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https://www.readbyqxmd.com/read/28532047/porous-chitosan-microspheres-for-application-as-quick-in-vitro-and-in-vivo-hemostat
#1
Jixiang Li, Xiaowei Wu, Yanqing Wu, Zonghao Tang, Xun Sun, Meng Pan, Yufeng Chen, Juanjuan Li, Rongdong Xiao, Zhengchao Wang, Haiqing Liu
Controlling massive hemorrhage is of great importance to lower transfusional medical cost, and to reduce death and mobility rate in battlefield and civilian accidents. We reported the fabrication of porous chitosan microspheres (CSMS) with tunable surface pore size by microemulsion combined with thermally induced phase separation technique, and its application as a quick hemostat. Their hemostatic property was characterized by blood clotting kinetics, adherence interaction between red blood cells/platelets and CSMS, in vitro and in vivo hemostasis by rat tail amputation and liver laceration models, and histological analysis...
August 1, 2017: Materials Science & Engineering. C, Materials for Biological Applications
https://www.readbyqxmd.com/read/28531782/the-financial-burden-of-malnutrition-in-hospitalized-pediatric-patients-under-five-years-of-age
#2
Kulnipa Kittisakmontri, Onwaree Sukhosa
BACKGROUND: Under-five children are a medically fragile group which is compromised by hospitalization. Malnutrition in those patients not only increases complications and mortality but also affects hospital resource utilization. Therefore, this study was conducted to clarify the impact of malnutrition on hospital expenditures. METHODS: This prospective cohort study was performed at a tertiary hospital in Thailand. Under-five children who were admitted to general pediatric wards were included...
October 2016: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/28531775/a-protocol-for-sustained-reduction-of-total-parenteral-nutrition-and-cost-savings-by-improvement-of-nutritional-care-in-hospitals
#3
Rian van Schaik, Kurt Van den Abeele, Glenn Melsens, Peter Schepens, Truus Lanssens, Bernadette Vlaemynck, Maria Devisch, Theo A Niewold
BACKGROUND AND AIMS: Malnutrition and the use of Total Parenteral Nutrition (TPN) contribute considerably to hospital costs. Recently, we reported on the introduction of malnutrition screening and monitoring of TPN use in our hospital, which resulted in a large (40%) reduction in TPN and improved quality of nutritional care in two years (2011/12). Here, we aimed to assure continuation of improved care by developing a detailed malnutrition screening and TPN use protocol involving instruction tools for hospital staff, while monitoring the results in the following two years (2013/14)...
October 2016: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/28531288/an-evaluation-of-systemic-reforms-of-public-hospitals-the-sanming-model-in-china
#4
Hongqiao Fu, Ling Li, Mingqiang Li, Chunyu Yang, William Hsiao
Low- and middle-income countries (LMICs) have been searching for effective strategies to reform their inefficient and wasteful public hospitals. Recently, China developed a model of systemic reforms called the Sanming model to address the inefficiency and waste at public hospitals. In this article, we explain and evaluate how the Sanming model reformed its 22 public hospitals in 2013 by simultaneously restructuring the hospital governance structure, altering the payment system to hospitals, and realigning physicians' incentives...
May 20, 2017: Health Policy and Planning
https://www.readbyqxmd.com/read/28531247/the-health-cost-of-tobacco-use-in-uganda
#5
Nigar Nargis, Kellen Nyamurungi, Sebastian Olakira Baine, Daniel Kadobera
The economic cost of tobacco use is well documented in high-income countries. It has been measured in relatively fewer low-and middle-income countries, and much less in sub-Saharan Africa despite the longstanding recognition of significant current and future health risk to people attributed by tobacco use in this region. This article fills this gap by estimating the economic cost of tobacco use in Uganda, a low-income country in sub-Saharan Africa. This study estimates the economic cost of tobacco use in Uganda using the cost-of-illnesses approach based on data collected from a survey of patients and caregivers in four major service centers in Mulago National Referral Hospital, namely, Uganda Cancer Institute, Uganda Heart Institute, Chest Clinic and Diabetic Clinic, key informant interviews and secondary sources for the year 2014...
