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https://www.readbyqxmd.com/read/29779180/the-impact-of-an-adolescent-depressive-disorders-clinical-pathway-on-healthcare-utilization
#1
Brooke Lifland, Davene R Wright, Rita Mangione-Smith, Arti D Desai
Clinical pathways are known to improve the value of health care in medical and surgical settings but have been rarely studied in the psychiatric setting. This study examined the association between level of adherence to an adolescent depressive disorders inpatient clinical pathway and length of stay (LOS), cost, and readmissions. Patients in the high adherence category had significantly longer LOS and higher costs compared to the low adherence category. There was no difference in the odds of 30-day emergency department return visits or readmissions...
May 19, 2018: Administration and Policy in Mental Health
https://www.readbyqxmd.com/read/29778302/impact-of-low-anorectal-malformation-on-parenting-stress-a-mixed-method-study
#2
Helena Wigander, Maria Öjmyr-Joelsson, Björn Frenckner, Tomas Wester, Margret Nisell
The purpose of this study was to investigate parenting stress among parents of children with low ARM. STUDY AIMS: 1) Compare parenting stress among parents of children with low ARM, with parents of healthy children using questionnaires. 2) Identify subscales within the questionnaire which needed to be further explored. 3) Use semi-structured interviews with parents of children with low ARM, to explore parenting stress and to explain, expand and or support the quantitative findings. DESIGN AND METHODS: An explanatory sequential mixed methods design was used in this follow up study...
May 17, 2018: Journal of Pediatric Nursing
https://www.readbyqxmd.com/read/29777045/ten-year-incidence-of-primary-angle-closure-in-elderly-chinese-the-liwan-eye-study
#3
Lanhua Wang, Wenyong Huang, Shengsong Huang, Jian Zhang, Xinxing Guo, David S Friedman, Paul J Foster, Mingguang He
PURPOSE: To determine the 10-year incidence of all forms of primary angle closure (PAC) in phakic eyes and its risk factors in an urban Chinese population aged 50 years and older. METHODS: Survivors of 1405 baseline participants were invited to attend the 10-year follow-up visit in the Liwan Eye Study. Participants with established baseline angle closure, including primary angle closure suspects (PACS), PAC and primary angle closure glaucoma (PACG), or those who underwent bilateral cataract surgery during the 10-year period, as well as those who did not tolerate gonioscopic examinations, were excluded from this analysis...
May 18, 2018: British Journal of Ophthalmology
https://www.readbyqxmd.com/read/29776436/rates-and-causes-of-30-day-readmission-and-emergency-room-utilization-following-head-and-neck-surgery
#4
Vincent Wu, Stephen F Hall
BACKGROUND: Unplanned returns to hospital are common, costly, and potentially avoidable. We aimed to investigate and characterize reasons for all-cause readmissions to hospital as in-patients (IPs) and visits to the Emergency Department (ED) within 30-days following patient discharge post head and neck surgery (HNS). METHODS: Retrospective case series with chart review. All patients within the Department of Otolaryngology - Head and Neck Surgery who underwent HNS for benign and malignant disease from January 1, 2010 to May 31, 2015 were identified...
May 18, 2018: Journal of Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/29774940/-prognostic-analysis-and-clinicopathological-features-of-20-patients-with-appendiceal-neuroendocrine-neoplasms
#5
Weilin Mao, Yang Lyu, Ning Pu, Jian'ang Li, Baobao Xin, Wenqi Chen, Dayong Jin, Wenhui Lou, Xuefeng Xu
OBJECTIVE: To investigate clinicopathological features and prognostic factors of appendiceal neuroendocrine neoplasms(a-NEN). METHODS: Clinical data of 20 patients diagnosed with a-NEN at Zhongshan Hospital of Fudan University between January 2000 and December 2016 were retrospectively analyzed. Pathological diagnosis was based on the WHO classification criteria of digestive system tumors (2010 edition). Based on the mitotic count and Ki-67 index, a-NENs were divided into grade 1 neuroendocrine tumor (NET G1), grade 2(G2) NET G2) and grade 3 (neuroendocrine carcinoma, NEC)...
