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[PMID]:29365282
[Au] Autor:Desai S; McWilliams JM
[Ad] Endereço:From the Department of Population Health, New York University, New York (S.D.); and the Department of Health Care Policy, Harvard Medical School (S.D., J.M.M.), and the Division of General Internal Medicine and Primary Care, Brigham and Women's Hospital (J.M.M.) - both in Boston.
[Ti] Título:Consequences of the 340B Drug Pricing Program.
[So] Source:N Engl J Med;378(6):539-548, 2018 02 08.
[Is] ISSN:1533-4406
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The 340B Drug Pricing Program entitles qualifying hospitals to discounts on outpatient drugs, increasing the profitability of drug administration. By tying the program eligibility of hospitals to their Disproportionate Share Hospital (DSH) adjustment percentage, which reflects the proportion of hospitalized patients who are low-income, the program is intended to expand resources for underserved populations but provides no direct incentives for hospitals to use financial gains to enhance care for low-income patients. METHODS: We used Medicare claims and a regression-discontinuity design, taking advantage of the threshold for program eligibility among general acute care hospitals (DSH percentage, >11.75%), to isolate the effects of the program on hospital-physician consolidation (i.e., acquisition of physician practices or employment of physicians by hospitals) and on the outpatient administration of parenteral drugs by hospital-owned facilities in three specialties in which parenteral drugs are frequently used. For low-income patients, we also assessed the effects of the program on the provision of care by hospitals and on mortality. RESULTS: Hospital eligibility for the 340B Program was associated with 2.3 more hematologist-oncologists practicing in facilities owned by the hospital, or 230% more hematologist-oncologists than expected in the absence of the program (P=0.02), and with 0.9 (or 900%) more ophthalmologists per hospital (P=0.08) and 0.1 (or 33%) more rheumatologists per hospital (P=0.84). Program eligibility was associated with significantly higher numbers of parenteral drug claims billed by hospitals for Medicare patients in hematology-oncology (90% higher, P=0.001) and ophthalmology (177% higher, P=0.03) but not rheumatology (77% higher, P=0.12). Program eligibility was associated with lower proportions of low-income patients in hematology-oncology and ophthalmology and with no significant differences in hospital provision of safety-net or inpatient care for low-income groups or in mortality among low-income residents of the hospitals' local service areas. CONCLUSIONS: The 340B Program has been associated with hospital-physician consolidation in hematology-oncology and with more hospital-based administration of parenteral drugs in hematology-oncology and ophthalmology. Financial gains for hospitals have not been associated with clear evidence of expanded care or lower mortality among low-income patients. (Funded by the Agency for Healthcare Research and Quality and others.).
[Mh] Termos MeSH primário: Custos de Medicamentos
Economia Hospitalar
Convênios Médico-Hospitalares/estatística & dados numéricos
Medicare Part B/economia
Pobreza
Mecanismo de Reembolso
[Mh] Termos MeSH secundário: Custos e Análise de Custo
Hematologia
Hospitais/estatística & dados numéricos
Seres Humanos
Oncologia
Mortalidade
Oftalmologia
Propriedade
Provedores de Redes de Segurança/economia
Estados Unidos/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180214
[Lr] Data última revisão:
180214
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180125
[St] Status:MEDLINE
[do] DOI:10.1056/NEJMsa1706475


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[PMID]:28466486
[Au] Autor:Shlebak AA; Bain BJ
[Ad] Endereço:Department of Haematology, Imperial College Healthcare NHS Trust Hospitals, London, UK.
[Ti] Título:Training future haematologists, a privilege or a burden? "A trainer's view".
[So] Source:Br J Haematol;178(4):501-507, 2017 08.
[Is] ISSN:1365-2141
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Recent decades have seen the emergence of new problems in haematology training, relating particularly to an expanding curriculum, less time available for training, staff shortages and the increasing separation of clinical haematology from its laboratory base. We have sought to identify the problems and propose possible solutions.
[Mh] Termos MeSH primário: Educação de Pós-Graduação em Medicina/organização & administração
Hematologia/educação
[Mh] Termos MeSH secundário: Comitês Consultivos
Currículo
Educação de Pós-Graduação em Medicina/tendências
Seres Humanos
Admissão e Escalonamento de Pessoal/legislação & jurisprudência
Reino Unido
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1709
[Cu] Atualização por classe:180209
[Lr] Data última revisão:
180209
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170504
[St] Status:MEDLINE
[do] DOI:10.1111/bjh.14697


