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141. Measuring patient-centred system performance: a scoping review of patient-centred care quality indicators. Full Text available with Trip Pro

Measuring patient-centred system performance: a scoping review of patient-centred care quality indicators. The shift to the patient-centred care (PCC) model as a healthcare delivery paradigm calls for systematic measurement and evaluation. In an attempt to develop patient-centred quality indicators (PC-QIs), this study aimed to identify quality indicators that can be used to measure PCC.Design: scoping review.studies were identified through searching seven electronic databases and the grey (...) -reviewed articles were assessed for eligibility for inclusion; of these, 9 articles were included in this review. From the non-peer-reviewed literature, eight documents met the criteria for inclusion in this study. This review revealed the heterogeneity describing and defining the nature of PC-QIs. Most PC-QIs were presented as PCC measures and identified as guidelines, surveys or recommendations, and therefore cannot be classified as actual PC-QIs. Out of 502 ways to measure PCC, only 25 were

2019 BMJ open

142. Mapping evidence on charitable food assistance system's compliance with safety and general hygiene requirements in Africa and the rest of the world: a systematic scoping review protocol. Full Text available with Trip Pro

Mapping evidence on charitable food assistance system's compliance with safety and general hygiene requirements in Africa and the rest of the world: a systematic scoping review protocol. The charitable food assistance system has an influential role in the larger effort to curtail the problem of food insecurity globally. They often play a crucial role in meeting the food security needs of the poor, particularly resource-limited settings where food security is a challenge. The aim of our study (...) is to compare evidence on the safety and general hygiene of charitable food assistance system in Africa and the rest of the world.This study will be conducted through a systematic scoping review. We will search for literature from the following electronic databases: African Index Medicus, PubMed, Google Scholar, EBSCOhost (MEDLINE with full text, Academic Search Complete, MEDLINE) and open access for unpublished theses and dissertations. Articles will also be searched through the 'Cited by' search as well

2019 Systematic reviews

143. Cataract grading systems: a review of past and present. (Abstract)

Cataract grading systems: a review of past and present. To provide a comprehensive summary of past cataract grading systems, how they have shaped current grading systems, and the developing technologies that are being used to assess and grade cataracts.This summary of cataract grading systems examines the development and limitations that existed in past grading systems and how they have shaped the grading systems of present time. The Lens Opacities Classification System III (LOCS III) system (...) is currently used both clinically and for research purposes. Recent advancements in imaging technologies have allowed researchers to create automatic systems that can locate lens landmarks and provide cataract grading scores that correlate well with LOCS III clinical grades. Utilizing existing technologies, researchers demonstrate that fundus photography and optical coherence tomography can be used as cataract grading tools. Lastly, deep learning has proved to be a powerful tool that can provide objective

2019 Current opinion in ophthalmology

144. Diffuse large B-cell lymphoma of the central nervous system presenting as "lymphomatosis cerebri" and dementia in elderly man: Case report and review of the literature. Full Text available with Trip Pro

Diffuse large B-cell lymphoma of the central nervous system presenting as "lymphomatosis cerebri" and dementia in elderly man: Case report and review of the literature. Lymphomatosis cerebri is a rare form of PCNSL, characterized by diffuse infiltration of lymphoma cells in cerebral parenchyma, without mass-formation and mild or no contrast enhancement on magnetic resonance (MR) imaging. There are less than 50 cases described in the literature under the term Lymphomatosis cerebri.A 74-year-old

2019 Medicine

145. Review of concentration yields in commercially available platelet-rich plasma (PRP) systems: a call for PRP standardization. (Abstract)

Review of concentration yields in commercially available platelet-rich plasma (PRP) systems: a call for PRP standardization. Platelet-rich plasma (PRP) has become increasingly popular in pain medicine with hopes of becoming a safe, effective alternative to routine treatments. However, given its autologous nature, PRP injectate may differ depending on the specific manufacturer and protocol. Currently, there is no standardization of reporting protocol. This systematic review compiles (...) and standardizes values on PRP preparation and final product composition of platelets, white cell count, and growth factors for ease of comparison. On review of 876 studies, 13 studies were selected according to our inclusion criteria. Data from 33 PRP systems and protocols were extracted and standardized. Overall, PRP final product concentrations as well as PRP preparation protocols varied widely between systems. However, platelet concentration was directly correlated with both volume of blood collected

