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https://www.readbyqxmd.com/read/28338552/is-the-future-of-coronary-arterial-revascularization-a-hybrid-approach-the-canadian-experience-across-three-centers
#1
Vincenzo Giambruno, Ahmad Hafiz, Stephanie A Fox, Hugues Jeanmart, Richard C Cook, Feras H Khaliel, Patrick Teefy, Kumar Sridhar, Shahar Lavi, Rodrigo Bagur, Varinder K Randhawa, Ivan Iglesias, Philip M Jones, Christopher C Harle, Daniel Bainbridge, Michael W A Chu, Bob B Kiaii
OBJECTIVE: Hybrid coronary revascularization offers and combines the advantages of both surgical and percutaneous revascularization and eliminates at the same time the disadvantages of both procedures. The objective of this study was to assess graft and stent patency at 6 months, rate of bleeding, intensive care unit and hospital stay, rate of reintervention, and long-term clinical follow-up. METHODS: From March 2004 to November 2015, a total of 203 patients underwent robotic-assisted minimally invasive direct coronary artery bypass graft of the left internal thoracic artery to the left anterior descending artery and PCI of a non-left anterior descending vessel in a single or two stage, at three different centers...
March 23, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28336758/evaluation-of-a-pharmacist-led-outpatient-direct-oral-anticoagulant-service
#2
Emily Ashjian, Brian Kurtz, Elizabeth Renner, Robert Yeshe, Geoffrey D Barnes
PURPOSE: The impact of a pharmacist-led direct oral anticoagulant (DOAC) service on prescription appropriateness and patient adherence was simultaneously evaluated. METHODS: In this retrospective analysis, patients age 18 years or older for whom a DOAC was prescribed from September 20, 2013, through December 31, 2014, were identified through electronic medical record review of all DOAC prescriptions within the University of Michigan Health System. Patients had their DOAC therapy managed by a pharmacist-led DOAC service or by their physician (usual care)...
April 1, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28333917/a-clinical-utility-study-of-exome-sequencing-versus-conventional-genetic-testing-in-pediatric-neurology
#3
Lisenka E L M Vissers, Kirsten J M van Nimwegen, Jolanda H Schieving, Erik-Jan Kamsteeg, Tjitske Kleefstra, Helger G Yntema, Rolph Pfundt, Gert Jan van der Wilt, Lotte Krabbenborg, Han G Brunner, Simone van der Burg, Janneke Grutters, Joris A Veltman, Michèl A A P Willemsen
PURPOSE: Implementation of novel genetic diagnostic tests is generally driven by technological advances because they promise shorter turnaround times and/or higher diagnostic yields. Other aspects, including impact on clinical management or cost-effectiveness, are often not assessed in detail prior to implementation. METHODS: We studied the clinical utility of whole-exome sequencing (WES) in complex pediatric neurology in terms of diagnostic yield and costs. We analyzed 150 patients (and their parents) presenting with complex neurological disorders of suspected genetic origin...
March 23, 2017: Genetics in Medicine: Official Journal of the American College of Medical Genetics
https://www.readbyqxmd.com/read/28333017/effect-of-prostate-magnetic-resonance-imaging-ultrasound-fusion-guided-biopsy-on-radiation-treatment-recommendations
#4
Aaron Reed, Luca F Valle, Uma Shankavaram, Andra Krauze, Aradhana Kaushal, Erica Schott, Theresa Cooley-Zgela, Bradford Wood, Peter Pinto, Peter Choyke, Baris Turkbey, Deborah E Citrin
PURPOSE: Targeted magnetic resonance imaging (MRI)/ultrasound fusion prostate biopsy (MRI-Bx) has recently been compared with the standard of care extended sextant ultrasound-guided prostate biopsy (SOC-Bx), with the former associated with an increased rate of detection of clinically significant prostate cancer. The present study sought to determine the influence of MRI-Bx on radiation therapy and androgen deprivation therapy (ADT) recommendations. METHODS AND MATERIALS: All patients who had received radiation treatment and had undergone SOC-Bx and MRI-Bx at our institution were included...
