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https://www.readbyqxmd.com/read/27906004/a-quantitative-evidence-base-for-population-health-applying-utilization-based-cluster-analysis-to-segment-a-patient-population
#1
Sabine I Vuik, Erik Mayer, Ara Darzi
BACKGROUND: To improve population health it is crucial to understand the different care needs within a population. Traditional population groups are often based on characteristics such as age or morbidities. However, this does not take into account specific care needs across care settings and tends to focus on high-needs patients only. This paper explores the potential of using utilization-based cluster analysis to segment a general patient population into homogenous groups. METHODS: Administrative datasets covering primary and secondary care were used to construct a database of 300,000 patients, which included socio-demographic variables, morbidities, care utilization, and cost...
November 25, 2016: Population Health Metrics
https://www.readbyqxmd.com/read/27905265/learning-together-part-2-training-costs-and-health-gain-a-cost-analysis
#2
Katherine Cullen, Wendy Riches, Chloe Macaulay, John Spicer
: Learning Together is a complex educational intervention aimed at improving health outcomes for children and young people. There is an additional cost as two doctors are seeing patients together for a longer appointment than a standard general practice (GP) appointment. Our approach combines the impact of the training clinics on activity in South London in 2014-15 with health gain, using NICE guidance and standards to allow comparison of training options. METHODS: Activity data was collected from Training Practices hosting Learning Together...
December 1, 2016: Education for Primary Care
https://www.readbyqxmd.com/read/27904904/clinical-evaluation-of-glycopegylated-recombinant-fviii-efficacy-and-safety-in-severe-haemophilia-a
#3
Paul Giangrande, Tatiana Andreeva, Pratima Chowdary, Silke Ehrenforth, Hideji Hanabusa, Frank W G Leebeek, Steven R Lentz, Laszlo Nemes, Lone Hvitfeldt Poulsen, Elena Santagostino, Chur Woo You, Wan Hui Ong Clausen, Peter G Jönsson, Johannes Oldenburg
Turoctocog alfa pegol (N8-GP) is a novel glycoPEGylated extended half-life recombinant factor VIII (FVIII) product developed for prophylaxis and treatment of bleeds in patients with haemophilia A, to enable higher activity levels with less frequent injections compared with standard FVIII products. This phase III (NCT01480180), multinational, open-label, non-randomised trial evaluated the safety and clinical efficacy of N8-GP when administered for treatment of bleeds and for prophylaxis, in previously treated patients aged ≥12 years with severe haemophilia A...
December 1, 2016: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/27903188/the-role-of-diffusion-tensor-imaging-tractography-for-gamma-knife-thalamotomy-planning
#4
João Gabriel Ribeiro Gomes, Alessandra Augusta Gorgulho, Amanda de Oliveira López, Crystian Wilian Chagas Saraiva, Lucas Petri Damiani, Anderson Martins Pássaro, João Victor Salvajoli, Ludmila de Oliveira Siqueira, Bernardo Peres Salvajoli, Antônio Afonso Ferreira De Salles
OBJECTIVE The role of tractography in Gamma Knife thalamotomy (GK-T) planning is still unclear. Pyramidal tractography might reduce the risk of radiation injury to the pyramidal tract and reduce motor complications. METHODS In this study, the ventralis intermedius nucleus (VIM) targets of 20 patients were bilaterally defined using Iplannet Stereotaxy Software, according to the anterior commissure-posterior commissure (AC-PC) line and considering the localization of the pyramidal tract. The 40 targets and tractography were transferred as objects to the GammaPlan Treatment Planning System (GP-TPS)...
December 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27903042/prevalence-and-management-of-diabetes-in-residential-aged-care-facilities-in-north-east-victoria-australia
#5
Helen M Haines, Holly Bannon-Murphy, Tim Amos, Robert Krones
BACKGROUND: Managing diabetes in residential aged care facilities (RACFs) presents challenges to general practitioners (GPs) as the incidence of the disease increases. OBJECTIVE: The objective of this article is to describe the prevalence and management of diabetes in RACFs in north-east Victoria. METHODS: The method used for this study was a cross-sectional audit of medical files. RESULTS: Ten RACFs were invited and agreed to participate, giving a sample of 593 residents...