2019 Regional Anesthesia and Pain Medicine

146. CHOROIDAL AND RETINAL THICKNESS IN SYSTEMIC AUTOIMMUNE AND INFLAMMATORY DISEASES: A REVIEW. (Abstract)

CHOROIDAL AND RETINAL THICKNESS IN SYSTEMIC AUTOIMMUNE AND INFLAMMATORY DISEASES: A REVIEW. In order to identify the risk of relapse and subclinical inflammatory stages of systemic autoimmune diseases, new tools are needed. In the recent years, choroidal and retinal thickness measured with ocular coherence tomography (OCT) have been proposed as an inflammatory marker for different systemic diseases, especially for conditions with a vascular component. Our aim in this article was to review (...) the literature regarding the role of choroidal and retinal thickness as a potential inflammatory marker in systemic autoimmune and inflammatory diseases measured by OCT. Current literature suggests that the choroid of patients thickens in active phases of inflammatory diseases with vascular involvement. This pattern is observed in lupus, systemic sclerosis, Behçet disease, spondylitis, and familial Mediterranean fever. Choroidal thickness may decrease with biological treatments, along with systemic

2019 Survey of Ophthalmology

147. Targeting the Immune System in Atherosclerosis: JACC State-of-the-Art Review. (Abstract)

Targeting the Immune System in Atherosclerosis: JACC State-of-the-Art Review. Atherosclerosis has long been known as an inflammatory disease. However, whether targeting inflammation improves outcomes was unproven until the recent results of CANTOS (Canakinumab Anti-Inflammatory Thrombosis Outcomes Study). In this review, we reflect on why it has taken a long time to prove the inflammatory hypothesis of atherosclerosis and derive important lessons for the future. In particular, we discuss (...) the off-target immune-modulatory effects of approved cardiovascular therapies, review the attempted anti-inflammatory therapies including the recently published CIRT (Cardiovascular Inflammation Reduction Trial), and discuss the likely reasons for their failures. We further build on CANTOS to review the immune-modulatory therapies for atherosclerosis currently in trials, and discuss the likelihood of their added value as well as the potential hazard associated with their use. We finally argue

2019 Journal of the American College of Cardiology

148. Bed rest and accelerated aging in relation to the musculoskeletal and cardiovascular systems and frailty biomarkers: A review. (Abstract)

Bed rest and accelerated aging in relation to the musculoskeletal and cardiovascular systems and frailty biomarkers: A review. Prolonged bed rest and lifelong physical inactivity cause deleterious effects to multiple physiological systems that appear to hasten aging processes. Many such changes are similar to those seen with microgravity in space, but at a much faster rate. Head down tilt bed rest models are used to study whole-body changes that occur with spaceflight. We propose that bed rest (...) can be used to quantify accelerated human aging in relation to frailty. In particular, frailty as a measure of the accumulation of deficits estimates the variability in aging across systems, and moves away from the traditional single-system approach. Here, we provide an overview of the impact of bed rest on the musculoskeletal and cardiovascular systems as well as frailty-related biological markers and inflammatory cytokines. We also propose future inquiries to study the accumulation of deficits

2019 Experimental Gerontology

149. The introduction of a Parkinson's disease email alert system to allow for early specialist team review of inpatients. Full Text available with Trip Pro

The introduction of a Parkinson's disease email alert system to allow for early specialist team review of inpatients. Patients with Parkinson's disease (PWP) have complex healthcare needs, and compared to the general population, are more likely to have an unplanned emergency department (ED) attendance to hospital, along with poorer outcomes. Innovative methods of notification, when patients have an ED attendance are needed to allow for earlier specialist team interventions. This study describes (...) the introduction of an email alert (e-alert) for a specialist Parkinson's team. In addition, the reason for admission, specialist team interventions, length of stay, frequency of readmission, discharge destination, mortality and the bed cost per ED attendance or admission episode will be explored.The e-alert was developed in collaboration with academics, a Parkinson's specialist team and hospital Information technology (IT) specialists, by employing existing software and IT system platforms. Patients were

2019 BMC health services research

150. Cardiac arrhythmia detection outcomes among patients monitored with the Zio patch system: a systematic literature review. Full Text available with Trip Pro

Cardiac arrhythmia detection outcomes among patients monitored with the Zio patch system: a systematic literature review. Cardiac arrhythmias can be serious and life threatening, and can impose significant burden on healthcare systems. Recent technological advances in ambulatory electrocardiogram recorders have led to the development of unobtrusive wearable biosensors which allow physicians to study patients' continuous cardiac rhythm data collected over multiple weeks. The objective (...) of this systematic literature review was to summarize evidence on the clinical effectiveness of the Zio patch ('Zio'; iRhythm Technologies), a long-term, continuous, uninterrupted cardiac monitoring system.Findings from searches of MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials, as well as grey literature, were screened by two reviewers to identify studies reporting cardiac arrhythmia detection outcomes among patients monitored with Zio for an intended duration ≥7 days.23 publications

