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Permanente Journal

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https://www.readbyqxmd.com/read/29035189/cancer-screening-reminders-addressing-the-spectrum-of-patient-preferences
#1
Susan D Brandzel, Erin J Aiello Bowles, Arika Wieneke, Susan Carol Bradford, Kilian Kimbel, Hongyuan Gao, Diana Sm Buist
CONTEXT: Health care systems continue to seek evidence about how to optimize the efficiency and effectiveness of cancer screening reminders. Annual reminders to receive preventive services can be an efficient strategy. OBJECTIVE: To understand patient motivators and barriers to cancer screening and preferences about reminder strategies. DESIGN: We conducted 11 focus groups among adults recommended for cancer screening within Kaiser Permanente Washington...
2017: Permanente Journal
https://www.readbyqxmd.com/read/29035188/finding-purpose-honing-the-practice-of-making-meaning-in-medicine
#2
Lois Leveen
Despite decades of advances in diagnosing and treating a broad range of illnesses, many changes in our health care system impede true caregiving, leaving patients and practitioners dissatisfied and creating an emotional burden for practitioners that contributes to the staggering rates of physician burnout. Given this dissatisfaction and disconnection, practitioners and patients alike can benefit from structured opportunities to explore the expectations, assumptions, and emotions that shape our understanding of health and illness, and thus our experiences within the health care system...
2017: Permanente Journal
https://www.readbyqxmd.com/read/29035187/defecation-specific-behavior-in-children-with-functional-defecation-issues-a-systematic-review
#3
REVIEW
Isabelle Beaudry-Bellefeuille, Debbie Booth, Shelly J Lane
CONTEXT: Atypical defecation habits are common and distressing for children and families and can have a major impact on quality of life. Often, no underlying factor can be identified, and the defecation disorder is considered functional. Current interventions are not successful for up to 50% of children. We suggest this high failure rate may be caused by lack of consistency in descriptors of behavioral indicators for functional defecation problems. Most investigations and descriptors focus on general behavior...
2017: Permanente Journal
https://www.readbyqxmd.com/read/29035186/left-ventricular-noncompaction-cardiomyopathy-and-recurrent-polymorphic-ventricular-tachycardia-a-case-report-and-literature-review
#4
Oluwaseun A Akinseye, Uzoma N Ibebuogu, Sunil K Jha
INTRODUCTION: Noncompaction cardiomyopathy is a rare phenotype of cardiomyopathy associated with severe cardiac arrhythmia and thromboembolic complications. CASE PRESENTATION: A 55-year-old woman presented with frank pulmonary edema and received a diagnosis of noncompaction cardiomyopathy. DISCUSSION: Left ventricular noncompaction cardiomyopathy is increasingly being diagnosed because of advances in imaging modalities. It is important to differentiate this new phenotype of cardiomyopathy from others because its diagnosis, management, and prognosis differ...
2017: Permanente Journal
https://www.readbyqxmd.com/read/29035185/image-diagnosis-yellow-palms-and-soles-look-beyond-the-eyes-and-think-beyond-hyperbilirubinemia
#5
Puneet Chhabra, Deepak K Bhasin
No abstract text is available yet for this article.
2017: Permanente Journal
https://www.readbyqxmd.com/read/29035184/the-art-of-healing-through-narrative-medicine-in-clinical-practice-a-reflection
#6
Aeman Muneeb, Hena Jawaid, Natasha Khalid, Asad Mian
The art of medicine has roots that lie deep in developing the biopsychosocial connection. Understanding a human body (both its physiology and pathology) along with components of emotional and spiritual cores can lead to provision of excellent medical care and better outcomes. The harmonization of psychosocial consequences of a biological disease is helpful not just for health care professionals but also for patients. Where it keeps the empathy and compassion alive and results in greater patient satisfaction, it also helps boost the physician's morale...
