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https://www.readbyqxmd.com/read/29151051/subclinical-propionibacterium-acnes-infection-estimation-in-the-intervertebral-disc-spine-id-protocol-for-a-prospective-cohort
#1
Nelson Astur, Delio E Martins, Marcelo Wajchenberg, Mario Ferretti, Fernando G Menezes, Andre M Doi, Laercio A Rosemberg, Durval C B Santos, Alexandre S Iutaka, Luciano M R Rodrigues, Marines D V Martino, Jorge R Pagura, Eduardo N Kihara Filho, Mario Lenza
INTRODUCTION: Low back pain and vertebral endplate abnormalities are common conditions within the population. Subclinical infection caused by indolent pathogens can potentially lead to these findings, with differentiation between them notably challenging from a clinical perspective. Progressive infection of the intervertebral disc has been extensively associated with increasing low back pain, with Propionibacterium acnes specifically implicated with in relation to sciatica. The main purpose of this study is to identify if the presence of an infective pathogen within the intervertebral disc is primary or is a result of intraoperative contamination, and whether this correlates to low back pain...
November 17, 2017: BMJ Open
https://www.readbyqxmd.com/read/29151009/risk-stratification-triage-and-implementation-of-an-expedited-hip-fracture-treatment-protocol-is-it-safe-and-effective
#2
William Zelenty, Richard Yoon, Lorraine Hutzler, Nirmal Tejwani, Joseph Bosco
INTRODUCTION: The population of patients in the USA over the age of 65 is expected to significantly increase over the next 40 years. These patients are at increased risk for hip fractures and will pose a burden to providers in the near future. In order to provide high value care, providers will need to maintain positive outcomes, mitigate complications, and reduce overall cost burdens. This study was designed to investigate the safety and efficacy of a patient transfer protocol between a large academic medical center and a single specialty orthopaedic institution...
December 2017: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/29150794/shunt-surgery-in-idiopathic-normal-pressure-hydrocephalus-is-cost-effective-a-cost-utility-analysis
#3
Mats Tullberg, Josefine Persson, Jakob Petersen, Per Hellström, Carsten Wikkelsø, Åsa Lundgren-Nilsson
BACKGROUND: The objective was to evaluate the cost-effectiveness of shunt surgery in patients with idiopathic normal pressure hydrocephalus (iNPH). METHODS: Health-related quality of life was evaluated before and 6 months after surgery using the EQ-5D-3 L (EuroQOL group five-dimensions health survey) in 30 patients (median age, 71 years; range, 65-89 years) diagnosed with iNPH. The costs associated with shunt surgery were assessed by a detailed survey with interviews and extraction of register data concerning the cost of hospital care, primary care, residential care, home-care service and informal care...
November 17, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/29150536/availability-sales-and-affordability-of-tobacco-cessation-medicines-in-kerala-india
#4
Smitha Sarma, Sivadasanpillai Harikrishnan, Abigail S Baldridge, Raji Devarajan, Aashna Mehta, Sakhtivel Selvaraj, Mohammed K Ali, Padinhare P Mohanan, Dorairaj Prabhakaran, Mark D Huffman
BACKGROUND: India is the world's second largest consumer of tobacco, but tobacco cessation remains uncommon due, at least in part, to underutilization of cessation pharmacotherapy. We evaluated the availability, sales, and affordability of nicotine replacement therapy, bupropion, and varenicline in the South Indian state of Kerala to understand potential reasons for underutilization. METHODS AND RESULTS: From November 2016 to April 2017, we collected data on availability, inventory, and pricing of cessation medication through a cross-sectional survey of 199 public, semiprivate (Karunya), and private pharmacies across 5 districts in Kerala using World Health Organization/Health Action International methodology...
November 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/29150316/low-threshold-extended-release-naltrexone-for-high-utilizers-of-public-services-with-severe-alcohol-use-disorder-a-pilot-study
#5
Shannon Smith-Bernardin, Chris Rowe, Emily Behar, Michelle Geier, Stuart Washington, Glenn-Milo Santos, Jason Euren, Judith Martin, Alice Gleghorn, Phillip O Coffin
Extended-release naltrexone (XRNTX) is an effective treatment for alcohol use disorder (AUD). We sought to evaluate the feasibility, acceptability, and preliminary effectiveness and cost-effectiveness of XRNTX delivered as a stand-alone service to persons with severe AUD who are high utilizers of multiple urgent and emergency medical services (HUMS). Of 15 HUMS persons with severe AUD selected based on chart review, 11 agreed to participate. Participants received a mean of 4.5 injections (range 2-7). Modest benefits from XRNTX were observed in terms of patients' Urge-to-Drink Score and the costs of emergency medical services utilized...
