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https://www.readbyqxmd.com/read/28088581/a-stepwise-algorithm-using-a-at-a-glance-first-line-test-for-the-non-invasive-diagnosis-of-advanced-liver-fibrosis-and-cirrhosis
#1
Jérôme Boursier, Victor de Ledinghen, Vincent Leroy, Rodolphe Anty, Sven Francque, Dominique Salmon, Adrien Lannes, Sandrine Bertrais, Frederic Oberti, Isabelle Fouchard-Hubert, Paul Calès
BACKGROUND & AIMS: Chronic liver diseases (CLD) are highly frequent and thus mainly managed by non-hepatologists. Because they lack access to the best non-invasive tests of liver fibrosis, these physicians cannot accurately determine the disease severity and the need for referral to a hepatologist. We aimed to implement an algorithm, comprising a new first-line test usable by all physicians, for the detection of advanced liver fibrosis in all CLD patients. METHODS: Diagnostic study: 3,754 CLD patients with liver biopsy were 2:1 randomized into derivation and validation sets...
January 11, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/28088236/economic-burden-of-family-caregiving-for-elderly-population-in-southern-ghana-the-case-of-a-peri-urban-district
#2
Stephen Tettey Nortey, Genevieve Cecilia Aryeetey, Moses Aikins, Djesika Amendah, Justice Nonvignon
BACKGROUND: Health systems in low and lower-middle income countries, particularly in sub-Sahara Africa, often lack the specialized personnel and infrastructure to provide comprehensive care for elderly/ageing populations. Close-to-client community-based approaches are a low-cost way of providing basic care and social support for elderly populations in such resource-constrained settings and family caregivers play a crucial role in that regard. However, family caregiving duties are often unremunerated and their care-related economic burden is often overlooked though this knowledge is important in designing or scaling up effective interventions...
January 14, 2017: International Journal for Equity in Health
https://www.readbyqxmd.com/read/28088174/feasibility-and-safety-of-dilatational-tracheotomy-using-the-rigid-endoscope-a-multicenter-study
#3
Andreas Nowak, Peter Kern, Sven Koscielny, Taras I Usichenko, Klaus Hahnenkamp, Markus Jungehülsing, Matthias Tittel, Jens Oeken, Eckart Klemm
BACKGROUND: Fiberoptic tracheo-bronchoscopy is the most commonly used procedure for percutaneous dilational tracheotomy (PDT). However, PDT can be associated with major complications, including death. Furthermore it is unclear, whether the tracheal ring fractures may contribute to the development of tracheal stenosis after PDT nor whether tracheal ring fractures can be prevented by using a rigid endoscope for this procedure. The purpose of this study was to evaluate the feasibility of and the incidence of complications for PDT using the rigid tracheotomy endoscope (TED)...
January 14, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28087208/-child-langerhans-cell-histiocytosis
#4
Jean Donadieu, Sébastien Héritier
DEFINITION: Langerhans cell histiocytosis (LCH) is defined by the association of a clinical and radiological involvement and a biopsy of a pathological tissue. Extension: it can affect any organ or system of the body but most commonly the bone (80% of cases), the skin (33%) and the pituitary (25%). Other organs are concerned such as liver, spleen, hematopoietic system and the lungs (15% each), lymph nodes (5-10%) and central nervous system (CNS) excluding the pituitary (2-4%). Natural history: the natural history of the disease is very heterogeneous, ranging from auto-regressive lesions to a disease affecting multiple organs with fatal consequences, while some lesions may be responsible for permanent sequels...
January 10, 2017: La Presse Médicale
https://www.readbyqxmd.com/read/28087054/care-pathway-of-patients-with-metastatic-pancreatic-cancer-in-daily-practice-in-france-results-from-the-repere-national-survey
#5
Pascal Hammel, Romain Coriat, Gérard Lledo, Mariella de Bausset, Marion Selosse, Stéphane Obled, Franck Bonnetain
Data in the literature regarding the care pathway of pancreatic cancer patients are limited. The objective of the REPERE survey was to identify and describe the initial stages of the care pathway of pancreatic patients in the metastatic phase. From May to October 2015, 62 oncologists (ON) or gastroenterologists specialized in digestive oncology (GESDO) and 300 general practitioners (GP) completed an electronic questionnaire on the pathway of 728 patients recently diagnosed with metastatic pancreatic adenocarcinoma...
