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https://www.readbyqxmd.com/read/28535554/anesthetic-considerations-and-perioperative-management-of-spinal-cord-stimulators-literature-review-and-initial-recommendations
#1
Michael E Harned, Brandon Gish, Allison Zuelzer, Jay S Grider
BACKGROUND: Patients with implanted spinal cord stimulators (SCS) present to the anesthesia care team for management at many different points along the care continuum. Currently, the literature is sparse on the perioperative management. What is available is confusing; monopolar electrocautery is contraindicated but often used, full body magnetic resonance imaging (MRI) is safe with particular systems but with other manufactures only head and specific extremities exams are safe. Moreover, there are anesthetizing locations outside of the operating room where implanted SCS can interact with surrounding medical equipment and pose significant risk to patient and device...
May 2017: Pain Physician
https://www.readbyqxmd.com/read/28535482/multiple-metal-exposures-and-their-correlation-with-monoamine-neurotransmitter-metabolism-in-chinese-electroplating-workers
#2
Lin-Lin Wu, Wei Gong, Si-Peng Shen, Zhong-He Wang, Jia-Xi Yao, Jun Wang, Jing Yu, Rong Gao, Gang Wu
Excessive metal exposure has been recognized as one of the detrimental factors for brain damage. However, the potential adverse effects induced by heavy metals on monoamine neurotransmitter pathways remains poorly understood. Our study aimed to investigate the possible association between metal exposure and neurotransmitter metabolism. By a cross-sectional investigation, 224 electroplating workers and 213 non-electroplating exposure workers were recruited in the exposure and control groups. Metal exposure levels were analyzed using inductively-coupled plasma mass spectrometry and monoamine neurotransmitter pathway metabolites were measured by ultra-performance liquid chromatography tandem mass spectrometry in human urine samples...
April 26, 2017: Chemosphere
https://www.readbyqxmd.com/read/28535410/effect-of-enzyme-inhibition-on-perampanel-pharmacokinetics-why-study-design-matters
#3
Barry E Gidal, Rama Maganti, Antonio Laurenza, Haichen Yang, David A Verbel, Edgar Schuck, Jim Ferry
OBJECTIVES: Perampanel, a selective, noncompetitive AMPA receptor antagonist, is indicated as adjunctive therapy for the treatment of partial seizures with or without secondarily generalized seizures and primary generalized tonic-clonic seizures in patients with epilepsy aged 12years and older. In vitro studies and Phase I trials indicate that perampanel is metabolized almost exclusively by CYP3A, with an elimination half-life (t1/2) averaging approximately 105h. Understanding of pharmacokinetic (PK) interactions-enzyme inhibition or induction-and anticipating their occurrence are important for management of patients with epilepsy...
April 26, 2017: Epilepsy Research
https://www.readbyqxmd.com/read/28535101/design-challenges-of-an-episode-based-payment-model-in-oncology-the-centers-for-medicare-medicaid-services-oncology-care-model
#4
Ronald M Kline, L Daniel Muldoon, Heidi K Schumacher, Larisa M Strawbridge, Andrew W York, Laura K Mortimer, Alison F Falb, Katherine J Cox, Carol Bazell, Ellen W Lukens, Mary C Kapp, Rahul Rajkumar, Amy Bassano, Patrick H Conway
The Centers for Medicare & Medicaid Services developed the Oncology Care Model as an episode-based payment model to encourage participating practitioners to provide higher-quality, better-coordinated care at a lower cost to the nearly three-quarter million fee-for-service Medicare beneficiaries with cancer who receive chemotherapy each year. Episode payment models can be complex. They combine into a single benchmark price all payments for services during an episode of illness, many of which may be delivered at different times by different providers in different locations...
