Value of pentraxin-3 and galectin-3 in acute coronary syndrome: a short-term prospective cohort study.

Background: Acute coronary syndrome (ACS) continues to be a leading cause of morbidity and mortality worldwide. Galectin-3 and pentraxin-3 are two prognostic biomarkers that have been studied in heart failure (HF). However, there are limited data on these biomarkers in the ACS population.

Riociguat: Something new in pulmonary hypertension therapeutics?

Pulmonary hypertension (PH) continues to be a disease that is associated with woeful outcomes. The search for an ideal drug molecule for PH led to the discovery of riociguat, which is a first-in-class drug molecule that activates soluble guanylate cyclase. We conducted a systematic literature search using databases such as PubMed, Science Direct, Springer, Cochrane Reviews and Google Scholar to gather evidence generated from published clinical trials on the efficacy, safety, pharmacokinetics and regulatory status of riociguat.

Divorce among physicians and other healthcare professionals in the United States: analysis of census survey data.

Objectives: To estimate the prevalence and incidence of divorce among US physicians compared with other healthcare professionals, lawyers, and non-healthcare professionals, and to analyze factors associated with divorce among physicians.

Design: Retrospective analysis of nationally representative surveys conducted by the US census, 2008-13.

Setting: United States.

Comparison of risk indicators of dental caries in children with and without cleft lip and palate deformities.

Objective: To test the hypothesis that there are no differences in various risk factors of dental caries among children with cleft lip and palate when compared to non-cleft high caries risk and non-cleft caries free children.

Design: Seventy-three children in the age range of 4-9 years comprised three groups; Group-I (n = 23, children with cleft lip and palate), Group-II (n = 25, non-cleft high caries risk children) and Group-III (n = 25, non-cleft caries free children). Various risk factors for dental caries like type of oral hygiene practice, sugar exposures/day, developmental defects of enamel, caries activity, salivary streptococci mutans levels and lactobacilli levels were evaluated and compared among the three groups of children.

Incidence of sexually transmitted infections after human papillomavirus vaccination among adolescent females.

Importance: Human papillomavirus (HPV) vaccination rates among US females remain low, in part because of concerns that HPV vaccination may promote unsafe sexual activity by lowering perceived risks of acquiring a sexually transmitted infection (STI).

Objective: To study whether HPV vaccination of females is associated with increases in STI rates.

Design, Setting, And Participants: Using a large, longitudinal insurance database of females aged 12 to 18 years insured from January 1, 2005, through December 31, 2010, in the United States, we examined whether HPV vaccination was associated with an increase in incident STIs among females who were vaccinated compared with those who were not.

Robot-assisted surgery for kidney cancer increased access to a procedure that can reduce mortality and renal failure.

Surgeons increasingly use robot-assisted minimally invasive surgery for a variety of medical conditions. For hospitals, the acquisition and maintenance of a robot requires a significant investment, but financial returns are not linked to any improvement in long-term patient outcomes in the current reimbursement environment. Kidney cancer provides a useful case study for evaluating the long-term value that this innovation can provide.

Effects of twin-block appliance on the anatomy of pharyngeal airway passage (PAP) in class II malocclusion subjects.

Background: The use of functional appliances for the correction of retrognathic mandible is very common in orthodontics. Similar appliances known as oral appliances are also frequently used in adults for the treatment of mild to moderate obstructive sleep apnea (OSA). Many studies have reported improvement of pharyngeal airway passage (PAP) dimensions following functional appliance therapy in children and oral appliance therapy in adults.

Mortality and treatment patterns among patients hospitalized with acute cardiovascular conditions during dates of national cardiology meetings.

Importance: Thousands of physicians attend scientific meetings annually. Although hospital physician staffing and composition may be affected by meetings, patient outcomes and treatment patterns during meeting dates are unknown.

Objective: To analyze mortality and treatment differences among patients admitted with acute cardiovascular conditions during dates of national cardiology meetings compared with nonmeeting dates.

Outcomes after out-of-hospital cardiac arrest treated by basic vs advanced life support.

Importance: Most out-of-hospital cardiac arrests receiving emergency medical services in the United States are treated by ambulance service providers trained in advanced life support (ALS), but supporting evidence for the use of ALS over basic life support (BLS) is limited.

Objective: To compare the effects of BLS and ALS on outcomes after out-of-hospital cardiac arrest.

Design, Setting, And Participants: Observational cohort study of a nationally representative sample of traditional Medicare beneficiaries from nonrural counties who experienced out-of-hospital cardiac arrest between January 1, 2009, and October 2, 2011, and for whom ALS or BLS ambulance services were billed to Medicare (31,292 ALS cases and 1643 BLS cases).

The Peltzman effect and compensatory markers in medicine.

Unintended consequences of health care interventions are unavoidable. For example, computerized order entry systems, implemented to reduce prescription errors, catalyze novel errors of their own, with providers unexpectedly relying on these systems to provide default dosing information rather than locating appropriate treatment guidelines. We argue that unintended behavioral responses by patients and physicians to health care interventions may explain why certain health care interventions that seem logical and foolproof fail to demonstrate real-world benefits.