May 22, 2017: Health Policy and Planning
https://www.readbyqxmd.com/read/28531205/cost-analysis-of-human-papillomavirus-related-cervical-diseases-and-genital-warts-in-swaziland
#6
Themba G Ginindza, Benn Sartorius, Xolisile Dlamini, Ellinor Östensson
BACKGROUND: Human papillomavirus (HPV) has proven to be the cause of several severe clinical conditions on the cervix, vulva, vagina, anus, oropharynx and penis. Several studies have assessed the costs of cervical lesions, cervical cancer (CC), and genital warts. However, few have been done in Africa and none in Swaziland. Cost analysis is critical in providing useful information for economic evaluations to guide policymakers concerned with the allocation of resources in order to reduce the disease burden...
2017: PloS One
https://www.readbyqxmd.com/read/28530527/health-care-costs-associated-with-addition-titration-and-switching-antihypertensive-medications-after-first-line-treatment-results-from-a-commercially-insured-sample
#7
Kalyani B Sonawane Deshmukh, Jingjing Qian, Kimberly B Garza, Bradley M Wright, Peng Zeng, Cecilia M Ganduglia Cazaban, Richard A Hansen
BACKGROUND: Treatment modifications are necessary for addressing issues related to efficacy and tolerance of first-line monotherapy, but they increase the economic burden on patients and their health plans. Understanding the differences in costs between alternative treatment modification strategies, if any, can serve as a guideline for clinical decision making and for designing cost-containment strategies. OBJECTIVE: To compare the health care utilization costs between (a) addition (i...
June 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28530525/cost-effectiveness-of-nivolumab-ipilimumab-combination-therapy-compared-with-monotherapy-for-first-line-treatment-of-metastatic-melanoma-in-the-united-states
#8
Anna Oh, Dang M Tran, Leann C McDowell, Dor Keyvani, Jay Andrew Barcelon, Oscar Merino, Leslie Wilson
BACKGROUND: The approval of new immunotherapies has dramatically changed the treatment landscape of metastatic melanoma. These survival gains come with trade-offs in side effects and costs, as well as important considerations for third-party payer systems, physicians, and patients. OBJECTIVE: To develop a Markov model to determine the cost-effectiveness of nivolumab, ipilimumab, and nivolumab-ipilimumab combination as firstline therapy in metastatic melanoma, while accounting for differential effectiveness in programmed death-ligand 1 (PD-L1) positive and negative patients...
June 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28530523/cost-effectiveness-of-peginterferon-beta-1a-and-alemtuzumab-in-relapsing-remitting-multiple-sclerosis
#9
Ankur A Dashputre, Khalid M Kamal, Gauri Pawar
BACKGROUND: Multiple sclerosis (MS) is a chronic inflammatory disorder of the central nervous system, affecting 2.5 million people globally and 400,000 people in the United States. While no cure exists for MS, the goal is to manage the disease using disease-modifying therapies (DMTs), which have been shown to slow disease progression and prevent relapses. Relapsing-remitting MS (RRMS) is the most common form of MS at the time of diagnosis. Peginterferon beta-1a (PEG) and alemtuzumab (ALT) were recently approved and have demonstrated good clinical outcomes, including reduced relapse rates in clinical trials...
June 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28530522/factors-associated-with-adherence-to-and-treatment-duration-of-erlotinib-among-patients-with-non-small-cell-lung-cancer
#10
Lisa M Hess, Anthony Louder, Katherine Winfree, Yajun E Zhu, Ana B Oton, Radhika Nair
BACKGROUND: In lung cancer, there is an increasing number of oral agents available for patients; however, little is known about the factors associated with adherence to and treatment duration on oral medications in non-small cell lung cancer (NSCLC). OBJECTIVE: To evaluate the clinical and demographic factors associated with adherence and treatment discontinuation, respectively, to oral oncolytics among patients with NSCLC. METHODS: A retrospective, claims-based analysis of the Humana Research Database supplemented with medical chart review was conducted among patients with NSCLC who started an oral oncolytic between January 1, 2008, and June 30, 2013...