May 25, 2018: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/29773778/a-collaboration-to-teach-us-mph-students-about-cuba-s-health-care-system
#6
Joan O'Connell, Ana María Gálvez-González, Jean Scandlyn, María R Sala-Adam, Xiomara Martín-Linares
In 2011, the US Department of the Treasury changed its regulations to allow US students to participate in short-term education programs in Cuba. Beginning in 2012, and each year thereafter, Cuba's National School of Public Health and the Colorado School of Public Health have jointly taught a class on the Cuban public health system. The program goals are to provide US students with an opportunity to learn about the Cuban national health system's focus on 1) prevention and primary health care services; 2) financial and geographic access to services and health equity; 3) continuum of care across the home, family doctor-and-nurse offices, polyclinics and hospitals; 4) data collection at all levels to understand health risks, including outbreaks, and to guide resource allocation; 5) assessing patients' health and risks using a comprehensive definition of health; 6) multisectoral collaborations between the Ministry of Public Health and other Cuban agencies and organizations to address population health risks; 7) disaster preparedness, response and recovery; and 8) provision of international health assistance...
April 2018: MEDICC Review
https://www.readbyqxmd.com/read/29767471/converting-immunosuppression-from-an-oral-suspension-to-a-granule-formulation-of-tacrolimus-in-pediatric-renal-transplant-recipients
#7
Georgia Malakasioti, Christine Booth, Stephen D Marks
OS of tacrolimus prepared from tacrolimus powder is not licensed for children. A licensed GF for OS allows flexibility for body weight-based dose adjustments. This study aimed at exploring the efficacy of conversion from OS to the GF of tacrolimus in stable pediatric renal transplant recipients. Records of 25 pediatric renal transplant recipients aged under 18 years who were switched from an unlicensed tacrolimus OS to GF were reviewed. At day 0, 1 week, and 4-8 weeks post-conversion, there were no differences regarding daily tacrolimus dose (3...
May 16, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29766400/social-media-in-the-rei-clinic-what-do-patients-want
#8
Darcy E Broughton, Allison Schelble, Kristina Cipolla, Michele Cho, Jason Franasiak, Kenan R Omurtag
PURPOSE: To elicit patient preferences for social media utilization and content in the infertility clinic. METHODS: This was a cross-sectional survey study conducted in three US fertility practices. Women presenting to the infertility clinic for an initial or return visit were offered an anonymous voluntary social media survey. The survey elicited patient perception of whether social media use in the infertility clinic is beneficial, and preferences regarding topics of interest...
May 15, 2018: Journal of Assisted Reproduction and Genetics
https://www.readbyqxmd.com/read/29765221/surgical-treatment-of-an-esophageal-bronchogenic-cyst-with-massive-upper-digestive-tract-hematoma-without-esophagectomy-a-case-report-and-the-review-of-the-literature
#9
Yuanjun Cheng, Donglai Chen, Li Shi, Wentao Yang, Yonghua Sang, Shanzhou Duan, Yongbing Chen
Esophageal bronchogenic cysts are extremely rare. Here we report a case of massive upper digestive tract hematoma and bronchogenic cyst mimicking aortic dissection that was safely removed without esophagectomy. A 30-year-old man was referred to our hospital for the treatment of a mediastinal cystic tumor located in the submucosa of the distal esophagus. His chief complaints were dysphagia > 1 week and severe persistent upper abdominal pain mimicking aortic dissection with constant vomiting for 1 day after gastroscopy examination...
2018: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/29765198/management-of-post-lasik-dry-eye-a-multicenter-randomized-comparison-of-a-new-multi-ingredient-artificial-tear-to-carboxymethylcellulose
#10
Avi Wallerstein, W Bruce Jackson, Jeffrey Chambers, Amir M Moezzi, Hugh Lin, Peter A Simmons
Purpose: To compare the efficacy and safety of a preservative-free, multi-ingredient formulation of carboxymethylcellulose 0.5%, hyaluronic acid 0.1%, and organic osmolytes (CMC-HA), to preservative-free carboxymethylcellulose 0.5% (CMC) in the management of postoperative signs and symptoms of dry eye following laser-assisted in situ keratomileusis (LASIK). Methods: This was a double-masked, randomized, parallel-group study conducted in 14 clinical centers in Canada and Australia...