2019 Current medical research and opinion

151. Mapping the use of soft systems methodology for change management in healthcare: a scoping review protocol. Full Text available with Trip Pro

Mapping the use of soft systems methodology for change management in healthcare: a scoping review protocol. It is notoriously challenging to implement evidence-based care and to update and improve healthcare practices. One reason for the difficulty is the complexity of healthcare and the powerful influence of context on implementation and improvement efforts. Thus, there is a need for multifaceted, flexible change methods that takes these complexities into consideration. One approach that has (...) the potential in this regard is soft systems methodology (SSM). However, little is known about how SSM has been applied in healthcare settings, making it difficult to assess the usefulness of SSM for implementation science or improvement research. The aim of the proposed scoping review is to examine and map the use and outcomes of SSM in healthcare.The review will adapt the framework outlined by Arksey and O'Malley (2005). Citations will be uncovered through a comprehensive database search of the peer

2019 BMJ open

152. Type and use of digital technology in learning health systems: a scoping review protocol. Full Text available with Trip Pro

Type and use of digital technology in learning health systems: a scoping review protocol. Health systems in North America and Europe have been criticised for their lack of safety, efficiency and effectiveness despite rising healthcare costs. In response, healthcare leaders and researchers have articulated the need to transform current health systems into continuously and rapidly learning health systems (LHSs). While digital technology has been envisioned as providing the transformational power (...) related to learning health systems. Records selection will be done in duplicate by two reviewers applying pre-defined inclusion and exclusion criteria. Data extraction from selected records will be done by two reviewers using a piloted data charting form. Results will be synthesised through a descriptive numerical summary and a mapping of digital technology use onto types of LHSs and phases of learning within LHSs.Ethical approval is not required for this scoping review. Preliminary results

2019 BMJ open

153. Motorized scooter injuries in the era of scooter-shares: A review of the national electronic surveillance system. (Abstract)

Motorized scooter injuries in the era of scooter-shares: A review of the national electronic surveillance system. There has been a spike in recent news regarding motorized scooter injuries due to the expansion of scooter sharing companies. Given the paucity of literature on this topic, the purpose of our study was to describe and quantify emergency department encounters associated with motorized scooter related injuries.The National Electronic Injury Surveillance System (NEISS) was queried

2019 American Journal of Emergency Medicine

154. Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome caused by first-line antituberculous drugs: two case reports and a review of the literature. (Abstract)

Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome caused by first-line antituberculous drugs: two case reports and a review of the literature. Patients suffering from drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome caused by first-line antituberculous drugs often need to be re-treated rapidly. Patch tests prior to the re-introduction of antituberculosis drugs are rarely performed.We aim to highlight those drugs most often involved in DRESS from (...) antituberculosis drugs, illustrate the potential value of patch tests to identify these culprit(s), and provide insights in how to rapidly re-treat these patients.A detailed description of the work-up of two illustrative patients, together with a literature review of similar cases, is provided.All first-line antituberculosis drugs may cause DRESS syndrome, but rifampicin and isoniazid are most frequently involved. Patch tests can be performed sooner than usually advised in the context of DRESS syndrome

2019 Contact Dermatitis

155. Impact of patient's health-related quality of life on physicians' therapy and perceived benefit in acute coronary syndromes: protocol for a systemic review of quantitative and qualitative studies. Full Text available with Trip Pro

Impact of patient's health-related quality of life on physicians' therapy and perceived benefit in acute coronary syndromes: protocol for a systemic review of quantitative and qualitative studies. Percutaneous coronary interventions (PCIs) and coronary angiography are two of the treatments administered to acute coronary syndrome (ACS) patients. However, whether and how patients' health-related quality of life (HRQoL) influences treatment decisions and subsequent risk benefit analyses is unclear (...) . In this study, we will review the available evidence on the impact of patients' HRQoL on physicians' prescribing or treatment decisions and on the estimation of mortality and bleeding risk in ACS patients.We will undertake a systematic review of all quantitative and qualitative studies. The search will include studies that describe the impact of HRQoL on prescribing PCIs or angiography, and impact of HRQoL on perceived risks in terms of mortality and bleeding events. We will conduct an initial search

2019 BMJ open

156. Pulmonary vascular involvement of IgG4-related disease: Case series with a PRISMA-compliant systemic review. Full Text available with Trip Pro

