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https://www.readbyqxmd.com/read/28431193/evaluation-of-cholesterol-as-a-biomarker-for-suicidality-in-a-veteran-sample
#1
Chuck Reuter, Barbara Caldwell, Heather Basehore
A reduction in total cholesterol may alter the microviscosity of the brain-cell-membrane, reducing serotonin receptor exposure. The resulting imbalance between serotonin and dopamine may lead to an increased risk for suicidality. The objective of this research was to evaluate total cholesterol as a biological marker for suicidality in a sample of US military veterans. The study population consisted of veterans who received care at the Coatesville Veterans Affairs Medical Center (VAMC) and were included in the Suicide Prevention Coordinator's database for having suicidal ideation with evidence of escalating intent, a documented suicide attempt, or committed suicide between 2009 and 2015...
April 21, 2017: Research in Nursing & Health
https://www.readbyqxmd.com/read/28428816/physical-health-policies-and-metabolic-screening-in-mental-health-care-systems-of-sub-saharan-african-countries-a-systematic-review
#2
REVIEW
James Mugisha, Marc De Hert, Brendon Stubbs, David Basangwa, Davy Vancampfort
BACKGROUND: There is a need for interventions to address the escalating mental health burden in sub-Saharan Africa (SSA). Addressing physical health needs should have a central role in reducing the burden and facilitating recovery in people with severe mental illness (SMI). We systematically investigated (1) physical health policies in the current mental health plans, and (2) the routine metabolic screening rates for people with SMI in SSA. METHODS: The Mental Health Atlas and MiNDbank of the World Health Organization were screened for physical health policies in mental health plans...
2017: International Journal of Mental Health Systems
https://www.readbyqxmd.com/read/28426675/indicators-of-suboptimal-biologic-therapy-over-time-in-patients-with-ulcerative-colitis-and-crohn-s-disease-in-the-united-states
#3
Haridarshan Patel, Trevor Lissoos, David T Rubin
This study assessed the occurrence of indicators for suboptimal biologic therapy among ulcerative colitis (UC) and Crohn's disease (CD) patients over time in the United States (US). Data from a large US claims database (2005-2013) were used to retrospectively identify patients with diagnosed with either UC or CD who were new biologic users. Indicators of suboptimal biologic therapy included: dose escalation during the maintenance phase, discontinuation of the initial biologic, switch to another biologic within 90 days following the last day of supply of the initial biologic, augmentation with a non-biologic systemic therapy, UC- or CD-related surgery, UC- or CD-related urgent care, and development of fistula (for CD only)...
2017: PloS One
https://www.readbyqxmd.com/read/28421005/autoimmune-aspects-of-neurodegenerative-and-psychiatric-diseases-a-template-for-innovative-therapy
#4
REVIEW
Peter de Haan, Hans C Klein, Bert A 't Hart
Neurodegenerative and psychiatric diseases (NPDs) are today's most important group of diseases, surpassing both atherosclerotic cardiovascular disease and cancer in morbidity incidence. Although NPDs have a dramatic impact on our society because of their high incidence, mortality, and severe debilitating character, remarkably few effective interventions have become available. The current treatments, if available, comprise the lifelong intake of general immunosuppressants to delay disease progression or neurotransmitter antagonists/agonists to dampen undesired behaviors...
2017: Frontiers in Psychiatry
https://www.readbyqxmd.com/read/28416559/a-novel-non-antibiotic-nitroglycerin-based-catheter-lock-solution-for-the-prevention-of-intraluminal-central-venous-catheter-infections-in-cancer-patients
#5
Anne-Marie Chaftari, Ray Hachem, Ariel Szvalb, Mahnaz Taremi, Bruno Granwehr, George Michael Viola, Amin Sapna, Andrew Assaf, Numan Yazan, Pankil Shah, Ketevan Gasitashvili, Elizabeth Natividad, Ying Jiang, Rebecca Slack, Ruth Reitzel, Joel Rosenblatt, Elie Mouhayar, Issam Raad
Background: For long-term central lines (CL), the lumen is the major source of central line associated bloodstream infections (CLABSI). Current standard of care for maintaining catheter patency includes flushing the CL with saline or heparin. Neither agent has any antimicrobial activity. Furthermore heparin may enhance staphylococcal biofilm formation. We evaluated the safety and efficacy of a novel non-antibiotic catheter lock solution for the prevention of CLABSI.Patients and Methods: Between November 2015, and February 2016, we enrolled 60 patients with hematologic malignancies who had peripherally inserted central catheter (PICC) to receive the study lock solution...