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[PMID]:29177551
[Au] Autor:Schmidt-Hieber M; Bierwirth J; Buchheidt D; Cornely OA; Hentrich M; Maschmeyer G; Schalk E; Vehreschild JJ; Vehreschild MJGT; AGIHO Working Group
[Ad] Endereço:Clinic for Hematology, Oncology, Tumor Immunology and Palliative Care, HELIOS Klinikum Berlin-Buch, Berlin, Germany.
[Ti] Título:Diagnosis and management of gastrointestinal complications in adult cancer patients: 2017 updated evidence-based guidelines of the Infectious Diseases Working Party (AGIHO) of the German Society of Hematology and Medical Oncology (DGHO).
[So] Source:Ann Hematol;97(1):31-49, 2018 Jan.
[Is] ISSN:1432-0584
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:Cancer patients frequently suffer from gastrointestinal complications. In this manuscript, we update our 2013 guideline on the diagnosis and management of gastrointestinal complications in adult cancer patients by the Infectious Diseases Working Party (AGIHO) of the German Society of Hematology and Medical Oncology (DGHO). An expert group was put together by the AGIHO to update the existing guideline. For each sub-topic, a literature search was performed in PubMed, Medline, and Cochrane databases, and strengths of recommendation and the quality of the published evidence for major therapeutic strategies were categorized using the 2015 European Society for Clinical Microbiology and Infectious Diseases (ESCMID) criteria. Final recommendations were approved by the AGIHO plenary conference. Recommendations were made with respect to non-infectious and infectious gastrointestinal complications. Strengths of recommendation and levels of evidence are presented. A multidisciplinary approach to the diagnosis and management of gastrointestinal complications in cancer patients is mandatory. Evidence-based recommendations are provided in this updated guideline.
[Mh] Termos MeSH primário: Gastroenteropatias/diagnóstico
Gastroenteropatias/etiologia
Gastroenteropatias/terapia
Neoplasias/complicações
[Mh] Termos MeSH secundário: Adulto
Doenças Transmissíveis/terapia
Alemanha
Hematologia/organização & administração
Hematologia/normas
Seres Humanos
Oncologia/organização & administração
Oncologia/normas
Neoplasias/diagnóstico
Neoplasias/terapia
Guias de Prática Clínica como Assunto
Sociedades Médicas/organização & administração
Sociedades Médicas/normas
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180130
[Lr] Data última revisão:
180130
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171128
[St] Status:MEDLINE
[do] DOI:10.1007/s00277-017-3183-7


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[PMID]:29319944
[Au] Autor:Food and Drug Administration, HHS.
[Ti] Título:Medical Devices; Hematology and Pathology Devices; Classification of the Whole Slide Imaging System. Final order.
[So] Source:Fed Regist;83(1):20-2, 2018 Jan 02.
[Is] ISSN:0097-6326
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The Food and Drug Administration (FDA or we) is classifying the whole slide imaging system into class II (special controls). The special controls that apply to the device type are identified in this order and will be part of the codified language for the whole slide imaging system's classification. We are taking this action because we have determined that classifying the device into class II (special controls) will provide a reasonable assurance of safety and effectiveness of the device. We believe this action will also enhance patients' access to beneficial innovative devices, in part by reducing regulatory burdens.
[Mh] Termos MeSH primário: Diagnóstico por Computador/classificação
Diagnóstico por Computador/instrumentação
Segurança de Equipamentos/classificação
Hematologia/classificação
Hematologia/instrumentação
Microscopia/classificação
Microscopia/instrumentação
Patologia/classificação
Patologia/instrumentação
[Mh] Termos MeSH secundário: Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180122
[Lr] Data última revisão:
180122
[Sb] Subgrupo de revista:T
[Da] Data de entrada para processamento:180111
[St] Status:MEDLINE


