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https://www.readbyqxmd.com/read/28748343/a-phase-i-ii-study-of-gemcitabine-during-radiotherapy-in-children-with-newly-diagnosed-diffuse-intrinsic-pontine-glioma
#1
Sophie E M Veldhuijzen van Zanten, Fatma E El-Khouly, Marc H A Jansen, Dewi P Bakker, Esther Sanchez Aliaga, Cornelis J A Haasbeek, Nicole I Wolf, C Michel Zwaan, W Peter Vandertop, Dannis G van Vuurden, Gertjan J L Kaspers
The purpose of this phase I/II, open-label, single-arm trial is to investigate the safety, tolerability, maximum tolerated dose and preliminary efficacy of the potential radiosensitizer gemcitabine, administered concomitantly to radiotherapy, in children with newly diagnosed diffuse intrinsic pontine glioma (DIPG). Six doses of weekly gemcitabine were administered intravenously, concomitantly to 6 weeks of hyperfractionated radiotherapy. Successive cohorts received increasing doses of 140, 175 and 200 mg/m(2) gemcitabine, respectively, following a 3 + 3 dose-escalation schedule without expansion cohort...
July 26, 2017: Journal of Neuro-oncology
https://www.readbyqxmd.com/read/28746936/defining-standards-in-experimental-microsurgical-training-recommendations-of-the-european-society-for-surgical-research-essr-and-the-international-society-for-experimental-microsurgery-isem
#2
René H Tolba, Zoltán Czigány, Suzanne Osorio Lujan, Mihai Oltean, Michael Axelsson, Yelena Akelina, Antonio Di Cataldo, Iren Miko, Istvan Furka, Uta Dahmen, Eiji Kobayashi, Mihai Ionac, Norbert Nemeth
BACKGROUND: Expectations towards surgeons in modern surgical practice are extremely high with minimal complication rates and maximal patient safety as paramount objectives. Both of these aims are highly dependent on individual technical skills that require sustained, focused, and efficient training outside the clinical environment. At the same time, there is an increasing moral and ethical pressure to reduce the use of animals in research and training, which has fundamentally changed the practice of microsurgical training and research...
July 26, 2017: European Surgical Research. Europäische Chirurgische Forschung. Recherches Chirurgicales Européennes
https://www.readbyqxmd.com/read/28746708/effectiveness-and-safety-of-dementia-care-management-in-primary-care-a-randomized-clinical-trial
#3
Jochen René Thyrian, Johannes Hertel, Diana Wucherer, Tilly Eichler, Bernhard Michalowsky, Adina Dreier-Wolfgramm, Ina Zwingmann, Ingo Kilimann, Stefan Teipel, Wolfgang Hoffmann
Importance: Dementia care management (DCM) can increase the quality of care for people with dementia. Methodologically rigorous clinical trials on DCM are lacking. Objective: To test the effectiveness and safety of DCM in the treatment and care of people with dementia living at home and caregiver burden (when available). Design, Setting, and Participants: This pragmatic, general practitioner-based, cluster-randomized intervention trial compared the intervention with care as usual at baseline and at 12-month follow-up...
July 26, 2017: JAMA Psychiatry
https://www.readbyqxmd.com/read/28746213/is-combined-topical-and-intravenous-tranexamic-acid-superior-to-single-use-of-tranexamic-acid-in-total-joint-arthroplasty-a-meta-analysis-from-randomized-controlled-trials
#4
Liqing Yang, Shuai Du, Yuefeng Sun
BACKGROUND: To compare the efficacy and safety of the combined application of both intravenous and topical tranexamic acid (TXA) versus the single use of either application in patients with total knee and hip arthroplasty (TKA and THA). METHODS: Potentially relevant studies were identified from electronic databases including Medline, PubMed, Embase, ScienceDirect, and the Cochrane Library. Randomized control trials (RCTs) of patients prepared for total joint arthroplasty that compared combined TXA with placebo were retrieved...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28745967/improving-patient-safety-and-healthcare-quality-examples-of-good-practice
#5
John Tingle
John Tingle, Reader in Health Law at Nottingham Trent University, discusses a recent report by the Care Quality Commission that showcases eight NHS trusts that have improved their patient safety and healthcare quality.