April 17, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28412887/preventing-and-de-escalating-aggressive-behavior-among-adult-psychiatric-patients-a-systematic-review-of-the-evidence
#6
Bradley N Gaynes, Carrie L Brown, Linda J Lux, Kimberly A Brownley, Richard A Van Dorn, Mark J Edlund, Emmanuel Coker-Schwimmer, Rachel Palmieri Weber, Brian Sheitman, Theodore Zarzar, Meera Viswanathan, Kathleen N Lohr
OBJECTIVE: The project goal was to compare the effectiveness of strategies to prevent and de-escalate aggressive behaviors among psychiatric patients in acute care settings, including interventions for reducing use of seclusion and restraint. METHODS: Relevant databases were systematically reviewed for comparative studies of violence prevention and de-escalation strategies involving adult psychiatric patients in acute care settings. Studies (trials and cohort studies) were required to report on aggression or seclusion or restraint outcomes...
April 17, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/28412043/assessment-of-high-priced-systemic-antifungal-prescriptions
#7
C Poulat, Y Nivoix, A Launoy, P Lutun, P Bachellier, S Rohr, M-L Woehl, D Levêque, V Bru, R Herbrecht, B Gourieux
OBJECTIVES: To assess compliance with international guidelines for costly antifungal prescriptions and to compare these results with a first study performed in 2007. METHODS: Retrospective study including all costly antifungal prescriptions made in surgical and medical intensive care units and in a hepatobiliary, pancreatic, and digestive surgery unit. Prescriptions were assessed in terms of indication, dosage, and antifungal de-escalation. RESULTS: Seventy-four treatments were analyzed...
April 12, 2017: Médecine et Maladies Infectieuses
https://www.readbyqxmd.com/read/28409699/potential-for-medicaid-savings-a-state-and-national-comparison-of-an-innovative-neonatal-abstinence-syndrome-treatment-model
#8
Lori Dickes, Julie Summey, Rachel Mayo, Jennifer Hudson, Windsor Westbrook Sherrill, Liwei Chen
In recent years, neonatal abstinence syndrome (NAS) rates have increased rapidly across the United States, rising from 1.2 (2000) to 5.8 (2012) per 1000 hospital births annually. Because most NAS infants are treated in an intensive care setting, associated hospital charges are high and continue to escalate, rising on average from $39,400 in 2000 to $66,700 in 2012. An innovative NAS treatment program, which includes early-initiated methadone therapy, rooming-in, and combined inpatient/outpatient weaning in a low-acuity nursery, has been in place since 2003 at a large Southeastern hospital...
April 14, 2017: Population Health Management
https://www.readbyqxmd.com/read/28407666/influence-of-erythropoiesis-stimulating-agents-on-hba1c-and-fructosamine-in-patients-with-haemodialysis
#9
Franz Maximilian Rasche, Thomas Ebert, Julia Beckmann, Volker Busch, Filip Barinka, Wilma Gertrud Rasche, Tom H Lindner, Jochen G Schneider, Stephan Schiekofer
HbA1c is the most accepted laboratory parameter for the long term observation of glucose control. There is still much of a debate about the use of HbA1c as a metabolic indicator in diabetic patients (DM) on haemodialysis (HD) and erythropoiesis-stimulating agent (ESA) therapy because of the altered erythrocyte turn over in patients with chronic kidney disease and haemodialysis (CKD5D). In 102 CKD5 patients with and without diabetes mellitus, we examined the dose dependent variability in HbA1c and fructosamine levels under haemodialysis and treated with epoetin α (n=48) and a new generation agent with continuous stimulation of methoxy polyethylene glycol epoetin beta (C...
April 13, 2017: Experimental and Clinical Endocrinology & Diabetes
https://www.readbyqxmd.com/read/28397334/a-nurse-led-education-and-cognitive-behaviour-therapy-based-intervention-among-adults-with-uncontrolled-type-2-diabetes-a-randomised-controlled-trial
#10
Lisa C Whitehead, Marie T Crowe, Janet D Carter, Virginia R Maskill, Dave Carlyle, Carol Bugge, Chris M A Frampton
RATIONALE, AIMS AND OBJECTIVES: Diabetes mellitus is associated with significant morbidity, mortality, and escalating health care costs. Research has consistently demonstrated the importance of glycaemic control in delaying the onset, and decreasing the incidence, of both the short-term and long-term complications of diabetes. Although glycaemic control is difficult to achieve and challenging to maintain, it is key to reducing negative disease outcomes. The aim of this study was to determine whether a nurse-led educational intervention alone or a nurse-led intervention using education and acceptance and commitment therapy (ACT) was effective in reducing hemoglobin A1c (HbA1c ) in people living with uncontrolled type 2 diabetes compared to usual care...