April 1, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/28331865/growth-hormone-utilization-review-in-a-pediatric-primary-care-setting
#5
Fatemeh Sayarifard, Fereshteh Bakhshi Imcheh, Shirinsadat Badri, Toktam Faghihi, Mostafa Qorbani, Mania Radfar
OBJECTIVE: One of the main problems facing public health providers and administrators in many countries is ensuring the rational use of high-cost drugs. In this regard, on-going process of medication use evaluation can be considered as a useful tool. In this study, we evaluated certain usage aspects of a highly-cost medication, that is, recombinant growth hormone (GH). METHODS: This cross-sectional study conducted from August 2012 to August 2014. Children receiving GH ± gonadotropin releasing hormone (GnRH) analogs were included in the study...
January 2017: Journal of Research in Pharmacy Practice
https://www.readbyqxmd.com/read/28331780/what-works-in-the-treatment-of-borderline-personality-disorder
#6
REVIEW
Lois W Choi-Kain, Ellen F Finch, Sara R Masland, James A Jenkins, Brandon T Unruh
PURPOSE OF THE REVIEW: This review summarizes advances in treatments for adults with borderline personality disorder (BPD) in the last 5 years. RECENT FINDINGS: Evidence-based advances in the treatment of BPD include a delineation of generalist models of care in contrast to specialist treatments, identification of essential effective elements of dialectical behavioral therapy (DBT), and the adaptation of DBT treatment to manage post-traumatic stress disorder (PTSD) and BPD...
2017: Current Behavioral Neuroscience Reports
https://www.readbyqxmd.com/read/28328872/the-role-of-the-iacuc-in-ensuring-research-reproducibility
#7
REVIEW
Jerald Silverman, James Macy, Patricia A Preisig
There is a "village" of people impacting research reproducibility, such as funding panels, the IACUC and its support staff, institutional leaders, investigators, veterinarians, animal facilities, and professional journals. IACUCs can contribute to research reproducibility by ensuring that reviews of animal use requests, program self-assessments and post-approval monitoring programs are sufficiently thorough, the animal model is appropriate for testing the hypothesis, animal care and use is conducted in a manner that is compliant with external and institutional requirements, and extraneous variables are minimized...
March 22, 2017: Lab Animal
https://www.readbyqxmd.com/read/28328764/simultaneous-determination-of-protein-unbound-cyclosporine-a-and-mycophenolic-acid-in-kidney-transplant-patients-using-liquid-chromatography-tandem-mass-spectrometry
#8
Heike Bittersohl, Juliane Herbinger, Ming Wen, Lutz Renders, Werner Steimer, Peter B Luppa
BACKGROUND: Therapeutic drug monitoring (TDM) of immunosuppressants is essential to optimize patient care after organ transplantation. In blood, most immunosuppressive drugs are bound to plasma proteins or located inside blood cells. However, it is generally assumed that only protein-unbound (free) drug concentrations are pharmacologically active and could therefore better reflect the clinical outcome. Study data are still limited due to lacking rapid analytical methods. Therefore, a simple multiplex method for direct measurement of free cyclosporine A (CsA) and mycophenolic acid (MPA) has been developed...
March 21, 2017: Therapeutic Drug Monitoring
https://www.readbyqxmd.com/read/28326200/the-anaesthesiologist-and-palliative-care-in-a-newborn-with-the-adam-sequence
#9
Alberto Vieira Pantoja, Maria Emília Gonçalves Estevez, Bruno Lima Pessoa, Fernando de Paiva Araújo, Bruno Mendonça Barcellos, Ciro Augusto Floriani, Marco Antonio Cardoso de Resende
Reports focusing on biomedical principlism and the role of anaesthesiologists in palliative care are rare. We present the case of a newborn with multiple craniofacial anomalies and a diagnosis of ADAM "sequence," in which surgical removal of placental adhesions to the dura mater and the correction of meningocele was not indicated due to the very short life expectancy. After 48 hours, the odor from the placenta indicted a necrotic process, which prevented the parents from being close to the child and increased his isolation...
2017: Case Reports in Anesthesiology
https://www.readbyqxmd.com/read/28325583/optimizing-endometrial-cancer-follow-up-and-survivorship-care-for-rural-and-other-underserved-women-patient-and-provider-perspectives
#10
Teresa L Rutledge, Miria Kano, Dolores Guest, Andrew Sussman, Anita Y Kinney
OBJECTIVES: This study describes patient and provider attitudes on transitioning cancer surveillance visits and treatment of comorbid conditions to the primary care setting in a rural patient population as a strategy for minimizing financial and travel related barriers for patients while simultaneously enhancing quality and availability of health care options. METHODS: Focus group discussions and telephone interviews were conducted with endometrial cancer (EC) survivors and primary care providers (PCPs) to provide insights into post-treatment follow-up practices and the acceptability of transitioning follow-up to primary care setting utilizing a cancer survivorship care plan model...