December 2016: Australian Family Physician
https://www.readbyqxmd.com/read/27902767/towards-a-non-human-primate-model-of-alpha-synucleinopathy-for-development-of-therapeutics-for-parkinson-s-disease-optimization-of-aav1-2-delivery-parameters-to-drive-sustained-expression-of-alpha-synuclein-and-dopaminergic-degeneration-in-macaque
#6
James B Koprich, Tom H Johnston, Gabriela Reyes, Vanessa Omana, Jonathan M Brotchie
Recent failures in clinical trials for disease modification in Parkinson's disease have highlighted the need for a non-human primate model of the synucleinopathy underpinning dopaminergic neuron degeneration. The present study was defined to begin the development of such a model in cynomolgus macaque. We have validated surgical and vector parameters to define a means to provide a robust over-expression of alpha-synuclein which is associated with Lewy-like pathology and robust degeneration of the nigrostriatal pathway...
2016: PloS One
https://www.readbyqxmd.com/read/27901493/has-aidi-injection-the-attenuation-and-synergistic-efficacy-to-gemcitabine-and-cisplatin-in-non-small-cell-lung-cancer-a-meta-analysis-of-36-randomized-controlled-trials
#7
Zheng Xiao, Chengqiong Wang, Ling Chen, Xuemei Tang, Lianhong Li, Nana Li, Jing Li, Qihai Gong, Fushan Tang, Jihong Feng, Xiaofei Li
Gemcitabine and cisplatin is the first line chemotherapy for non-small cell lung cancer with high toxicity. Aidi injection is a cantharidin and astragalu-based Chinese herbs injection in China. Has Aidi injection attenuation and synergistic efficacy to GP in NSCLC? There is lack of strong evidence to prove it. To further reveal it, we systematically evaluated all related studies. We collected all studies about Aidi injection plus GP for NSCLC in Medline, Embase, Web of Science, CNKI, VIP, Wanfang Database, CBM, CCRCT, Chi-CTR, and US-clinical trials (established to June 2015)...
November 25, 2016: Oncotarget
https://www.readbyqxmd.com/read/27900392/is-personality-a-driving-force-for-socioeconomic-differences-in-young-adults-health-care-use-a-prospective-cohort-study
#8
Maren Kraft, Koos Arts, Tanja Traag, Ferdy Otten, Hans Bosma
OBJECTIVES: To relate personality characteristics at the age of 12 to socioeconomic differences in health care use in young adulthood. And thereby examining the extent to which socioeconomic differences in the use of health care in young adulthood are based on differences in personality characteristics, independent of the (parental) socioeconomic background. METHODS: Personality of more than 13,000 Dutch 12-year old participants was related to their health and socioeconomic position after a follow-up of 13 years (when the participants had become young adults)...
November 30, 2016: International Journal of Public Health
https://www.readbyqxmd.com/read/27899167/motivators-and-barriers-for-paediatricians-discharging-patients
#9
Erin Turbitt, Marina Kunin, Sarah Gafforini, Gary L Freed
The aim of this study was to identify motivators and barriers that paediatricians face when discharging patients from outpatient specialty care. A questionnaire was administered to outpatient care paediatricians in Victoria working in one of five speciality public hospital clinics. Questions focused on how important various motivators and barriers were in respondents' decision to discharge a patient from their clinic. Nearly all (91%, n=74) paediatricians invited to participate provided responses. The factor influencing the greatest proportion of paediatricians in their decision to discharge patients back to primary care was the potential that patients may not receive the required care from a GP...
November 30, 2016: Australian Journal of Primary Health
https://www.readbyqxmd.com/read/27899006/french-women-s-representations-and-experiences-of-the-post-treatment-management-of-breast-cancer-and-their-perception-of-the-general-practitioner-s-role-in-follow-up-care-a-qualitative-study
#10
Catherine Laporte, Julie Vaure, Anne Bottet, Bénédicte Eschalier, Clémentine Raineau, Denis Pezet, Philippe Vorilhon
BACKGROUND: In France, the Cancer Plan II 2009-2013 was launched to improve post-cancer management and promote greater involvement of general practitioners (GPs) in follow-up care. OBJECTIVES: We investigated how women experienced the post-treatment management of breast cancer and perceived the role of the GP in follow-up care. DESIGN: We conducted a qualitative study based on semi-structured interviews with women with breast cancer in remission...
November 29, 2016: Health Expectations: An International Journal of Public Participation in Health Care and Health Policy
https://www.readbyqxmd.com/read/27898360/novel-oral-administrated-paclitaxel-micelles-with-enhanced-bioavailability-and-antitumor-efficacy-for-resistant-breast-cancer
#11
Ting Zhang, Jingwen Luo, Yao Fu, Hanmei Li, Rui Ding, Tao Gong, Zhirong Zhang
Paclitaxel (PTX) is a widely used antineoplastic drug in clinic. Due to poor aqueous solubility, it is administrated by intravenous infusion of cremophor EL containing formulation with serious adverse effects. The low oral bioavailability is a great challenge for oral formulation development. In addition, P-gp mediated multidrug resistance limit its clinical use in various resistant cancers. In this study, a novel super-antiresistant PTX micelle formulation for oral administration was developed. A P-gp inhibitor, bromotetrandrine (W198) was co-encapsulated in the micelle...
