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991.
992.
Lindsey M. Philpot Priya Ramar Muhamad Y. Elrashidi Tiffany A. Sinclair Jon O. Ebbert 《Mayo Clinic proceedings. Mayo Clinic》2018,93(10):1431-1439
Objective
To evaluate the impact of opioid controlled substance agreements (CSAs) enrollment on health care utilization.Patients and Methods
We retrospectively evaluated health care utilization changes among 772 patients receiving long-term opioid therapy for chronic noncancer pain enrolled in a CSA between July 1, 2015, and December 31, 2015. We ascertained patient characteristics and utilization 12 months before and after CSA enrollment. Decreased utilization was defined as a decrease of 1 or more hospitalizations or emergency department visits and 3 or more outpatient primary and specialty care visits. Multivariate modeling assessed demographic characteristics associated with utilization changes.Results
The 772 patients enrolled in an opioid CSA during the study period had a mean ± SD age of 63.5±14.9 years and were predominantly female, white, and married. The CSA enrollment was associated with decreased outpatient primary care visits (odds ratio [OR], 0.16; 95% CI, 0.14-0.19) and increased diagnostic radiology services (OR, 1.22; 95% CI, 1.02-1.47). After CSA enrollment, patients with greater comorbidity (Charlson Comorbidity Index score >3) were more likely to have reduced hospitalizations (adjusted OR, 2.8; 95% CI, 1.3-6.0; P=.008), reduced outpatient primary care visits (adjusted OR, 2.0; 95% CI, 1.2-3.2; P=.005), and reduced specialty care visits (adjusted OR, 2.0; 95% CI, 1.2-3.3; P=.006).Conclusion
For patients receiving long-term opioid therapy for chronic noncancer pain, CSA enrollment is associated with reductions in primary care visits and increased radiologic service utilization. Patients with greater comorbidity were more likely to have reductions in hospitalizations, outpatient primary care visits, and outpatient specialty clinic visits after CSA enrollment. The observational nature of the study does not allow the conclusion that CSA implementation is the primary reason for these observed changes. 相似文献993.
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Clinical input of anti‐D quantitation by continuous‐flow analysis on autoanalyzer in the management of high‐titer anti‐D maternal alloimmunization
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997.
Anne F. Kristensen Søren R. Kristensen Ursula Falkmer Anna-Marie B. Münster Shona Pedersen 《Scandinavian journal of clinical and laboratory investigation》2018,78(3):175-179
Background: The Calibrated Automated Thrombography (CAT) is an in vitro thrombin generation (TG) assay that holds promise as a valuable tool within clinical diagnostics. However, the technique has a considerable analytical variation, and we therefore, investigated the analytical and between-subject variation of CAT systematically. Moreover, we assess the application of an internal standard for normalization to diminish variation.Methods: 20 healthy volunteers donated one blood sample which was subsequently centrifuged, aliquoted and stored at ?80?°C prior to analysis. The analytical variation was determined on eight runs, where plasma from the same seven volunteers was processed in triplicates, and for the between-subject variation, TG analysis was performed on plasma from all 20 volunteers. The trigger reagents used for the TG assays included both PPP reagent containing 5?pM tissue factor (TF) and PPPlow with 1?pM TF. Plasma, drawn from a single donor, was applied to all plates as an internal standard for each TG analysis, which subsequently was used for normalization.Results: The total analytical variation for TG analysis performed with PPPlow reagent is 3–14% and 9–13% for PPP reagent. This variation can be minimally reduced by using an internal standard but mainly for ETP (endogenous thrombin potential). The between-subject variation is higher when using PPPlow than PPP and this variation is considerable higher than the analytical variation.Conclusion: TG has a rather high inherent analytical variation but considerable lower than the between-subject variation when using PPPlow as reagent. 相似文献
998.
Red blood cells treated with the amustaline (S‐303) pathogen reduction system: a transfusion study in cardiac surgery
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Veronika Brixner Arndt‐Holger Kiessling Katharina Madlener Markus M. Müller Johannes Leibacher Sarah Dombos Iuliia Weber Hans‐Ulrich Pfeiffer Christof Geisen Michael Schmidt Reinhard Henschler Anne North Norman Huang Nina Mufti Anna Erickson Christine Ernst Salvador Rico Richard J. Benjamin Laurence M. Corash Erhard Seifried 《Transfusion》2018,58(4):905-916
999.
Marcas M. Bamman Gary R. Cutter David M. Brienza John Chae Daniel M. Corcos Stephanie DeLuca Edelle Field-Fote Mona N. Fouad Catherine E. Lang Anne Lindblad Robert W. Motl Carla G. Perna Darcy Reisman Kenneth M. Saag Sean I. Savitz Kathryn H Schmitz Jennifer Stevens-Lapsley John Whyte Mary E. Michel 《Archives of physical medicine and rehabilitation》2018,99(12):2637-2648
The purpose of this Special Communication is to summarize guidelines and recommendations stemming from an expert panel convened by the National Institutes of Health, National Center for Medical Rehabilitation Research (NCMRR) for a workshop entitled The Future of Medical Rehabilitation Clinical Trials, held September 29-30, 2016, at the NCMRR offices in Bethesda, Maryland. The ultimate goal of both the workshop and this summary is to offer guidance on clinical trials design and operations to the medical rehabilitation research community, with the intent of maximizing the effect of future trials. 相似文献
1000.
Cognitive‐Behavioral Therapy for Insomnia to Reduce Chronic Migraine: A Sequential Bayesian Analysis
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