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https://www.readbyqxmd.com/read/28651351/applying-a-theory-driven-framework-to-guide-quality-improvement-efforts-in-nursing-homes-the-lock-model
#1
Whitney L Mills, Camilla B Pimentel, Jennifer A Palmer, A Lynn Snow, Nancy J Wewiorski, Rebecca S Allen, Christine W Hartmann
Purpose of the Study: Implementing quality improvement (QI) programs in nursing homes continues to encounter significant challenges, despite recognized need. QI approaches provide nursing home staff with opportunities to collaborate on developing and testing strategies for improving care delivery. We present a theory-driven and user-friendly adaptable framework and facilitation package to overcome existing challenges and guide QI efforts in nursing homes. Design and development: The framework is grounded in the foundational concepts of strengths-based learning, observation, relationship-based teams, efficiency, and organizational learning...
June 23, 2017: Gerontologist
https://www.readbyqxmd.com/read/28651292/acute-onset-neurological-disorders-during-pregnancy-a-literature-review
#2
Zita Ferraz, Joana Parra, Ana Luísa Areia, Elsa Vasco, Paulo Moura
Objectives To characterize the most common peripheral and central neurological disorders during pregnancy. Methods Original research and review of the literature on neurological complications during pregnancy. We searched for keywords related to the topic on different databases. Results Pregnancy involves physiological changes that can trigger peripheral neurological and/or central nervous system pathologies, which can sometimes be associated with hypertensive disorders. A definitive diagnosis of neurological disorders can be made according to the trimester of pregnancy and the clinical findings...
June 26, 2017: Revista Brasileira de Ginecologia e Obstetrícia
https://www.readbyqxmd.com/read/28651207/metacognitive-therapy-versus-disorder-specific-cbt-for-comorbid-anxiety-disorders-a-randomized-controlled-trial
#3
Sverre Urnes Johnson, Asle Hoffart, Hans M Nordahl, Bruce E Wampold
Few studies have compared the effects of Metacognitive therapy (MCT) and Cognitive behavioral therapy (CBT) for comorbid anxiety disorders. In the current study we compared CBT and MCT for heterogeneous anxiety disorders in a residential setting. Ninety patients with a primary diagnosis of Post Traumatic Stress Disorder, Social Phobia or Panic disorder, with and without Agoraphobia, were randomized to either CBT or MCT. Patients were assessed at pre-treatment, post-treatment and one-year follow-up. Primary outcome measures were Beck Anxiety Inventory and ADIS IV and secondary outcome measures were SCID II, Beck Depression Inventory, Penn State Worry Questionnaire, The Symptom Checklist-90 and the Inventory of Interpersonal Problems-64...
June 15, 2017: Journal of Anxiety Disorders
https://www.readbyqxmd.com/read/28651157/different-patterns-in-the-risk-of-newly-developed-fatty-liver-and-lipid-changes-with-tamoxifen-versus-aromatase-inhibitors-in-postmenopausal-women-with-early-breast-cancer-a-propensity-score-matched-cohort-study
#4
Namki Hong, Han Gyul Yoon, Da Hea Seo, Seho Park, Seung Il Kim, Joo Hyuk Sohn, Yumie Rhee
BACKGROUND: Management of metabolic complications of long-term adjuvant endocrine therapy in early breast cancer remained an unmet need. We aimed to compare the effects of tamoxifen (TMX) and aromatase inhibitors (AIs) on the risk of fatty liver in conjunction with longitudinal changes in the serum lipid parameters. METHODS: Among 1203 subjects who were taking adjuvant TMX or AI (anastrozole or letrozole) without fatty liver at baseline, those taking TMX or AI were 1:1 matched on the propensity score...
June 23, 2017: European Journal of Cancer
https://www.readbyqxmd.com/read/28651014/a-decade-of-haart-in-latin-america-long-term-outcomes-among-the-first-wave-of-hiv-patients-to-receive-combination-therapy
#5
Marcelo J Wolff, Mark J Giganti, Claudia P Cortes, Pedro Cahn, Beatriz Grinsztejn, Jean W Pape, Denis Padgett, Juan Sierra-Madero, Eduardo Gotuzzo, Stephany N Duda, Catherine C McGowan, Bryan E Shepherd
BACKGROUND: In Latin America, the first wave of HIV-infected patients initiated highly active antiretroviral therapy (HAART) 10 or more years ago. Characterizing their treatment experience and corresponding outcomes across a decade of HAART may yield insights relevant to the ongoing care of such patients and those initiating HAART more recently in similar clinical settings. METHODS: This retrospective study included adults initiating HAART before 2004 at 8 sites in Argentina, Brazil, Chile, Haiti, Honduras, and Mexico...