January 10, 2017: Bulletin du Cancer
https://www.readbyqxmd.com/read/28086970/trends-determinants-and-inequities-of-4-anc-utilisation-in-bangladesh
#6
Aminur Rahman, Monjura Khatun Nisha, Tahmina Begum, Sayem Ahmed, Nurul Alam, Iqbal Anwar
BACKGROUND: The objectives of this study are to document the trend on utilisation of four or more (4(+)) antenatal care (ANC) over the last 22 years period and to explore the determinants and inequity of 4(+) ANC utilisation as reported by the last two Bangladesh Demographic and Health surveys (BDHS) (2011 and 2014). METHODS: The data related to ANC have been extracted from the BDHS data set which is available online as an open source. STATA 13 software was used for organising and analysing the data...
January 13, 2017: Journal of Health, Population, and Nutrition
https://www.readbyqxmd.com/read/28086918/atypical-monoarthritis-presentation-in-children-with-oligoarticular-juvenile-idiopathic-arthritis-a-case-series
#7
Natasha Lepore, Megan Cashin, Debra Bartley, Daniela Simona Ardelean
BACKGROUND: Oligoarticular juvenile idiopathic arthritis (oligoJIA), the most common chronic inflammatory arthritis of childhood, usually involves the knees and ankles. Severe oligoJIA monoarthritis presenting in a joint other than knees and ankles, is rare. FINDINGS: We report four children who presented with severe isolated arthritis of the hip, wrist or elbow and were diagnosed with oligoJIA. All four were girls with a median age of 11.5 years. Those with hip arthritis also met the classification criteria for juvenile-onset spondylarthopathy...
January 13, 2017: Pediatric Rheumatology Online Journal
https://www.readbyqxmd.com/read/28086770/social-pediatrics-weaving-horizontal-and-vertical-threads-through-pediatric-residency
#8
Meta van den Heuvel, Maria Athina Tina Martimianakis, Rebecca Levy, Adelle Atkinson, Elizabeth Ford-Jones, Michelle Shouldice
BACKGROUND: Social pediatrics teaches pediatric residents how to understand disease within their patients' social, environmental and political contexts. It's an essential component of pediatric residency training; however there is very little literature that addresses how such a broad-ranging topic can be taught effectively. The aim of this study was to determine and characterize social pediatric education in our pediatric residency training in order to identify strengths and gaps. METHODS: A social pediatrics curriculum map was developed, attending to 3 different dimensions: (1) the intended curriculum as prescribed by the Objectives of Training for Pediatrics of the Royal College of Physicians and Surgeons of Canada (RCPSC), (2) the formal curriculum defined by rotation-specific learning objectives, and (3) the informal/hidden curriculum as reflected in resident and teacher experiences and perceptions...
January 13, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/28079809/a-comparison-of-the-surgical-mortality-due-to-colorectal-perforation-at-different-hospitals-with-data-from-10-090-cases-in-the-japanese-national-clinical-database
#9
Takeshi Ohki, Masakazu Yamamoto, Hiroaki Miyata, Yasuto Sato, Yoshihisa Saida, Tsuyoshi Morimoto, Hiroyuki Konno, Yasuyuki Seto, Koichi Hirata
Colorectal perforation has a high rate of mortality. We compared the incidence and fatality rates of colorectal perforation among different hospitals in Japan using data from the nationwide surgical database.Patients were registered in the National Clinical Database (NCD) between January 1st, 2011 and December 31st, 2013. Patients with colorectal perforation were identified from surgery records by examining if acute diffuse peritonitis (ADP) and diseases associated with a high probability of colorectal perforation were noted...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28079725/new-medicine-for-the-u-s-health-care-system-training-physicians-for-structural-interventions
#10
Helena Hansen, Jonathan M Metzl
Structural competency provides a language and theoretical framework to promote institutional-level interventions by clinical practitioners working with community organizations, non-health-sector institutions, and policy makers. The special collection of articles on structural competency in this issue of Academic Medicine addresses the need to move from theory to an appraisal of core educational interventions that operationalize the goals of and foster structural competency. In this Commentary, the authors review the role of clinical practitioners in enhancing population-level health outcomes through collaborations with professionals in fields outside medicine, including the social sciences and law...
