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https://www.readbyqxmd.com/read/28535106/value-tools-in-managed-care-decision-making-current-hurdles-and-future-opportunities
#1
Jeremy Schafer, Dominic Galante, Jason Shafrin
BACKGROUND: Organizations such as the National Comprehensive Cancer Network, American Society of Clinical Oncology, Institute for Clinical and Economic Review, and Memorial Sloan Kettering have created distinct tools to help different stakeholders assess the value of oncology treatments. However, the oncology value tools were not necessarily created for payers, and it is unclear whether payers are using these tools as part of their drug management process. OBJECTIVE: To understand what value tools payers are using in oncology management and what benefits and shortcomings the tools may have from the payer perspective...
June 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28527672/quality-of-life-among-long-term-survivors-of-advanced-stage-ovarian-cancer-a-cross-sectional-approach
#2
Susan K Lutgendorf, Eileen Shinn, Jeanne Carter, Susan Leighton, Keith Baggerly, Michele Guindani, Bryan Fellman, Marianne Matzo, George M Slavich, Marc T Goodman, William Tew, Jenny Lester, Kathleen M Moore, Beth Y Karlan, Douglas A Levine, Anil K Sood
PURPOSE: Long-term survival of women with advanced-stage ovarian cancer is relatively rare. Little is known about quality of life (QOL) and survivorship concerns of these women. Here, we describe QOL of women with advanced-stage ovarian cancer surviving for 8.5 years or longer and compare women with 0-1 recurrence to those with multiple recurrences. METHODS: Participants (n=56) recruited from 5 academic medical centers and the Ovarian Cancer Research Fund Alliance completed surveys regarding QOL (FACT-O), mood (CESD), social support (SPS), physical activity (IPAQ-SF), diet, and clinical characteristics...
May 17, 2017: Gynecologic Oncology
https://www.readbyqxmd.com/read/28526053/pre-hospital-triage-performance-after-standardized-trauma-courses
#3
Maria Lampi, Johan Junker, Peter Berggren, Carl-Oscar Jonson, Tore Vikström
BACKGROUND: The pre-hospital triage process aims at identifying and prioritizing patients in the need of prompt intervention and/or evacuation. The objective of the present study was to evaluate triage decision skills in a Mass Casualty Incident drill. The study compares two groups of participants in Advanced Trauma Life Support and Pre-Hospital Trauma Life Support courses. METHODS: A questionnaire was used to deal with three components of triage of victims in a Mass Casualty Incident: decision-making; prioritization of 15 hypothetical casualties involved in a bus crash; and prioritization for evacuation...
May 19, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28522405/challenges-and-opportunities-for-the-development-of-new-antipsychotic-drugs
#4
REVIEW
Carlos Forray, Raimund Buller
In spite of the significant impact that the serendipitous discovery of drugs with antipsychotic properties had on the care of patients with psychotic disorders, there are significant challenges when aiming at therapeutic goals such as remission, recovery, improved health-related quality of life and functioning. The efficacy and effectiveness of existing antipsychotic drugs fail to address the full spectrum of symptoms and functional deficits that currently prevent patients with psychotic disorders from achieving fulfilling lives...
May 15, 2017: Biochemical Pharmacology
https://www.readbyqxmd.com/read/28520498/palliative-care-and-parkinson-s-disease-caregiver-perspectives
#5
Isabel Boersma, Jacqueline Jones, Christina Coughlan, Julie Carter, David Bekelman, Janis Miyasaki, Jean Kutner, Benzi Kluger
BACKGROUND: Palliative care for Parkinson's disease (PD) is an emerging area of interest for clinicians, patients and families. Identifying the palliative care needs of caregivers is central to developing and implementing palliative services for families affected by PD. The objective of this paper was to elicit PD caregiver needs, salient concerns, and preferences for care using a palliative care framework. MATERIALS AND METHODS: 11 PD caregivers and one non-overlapping focus group (n = 4) recruited from an academic medical center and community support groups participated in qualitative semi-structured interviews...