2017: PloS One
https://www.readbyqxmd.com/read/28650965/epigenetic-adaptation-of-the-placental-serotonin-transporter-gene-slc6a4-to-gestational-diabetes-mellitus
#6
Sofia Blazevic, Marina Horvaticek, Maja Kesic, Peter Zill, Dubravka Hranilovic, Marina Ivanisevic, Gernot Desoye, Jasminka Stefulj
We tested the hypothesis that gestational diabetes mellitus (GDM) alters the DNA methylation pattern of the fetal serotonin transporter gene (SLC6A4), and examined the functional relevance of DNA methylation for regulation of the SLC6A4 expression in the human placenta. The study included 50 mother-infant pairs. Eighteen mothers were diagnosed with GDM and 32 had normal glucose tolerance (NGT). All neonates were of normal birth weight and born at term by planned Cesarean section. DNA and RNA were isolated from samples of tissue collected from the fetal side of the placenta immediately after delivery...
2017: PloS One
https://www.readbyqxmd.com/read/28650950/neurobiologic-correlates-of-attention-and-memory-deficits-following-critical-illness-in-early-life
#7
Raisa M Schiller, Hanneke IJsselstijn, Marlous J Madderom, André B Rietman, Marion Smits, Arno F J van Heijst, Dick Tibboel, Tonya White, Ryan L Muetzel
OBJECTIVES: Survivors of critical illness in early life are at risk of long-term-memory and attention impairments. However, their neurobiologic substrates remain largely unknown. DESIGN: A prospective follow-up study. SETTING: Erasmus MC-Sophia Children's Hospital, Rotterdam, the Netherlands. PATIENTS: Thirty-eight school-age (8-12 yr) survivors of neonatal extracorporeal membrane oxygenation and/or congenital diaphragmatic hernia with an intelligence quotient greater than or equal to 80 and a below average score (z score ≤ -1...
June 23, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28650946/the-hyperextension-tibial-plateau-fracture-pattern-a-predictor-of-poor-outcome
#8
Leah J Gonzalez, Ariana Lott, Sanjit Konda, Kenneth A Egol
OBJECTIVES: To assess the outcome of patients with hyperextension bicondylar tibial plateau fractures (HEBTP) to those with other complex tibial plateau fractures DESIGN:: Retrospective cohort design SETTING:: Academic Medical Center PATIENTS:: A total of 84 patients were included in the study. There were 69 patients with 69 knees (82%) that had sustained non-hyperextension bicondylar tibial plateau fractures and 15 patients with 15 knees (18%) that had hyperextension bicondylar tibial plateau fractures (HEBTP) INTERVENTION:: Surgical repair of bicondylar tibial plateau fracture MAIN OUTCOME MEASURES:: Clinical and functional outcomes included knee range of motion, post-operative alignment, NRS pain scores and Short Musculoskeletal Functional Assessment (SMFA) scores at long-term follow-up...
June 15, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28650749/comparative-effectiveness-of-radial-extracorporeal-shockwave-therapy-and-ultrasound-guided-local-corticosteroid-injection-treatment-for-plantar-fasciitis
#9
Sehriban Hocaoglu, Umit Erkan Vurdem, Mehtap Aykac Cebicci, Serap Tomruk Sutbeyaz, Zuhal Guldeste, Serap Gurek Yunsuroglu
BACKGROUND: We compared the long-term clinical and ultrasonographic effects of radial extracorporeal shockwave therapy (rESWT) versus ultrasound-guided corticosteroid injection treatment in patients with plantar fasciitis unresponsive to conservative therapy. METHODS: Seventy-two patients with unilateral plantar fasciitis were randomized to receive either rESWT (three times once per week) (n = 36) or corticosteroid treatment (a single 1-mL dose of betamethasone sodium plus 0...
May 2017: Journal of the American Podiatric Medical Association
https://www.readbyqxmd.com/read/28650474/an-activating-mutation-of-gnb1-is-associated-with-resistance-to-tyrosine-kinase-inhibitors-in-etv6-abl1-positive-leukemia
#10
O Zimmermannova, E Doktorova, J Stuchly, V Kanderova, D Kuzilkova, H Strnad, J Starkova, M Alberich-Jorda, J H F Falkenburg, J Trka, J Petrak, J Zuna, M Zaliova
Leukemias harboring the ETV6-ABL1 fusion represent a rare subset of hematological malignancies with unfavorable outcomes. The constitutively active chimeric Etv6-Abl1 tyrosine kinase can be specifically inhibited by tyrosine kinase inhibitors (TKIs). Although TKIs represent an important therapeutic tool, so far, the mechanism underlying the potential TKI resistance in ETV6-ABL1-positive malignancies has not been studied in detail. To address this issue, we established a TKI-resistant ETV6-ABL1-positive leukemic cell line through long-term exposure to imatinib...