Pulmonary vascular involvement of IgG4-related disease: Case series with a PRISMA-compliant systemic review. Immunoglobulin G4-related disease (IgG4-RD) is a recently recognized, immune-mediated chronic fibrotic inflammation that can involve almost all organs, causing tumefaction and dysfunction. Its presence in pulmonary circulation is underestimated and has not yet been investigated.We describe a representative IgG4-RD patient with pulmonary artery stenosis and pulmonary embolism, leading (...) to reversible pulmonary hypertension. Literature review of IgG4-RD with pulmonary circulation involvement was conducted.References for this review were identified through searches via PubMed, EBSCO, and Web of Science for published articles before November 2016.There were 15 published cases of IgG4-RD with pulmonary vascular involvement, 3 with pulmonary arteritis, 2 with pulmonary artery aneurysm, 3 with pulmonary artery stenosis, 1 with obliterative phlebitis, and 1 with pulmonary embolism. Possible

2019 Medicine

157. Review article: shared disease mechanisms between non-alcoholic fatty liver disease and metabolic syndrome - translating knowledge from systems biology to the bedside. (Abstract)

Review article: shared disease mechanisms between non-alcoholic fatty liver disease and metabolic syndrome - translating knowledge from systems biology to the bedside. Non-alcoholic fatty liver disease (NAFLD) is the leading cause of chronic liver disease worldwide. Characterised by abnormal fat accumulation in the liver, NAFLD presents high degree of comorbidity with disorders of the metabolic syndrome, including type 2 diabetes, obesity and cardiovascular disease. These comorbidities have (...) strong negative impact on the natural course of NAFLD and vice versa, whereby the presence of NAFLD substantially modifies the course and prognosis of metabolic syndrome-associated diseases.To use systems biology strategies to interrogate disease mechanisms that are common to NAFLD and metabolic syndrome.We mapped shared gene/protein-disease interaction networks, we performed gene-disease enrichment analysis to assess pleiotropy, and we created a gene-drug connectivity network.We found that a shared

2019 Alimentary Pharmacology & Therapeutics

158. The Relevance of the Judet and Letournel Acetabular Fracture Classification System in the Modern Era: A Review. (Abstract)

The Relevance of the Judet and Letournel Acetabular Fracture Classification System in the Modern Era: A Review. The Judet and Letournel acetabular fracture classification system, based on the idea of bicolumnar support of the acetabulum, was first described in a landmark article published in the 1960s. It has stood the test of time and continues to be the preferred method for describing acetabular fractures for the majority of orthopaedic trauma surgeons. Still, there have been attempts (...) to modify or replace Letournel system since its introduction for a variety of reasons, chief among them a perceived inability of the classification system to account for a number of transitional fracture patterns and injury modifiers that may affect surgical decision making and patient outcomes. In this review, we present the literature related to the Judet and Letournel acetabular fracture classification system, over 50 years after its first formal description. We summarize its strengths, weaknesses

2019 Journal of Orthopaedic Trauma

159. Biologic TNF-alpha inhibitors in the treatment of Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis: a systemic review. (Abstract)

Biologic TNF-alpha inhibitors in the treatment of Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis: a systemic review. Stevens-Johnson syndrome and toxic epidermal necrolysis (SJS-TEN) is one of severe cutaneous adverse reactions with low morbidity but high mortality. Different systemic immunomodulating treatments are proposed but still remain controversial. Tumor necrosis factor (TNF)-alpha is long thought to be a vital mediator of epithelial cell death in SJS-TEN, indicating (...) a potential target for therapy.The aim of this systemic review is to evaluate the efficacy and safety of biologic TNF-alpha inhibitors in the treatment of SJS-TEN.We reviewed the published literature by searching from PubMed, EMBASE, Web of Science and ClinicalTrial.gov. A total of 27 articles fulfilling our inclusion criteria were found and analyzed.There were 21 case reports, four case series and two randomized controlled trials (RCTs) on the biologic TNF-alpha inhibitors for SJS-TEN therapy, comprising

2019 Journal of Dermatological Treatment

160. Identifying areas for improvement in paediatric trauma care in NSW Australia using a clinical, system and human factors peer-review tool. Full Text available with Trip Pro

Identifying areas for improvement in paediatric trauma care in NSW Australia using a clinical, system and human factors peer-review tool. There is known variability in the quality of care delivered to injured children. Identifying where care improvement can be made is critical. This study aimed to review paediatric trauma cases across the most populous Australian State to identify factors contributing to clinical incidents.Medical records from three New South Wales Paediatric Trauma Centres (...) 535 records were reviewed and 41 cases were peer-reviewed. The median (IQR) age was 7 (2-12) years, the median ISS was 25 (IQR 16-30). The peer-review identified a combination of clinical (85%), systems (51%) and communication (12%) problems that contributed to difficulties in care delivery. In 85% of records, staff actions were identified to contribute to events; with medical task failure the most frequently identified cause (89%).The peer-review of paediatric trauma cases assisted

2019 Injury

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