May 23, 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28534659/health-care-costs-among-men-with-favorable-risk-prostate-cancer-managed-with-observation-strategies-versus-immediate-treatment-in-an-integrated-health-care-system
#5
Furaha Kariburyo, Yuexi Wang, I-Ning Elaine Cheng, Lisa Wang, David Morgenstern, Igor Asner, Lin Xie, Eric Meadows, John Danella
OBJECTIVE: This study explored short-term health care costs of men managed with observation strategies (OBS) versus immediate treatment (IMT) for favorable risk prostate cancer (PCa) from Geisinger Health System, a single integrated health system in Pennsylvania, as evidence from the community setting is limited. METHODS: A retrospective cohort study was conducted using electronic health records from men aged ≥40 years diagnosed with favorable risk PCa (T1 or 2, PSA ≤15 ng/mL, Gleason ≤7 [3 + 4]) between January 2005 and October 2013...
May 23, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28534602/the-management-of-moderate-to-severe-chronic-plaque-psoriasis
#6
Annalisa Tonini, Salvatore Panduri, Angelo M D'Erme, Francesca Papadia, Marco Romanelli, James G Krueger, Andrea Chiricozzi
Recent approval and marketization of novel treatments have widened the range of therapeutic opportunities for moderate-to-severe psoriasis. In the next years, this panorama will be further enlarged as many other agents, both oral small molecules and biologics, have passed phase III and are expected to be approved, and subsequently marketed, shortly. In spite of this array of therapeutic possibilities, there is still an unmet need for an appropriate treatment in a large number of cases. This review was aimed to describe general principles regarding the therapeutic approach to moderate-severe plaque psoriasis, providing an updated overview of the therapeutic armamentarium that is specifically available in Italy, drug prescribility, and some peculiar limitations for reimbursement defined by our National Health Care System...
May 23, 2017: Giornale Italiano di Dermatologia e Venereologia: Organo Ufficiale, Società Italiana di Dermatologia e Sifilografia
https://www.readbyqxmd.com/read/28533899/genetic-diversity-and-structure-of-an-endangered-desert-shrub-and-the-implications-for-conservation
#7
Zhihao Su, Bryce A Richardson, Li Zhuo, Xiaolong Jiang, Wenjun Li, Xiaoshan Kang
Population genetic information can provide valuable insight for the conservation and management of threatened and endangered plant species. Tamarix taklamakanensis is an endangered shrub endemic to arid basins of northwestern China. This species serves to stabilize soils in this region, but has seen substantial loss in its abundance due to depletion of ground water. The populations of this species have become small and fragmented, warranting conservation. Seven microsatellite loci were used to assess the genetic diversity and structure of 15 populations in the Tarim Basin, China...
May 2017: AoB Plants
https://www.readbyqxmd.com/read/28533729/anmco-gicr-iacpr-sici-gise-consensus-document-the-clinical-management-of-chronic-ischaemic-cardiomyopathy
#8
Carmine Riccio, Michele Massimo Gulizia, Furio Colivicchi, Andrea Di Lenarda, Giuseppe Musumeci, Pompilio Massimo Faggiano, Maurizio Giuseppe Abrignani, Roberta Rossini, Francesco Fattirolli, Serafina Valente, Gian Francesco Mureddu, Pier Luigi Temporelli, Zoran Olivari, Antonio Francesco Amico, Giancarlo Casolo, Claudio Fresco, Alberto Menozzi, Federico Nardi
Stable coronary artery disease (CAD) is a clinical entity of great epidemiological importance. It is becoming increasingly common due to the longer life expectancy, being strictly related to age and to advances in diagnostic techniques and pharmacological and non-pharmacological interventions. Stable CAD encompasses a variety of clinical and anatomic presentations, making the identification of its clinical and anatomical features challenging. Therapeutic interventions should be defined on an individual basis according to the patient's risk profile...
