54,631 results match your criteria outcomes terms

Does the power of the laser devices matter for a successful HoLEP procedure? A prospective comparative study.

Int J Clin Pract 2021 Jun 15:e14531. Epub 2021 Jun 15.

Department of Urology, Biruni University School of Medicine, Istanbul, Turkey.

Background: The objectives of this prospective study were to evaluate the efficiency, safety and applicability of medium power (MP) holmium laser devices in the endoscopic enucleation of the enlarged prostate (HoLEP) compared to high power (HP) laser devices.

Methods: From October 2019 to July 2020, a total of 120 consecutive patients planned for HoLEP were divided randomly into two groups formed in terms of the power of the device used. While patients in Group 1 were treated with a MP device (50W) at 39. Read More

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Evaluation on effectiveness of treatment strategies for degenerative lumbar spinal stenosis: a systematic review and network meta-analysis of clinical studies.

World Neurosurg 2021 Jun 12. Epub 2021 Jun 12.

The Center for Pain Medicine, Peking University Third Hospital, Beijing 100191, China. Electronic address:

Objective: Lumbar spinal stenosis (LSS) is a common disease in spinal surgery. At present, many related treatment methods have been reported, but their effectiveness still lacks a systematic comparison. We aimed to evaluate the clinical outcomes related to the efficacy and safety of these treatment strategies via a network meta-analysis. Read More

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The optimal timing of interval laparoscopic cholecystectomy following percutaneous cholecystostomy based on pathological findings and the incidence of biliary events.

J Hepatobiliary Pancreat Sci 2021 Jun 15. Epub 2021 Jun 15.

Division of General Surgery, Chang Gung Memorial Hospital, Taoyuan City, Taiwan.

Background: The incidence of biliary events (BE) following percutaneous cholecystostomy (PC) in acute cholecystitis (AC) patients is high. Therefore, definitive laparoscopic cholecystectomy (LC) is recommended. We aimed to investigate the optimal timing of LC following PC with regard to the clinical course and pathological findings. Read More

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Time-Driven Activity-Based Costing for Cataract Surgery in Canada: The Case of the Kensington Eye Institute.

Healthc Policy 2021 May;16(4):97-108

Director, Health System Strategy, Medtronic ULC, Brampton, ON.

Time-driven activity-based costing (TDABC) has received considerable attention globally as a way to measure value in healthcare systems. This study aimed to apply TDABC for cataract surgery at the Kensington Eye Institute (KEI). During a field evaluation, a detailed process map was created for cataract surgery at KEI. Read More

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Impact of Insulin Treatment on the Effect of Eplerenone: Insights From the EMPHASIS-HF Trial.

Circ Heart Fail 2021 Jun 15;14(6):e008075. Epub 2021 Jun 15.

Université de Lorraine, Inserm, Centre d'Investigations Cliniques, - Plurithématique 14-33, and Inserm U1116, CHRU, F-CRIN INI-CRCT (Cardiovascular and Renal Clinical Trialists), Nancy, France (J.P.F., Z.L., P.R., F.Z.).

Background: Patients with heart failure with reduced ejection fraction (HFrEF) and insulin-treated diabetes have a high risk of cardiovascular complications. Mineralocorticoid receptor antagonists may mitigate this risk. We aim to explore the effect of eplerenone on cardiovascular outcomes and all-cause mortality in HFrEF patients with diabetes, including those treated with insulin in the EMPHASIS-HF trial (Eplerenone in Patients with Systolic Heart Failure and Mild Symptoms). Read More

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Improving Dialysis Adequacy And Quality Of Life In Patients Undergoing Hemodialyis with Twice a Week Range of Motion Exercise.

Ther Apher Dial 2021 Jun 15. Epub 2021 Jun 15.

Lecturers in School of Medicine, Universitas Muhammadiyah Yogyakarta.

The study aimed to determine the effects of giving range of motion (ROM) twice a week as a form intradialytic exercise on patients' dialysis adequacy and quality of life. A total of 48 eligible participants were recruited and completed this study. The intervention group (n=24) received twice a week range of motion exercise over a 4 weeks period. Read More

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Bi-level Nasal Positive Airway Pressure (BiPAP) versus Nasal Continuous Positive Airway Pressure (CPAP) for Preterm Infants with Birth Weight Less Than 1500 g and Respiratory Distress Syndrome Following INSURE Treatment: A Two-center Randomized Controlled Trial.