June 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28530521/the-direct-cost-of-managing-a-rare-disease-assessing-medical-and-pharmacy-costs-associated-with-duchenne-muscular-dystrophy-in-the-united-states
#11
Sarah Thayer, Christopher Bell, Craig M McDonald
BACKGROUND: A Duchenne muscular dystrophy (DMD) cohort was identified using a claims-based algorithm to estimate health care utilization and costs for commercially insured DMD patients in the United States. Previous analyses have used broad diagnosis codes that include a range of muscular dystrophy types as a proxy to estimate the burden of DMD. OBJECTIVE: To estimate DMD-associated resource utilization and costs in a sample of patients identified via a claims-based algorithm using diagnosis codes, pharmacy prescriptions, and procedure codes unique to DMD management based on DMD clinical milestones...
June 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28530519/does-a-one-size-fits-all-cost-sharing-approach-incentivize-appropriate-medication-use-a-roundtable-on-the-fairness-and-ethics-associated-with-variable-cost-sharing
#12
Jennifer S Graff, Chuck Shih, Thomas Barker, Gabriela Dieguez, Cheryl Larson, Helen Sherman, Robert W Dubois
BACKGROUND: Tiered formularies, in which patients pay copays or coinsurance out-of-pocket (OOP), are used to manage costs and encourage more efficient health care resource use. Formulary tiers are typically based on the cost of treatment rather than the medical appropriateness for the patient. Cost sharing may have unintended consequences on treatment adherence and health outcomes. Use of higher-cost, higher-tier medications can be due to a variety of factors, including unsuccessful treatment because of lack of efficacy or side effects, patient clinical or genetic characteristics, patient preferences to avoid potential side effects, or patient preferences based on the route of administration...
June 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28530492/3d-printing-in-liver-surgery-a-systematic-review
#13
Jan Sylwester Witowski, Jasamine Coles-Black, Tomasz Zbigniew Zuzak, Michał Pędziwiatr, Jason Chuen, Piotr Major, Andrzej Budzyński
BACKGROUND: Rapid growth of three-dimensional (3D) printing in recent years has led to new applications of this technology across all medical fields. This review article presents a broad range of examples on how 3D printing is facilitating liver surgery, including models for preoperative planning, education, and simulation. MATERIALS AND METHODS: We have performed an extensive search of the medical databases Ovid/MEDLINE and PubMed/EMBASE and screened articles fitting the scope of review, following previously established exclusion criteria...
May 22, 2017: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/28530330/-the-sherlock-system-clinical-and-logistic-pharmaceutical-services
#14
Roni Leibowitz, Shahar Aflalo, Ornit Cohen, Ahuva Lustig
BACKGROUND: The drug inventory in the hospital consumes a large part of the hospital's budget. Classic drug management is based on weekly visits of the pharmacist in the departments, writing an order and dispensing it. This method is wasteful in terms of sending a bulk of drugs that will not necessarily be utilized, and it is also inefficient in terms of human resources. The unit-dose method, which is more advanced, is based on filling out individual prescriptions for each of the inpatients in the department...
August 2016: Harefuah
https://www.readbyqxmd.com/read/28530118/readmission-to-intensive-care-unit-incidence-risk-factors-resource-use-and-outcomes-a-retrospective-cohort-study
#15
Carolina R Ponzoni, Thiago D Corrêa, Roberto R Filho, Ary Serpa Neto, Murillo Sc Assunção, Andreia Pardini, Guilherme Pp Schettino
RATIONALE: Readmission to intensive care unit (ICU) is associated with poor clinical outcomes, increased length of ICU and hospital stay and higher costs. Nevertheless, knowledge on epidemiology of ICU readmissions, risk factors and attributable outcomes are restricted to developed countries. OBJECTIVES: Determine the effect of ICU readmissions on in-hospital mortality, incidence of ICU readmissions, identify predictors of ICU readmissions and hospital mortality and compare resource use and outcomes between readmitted and nonreadmitted patients in a developing country...
