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Permanente Journal

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https://www.readbyqxmd.com/read/28080950/image-diagnosis-a-striking-bleomycin-induced-skin-toxicity-flagellate-hyperpigmentation
#1
Lin Hao, Fade Mahmoud
No abstract text is available yet for this article.
2017: Permanente Journal
https://www.readbyqxmd.com/read/27673708/consideration-of-personal-adverse-childhood-experiences-during-implementation-of-trauma-informed-care-curriculum-in-graduate-health-programs
#2
Joshua Strait, Tiffany Bolman
CONTEXT: Scientific findings of adverse childhood experiences (ACEs) and their lifelong graded relationship with leading causes of death are well established. Many health care practitioners, however, have yet to implement ACEs screening in clinical practice. Furthermore, ACEs screening and trauma-informed care (TIC) are not part of standard graduate-level training. OBJECTIVE: To 1) implement trauma-informed curriculum for multiple graduate health programs, 2) determine student understanding of and willingness to address ACEs, and 3) assess the relationship between students voluntarily evaluating their individual ACE Score and their attitude toward ACEs and TIC...
2017: Permanente Journal
https://www.readbyqxmd.com/read/27213488/refining-reporting-mechanisms-in-oregon-s-patient-centered-primary-care-home-program-to-improve-performance
#3
Sherril Gelmon, Billie Sandberg, Nicole Merrithew, Rebekah Bally
INTRODUCTION: As part of its strategy to achieve the Triple Aim, the Oregon Health Authority implemented the Patient-Centered Primary Care Home (PCPCH) Program in 2009. In 2014, the program recognized more than 500 primary care practices and had become an essential component of Oregon's strategy for transforming health services delivery. To assist the Oregon Health Authority with evaluating practices' achievement of the PCPCH model along its 6 core attributes (access, accountability, comprehensive care, continuity, coordination, and person-centered care), the research team developed an innovative scoring method...
May 20, 2016: Permanente Journal
https://www.readbyqxmd.com/read/28080957/understanding-preferences-for-osteoporosis-information-to-develop-an-osteoporosis-patient-education-brochure
#4
Stephanie W Edmonds, Samantha L Solimeo, Vu-Thuy Nguyen, Nicole C Wright, Douglas W Roblin, Kenneth G Saag, Peter Cram
CONTEXT: Patient education materials can provide important information related to osteoporosis prevention and treatment. However, available osteoporosis education materials fail to follow best-practice guidelines for patient education. OBJECTIVE: To develop an educational brochure on bone health for adults aged 50 years and older using mixed-method, semistructured interviews. DESIGN: This project consisted of 3 phases. In Phase 1, we developed written content that included information about osteoporosis...
2016: Permanente Journal
https://www.readbyqxmd.com/read/28080956/ecg-diagnosis-deep-t-wave-inversions-associated-with-intracranial-hemorrhage
#5
Joel T Levis
No abstract text is available yet for this article.
2016: Permanente Journal
https://www.readbyqxmd.com/read/28080955/leukocytoclastic-vasculitis-secondary-to-pyridostigmine-mestinon-report-of-a-possible-first-case
#6
Gunveen Singh, Tim Hodgson, David E Clarke
INTRODUCTION: Pyridostigmine is an acetylcholinesterase inhibitor commonly used in the treatment of myasthenia gravis. We describe a patient who developed a rash after recently being started on pyridostigmine and give a general review of leukocytoclastic vasculitis. CASE PRESENTATION: A 91-year-old man was diagnosed with ocular myasthenia gravis. He was started on pyridostigmine, and 2 weeks later he developed a rash. The rash was biopsied and found to be secondary to leukocytoclastic vasculitis; the pyridostigmine was stopped, loratadine was started, and the rash resolved...
2016: Permanente Journal
https://www.readbyqxmd.com/read/28080954/sj%C3%A3-gren-syndrome-and-pregnancy-a-literature-review
#7
REVIEW
Suruchi Gupta, Nikhil Gupta
OBJECTIVES: Autoimmune diseases do not impair fertility, and women with autoimmune diseases who become pregnant are likely to experience more complicated pregnancies than are women without the disease. Pregnancies complicated by these disorders have a high clinical impact on both the pregnancy and the disease. The effect of autoimmune disease on pregnancy differs according to the type of maternal disease, disease activity, severity of organ damage, antibody profile, and drug treatment...
2016: Permanente Journal
https://www.readbyqxmd.com/read/28080953/childhood-disrupted-how-your-biography-becomes-your-biology-and-how-you-can-heal
#8
REVIEW
David D Clarke
No abstract text is available yet for this article.
2016: Permanente Journal
https://www.readbyqxmd.com/read/28080952/what-about-me-puberty-education-for-preteens
#9
REVIEW
Michael E Lynch
No abstract text is available yet for this article.
2016: Permanente Journal
https://www.readbyqxmd.com/read/28080951/primary-upper-limb-lymphedema-case-report-of-a-rare-pathology
#10
Michael Ec Mcfarlane
INTRODUCTION: Lymphedema is characterized by a defect in the lymphatic system that causes limb swelling. Impaired uptake and transport of lymphatic fluid through lymphatic vessels causes accumulation of protein-rich fluid in the interstitial spaces, which leads to swelling of the limb. Primary lymphedema often presents at birth. The rare cases that arise after age 35 years are described as lymphedema tarda. The great majority of patients with lymphedema have swelling of the lower limbs-upper limb lymphedema is a rare disorder...