June 26, 2017: Oncogene
https://www.readbyqxmd.com/read/28650357/defining-the-role-of-minimally-invasive-proctectomy-for-locally-advanced-rectal-adenocarcinoma
#11
Sarath Sujatha-Bhaskar, Mehraneh D Jafari, John V Gahagan, Colette S Inaba, Christina Y Koh, Steven D Mills, Joseph C Carmichael, Michael J Stamos, Alessio Pigazzi
OBJECTIVE: National examination of open proctectomy (OP), laparoscopic proctectomy (LP), and robotic proctectomy (RP) in pathological outcomes and overall survival (OS). BACKGROUND: Surgical management for rectal adenocarcinoma is evolving towards utilization of LP and RP. However, the oncological impacts of a minimally invasive approach to rectal cancer have yet to be defined. METHODS: Retrospective review of the National Cancer Database identified patients with nonmetastatic locally advanced rectal adenocarcinoma from 2010 to 2014, who underwent neoadjuvant chemoradiation, surgical resection, and adjuvant therapy...
July 22, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28650247/burden-of-alcohol-abuse-or-dependence-among-long-term-opioid-users-with-chronic-noncancer-pain
#12
Pamela B Landsman-Blumberg, Nathaniel Katz, Kavita Gajria, Anna D Coutinho, Paul P Yeung, Richard White
BACKGROUND: Substance abuse disorders among chronic noncancer pain (CNCP) patients add to the clinical challenges and economic burden of caring for such patients. Despite potential risks, some CNCP patients with a history of alcohol abuse or dependence (AAD) and pain that is refractory to nonopioid treatment options may still need opioids for pain management. However, there is a lack of data on adverse outcomes in long-term opioid users with CNCP and a history of substance abuse or AAD disorders...
July 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28650108/a-matched-pair-analysis-of-multicenter-long-term-follow-up-after-split-liver-transplantation-with-extended-right-grafts
#13
M W Ross, M Cescon, R Angelico, E Andorno, G Rossi, A Pinna, L De Carlis, U Baccarani, U Cillo, M Colledan, V Mazzaferro, G Tisone, M Rossi, F Tuzzolino, D Pagano, S Gruttadauria, G Mazariegos, B Gridelli, M Spada
Split liver transplantation has been proposed as an alternative to whole liver transplantation to expand the donor pool, but studies comparing adult long-term outcomes between the two methods are conflicting and limited. This is the first Italian multicenter study that retrospectively analyzed 119 matched-pair recipients of whole and extended right grafts for long-term survival outcomes. In the overall population, whole liver recipients showed higher patient survival at one- (93% vs. 73%), five- (87% vs. 65%) and ten-year (83% vs...
June 26, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28650086/systemic-thrombolysis-catheter-directed-thrombolysis-and-anticoagulation-for-intermediate-risk-pulmonary-embolism-a-simulation-modeling-analysis
#14
Christopher Kabrhel, Ayman Ali, Jin Choi, Chin Hur
OBJECTIVES: Decision-making around the use of thrombolysis for patients with intermediate-risk (submassive) PE remains challenging. Studies indicate favorable clinical outcomes with systemic thrombolytics (IV tPA), but the risk of major bleeding and hemorrhagic stroke is a deterrent. Catheter-directed thrombolysis (CDT) may be a preferable strategy, as it has been shown to have a lower risk of bleeding than systemic thrombolysis. However, a three-arm randomized control study comparing IV tPA, CDT, and anticoagulation alone, with long-term follow up, would be costly and is unlikely to be performed...
June 26, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28650061/-effectiveness-of-education-based-on-neuroscience-in-the-treatment-of-musculoskeletal-chronic-pain
#15
J D Cuenda-Gago, L Espejo-Antunez
INTRODUCTION: Chronic pain is one of the most frequent health, economic and social problems. Given this, numerous approaches have been described, one of which is pain neuroscience education. AIM: To examine the effectiveness of pain neuroscience education in the treatment of musculoskeletal disorders with chronic pain and to explore the impact of specific aspects of the technique on its effectiveness. MATERIAL AND METHODS: Relevant studies published between 2000 and 2015 were identified by searching PubMed, Scopus and Web of Science...