July 27, 2017: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/28745818/is-repeat-botulinum-toxin-a-injection-valuable-for-neurogenic-detrusor-overactivity-a-systematic-review-and-meta-analysis
#6
REVIEW
Jianshu Ni, Xiaohu Wang, Nailong Cao, Jiemin Si, Baojun Gu
AIM: To investigate the value of repeat botulinum toxin A (BTX-A) injections in patients with neurogenic detrusor overactivity (NDO). METHODS: We searched the PubMed, EMBASE, and EBSCO databases for articles published until June 2016. Studies that reported the efficacy and safety of repeat BTX-A injections for adult patients with NDO were eligible. The effect size for each outcome was calculated as the standardized mean difference ± standard error and 95% confidence interval, and was graded as small, >0...
July 26, 2017: Neurourology and Urodynamics
https://www.readbyqxmd.com/read/28745210/variability-in-threshold-for-medication-error-reporting-between-physicians-nurses-pharmacists-and-families
#7
Patricia Keefer, Kelley Kidwell, Candace Lengyel, Kavita Warrier, Deborah Wagner
BACKGROUND: Voluntary medication error reporting is an imperfect resource used to improve the quality of medication administration. It requires judgment by front-line staff to determine how to report enough to identify opportunities to improve patient safety but not jeopardize that safety by creating a culture of "report fatigue." OBJECTIVE: This study aims to provide information on interpretability of medication error and the variability between subgroups of caregivers in the hospital setting...
July 24, 2017: Current Drug Safety
https://www.readbyqxmd.com/read/28745181/praise-for-mental-health-staff-despite-safety-fears
#8
Matthew Mckew
A fall in the number of mental health nurses has been linked to increased risk to patient safety, in an England-wide Care Quality Commission (CQC) report.
July 26, 2017: Nursing Standard
https://www.readbyqxmd.com/read/28745137/exploring-the-value-proposition-of-primary-care-for-safety-net-patients-who-utilize-emergency-departments-to-address-unmet-needs
#9
Kimberly R Enard, Deborah M Ganelin
BACKGROUND: An underlying assumption of strategies intended to promote appropriate primary care over emergency department (ED) use for ongoing health care needs is that patients will understand the "value proposition" of primary care: that they will receive specific benefits from primary care providers over and above what they receive from EDs. However, there is evidence that this value proposition may be unclear to safety-net patients. The goals of this study are to describe factors motivating ED use for low-acuity conditions; describe similarities and differences in usual source of care (USOC) experiences, by ED versus non-ED setting; and assess awareness and perceptions of the patient-centered medical home (PCMH) concept among safety-net patients...
July 1, 2017: Journal of Primary Care & Community Health
https://www.readbyqxmd.com/read/28744879/procarbazine-lomustine-and-vincristine-for-recurrent-high-grade-glioma
#10
REVIEW
Saurabh Parasramka, Goutham Talari, John L Villano, Myrna Rosenfeld, Jing Guo
BACKGROUND: Recurrent high-grade glioma (HGG) carries an extremely poor prognosis. There is no current standard of care or guideline-based recommendations. Nitrosourea-based multidrug chemotherapy or PCV - procarbazine, lomustine (CCNU) and vincristine - is one of the treatment options at recurrence. There has been no meta-analysis which looks at the benefits and harms of PCV chemotherapy in adults with recurrent HGG. OBJECTIVES: To assess the effectiveness and safety of procarbazine, lomustine, and vincristine (PCV) chemotherapy with other interventions in adults with recurrent high-grade glioma...