April 11, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28395369/antibiotics-prescriptions-in-the-neonatal-intensive-care-unit-how-to-overcome-everyday-challenges
#11
D Donà, E Mozzo, V Mardegan, U Trafojer, P Lago, S Salvadori, E Baraldi, C Giaquinto
Antimicrobial prescriptions in neonatal intensive care units (NICUs) represent a point of concern for the emergence of MDROs and for morbidity associated with prolonged antibiotic exposure (e.g., invasive candidiasis, necrotizing enterocolitis, and late-onset sepsis). Antimicrobial stewardship programs (ASPs) have shown to be a valuable tool for the prevention of resistance with the goals of optimizing clinical outcomes while decreasing unnecessary prescribing. The most frequent ASP strategies include the correct collection and interpretation of microbiological specimens, prescription of the narrowest-spectrum antibiotic appropriate for a particular case, and de-escalation or discontinuation of therapy in defined situations...
April 10, 2017: American Journal of Perinatology
https://www.readbyqxmd.com/read/28392749/patients-willingness-to-pay-for-their-drugs-in-primary-care-clinics-in-an-urbanized-setting-in-malaysia-a-guide-on-drug-charges-implementation
#12
Sharifa Ezat Wan Puteh, Siti Nurul Akma Ahmad, Azimatun Noor Aizuddin, Ramli Zainal, Ruhaini Ismail
BACKGROUND: Malaysia is an upper middle income country that provides subsidized healthcare to ensure universal coverage to its citizens. The challenge of escalating health care cost occurs in most countries, including Malaysia due to increase in disease prevalence, which induced an escalation in drug expenditure. In 2009, the Ministry of Health has allocated up to Malaysian Ringgit (MYR) 1.402 billion (approximately USD 390 million) on subsidised drugs. This study was conducted to measure patients' willingness to pay (WTP) for treatment of chronic condition or acute illnesses, in an urbanized population...
2017: Asia Pacific Family Medicine
https://www.readbyqxmd.com/read/28392713/a-case-report-on-the-treatment-of-complex-chronic-pain-and-opioid-dependence-by-a-multidisciplinary-transitional-pain-service-using-the-act-matrix-and-buprenorphine-naloxone
#13
Aliza Z Weinrib, Lindsay C Burns, Alex Mu, Muhammad Abid Azam, Salima Sj Ladak, Karen McRae, Rita Katznelson, Saam Azargive, Cieran Tran, Joel Katz, Hance Clarke
In an era of growing concern about opioid prescribing, the postsurgical period remains a critical window with the risk of significant opioid dose escalation, particularly in patients with a history of chronic pain and presurgical opioid use. The purpose of this case report is to describe the multidisciplinary care of a complex, postsurgical pain patient by an innovative transitional pain service (TPS). A 59-year-old male with complex chronic pain, as well as escalating long-term opioid use, presented with a bleeding duodenal ulcer requiring emergency surgery...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28390539/retrospective-analysis-of-self-reporting-pain-scores-and-pain-management-during-head-and-neck-imrt-radiotherapy-a-single-institution-experience
#14
P O'Connor, J Bisson, P Asplin, D Gahir
AIMS: Head and neck carcinomas are relatively rare in the United Kingdom with an estimated 9000 cases diagnosed annually. However, pain associated with disease and treatment side effects such as oral mucositis present a major issue for therapy radiographers in providing effective care and maintaining radiotherapy treatment compliance, all factors that can compromise patient outcome if not managed appropriately. METHOD: This retrospective analysis of self-reporting pain scores collected during a course of radiotherapy aims to assess the perceived pain intensity scores in 30 patients...
