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https://www.readbyqxmd.com/read/28431457/precision-medicine-and-pharmacogenetics-what-does-oncology-have-that-addiction-medicine-does-not
#1
Henry R Kranzler, Rachel V Smith, Robert Schnoll, Afaf Moustafa, Emma Greenstreet-Akman
BACKGROUND AND AIMS: Precision, personalized or stratified medicine, which promises to deliver the right treatment to the right patient, is a topic of international interest in both the lay press and the scientific literature. A key aspect of precision medicine is the identification of biomarkers that predict the response to medications (i.e. pharmacogenetics). We examined why, despite the great strides that have been made in biomarker identification in many areas of medicine, only in oncology has there been substantial progress in their clinical implementation...
April 21, 2017: Addiction
https://www.readbyqxmd.com/read/28431439/-quality-of-and-attendance-at-healthy-child-clinics-in%C3%A2-germany
#2
Alexandra Weithase, Mandy Vogel, Henriette Kiep, Sarah Schwarz, Laura Meißner, Janine Herrmann, Kristin Rieger, Christiane Koch, Volker Schuster, Wieland Kiess
Background For several years the German healthy child clinics program has been a highly appreciated preventive measure and is subject to constant development. However, attendance depends on the families' sociodemographic situation. Findings are documented in a medical checkup booklet (the so-called Gelbes Heft). Currently, there is no procedure to use the data collected for epidemiological purposes nor to evaluate the pediatric prevention measures in Germany. Methods Between 2011 and 2016, we recruited 3480 study participants for our population-based cohort study LIFE Child in Leipzig...
April 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28431364/the-humanistic-and-economic-burden-of-dravet-syndrome-on-caregivers-and-families-implications-for-future-research
#3
REVIEW
Mark P Jensen, Andreas Brunklaus, Liam Dorris, Sameer M Zuberi, Kelly G Knupp, Bradley S Galer, Arnold R Gammaitoni
We reviewed the current literature with respect to the humanistic and financial burdens of Dravet Syndrome (DS) on the caregivers of children with DS, in order to (1) identify key unanswered questions or gaps in knowledge that need to be addressed and then, based on these knowledge gaps, (2) propose a research agenda for the scientific community to address in the coming decade. The findings support the conclusion that caring for a child with DS is associated with significant humanistic burden and direct costs...
April 17, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28431202/pharmacological-interventions-for-acute-pancreatitis
#4
REVIEW
Elisabetta Moggia, Rahul Koti, Ajay P Belgaumkar, Federico Fazio, Stephen P Pereira, Brian R Davidson, Kurinchi Selvan Gurusamy
BACKGROUND: In people with acute pancreatitis, it is unclear what the role should be for medical treatment as an addition to supportive care such as fluid and electrolyte balance and organ support in people with organ failure. OBJECTIVES: To assess the effects of different pharmacological interventions in people with acute pancreatitis. SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials (CENTRAL, 2016, Issue 9), MEDLINE, Embase, Science Citation Index Expanded, and trial registers to October 2016 to identify randomised controlled trials (RCTs)...
April 21, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28430850/trends-in-hospitalization-for-hypertensive-emergency-and-relationship-of-end-organ-damage-with-in-hospital-mortality
#5
Mahek Shah, Shantanu Patil, Brijesh Patel, Shilpkumar Arora, Nilay Patel, Lohit Garg, Sahil Agrawal, Larry Jacobs, Susan P Steigerwalt, Matthew W Martinez
BACKGROUND: There are no comprehensive guidelines on management of hypertensive emergency (HTNE) and complications. Despite advances in antihypertensive medications HTNE is accompanied with significant morbidity and mortality. METHODS: We queried the 2002-2012 nationwide inpatient sample database to identify patients with HTNE. Trends in incidence of HTNE and in-hospital mortality were analyzed. Logistic regression analysis was used to assess the relationship between end-organ complications and in-hospital mortality...
