Read by QxMD icon Read

Permanente Journal

Ramzi B Jabaji, Heidi Fischer, Tyler Kern, Gary W Chien
INTRODUCTION: Rapid adoption of robotics has introduced a paradigm change in prostate cancer treatment, with more than 80% of prostatectomies performed robotically in 2015. For treatment of renal cell carcinoma (RCC), this change has not previously been reported. We evaluated trends in surgical management of RCC in Kaiser Permanente Southern California (KPSC) within the last 16 years, especially after adoption of robotics. METHODS: From January 1999 to September 2015, all KPSC members who underwent surgical treatment of suspected RCC were included retrospectively...
2019: Permanente Journal
Jennifer Moeller, Rachele Solomon, Chauniqua Kiffin, Jordan J Ditchek, Dafney L Davare
INTRODUCTION: Melanosis coli is a condition in which the colon develops a brown to black discoloration. It is associated with chronic laxative use and frequently diagnosed incidentally during colonoscopy or histopathologic evaluation. CASE PRESENTATION: A 74-year-old woman presented to the Emergency Department with severe abdominal pain and bilious emesis. During a cecal volvulus repair, her melanosis coli was nearly misdiagnosed as bowel ischemia. DISCUSSION: Melanosis coli is a diagnostic finding that can easily be confused with bowel ischemia, which may create a dilemma for the surgeon who is attempting to make a decision regarding the extent of a colonic resection...
2019: Permanente Journal
Michael Lowry, Latha Achanta
No abstract text is available yet for this article.
2019: Permanente Journal
Yadav Pandey, Rimsha Hasan, Krishna P Joshi, Fuad J Habash, Rajani Jagana
INTRODUCTION: Cardiac complications associated with influenza infection can occur either via a direct effect of the virus on the heart or through exacerbation of preexisting cardiovascular disease. We present a case of a 57-year-old man with acute influenza infection complicated by pericardial effusion and cardiac tamponade. CASE PRESENTATION: A 57-year-old white man presented to the Emergency Department with sudden onset of severe, nonexertional, retrosternal, pressure-like chest pain for a few hours and with fever and muscle aches for 2 days...
2019: Permanente Journal
Chirag Punatar, Kunal Jadhav, Vikash Kumar, Vinod Joshi, Sharad Sagade
INTRODUCTION: We studied the value of neutrophil:lymphocyte ratio (NLR) in predicting the success of nephron-sparing procedures in management of emphysematous pyelonephritis. METHODS: In this single-center retrospective study, patients underwent nephron-sparing procedures between 2007 and 2014. Severity was graded by Huang-Tseng classification. Thrombocytopenia, acute renal failure (ARF), shock, altered sensorium, and admission NLR were evaluated for predictive value for successful outcomes...
2019: Permanente Journal
Jennifer L Kuntz, Louis Kouch, Daniel Christian, Weiming Hu, Preston L Peterson
INTRODUCTION: Use of nonbenzodiazepine sedative hypnotics or "Z-drugs"-including eszopiclone, zolpidem, or zaleplon-is discouraged for older adults; however, these medications commonly are prescribed to treat insomnia in this population. We evaluated the impact of direct-to-patient education, with or without a pharmacist consultation, on Z-drug discontinuation among Kaiser Permanente Northwest members age 64 years and older. METHODS: We randomized 150 patients to usual care (UC), educational information only, or educational information and pharmacist consultation...
2019: Permanente Journal
Rebecca Gologorsky, Elizabeth Cureton, Veronica Shim
BACKGROUND: American Society of Clinical Oncology and College of American Pathologists guidelines recommend repeated evaluation of human epidermal growth factor receptor 2 (HER2) status on surgical specimens from patients with a diagnosis by core-needle biopsy of Grade 3, HER2-negative invasive tumors of the breast. However, there are limited data to support reflexive testing. OBJECTIVE: To evaluate the utility of HER2 retesting of histologic Grade 3, HER2-negative invasive breast carcinomas...
2019: Permanente Journal
James J Annesi
BACKGROUND: Parkinson disease (PD) is a degenerative nervous disorder that affects motor functioning. Although physical activity is beneficial, it often is reduced, and psychosocial issues persist such as low mood and perceptions of loss of control over health. OBJECTIVE: To determine the extent to which a community-based physical activity/self-regulatory skills intervention affects overall physical activity and changes in psychosocial factors in adults with PD and in adults with reduced mobility without PD...
2019: Permanente Journal
Jennifer L Kuntz, Alison Firemark, Jennifer Schneider, Michelle Henninger, Karin Bok, Allison Naleway
INTRODUCTION: There is a lack of research into the perspectives of patients, parents, and clinicians regarding strategies for vaccine-related pain and syncope prevention that may improve the adolescent vaccination experience and encourage future vaccination. OBJECTIVE: To develop an intervention on the basis of preference for strategies to reduce pain and prevent syncope associated with adolescent vaccination. METHODS: We conducted focus groups and interviews with 8 recently vaccinated Kaiser Permanente Northwest (KPNW) members aged 11 to 17 years and their parents to explore perceptions of pain and syncope after vaccination as well as receptivity to potential interventions...
2019: Permanente Journal
Scott Shannon, Nicole Lewis, Heather Lee, Shannon Hughes
CONTEXT: Cannabidiol (CBD) is one of many cannabinoid compounds found in cannabis. It does not appear to alter consciousness or trigger a "high." A recent surge in scientific publications has found preclinical and clinical evidence documenting value for CBD in some neuropsychiatric disorders, including epilepsy, anxiety, and schizophrenia. Evidence points toward a calming effect for CBD in the central nervous system. Interest in CBD as a treatment of a wide range of disorders has exploded, yet few clinical studies of CBD exist in the psychiatric literature...