May 2017: European Heart Journal Supplements: Journal of the European Society of Cardiology
https://www.readbyqxmd.com/read/28533697/a-comparison-of-predictors-and-intensity-of-acute-postsurgical-pain-in-patients-undergoing-total-hip-and-knee-arthroplasty
#9
Patrícia R Pinto, Teresa McIntyre, Vera Araújo-Soares, Patrício Costa, Ramón Ferrero, Armando Almeida
BACKGROUND: Acute pain is an expected result after surgery. Nevertheless, when not appropriately controlled, acute pain has a very negative impact on individual clinical outcomes, impairing healing and recovery, and has clear consequences on health care system costs. Augmenting knowledge on predictors and potentially modifiable determinants of acute postsurgical pain can facilitate early identification of and intervention in patients at risk. However, only a few studies have examined and compared acute pain after total hip arthroplasty (THA) and total knee arthroplasty (TKA)...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28533626/nonhealing-progressive-stress-fractures-of-the-foot-in-a-13-year-old-basketball-player-is-vitamin-k-deficiency-a-risk-factor
#10
Meral Bayramoğlu, Nuray Ünlütürk
[Purpose] To report an adolescent male basketball player with nonhealing stress fractures of the foot and discuss the probable factors. [Subject and Methods] A 13-year-old basketball player presented with right foot pain. He had been playing basketball for three years and practicing 5 days/week. He denied any increase in daily training intensity. Magnetic resonance imaging confirmed stress fractures of the cuboid and cuneiform, with mild edema of the soft tissues between the tarsal bones and tenosynovitis of the flexor hallucis and flexor digitorum longi...
April 2017: Journal of Physical Therapy Science
https://www.readbyqxmd.com/read/28532892/a-decade-of-studying-implicit-racial-ethnic-bias-in-healthcare-providers-using-the-implicit-association-test
#11
Ivy W Maina, Tanisha D Belton, Sara Ginzberg, Ajit Singh, Tiffani J Johnson
Disparities in the care and outcomes of US racial/ethnic minorities are well documented. Research suggests that provider bias plays a role in these disparities. The implicit association test enables measurement of implicit bias via tests of automatic associations between concepts. Hundreds of studies have examined implicit bias in various settings, but relatively few have been conducted in healthcare. The aim of this systematic review is to synthesize the current knowledge on the role of implicit bias in healthcare disparities...
May 4, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28532688/progress-in-the-contemporary-management-of-hemophilia-the-new-issue-of-patient-aging
#12
REVIEW
Pier Mannuccio Mannucci, Massimo Iacobelli
The management of inherited coagulation disorders such as hemophilia A and B has witnessed dramatic progresses since the last few decades of the last century. Accordingly, persons with hemophilia (PWH) now enjoy a life expectancy at birth not different from that of males in the general population, at least in high income countries. Nowadays, a substantial proportion of PWH are aging, like their peers in the general population. This outstanding progress is accompanied by problems that are in part similar to those of any old person (multiple concomitant diseases and the resulting intake of multiple drugs other than those specific for hemophilia treatment)...
May 20, 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/28532463/exploring-patient-centered-hospitals-a-systematic-review-to-understand-change
#13
Irene Gabutti, Daniele Mascia, Americo Cicchetti
BACKGROUND: The healthcare scenario in developed countries is changing deeply: patients, who are frequently affected by multi-pathological chronic conditions, have risen their expectations. Simultaneously, there exist dramatic financial pressures which require healthcare organizations to provide more and better services with equal (or decreasing) resources. In response to these challenges, hospitals are facing radical transformations by bridging, redesigning and engaging their organization and staff...
May 22, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28532401/risk-reassurance-and-routine-a-qualitative-study-of-narrative-understandings-of-the-potential-for-hiv-self-testing-among-men-who-have-sex-with-men-in-england
#14
T Charles Witzel, Peter Weatherburn, Alison J Rodger, Adam H Bourne, Fiona M Burns
BACKGROUND: HIV testing has seen a rapid evolution over the last decade with multiple modalities now in use globally. In recent years HIV self-testing (HIVST) has been legalised in the UK paving the way for further expansion of testing. Interventions are delivered in particular social contexts which shape uptake. It is therefore important to understand how novel interventions are likely to be received by their intended users. This study aims to understand how HIVST compliments existing testing strategies considered or adopted by men who have sex with men (MSM)...
May 22, 2017: BMC Public Health
https://www.readbyqxmd.com/read/28531157/hybrid-aware-model-for-senior-wellness-service-in-smart-home
#15
Yuchae Jung
Smart home technology with situation-awareness is important for seniors to improve safety and security. With the development of context-aware computing, wearable sensor technology, and ubiquitous computing, it is easier for seniors to manage their health problem in smart home environment. For monitoring senior activity in smart home, wearable, and motion sensors-such as respiration rate (RR), electrocardiography (ECG), body temperature, and blood pressure (BP)-were used for monitoring movements of seniors. For context-awareness, environmental sensors-such as gas, fire, smoke, dust, temperature, and light sensors-were used for senior location data collection...