April 20, 2017: American Journal of Hypertension
https://www.readbyqxmd.com/read/28430557/utilization-management-of-high-cost-imaging-in-an-outpatient-setting-in-a-large-stable-patient-and-provider-cohort-over-7-years
#6
Jeffrey B Weilburg, Christopher L Sistrom, Daniel I Rosenthal, Markus B Stout, Keith J Dreyer, Helaine R Rockett, Jason M Baron, Timothy G Ferris, James H Thrall
Purpose To quantify the effect of a comprehensive, long-term, provider-led utilization management (UM) program on high-cost imaging (computed tomography, magnetic resonance imaging, nuclear imaging, and positron emission tomography) performed on an outpatient basis. Materials and Methods This retrospective, 7-year cohort study included all patients regularly seen by primary care physicians (PCPs) at an urban academic medical center. The main outcome was the number of outpatient high-cost imaging examinations per patient per year ordered by the patient's PCP or by any specialist...
April 21, 2017: Radiology
https://www.readbyqxmd.com/read/28430007/the-feasibility-and-impact-of-prospective-medication-review-in-the-emergency-department
#7
Billy Sin, Kwong Lau, Richard Tong, Josel Ruiz, Kimberly Sarosky, Robert DiGregorio, Shalom Butel, Sylvie de Souza
OBJECTIVE: We evaluated the feasibility and impact of prospective medication review (PMR) in the emergency department (ED). METHODS: This was a retrospective cohort study of all nonadmitted ED patients who were prescribed medication orders by ED clinicians from September 2014 to September 2015 to determine the time intervals utilized during each step of the medication use process and quantify the number of interventions conducted by the pharmacist and cost avoidance accrued from the interventions...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/28429986/have-individual-medical-savings-accounts-accumulated-meaningful-balances-after-10-years-of-enrolment-empirical-evidence-from-china
#8
Hao Yu, Jiaying Chen
Objectives To examine whether medical savings accounts in China have achieved the intended goal of promoting individual savings for medical care. Method Longitudinal data were obtained from one of the first Chinese cities that implemented medical savings accounts. The sample includes 246,681 enrolees with participation of at least 10 years by the end of 2010. We conducted descriptive analyses of medical savings account balances and a series of multivariate logistic analyses of risk factors for having low medical savings account accumulation...
January 1, 2017: Journal of Health Services Research & Policy
https://www.readbyqxmd.com/read/28429975/the-real-cost-of-training-health-professionals-in-australia-it-costs-as-much-to-build-a-dietician-workforce-as-a-dental-workforce
#9
Leonie Segal, Claire Marsh, Rob Heyes
Objectives We explored the real cost of training the workforce in a range of primary health care professions in Australia with a focus on the impact of retention to contribute to the debate on how best to achieve the optimal health workforce mix. Methods The cost to train an entry-level health professional across 12 disciplines was derived from university fees, payment for clinical placements and, where relevant, cost of internship, adjusted for student drop-out. Census data were used to identify the number of qualified professionals working in their profession over a working life and to model expected years of practice by discipline...
April 2017: Journal of Health Services Research & Policy
https://www.readbyqxmd.com/read/28429577/investigating-general-medication-prescription-by-general-practitioners-during-a-12-month-randomized-controlled-weight-loss-trial
#10
N R Fuller, N S Lau, T P Markovic, I D Caterson
Much healthcare expenditure is on pharmaceutical drugs. Expenditure on medications has increased both in absolute terms, and as a proportion of total health expenditure. No previous studies have investigated the prescribing costs by general practitioners when managing patients during a weight loss intervention. This study evaluated the medication costs by individual class during a 1-year study in which 268 participants were randomized to one of two weight loss programmes, either standard care (SC) as defined by national guidelines, or a commercial provider (Weight Watchers) (CP)...