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[PMID]:29218389
[Au] Autor:Mellinghoff SC; Panse J; Alakel N; Behre G; Buchheidt D; Christopeit M; Hasenkamp J; Kiehl M; Koldehoff M; Krause SW; Lehners N; von Lilienfeld-Toal M; Löhnert AY; Maschmeyer G; Teschner D; Ullmann AJ; Penack O; Ruhnke M; Mayer K; Ostermann H; Wolf HH; Cornely OA
[Ad] Endereço:Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany. sibylle.mellinghoff@uk-koeln.de.
[Ti] Título:Primary prophylaxis of invasive fungal infections in patients with haematological malignancies: 2017 update of the recommendations of the Infectious Diseases Working Party (AGIHO) of the German Society for Haematology and Medical Oncology (DGHO).
[So] Source:Ann Hematol;97(2):197-207, 2018 Feb.
[Is] ISSN:1432-0584
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:Immunocompromised patients are at high risk of invasive fungal infections (IFI), in particular those with haematological malignancies undergoing remission-induction chemotherapy for acute myeloid leukaemia (AML) or myelodysplastic syndrome (MDS) and recipients of allogeneic haematopoietic stem cell transplants (HSCT). Despite the development of new treatment options in the past decades, IFI remains a concern due to substantial morbidity and mortality in these patient populations. In addition, the increasing use of new immune modulating drugs in cancer therapy has opened an entirely new spectrum of at risk periods. Since the last edition of antifungal prophylaxis recommendations of the German Society for Haematology and Medical Oncology in 2014, seven clinical trials regarding antifungal prophylaxis in patients with haematological malignancies have been published, comprising 1227 patients. This update assesses the impact of this additional evidence and effective revisions. Our key recommendations are the following: prophylaxis should be performed with posaconazole delayed release tablets during remission induction chemotherapy for AML and MDS (AI). Posaconazole iv can be used when the oral route is contraindicated or not feasible. Intravenous liposomal amphotericin B did not significantly decrease IFI rates in acute lymphoblastic leukaemia (ALL) patients during induction chemotherapy, and there is poor evidence to recommend it for prophylaxis in these patients (CI). Despite substantial risk of IFI, we cannot provide a stronger recommendation for these patients. There is poor evidence regarding voriconazole prophylaxis in patients with neutropenia (CII). Therapeutic drug monitoring TDM should be performed within 2 to 5 days of initiating voriconazole prophylaxis and should be repeated in case of suspicious adverse events or of dose changes of interacting drugs (BIItu). General TDM during posaconazole prophylaxis is not recommended (CIItu), but may be helpful in cases of clinical failure such as breakthrough IFI for verification of compliance or absorption.
[Mh] Termos MeSH primário: Antifúngicos/uso terapêutico
Hospedeiro Imunocomprometido
Infecções Fúngicas Invasivas/prevenção & controle
Leucemia Mieloide Aguda/terapia
Síndromes Mielodisplásicas/terapia
Prevenção Primária/métodos
[Mh] Termos MeSH secundário: Ensaios Clínicos como Assunto
Monitoramento de Medicamentos
Hematologia
Transplante de Células-Tronco Hematopoéticas
Seres Humanos
Quimioterapia de Indução
Infecções Fúngicas Invasivas/imunologia
Infecções Fúngicas Invasivas/microbiologia
Leucemia Mieloide Aguda/imunologia
Leucemia Mieloide Aguda/patologia
Oncologia
Síndromes Mielodisplásicas/imunologia
Síndromes Mielodisplásicas/patologia
Sociedades Médicas
Triazóis/uso terapêutico
Voriconazol/uso terapêutico
[Pt] Tipo de publicação:JOURNAL ARTICLE; PRACTICE GUIDELINE; REVIEW
[Nm] Nome de substância:
0 (Antifungal Agents); 0 (Triazoles); 6TK1G07BHZ (posaconazole); JFU09I87TR (Voriconazole)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180123
[Lr] Data última revisão:
180123
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171209
[St] Status:MEDLINE
[do] DOI:10.1007/s00277-017-3196-2