January 10, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28079556/cardiac-arrest-obstetric-cpr-acls
#11
Benjamin Cobb, Steven Lipman
In contrast with other high-resource countries, maternal mortality has seen an increase in the United States. Caring for pregnant women in cardiac arrest may prove uniquely challenging given the rarity of the event coupled by the physiological changes of pregnancy. Optimization of resuscitative efforts warrants special attention as described in the 2015 American Heart Association's "Scientific Statement on Maternal Cardiac Arrest." Current recommendations address a variety of topics ranging from the basic components of chest compressions and airway management to some of the logistical complexities and operational challenges involved in maternal cardiac arrest...
January 10, 2017: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28077453/state-regulatory-approaches-for-dementia-care-in-residential-care-and-assisted-living
#12
Paula C Carder
PURPOSE: This policy study analyzed states' residential care and assisted living (RC/AL) regulations for dementia care requirements. Estimates suggest that at least half of RC/AL residents have dementia, and 22% of settings provide or specialize in dementia care. Residents with dementia might benefit from regulations that account for specific behaviors and needs associated with dementia, making states' RC/AL regulations address dementia care an important policy topic. DESIGN AND METHODS: This study examined RC/AL regulations in all 50 states and the District of Columbia for regulatory requirements on five topics important to the quality of life of RC/AL residents with dementia: pre-admission assessment, consumer disclosure, staffing types and levels, administrator training, and physical environment...
January 10, 2017: Gerontologist
https://www.readbyqxmd.com/read/28077203/clostridium-difficile-infection-in-older-adults-systematic-review-of-efforts-to-reduce-occurrence-and-improve-outcomes
#13
Leisa L Marshall, Samuel Peasah, Gregg A Stevens
OBJECTIVE: Provide a systematic review of the primary literature on efforts to reduce Clostridium difficile infection (CDI) occurrence and improve outcomes in older adults. DATA SOURCES, STUDY SELECTION, DATA EXTRACTION: PubMed and CINAHL databases were searched for research studies using search terms CDI, CDI prevention, reduction, control, management, geriatric, elderly, adults 65 years of age and older. The MeSH categories Aged and Aged, 80 and older, were used...
January 1, 2017: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
https://www.readbyqxmd.com/read/28077148/linking-communities-to-formal-health-care-providers-through-village-health-teams-in-rural-uganda-lessons-from-linking-social-capital
#14
Laban Kashaija Musinguzi, Emmanueil Benon Turinawe, Jude T Rwemisisi, Daniel H de Vries, David K Mafigiri, Denis Muhangi, Marije de Groot, Achilles Katamba, Robert Pool
BACKGROUND: Community-based programmes, particularly community health workers (CHWs), have been portrayed as a cost-effective alternative to the shortage of health workers in low-income countries. Usually, literature emphasises how easily CHWs link and connect communities to formal health care services. There is little evidence in Uganda to support or dispute such claims. Drawing from linking social capital framework, this paper examines the claim that village health teams (VHTs), as an example of CHWs, link and connect communities with formal health care services...
January 11, 2017: Human Resources for Health
https://www.readbyqxmd.com/read/28077099/a-prospective-study-on-the-characteristics-and-subjects-of-pediatric-palliative-care-case-management-provided-by-a-hospital-based-palliative-care-team
#15
Charissa T Jagt-van Kampen, Marijke C Kars, Derk A Colenbrander, Diederik K Bosman, Martha A Grootenhuis, Huib N Caron, Antoinette Y N Schouten-van Meeteren
BACKGROUND: Case management is a subject of interest within pediatric palliative care. Detailed descriptions of the content of this type of case management are lacking. We aim to describe the contents of care provided, utilization of different disciplines, and times of usage of a pediatric palliative care case management program compared for patients with malignant disease (MD) and non-malignant disease (NMD). METHODS: A three-month prospective study, with questionnaires filled in by members of a pediatric palliative care team (PPCT) for each contact with parents...
