• Owen Bowen posted an update 6 months, 2 weeks ago

    This study provides new insights regarding the role of natural genetic variation in regulating gene expression and generates testable hypotheses for future functional analyses. © 2020 Everett et al.; Published by Cold Spring Harbor Laboratory Press.BACKGROUND The rapid cost escalation of the government employee scheme in Thailand was driven by the overprescription of non-essential drugs (NEDs), which were not listed in the National Lists of Essential Medicines. A restrictive reimbursement policy implemented in October 2012 required prescribers to base the prescription of NEDs on six criteria, including A and B for safety, C for effectiveness, D for availability, and E and F for costs, hence known as the A-F policy. OBJECTIVE The A-F policy was examined in terms of its outcomes regarding the prescription volume and reimbursement expenditure for lipid-lowering drugs (LLDs). METHODS Data on LLD prescription in 2012-2015 from outpatient settings in 29 public hospitals were standardized using quantities based on the World Health Organization’s Anatomical, Therapeutic and Chemical (ATC) classification and the defined daily dose (DDD) system. The policy effects were estimated using an interrupted time-series analysis. RESULTS The restrictive reimbursement policy decreased both the prescription volume and the reimbursement value of non-essential LLDs. Within the first month of policy implementation, the percentage of NEDs, as defined by DDDs and reimbursement expenditure, immediately decreased by 15.1 and 15.2% points in provincial hospitals and by 8.3 and 4.4% points in military hospitals, respectively. The prescription of NEDs continued to decrease thereafter, despite there being no statistically significant changes in the trend of decreased prescribing compared with the prepolicy period. The decrease in the prescription of NEDs resulted in the declining reimbursed amount per day and stable expenditure of LLDs as a whole. CONCLUSION The effectiveness on the A-F restrictive reimbursement on NED prescribing helped stabilize the expenditure on LLDs. BACKGROUND The performance of pharmacists in clinical services contributes to improving outcomes in patient drug therapy. In the context of streamlined resources and high health services’ demand, the use of patient selection tools can screen those who would benefit more from a pharmaceutical service. OBJECTIVE This review aims to map and describe tools developed for patient selection for pharmaceutical services delivered in primary health care and outpatient settings. METHODS The search was conducted in MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and the Latin American and Caribbean Health Sciences. The search strategy included terms relating to patient selection and outpatient pharmaceutical service. We included papers on outpatient settings, and which described the tool developed for the selection of a patient for pharmaceutical service. Two reviewers extracted data of each study concerning the types and items making up the tool. The items composing the tools were grouped into categoriefy patients who would benefit from the pharmaceutical service accurately. PURPOSE To compare intraocular lens (IOL) dynamics and refractive prediction errors between eyes that underwent phacovitrectomy and eyes that underwent phacoemulsification alone. DESIGN Prospective, nonrandomized, comparative, observational study. PARTICIPANTS Sixty eyes of 60 patients who underwent 25-gauge phacovitrectomy without gas injection for macular pathology and 60 eyes of 60 patients who underwent phacoemulsification alone for cataract were enrolled. METHODS Preoperative optical biometry was performed using the IOLMaster 700 (Carl Zeiss Meditec, Inc, Dublin, CA) to calculate the IOL power with the Barrett Universal II formula. Monofocal, nontoric, single-piece foldable aspherical IOLs were implanted in each patient. Comprehensive ocular examinations, including CASIA2 (Tomey Corp, Nagoya, Japan) evaluations of the preoperative crystalline lens and postoperative IOL positions (i.e., decentration, tilt, and aqueous depth), were performed before and 3 days, 1 month, and 3 months after surgery. MAIN OUTCtoperative IOL positions between the 2 study groups, except for a significantly deeper mean aqueous depth at 3 days after surgery in the phacovitrectomy group. CONCLUSIONS Neither myopic shift nor IOL displacement occurs after 25-gauge phacovitrectomy with a single-piece IOL without gas injection for macular pathology compared with phacoemulsification alone. PURPOSE To estimate rates and risk factors for progression to geographic atrophy (GA) or choroidal neovascularization (CNV) among eyes diagnosed with early or intermediate age-related macular degeneration (AMD) in clinical practice. DESIGN Retrospective cohort analysis of a multicenter electronic medical record (EMR) database from the United Kingdom. PARTICIPANTS Patients aged 50 years or more with diagnosis of early/intermediate AMD in at least 1 eye (the study eye) and no evidence of CNV or GA in the study eye, from 10 clinical sites using the EMR. https://www.selleckchem.com/ METHODS Anonymized data for 40 543 patients with a diagnosis of early/intermediate AMD were extracted between October 2000 and February 2016 from EMR database records held in the 10 sites. A sample of records randomly selected from each center was used to validate disease definitions. Records were analyzed by subgroup, based on the AMD status of the fellow eye. Multivariate Cox regression models identified other predictors of disease progression. MAIN OUTCOME MEAyes with early/intermediate AMD, with the status of the fellow eye affecting the rate of progression. Novel associations with risk factors were observed and require replication in other cohorts. BACKGROUND The main goal of oncoplastic breast-conserving surgery (OBCS) is to obtain tumor-free resection margins after cancer excision with satisfactory cosmetic results. Positive tumor margins are associated with high rates of tumor recurrence requiring reoperation. The aim of this prospective clinical trial was to demonstrate the reliability of intraoperative ultrasound (IOUS) to obtain tumor-free resection margins in OBCS. PATIENTS AND METHODS Between December 2016 and March 2018, data from 130 patients with by T1-2 breast cancer, either invasive or in situ, who underwent OBCS were prospectively collected. The oncoplastic surgeon performed IOUS in the operating theater to localize the lesion and mark its skin projection. Then specimens were examined to assess the presence of the lesion and margin adequacy. Definitive histologic reports were reviewed, with a focus on margin status. RESULTS All patients experienced oncoplastic approaches, and lesions were always found on the specimen at the histologic report.

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