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https://www.readbyqxmd.com/read/28343205/-biliary-atresia-signs-and-symptoms-diagnosis-clinical-management
#1
Ewa Orłowska, Piotr Czubkowski, Piotr Socha
Biliary atresia is a chronic cholangiopathy leading to progressive fibrosis of both intra- and extrahepatic bile ducts. The cause of the condition is unknown. Fundamental management of biliary atresia is surgical intervention and the outcomes of the treatment depend on the child's age with best results when performed within the first 2 months of life. Thus, the main role of pediatric healthcare is an urgent differential diagnosis and prompt qualification for the surgery, optimal postoperative management and early qualification for the liver transplantation in patients with persistent cholestasis...
2017: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/28343189/study-of-motivational-factors-in-doctors-in-respect-of-healthcare-quality-improvement
#2
Vladyslav A Smiianov, Olga I Smiianova, Tetiana S Gruzieva, Liudmyla Vygivska, Lesia A Rudenko
INTRODUCTION: The article presents the results of a survey among doctors with different certification categories and experience who work at inpatient and outpatient departments of Sumy healthcare institutions, in respect of the main factors that motivate them to provide quality healthcare. The aim of the study is to identify the factors that may be used as motivators to improve healthcare quality in terms of medical staff in order to ensure system construction of motivational component of healthcare quality management ("incentive picture")...
2017: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/28342891/cost-utility-of-group-acceptance-and-commitment-therapy-for-fibromyalgia-versus-recommended-drugs-an-economic-analysis-alongside-a-6-month-randomised-controlled-trial-conducted-in-spain-effigact-study
#3
Juan V Luciano, Francesco D'Amico, Albert Feliu-Soler, Lance M McCracken, Jaume Aguado, María T Peñarrubia-María, Martin Knapp, Antoni Serrano-Blanco, Javier García-Campayo
The aim of this study was to analyse the cost-utility of a group-based form of Acceptance and Commitment Therapy (GACT) in patients with fibromyalgia (FM) compared to patients receiving recommended pharmacological treatment (RPT) or on a waiting list (WL). The data were derived from a previously published study, an RCT that focused on clinical outcomes. Health economic outcomes included health-related quality of life and healthcare use at baseline and at 6-month follow-up using the EuroQol (EQ-5D-3L) and the Client Service Receipt Inventory (CSRI), respectively...
March 22, 2017: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/28342658/educational-needs-of-adolescents-with-congenital-heart-disease-impact-of-a-transition-intervention-programme
#4
Magalie Ladouceur, Johanna Calderon, Maladon Traore, Radhia Cheurfi, Christine Pagnon, Diala Khraiche, Fanny Bajolle, Damien Bonnet
BACKGROUND: Adolescents and young adults with congenital heart disease (CHD) have complex health needs and require lifelong follow-up. Interventions to facilitate the paediatric-to-adult healthcare transition are recommended, but outcomes remain largely under-investigated. AIMS: To identify the educational needs and the impact of a transition intervention on knowledge and self-management skills in adolescents and young adults with CHD. METHODS: From September 2014 to May 2015, 115 adolescents and young adults with CHD (mean age 17±2 years; 47 girls) were consecutively enrolled...
March 22, 2017: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/28342617/a-study-of-stigma-among-iranian-family-caregivers-of-patients-with-multiple-sclerosis-a-descriptive-explorative-qualitative-study
#5
Reza Masoudi, Fereydoon Khayeri, Leili Rabiei, Kourosh Zarea
AIM: This study was done to investigate the experiences of family caregivers of people with multiple sclerosis (MS) about stigmatization in Iranian health care context. BACKGROUND: Stigmatization has been observed obviously among patients with MS but few studies have been conducted on stigma among the family caregivers of these patients. METHODS: This qualitative study with thematic analysis was done to explore this issue. Fourteen family caregivers of patients with MS were selected by purposive sampling...