January 12, 2017: BMC Palliative Care
https://www.readbyqxmd.com/read/28077067/use-of-antidepressants-during-pregnancy-in-the-netherlands-observational-study-into-postpartum-interventions
#16
Noera Kieviet, Fokke de Jong, Fedde Scheele, Koert M Dolman, Adriaan Honig
BACKGROUND: Psychiatric disorders and use of selective antidepressants during pregnancy can have negative effects on mother and infant postpartum. This study aimed to provide evidence-based recommendations on observation of antidepressant-exposed mother-infant dyads. METHODS: In this observational study, mother-infant dyads were observed for possible consequences of either the maternal psychiatric disorder or fetal exposure to selective antidepressants during pregnancy...
January 11, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28076637/a-five-year-review-of-vertical-hiv-transmission-in-a-specialized-service-cross-sectional-study
#17
Izabel Cristina Hoffmann, Wendel Mombaque Dos Santos, Stela Maris de Mello Padoin, Sonia Maria Oliveira de Barros
CONTEXT AND OBJECTIVE: Healthcare professionals need to instill the process of prevention, control and treatment of people infected with HIV into care practice. Through maintaining preventive treatment among HIV-infected pregnant women, it has been demonstrated that prophylactic antiretroviral therapy, scheduled cesarean section and the prohibition of breastfeeding significantly reduce vertical HIV transmission. This study aimed to assess the rates of vertical HIV transmission in a specialized service and identify the factors associated with it...
November 2016: São Paulo Medical Journal, Revista Paulista de Medicina
https://www.readbyqxmd.com/read/28076441/effects-of-an-integrated-fast-track-rehabilitation-service-for-multi-trauma-patients-a-non-randomized-clinical-trial-in-the-netherlands
#18
Ans I E Bouman, Bea Hemmen, Silvia M A A Evers, Henk van de Meent, Ton Ambergen, Pieter E Vos, Peter R G Brink, Henk A M Seelen
OBJECTIVES: The effects on health related outcomes of a newly-developed rehabilitation program, called 'supported Fast Track multi-trauma rehabilitation service' (Fast Track), were evaluated in comparison with conventional trauma rehabilitation service (Care as Usual). METHODS: Prospective, multi-center, non-randomized controlled study. Between 2009 and 2012, 132 adult multi-trauma patients were included: 65 Fast Track and 67 Care as Usual patients with an Injury Severity Score ≥16, complex multiple injuries in several extremities or complex pelvic and/or acetabulum fractures...
2017: PloS One
https://www.readbyqxmd.com/read/28076003/reducing-functional-mr-imaging-acquisition-times-by-optimizing-workflow
#19
Wilson B Chwang, Michael Iv, Jason Smith, Aleksandrs Kalnins, Jake Mickelsen, Roland Bammer, Dominik Fleischmann, David B Larson, Max Wintermark, Michael Zeineh
Functional magnetic resonance (MR) imaging is a complex, specialized examination that is able to noninvasively measure information critical to patient care such as hemispheric language lateralization ( 1 ). Diagnostic functional MR imaging requires extensive patient interaction as well as the coordinated efforts of the entire health care team. We observed in our practice at an academic center that the times to perform functional MR imaging examinations were excessively lengthy, making scheduling of the examination difficult...
January 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/28075641/the-transgender-women-of-color-initiative-implementing-and-evaluating-innovative-interventions-to-enhance-engagement-and-retention-in-hiv-care
#20
Gregory Rebchook, JoAnne Keatley, Robert Contreras, Judy Perloff, Luis Freddy Molano, Cathy J Reback, Kelly Ducheny, Tooru Nemoto, Royce Lin, Jeffrey Birnbaum, Tiffany Woods, Jessica Xavier
To improve health outcomes among transgender women of color living with HIV, the Health Resources and Services Administration's Special Programs of National Significance program funded the Enhancing Engagement and Retention in Quality HIV Care for Transgender Women of Color Initiative in 2012. Nine demonstration projects in four US urban areas implemented innovative, theory-based interventions specifically targeting transgender women of color in their jurisdictions. An evaluation and technical assistance center was funded to evaluate the outcomes of the access to care interventions, and these findings will yield best practices and lessons learned to improve the care and treatment of transgender women of color living with HIV infection...
February 2017: American Journal of Public Health
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