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Permanente Journal

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https://www.readbyqxmd.com/read/28898198/appropriate-interval-for-imaging-follow-up-of-small-simple-pancreatic-cysts
#1
Jordan Menda, Maile E Yoon, Hyo-Chun Yoon
CONTEXT: The frequency at which patients should undergo follow-up imaging of small pancreatic cysts is problematic because different medical societies have different follow-up guidelines. OBJECTIVE: To determine whether short-term follow-up of small pancreatic cysts is necessary to detect pancreatic cancer or cystic neoplasia. DESIGN: We retrospectively reviewed all abdominal magnetic resonance imaging (MRI) studies obtained in a geographically isolated health maintenance organization between January 1, 2012, and December 31, 2014, looking for pancreatic cysts...
2017: Permanente Journal
https://www.readbyqxmd.com/read/28898197/urgent-need-for-improved-mental-health-care-and-a-more-collaborative-model-of-care
#2
James Lake, Mason Spain Turner
Current treatments and the dominant model of mental health care do not adequately address the complex challenges of mental illness, which accounts for roughly one-third of adult disability globally. These circumstances call for radical change in the paradigm and practices of mental health care, including improving standards of clinician training, developing new research methods, and re-envisioning current models of mental health care delivery. Because of its dominant position in the US health care marketplace and its commitment to research and innovation, Kaiser Permanente (KP) is strategically positioned to make important contributions that will shape the future of mental health care nationally and globally...
2017: Permanente Journal
https://www.readbyqxmd.com/read/28898196/teens-and-technology-transforming-acne-treatment
#3
Donna Lee Ettel, Lora Rose Lamanno, Sarah Anne Neyra, Wallace John Ettel, George Leonard Ettel Iii, Matthew Kevin Mitchell
INTRODUCTION: Although the Internet contains many health Web sites with valid information, it also contains sites with false information. OBJECTIVE: To learn whether high school students searching health care information believe they are using evidence-based sites and to understand their topics of interest, frequently navigated sites, and trust/confidence in the credibility of information found. DESIGN: Cross-sectional. MAIN OUTCOME MEASURES: Students at a private high school answered an anonymous survey inquiring about their belief that they were using evidence-based sites, topics of interest, search engines of choice, and their trust in information obtained...
2017: Permanente Journal
https://www.readbyqxmd.com/read/28898195/user-centered-design-for-developing-interventions-to-improve-clinician-recommendation-of-human-papillomavirus-vaccination
#4
Michelle L Henninger, Carmit K Mcmullen, Alison J Firemark, Allison L Naleway, Nora B Henrikson, Joseph A Turcotte
INTRODUCTION: Human papillomavirus (HPV) is the most common sexually transmitted infection in the US and is associated with multiple types of cancer. Although effective HPV vaccines have been available since 2006, coverage rates in the US remain much lower than with other adolescent vaccinations. Prior research has shown that a strong recommendation from a clinician is a critical determinant in HPV vaccine uptake and coverage. However, few published studies to date have specifically addressed the issue of helping clinicians communicate more effectively with their patients about the HPV vaccine...
2017: Permanente Journal
https://www.readbyqxmd.com/read/28746028/the-kaiser-permanente-northern-california-enhanced-recovery-after-surgery-program-design-development-and-implementation
#5
Vincent X Liu, Efren Rosas, Judith C Hwang, Eric Cain, Anne Foss-Durant, Molly Clopp, Mengfei Huang, Alexander Mustille, Vivian M Reyes, Shirley S Paulson, Michelle Caughey, Stephen Parodi
Complications are common after surgery, highlighting the need for innovations that reduce postsurgical morbidity and mortality. In this report, we describe the design, development, and implementation of an Enhanced Recovery After Surgery program in the Kaiser Permanente Northern California integrated health care delivery system. This program was implemented and disseminated in 2014, targeting patients who underwent elective colorectal resection and those who underwent emergent hip fracture repair across 20 Medical Centers...
2017: Permanente Journal
https://www.readbyqxmd.com/read/28746027/abdominal-distension-an-unexpected-gift
#6
Ching Soong Khoo
No abstract text is available yet for this article.
2017: Permanente Journal
https://www.readbyqxmd.com/read/28746026/complementary-and-alternative-medicine-in-an-integrated-health-care-delivery-system-users-of-chiropractic-acupuncture-and-massage-services
#7
Tracy Mccubbin, Karin L Kempe, Arne Beck
INTRODUCTION: Complementary and alternative medicine research has relied primarily on survey data from community populations rather than from patient populations receiving these services in integrated health care delivery systems (IHDS). OBJECTIVES: To describe patients seeking chiropractic, acupuncture, or massage therapy in a dedicated Center for Complementary Medicine (CCM) within an IHDS. METHODS: Patient surveys at the initial CCM visit included chief complaint, prior treatments, and relief with treatment (0% to 100% relief)...