Curr Med Sci 2021 Jun 15. Epub 2021 Jun 15.

Department of Neonatology, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, 430030, China.

The present study aimed to examine the effectiveness of bi-level positive airway pressure (BiPAP) versus continuous positive airway pressure (CPAP) in preterm infants with birth weight less than 1500 g and respiratory distress syndrome (RDS) following intubation-surfactant-extubation (INSURE) treatment. A two-center randomized control trial was performed. The primary outcome was the reintubation rate of infants within 72 h of age after INSURE. Read More

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Laparoscopic complete mesocolic excision versus conventional resection for right-sided colon cancer: a propensity score matching analysis of short-term outcomes.

Surg Endosc 2021 Jun 15. Epub 2021 Jun 15.

Division of Minimally-Invasive Surgical Oncology, ASST Grande Ospedale Metropolitano Niguarda, Piazza Ospedale Maggiore, 3, 20162, Milan, Italy.

Background: Complete mesocolic excision (CME) for right-sided colon cancer (RCC) is a demanding operation, especially when performed laparoscopically. The potential impact of CME in increasing postoperative complications is still unclear. The aim of our study was to evaluate the safety and feasibility of laparoscopic CME compared with laparoscopic non-complete mesocolic excision (NCME) during colectomy for RCC. Read More

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Efficacy of erythropoietin alone in treatment of neonates with hypoxic-ischemic encephalopathy: A protocol for systematic review and meta-analysis.

Medicine (Baltimore) 2021 Jun;100(24):e26365

Neonatal Medicine, Shanxi Children's Hospital, Shanxi, China.

Background: Multiple clinical trials have demonstrated the safety and efficacy of erythropoietin in improving neurodevelopmental outcomes in infants with hypoxic-ischemic encephalopathy (HIE). It is undoubtedly urgent to include only randomized controlled trials (RCTs) for more standardized systematic reviews and meta-analyses. The purpose of this study is to examine whether erythropoietin reduces the risk of death and improve neurodevelopmental disorders in infants with HIE. Read More

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Nonstigmatizing and Precise Terminology to Describe Processes and Outcomes in Addiction Medicine.

J Addict Med 2021 Jun 14. Epub 2021 Jun 14.

Center on Alcohol, Substance use, and Addictions, University of New Mexico, Albuquerque, NM (RAP, KW), Durham VA Medical Center (SCP); Department of Psychology, Idaho State University, Pocatello, ID (JKS).

Scholarly journals and professional organizations in addiction medicine have recently discussed the importance of adopting nonstigmatizing and precise terminology. The present commentary expands that ongoing discussion to terms related to treatment processes and outcomes. Four implicit assumptions of stigmatizing and imprecise terms related to treatment processes and outcomes are overviewed, and research evidence against these assumptions is presented. Read More

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Efficacy of Repetitive Transcranial Magnetic Stimulation (rTMS) for Tinnitus: A Retrospective Study.

Ear Nose Throat J 2021 Jun 15:1455613211016896. Epub 2021 Jun 15.

Department of Hearing and Speech Science, Xinhua College, Sun Yat-sen University, Guangzhou, China.

Objective: Current studies still find insufficient evidence to support the routine use of repetitive transcranial magnetic stimulation (rTMS) in tinnitus. This study aimed to assess response of tinnitus to treatment with rTMS and identify factors influencing the overall response.

Methods: Between January 2016 and May 2017, 199 tinnitus patients were identified from a retrospective review of the electronic patient record at the Sun Yat-sen Memorial Hospital. Read More

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Returning to dialysis after kidney allograft failure: the experience of the Italian Registry of Paediatric Chronic Dialysis.

Pediatr Nephrol 2021 Jun 14. Epub 2021 Jun 14.

Dialysis Unit, Department of Pediatrics, IRCCS Giannina Gaslini, Genova, Italy.