May 22, 2017: Sensors
https://www.readbyqxmd.com/read/28529657/in-situ-pinning-in-slipped-capital-femoral-epiphysis-long-term-follow-up-studies
#16
F Accadbled, J Murgier, B Delannes, J P Cahuzac, J Sales de Gauzy
BACKGROUND: Management of moderately displaced slipped capital femoral epiphysis (SCFE) is debated, mostly because of the risks related to open reduction on one hand, and subsequent evolution toward femoroacetabular impingement (FAI) on the other. METHOD: All SCFE cases treated with in situ fixation (ISF) and a minimum of ten years of follow-up beyond skeletal maturity were analysed in a retrospective multicentre study. Coxometry parameters were measured. Long-term results of ISF were meanwhile analysed at our Institution...
April 2017: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/28527507/it-takes-two-to-tango-engaging-patients-and-providers-with-portals
#17
REVIEW
Sachin D Shah, David Liebovitz
Patient portals are designed to be tools to more fully engage patients in their health care and help enable them to better manage their own health information. As the U.S. health care system rapidly adopted electronic health records (EHRs) over the past decade, many with linked patient portals, enthusiasm and expectations for this new technology as a means to engage and empower patients grew. Most patient portals have a set of core features designed to facilitate health care transactions, information tracking, and communication with care team members...
May 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/28527504/telehealth-in-physical-medicine-and-rehabilitation-a-narrative-review
#18
REVIEW
Adam S Tenforde, Jaye E Hefner, Jodi E Kodish-Wachs, Mary A Iaccarino, Sabrina Paganoni
Telehealth refers to health care interactions that leverage telecommunication devices to provide medical care outside the traditional face-to-face, in-person medical encounter. Technology advances and research have expanded use of telehealth in health care delivery. Physical medicine and rehabilitation providers may use telehealth to deliver care to populations with neurologic and musculoskeletal conditions, commonly treated in both acute care and outpatient settings. Patients with impaired mobility and those living in locations with reduced access to care may particularly benefit...
May 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/28526538/trastuzumab-emtansine-versus-treatment-of-physician-s-choice-in-patients-with-previously-treated-her2-positive-metastatic-breast-cancer-th3resa-final-overall-survival-results-from-a-randomised-open-label-phase-3-trial
#19
Ian E Krop, Sung-Bae Kim, Antonio Gonzalez Martin, Patricia M LoRusso, Jean-Marc Ferrero, Tanja Badovinac-Crnjevic, Silke Hoersch, Melanie Smitt, Hans Wildiers
BACKGROUND: In the randomised, parallel assignment, open-label, phase 3 TH3RESA study, progression-free survival was significantly longer with trastuzumab emtansine versus treatment of physician's choice in previously treated patients with HER2-positive advanced breast cancer. We report results from the final overall survival analysis of the TH3RESA trial. METHODS: Eligible patients for the TH3RESA trial were men and women (aged ≥18 years) with centrally confirmed HER2-positive advanced breast cancer previously treated with both trastuzumab and lapatinib (advanced setting) and a taxane (any setting) and with progression on two or more HER2-directed regimens in the advanced setting...
May 16, 2017: Lancet Oncology
https://www.readbyqxmd.com/read/28526461/-anesthesia-in-a-child-operated-for-cleft-lip-associated-with-patau-s-syndrome
#20
Manoj Kamal, Don Varghese, Jeet Bhagde, Geeta Singariya, Annie Miju Simon, Amar Singh
Patients with Patau's syndrome (Trisomy 13) have multiple craniofacial, cardiac, neurological and renal anomalies with very less life expectancy. Among craniofacial anomalies cleft lip and palate are common. These craniofacial and cardiac anomalies present difficulties with anesthesia. We therefore describe the anesthetic management in the case of a Trisomy 13 child for operated for cleft lip at 10 months of age.
May 16, 2017: Revista Brasileira de Anestesiologia
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