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Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

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At least 109 records · Page 6Linked to original sources
PubMed2001

Promoting quality of care for ESRD patients: the role of the ESRD Networks.

The 18 End Stage Renal Disease (ESRD) Networks were established by Congress to oversee the care of Medicare beneficiaries with ESRD, serving as HCFA's primary quality improvement (QI) agents. The Networks play a critical role in the ESRD surveillance system by collecting, analyzing and disseminating data from dialysis clinics regarding the occurrence of ESRD, and the processes of care and outcomes of ESRD patients. In addition, under the direction of volunteer Medical Review Boards, the Networks propose, design and implement regional QI activities targeting specific areas in the delivery of ESRD care, and provide technical assistance to foster QI at the facility level. In this article, we discuss the ESRD Network system and review the scope of QI activities through which the Networks accomplish their mission.

Communication↗
PubMed2002

Solvent abuse in pregnancy: a perinatal perspective.

OBJECTIVE: To review the scope and sequelae of solvent abuse in women presenting to a Manitoba teaching hospital. METHODS: Fifty-six patient charts with a diagnosis of solvent abuse in pregnancy were identified through computer search in the medical records of Winnipeg Health Sciences Centre, General Hospital. These charts were reviewed and data obtained from birthing records and associated pediatric charts. RESULTS: Renal tubular acidosis was diagnosed in three patients (5.3%). Two patients (3.6%) had adverse neurological sequelae. One patient was diagnosed with brain damage, including expressive aphasia. Twelve patients (21.4%) delivered preterm infants. Nine infants (16.1%) had major anomalies. Seven infants (12.5%) had fetal alcohol syndrome (FAS)-like facial features. Six neonates (10.7%) had hearing loss. CONCLUSION: Substance abuse in pregnancy is associated with severe maternal and neonatal sequelae. Physicians must be aware of this increasing problem in the obstetrical population and assistance should be offered to each woman, ideally before a woman becomes pregnant, but at least at the first contact a pregnant woman makes with the health care community.

Acidosis, Renal Tubular↗
PubMedDate not supplied

[Cochrane EPOC group: closing the gap between quality assurance and organization of care research and front line professionals].

Keeping physicians informed on an ongoing basis is a new challenge for continuing medical education and quality assurance. In Italy over the last 5 years interest in evidence based literature is growing. This is demonstrated by the launch of an Italian edition of Clinical Evidence and by the growing number of guidelines and systematic reviews produced by Italian authors and institutions. However, there is some uncertainty concerning the familiarity of Italian policy makers and public health physicians with the evidence-based resources, including also how to access them. This article attempts to close this gap, by describing the activities of the Cochrane Collaboration and, within it, of the Cochrane Effective Practice and Organisation of Care Group (EPOC), both aim to prepare and maintaining SR of health care interventions. Specifically, the EPOC group develops systematic reviews of professional, financial, organisational and regulatory interventions that are designed to improve professional practice and the delivery of effective health services. EPOC has 31 reviews and 24 protocols published in Issue 4, 2004 of the Cochrane Library and has developed standard methods to assist people, such as quality criteria for study design specific to health services research. The EPOC specialized register contains details of over 2200 studies that fall within the group's scope. Systematic reviews provide a valuable and efficient source of information for policy makers and health care professionals aimed at implementing effective and efficient strategies to encourage medical behavioural change and deliver of high quality services.

Biomedical Research↗
PubMed2004

Observational research in rheumatic disorders.

Observational research plays an important role in science. Much of human knowledge, including health knowledge, comes from observations, not experiments. Within medicine, observational studies cover a wide scope that ranges from case reports and case series, to descriptive studies, to analytic observational studies for causal questions. These studies often are complementary; each provides a piece of information that can be synthesized into a description and analysis of a health problem in a way that tests hypotheses and advances medical science and has the potential to lead to interventions that can improve health and quality of life. This article reviews the scope of observational studies, principles of causal inference in observational studies, and various types of observational studies with a focus of their applications in rheumatic disorders.

Causality↗
PubMed2004

Selection and optimisation of biventricular pacing: the role of echocardiography.