Background: The need for dialysis after kidney allograft failure (DAGF) is among the top five reasons for dialysis initiation, making this an important topic in clinical nephrology. However, data are scarce on dialysis choice after transplantation and clinical outcomes for DAGF in children.

Methods: Patients receiving chronic dialysis < 18 years were recorded from January 1991 to January 2019 by the Italian Registry of Pediatric Chronic Dialysis (IRPCD). Read More

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A Pilot Clinical study of an add on Ayurvedic formulation containing and in mild to moderate Covid - 19.

J Ayurveda Integr Med 2021 Jun 10. Epub 2021 Jun 10.

Medanta, The Medicity, Gurgaon, Haryana, India.

After declaration of Covid - 19 as pandemic by WHO, countries adopted several measures to contain the spread as well as test and treat the patients. Further, as no effective management protocols to address this pandemic were available, a need was felt to explore the integration of modern and traditional medicines to treat Covid 19 cases. In view of this an exploratory nonrandomized prospective study has been undertaken for comparing the outcomes of traditional Ayurvedic classical formulation of () and () as an add on to standard of care (SOC) using modern medicine with SOC alone. Read More

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A simulation-based evaluation of machine learning models for clinical decision support: application and analysis using hospital readmission.

NPJ Digit Med 2021 Jun 14;4(1):98. Epub 2021 Jun 14.

Department of Anesthesiology and Perioperative Medicine, University of California Los Angeles, Los Angeles, CA, USA.

The interest in applying machine learning in healthcare has grown rapidly in recent years. Most predictive algorithms requiring pathway implementations are evaluated using metrics focused on predictive performance, such as the c statistic. However, these metrics are of limited clinical value, for two reasons: (1) they do not account for the algorithm's role within a provider workflow; and (2) they do not quantify the algorithm's value in terms of patient outcomes and cost savings. Read More

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Prognostic implications of troponin T variations in inherited cardiomyopathies using systems biology.

NPJ Genom Med 2021 Jun 14;6(1):47. Epub 2021 Jun 14.

Cardiology department, Health In Code. As Xubias s/n, Edificio El Fortín, 15006, A Coruña, Spain.

The cardiac troponin T variations have often been used as an example of the application of clinical genotyping for prognostication and risk stratification measures for the management of patients with a family history of sudden cardiac death or familial cardiomyopathy. Given the disparity in patient outcomes and therapy options, we investigated the impact of variations on the intermolecular interactions across the thin filament complex as an example of an unbiased systems biology method to better define clinical prognosis to aid future management options. We present a novel unbiased dynamic model to define and analyse the functional, structural and physico-chemical consequences of genetic variations among the troponins. Read More

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Evaluation of clustering and topic modeling methods over health-related tweets and emails.

Artif Intell Med 2021 Jul 7;117:102096. Epub 2021 May 7.

Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL, USA.

Background: Internet provides different tools for communicating with patients, such as social media (e.g., Twitter) and email platforms. Read More

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Who should I involve in my research and why? Patients, carers or the public?

Res Involv Engagem 2021 Jun 14;7(1):41. Epub 2021 Jun 14.

NCRI Consumer Forum, Sarcoma Patients Euronet, Shropshire, UK.

Patient and public involvement in research helps to make it more relevant and useful to the end-users. Involvement influences the design, delivery and dissemination of research, ultimately leading to better services, treatments and care. Researchers are therefore keen to involve patients, carers and public in their work, but are sometimes uncertain about who to involve. Read More

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Case studies for implementing MCDA for tender and purchasing decisions in hospitals in Indonesia and Thailand.

J Pharm Policy Pract 2021 Jun 14;14(1):52. Epub 2021 Jun 14.

Abbott Laboratories ltd, No.1, Q House Lumpini, 30th & 33rd Floor, South Sathorn Road, Thungmahamek, Sathorn, Bangkok, 10120, Thailand.

Background: A multi-criteria decision analysis (MCDA) approach has been suggested for helping purchasers in low- and middle-income countries in an evidence-based assessment of multi-source pharmaceuticals to mitigate potential adverse consequences of price-based decisions on patient access to effective medicines. Six workshops for developing MCDA-instruments for purchasing were conducted in Indonesia, Kazakhstan, Thailand, and Kuwait in 2017-2020. In Indonesia and Thailand, two pilot-initiatives aimed to implement the instruments for hospital drug purchasing decisions. Read More

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An innovative training based on robotics for older people with subacute stroke: study protocol for a randomized controlled trial.