July 26, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28744772/breakthrough-pain-management-with-sublingual-fentanyl-tablets-in-patients-with-cancer-age-subgroup-analysis-of-a-multicenter-prospective-study
#11
Jordi Guitart, María Isabel Vargas, Vicente De Sanctis, Jordi Folch, Rafael Salazar, José Fuentes, Joan Coma, Julia Ferreras, Jordi Moya, Albert Tomás, Pere Estivill, Francisco Rodelas, Antonio Javier Jiménez, Almudena Sanz
INTRODUCTION: Breakthrough pain (BTP) management in patients with cancer is challenging, especially in the elderly. However, no studies examining the influence of age on BTP medication have been conducted. The aim of this work was to investigate the effect of sublingual fentanyl tablets (SFTs) in terms of efficacy, safety, and quality of life in two age categories. METHODS: We performed age subgroup analyses (<65 and ≥65 years) from a recently completed study conducted in Spain...
July 25, 2017: Drugs in R&D
https://www.readbyqxmd.com/read/28743191/successful-utilization-of-an-electronic-pain-diary-in-a-multinational-phase-3-interventional-study-of-pediatric-sickle-cell-anemia
#12
Lori E Heath, Matthew M Heeney, Carolyn C Hoppe, Samuel Adjei, Tsiri Agbenyega, Mohamed Badr, Nicoletta Masera, Chunmei Zhou, Patricia B Brown, Joseph A Jakubowski, Carlton Dampier
BACKGROUND/AIMS: Patients with sickle cell anemia can experience recurrent pain episodes, which affect quality of life. The reported prevalence of pain is higher in studies using patient diaries than in healthcare facility utilization data. Determining Effects of Platelet Inhibition on Vaso-Occlusive Events was a multinational study that assessed the efficacy and safety of prasugrel in reducing the rate of vaso-occlusive events in children with sickle cell anemia (NCT01794000) and included an electronic patient-reported outcome diary to record pain occurrence...
July 1, 2017: Clinical Trials: Journal of the Society for Clinical Trials
https://www.readbyqxmd.com/read/28741377/renal-cell-carcinoma-alternative-nephron-sparing-treatment-options-for-small-renal-masses-a-systematic-review
#13
Fieke M Prins, Linda G W Kerkmeijer, Anne A Pronk, Evert-Jan P A Vonken, Richard P Meijer, Axel Bex, Maurits M Barendrecht
<i>Background</i> The standard treatment of T1 renal cell carcinoma is (partial-) nephrectomy. For patients where surgery is not the treatment of choice, for example in the elderly, in case of severe comorbidity, inoperability or refusal of surgery, alternative treatment options are available. These treatment options include active surveillance, radiofrequency ablation, cryoablation, microwave ablation or stereotactic body radiotherapy. In the present overview, the efficacy, safety and outcome of these different options are summarized, particularly focusing on recent developments...
July 25, 2017: Journal of Endourology
https://www.readbyqxmd.com/read/28741364/propofol-sedation-implementation-utility-of-the-failure-mode-and-effect-analysis-patient-focused-quality-and-safety
#14
Adrián Huergo Fernández, Pedro Amor Martín, Fernando Fernández Cadenas
Sedation is a key component of digestive endoscopy. While ensuring procedural safety and quality represents a primary goal, a detailed assessment of patient-focused risks and improvements is lacking on most occasions. Failure mode and effect analysis (FMEA) is a useful tool in this context as a means of raising barriers and defense mechanisms to prevent adverse events from developing.
July 25, 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28741303/open-retropubic-colposuspension-for-urinary-incontinence-in-women
#15
REVIEW
Marie Carmela M Lapitan, June D Cody, Atefeh Mashayekhi
BACKGROUND: Urinary incontinence is a common and potentially debilitating problem. Stress urinary, incontinence as the most common type of incontinence, imposes significant health and economic burdens on society and the women affected. Open retropubic colposuspension is a surgical treatment which involves lifting the tissues near the bladder neck and proximal urethra in the area behind the anterior pubic bones to correct deficient urethral closure to correct stress urinary incontinence...