Effect of hospital use of oral nutritional supplementation on length of stay, hospital cost, and 30-day readmissions among Medicare patients with COPD.

Background: COPD is a leading cause of death and disability in the United States. Patients with COPD are at a high risk of nutritional deficiency, which is associated with declines in respiratory function, lean body mass and strength, and immune function. Although oral nutritional supplementation (ONS) has been associated with improvements in some of these domains, the impact of hospital ONS on readmission risk, length of stay (LOS), and cost among hospitalized patients is unknown.

Medical malpractice reform: noneconomic damages caps reduced payments 15 percent, with varied effects by specialty.

The impact of medical malpractice reforms on the average size of malpractice payments in specific physician specialties is unknown and subject to debate. We analyzed a national sample of malpractice claims for the period 1985-2010, merged with information on state liability reforms, to estimate the impact of state noneconomic damages caps on average malpractice payment size for physicians overall and for ten different specialty categories. We then compared how the effects differed according to the restrictiveness of the cap ($250,000 versus $500,000).

Exposing physicians to reduced residency work hours did not adversely affect patient outcomes after residency.

In 2003, work hours for physicians-in-training (residents) were capped by regulation at eighty hours per week, leading to the hotly debated but unexplored issue of whether physicians today are less well trained as a result of these work-hour reforms. Using a unique database of nearly all hospitalizations in Florida during 2000-09 that were linked to detailed information on the medical training history of the physician of record for each hospitalization, we studied whether hospital mortality and patients' length-of-stay varied according to the number of years a physician was exposed to the 2003 duty-hour regulations during his or her residency. We examined this database of practicing Florida physicians, using a difference-in-differences analysis that compared trends in outcomes of junior physicians (those with one-year post-residency experience) pre- and post-2003 to a control group of senior physicians (those with ten or more years of post-residency experience) who were not exposed to these reforms during their residency.

Simultaneous whole-body ¹⁸F-FDG PET-MRI in primary staging of breast cancer: a pilot study.

Purpose: Accurate initial staging in breast carcinoma is important for treatment planning and for establishing the likely prognosis. The purpose of this study was to assess the utility of whole body simultaneous (18)F-FDG PET-MRI in initial staging of breast carcinoma.

Methods: 36 patients with histologically confirmed invasive ductal carcinoma underwent simultaneous whole body (18)F-FDG PET-MRI on integrated 3T PET-MR scanner (Siemens Biograph mMR) for primary staging.

Impact of oral nutrition supplements on hospital outcomes in pediatric patients.

Background: Nutrition deficiency is common among hospitalized children. Although oral nutrition supplements (ONS) may improve malnutrition in this population, the benefits and healthcare costs associated with their use have not yet been fully explored. The objective of this study was to assess the effect of ONS use on inpatient length of stay (LOS) and episode cost in hospitalized children.

Association between treatment toxicity and outcomes in oncology clinical trials.

Background: Whether or not toxicity predicts clinical outcomes has long been a question regarding cancer treatments. While prior studies have focused on specific cancers, therapies, and toxicities, no comprehensive evidence exists on whether treatment toxicity predicts favorable outcomes.

Methods: We abstracted treatment toxicity and clinical outcome data from a sample of phase III oncology randomized clinical trials (n = 99 trials).

Anti-inflammatory activity of Odina wodier Roxb, an Indian folk remedy, through inhibition of toll-like receptor 4 signaling pathway.

Inflammation is part of self-limiting non-specific immune response, which occurs during bodily injury. In some disorders the inflammatory process becomes continuous, leading to the development of chronic inflammatory diseases including cardiovascular diseases, diabetes, cancer etc. Several Indian tribes used the bark of Odina wodier (OWB) for treating inflammatory disorders.

Prevalence of Rubber Dam Usage during Endodontic Procedure: A Questionnaire Survey.

Aim: To determine the prevalence and frequency of rubber dam usage for endodontic procedures among general practitioners, specialized practitioners, undergraduate final year students and Endodontists in the state of Odisha, India.

Methodology: A pre-piloted questionnaire was distributed among 737 subjects. Dentists and final year students were surveyed in relation to their prevalence of rubber dam usage.

Turning evidence into practice under payment reform: the new frontier of translational science.

Momentum is building to replace the current fee-for-service payment system with value-based reimbursement models that aim to deliver high quality care at lower costs. Although the goals of payment and delivery system reforms to improve quality and reduce costs are clear, the actual path by which provider groups can achieve these goals is not well understood, in large part because the role of identifying and discouraging the use of low-value, high-cost services and encouraging the use of high-value, low-cost services has traditionally fallen to health plans, not provider groups. The shifting focus towards provider accountability for costs and quality promises to expand the role of provider organizations from mainly delivering care to both delivering and prioritizing it based on costs and quality.