November 8, 2017: Journal of Substance Abuse Treatment
https://www.readbyqxmd.com/read/29149993/label-free-determination-of-prostate-specific-membrane-antigen-in-human-whole-blood-at-nanomolar-levels-by-magnetically-assisted-surface-enhanced-raman-spectroscopy
#6
Zuzana Chaloupková, Anna Balzerová, Jitka Bařinková, Zdenka Medříková, Pavel Šácha, Petr Beneš, Václav Ranc, Jan Konvalinka, Radek Zbořil
Prostate cancer is one of the most common cancers among men and can in its later stages cause serious medical problems. Due to the limited suitability of current diagnostic biochemical markers, new biomarkers for the detection of prostate cancer are highly sought after. An ideal biomarker should serve as a reliable prognostic marker, be applicable for early diagnosis, and be applicable for monitoring of therapeutic response. One potential candidate is glutamate carboxypeptidase II (GCPII), also known as prostate specific membrane antigen (PSMA), which has a promising role for direct imaging...
January 2, 2018: Analytica Chimica Acta
https://www.readbyqxmd.com/read/29149912/trial-to-incentivise-adherence-for-diabetes-triad-study-protocol-for-a-randomised-controlled-trial
#7
Marcel Bilger, Mitesh Shah, Ngiap Chuan Tan, Kaye Louise Howard, Hui Yan Xu, Ecosse Luc Lamoureux, Eric Andrew Finkelstein
BACKGROUND: Many people with diabetes have suboptimal glycaemic control due to not being adherent to their treatment regimen. Behavioural economic theory suggests that the lack of adherence results from the disconnect between the timing of when costs and benefits accrue. One strategy to address this discontinuity is to offer patients a near-term benefit, such as a financial reward. Whereas there is evidence that rewards can improve treatment adherence and sometimes health outcomes, further research is needed to determine whether rewards are more effective when targeting processes or intermediary health outcomes...
November 17, 2017: Trials
https://www.readbyqxmd.com/read/29149469/cuffed-versus-uncuffed-endotracheal-tubes-for-general-anaesthesia-in-children-aged-eight-years-and-under
#8
REVIEW
Flavia A De Orange, Rebeca Gac Andrade, Andrea Lemos, Paulo Sgn Borges, José N Figueiroa, Pete G Kovatsis
BACKGROUND: Since the introduction of endotracheal intubation in paediatrics, uncuffed endotracheal tubes (ETTs) have been the standard of care for children under eight years old, based on the presumption that complications, particularly postoperative stridor, are higher with cuffed ETTs. The major disadvantages of uncuffed ETTs cited for this shift in procedure include the difficulty in achieving tidal volumes due to leakage around an uncuffed ETT. To seal the airway adequately, uncuffed tubes may need to be exchanged for another tube with a larger diameter, which sometimes requires several attempts before the appropriate size is found...
November 17, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29149126/pharmacogenomics-principles-and-relevance-to-oncology-nursing%C3%A2
#9
Crystal H Dodson
BACKGROUND: Pharmacogenomics is the fastest growing field in precision medicine. Based on current use, oncology encompasses the largest share of the precision medicine market, necessitating that oncology nurses understand the principles of pharmacogenomics and how it affects clinical practice.
. OBJECTIVES: This article will define precision medicine and pharmacogenomics and will provide examples of pharmacogenomic tests, including those associated with tumor markers, and nursing implications...
December 1, 2017: Clinical Journal of Oncology Nursing
https://www.readbyqxmd.com/read/29148332/medicare-advantage-and-traditional-medicare-hospitalization-intensity-and-readmissions
#10
Rachel Mosher Henke, Zeynal Karaca, Teresa B Gibson, Eli Cutler, Marguerite L Barrett, Katharine Levit, Jayne Johann, Lauren Hersch Nicholas, Herbert S Wong
Medicare Advantage plans have incentives and tools to optimize patient care. Therefore, Medicare Advantage hospitalizations may have lower cost and higher quality than similar traditional Medicare hospitalizations. We applied a coarsened matching approach to 2013 Healthcare Cost and Utilization Project hospital discharge data from 22 states to compare hospital cost, length of stay, and readmissions for Traditional Medicare and Medicare Advantage. We found that Medicare Advantage hospitalizations were substantially less expensive and shorter for mental health stays but costlier and longer for injury and surgical stays...
