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Jaein Seo, B Douglas Smith, Elihu Estey, Ernest Voyard, Bernadette O' Donoghue, John F P Bridges
OBJECTIVE: Acute myeloid leukemia (AML) is a progressive blood cancer with few effective treatment options. As part of a patient-focused drug development (PFDD) initiative led by the Leukemia and Lymphoma Society (LLS), we sought to use a community-centered approach to develop and pilot an instrument to measure patient preferences for the benefits and risks of treating AML. METHODS: Instrument development was informed by a literature review, engagement with expert stakeholders (n = 12), engagement with community stakeholders, and pretesting...
March 22, 2018: Current Medical Research and Opinion
S Blecha, H J Schlitt, B M Graf, M Leitzmann, T Bein
BACKGROUND: In critical illnesses low socioeconomic status (SES) is associated with higher morbidity and mortality. In addition to the SES, further factors at an individual level (e.g., sex, health insurance status and place of residence) may influence the severity of illness and medical treatment. We investigated these additional parameters in a secondary analysis of the ECSSTASI data. METHODS: Within the framework of the ECSSTASI study, 996 patients were recruited from a surgical intensive care unit...
March 21, 2018: Der Anaesthesist
Jung Yeon Park, Hyo Jeong Ahn, Ba Raem Yoo, Kyu Ri Hwang, Taek Sang Lee, Hye Won Jeon, Sun Min Kim, Byoung Jae Kim
Objective: This study was conducted to determine the effectiveness and safety of medical treatment with sublingual misoprostol (MS) in the 1st trimester miscarriage under the approval by Health Insurance Review and Assessment Service (HIRA) for off-label usage by the single medical center in Korea. Methods: A retrospective cohort study was performed in one institution between April 2013 and June 2016. Ninety-one patients diagnosed with miscarriage before 14 weeks of gestation and wanted to try medical treatment were included...
March 2018: Obstetrics & Gynecology Science
Anita N Shah, Andrew F Beck, Heidi J Sucharew, Stacey Litman, Cory Pfefferman, Julianne Haney, Samir S Shah, Jeffrey M Simmons, Katherine A Auger
BACKGROUND AND OBJECTIVES: Adults with a history of adverse childhood experiences (ACEs) (eg, abuse) have suboptimal health outcomes. Resilience may blunt this effect. The effect of parental ACEs (and resilience) on coping with challenges involving their children (eg, hospitalization) is unclear. We sought to quantify ACE and resilience scores for parents of hospitalized children and evaluate their associations to parental coping after discharge. METHODS: We conducted a prospective cohort study at a children's hospital (August 2015-May 2016)...
March 21, 2018: Pediatrics
Hubert Y Pan, Jing Jiang, Karen E Hoffman, Chad Tang, Seungtaek L Choi, Quynh-Nhu Nguyen, Steven J Frank, Mitchell S Anscher, Ya-Chen Tina Shih, Benjamin D Smith
Purpose To compare the toxicities and cost of proton radiation and stereotactic body radiotherapy (SBRT) with intensity-modulated radiotherapy (IMRT) for prostate cancer among men younger than 65 years of age with private insurance. Methods Using the MarketScan Commercial Claims and Encounters database, we identified men who received radiation for prostate cancer between 2008 and 2015. Patients undergoing proton therapy and SBRT were propensity score-matched to IMRT patients on the basis of clinical and sociodemographic factors...
March 21, 2018: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Wen-Hsun Chang, Huann-Cheng Horng, Chang-Ching Yeh, Chao-Yu Guo, Yiing-Jeng Chou, Nicole Huang, Hsin-Yi Huang, Yi-Jen Chen, Wen-Ling Lee, Peng-Hui Wang
This article aims to test the hypothesis that the risk of female genital tract related cancer (gynecological cancer: GC) or breast cancer (BC) of women with chronic kidney disease (CKD) might be different from that of those women without CKD.A nationwide 17-year historic cohort study using the National Health Insurance Research Database (NHIRD) of Taiwan and the Registry for Catastrophic Illness Patients was conducted. A total of 3045 women with a diagnosis of CKD from 1996 to 2013 and 3045 multivariable-matched controls (1:1) were selected...
March 2018: Medicine (Baltimore)
Amie Goodin, Ming Chen, Driss Raissi, Qiong Han, Hong Xiao, Joshua Brown
To examine the association between patient and hospital characteristics and inferior vena cava filter (IVCF) utilization in patients with venous thromboembolism (VTE).The 2013 to 2014 Nationwide Readmissions Database was used to define a cohort of patients with VTE aged ≥18 after a primary VTE diagnosis. Comorbidities of interest were classified via diagnosis codes and IVCF placement was identified via procedure code. Chi square analysis tested differences between patient and hospital-level characteristics and whether or not IVCFs were placed...