May 2017: Radiography
https://www.readbyqxmd.com/read/28385912/translating-concerns-into-action-a-detailed-qualitative-evaluation-of-an-interdisciplinary-intervention-on-medical-wards
#15
Samuel Pannick, Stephanie Archer, Maximillian J Johnston, Iain Beveridge, Susannah Jane Long, Thanos Athanasiou, Nick Sevdalis
OBJECTIVES: To understand how frontline reports of day-to-day care failings might be better translated into improvement. DESIGN: Qualitative evaluation of an interdisciplinary team intervention capitalising on the frontline experience of care delivery. Prospective clinical team surveillance (PCTS) involved structured interdisciplinary briefings to capture challenges in care delivery, facilitated organisational escalation of the issues they identified, and feedback...
April 5, 2017: BMJ Open
https://www.readbyqxmd.com/read/28385419/vital-signs-and-other-observations-used-to-detect-deterioration-in-pregnant-women-an-analysis-of-vital-sign-charts-in-consultant-led-uk-maternity-units
#16
G B Smith, R Isaacs, L Andrews, M Y K Wee, E van Teijlingen, D E Bick, V Hundley
BACKGROUND: Obstetric early warning systems are recommended for monitoring hospitalised pregnant and postnatal women. We decided to compare: (i) vital sign values used to define physiological normality; (ii) symptoms and signs used to escalate care; (iii) type of chart used; and (iv) presence of explicit instructions for escalating care. METHODS: One hundred and twenty obstetric early warning charts and escalation protocols were obtained from consultant-led maternity units in the UK and Channel Islands...
March 10, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28384858/antimicrobial-resistance-surveillance-among-intensive-care-units-of-a-tertiary-care-hospital-in-southern-india
#17
Kailash Moolchandani, Apurba Sankar Sastry, R Deepashree, Sujatha Sistla, B N Harish, Jharna Mandal
INTRODUCTION: Hospital Acquired Infections (HAIs) are the rising threat in the health care facilities across the globe. As most Intesive Care Unit (ICU) patients are frequently on broad spectrum antimicrobials, this induces selective antibiotic pressure which leads to development of Antimicrobial Resistance (AMR) among the microorganisms of ICUs. AIM: To study the occurrence of different types of HAIs in patients admitted to various ICUs of JIPMER and the AMR pattern of the bacterial pathogens isolated from them...
February 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28383621/-violence-on-health-care-workers
#18
M Cannavò, N Fusaro, F Colaiuda, G Rescigno, M Fioravanti
OBJECTIVES: The Emergency Department (ED) is vulnerable for workplace violence, but little is known about this and its consequences. Objectives of this study were presence, characteristics and effects of violence from patients and visitors on health care workers in an Emergency Department (ED). MATERIALS AND METHODS: This study was about the Accident and Emergency Department, S. Pertini Hospital, (ASL RMB, Rome, Italy). Data were collected from November 2014 to January 2015 on frequency and type of violent behavior in the past five years experienced by staff members and their level of stress by an ad hoc questionnaire for the evaluation of violent events in health activities (QVS) and a questionnaire on perceived work-related stress (QES)...
March 2017: La Clinica Terapeutica
https://www.readbyqxmd.com/read/28382678/recognising-and-responding-to-in-hospital-clinical-deterioration-an-integrative-review-of-interprofessional-practice-issues
#19
REVIEW
Emily Allen, Doug Elliott, Debra Jackson
AIMS AND OBJECTIVES: To identify, appraise and synthesise current evidence regarding organisation-wide interprofessional practice issues that facilitate or inhibit effective recognition and response to clinical deterioration, using a theoretical Rapid Response System (RRS) model. BACKGROUND: Recognition and response to clinical deterioration, in adult general medical-surgical ward patients, is embedded as a routine interprofessional practice in acute healthcare organisations worldwide...
April 5, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28382400/associations-among-depressive-symptoms-wellness-patient-involvement-provider-cultural-competency-and-treatment-nonadherence-a-pilot-study-among-community-patients-seen-at-a-university-medical-center
#20
Lisa M Hooper, Lauren E Huffman, John C Higginbotham, George C T Mugoya, Annie K Smith, Tia N Dumas
Treatment nonadherence is a pernicious problem associated with increasing rates of chronic diseases, escalating healthcare costs, and rising mortality in some patients. Although researchers have suggested numerous factors related to treatment nonadherence, several understudied aspects warrant attention, such as primary-care settings, provider cultural competence, and patient involvement. Adding to the research base, the present pilot study examined 88 primarily Black American and White American community patients from a large university medical center in the southern part of the United States...
April 5, 2017: Community Mental Health Journal
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