2018: Clinical Ophthalmology
https://www.readbyqxmd.com/read/29764963/reducing-missed-opportunities-for-influenza-vaccination-in-patients-with-rheumatoid-arthritis-evaluation-of-a-multisystem-intervention
#11
Rachel Broderick, Iazsmin Ventura, Sunoz Soroosh, Lourdes Franco, Jon T Giles
OBJECTIVE: To assess a multimodal intervention for reducing missed opportunities for outpatient influenza vaccination in individuals with rheumatoid arthritis (RA). METHODS: Patients with RA were enrolled from a single center and each rheumatology outpatient visit was tracked for missed opportunities for influenza vaccination, defined as a visit in which an unvaccinated patient without contraindications remained unvaccinated or lacked documentation of vaccine recommendation in the electronic medical record (EMR)...
May 15, 2018: Journal of Rheumatology
https://www.readbyqxmd.com/read/29763253/croup-diagnosis-and-management
#12
Dustin K Smith, Andrew J McDermott, John F Sullivan
Croup is a common respiratory illness affecting 3% of children six months to three years of age. It accounts for 7% of hospitalizations annually for fever and/or acute respiratory illness in children younger than five years. Croup is a manifestation of upper airway obstruction resulting from swelling of the larynx, trachea, and bronchi, leading to inspiratory stridor and a barking cough. Many patients experience low-grade fevers, but fever is not necessary for diagnosis. Less commonly, stridor can be associated with acute epiglottitis, bacterial tracheitis, and foreign body airway obstruction...
May 1, 2018: American Family Physician
https://www.readbyqxmd.com/read/29762428/outcomes-of-conservative-management-of-high-grade-squamous-intraepithelial-lesions-in-young-women
#13
Marette H Lee, Sarah J Finlayson, Ksenia Gukova, Gillian Hanley, Dianne Miller, Leslie Ann Sadownik
OBJECTIVE: The aim of the study was to determine regression rates of cervical intraepithelial neoplasia (CIN) 2 and 3 in women younger than 24 years, followed conservatively for up to 24 months. MATERIALS AND METHODS: This is a retrospective chart review of colposcopy patients in clinic database based on the following: (1) younger than 24 years at first visit; (2) first visit January 1, 2010, to May 31, 2013, and at least 1 follow-up visit after diagnosis; (3) histologic diagnosis of CIN2+; and (4) optimal conservative management (observation for up to 24 months or to 24 years, whichever occurred first)...
May 4, 2018: Journal of Lower Genital Tract Disease
https://www.readbyqxmd.com/read/29762336/radiology-callbacks-to-a-pediatric-emergency-department-and-their-clinical-impact
#14
Rajan Arora, Nirupama Kannikeswaran
BACKGROUND: Clinical impact of radiology callbacks (missed initial radiologic diagnosis) remains largely unknown in the pediatric emergency department (PED). OBJECTIVE: The aim of this study was to describe the incidence, nature of radiology callbacks, and the impact on clinical care during the return visit (RV). METHODS: We performed a retrospective chart review of quality assurance database of RVs for radiology callbacks to our PED over a 1-year period...
May 14, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29754411/a-case-study-of-nurse-practitioner-care-compared-to-general-practitioner-care-for-children-with-respiratory-tract-infections
#15
Saskia F van Vugt, Alma C van de Pol, Frits G W Cleveringa, Rebecca K Stellato, Marieke P Kappers, Niek J de Wit, Roger A M J Damoiseaux
AIM: To compare quality of care provided by nurse practitioners with care provided by general practitioners for children with respiratory tract infections in the Netherlands. BACKGROUND: Nurse practitioners increasingly manage acute conditions in general practice, with opportunities for more protocolled care. Studies on quality of nurse practitioners' care for children with respiratory tract infections are limited to the US health care system and do not take into account baseline differences in illness severity...
May 13, 2018: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/29752922/a-non-inferiority-randomized-controlled-trial-to-compare-transabdominal-and-transvaginal-sonography-for-eligibility-assessment-prior-to-medical-abortion
#16
Annie Fu, Caitlin E Weber, Emma Gilmore, Anne R Davis, Gregory Hirsch, Carolyn L Westhoff
OBJECTIVES: To compare transabdominal sonography (TAS) to transvaginal sonography (TVS) in medical abortion eligibility assessment; specifically to measure how often clinicians chose to order additional testing for eligibility assessment following TAS and TVS, and to look for differences by patient and clinician characteristics. Also, to compare patient acceptability between the two modalities. STUDY DESIGN: This pragmatic multi-site randomized non-inferiority trial compared TAS to TVS at 10 New York City and New Jersey health centers that provide medical abortion...
