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Permanente Journal

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https://www.readbyqxmd.com/read/28488993/physician-guide-to-appropriate-opioid-prescribing-for-noncancer-pain
#1
Timothy Munzing
Prescription opioid use for relief of noncancer pain has risen dramatically in the last 15 years, contributing to a quadrupling of opioid overdoses and prescription opioid-related deaths. This crisis is resulting in heightened attention by health care professionals and organizations, law enforcement, and the government. In this article, I highlight key topics in the management of patients using opioids (or potentially needing opioids) in outpatient clinical practice; federal and state law enforcement actions regarding physicians' illegal prescribing of opioids; multimodal approaches to pain control; nonmedication management of pain; response strategies when suspecting a patient of diverting or misusing opioids; and warning signs for abuse or diversion...
2017: Permanente Journal
https://www.readbyqxmd.com/read/28488992/image-diagnosis-splenic-infarction-associated-with-oral-contraceptive-pills-in-a-healthy-young-woman
#2
Al-Ola Abdallah, Varinder Kaur, Fade Mahmoud, Pooja Motwani
No abstract text is available yet for this article.
2017: Permanente Journal
https://www.readbyqxmd.com/read/28488991/geriatric-hip-fracture-care-fixing-a-fragmented-system
#3
Mary E Anderson, Kelly Mcdevitt, Ethan Cumbler, Heather Bennett, Zachary Robison, Bryan Gomez, Jason W Stoneback
CONTEXT: Fragmentation in geriatric hip fracture care is a growing concern because of the aging population. Patients with hip fractures at our institution historically were admitted to multiple different services and units, leading to unnecessary variation in inpatient care. Such inconsistency contributed to delays in surgery, discharge, and functional recovery; hospital-acquired complications; failure to adhere to best practices in osteoporosis management; and poor coordination with outpatient practitioners...
2017: Permanente Journal
https://www.readbyqxmd.com/read/28488990/patient-and-practitioner-perspectives-on-culturally-centered-integrated-care-to-address-health-disparities-in-primary-care
#4
Glenda Wrenn, Fatima Kasiah, Allyson Belton, Sheena Dorvil, Kristin Roberts, Brian Mcgregor, Kisha Holden
INTRODUCTION: Addressing the multifaceted health and mental health needs of ethnically and culturally diverse individuals is a challenge within the current health care system. Integrated care provides a promising approach to improve mental health treatment-seeking disparities; however, adaptation of care models to impact African Americans is lacking. Although resources to support engagement of diverse populations in depression care exist, little has been developed to tailor patient preferences in accessing and engaging mental health services that are integrated into primary care...
2017: Permanente Journal
https://www.readbyqxmd.com/read/28488989/spice-y-kidney-failure-a-case-report-and-systematic-review-of-acute-kidney-injury-attributable-to-the-use-of-synthetic-cannabis
#5
REVIEW
Ceyda Zarifi, Shuchi Vyas
INTRODUCTION: Spice is a synthetic cannabinoid that is readily available for purchase in smoke shops at relatively low cost. Spice is not detectable upon routine drug screening, making it an increasingly popular new street drug. CASE REPORT: A 21-year-old man presented with new-onset seizures. During the next 2 days, he developed uncontrollable hypertension, agitation, respiratory failure requiring intubation, pulmonary hypertension, and acute kidney injury (AKI) with a maximum blood urea nitrogen/creatinine level of 54/7...
2017: Permanente Journal
https://www.readbyqxmd.com/read/28488988/are-they-too-old-for-surgery-safety-of-cholecystectomy-in-superelderly-patients-%C3%A2-age-90
#6
Busayo Irojah, Ted Bell, Rodney Grim, Jennifer Martin, Vanita Ahuja
CONTEXT: Cholecystectomy is the most common general surgery procedure in patients older than age 65 years. By 2050, it is estimated that 2.0% of the population will be older than age 90 years. OBJECTIVE: To assess the mortality of cholecystectomy in superelderly patients (≥ age 90 years). DESIGN: Using the American College of Surgeons National Surgical Quality Improvement Program database, a retrospective analysis was performed of superelderly patients who underwent laparoscopic and open cholecystectomy between 2005 and 2012...