November 21, 2016: Colloids and Surfaces. B, Biointerfaces
https://www.readbyqxmd.com/read/27897269/an-integrated-pharmacokinetic-pharmacogenomic-analysis-of-abcb1-and-slco1b1-polymorphisms-on-edoxaban-exposure
#12
A G Vandell, J Lee, M Shi, I Rubets, K S Brown, J R Walker
Edoxaban and its low-abundance, active metabolite M4 are substrates of P-glycoprotein (P-gp; MDR1) and organic anion transporter protein 1B1 (OATP1B1), respectively, and pharmacological inhibitors of P-gp and OATP1B1 can affect edoxaban and M4 pharmacokinetics (PK). In this integrated pharmacogenomic analysis, genotype and concentration-time data from 458 healthy volunteers in 14 completed phase 1 studies were pooled to examine the impact on edoxaban PK parameters of allelic variants of ABCB1 (rs1045642: C3435T) and SLCO1B1 (rs4149056: T521C), which encode for P-gp and OATP1B1...
November 29, 2016: Pharmacogenomics Journal
https://www.readbyqxmd.com/read/27896170/postoperative-gastric-perforation-in-a-newborn-with-duodenal-atresia
#13
Anko Antabak, Marko Bogović, Jurica Vuković, Ruža Grizelj, Vinka Barbarić Babić, Dino Papeš, Tomislav Luetić
Gastric perforation (GP) in neonates is a rare entity with high mortality. Although the etiology is not completely understood, it mostly occurs in premature neonates on assisted ventilation. Combination of duodenal atresia and gastric perforation is very rare. We present a case duodenal atresia who developed gastric perforation after operetion for duodenal atresia. Analysis of the patient medical record and histology report did not reveal the etiology of the perforation.
October 2016: Journal of Neonatal Surgery
https://www.readbyqxmd.com/read/27895784/resveratrol-reverses-p-glycoprotein-mediated-multidrug-resistance-of-u2os-adr-cells-by-suppressing-the-activation-of-the-nf-%C3%AE%C2%BAb-and-p38-mapk-signaling-pathways
#14
Rui Zhang, Ming Lu, Zhen Zhang, Xiliang Tian, Shouyu Wang, Decheng Lv
The present study aimed to investigate the reversal effect of resveratrol on the phenomenon of multidrug resistance in U2OS/adriamycin (ADR) cells and to clarify the molecular mechanisms. To examine the cell survival and half-inhibitory concentration (IC50) of ADR in U2OS and U2OS/ADR cells, 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay was used. The accumulation of ADR in U2OS and U2OS/ADR cells was investigated by flow cytometry. Reverse transcription-quantitative polymerase chain reaction and western blot analysis were used to detect the expression of multidrug resistance protein 1 (MDR1), P-glycoprotein (P-gp), p65 and p38...
November 2016: Oncology Letters
https://www.readbyqxmd.com/read/27895754/evaluation-of-the-efficacy-of-paclitaxel-with-curcumin-combination-in-ovarian-cancer-cells
#15
Zeng Liu, Yuan-Yuan Zhu, Zhao-Yuan Li, Si-Qing Ning
The aim of the present study was to evaluate the efficacy of paclitaxel combined with curcumin (CUR) against drug resistance in ovarian cancer cells. PLGA-phospholipid-PEG nanoparticles were prepared using the nano precipitation method. The size and morphology of the nanoparticles were determined using a transmission electron microscope and particle size analyzer. The encapsulation efficiency of nanoparticles was determined using the ultrafiltration centrifugation method. The dialysis method was used to study the release of PLGA-phospholipid-PEG nanoparticles...