May 18, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28518131/incidence-of-respiratory-viral-infection-in-infants-with-respiratory-symptoms-evaluated-for-late-onset-sepsis
#6
J B Cerone, R P Santos, D Tristram, D M Lamson, K A Stellrecht, K St George, M J Horgan, A Rios
OBJECTIVE: To determine the frequency, etiology and impact of respiratory viral infection (RVI) on infants evaluated for late-onset sepsis (LOS), defined as sepsis occurring >72 h of life, in the neonatal intensive care unit. STUDY DESIGN: Prospective observational study conducted from 6 March 2014 to 3 May 2016 on infants evaluated for LOS. PCR viral panel performed on nasopharyngeal specimens among infants with clinical suspicion for RVI. Sequence analysis was performed to determine viral subtypes...
May 18, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28513831/avoidance-versus-use-of-neuromuscular-blocking-agents-for-improving-conditions-during-tracheal-intubation-or-direct-laryngoscopy-in-adults-and-adolescents
#7
REVIEW
Lars H Lundstrøm, Christophe Hv Duez, Anders K Nørskov, Charlotte V Rosenstock, Jakob L Thomsen, Ann Merete Møller, Søren Strande, Jørn Wetterslev
BACKGROUND: Tracheal intubation during induction of general anaesthesia is a vital procedure performed to secure a patient's airway. Several studies have identified difficult tracheal intubation (DTI) or failed tracheal intubation as one of the major contributors to anaesthesia-related mortality and morbidity. Use of neuromuscular blocking agents (NMBA) to facilitate tracheal intubation is a widely accepted practice. However, because of adverse effects, NMBA may be undesirable. Cohort studies have indicated that avoiding NMBA is an independent risk factor for difficult and failed tracheal intubation...
May 17, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28513531/who-should-lead-a-trauma-team-surgeon-or-non-surgeon-a-systematic-review-and-meta-analysis
#8
Shahab Hajibandeh, Shahin Hajibandeh
BACKGROUND: Presence of a trauma team leader (TTL) in the trauma team is associated with positive patient outcomes in major trauma. The TTL is traditionally a surgeon who coordinates the resuscitation and ensures adherence to Advanced Trauma Life Support (ATLS) guidelines. The necessity of routine surgical leadership in the resuscitative component of trauma care has been questioned by some authors. Therefore, it remains controversial who should lead the trauma team. We aimed to evaluate outcomes associated with surgeon versus non-surgeon TTLs in management of trauma patients...
June 1, 2017: Journal of Injury & Violence Research
https://www.readbyqxmd.com/read/28513400/role-of-nurses-in-supporting-patients-to-self-manage-chronic-conditions
#9
Vivien Coates
The burden of chronic illness is increasing globally as a result of increased life expectancy, unhealthy lifestyles, and advances in medical interventions and treatments. Therefore, people living with chronic conditions, and their families, will have to assume greater responsibility in managing such conditions. However, to do so they require appropriate support from healthcare services. This article explores some of the tensions that hinder the self-management of chronic conditions. It emphasises the importance of individuals and their families having the desire, and being enabled, to assume an active and decisive role in the management of chronic conditions...
May 17, 2017: Nursing Standard
https://www.readbyqxmd.com/read/28509934/the-role-of-the-prefrontal-cortex-in-freezing-of-gait-in-parkinson-s-disease-insights-from-a-deep-repetitive-transcranial-magnetic-stimulation-exploratory-study
#10
Moria Dagan, Talia Herman, Anat Mirelman, Nir Giladi, Jeffrey M Hausdorff
Freezing of Gait (FOG) is one of the most debilitating gait impairments in Parkinson's disease (PD), leading to increased fall risk and reduced health-related quality of life. The utility of parkinsonian medications is often limited in the case of FOG and it frequently becomes dopamine resistant. Recent studies have suggested that pre-frontal cortex (PFC) dysfunction contributes to FOG; however, most previous findings provide only indirect evidence. To better understand the role of the PFC, we aimed to investigate the impact of high frequency, deep, repetitive transcranial magnetic stimulation (drTMS) of the medial PFC on FOG and its mediators...
May 16, 2017: Experimental Brain Research. Experimentelle Hirnforschung. Expérimentation Cérébrale
https://www.readbyqxmd.com/read/28509786/igg4-related-disease-of-the-biliary-tract-and-pancreas-clinical-and-experimental-advances
#11
Lowiek M Hubers, Ulrich Beuers
PURPOSE OF REVIEW: IgG4-related disease (IgG4-RD) is an immune-mediated disease of unknown cause. It predominantly affects the biliary tract [IgG4-associated cholangitis (IAC)] and pancreas [autoimmune pancreatitis (AIP)] of mostly elderly men. Accurate diagnostic tests are lacking. Patients benefit from predniso(lo)ne treatment. However, disease relapse is often seen. This review will address pathophysiological aspects and advances in diagnostic and therapeutic strategies. RECENT FINDINGS: The role of IgG1 and IgG4 in the pathophysiology of IgG4-RD was studied in mice which showed more intense organ damage of pancreas and salivary glands when IgG1 rather than IgG4 of patients with IgG4-RD was injected...