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[PMID]:28468985
[Au] Autor:Dinauer MC
[Ad] Endereço:Departments of Pediatrics and Pathology and Immunology, Washington University School of Medicine, St. Louis, Missouri, USA mdinauer@wustl.edu.
[Ti] Título:Laurence Alan Boxer, M.D. (1940-2017).
[So] Source:J Leukoc Biol;101(5):1075, 2017 05.
[Is] ISSN:1938-3673
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Hematologia/história
[Mh] Termos MeSH secundário: História do Século XX
História do Século XXI
Estados Unidos
[Pt] Tipo de publicação:BIOGRAPHY; HISTORICAL ARTICLE; JOURNAL ARTICLE; PORTRAITS
[Ps] Nome de pessoa como assunto:Boxer LA
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171220
[Lr] Data última revisão:
171220
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170505
[St] Status:MEDLINE
[do] DOI:10.1189/jlb.1LT0217-060


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[PMID]:28468984
[Au] Autor:Cowland JB; Horn C; Nauseef WM
[Ad] Endereço:The Granulocyte Research Laboratory, Department of Hematology, National University Hospital, Copenhagen, Denmark.
[Ti] Título:Niels Borregaard, M.D. (1951-2017).
[So] Source:J Leukoc Biol;101(5):1071-1073, 2017 05.
[Is] ISSN:1938-3673
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Hematologia/história
[Mh] Termos MeSH secundário: Dinamarca
História do Século XX
História do Século XXI
[Pt] Tipo de publicação:BIOGRAPHY; HISTORICAL ARTICLE; JOURNAL ARTICLE; PORTRAITS
[Ps] Nome de pessoa como assunto:Borregaard N
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171220
[Lr] Data última revisão:
171220
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170505
[St] Status:MEDLINE
[do] DOI:10.1189/jlb.4LT0217-049R


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[PMID]:28727248
[Au] Autor:Adams DM; Brandão LR; Peterman CM; Gupta A; Patel M; Fishman S; Trenor CC
[Ad] Endereço:Vascular Anomalies Center, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts.
[Ti] Título:Vascular anomaly cases for the pediatric hematologist oncologists-An interdisciplinary review.
[So] Source:Pediatr Blood Cancer;65(1), 2018 Jan.
[Is] ISSN:1545-5017
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Vascular anomalies (VAs) are classified as tumors or malformations depending on their clinical characteristics, pathological diagnosis, and genomic information. Diagnosis can be challenging because of the heterogeneity of clinical presentation; thus, the best diagnosis and care are provided by an interdisciplinary team of specialists. Over the past 10 years, an increasing number of pediatric hematologist/oncologists are caring for patients with VAs secondary to new medical therapy options and clinical trials. This paper focuses on complicated VA issues often seen by the pediatric hematologist/oncologist. The paper reviews clinical pearls on diagnosis, histology, radiology, and treatment options.
[Mh] Termos MeSH primário: Malformações Vasculares
[Mh] Termos MeSH secundário: Adolescente
Criança
Pré-Escolar
Ensaios Clínicos como Assunto
Feminino
Hematologia
Seres Humanos
Lactente
Masculino
Oncologia
Malformações Vasculares/diagnóstico
Malformações Vasculares/diagnóstico por imagem
Malformações Vasculares/patologia
Malformações Vasculares/terapia
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171201
[Lr] Data última revisão:
171201
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170721
[St] Status:MEDLINE
[do] DOI:10.1002/pbc.26716