July 25, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28741101/bundled-payments-in-total-joint-replacement-keeping-our-care-affordable-and-high-in-quality
#16
REVIEW
Alexander S McLawhorn, Leonard T Buller
PURPOSE OF REVIEW: The purpose of this review was to evaluate the literature regarding bundle payment reimbursement models for total joint arthroplasty (TJA). RECENT FINDINGS: From an economic standpoint, TJA are cost-effective, but they represent a substantial expense to the Centers for Medicare & Medicaid Services (CMS). Historically, fee-for-service payment models resulted in highly variable cost and quality. CMS introduced Bundled Payments for Care Improvement (BPCI) in 2012 and subsequently the Comprehensive Care for Joint Replacement (CJR) reimbursement model in 2016 to improve the value of TJA from the perspectives of both CMS and patients, by improving quality via cost control...
July 24, 2017: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/28741090/direct-comparison-of-tadalafil-with-sildenafil-for-the-treatment-of-erectile-dysfunction-a-systematic-review-and-meta-analysis
#17
Binbin Gong, Ming Ma, Wenjie Xie, Xiaorong Yang, Yongming Huang, Ting Sun, Yanping Luo, Jiao Huang
AIMS: Erectile dysfunction (ED) is a major care problem worldwide. Tadalafil and sildenafil are the two most common phosphodiesterase 5 inhibitors used to treat ED. This systematic review and meta-analysis were conducted to directly compare tadalafil with sildenafil for the treatment of ED. METHODS: We designed a strategy for searching the PubMed, Embase, EBSCO, Web of Science and Cochrane library databases; the reference lists of the retrieved studies were also investigated...
July 24, 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/28741039/association-of-opioid-prescription-and-perioperative-complications-in-obstructive-sleep-apnea-patients-undergoing-total-joint-arthroplasties
#18
Eva E Mörwald, Ashley Olson, Crispiana Cozowicz, Jashvant Poeran, Madhu Mazumdar, Stavros G Memtsoudis
PURPOSE: Obstructive sleep apnea (OSA) has been linked to higher rates of perioperative complications. Practice guidelines recommend minimizing opioids in this cohort to reduce complications. However, a paucity of evidence exists relating different levels of opioid prescription to perioperative complications. Our aim was to investigate if different levels of opioid prescription are related to perioperative complication risk in patients with OSA. METHODS: A total of 107,610 OSA patients undergoing total knee or hip arthroplasty between 2006 and 2013 were identified in a nationwide database and divided into subgroups according to the amount of opioids prescribed...
July 24, 2017: Sleep & Breathing, Schlaf & Atmung
https://www.readbyqxmd.com/read/28740733/when-is-evidence-enough-evidence-a-systematic-review-and-meta-analysis-of-the-trabectome-as-a-solo-procedure-in-patients-with-primary-open-angle-glaucoma
#19
REVIEW
Jeffrey T Y Chow, Cindy M L Hutnik, Karla Solo, Monali S Malvankar-Mehta
The purpose of this systematic review and meta-analysis was to examine the availability of evidence for one of the earliest available minimally invasive glaucoma surgery (MIGS) procedures, the Trabectome. Various databases were searched up to December 20, 2016, for any published studies assessing the use of the Trabectome as a solo procedure in patients with primary open-angle glaucoma (POAG). The standardized mean differences (SMD) were calculated for the change in intraocular pressure (IOP) and number of glaucoma mediations used at 1-month, 6-month, and 12-month follow-up...
2017: Journal of Ophthalmology
https://www.readbyqxmd.com/read/28738443/urethral-injection-therapy-for-urinary-incontinence-in-women
#20
REVIEW
Vivienne Kirchin, Tobias Page, Phil E Keegan, Kofi Om Atiemo, June D Cody, Samuel McClinton, Patricia Aluko
BACKGROUND: Urinary incontinence imposes a significant health and economic burden to society. Periurethral or transurethral injection of bulking agents is a minimally invasive surgical procedure used as one the surgical treatments of stress urinary incontinence (SUI) in adult women. OBJECTIVES: To assess the effects of periurethral or transurethral injection therapy on the cure or improvement of urinary incontinence in women. SEARCH METHODS: We searched the Cochrane Incontinence Group Specialised Trials Register (searched 8 November 2010) and the reference lists of relevant articles...
July 25, 2017: Cochrane Database of Systematic Reviews
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