Trials 2021 Jun 14;22(1):400. Epub 2021 Jun 14.

Clinical Unit of Physical Rehabilitation, IRCCS INRCA, Ancona, Italy.

Background: Stroke is a leading cause of disability, injury, and death in elderly people and represents a major public health problem with substantial medical and economic consequences. The incidence of stroke rapidly increases with age, doubling for each decade after age 55 years. Gait impairment is one of the most important problems after stroke, and improving walking function is often a key component of any rehabilitation program. Read More

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Management of Chronic Rhinosinusitis Prior to Otolaryngology Referral: An Opportunity for Quality Improvement.

Otolaryngol Head Neck Surg 2021 Jun 15:1945998211017486. Epub 2021 Jun 15.

Surgery Center for Outcomes Research, Duke University, Durham, North Carolina, USA.

Objective: The management of chronic rhinosinusitis (CRS) by a nonotolaryngologist prior to otolaryngology referral is an important component of the patient care pathway. The purpose of this study is to characterize CRS management during this period and to identify areas of quality improvement.

Study Design: Retrospective review of a national claims database. Read More

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Distinct Behavior of Traumatic versus Nontraumatic Intracerebral Hematomas: Different Biology or Impact of Age?

J Neurol Surg A Cent Eur Neurosurg 2021 Jun 14. Epub 2021 Jun 14.

Department of General and Trauma Surgery, BG Bergmannsheil University Hospital Bochum, Bochum, Germany.

Background And Study Aims:  Patients with large intracerebral hematomas (ICH) may demonstrate different demographics and underlying brain and systemic diseases, as well as different radiologic courses and distinct outcomes. It remains unclear whether their different behavior attributes to a different biology of the ICH or to the asymmetric characteristics of the two populations. To analyze and adjust for potential sources of selection and treatment bias, our study compared age-matched patients with traumatic and nontraumatic ICH in a single cohort diagnosed and treated in the same surgical department. Read More

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The importance of biomechanical assessment after Return to Play in athletes with ACL-Reconstruction.

Gait Posture 2021 Jun 8;88:240-246. Epub 2021 Jun 8.

Department of Basic Medical Sciences, Neuroscience and Sense Organs, School of Medicine, University of Bari "Aldo Moro", AOU Consorziale Policlinico, Piazza Giulio Cesare 11, 70124 Bari, Italy; Orthopaedic & Trauma Unit, AOU Consorziale Policlinico, Piazza Giulio Cesare 11, 70124 Bari, Italy.

Background: Barriers to successful return to previous level of activity following Anterior Cruciate Ligament Reconstruction (ACLR) are multifactorial and recent research suggests that athletic performance deficits persist after completion of the rehabilitation course in a large percentage of patients.

Research Question: Do technology-based biomechanical assessments reveal underneath differences in both recreational and competitive athletes in Return to Play after ACL-Reconstruction?

Methods: Thirty soccer athletes (26.9 ± 5. Read More

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Risk assessment of obstructive sleep apnea syndrome and other sleep disorders in multiple sclerosis patients.

Clin Neurol Neurosurg 2021 Jun 8;207:106749. Epub 2021 Jun 8.

Department of Neurology, Marmara University School of Medicine, Istanbul, Turkey.

Background: The aim of the present study was to determine the possible risk of OSAS in patients with MS through the STOP-BANG questionnaire, and to confirm the pre-diagnosis of OSAS by recording polysomnographic investigation in individuals with high risk. In addition, the relationship between OSAS risk and fatigue, sleepiness, depression, and disability status will be examined.

Methods: Totally 97 patients with multiple sclerosis including 36 males and 61 females with an age average of 39. Read More

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Awake Spinal Fusion.

JBJS Rev 2021 06 14;9(6). Epub 2021 Jun 14.

WESTMED Spine Center, Yonkers, New York.

»: Awake spinal fusion (ASF) integrates advancements in surgical techniques and anesthetic modalities with the aim to maximize benefits and improve outcomes from the surgical and anesthetic standpoints.