March 18, 2017: Gynecologic Oncology
https://www.readbyqxmd.com/read/28322584/editorial-comment-on-end-2016-0851-ra-r1
#11
Sara L Best
In their meta-analysis, Jones and colleagues found that bilateral synchronous PCNL was associated with similar stone free outcomes and complication rates as those reported for unilateral PCNL. The authors do an excellent job in emphasizing that BS-PCNL has primarily been reported by high volume centers. Previous investigations have demonstrated that PCNL outcomes are better and complication rates are lower at high volume centers.(1) Institutions that perform few PCNLs should be cautious about performing simultaneous bilateral procedures as their complication rate may be higher and exposing the patient to acute kidney injury could prove devastating...
March 21, 2017: Journal of Endourology
https://www.readbyqxmd.com/read/28322345/nursing-staff-fluctuation-and-pathogenic-burden-in-the-nicu-effective-outbreak-management-and-the-underestimated-relevance-of-non-resistant-strains
#12
Kai O Hensel, Rhea van den Bruck, Ingo Klare, Michael Heldmann, Beniam Ghebremedhin, Andreas C Jenke
In the course of a hospital management takeover, a microbial outbreak took place in a tertiary neonatal intensive care unit (NICU). Here, we characterize the outbreak and its management. About 4 months prior to takeover, there was a sharp increase in positive isolates for MSSA and multidrug-resistant organisms (MDROs). Simultaneously, the nursing staff sick leave rate increased dramatically which directly correlated with the number of infection/colonization per week (r(2) = 0.95, p = 0.02). During the following months we observed several peaks in positive isolates of methicillin-sensitive staphylococcus aureus (MSSA), MDROs and subsequently a vancomycin-resistant enterococcus (VRE) outbreak...
March 21, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28320688/implementation-of-a-home-monitoring-system-for-heart-failure-patients-a-feasibility-study
#13
Martin Steven Kohn, Jeffrey Haggard, Jack Kreindler, Kade Birkeland, Ilan Kedan, Raymond Zimmer, Raj Khandwalla
BACKGROUND: Improving the management of patients with complex chronic disease is a substantial undertaking with the simultaneous goals of improving patient outcomes and controlling costs. Reducing avoidable hospitalization for such patients is a step toward both objectives. Some of the deterioration experienced in chronic disease patients occurs outside the view of their clinicians, and before the patient becomes overtly symptomatic. Home monitoring has been used for more than 20 years to detect deterioration earlier so that the patients could be treated before they became ill enough to require hospitalization...
March 20, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28319721/methods-for-specifying-spatial-boundaries-of-cities-in-the-world-the-impacts-of-delineation-methods-on-city-sustainability-indices
#14
Yuta Uchiyama, Koichiro Mori
The purpose of this paper is to analyze how different definitions and methods for delineating the spatial boundaries of cities have an impact on the values of city sustainability indicators. It is necessary to distinguish the inside of cities from the outside when calculating the values of sustainability indicators that assess the impacts of human activities within cities on areas beyond their boundaries. For this purpose, spatial boundaries of cities should be practically detected on the basis of a relevant definition of a city...
March 16, 2017: Science of the Total Environment
https://www.readbyqxmd.com/read/28319528/postburn-microstomia-prevention-using-an-appliance-providing-simultaneous-horizontal-and-vertical-adjustable-forces
#15
Gregory S Antonarakis, Sandra Fastlicht, Taras Masnyi, Bryan Tompson
Microstomia, an abnormally small oral orifice, is a complication of perioral facial burns. In this case, contraction of the circumoral tissues and hypotonia of the musculature is responsible for this microstomia, which can produce aesthetic and functional impairment with eating, swallowing, communication (speech and facial expressions), compromised dental care and maintenance due to limited oral access, social interactions, and psychological well-being. Conservative management involves providing physical resistance to scar contracture, with opposing horizontal and vertical circumoral forces by means of appliances that aim to stretch the commissures and fibrotic muscles...