May 13, 2017: Current Opinion in Gastroenterology
https://www.readbyqxmd.com/read/28509730/american-college-of-critical-care-medicine-clinical-practice-parameters-for-hemodynamic-support-of-pediatric-and-neonatal-septic-shock
#12
Alan L Davis, Joseph A Carcillo, Rajesh K Aneja, Andreas J Deymann, John C Lin, Trung C Nguyen, Regina S Okhuysen-Cawley, Monica S Relvas, Ranna A Rozenfeld, Peter W Skippen, Bonnie J Stojadinovic, Eric A Williams, Tim S Yeh, Fran Balamuth, Joe Brierley, Allan R de Caen, Ira M Cheifetz, Karen Choong, Edward Conway, Timothy Cornell, Allan Doctor, Marc-Andre Dugas, Jonathan D Feldman, Julie C Fitzgerald, Heidi R Flori, James D Fortenberry, Ana Lia Graciano, Bruce M Greenwald, Mark W Hall, Yong Yun Han, Lynn J Hernan, Jose E Irazuzta, Elizabeth Iselin, Elise W van der Jagt, Howard E Jeffries, Saraswati Kache, Chhavi Katyal, Niranjan Tex Kissoon, Alexander A Kon, Martha C Kutko, Graeme MacLaren, Timothy Maul, Renuka Mehta, Fola Odetola, Kristine Parbuoni, Raina Paul, Mark J Peters, Suchitra Ranjit, Karin E Reuter-Rice, Eduardo J Schnitzler, Halden F Scott, Adalberto Torres, Jacki Weingarten-Abrams, Scott L Weiss, Jerry J Zimmerman, Aaron L Zuckerberg
OBJECTIVES: The American College of Critical Care Medicine provided 2002 and 2007 guidelines for hemodynamic support of newborn and pediatric septic shock. Provide the 2014 update of the 2007 American College of Critical Care Medicine "Clinical Guidelines for Hemodynamic Support of Neonates and Children with Septic Shock." DESIGN: Society of Critical Care Medicine members were identified from general solicitation at Society of Critical Care Medicine Educational and Scientific Symposia (2006-2014)...
June 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28508832/disease-characteristics-and-treatment-attributes-of-patients-admitted-to-the-oncology-ward-of-a-tertiary-care-government-hospital
#13
Virender Suhag, B S Sunita, Pankaj Vats, Arti Sarin, A K Singh, Mayuri Jain
BACKGROUND: The burden of oncology patients in the most developing countries including India has witnessed a steady, progressive, and significant upward trend attributed mainly to increased life span, availability of better imaging modalities, increased awareness, and lifestyle and environmental changes. The management of such patients in government setup often presents lots of challenges such as advanced stage of presentation, existence of medical comorbid conditions, scarcity of beds, and long multimodal treatment often complicated with therapy-induced toxicities...
January 2017: Journal of Cancer Research and Therapeutics
https://www.readbyqxmd.com/read/28506439/clinical-review-loperamide-toxicity
#14
REVIEW
Peter E Wu, David N Juurlink
Loperamide is a nonprescription opioid widely used for the treatment of diarrhea. Although it is relatively safe at therapeutic doses, increasing reports describe its misuse and abuse at very high doses either for euphoric effects or to attenuate symptoms of opioid withdrawal. Life-threatening loperamide toxicity can result from the relatively new clinical syndrome of loperamide-induced cardiac toxicity. These patients are often young and may present in cardiac arrest or with unheralded, recurrent syncope in conjunction with ECG abnormalities, including marked QT-interval prolongation, QRS-interval widening, and ventricular dysrhythmias...