April 2017: Applied Nursing Research: ANR
https://www.readbyqxmd.com/read/28339642/meaningful-use-of-health-information-technology-and-declines-in-in-hospital-adverse-drug-events
#6
Michael F Furukawa, William D Spector, M Rhona Limcangco, William E Encinosa
Objective: Nationwide initiatives have promoted greater adoption of health information technology as a means to reduce adverse drug events (ADEs). Hospital adoption of electronic health records with Meaningful Use (MU) capabilities expected to improve medication safety has grown rapidly. However, evidence that MU capabilities are associated with declines in in-hospital ADEs is lacking. Methods: Data came from the 2010-2013 Medicare Patient Safety Monitoring System and the 2008-2013 Healthcare Information and Management Systems Society (HIMSS) Analytics Database...
February 16, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28339427/a-critical-analysis-of-obamacare-affordable-care-or-insurance-for-many-and-coverage-for-few
#7
Laxmaiah Manchikanti, Standiford Helm Ii, Ramsin M Benyamin, Joshua A Hirsch
The Affordable Care Act (ACA), of 2010, or Obamacare, was the most monumental change in US health care policy since the passage of Medicaid and Medicare in 1965. Since its enactment, numerous claims have been made on both sides of the aisle regarding the ACA's success or failure; these views often colored by political persuasion. The ACA had 3 primary goals: increasing the number of the insured, improving the quality of care, and reducing the costs of health care. One point often lost in the discussion is the distinction between affordability and access...
March 2017: Pain Physician
https://www.readbyqxmd.com/read/28338880/the-yield-and-feasibility-of-integrated-screening-for-tb-diabetes-and-hiv-in-four-public-hospitals-in-ethiopia
#8
Degu Jerene, Nebiyu Hiruy, Ilili Jemal, Wondimu Gebrekiros, Tadesse Anteneh, Dereje Habte, Muluken Melese, Pedro Suarez, Gloria Sangiwa
Background: Our objective was to demonstrate the feasibility of integrated care for TB, HIV and diabetes mellitus (DM) in a pilot project in Ethiopia. Methods: Healthcare workers in four hospitals screened patients with TB for HIV and DM; patients with HIV for DM and TB; and patients with DM for TB. Fasting and random plasma glucose (RPG) tests were used to confirm the diagnosis of DM. We used screening checklists for TB and DM, and additional risk scoring criteria to identify patients at risk of DM...
March 2, 2017: International Health
https://www.readbyqxmd.com/read/28337730/current-concepts-of-shared-decision-making-in-orthopedic-surgery
#9
REVIEW
Kevin Klifto, Christopher Klifto, James Slover
PURPOSE OF REVIEW: The Shared Decision Making (SDM) model, a collaborative decision making process between the physician and patient to make an informed clinical decision that enhances the chance of treatment success as defined by each patient's preferences and values, has become a new and promising tool in the healthcare process; however, minimal data exists on its application in the orthopedic surgical specialty. Increasing evidence has demonstrated that this once novel idea can be implemented successfully in the orthopedic setting to improve patient outcomes...
March 23, 2017: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/28337689/managing-chronic-pain-in-primary-care-it-really-does-take-a-village
#10
Karen Seal, William Becker, Jennifer Tighe, Yongmei Li, Tessa Rife
Some healthcare systems are relieving primary care providers (PCPs) of "the burden" of managing chronic pain and opioid prescribing, instead offloading chronic pain management to pain specialists. Last year the Centers for Disease Control and Prevention recommended a biopsychosocial approach to pain management that discourages opioid use and promotes exercise therapy, cognitive behavioral therapy and non-opioid medications as first-line patient-centered, multi-modal treatments best delivered by an interdisciplinary team...
March 23, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28336790/prioritizing-functional-capacity-as-a-principal-end-point-for-therapies-oriented-to-older-adults-with-cardiovascular-disease-a-scientific-statement-for-healthcare-professionals-from-the-american-heart-association
#11
REVIEW
Daniel E Forman, Ross Arena, Rebecca Boxer, Mary A Dolansky, Janice J Eng, Jerome L Fleg, Mark Haykowsky, Arshad Jahangir, Leonard A Kaminsky, Dalane W Kitzman, Eldrin F Lewis, Jonathan Myers, Gordon R Reeves, Win-Kuang Shen
Adults are living longer, and cardiovascular disease is endemic in the growing population of older adults who are surviving into old age. Functional capacity is a key metric in this population, both for the perspective it provides on aggregate health and as a vital goal of care. Whereas cardiorespiratory function has long been applied by cardiologists as a measure of function that depended primarily on cardiac physiology, multiple other factors also contribute, usually with increasing bearing as age advances...