April 20, 2017: Clinical Obesity
https://www.readbyqxmd.com/read/28428922/the-cost-benefit-balance-of-statins-in-hawai-i-a-moving-target
#11
Corey J Lum, Kazuma Nakagawa, Ralph V Shohet, Todd B Seto, Deborah A Taira
Statins are lipid-lowering medications used for primary and secondary prevention of atherosclerotic disease and represent a substantial portion of drug costs in the United States. A better understanding of prescribing patterns and drug costs should lead to more rational utilization and help constrain health care expenditures in the United States. The 2013 Medicare Provider Utilization and Payment Data: Part D Prescriber Public Use File for the State of Hawai'i was analyzed. The number of prescriptions for statins, total annual cost, and daily cost were calculated by prescriber specialty and drug...
April 2017: Hawai'i Journal of Medicine & Public Health: a Journal of Asia Pacific Medicine & Public Health
https://www.readbyqxmd.com/read/28428160/simulated-conversations-with-virtual-humans-to-improve-patient-provider-communication-and-reduce-unnecessary-prescriptions-for-antibiotics-a-repeated-measure-pilot-study
#12
Antoinette Schoenthaler, Glenn Albright, Judith Hibbard, Ron Goldman
BACKGROUND: Despite clear evidence that antibiotics do not cure viral infections, the problem of unnecessary prescribing of antibiotics in ambulatory care persists, and in some cases, prescribing patterns have increased. The overuse of antibiotics for treating viral infections has created numerous economic and clinical consequences including increased medical costs due to unnecessary hospitalizations, antibiotic resistance, disruption of gut bacteria, and obesity. Recent research has underscored the importance of collaborative patient-provider communication as a means to reduce the high rates of unnecessary prescriptions for antibiotics...
April 19, 2017: JMIR Medical Education
https://www.readbyqxmd.com/read/28428157/texting-and-mobile-phone-app-interventions-for-improving-adherence-to-preventive-behavior-in-adolescents-a-systematic-review
#13
Sherif M Badawy, Lisa M Kuhns
BACKGROUND: Many preventable behaviors contribute to adolescent mortality and morbidity. Non-adherence to preventive measures represents a challenge and has been associated with worse health outcomes in this population. The widespread use of electronic communication technologies by adolescents, particularly the use of text messaging (short message service, SMS) and mobile phones, presents new opportunities to intervene on risk and preventive risk behavior, but little is known about their efficacy...
April 19, 2017: JMIR MHealth and UHealth
https://www.readbyqxmd.com/read/28427977/decompressive-craniectomy-in-spontaneous-intracerebral-hemorrhage-a-case-control-study
#14
Yu Tung Lo, Angela An Qi See, Nicolas Kon Kam King
BACKGROUND: Decompressive craniectomy is performed to relieve intracranial pressure as an emergency procedure. There is no large study to systematically evaluate the benefit of decompressive craniectomy versus best medical therapy. This study evaluates the survival and long-term functional outcomes of decompressive craniectomy for spontaneous intracranial hemorrhage. METHODS: A total of 54 eligible patients with spontaneous supratentorial hemorrhage (median age 55, IQR 47-64) who underwent decompressive craniectomy were retrospectively matched to 72 patients managed with best medical treatment (median age 58, IQR 32-74)...
April 17, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28427793/contribution-of-health-care-factors-to-the-burden-of-skin-disease-in-the-united-states
#15
Henry W Lim, Scott A B Collins, Jack S Resneck, Jean L Bolognia, Julie A Hodge, Thomas A Rohrer, Marta J Van Beek, David J Margolis, Arthur J Sober, Martin A Weinstock, David R Nerenz, Wendy Smith Begolka, Jose V Moyano
The American Academy of Dermatology has developed an up-to-date national Burden of Skin Disease Report on the impact of skin disease on patients and on the US population. In this second of 3 manuscripts, data are presented on specific health care dimensions that contribute to the overall burden of skin disease. Through the use of data derived from medical claims in 2013 for 24 skin disease categories, these results indicate that skin disease health care is delivered most frequently to the aging US population, who are afflicted with more skin diseases than other age groups...