May 21, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28530050/-modern-over-the-good-and-old
#16
Sharon Baum, Aviv Barzilai
Modern dermatology is a reflection of the advances achieved in the general medical world. Thus, in recent years, dermatology encompasses many different fields and consequently, various subspecialties were created. In addition to dermatopathology and dermatosurgery, which are formal subspecialties, other fields of expertise include: autoimmune diseases, especially bullous diseases, hair and nail disorders, allergic diseases, infectious diseases and pigmented lesion clinics and oncodermatology. This current issue of "Harefuah" incorporates research and review articles from experts of the different subspecialties mentioned...
October 2016: Harefuah
https://www.readbyqxmd.com/read/28529224/-i-need-my-own-place-to-get-better-patient-perspectives-on-the-role-of-housing-in-potentially-preventable-hospitalizations
#17
Michelle L Quensell, Deborah A Taira, Todd B Seto, Kathryn L Braun, Tetine L Sentell
OBJECTIVE: To analyze patient perspectives on the role of housing in their potentially preventable hospitalization. METHODS: Individuals admitted with cardiovascular-or diabetes-related diagnoses (n = 90) in a major medical center in Hawai'i completed an in-person interview eliciting patient perspectives on key factors leading to hospitalization. Using the framework approach, two independent coders identified themes. This study focused on housing-related findings...
2017: Journal of Health Care for the Poor and Underserved
https://www.readbyqxmd.com/read/28529202/an-evaluation-of-automated-chest-radiography-reading-software-for-tuberculosis-screening-among-public-and-private-sector-patients
#18
Md Toufiq Rahman, Andrew J Codlin, Md Mahfuzur Rahman, Ayenun Nahar, Mehdi Reja, Tariqul Islam, Zhi Zhen Qin, Md Abdus Shakur Khan, Sayera Banu, Jacob Creswell
Computer-aided reading (CAR) of medical images is becoming increasingly common, but few studies exist for CAR in tuberculosis (TB). We designed a prospective study evaluating CAR for chest radiography (CXR) as a triage tool before Xpert MTB/RIF (Xpert).Consecutively enrolled adults in Dhaka, Bangladesh, with TB symptoms received CXR and Xpert. Each image was scored by CAR and graded by a radiologist. We compared CAR with the radiologist for sensitivity and specificity, area under the receiver operating characteristic curve (AUC), and calculated the potential Xpert tests saved...
May 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/28528713/sociodemographics-and-the-impact-of-a-colostomy-to-indigent-families-and-children-with-colorectal-disorders-in-honduras
#19
W Krois, A J M Dingemans, P X Hernández, M L Metzelder, J Craniotis Rios, C A Reck-Burneo
INTRODUCTION: To describe the social impact of a colostomy on indigent families and affected children with anorectal malformations (ARM) or Hirschsprung's disease (HD) in San Pedro Sula, Honduras, we specifically targeted very low-income households that attended an international medical brigade for ARM and HD in 2016. METHODS: The impact of a colostomy on the families and children's daily life was analyzed by personal interviews with a questionnaire. RESULTS: Twenty families with children were included in the study...
May 12, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28527738/life-cycle-assessment-of-sustainable-raw-material-acquisition-for-functional-magnetite-bionanoparticle-production
#20
Jhuma Sadhukhan, Nimisha Joshi, Mobolaji Shemfe, Jonathan R Lloyd
Magnetite nanoparticles (MNPs) have several applications, including use in medical diagnostics, renewable energy production and waste remediation. However, the processes for MNP production from analytical-grade materials are resource intensive and can be environmentally damaging. This work for the first time examines the life cycle assessment (LCA) of four MNP production cases: (i) industrial MNP production system; (ii) a state-of-the-art MNP biosynthesis system; (iii) an optimal MNP biosynthesis system and (iv) an MNP biosynthesis system using raw materials sourced from wastewaters, in order to recommend a sustainable raw material acquisition pathway for MNP synthesis...
May 17, 2017: Journal of Environmental Management
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