March 1, 2017: Medical Care Research and Review: MCRR
https://www.readbyqxmd.com/read/29148331/financial-performance-of-health-insurers-state-run-versus-federal-run-exchanges
#11
Mark A Hall, Michael J McCue, Jennifer R Palazzolo
Many insurers incurred financial losses in individual markets for health insurance during 2014, the first year of Affordable Care Act mandated changes. This analysis looks at key financial ratios of insurers to compare profitability in 2014 and 2013, identify factors driving financial performance, and contrast the financial performance of health insurers operating in state-run exchanges versus the federal exchange. Overall, the median loss of sampled insurers was -3.9%, no greater than their loss in 2013. Reduced administrative costs offset increases in medical losses...
March 1, 2017: Medical Care Research and Review: MCRR
https://www.readbyqxmd.com/read/29148258/influence-of-medical-insurance-schemes-and-charity-assistance-projects-on-regular-prophylaxis-treatment-of-the-boys-with-severe-haemophilia-a-in-china
#12
Z Li, J Wu, Y Zhao, R Liu, K Li, Y Zhou, R Wu, R Yang, X Zhang, S Lian, Q Hu, X Li, J Gu, R Zhou, J Sun, C Li, W Xu, M-C Poon, J Xiao
OBJECTIVE: To explore the influence of medical insurance policy and charity assistance projects on the uptake and discontinuation of regular prophylaxis treatment in Chinese severe haemophilia A children. METHODOLOGY: This retrospective study was conducted on children with severe haemophilia A, who received FVIII prophylaxis treatment at 12 haemophilia centres in China from 1 November 2007 to 31 May 2013. RESULTS: The average duration of prophylaxis treatment received by haemophilia children significantly increased from 16...
November 17, 2017: Haemophilia: the Official Journal of the World Federation of Hemophilia
https://www.readbyqxmd.com/read/29147993/preparation-and-characterization-of-gelatin-sericin-carboxymethyl-chitosan-medical-tissue-glue
#13
Min Liang, Zhenzhu Li, Cengceng Gao, Fuping Wang, Zhongmin Chen
BACKGROUND: The development and application of medical glue has been continuously expanding and advancing. However, there are few glues that combine low-cost with excellent biocompatibility. METHODS: We have prepared a medical tissue glue using a gelatin (Gel), sericin (SS) and carboxymethyl chitosan (CMCS) blend solution, cross-linked with 1-ethyl-3-(3-dimethylaminopropyl)-carbodiimide (EDC). The combination's characteristics and microstructure morphology were observed by Fourier transform infrared spectroscopy (FT-IR) and scanning electron microscope (SEM)...
November 16, 2017: Journal of Applied Biomaterials & Functional Materials
https://www.readbyqxmd.com/read/29147645/real-world-cure-rates-for-hepatitis-c-virus-treatments-that-include-simeprevir-and-or-sofosbuvir-are-comparable-to-clinical-trial-results
#14
Kian Bichoupan, Neeta Tandon, James F Crismale, Joshua Hartman, David Del Bello, Neal Patel, Sweta Chekuri, Alyson Harty, Michel Ng, Keith M Sigel, Meena B Bansal, Priya Grewal, Charissa Y Chang, Jennifer Leong, Gene Y Im, Lawrence U Liu, Joseph A Odin, Nancy Bach, Scott L Friedman, Thomas D Schiano, Ponni V Perumalswami, Douglas T Dieterich, Andrea D Branch
AIM: To assess the real-world effectiveness and cost of simeprevir (SMV), and/or sofosbuvir (SOF)-based therapy for chronic hepatitis C virus (HCV) infection. METHODS: The real-world performance of patients treated with SMV/SOF ± ribavirin (RBV), SOF/RBV, and SOF/RBV with pegylated-interferon (PEG) were analyzed in a consecutive series of 508 patients with chronic HCV infection treated at a single academic medical center. Patients with genotypes 1 through 4 were included...
November 12, 2017: World Journal of Virology
https://www.readbyqxmd.com/read/29147166/a-cost-utility-analysis-of-endovascular-aneurysm-repair-for-abdominal-aortic-aneurysm
#15
Yutaka Takayama
Objective: To assess medical economic adequacy of endovascular aneurysm repair (EVAR) for abdominal aortic aneurysm (AAA). Methods: Cost-utility analysis. A total of 21 patients with AAA treated at Ibaraki Prefectural Central Hospital in 2014 were divided into non-ruptured EVAR (Group E) and open surgery (OS) (Group O), and ruptured OS (Group R) groups, and hospital costs were aggregated with a medical accounting system. Mid-level hospital costs were estimated by a diagnosis-procedure-combination analysis system...