July 1, 2017: Revista de Neurologia
https://www.readbyqxmd.com/read/28649980/mid-term-outcomes-of-stent-overlap-in-long-total-occluded-lesions-of-superficial-femoral-artery
#16
Ulas Bildirici, Mujdat Aktas, Emir Dervis, Umut Celikyurt
BACKGROUND Superficial femoral artery chronic total occlusion (SCTO) is a common type of peripheral arterial disease (PAD). Endovascular therapy is a treatment approach that has a poor long-term success rate in this group. The aim of this study was to compare the mid-term results of two different uses of nitinol stents in long SCTO lesions (>100 mm): the use of one long stent or two shorter stents. MATERIAL AND METHODS Of 154 patients who underwent percutaneous infrainguinal interventions from 2011 to 2014, a total of 170 CTO lesions were selected for this retrospective study analysis...
June 26, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28649943/cost-effectiveness-of-insulin-detemir-versus-insulin-glargine-for-thai-type-2-diabetes-from-payer-s-perspective
#17
Unchalee Permsuwan, Kednapa Thavorn, Piyameth Dilokthornsakul, Surasak Saokaew, Nathorn Chaiyakunapruk
AIMS: An economic evidence is a vital tool that can inform the decision to use costly insulin analogues. This study aimed to evaluate long-term cost-effectiveness of insulin detemir (IDet) compared with insulin glargine (IGlar) in type 2 diabetes (T2DM) from the Thai payer's perspective. METHODS: Long-term costs and outcomes were projected using a validated IMS CORE Diabetes Model version 8.5. Cohort characteristics, baseline risk factors, and costs of diabetes complications were derived from Thai data sources...
June 26, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28649881/cost-effectiveness-analysis-of-insulin-degludec-compared-with-insulin-glargine-u100-for-the-management-of-type-1-and-type-2-diabetes-mellitus-from-the-spanish-national-health-system-perspective
#18
Pedro Mezquita-Raya, Josep Darba, Meritxell Ascanio, Antonio Ramírez de Arellano
AIMS: The objective of this study was to assess the cost-effectiveness of insulin degludec versus insulin glargine, from the Spanish NHS in three groups of patients. METHODS: A short-term cost utility model was developed to estimate effectiveness results in terms of the total number of hypoglycaemic events and their disutility impact throughout the year on the initial level of quality of life for patients in each treatment. RESULTS: Degludec was the dominant strategy for T2DM BOT and exhibited an incremental cost-effectiveness ratio of 52...
June 26, 2017: Expert Review of Pharmacoeconomics & Outcomes Research
https://www.readbyqxmd.com/read/28649802/punctal-occlusion-for-dry-eye-syndrome
#19
REVIEW
Ann-Margret Ervin, Andrew Law, Andrew D Pucker
BACKGROUND: Dry eye syndrome is a disorder of the tear film that is associated with symptoms of ocular discomfort. Punctal occlusion is a mechanical treatment that blocks the tear drainage system in order to aid in the preservation of natural tears on the ocular surface. OBJECTIVES: To assess the effects of punctal plugs versus no punctal plugs, different types of punctal plugs, and other interventions for managing dry eye. SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (which contains the Cochrane Eyes and Vision Trials Register) (2016, Issue 11), MEDLINE Ovid (1946 to 8 December 2016), Embase...
June 26, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28649514/early-hematopoietic-stem-cell-transplantation-in-a-patient-with-severe-mucopolysaccharidosis-ii-a-7%C3%A2-years-follow-up
#20
Anneliese L Barth, Tatiana S P C de Magalhães, Ana Beatriz R Reis, Maria Lucia de Oliveira, Fernanda B Scalco, Nicolette C Cavalcanti, Daniel S E Silva, Danielle A Torres, Alessandra A P Costa, Carmem Bonfim, Roberto Giugliani, Juan C Llerena, Dafne D G Horovitz
Mucopolysaccharidosis type II (MPS II - Hunter syndrome) is an X-linked lysosomal storage disorder caused by a deficiency in the enzyme iduronate-2 sulfatase (I2S), leading to the accumulation of the glycosaminoglycans, affecting multiple organs and systems. Enzyme replacement therapy does not cross the blood brain barrier, limiting results in neurological forms of the disease. Another option of treatment for severe MPS, hematopoietic stem cell transplantation (HSCT) has become the treatment of choice for the severe form of MPS type I, since it can preserve neurocognition when performed early in the course of the disease...
September 2017: Molecular Genetics and Metabolism Reports
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