinus dilation (BSD) plus medical management (MM) provides a significant improvement in the quality of life (QOL) at 24 weeks postprocedure compared to MM alone. Objective The primary objective of this final analysis was to evaluate the durability of treatment effects through the 52-week follow-up...
January 1, 2018: American Journal of Rhinology & Allergy
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