September 25, 2017: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/29146657/a-randomised-controlled-trial-of-a-duodenal-jejunal-bypass-sleeve-device-endobarrier-compared-with-standard-medical-therapy-for-the-management-of-obese-subjects-with-type-2-diabetes-mellitus
#16
Michael Alan Glaysher, Aruchuna Mohanaruban, Christina Gabriele Prechtl, Anthony P Goldstone, Alexander Dimitri Miras, Joanne Lord, Navpreet Chhina, Emanuela Falaschetti, Nicholas Andrew Johnson, Werd Al-Najim, Claire Smith, Jia V Li, Mayank Patel, Ahmed R Ahmed, Michael Moore, Neil Poulter, Stephen Bloom, Ara Darzi, Carel Le Roux, James P Byrne, Julian P Teare
INTRODUCTION: The prevalence of obesity and obesity-related diseases, including type 2 diabetes mellitus (T2DM), is increasing. Exclusion of the foregut, as occurs in Roux-en-Y gastric bypass, has a key role in the metabolic improvements that occur following bariatric surgery, which are independent of weight loss. Endoscopically placed duodenal-jejunal bypass sleeve devices, such as the EndoBarrier (GI Dynamics, Lexington, Massachusetts, USA), have been designed to create an impermeable barrier between chyme exiting the stomach and the mucosa of the duodenum and proximal jejunum...
November 15, 2017: BMJ Open
https://www.readbyqxmd.com/read/29146652/dynamic-treatment-selection-and-modification-for-personalised-blood-pressure-therapy-using-a-markov-decision-process-model-a-cost-effectiveness-analysis
#17
Sung Eun Choi, Margaret L Brandeau, Sanjay Basu
OBJECTIVE: Personalised medicine seeks to select and modify treatments based on individual patient characteristics and preferences. We sought to develop an automated strategy to select and modify blood pressure treatments, incorporating the likelihood that patients with different characteristics would benefit from different types of medications and dosages and the potential severity and impact of different side effects among patients with different characteristics. DESIGN, SETTING AND PARTICIPANTS: We developed a Markov decision process (MDP) model to incorporate meta-analytic data and estimate the optimal treatment for maximising discounted lifetime quality-adjusted life-years (QALYs) based on individual patient characteristics, incorporating medication adjustment choices when a patient incurs side effects...
November 15, 2017: BMJ Open
https://www.readbyqxmd.com/read/29146648/economic-evaluation-of-an-e-mental-health-intervention-for-patients-with-retinal-exudative-diseases-who-receive-intraocular-anti-vegf-injections-e-pseye-protocol-for-a-randomised-controlled-trial
#18
Hilde P A van der Aa, Ger H M B van Rens, Frank D Verbraak, Machteld Bosscha, Marc A Koopmanschap, Hannie C Comijs, Pim Cuijpers, Ruth M A van Nispen
INTRODUCTION: Because of the great potential of vascular endothelial growth factor inhibitors (anti-VEGF) for retinal exudative diseases, an increased number of patients receives this treatment. However, during this treatment, patients are subjected to frequent invasive intravitreal injections, and the effects on reversing the process of vision loss are uncertain, which may have negative consequences for patients' mental health. One in three patients experience at least mild symptoms of depression/anxiety...
November 15, 2017: BMJ Open
https://www.readbyqxmd.com/read/29146647/initial-non-operative-management-of-uncomplicated-appendicitis-in-children-a-protocol-for-a-multicentre-randomised-controlled-trial-apac-trial
#19
Max Knaapen, Johanna H van der Lee, Roel Bakx, Sarah-May L The, Ernst W E van Heurn, Hugo A Heij, Ramon R Gorter
INTRODUCTION: Based on epidemiological, immunological and pathology data, the idea that appendicitis is not necessarily a progressive disease is gaining ground. Two types are distinguished: simple and complicated appendicitis. Non-operative treatment (NOT) of children with simple appendicitis has been investigated in several small studies. So far, it is deemed safe. However, its effectiveness and effect on quality of life (QoL) have yet to be established in an adequately powered randomised trial...
November 15, 2017: BMJ Open
https://www.readbyqxmd.com/read/29146646/cross-sectional-study-of-the-financial-cost-of-training-to-the-surgical-trainee-in-the-uk-and-ireland
#20
John O'Callaghan, Helen M Mohan, Anna Sharrock, Vimal Gokani, J Edward Fitzgerald, Adam P Williams, Rhiannon L Harries
OBJECTIVES: Applications for surgical training have declined over the last decade, and anecdotally the costs of training at the expense of the surgical trainee are rising. We aimed to quantify the costs surgical trainees are expected to cover for postgraduate training. DESIGN: Prospective, cross-sectional, questionnaire-based study. SETTING/PARTICIPANTS: A non-mandatory online questionnaire for UK-based trainees was distributed nationally...
November 15, 2017: BMJ Open
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