May 13, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28506309/social-isolation-and-cancer-management-advanced-rectal-cancer-with-patient-delay-following-the-2011-triple-disaster-in-fukushima-japan-a-case-report
#15
Akihiko Ozaki, Claire Leppold, Toyoaki Sawano, Masaharu Tsubokura, Manabu Tsukada, Tetsuya Tanimoto, Masahiro Kami, Hiromichi Ohira
BACKGROUND: Little is known about the effects of social isolation in the elderly on their process of gaining health information and seeking health care. CASE PRESENTATION: In March 2011, Fukushima, Japan experienced an earthquake, tsunami, and nuclear disaster, also known as Japan's triple disaster. In June 2016, an 80-year-old Japanese man, who lived alone after divorce at the age of 42, presented to our hospital with bloody stools and dizziness. Although his bloody stools initially occurred in May 2015, a year earlier, he did not pursue the possibility of malignancy...
May 16, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28504894/preventing-burdensome-transitions-of-nursing-home-residents-with-advanced-dementia-it-s-more-than-advance-directives
#16
Ruth Palan Lopez, Susan L Mitchell, Jane L Givens
BACKGROUND: Although a palliative approach to care is recommended for people with advanced dementia, many nursing home (NH) residents with dementia experience burdensome interventions such as hospital transfers at the end of life. OBJECTIVE: The goal of this study was to examine how decisions to transfer NH residents with advanced dementia are made, from the perspective of NH nurses and physicians. METHODS: A qualitative, descriptive method was used...
May 15, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28502218/recommendations-to-reduce-inequalities-for-lgbt-people-facing-advanced-illness-accesscare-national-qualitative-interview-study
#17
Katherine Bristowe, Matthew Hodson, Bee Wee, Kathryn Almack, Katherine Johnson, Barbara A Daveson, Jonathan Koffman, Linda McEnhill, Richard Harding
BACKGROUND: Lesbian, gay, bisexual and/or trans (LGBT) people have higher risk of certain life-limiting illnesses and unmet needs in advanced illness and bereavement. ACCESSCare is the first national study to examine in depth the experiences of LGBT people facing advanced illness. AIM: To explore health-care experiences of LGBT people facing advanced illness to elicit views regarding sharing identity (sexual orientation/gender history), accessing services, discrimination/exclusion and best-practice examples...
April 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28491126/developing-obstetric-medicine-training-in-latin-america
#18
José Rojas-Suarez, Niza Suarez, Oier Ateka-Barrutia
Maternal mortality is an important indicator of health in populations around the world. The distribution of maternal mortality ratio globally shows that middle- and low-income countries have ∼99% of the mortality burden. Most countries of Latin America are considered to be middle- or low-income countries, as well as areas of major inequities among the different social classes. Medical problems in pregnancy remain an important cause of morbidity and mortality in this region. Previous data indicate the need for a call to action for adequate diagnosis and care of medical diseases in obstetric care...
March 2017: Obstetric Medicine
https://www.readbyqxmd.com/read/28489224/current-concepts-of-transition-of-care-in-cystic-fibrosis
#19
Ajanta Patel, Maria Dowell, B Louise Giles
Over the past 6 decades, advances in cystic fibrosis (CF) diagnosis and management have extended the life expectancy of patients far beyond childhood; therefore, all pediatric CF patients must prepare for transition to adult care. Readiness assessment, knowledge and skill education, and support structures are all elements of ideal transition. Transition should begin early in life with teaching skills and knowledge for disease care, and in adolescence the readiness to transition should be addressed. Transition is a gradual process of increasing responsibilities in self-care and disease management, an improvement in the understanding of CF, and an iterative process of self-assessment with knowledge acquisition...
May 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/28486962/quality-of-life-psychological-burden-needs-and-satisfaction-during-specialized-inpatient-palliative-care-in-family-caregivers-of-advanced-cancer-patients
#20
Anneke Ullrich, Lilian Ascherfeld, Gabriella Marx, Carsten Bokemeyer, Corinna Bergelt, Karin Oechsle
BACKGROUND: This pilot study aimed to investigate quality of life, psychological burden, unmet needs, and care satisfaction in family caregivers of advanced cancer patients (FCs) during specialized inpatient palliative care (SIPC) and to test feasibility and acceptance of the questionnaire survey. METHODS: During a period of 12 weeks, FCs were recruited consecutively within 72 h after the patient's admission. They completed validated scales on several outcomes: quality of life (SF-8), distress (DT), anxiety (GAD-7), depression (PHQ-9), supportive needs (FIN), palliative care outcome (POS), and satisfaction with care (FAMCARE-2)...
May 10, 2017: BMC Palliative Care
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