2017: Permanente Journal
https://www.readbyqxmd.com/read/28746025/-it-keeps-us-from-putting-drugs-in-pockets-how-a-public-private-partnership-for-hospital-management-may-help-curb-corruption
#8
Taryn Vian, Nathalie Mcintosh, Aria Grabowski
INTRODUCTION: Health care sector corruption diverts resources that could otherwise be used to improve access to health services. Use of private-sector practices such as a public-private partnership (PPP) model for hospital governance and management may reduce corruption. In 2011, a government-run hospital in Lesotho was replaced by a PPP hospital, offering an opportunity to compare hospital systems and practices. OBJECTIVE: To assess whether a PPP model in a hospital can help curb corruption...
2017: Permanente Journal
https://www.readbyqxmd.com/read/28746024/impact-of-longitudinal-electronic-health-record-training-for-residents-preparing-for-practice-in-patient-centered-medical-homes
#9
Jung G Kim, Hector P Rodriguez, Katherine At Estlin, Carl G Morris
INTRODUCTION: Competence in using an electronic health record (EHR) is considered a critical skill for physicians practicing in patient-centered medical homes (PCMHs), but few studies have examined the impact of EHR training for residents preparing to practice in PCMHs. This study explored the educational outcomes associated with comprehensive EHR training for family medicine residents. METHODS: The PCMH EHR training consisted of case-based routine clinic visits delivered to 3 resident cohorts (N = 18)...
2017: Permanente Journal
https://www.readbyqxmd.com/read/28746023/the-patient-centered-medical-home-as-a-community-based-strategy
#10
Berkeley A Franz, John W Murphy
Increasing attention has been devoted to the important role that primary care will play in improving population health. One innovation, the patient-centered medical home (PCMH), aims to unite a variety of professionals with patients in the prevention and treatment of illness. Although patient perspectives are critical to this model, this article questions whether the PCMH in practice is truly community-based. That is, do physicians, planners, and other health care professionals take seriously the value of integrating local knowledge into medical care? The argument presented is that community-based philosophy contains a foundational principle that the perspectives of health care practitioners and community members must be integrated...
2017: Permanente Journal
https://www.readbyqxmd.com/read/28746022/mortality-after-total-knee-and-total-hip-arthroplasty-in-a-large-integrated-health-care-system
#11
Maria C S Inacio, Mark T Dillon, Alex Miric, Ronald A Navarro, Elizabeth W Paxton
CONTEXT: The number of excess deaths associated with elective total joint arthroplasty in the US is not well understood. OBJECTIVE: To evaluate one-year postoperative mortality among patients with elective primary and revision arthroplasty procedures of the hip and knee. DESIGN: A retrospective analysis was conducted of hip and knee arthroplasties performed in 2010. Procedure type, procedure volume, patient age and sex, and mortality were obtained from an institutional total joint replacement registry...
2017: Permanente Journal
https://www.readbyqxmd.com/read/28746021/use-of-a-technetium99m-sestamibi-scan-to-detect-ipsilateral-double-adenoma-in-a-patient-with-primary-hyperparathyroidism-a-case-report
#12
Joseph Gabriel Gabriel, Alejandro Contreras, Andrew Rosenthal
INTRODUCTION: Patients with primary hyperparathyroidism generally have a single parathyroid adenoma that causes excessive excretion of parathyroid hormone. For about 2% to 15% of these patients, a double adenoma is present that involves one lesion on each side of the neck. CASE PRESENTATION: We describe a case of double parathyroid adenoma causing asymptomatic hypercalcemia. A presurgical technetium99m (Tc99m) sestamibi scan suggested an ipsilateral double adenoma in the left thyroid lobe...
2017: Permanente Journal
https://www.readbyqxmd.com/read/28746020/pembrolizumab-induced-pancytopenia-a-case-report
#13
Dinesh Atwal, Krishna P Joshi, Rahul Ravilla, Fade Mahmoud
INTRODUCTION: Programmed death receptor-1 blockade with pembrolizumab is approved by the US Food and Drug Administration to treat patients with metastatic melanoma. Activating T cells to fight cancer may cause immune-mediated adverse events. Pembrolizumab-induced pancytopenia has not been previously reported in the medical literature, to our knowledge. CASE PRESENTATION: A 52-year-old Caucasian woman with a diagnosis of metastatic melanoma of the rectum experienced multiple adverse events along her course of therapy with pembrolizumab, ranging from colitis, hepatitis, gastritis, and vitiligo after the fifth cycle of pembrolizumab; to knee synovitis after the 14th cycle; and to severe pancytopenia after the 18th cycle of pembrolizumab...