2019: Permanente Journal
Vincent J Felitti
This article describes the origins of the Division of Health Appraisal in Southern California Permanente Medical Group's San Diego Department of Preventive Medicine, which provided a comprehensive and nontraditional array of preventive medicine services to more than 50,000 members a year. The fusion of Health Appraisal with the Positive Choice risk abatement services provided the origins of the now internationally recognized Adverse Childhood Experiences Study and its major implications for the outcomes and costs of medical care...
2019: Permanente Journal
Mitsuro Chiba, Kunio Nakane, Masafumi Komatsu
Inflammatory bowel disease (IBD), a collective term for Crohn disease and ulcerative colitis, is a polygenic disease thought to be triggered by environmental factors. A Western or westernized lifestyle may be a major driver of the growing incidence of IBD. IBD may represent dysregulated mucosal inflammation to gut microbiota. Despite many review articles on environmental factors in IBD, no consensus exists regarding which factor contributes most to trigger the onset of IBD. Identification and recognition of major environmental factors are prerequisite for effective disease treatment and prevention...
2019: Permanente Journal
Paul Kalnins, Mikael Brucker, Donald Spears
INTRODUCTION: Idiopathic pulmonary fibrosis (IPF) is a lethal, chronic, degenerative disease most commonly affecting the elderly population. The pathologic finding of this restrictive lung condition is excessive deposition of fibrotic tissue in the alveolar interstitium. Conventional therapies minimally alter the course of disease, and mean survival time from diagnosis is only 2 to 4 years. CASE PRESENTATION: A 65-year-old man, diagnosed with IPF in 2007, was being monitored by a conventional pulmonologist while being treated with weekly acupuncture targeting a Chinese medicine diagnosis of spleen dampness and lung qi weakness and with botanical medicine targeting the stimulation of adrenal dehydroepiandrosterone secretion...
2019: Permanente Journal
Sandra Hoyt Stenmark, John F Steiner, Sanjana Marpadga, Marydale Debor, Kathleen Underhill, Hilary Seligman
Traditionally, health care systems have addressed gaps in patients' diet quality with programs that provide dietary counseling and education, without addressing food security. However, health care systems increasingly recognize the need to address food security to effectively support population health and the prevention and management of diet-sensitive chronic illnesses. Numerous health care systems have implemented screening programs to identify food insecurity in their patients and to refer them to community food resources to support food security...
October 5, 2018: Permanente Journal
Alyssa Finger, Mark Harris, Emily Nishimura, Hyo-Chun Yoon
CONTEXT: As the use of computed tomography (CT) scans, which are expensive and result in considerable radiation exposure to the patient, continues to increase, communication between physicians and radiologists remains vital to explain the clinical context for the examination. However, the clinical information provided to the radiologist is often lacking. OBJECTIVE: To determine whether the clinical information provided in CT scan requests meets minimum criteria for requesting the examination...
October 5, 2018: Permanente Journal
Julie A Schmittdiel, Wendy T Dyer, Cassondra J Marshall, Roberta Bivins
CONTEXT: Research on predictors of clinical outcomes usually focuses on the impact of individual patient factors, despite known relationships between neighborhood environment and health. OBJECTIVE: To determine whether US census information on where a patient resides is associated with diabetes development among patients with prediabetes. DESIGN: Retrospective cohort study of all 157,752 patients aged 18 years or older from Kaiser Permanente Northern California with laboratory-defined prediabetes (fasting plasma glucose, 100 mg/dL-125 mg/dL, and/or glycated hemoglobin, 5...
October 5, 2018: Permanente Journal
Kumara Raja Sundar
CONTEXT: Kaiser Permanente's Care Management Institute created a screening tool, Your Current Life Situation (YCLS), which primarily is used to identify social needs for populations at risk of high health care utilization. OBJECTIVE: This frontline improvement project was designed to address key stakeholder concerns about implementing universal screening for social needs using the YCLS in a primary care clinic. METHODS: I conducted a rapid stakeholder analysis through informal conversations to identify the most important concerns...
October 5, 2018: Permanente Journal
David Cawthorpe, Brian Marriott, Jaime Paget, Iraj Moulai, Sandra Cheung
CONTEXT: Developmental psychopathology theory suggests a relationship between early childhood adversity and mental disorder. OBJECTIVE: To examine the relationship between the specific items on the Adverse Childhood Experiences (ACE) survey and the International Classification of Diseases, Tenth Revision (ICD-10) categories of psychiatric diagnoses in a pediatric sample. DESIGN: The sample included patients enrolled in the Child and Adolescent Addiction Mental Health and Psychiatry Program with both a completed ACE survey and at least 1 diagnosis of record (per admission)...
October 5, 2018: Permanente Journal
Kumara Raja Sundar
Using a patient story, this narrative demonstrates why health care organizations, specifically primary care clinics, should strive to identify and to address social needs. This story demonstrates how Kaiser Permanente Washington, by using community resource specialists, has empowered primary care clinics to address social needs in a health care setting to improve patient care and experience.
October 1, 2018: Permanente Journal
Felicitas Livaudais
No abstract text is available yet for this article.
October 1, 2018: Permanente Journal
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"