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81.
Matthew L. Goldman Brigitta Spaeth-Rublee Abraham D. Nowels Parashar Pravin Ramanuj Harold Alan Pincus 《Current psychiatry reports》2016,18(4):39
The development of quality measures has gained increasing attention as health care reimbursements transition from fee-for-service to value-based payment models. As behavioral health care moves towards integration of services with primary care, specific measures and payment incentives will be needed to successfully expand access. This study uses a keyword search to identify 730 quality indicators that are relevant to behavioral health and general medical health. Measures identified have been coded and grouped into domains based on a taxonomy developed by the authors. The analysis reveals that quality measures focusing on general medical conditions exceed those focused on behavioral health diagnoses for evidence-based treatments, patient safety, and outcomes. Furthermore, measures predominantly concentrate on care during or following hospitalizations, which represents a minority of behavioral health care and does not characterize the outpatient settings that are the focus of many models of integrated care. The authors offer recommendations for future steps to identify the quality measures that can best evaluate the evolving behavioral health care system. 相似文献
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83.
Yuliya Kats M.D. Pallavi Solanki M.D. Alfonso H. Waller M.D. Pierre D. Maldjian M.D. † Kamran Hamirani M.D. Steve C. Tsai M.D. Vivek Dhruva D.O. Marc Klapholz M.D. Muhamed Saric M.D. Ph.D. 《Echocardiography (Mount Kisco, N.Y.)》2010,27(1):E13-E17
We describe a patient with an infrequent combination of variants in both the right and the left coronary arterial ostia, namely a combination of two separate right coronary artery (RCA) ostia from the aorta, and an anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA). To our knowledge, such a combination has not been previously reported. Based on published statistics for individual variants, such a combination is expected to occur approximately once for every 500,000 to one million live births. ALCAPA and dual RCA anatomy was characterized in our patient by echocardiography, conventional angiography, and multidetector computed tomography before and after Takeuchi repair. (Echocardiography 2010;27:E13-E17) 相似文献
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Treatment of syndactyly necessitates creation of neo-web space and separation of fingers. Traditionally, this has been done
by use of flaps taken from the dorsum; the resultant raw areas thus created have been managed by use of skin grafts. The classical
teaching has been that the separated fingers will need skin graft as primary closure is not possible. The skin grafts have
a tendency to contract and lead to finger flexion contractures and “creep” of the web space. We describe a flap based upon
subcutaneous tissue in the web that is moved in a V–Y fashion to resurface the neo-web. The flap donor site can easily be
closed primarily. The fingers are then separated; the subcutaneous fat is carefully removed from the finger flaps under magnification
to allow primary closure of the finger defects. It has been possible to primarily close the donor site and fingers in all
the patients. The procedure has been used in seven patients with 14 web releases. The age varied between 10 months to 3 years.
The V–Y advancement flap based upon the subcutaneous pedicle in the region of the web allows adequate creation of a new web
space. The careful de-fattening of skin flaps allows the separated fingers to be closed primarily. 相似文献
86.
Opinion statement Depression is common in the community and is a risk factor for the development of coronary heart disease (CHD). In patients
with CHD, the prevalence of major depression is nearly 20% and the prevalence of minor depressive disorder is approximately
27%. When present in patients with existing CHD, depression is independently associated with worse outcome, including higher
morbidity and mortality, and worse health status. Observational studies suggest that use of antidepressant medications in
patients with CHD is associated with decreased risk of cardiovascular events. However, only one randomized controlled trial,
the ENRICHD (Enhancing Recovery in Coronary Heart Disease) study, was designed to evaluate whether treatment of depression
in patients with CHD can improve cardiac prognosis. Although the study showed that cognitive behavior therapy was better than
usual care in improving depression, there was no improvement in all-cause mortality or recurrent cardiac events. There have
been no clinical trials specifically designed to evaluate whether pharmacologic treatment of depression improves cardiovascular
outcomes in patients with CHD. Thus, there is a clear need for additional trials testing interventions to improve cardiac
prognosis based on treatment of depression. In the meantime, depression remains an important illness in its own right and
deserves treatment. Safe and effective treatments of depression in patients with CHD include cognitive behavior therapy and
selective serotonin reuptake inhibitors. 相似文献
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88.
M.M. Freeman T. Kerin J. Hull E. Teel M. Esona U. Parashar R.I. Glass J.R. Gentsch 《Journal of medical virology》2009,81(4):736-746
Rotavirus serotype G12 was initially identified in the Philippines in 1987 and was not described again until it reemerged more than 13 years later. G12 strains were first detected in the United States in 2002 and have recently assumed a worldwide distribution. The high similarity between the sequence of the major outer capsid VP7 gene of human G12 strains and the single porcine G12 isolate raised the prospect that human strains may have arisen through reassortment with porcine strains or, alternatively, that the porcine strain originally came from humans. We sequenced portions of the remaining 10 segments of two human G12 strains (G12P[8] and G12P[6]) and a currently circulating common strain (G1P[8]) identified during the 2005–2006 surveillance season and compared the sequences with those of strains available through GenBank. By comparison, the three strains were all Wa‐like and not porcine‐like. A newly outlined classification system proposed genotypes for each gene segment based on nucleotide similarity. Using this approach, gene segments VP1–3, VP6 and NSP1–5 grouped within the same genotype, indicating that the three strains analyzed were closely related. These results suggest that the novel G12P[8] strain could have been formed by the solitary introduction of a VP7 gene into a globally common rotavirus strain, G1P[8]. Classifying rotavirus strains based only on VP7 (G) and VP4 (P) genotype potentially underestimates diversity and sequence analysis of the other segments is required to assess the complete genetic relationships between strains. J. Med. Virol. 81:736–746, 2009 © 2009 Wiley‐Liss, Inc. 相似文献
89.
90.
Jalalpure SS Mandavkar YD Khalure PR Shinde GS Shelar PA Shah AS 《Journal of ethnopharmacology》2011,138(3):700-704