2017: Permanente Journal
https://www.readbyqxmd.com/read/28746019/evaluation-of-a-just-in-time-nurse-consultation-on-bone-health-a-pilot-randomized-controlled-trial
#14
Douglas W Roblin, David Zelman, Sally Plummer, Brandi E Robinson, Yiyue Lou, Stephanie W Edmonds, Fredric D Wolinsky, Kenneth G Saag, Peter Cram
CONTEXT: Evidence is inconclusive whether a nurse consultation can improve osteoporosis-related patient outcomes. OBJECTIVE: To evaluate whether a nurse consultation immediately after dual-energy x-ray absorptiometry (DXA) produced better osteoporosis-related outcomes than a simple intervention to activate adults in good bone health practices or usual care. DESIGN: Pilot randomized controlled trial, conducted within the larger Patient Activation After DXA Result Notification (PAADRN) trial (NCT01507662)...
2017: Permanente Journal
https://www.readbyqxmd.com/read/28746018/splenic-abscess-in-immunocompetent-patients-managed-primarily-without-splenectomy-a-series-of-7-cases
#15
S Divyashree, Nikhil Gupta
INTRODUCTION: Splenic abscesses are rare in immunocompetent adults. Despite advances in diagnosis and treatment, these abscesses are still potentially life threatening. Various factors have been reported to predispose otherwise immunocompetent adults to splenic abscesses. Splenectomy was once considered the "gold standard" treatment. However, the trend is shifting to a conservative approach. CASE DESCRIPTION: We describe seven cases of splenic abscess in immunocompetent adults, the cause of which ranged from tuberculosis to salmonella and was as rare as Plasmodium vivax...
2017: Permanente Journal
https://www.readbyqxmd.com/read/28678695/body-mass-index-and-mortality-in-a-very-large-cohort-is-it-really-healthier-to-be-overweight
#16
Arthur L Klatsky, Jasmine Zhang, Natalia Udaltsova, Yan Li, H Nicole Tran
CONTEXT: Controversy persists about optimal body weight. Many experts define "normal" (healthy) body mass index (BMI) as 18.5 to 24.9 kg/m(2), 25 to 29.9 kg/m(2) as overweight, and 30 kg/m(2) or greater as obese. Obesity is subdivided into 30 to 34.9 kg/m(2) (Grade 1), 35 to 39.9 kg/m(2) (Grade 2), and 40 kg/m(2) and above (Grade 3). Studies consistently show higher mortality for underweight and Grade 2 or 3 obesity, but results conflict for the overweight category and Grade 1 obesity...
2017: Permanente Journal
https://www.readbyqxmd.com/read/28678694/image-diagnosis-carcinoid-tumorlets-and-pulmonary-sequestration-in-a-patient-with-chronic-cough-without-a-history-of-malignancy
#17
Zhou Zhang, Harleen Hayreh
No abstract text is available yet for this article.
2017: Permanente Journal
https://www.readbyqxmd.com/read/28678693/effect-of-age-on-outcomes-of-shoulder-arthroplasty
#18
Oke A Anakwenze, Tameem Yehyawi, Mark T Dillon, Elizabeth Paxton, Ronald Navarro, Anshuman Singh
CONTEXT: Outcomes of total shoulder arthroplasty (TSA) and reverse total shoulder arthroplasty (RTSA) as a function of age are not well known. OBJECTIVE: To understand the effects of age on revision rate, mortality, and hospital readmissions. DESIGN: A retrospective cohort study of prospectively collected data. Using an integrated health care system's shoulder arthroplasty registry, we identified patients who underwent TSA and RTSA between January 2007 and June 2012...
2017: Permanente Journal
https://www.readbyqxmd.com/read/28678692/incidence-of-pulmonary-arterial-hypertension-in-patients-with-psoriasis-a-retrospective-cohort-study
#19
Young M Choi, Shannon Famenini, Jashin J Wu
CONTEXT: Inflammatory signaling may play an important role in the pathogenesis of pulmonary arterial hypertension (PAH). OBJECTIVE: To assess the incidence of PAH in patients with mild and severe psoriasis compared with their respective controls. DESIGN: From January 2004 to November 2012, we performed a retrospective cohort study of patients with psoriasis in the Kaiser Permanente Southern California Health Plan. Patients with an International Classification of Diseases, Ninth Revision Clinical Modification diagnostic code for psoriasis (696...
2017: Permanente Journal
https://www.readbyqxmd.com/read/28678691/deer-in-the-headlights
#20
Tom Paluch
No abstract text is available yet for this article.
2017: Permanente Journal
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