April 17, 2017: Journal of the American Academy of Dermatology
https://www.readbyqxmd.com/read/28427766/evaluation-of-a-model-of-integrated-care-for-patients-with-chronic-medical-and-psychiatric-illness
#16
Aghaegbulam Uga, Shreedhar Kulkarni, Vineka Heeramun, Kathy Bottum
BACKGROUND: Chronic illnesses are prevalent in general medical and psychiatric practices, causing significant disease burden to care givers and providers. Systems of care that treat individuals with mental illness are often separate from general medical systems of care. OBJECTIVE: This study sought to compare the quality of life, satisfaction with care, and utilization of care in patients with comorbid chronic medical and mental illnesses. METHODS: A total of 64 participants from an integrated medicine and psychiatry clinic (med/psych), were compared with 52 patients from separate internal medicine and psychiatry clinics (within the same institution) for quality of life, satisfaction with care, and utilization of care...
February 20, 2017: Psychosomatics
https://www.readbyqxmd.com/read/28427550/home-made-spacer-as-an-auxiliary-device-in-administration-of-beclomethasone-via-pressurized-metered-dose-inhaler-for-asthma-control-a-randomized-controlled-pragmatic-trial
#17
Deborah Schor, José Ângelo Rizzo, Decio Medeiros, Ana Carolina Dela Bianca, Almerinda Rego Silva, Carlos Nunes, Mário Morais-Almeida, Emanuel Sarinho
BACKGROUND: Holding chambers or spacers can enhance the efficacy of pressurized metered dose inhalers (pMDI) in delivering inhaled medications, as they reduce the need for hand-breath coordination and improve lower airways deposition. Nevertheless, their cost can be high for patients in low-income countries. OBJECTIVE: To compare asthma control achieved with beclomethasone-dipropionate administered through a hydrofluoroalkane-driven pMDI (BDp-pMDI) coupled to a home-made spacer (HmS) or to a valved commercial spacer (VCS) as auxiliary devices...
May 2017: Respiratory Medicine
https://www.readbyqxmd.com/read/28427338/-working-is-out-of-the-question-a-qualitative-text-analysis-of-medical-certificates-of-disability
#18
Guri Aarseth, Bård Natvig, Eivind Engebretsen, Anne Kveim Lie
BACKGROUND: Medical certificates influence the distribution of economic benefits in welfare states; however, the qualitative aspects of these texts remain largely unexplored. The present study is the first systematic investigation done of these texts. Our aim was to investigate how GPs select and mediate information about their patients' health and how they support their conclusions about illness, functioning and fitness for work in medical certificates. METHODS: We performed a textual analysis of thirty-three medical certificates produced by general practitioners (GP) in Norway at the request of the Norwegian Labour and Welfare Administration (NAV)...
April 20, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28427321/in-silico-assessment-of-biomedical-products-the-conundrum-of-rare-but-not-so-rare-events-in-two-case-studies
#19
Marco Viceconti, Claudio Cobelli, Tarek Haddad, Adam Himes, Boris Kovatchev, Mark Palmer
In silico clinical trials, defined as "The use of individualized computer simulation in the development or regulatory evaluation of a medicinal product, medical device, or medical intervention," have been proposed as a possible strategy to reduce the regulatory costs of innovation and the time to market for biomedical products. We review some of the the literature on this topic, focusing in particular on those applications where the current practice is recognized as inadequate, as for example, the detection of unexpected severe adverse events too rare to be detected in a clinical trial, but still likely enough to be of concern...
May 2017: Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine
https://www.readbyqxmd.com/read/28426843/understanding-the-risks-and-harms-of-management-of-incidental-thyroid-nodules-a-review
#20
Jenny K Hoang, Xuan V Nguyen
Importance: Incidental thyroid nodules are defined as nodules originally detected in a patient with no thyroid-related clinical symptoms, examination findings, or suspected thyroid disease. Medical imaging for diseases in the neck, chest, and spine is a common source of incidental thyroid nodules. They are easily detected but poorly characterized. The next step is to decide whether the incidental thyroid nodule should be further evaluated with ultrasonography. Observations: Indiscriminate workup of incidental thyroid nodules with ultrasonography is not cost-effective and is potentially harmful...
April 20, 2017: JAMA Otolaryngology—Head & Neck Surgery
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