March 13, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28318863/it-is-a-brave-new-world-alternative-payment-models-and-value-creation-in-total-joint-arthroplasty-creating-value-for-tjr-quality-and-cost-effectiveness-programs
#16
Kevin K Chen, Jonathan H Harty, Joseph A Bosco
BACKGROUND: The increasing cost of our country's healthcare is not sustainable. To address this crisis, the federal government is transiting healthcare reimbursement from the traditional volume-based system to a value-based system. As such, increasing healthcare value has become an essential point of discussion for all healthcare stakeholders. METHODS: The purpose of this study is to discuss the importance of healthcare value as a means to achieve this goal of value-based medicine and 3 methods to create value in total joint arthroplasty...
February 14, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28315990/model-based-registration-of-preprocedure-mr-and-intraprocedure-us-of-the-lumbar-spine
#17
Delaram Behnami, Alireza Sedghi, Emran Mohammad Abu Anas, Abtin Rasoulian, Alexander Seitel, Victoria Lessoway, Tamas Ungi, David Yen, Jill Osborn, Parvin Mousavi, Robert Rohling, Purang Abolmaesumi
PURPOSE: Epidural and spinal needle insertions, as well as facet joint denervation and injections are widely performed procedures on the lumbar spine for delivering anesthesia and analgesia. Ultrasound (US)-based approaches have gained popularity for accurate needle placement, as they use a non-ionizing, inexpensive and accessible modality for guiding these procedures. However, due to the inherent difficulties in interpreting spinal US, they yet to become the clinical standard-of-care...
March 18, 2017: International Journal of Computer Assisted Radiology and Surgery
https://www.readbyqxmd.com/read/28314475/pharmacokinetic-based-study-on-lagged-stimulation-of-curcumae-longae-rhizoma-piper-nigrum-couplet-in-their-main-active-components-metabolism-using-uplc-ms-ms
#18
Zhao Chen, Dongmei Sun, Xiaoli Bi, Xiaohui Zeng, Wenhui Luo, Dake Cai, Qiaohuang Zeng, Aili Xu
BACKGROUND: Curcumae Longae Rhizoma is one of the commonly used traditional Chinese medicines, which has multiple biological activities such as relieving stagnation and stasis, pain alleviation, curing amenorrhea and wounds. However, its main active component-curcumin has poor absorption and very fast metabolism in body. To solve this problem, Piper nigrum was introduced for its ability to strengthen bioavailability of other compounds. PURPOSE: In most cases of TCM couplets, all ingredients were prepared and taken simultaneously, which in our opinion did not take full advantage of their interactions...
April 15, 2017: Phytomedicine: International Journal of Phytotherapy and Phytopharmacology
https://www.readbyqxmd.com/read/28304399/chemical-profiling-analysis-of-maca-using-uhplc-esi-orbitrap-ms-coupled-with-uhplc-esi-qqq-ms-and-the-neuroprotective-study-on-its-active-ingredients
#19
Yanyan Zhou, Peng Li, Adelheid Brantner, Hongjie Wang, Xinbin Shu, Jian Yang, Nan Si, Lingyu Han, Haiyu Zhao, Baolin Bian
Lepidium meyenii (Maca), originated from Peru, has been cultivated widely in China as a popular health care food. However, the chemical and effective studies of Maca were less in-depth, which restricted its application seriously. To ensure the quality of Maca, a feasible and accurate strategy was established. One hundred and sixty compounds including 30 reference standards were identified in 6 fractions of methanol extract of Maca by UHPLC-ESI-Orbitrap MS. Among them, 15 representative active compounds were simultaneously determined in 17 samples by UHPLC-ESI-QqQ MS...
March 17, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28302740/genetics-and-genomics-of-congenital-heart-disease
#20
Samir Zaidi, Martina Brueckner
Congenital heart disease is the most common birth defect, and because of major advances in medical and surgical management, there are now more adults living with congenital heart disease (CHD) than children. Until recently, the cause of the majority of CHD was unknown. Advances in genomic technologies have discovered the genetic causes of a significant fraction of CHD, while at the same time pointing to remarkable complexity in CHD genetics. This review will focus on the evidence for genetic causes underlying CHD and discuss data supporting both monogenic and complex genetic mechanisms underlying CHD...
March 17, 2017: Circulation Research
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