March 2018: Medicine (Baltimore)
Nikhil Jain, Frank M Phillips, Tristan Weaver, Safdar N Khan
STUDY DESIGN: Retrospective, economic analysis. OBJECTIVE: To study patient profile associated with preoperative chronic opioid therapy (COT), and study COT as a risk factor for 90-day complications, emergency department (ED) visits, and readmission after primary one- to two-level posterior lumbar fusion (PLF) for degenerative spine disease. We also evaluated associated costs, risk factors, and adverse events related to long-term postoperative opioid use. SUMMARY OF BACKGROUND DATA: Chronic opioid use is associated with poor outcomes and dependence after spine surgery...
March 20, 2018: Spine
Andrée-Anne Fafard St-Germain, Valerie Tarasuk
OBJECTIVE: Food insecurity is a potent determinant of health and indicator of material deprivation in many affluent countries. Food insecurity is associated with compromises in food and housing expenditures, but how it relates to other expenditures is unknown. The present study described households' resource allocation over a 12-month period by food insecurity status. DESIGN: Expenditure data from the 2010 Survey of Household Spending were aggregated into four categories (basic needs, other necessities, discretionary, investments/assets) and ten sub-categories (food, clothing, housing, transportation, household/personal care, health/education, leisure, miscellaneous, personal insurance/pension, durables/assets)...
March 21, 2018: Public Health Nutrition
Shao-Yuan Chuang, Pai-Feng Hsu, Fang-Ju Lin, Ya-Wen Huang, Gou-Zhau Wang, Wei-Chiao Chang, Hui-Ju Tsai
AIMS: It remains inconclusive whether the use of nonsteroidal anti-inflammatory drugs (NSAIDs) increases the risk of atrial fibrillation (AF), especially in middle-aged Asian populations. In this study, we evaluated the association between NSAID use and the risk of AF in a nationwide population-based study of middle-aged individuals in Taiwan. METHODS: A nested case-control study was conducted using the National Health Insurance Research Database (NHIRD) in Taiwan...
March 20, 2018: British Journal of Clinical Pharmacology
Yeong Guk Lee, Seung Chan Kim, Misoo Chang, Eunwoo Nam, Seul Gi Kim, Sung-Il Cho, Dong Hee Ryu, Sin Kam, Bo Youl Choi, Si-Bog Park, Mi Jung Kim
Objective: To explore the incidence, characteristics, complications and socioeconomic impacts associated with falls in community-dwelling elderly. Methods: From September 1, 2015 to October 12, 2015, a questionnaire-based survey was conducted involving a total of 2,012 elderly who lived in Guro-gu (Seoul), Yeongdeungpo-gu (Seoul), Yangpyeong-gu (Gyeonggi-do), Dalseong-gu (Daegu), and Jung-gu (Daegu). The subjects were interviewed using a structured questionnaire to obtain demographic characteristics and comprehensive falling histories...
February 2018: Annals of Rehabilitation Medicine
Faisal Akhtar, Sabah Rehman
Hepatitis B and Hepatitis C have been major disease-causing agents among humans since they were discovered in the 1960s. Both cause jaundice-like symptoms initially but their prognosis and treatment are somehow different and depend upon many demographic details, such as the age and susceptibility of the patients and any other comorbid conditions. They clinically present primarily with hepatitis and can have many adverse effects or even be life-threatening at times, if not treated properly. However, their epidemiological background and findings in terms of morbidity, mortality, and case fatality rates are different...
January 16, 2018: Curēus
Luk Van Baelen, Karin De Ridder, Jérôme Antoine, Lies Gremeaux
Background: Although gabapentin has been licensed in the European Union only for neuropathic pain and epilepsy for patients who have partial seizures, it has also been prescribed in treatment for substance use disorders. Many studies report the potential risk of abuse of gabapentin by people with substance use disorders. The objective of this paper is to determine if people who have been in treatment for substance use disorders bought gabapentin in a time span that could indicate consumption at a dose that exceeded the maximum approved dose of 3600 mg/day...