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[PMID]:28467597
[Au] Autor:Cook AM; Moritz A; Freeman KP; Bauer N
[Ad] Endereço:Department of Clinical Sciences, Clinical Pathophysiology and Clinical Pathology, Faculty of Veterinary Medicine, Justus-Liebig-University Gießen, Gießen, Germany.
[Ti] Título:Objective evaluation of analyzer performance based on a retrospective meta-analysis of instrument validation studies: point-of-care hematology analyzers.
[So] Source:Vet Clin Pathol;46(2):248-261, 2017 Jun.
[Is] ISSN:1939-165X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Information on quality requirements and objective evaluation of performance of veterinary point-of-care analyzers (POCAs) is scarce. OBJECTIVES: The study was aimed at assessing observed total errors (TE s) for veterinary hematology POCAs via meta-analysis and comparing TE to allowable total error (TE ) specifications based on experts' opinions. METHODS: The TE for POCAs (impedance and laser-based) was calculated based on data from instrument validation studies published between 2006 and 2013 as follows: TE = 2 × CV [%] + bias [%]. The CV was taken from published studies; the bias was estimated from the regression equation at 2 different concentration levels of measurands. To fulfill quality requirements, TE should be < TE . Measurands were considered as globally acceptable if > 60% of analyzers showed TE < TE . RESULTS: Six studies evaluating 11 analyzers and 5 studies evaluating 5 analyzers were included for canine and feline hematology variables, respectively. For the CBC, TE was < 15% for canine and < 13% for feline measurands, except for HGB and platelet counts. Measurands of the CBC, excluding differential WBC and platelet counts, and HGB concentration were considered globally acceptable. For most of the cell types in the WBC differential count, TE was > TE (data from 3 analyzers). CONCLUSION: This meta-analysis is considered a pilot study. Experts' requirements (TE < TE ) were fulfilled for most measurands except HGB (due to instrument-related bias for the ADVIA 2120) and platelet counts. Available data on the WBC differential count suggest an analytic bias, so nonstatistical quality control is recommended.
[Mh] Termos MeSH primário: Hematologia/instrumentação
Patologia Veterinária/instrumentação
Sistemas Automatizados de Assistência Junto ao Leito
[Mh] Termos MeSH secundário: Animais
Contagem de Células Sanguíneas/instrumentação
Contagem de Células Sanguíneas/veterinária
Doenças do Gato/sangue
Gatos/sangue
Doenças do Cão/sangue
Cães/sangue
Hematologia/normas
Hemoglobinometria/instrumentação
Hemoglobinometria/veterinária
Contagem de Leucócitos/instrumentação
Contagem de Leucócitos/veterinária
Patologia Veterinária/normas
Contagem de Plaquetas/instrumentação
Contagem de Plaquetas/veterinária
Sistemas Automatizados de Assistência Junto ao Leito/normas
Estudos Retrospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171129
[Lr] Data última revisão:
171129
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170504
[St] Status:MEDLINE
[do] DOI:10.1111/vcp.12492


  10 / 4698 MEDLINE  
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[PMID]:29016811
[Au] Autor:Amukele TK; Hernandez J; Snozek CLH; Wyatt RG; Douglas M; Amini R; Street J
[Ad] Endereço:Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD.
[Ti] Título:Drone Transport of Chemistry and Hematology Samples Over Long Distances.
[So] Source:Am J Clin Pathol;148(5):427-435, 2017 Nov 02.
[Is] ISSN:1943-7722
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Objectives: We addressed the stability of biological samples in prolonged drone flights by obtaining paired chemistry and hematology samples from 21 adult volunteers in a single phlebotomy event-84 samples total. Methods: Half of the samples were held stationary, while the other samples were flown for 3 hours (258 km) in a custom active cooling box mounted on the drone. After the flight, 19 chemistry and hematology tests were performed. Results: Seventeen analytes had small or no bias, but glucose and potassium in flown samples showed an 8% and 6.2% bias, respectively. The flown samples (mean, 24.8°C) were a mean of 2.5°C cooler than the stationary samples (mean, 27.3°C) during transportation to the flight field as well as during the flight. Conclusions: The changes in glucose and potassium are consistent with the magnitude and duration of the temperature difference between the flown and stationary samples. Long drone flights of biological samples are feasible but require stringent environmental controls to ensure consistent results.
[Mh] Termos MeSH primário: Química Clínica/métodos
Hematologia/métodos
Manejo de Espécimes
[Mh] Termos MeSH secundário: Adulto
Feminino
Seres Humanos
Masculino
Fatores de Tempo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171113
[Lr] Data última revisão:
171113
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171011
[St] Status:MEDLINE
[do] DOI:10.1093/ajcp/aqx090



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