November 2016: Oncology Letters
https://www.readbyqxmd.com/read/27895462/effects-of-resveratrol-on-p-glycoprotein-and-cytochrome-p450-3a-in-vitro-and-on-pharmacokinetics-of-oral-saquinavir-in-rats
#16
Jiapeng Li, Yang Liu, Jingru Zhang, Xiaotong Yu, Xiaoling Wang, Libo Zhao
BACKGROUND: The intestinal cytochrome P450 3A (CYP 3A) and P-glycoprotein (P-gp) present a barrier to the oral absorption of saquinavir (SQV). Resveratrol (RESV) has been indicated to have modulatory effects on P-gp and CYP 3A. Therefore, this study was to investigate the effects of RESV on P-gp and CYP 3A activities in vitro and in vivo on oral SQV pharmacokinetics in rats. METHODS: In vitro, intestinal microsomes were used to evaluate RESV effect on CYP 3A-mediated metabolism of SQV; MDR1-expressing Madin-Darby canine kidney (MDCKII-MDR1) cells were employed to assess the impact of RESV on P-gp-mediated efflux of SQV...
2016: Drug Design, Development and Therapy
https://www.readbyqxmd.com/read/27894911/personal-and-provider-level-factors-influence-participation-to-cervical-cancer-screening-a-retrospective-register-based-study-of-1-3-million-women-in-norway
#17
Maarit K Leinonen, Suzanne Campbell, Ole Klungsøyr, Stefan Lönnberg, Bo T Hansen, Mari Nygård
High coverage is essential for an effective screening programme. Here we present screening barriers and facilitators among 1.3 million women aged 25-69years eligible for screening within the Norwegian Cervical Cancer Screening Program (NCCSP). We defined non-adherence as no screening test in 2008-2012. We divided adherent women into those screened spontaneously, and those who had a smear after receiving a reminder from the NCCSP. Explanatory variables were extracted from several nationwide registers, and modelled by modified Poisson regression...
November 25, 2016: Preventive Medicine
https://www.readbyqxmd.com/read/27894308/capacity-evaluation-for-general-practitioners-in-pudong-new-area-of-shanghai-an-empirical-study
#18
Ming Li, Zhiqun Shu, Xuan Huang, Zhaohui Du, Jun Wu, Qingshi Xia, Kun Liu, Jiquan Lou, Limei Jing
BACKGROUND: Building highly qualified General Practitioners (GPs) is key to the development of primary health care. It's therefore urgent to ensure the GPs' quality service under the background of the new round of health care system reforms in China. A new model of GP qualification examination was originally implemented in Pudong New Area of Shanghai, China, which aimed to empirically evaluate the GPs' capability in terms of clinical performance and social recognition. In the current study, an analysis was made of the first two years (2014-2015) of such theoretical and practical examinations on the GPs there with a view to getting a deep insight into the GP community so as to identify the barriers to such a form of GP qualification examination...
November 28, 2016: International Journal for Equity in Health
https://www.readbyqxmd.com/read/27894265/long-term-condition-morbidity-in-english-general-practice-a-cross-sectional-study-using-three-composite-morbidity-measures
#19
Charlotte Weston, Alexander Gilkes, Stevo Durbaba, Peter Schofield, Patrick White, Mark Ashworth
BACKGROUND: The burden of morbidity represented by patients with long term conditions (LTCs) varies substantially between general practices. This study aimed to determine the characteristics of general practices with high morbidity burden. METHOD: Retrospective cross-sectional study; general practices in England, 2014/15. Three composite morbidity measures (MMs) were constructed to quantify LTC morbidity at practice level: a count of LTCs derived from the 20 LTCs included in the UK Quality and Outcomes Framework (QOF) disease registers, expressed as 'number of QOF LTCs per 100 registered patients'; the % of patients with one or more QOF LTCs; the % of patients with one or more of 15 broadly defined LTCs included in the GP Patient Survey (GPPS)...
November 29, 2016: BMC Family Practice
https://www.readbyqxmd.com/read/27893182/inter-individual-variability-in-dabigatran-and-rivaroxaban-exposure-contribution-of-abcb1-genetic-polymorphisms-and-interaction-with-clarithromycin
#20
I Gouin-Thibault, X Delavenne, A Blanchard, V Siguret, J E Salem, C Narjoz, P Gaussem, P Beaune, C Funck-Brentano, M Azizi, P Mismetti, M A Loriot
BACKGROUND: The direct oral anticoagulants (DOACs) dabigatran and rivaroxaban are both substrates of the P-glycoprotein (P-gp) transporter, encoded by the ABCB1 gene. Rivaroxaban is metabolized by CYP3A4. Inter-individual variability in DOAC exposure and frequent P-gp associated drug-drug interactions have been described in patients. OBJECTIVE: To assess the influence of ABCB1 polymorphisms on the pharmacokinetics (PK) of dabigatran and rivaroxaban, associated or not with clarithromycin, a P-gp and CYP3A4 inhibitor...
November 28, 2016: Journal of Thrombosis and Haemostasis: JTH
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