2018: Archives of Public Health, Archives Belges de Santé Publique
John Q Wong, Nel Jason Haw, Jhanna Uy, Diana Beatriz Bayani
The World Health Organization (WHO) launched the OneHealth Tool (OHT) to help low and middle income countries to develop their capacities for sector-wide priority setting. In 2016, we sought to use the OHT to aid the Philippine Health Insurance Corporation (PHIC), the national health insurer of the Philippines, in decisions to expand benefit packages using cost-effectiveness analyses. With technical support from the WHO, we convened health planning officers from the Philippine Department of Health (DOH) and the Philippine Health Insurance Corporation (PHIC) conduct generalized cost-effective analyses (GCEA) of selected un-financed noncommunicable disease interventions using OHT...
2018: F1000Research
Paul L Weygandt, Scott M Dresden, Emilie S Powell, Joe Feinglass
Introduction: Illinois hospitals have experienced a marked decrease in the number of uninsured patients after implementation of the Affordable Care Act (ACA). However, the full impact of health insurance expansion on trauma mortality is still unknown. The objective of this study was to determine the impact of ACA insurance expansion on trauma patients hospitalized in Illinois. Methods: We performed a retrospective cohort study of 87,001 trauma inpatients from third quarter 2010 through second quarter 2015, which spans the implementation of the ACA in Illinois...
March 2018: Western Journal of Emergency Medicine
Pei-Chun Fan, Tien-Hsing Chen, Cheng-Chia Lee, Tsung-Yu Tsai, Yung-Chang Chen, Chih-Hsiang Chang
Acute kidney injury (AKI), a common and crucial complication of acute coronary syndrome (ACS) after receiving percutaneous coronary intervention (PCI), is associated with increased mortality and adverse outcomes. This study aimed to develop and validate a risk prediction model for incident AKI after PCI for ACS. We included 82,186 patients admitted for ACS and receiving PCI between 1997 and 2011 from the Taiwan National Health Insurance Research Database and randomly divided them into a training cohort (n = 57,630) and validation cohort (n = 24,656) for risk model development and validation, respectively...
2018: International Journal of Medical Sciences
Po-Ya Chang, Li-Nien Chien, Chyi-Huey Bai, Yuh-Feng Lin, Hung-Yi Chiou
Purpose: Effective management for type 2 diabetes mellitus (DM) can slow the progression of kidney outcomes and reduce hospital admissions. Better continuity of care (COC) was found to improve patients' adherence and self-management. This study examined the associations between COC, hospitalization, and end-stage renal disease (ESRD) in DM patients. Patients and methods: In the cohort study, data from 1996 to 2012 were retrieved from the Longitudinal Health Insurance Database, using inverse probability weighted analysis...
2018: Therapeutics and Clinical Risk Management
J M Zillioux, J N Jackson, C D A Herndon, S T Corbett, N G Kern
INTRODUCTION: Congenitalism is an emerging field that recognizes the complex needs of adult patients with congenital urologic issues. Despite the onset of transitional care clinics, these patients remain difficult to care for due to resource availability, insurance coverage, and multi-disciplinary needs. OBJECTIVE: The current study sought to characterize practice patterns and opinions regarding care for urologic transition patients. DESIGN: An anonymous 20-question survey was sent to members of the Society of Pediatric Urology listserv...
March 2, 2018: Journal of Pediatric Urology
Hsin-Fu Lee, Yi-Hsin Chan, Hui-Tzu Tu, Chi-Tai Kuo, Yung-Hsin Yeh, Shang-Hung Chang, Lung-Sheng Wu, Lai-Chu See
BACKGROUND: Rivaroxaban (20 mg/15 mg once daily) is an effective and safe alternative to warfarin for stroke prevention in patients with non-valvular AF (NVAF). Low-dose rivaroxaban (15 mg/10 mg once daily) has been only approved for NVAF patients in Japan and Taiwan, although its effectiveness and safety at low doses remain unclear among Asians with NVAF. The objective of the study is to compare the effectiveness and safety of low-dose rivaroxaban to those of warfarin among Asians with NVAF...
March 14, 2018: International Journal of Cardiology
Anya Romanoff, Hank Schmidt, Matthew McMurray, Christina Weltz, Monica Schwartzman, Kathryn Friedman, Laurie Margolies, Elisa Port
The role of MRI in the workup of newly diagnosed breast cancer patients remains controversial. Breast MRI detects additional disease, but this has not translated into improved outcomes. In light of a dramatic rise in MRI use, we investigated patterns of MRI ordering for newly diagnosed breast cancer. All newly diagnosed breast cancer cases presenting for surgical management to a specialized breast center from 2011 to 2013 were reviewed. Patients who had an MRI ordered by their operating surgeon were compared with those who had an MRI completed previously...
March 1, 2018: American Surgeon
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