March 23, 2017: Circulation
https://www.readbyqxmd.com/read/28336742/current-and-potential-providers-of-blood-pressure-self-screening-a-mixed-methods-study-in-oxfordshire
#12
A C Tompson, S G Fleming, C J Heneghan, R J McManus, S M Greenfield, F D R Hobbs, A M Ward
OBJECTIVES: To (1) establish the extent of opportunities for members of the public to check their own blood pressure (BP) outside of healthcare consultations (BP self-screening), (2) investigate the reasons for and against hosting such a service and (3) ascertain how BP self-screening data are used in primary care. DESIGN: A mixed methods, cross-sectional study. SETTING: Primary care and community locations in Oxfordshire, UK. PARTICIPANTS: 325 sites were surveyed to identify where and in what form BP self-screening services were available...
March 22, 2017: BMJ Open
https://www.readbyqxmd.com/read/28335987/community-health-indicators-associated-with-outcomes-of-pancreatectomy
#13
Lauren Slakey Pointer, Zaid Al-Qurayshi, David Taylor Pointer, Emad Kandil, Douglas Philip Slakey
PURPOSE: This study evaluates the association of environmental, social and health risk factors in relation to outcomes of pancreatic surgery. METHODS: Patients who underwent pancreatectomy with a 30 day postoperative follow up in Florida, New York and Washington states were identified using the State Inpatient Databases (SID) from 2010 to 2011. This data was merged with community health indicators complied from the County Health Ranking database. Fourteen community health indicators were used to determine higher risk communities...
March 10, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28335777/the-reasons-why-pakistan-might-be-at-high-risk-of-crimean-congo-haemorrhagic-fever-epidemic-a-scoping-review-of-the-literature
#14
REVIEW
Muhammad Atif, Anum Saqib, Raazeyah Ikram, Muhammad Rehan Sarwar, Shane Scahill
Pakistan has faced a number of significant healthcare challenges over the past decade. In 2000, one of these events - a deadly epidemic of Crimean Congo Haemorrhagic Fever (CCHF) - struck Pakistan. The people of Pakistan are at a very high risk of acquiring CCHF, due to a number of factors which emerge from a scoping review of the literature. First, the underdeveloped healthcare system of the country is currently not prepared to cope with challenges of this nature. Healthcare professionals and medical institutes are not sufficiently equipped to properly diagnose, manage and prevent CCHF...
March 23, 2017: Virology Journal
https://www.readbyqxmd.com/read/28335770/a-model-of-influences-on-the-clinical-learning-environment-the-case-for-change-at-one-u-s-medical-school
#15
Howard B Fleit, Richard J Iuli, Janet E Fischel, Wei-Hsin Lu, Latha Chandran
BACKGROUND: The learning environment within a school of medicine influences medical students' values and their professional development. Despite national requirements to monitor the learning environment, mistreatment of medical students persists. METHODS: We designed a program called WE SMILE: We can Eradicate Student Mistreatment In the Learning Environment with a vision to enhance trainee and faculty awareness and ultimately eliminate medical student mistreatment...
March 23, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/28333923/interdisciplinary-approach-at-the-primary-healthcare-level-for-bolivian-immigrants-with-chagas-disease-in-the-city-of-s%C3%A3-o-paulo
#16
Maria Aparecida Shikanai Yasuda, Camila Gonçalves Sátolo, Noemia Barbosa Carvalho, Magda Maya Atala, Rosario Quiroga Ferrufino, Ruth Moreira Leite, Célia Regina Furucho, Expedito Luna, Rubens Antonio Silva, Marcia Hage, Caroline Medeji Ramos de Oliveira, Felipe Delatorre Busser, Vera Lucia Teixeira de Freitas, Dalva Marli Valerio Wanderley, Luzia Martinelli, Sonia Regina Almeida, Pedro Albajar Viñas, Nivaldo Carneiro
BACKGROUND/METHODS: In a pioneering cross-sectional study among Bolivian immigrants in the city of São Paulo, Brazil, the epidemiological profile, clinical manifestations and morbidity of Chagas disease were described. The feasibility of the management of Chagas disease at primary healthcare clinics using a biomedical and psychosocial interdisciplinary approach was also tested. Previously, a Trypanosoma cruzi (T. cruzi) infection rate of 4.4% among 633 immigrants was reported. The samples were screened using two commercial enzyme-linked immunoassay (ELISA) tests generated with epimastigote antigens, and those with discrepant or seropositive results were analyzed by confirmatory tests: indirect immunofluorescence (IFI), TESA-blot and a commercial recombinant ELISA...