May 9, 2018: Contraception
https://www.readbyqxmd.com/read/29751798/clinic-flow-for-sti-hiv-and-tb-patients-in-an-urban-infectious-disease-clinic-offering-point-of-care-testing-services-in-durban-south-africa
#17
Katrina J Stime, Nigel Garrett, Yukteshwar Sookrajh, Jienchi Dorward, Ntuthu Dlamini, Ayo Olowolagba, Monisha Sharma, Ruanne V Barnabas, Paul K Drain
BACKGROUND: Many clinics in Southern Africa have long waiting times. The implementation of point-of-care (POC) tests to accelerate diagnosis and improve clinical management in resource-limited settings may improve or worsen clinic flow and waiting times. The objective of this study was to describe clinic flow with special emphasis on the impact of POC testing at a large urban public healthcare clinic in Durban, South Africa. METHODS: We used time and motion methods to directly observe patients and practitioners...
May 11, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29747644/electronic-health-record-tools-to-assist-with-children-s-insurance-coverage-a-mixed-methods-study
#18
Jennifer E DeVoe, Megan Hoopes, Christine A Nelson, Deborah J Cohen, Aleksandra Sumic, Jennifer Hall, Heather Angier, Miguel Marino, Jean P O'Malley, Rachel Gold
BACKGROUND: Children with health insurance have increased access to healthcare and receive higher quality care. However, despite recent initiatives expanding children's coverage, many remain uninsured. New technologies present opportunities for helping clinics provide enrollment support for patients. We developed and tested electronic health record (EHR)-based tools to help clinics provide children's insurance assistance. METHODS: We used mixed methods to understand tool adoption, and to assess impact of tool use on insurance coverage, healthcare utilization, and receipt of recommended care...
May 10, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29743886/efficacy-of-mesoglycan-in-pain-control-after-excisional-hemorrhoidectomy-a-pilot-comparative-prospective-multicenter-study
#19
Gaetano Gallo, Massimiliano Mistrangelo, Roberto Passera, Valentina Testa, Mauro Pozzo, Roberto Perinotti, Ivan Lanati, Ivano Lazzari, Paolo Tonello, Elettra Ugliono, Emilia De Luca, Alberto Realis Luc, Giuseppe Clerico, Mario Trompetto
Introduction: Various pain management strategies for patients undergoing open excisional hemorrhoidectomy have been proposed, yet postoperative pain remains a frequent complaint. Objective: To determine whether mesoglycan (30 mg two vials i.m. once/day for the first 5 days postoperative, followed by 50 mg 1 oral tablet twice/day for 30 days) would reduce the edema of the mucocutaneous bridges and thus improve postoperative pain symptoms. Patients and Methods: For this prospective observational multicenter study, 101 patients undergoing excisional diathermy hemorrhoidectomy for III-IV degree hemorrhoidal disease were enrolled at 5 colorectal referral centers...
2018: Gastroenterology Research and Practice
https://www.readbyqxmd.com/read/29743320/prospective-longitudinal-study-of-the-pregnancy-dna-methylome-the-us-pregnancy-race-environment-genes-preg-study
#20
Dana M Lapato, Sara Moyer, Emily Olivares, Ananda B Amstadter, Patricia A Kinser, Shawn J Latendresse, Colleen Jackson-Cook, Roxann Roberson-Nay, Jerome F Strauss, Timothy P York
PURPOSE: The goal of the Pregnancy, Race, Environment, Genes study was to understand how social and environmental determinants of health (SEDH), pregnancy-specific environments (PSE) and biological processes influence the timing of birth and account for the racial disparity in preterm birth. The study followed a racially diverse longitudinal cohort throughout pregnancy and included repeated measures of PSE and DNA methylation (DNAm) over the course of gestation and up to 1 year into the postpartum period...
May 9, 2018: BMJ Open
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