The quantification of ventricular dyssynchrony is a key factor in identifying patients with severe heart failure who may benefit from cardiac resynchronisation with biventricular pacing (BVP). Echocardiographic techniques appear to offer superior sensitivity and specificity than the ECG in selecting these patients. This paper reviews the scope of current echocardiographic techniques for guiding both patient selection and optimisation of device programming following implantation.

Bundle-Branch Block↗
PubMed1980

Operative choledochoscopy: experience with a rigid choledochoscope.

The use of a choledochoscope after exploration of the common bile ducts should minimize the occurrence of retained common bile duct stones. Experience gained at 50 endoscopies with a rigid choledochoscope is reviewed. In 7 cases stones or debris were found remaining in the bile duct. In one case an unsuspected neoplasm was demonstrated and in another a suspected neoplastic stricture was confirmed. In the remaining 41 cases choledochoscopy showed the ducts to be free of stones. Postoperative cholangiography demonstrated a retained stone in 2 cases. There were 2 deaths in the series. The experience of other authors with rigid and flexible scopes is reviewed.

Adult↗
PubMed1989

Medico-legal issues in detecting and proving the sexual abuse of children.

In this article the author reviews the scope and magnitude of the problem currently faced by medical and investigative personnel in detecting and proving the sexual molestation of children. The legal effects of poor medical records are discussed in detail. Various medical and legal issues that may present pitfalls for the unwary examining physician are identified and discussed. The admissibility of various portions of the medical examination and medical report as evidence in courts of law is reviewed as well as newly emerging forensic tests and techniques for collecting medical evidence. The author provides a comprehensive and detailed summary of steps to be followed in the physical examination of a child sex abuse victim, emphasizing the importance of a strict, thorough procedure for protecting the interests of the patient, the physician and society.

Child↗
PubMed2002

Focus groups to support the industrial/product designer: a review based on current literature and designers' feedback.

Focus groups are widely used within human factors, social sciences and market research. Whilst user-research methods may be familiar to other disciplines, conventional design training has not, until recently, incorporated such activities. With the increased awareness for the necessity to elicit user needs beyond the functional, design research is becoming more established. However, there is a significant gap in training material for design research. This paper will review the scope of application of focus group techniques, with particular emphasis on the suitability of focus groups for use by industrial/product designers, based on the current literature and designer feedback from two case studies.

Equipment Design↗
PubMed1992

[Chronic disease, the chronic patient and his family. Psychosocial impact of diabetes mellitus].

Concerning a revision about the mutual influence between the diabetes, the diabetic and his family, the author reviews the literature about the psychosocial area of the Family Physician content's work. It is also confirmed the high prevalency of the chronic disease and the importance of the family ecosystem, not only as support but also as problem to the bearing person of such type of disease. Studies of chronic disease indicate that family dysfunction is associated with poor health outcomes. The areas which more and better have been studied in this scope are reviewed. Thus, having as backdrop the diabetes management, the family's diabetic influence in general is reviewed, as well as the parental attitudes, the family organization and the family life events. Finally, the health care team role is reviewed and particulary the role of the family physician in the management of this type of patients. It is pointed out, as example of the Family Medicine specific contribution, the improving cooperation with medical treatment from the diabetic.

Adaptation, Psychological↗
PubMed2005

Concordance, compliance and adherence in healthcare: closing gaps and improving outcomes.

The gap between best care and usual care is large for many important diseases. In particular, poor adherence remains a significant, inadequately addressed, cause of the care gap. About half of all patients with chronic diseases stop refilling prescriptions by one year. Several effective interventions are available and adaptations of clinical trials practices offer promise for further improvement. Poor adherence is a remedial problem in healthcare quality and its improvement and accountability offer shared opportunities for providers and patients. There is a large gap between best care, defined as the optimal use of proven efficacious therapies in whole populations at risk from any disease, and usual care, the actual level of efficacious care being provided (Montague et al. 1997). This gap in patient care has four main causes: diseases may not be diagnosed, efficacious therapies may not be prescribed, access to therapy may be restricted or patients may not adhere to prescriptions. Irrespective of causation, the ultimate result of care gaps is the same--less than optimal clinical outcomes and associated lost opportunities for improved quality of life and productivity. Systematic approaches to improving prescribing practices are increasing, and there is much debate around improving patients' access to care. Poor diagnosis is judged to be relatively uncommon, leaving decayed adherence as the major under-addressed cause of care gaps and a major opportunity for improvement. This paper reviews the scope and causation of sub-optimal adherence, evaluates improvement strategies and explores a best-practice benchmark.