March 23, 2017: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/28333597/when-is-parenteral-nutrition-appropriate
#17
Patricia Worthington, Jane Balint, Matthew Bechtold, Angela Bingham, Lingtak-Neander Chan, Sharon Durfee, Andrea K Jevenn, Ainsley Malone, Maria Mascarenhas, Daniel T Robinson, Beverly Holcombe
Parenteral nutrition (PN) represents one of the most notable achievements of modern medicine, serving as a therapeutic modality for all age groups across the healthcare continuum. PN offers a life-sustaining option when intestinal failure prevents adequate oral or enteral nutrition. However, providing nutrients by vein is an expensive form of nutrition support, and serious adverse events can occur. In an effort to provide clinical guidance regarding PN therapy, the Board of Directors of the American Society for Parenteral and Enteral Nutrition (ASPEN) convened a task force to develop consensus recommendations regarding appropriate PN use...
March 2017: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28333393/laser-generated-shockwaves-enhance-antibacterial-activity-against-biofilms-in-vitro
#18
William Yao, Edward C Kuan, Nathan C Francis, Maie A St John, Warren S Grundfest, Zachary D Taylor
BACKGROUND AND OBJECTIVES: Bacterial biofilm formation within chronic wound beds, which provides an effective barrier against antibiotics, is a known cause of recalcitrant infections and a significant healthcare burden, often requiring repeated surgical debridements. Laser-generated shockwaves (LGS) is a novel, minimally invasive, and nonthermal modality for biofilm mechanical debridement which utilizes compressive stress waves, generated by photonic absorption in thin titanium films to mechanically disrupt the biofilm...
March 23, 2017: Lasers in Surgery and Medicine
https://www.readbyqxmd.com/read/28332780/differentiation-of-patented-crystalline-glucosamine-sulfate-from-other-glucosamine-preparations-will-optimize-osteoarthritis-treatment
#19
REVIEW
Sukit Saengnipanthkul, Saranatra Waikakul, Sattaya Rojanasthien, Kitti Totemchokchyakarn, Attarit Srinkapaibulaya, Tai Cheh Chin, Nguyen Mai Hong, Olivier Bruyère, Cyrus Cooper, Jean-Yves Reginster, Myat Lwin
Symptomatic slow-acting drugs for osteoarthritis (SYSADOAs) are recommended for the medium- to long-term management of knee osteoarthritis (OA) due to their abilities to control pain, improve function and delay joint structural changes. Among SYSADOAs, evidence is greatest for the patented crystalline glucosamine sulfate (pCGS) formulation (Mylan). Glucosamine is widely available as glucosamine sulfate (GS) and glucosamine hydrochloride (GH) preparations that vary substantially in molecular form, pharmaceutical formulation and dose regimen...
March 23, 2017: International Journal of Rheumatic Diseases
https://www.readbyqxmd.com/read/28332417/cost-effectiveness-of-angiotensin-converting-enzyme-inhibitors-versus-angiotensin-ii-receptor-blockers-as-first-line-treatment-in-autosomal-dominant-polycystic-kidney-disease
#20
L A Clark, S Whitmire, S Patton, C Clark, C M Blanchette, R Howden
INTRODUCTION: Autosomal dominant polycystic kidney disease (ADPKD) is a rare kidney disorder impacting approximately 1:2500 individuals among the general US population. Hypertension is a significant predictor of ADPKD progression and risk factor for development of cardiovascular disease (CVD), the most common cause for mortality among ADPKD patients. Angiotensin-converting enzymes inhibitors (ACE-I) are widely used as first-line treatment in ADPKD for the management of hypertension. However, their cost-effectiveness relative to other hypertensive medications, such as angiotensin II receptor blockers (ARB) has never been assessed...
March 23, 2017: Journal of Medical Economics
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