2017: Permanente Journal
https://www.readbyqxmd.com/read/28488987/from-the-bedside-a-family-physician-experiences-health-care-from-the-patient-side
#7
Michael Ismail
No abstract text is available yet for this article.
2017: Permanente Journal
https://www.readbyqxmd.com/read/28488986/effect-of-a-smoking-cessation-program-on-sexual-function-recovery-following-robotic-prostatectomy-at-kaiser-permanente-southern-california
#8
Seena Safavy, Patrick S Kilday, Jeff M Slezak, George A Abdelsayed, Teresa N Harrison, Steven J Jacobsen, Gary W Chien
INTRODUCTION: The association between cigarette smoking and erectile dysfunction has been well established. Studies demonstrate improvements in erectile rigidity and tumescence as a result of smoking cessation. Radical prostatectomy is also associated with worsening of erectile function secondary to damage to the neurovascular bundles. To our knowledge, no previous studies have examined the relationship between smoking cessation after prostate cancer diagnosis and its effect on sexual function following robotic prostatectomy...
2017: Permanente Journal
https://www.readbyqxmd.com/read/28488985/an-alternative-paradigm-for-evidence-based-medicine-revisiting-lawrence-weed-md-s-systems-approach
#9
Ali Rafik Shukor
Lawrence Weed, MD, is renowned for being the father of the Problem-Oriented Medical Record (POMR), the medical care standard for collecting, managing, and contextualizing patient data in medical records. What have been consistently overlooked are his teachings on knowledge coupling, which refers to matching patient data with associated medical knowledge. Together, the POMR standard and knowledge coupling are meant to form the basis of a systems approach that enables individualized evidence-based decision making within the context of multimorbidity and patient complexity...
2017: Permanente Journal
https://www.readbyqxmd.com/read/28488984/research-letter-anticholinergic-drugs-and-the-gallbladder-a-neglected-effect
#10
LETTER
Gary D Friedman, Ninah Achacoso, Laurel A Habel
No abstract text is available yet for this article.
2017: Permanente Journal
https://www.readbyqxmd.com/read/28488983/effectiveness-of-electrostimulation-on-whole-salivary-flow-among-patients-with-type-2-diabetes-mellitus
#11
Sujatha Dyasnoor, Shwetha Kamath, Nishat Fatima Abdul Khader
CONTEXT: Xerostomia and hyposalivation are associated with diabetes. Research is sparse regarding electrostimulation as a mainstream therapy for salivary gland hypofunction. OBJECTIVE: To clinically evaluate the effectiveness of transcutaneous electric nerve stimulation (TENS) therapy in stimulating whole salivary flow among patients with xerostomia and hyposalivation caused by diabetes mellitus. DESIGN: Forty patients between age 30 to 75 years with diabetes mellitus categorized as controlled or uncontrolled who had subjective symptoms of xerostomia and an objective sign of hyposalivation were included in a prospective study...
2017: Permanente Journal
https://www.readbyqxmd.com/read/28488982/philanthropy-and-beyond-creating-shared-value-to-promote-well-being-for-individuals-in-their-communities
#12
EDITORIAL
Thomas E Kottke, Nico Pronk, Andrew R Zinkel, George J Isham
Health care organizations can magnify the impact of their community service and other philanthropic activities by implementing programs that create shared value. By definition, shared value is created when an initiative generates benefit for the sponsoring organization while also generating societal and community benefit. Because the programs generate benefit for the sponsoring organizations, the magnitude of any particular initiative is limited only by the market for the benefit and not the resources that are available for philanthropy...
2017: Permanente Journal
https://www.readbyqxmd.com/read/28488981/a-survey-of-parents-with-children-on-the-autism-spectrum-experience-with-services-and-treatments
#13
Tracy A Becerra, Maria L Massolo, Vincent M Yau, Ashli A Owen-Smith, Frances L Lynch, Phillip M Crawford, Kathryn A Pearson, Magdalena E Pomichowski, Virginia P Quinn, Cathleen K Yoshida, Lisa A Croen
INTRODUCTION: Autism spectrum disorders (ASD) are lifelong neurodevelopmental disorders, and little is known about how parents address the health and psychosocial consequences of ASD. Few studies have examined use of various treatments and services in a large, diverse sample of children with ASD and their families. OBJECTIVE: This paper presents methods to create an autism research resource across multiple large health delivery systems and describes services and treatments used by children with ASD and their families...