Chronic Disease↗
PubMed1998

The evolution of courses in professional skills and perspectives for medical students.

A number of medical schools substantially revised their curricula in response to the GPEP Report, issued by the Association of American Medical Colleges in 1984. One of the most important areas of change has been in the way students are introduced to the professional skills and perspectives they will need to practice clinical medicine. A number of schools have recently developed interdisciplinary courses to accomplish this goal. Such courses may differ in scheduling, format, and focus, but they share a commitment to broadening skills and perspectives through experiential learning and small-group work. Most of these courses span the entire first two years of the curriculum, and some extend into the third and fourth years, blurring the line between the "preclinical" and "clinical" years. The near-simultaneous, largely independent introduction of major courses of this type into the curricula of some medical schools has gone largely unreported in the literature. This overview article discusses the origins of these courses and reviews the scope of the curricula now in place. Among the most comprehensive programs are those at Northwestern University, Oregon Health Sciences University, the University of California, Los Angeles, and the University of Nebraska, each of which is described and discussed in the following papers.

Academic Medical Centers↗
PubMed1991

Urinary tract injuries in pelvic surgery.

In this article, we have reviewed the scope of surgically induced damage to the lower urinary tract. Preventative and reparative techniques have been presented. As pelvic surgeons become more confident in their efforts to safeguard the urinary tract, the chance of an unrecognized injury causing morbidity will diminish.

Female↗
PubMed2006

Current practice in paediatric videofluoroscopy.

Use of the videofluoroscopy swallow study (VFSS), also known as the modified barium swallow (MBS), continues to increase in children. This article reviews the scope and limitations of the examination, explores the current techniques and illustrates some of the main findings. As moving images are key to the understanding of the use of this technique short videos are available in the on-line version of this paper.

Barium Sulfate↗
PubMed2001

[Ultrasound in pediatric urology].

UNLABELLED: GENERAL OBJECTIVE: To review technical considerations, indications, findings and limitations of ultrasound and Doppler in pediatric urology. EDUCATIONAL OBJECTIVES: This course aims to help the reader improve his/her own technical skills and knowledge of ultrasound findings as well as their significance in pediatric urology. The most common causes of misinterpretation and limitations are reviewed. The scope of the article is limited to common diseases: infection, urinary tract malformation, trauma and tumor. Because ultrasound cannot be separated from other imaging modalities, the indications for each of these imaging modalities are provided in relevant sections.

Age Factors↗
PubMed2004

The renal patient with coronary artery disease: current concepts and dilemmas.

The patient with chronic kidney disease and coronary artery disease (CAD) presents special challenges. This report reviews the scope of the challenge, the hostile internal milieu predisposing to CAD and cardiac events, management issues, unresolved dilemmas, and the need for randomized trials to allow for evidence-based treatment.

Angioplasty, Balloon, Coronary↗
PubMed2005

The sensitized pediatric heart transplant candidate: causes, consequences, and treatment options.

Sensitization to HLA antigens and the subsequent development of HLA antibodies in children under consideration for heart transplantation is a significant impediment to survival after listing. This is related both to the frequent need for prospective donor-specific crossmatching (thus limiting donor availability and increasing pretransplant morbidity and mortality), and to the increased risk of adverse outcomes after transplantation. This article will review the scope of this problem in children under consideration for heart transplantation, the different methods available for diagnosing HLA sensitization, the known causes of HLA sensitization, the consequences of these preformed antibodies on outcomes before and after heart transplantation, and the different methods of preventing and treating this sensitization that are currently available. Improved methods of diagnosing, preventing, and treating this problem can only lead to better outcomes for children who require heart transplantation.

Antibodies, Monoclonal↗