2017: Permanente Journal
https://www.readbyqxmd.com/read/29035183/atypical-presentation-of-acute-angle-closure-glaucoma-in-maroteaux-lamy-mucopolysaccharidosis-with-patent-prophylactic-laser-peripheral-iridotomy-a-case-report
#7
Malini Veerappan, Garrick Chak, Christine Shieh, Pratap Challa
INTRODUCTION: Maroteaux-Lamy syndrome (MLS) is a rare progressive condition characterized by inflammation and scarring of multiple organs. Ocular complications caused by anterior segment abnormalities commonly cause visual impairment in MLS. Angle-closure glaucoma is one such complication, but there are limited data on presentation, workup, and management of this condition. CASE PRESENTATION: This case report describes an atypical presentation of acute angle-closure glaucoma in a patient with MLS despite a prior prophylactic laser peripheral iridotomy-which would typically prevent an acute angle-closure attack-that was patent and intact at the time of angle closure...
2017: Permanente Journal
https://www.readbyqxmd.com/read/29035182/induction-with-infliximab-and-a-plant-based-diet-as-first-line-ipf-therapy-for-crohn-disease-a-single-group-trial
#8
Mitsuro Chiba, Tsuyotoshi Tsuji, Kunio Nakane, Satoko Tsuda, Hajime Ishii, Hideo Ohno, Kenta Watanabe, Mai Ito, Masafumi Komatsu, Takeshi Sugawara
BACKGROUND: Approximately 30% of patients with Crohn disease (CD) are unresponsive to biologics. No previous study has focused on a plant-based diet in an induction phase of CD treatment. OBJECTIVE: To investigate the remission rate of infliximab combined with a plant-based diet as first-line (IPF) therapy for CD. METHODS: This was a prospective single-group trial conducted at tertiary hospitals. Subjects included consecutive adults with a new diagnosis (n = 26), children with a new diagnosis (n = 11), and relapsing adults (n = 9) with CD who were naïve to treatment with biologics...
2017: Permanente Journal
https://www.readbyqxmd.com/read/29035181/minimizing-medical-radiation-exposure-by-incorporating-a-new-radiation-vital-sign-into-the-electronic-medical-record-quality-of-care-and-patient-safety
#9
Jonathan Lukoff, Jaime Olmos
There is a clearly perceived and imminent need to decrease unnecessary and detrimental exposure to medical ionizing radiation. We propose a new radiation "vital sign" that incorporates cumulative radiation exposure to create a risk score on the basis of an individualized assessment of potential harm from additional exposure to medical radiation. We propose to then tie the risk score to real-time, evidence-based, clinical decision support for procedures that use ionizing radiation. Additionally, we offer recommendations that minimize unnecessary or low-yield uses...
2017: Permanente Journal
https://www.readbyqxmd.com/read/29035180/ten-year-trends-in-preventive-service-use-before-and-after-prostate-cancer-diagnosis-a-comparison-with-noncancer-controls
#10
Lauren P Wallner, Jeffrey M Slezak, Ronald K Loo, Roshan Bastani, Steven J Jacobsen
CONTEXT: Few studies have assessed the longer-term quality of preventive care in prostate cancer (PCa) survivors. OBJECTIVE: To compare the rates of preventive services among PCa survivors five years before and after diagnosis, to men without PCa. DESIGN: Men enrolled in Kaiser Permanente Southern California with newly diagnosed PCa (2002-2008) were matched 1:1 to men without a PCa diagnosis on age, race, and timing of prostate-specific antigen test (N = 31,180)...
2017: Permanente Journal
https://www.readbyqxmd.com/read/29035179/knee-osteoarthritis-a-primer
#11
REVIEW
Michelle J Lespasio, Nicolas S Piuzzi, M Elaine Husni, George F Muschler, Aj Guarino, Michael A Mont
The purpose of this article is to provide a synopsis of the current medical understanding of knee osteoarthritis. We describe the prevalence, causes and associated risk factors, symptoms, diagnosis and classification, and treatment options. A quiz serves to assist readers in their understanding of the presented material.