2017: Permanente Journal
https://www.readbyqxmd.com/read/28488980/response-to-functional-medicine-case-study-and-editorial
#14
LETTER
Craig W Robbins, Meighan Elder, Michelene A Kuhr, Mark S Hoskinson
No abstract text is available yet for this article.
2017: Permanente Journal
https://www.readbyqxmd.com/read/28488979/an-unlikely-rapid-transformation-of-myelodysplastic-syndrome-to-acute-leukemia-a-case-report
#15
Andrew Pourmoussa, Karen Kwan
INTRODUCTION: Myelodysplastic syndrome is characterized by stem-cell-derived clonal myelopoiesis with an alteration in proliferation and differentiation. This condition carries a potential for transformation to acute leukemia, primarily in cases that are accompanied by high-risk features at diagnosis. CASE PRESENTATION: A 68-year-old man with recently diagnosed myelodysplastic syndrome and Sweet syndrome (acute febrile neutrophilic dermatosis) presented to our Emergency Department with shortness of breath...
2017: Permanente Journal
https://www.readbyqxmd.com/read/28488978/stevens-johnson-syndrome-toxic-epidermal-necrolysis-and-treatment-with-a-biologic-a-case-report
#16
Ian Chong, Alice Chao
INTRODUCTION: One of the most dangerous dermatologic emergencies is Stevens-Johnson Syndrome (SJS)/toxic epidermal necrolysis (TEN). Although a rare disease, it can often lead to significant mortality. CASE PRESENTATION: In this case report, we present a 77-year-old man who developed a sloughing rash that was secondary to a nonsteroidal anti-inflammatory drug. In addition to the recommended supportive care, the patient was treated with etanercept, a new, less commonly used intervention...
2017: Permanente Journal
https://www.readbyqxmd.com/read/28406794/experiences-in-an-italian-rehabilitation-hospital-two-stories
#17
Claudio Crisci, Biagio Arnone
No abstract text is available yet for this article.
2017: Permanente Journal
https://www.readbyqxmd.com/read/28406793/population-level-incidence-and-predictors-of-surgically-induced-diabetes-and-exocrine-insufficiency-after-partial-pancreatic-resection
#18
Irmina A Elliott, Irene Epelboym, Megan Winner, John D Allendorf, Philip I Haigh
CONTEXT: Endocrine and exocrine insufficiency after partial pancreatectomy affect quality of life, cardiovascular health, and nutritional status. However, their incidence and predictors are unknown. OBJECTIVE: To identify the incidence and predictors of new-onset diabetes and exocrine insufficiency after partial pancreatectomy. DESIGN: We retrospectively reviewed 1165 cases of partial pancreatectomy, performed from 1998 to 2010, from a large population-based database...
2017: Permanente Journal
https://www.readbyqxmd.com/read/28406792/image-diagnosis-unusual-cause-of-gastrointestinal-bleeding-in-a-young-man-isolated-gastric-angiodysplasias
#19
Sandeep Lamoria, Arka De, Vishal Sharma
No abstract text is available yet for this article.
2017: Permanente Journal
https://www.readbyqxmd.com/read/28406791/health-care-systems-support-to-enhance-patient-centered-care-lessons-from-a-primary-care-based-chronic-pain-management-initiative
#20
Charles R Elder, Lynn L Debar, Cheryl Ritenbaugh, Maureen H Rumptz, Charlotte Patterson, Allison Bonifay, Penney Cowan, Lindsay Lancaster, Richard A Deyo
BACKGROUND: Supporting day-to-day self-care activities has emerged as a best practice when caring for patients with chronic pain, yet providing this support may introduce challenges for both patients and primary care physicians. It is essential to develop tools that help patients identify the issues and outcomes that are most important to them and to communicate this information to primary care physicians at the point of care. OBJECTIVE: We describe our process to engage patients, primary care physicians, and other stakeholders in the context of a pilot randomized controlled trial of a patient-centered assessment process implemented in an everyday practice setting...
2017: Permanente Journal
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