»: ASF employs minimally invasive or endoscopic surgical techniques that are complemented by regional modalities of anesthesia and analgesia.

»: The current evidence, albeit limited, has shown better results with ASF in terms of postoperative pain scores, a patient's need for opioids, postoperative hospital length of stay, and rehabilitation compared with the conventional technique of open spinal fusion with the patient under general anesthesia. Read More

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A Determinants-of-Fertility Ontology for Detecting Future Signals of Fertility Issues From Social Media Data: Development of an Ontology.

J Med Internet Res 2021 Jun 14;23(6):e25028. Epub 2021 Jun 14.

Department of Health Management, Samyook University, Seoul, Republic of Korea.

Background: South Korea has the lowest fertility rate in the world despite considerable governmental efforts to boost it. Increasing the fertility rate and achieving the desired outcomes of any implemented policies requires reliable data on the ongoing trends in fertility and preparations for the future based on these trends.

Objective: The aims of this study were to (1) develop a determinants-of-fertility ontology with terminology for collecting and analyzing social media data; (2) determine the description logics, content coverage, and structural and representational layers of the ontology; and (3) use the ontology to detect future signals of fertility issues. Read More

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Improving Access to Psychological Therapies (IAPT) has potential but is not sufficient: How can it better meet the range of primary care mental health needs?

Br J Clin Psychol 2021 Jun 14. Epub 2021 Jun 14.

Independent Consultant Clinical Psychologist, London, UK.

Background: The Improving Access to Psychological Therapies (IAPT) programme has been impactful in increasing access to psychological therapies at primary care level. However, it remains unclear whether IAPT's widely disseminated achievements include the reduction in service users' transition to secondary care services and whether IAPT services are providing interventions that match the level of complexity of presenting problems of those who are referred.

Aims: This review sets out to clarify the clinical characteristics of IAPT cohorts, whether the interventions provided target these characteristics, and whether outcomes are related to the use of the stepped-care model advocated in the operationalization of IAPT services. Read More

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Identification of CD8+ T Cell-Related Genes: Correlations with Immune Phenotypes and Outcomes of Liver Cancer.

J Immunol Res 2021 2;2021:9960905. Epub 2021 Jun 2.

Department of Hepatobiliary Surgery and Organ Transplantation, Key Laboratory of Organ Transplantation of Liaoning Province, First Hospital of China Medical University, China.

Purpose: Treatment outcomes for advanced liver cancer are poor. Immunotherapy is a treatment strategy that has been widely used to treat other cancers. Studies have shown that CD8+ T lymphocytes are essential factors affecting the efficacy of immunotherapy. Read More

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Surgery or Non-surgical Treatment of ≤8 mm Non-small Cell Lung Cancer: A Population-Based Study.

Front Surg 2021 26;8:632561. Epub 2021 May 26.

Department of Thoracic Surgery, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.

Timing for intervention of small indeterminate pulmonary nodules has long been a topic of debate given the low incidence of malignancy and difficulty in obtaining a definite preoperative diagnosis. We sought to determine survival outcomes of surgical and non-surgical managements in non-small cell lung cancer (NSCLC) ≤8 mm, which may provide a reference for prospective decision-making for patients with suspected NSCLC. A total of 1,652 patients with Stage IA NSCLC ≤8 mm were identified from the Surveillance, Epidemiology, and End Results (SEER) database and categorized into surgery and non-surgery groups. Read More

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Early Prediction of Sepsis in the ICU Using Machine Learning: A Systematic Review.

Front Med (Lausanne) 2021 28;8:607952. Epub 2021 May 28.

Machine Learning and Computational Biology Lab, Department of Biosystems Science and Engineering, Eidgenössische Technische Hochschule Zürich (ETH Zurich), Basel, Switzerland.

Sepsis is among the leading causes of death in intensive care units (ICUs) worldwide and its recognition, particularly in the early stages of the disease, remains a medical challenge. The advent of an affluence of available digital health data has created a setting in which machine learning can be used for digital biomarker discovery, with the ultimate goal to advance the early recognition of sepsis. To systematically review and evaluate studies employing machine learning for the prediction of sepsis in the ICU. Read More

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