2017: Permanente Journal
https://www.readbyqxmd.com/read/29035178/patient-perspectives-on-communication-with-primary-care-physicians-about-chronic-low-back-pain
#12
Sarah Evers, Clarissa Hsu, Karen J Sherman, Ben Balderson, Rene Hawkes, Georgie Brewer, Anne-Marie La Porte, John Yeoman, Dan Cherkin
OBJECTIVES: Chronic low back pain (CLBP) is a common health problem with challenges for providing satisfactory care. This study was undertaken to identify opportunities to improve key aspects of physicians' communications with CLBP-affected patients. METHODS: A series of 3 focus groups, each with 7 to 11 patients with CLBP, were recruited from primary care settings and grouped by risk level of reduced function resulting from back pain, to elicit perspectives about interactions with their primary care physicians...
2017: Permanente Journal
https://www.readbyqxmd.com/read/29035177/use-of-epidural-analgesia-as-an-adjunct-in-elective-abdominal-wall-reconstruction-a-review-of-4983-cases
#13
Efstathios Karamanos, Sophie Dream, Anthony Falvo, Nathan Schmoekel, Aamir Siddiqui
CONTEXT: Use of epidural analgesia in patients undergoing elective abdominal wall reconstruction is common. OBJECTIVE: To assess the impact of epidural analgesia in patients undergoing abdominal wall reconstruction. DESIGN: All patients who underwent elective ventral hernia repair from 2005 to 2014 were retrospectively identified. Patients were divided into two groups by the postoperative use of epidural analgesics as an adjunct analgesic method...
2017: Permanente Journal
https://www.readbyqxmd.com/read/29035176/comparing-hospital-processes-and-outcomes-in-california-medicare-beneficiaries-simulation-prompts-reconsideration
#14
Gabriel J Escobar, Jennifer M Baker, Benjamin J Turk, David Draper, Vincent Liu, Patricia Kipnis
INTRODUCTION: This article is not a traditional research report. It describes how conducting a specific set of benchmarking analyses led us to broader reflections on hospital benchmarking. We reexamined an issue that has received far less attention from researchers than in the past: How variations in the hospital admission threshold might affect hospital rankings. Considering this threshold made us reconsider what benchmarking is and what future benchmarking studies might be like. Although we recognize that some of our assertions are speculative, they are based on our reading of the literature and previous and ongoing data analyses being conducted in our research unit...
2017: Permanente Journal
https://www.readbyqxmd.com/read/29035175/lifestyle-medicine-a-brief-review-of-its-dramatic-impact-on-health-and-survival
#15
Balazs I Bodai, Therese E Nakata, William T Wong, Dawn R Clark, Steven Lawenda, Christine Tsou, Raymond Liu, Linda Shiue, Neil Cooper, Michael Rehbein, Benjamin P Ha, Anne Mckeirnan, Rajiv Misquitta, Pankaj Vij, Andrew Klonecke, Carmelo S Mejia, Emil Dionysian, Sean Hashmi, Michael Greger, Scott Stoll, Thomas M Campbell
By ignoring the root causes of disease and neglecting to prioritize lifestyle measures for prevention, the medical community is placing people at harm. Advanced nations, influenced by a Western lifestyle, are in the midst of a health crisis, resulting largely from poor lifestyle choices. Epidemiologic, ecologic, and interventional studies have repeatedly indicated that most chronic illnesses, including cardiovascular disease, cancer, and type 2 diabetes, are the result of lifestyles fueled by poor nutrition and physical inactivity...
2017: Permanente Journal
https://www.readbyqxmd.com/read/28898198/appropriate-interval-for-imaging-follow-up-of-small-simple-pancreatic-cysts
#16
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
#17
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
#18
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
#19
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
#20
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
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