2016: Permanente Journal
https://www.readbyqxmd.com/read/28080949/image-diagnosis-endobronchial-tuberculosis-masquerading-as-an-endobronchial-tumor-with-presentation-as-middle-lobe-syndrome
#11
Kamal Gera, Nevin Kishore
No abstract text is available yet for this article.
2016: Permanente Journal
https://www.readbyqxmd.com/read/28080948/ecg-diagnosis-right-ventricular-myocardial-infarction
#12
Manvi R Nagam, David R Vinson, Joel T Levis
No abstract text is available yet for this article.
2016: Permanente Journal
https://www.readbyqxmd.com/read/27828774/ethical-analysis-for-physicians-considering-the-provision-of-life-ending-medication-in-compliance-with-the-california-end-of-life-option-act
#13
D Malcolm Shaner
The End of Life Option Act in California, effective June 9, 2016, permits physicians to prescribe lethal medication to patients confirmed to be terminally ill and capable of independently making and carrying out a decision to ingest deadly medication. Medicine has traditionally excluded the provision of deadly medication from proper practice. Physicians reasonably may hold to that limit. However, honoring a repeated request from a capable, terminally ill patient to receive life-ending medication still can be considered to be a moral and permissible approach to relieve suffering...
2016: Permanente Journal
https://www.readbyqxmd.com/read/27828773/implementation-of-the-ymca-diabetes-prevention-program-throughout-an-integrated-health-system-a-translational-study
#14
Ron Adams, Christopher J Hebert, Linda Mcvey, Roger Williams
CONTEXT: HealthSpan Physicians (HSP), an integrated medical system in Northeast Ohio, partnered with the Young Men's Christian Association (YMCA) of Greater Cleveland to implement a referral system for the evidence-based Diabetes Prevention Program (DPP) throughout HSP. The YMCA of USA employs a cost-effective, customized version of the original DPP in which coaches take the place of in-house clinical staff. Efficacy of the YMCA DPP was shown earlier in the DEPLOY Study. OBJECTIVE: To improve outcomes of metrics used in the DEPLOY Study...
2016: Permanente Journal
https://www.readbyqxmd.com/read/27768570/effectiveness-of-cannabidiol-oil-for-pediatric-anxiety-and-insomnia-as-part-of-posttraumatic-stress-disorder-a-case-report
#15
Scott Shannon, Janet Opila-Lehman
INTRODUCTION: Anxiety and sleep disorders are often the result of posttraumatic stress disorder and can contribute to an impaired ability to focus and to demonstration of oppositional behaviors. CASE PRESENTATION: These symptoms were present in our patient, a ten-year-old girl who was sexually abused and had minimal parental supervision as a young child under the age of five. Pharmaceutical medications provided partial relief, but results were not long-lasting, and there were major side effects...
2016: Permanente Journal
https://www.readbyqxmd.com/read/27768569/refractory-depression-fatigue-irritable-bowel-syndrome-and-chronic-pain-a-functional-medicine-case-report
#16
Gregory Plotnikoff, Melissa Barber
INTRODUCTION: Single-disorder or single-organ-system clinical practice guidelines are often of limited usefulness in guiding effective management of patients with chronic multidimensional signs and symptoms. The presence of multiple long-standing medical problems in a given patient despite intensive medical effort suggests that addressing systemic core imbalances could complement more narrowly focused approaches. CASE PRESENTATION: A 72-year-old man experiencing longstanding depression, fatigue, irritable bowel syndrome, and chronic pain in the context of additional refractory illnesses was assessed and treated, guided by a system-oriented approach to underlying core imbalances termed functional medicine...
2016: Permanente Journal
https://www.readbyqxmd.com/read/27768568/association-of-unplanned-reintubation-with-higher-mortality-in-old-frail-patients-a-national-surgical-quality-improvement-program-analysis
#17
Efstathios Karamanos, Nathan Schmoekel, Dionne Blyden, Anthony Falvo, Ilan Rubinfeld
BACKGROUND: Unplanned postoperative reintubation increases the risk of mortality, but associated factors are unclear. OBJECTIVE: To elucidate factors associated with increased mortality risk in patients with unplanned postoperative reintubation. DESIGN: Retrospective study. Patients older than 40 years who underwent unplanned reintubation from 2005 to 2010 were identified using the American College of Surgeons National Surgical Quality Improvement Program database...
2016: Permanente Journal
https://www.readbyqxmd.com/read/27768567/form-follows-function-a-functional-medicine-overview
#18
EDITORIAL
Patrick Hanaway
No abstract text is available yet for this article.
2016: Permanente Journal
https://www.readbyqxmd.com/read/27768566/development-and-application-of-a-plant-based-diet-scoring-system-for-japanese-patients-with-inflammatory-bowel-disease
#19
Mitsuro Chiba, Kunio Nakane, Yuko Takayama, Kae Sugawara, Hideo Ohno, Hajime Ishii, Satoko Tsuda, Tsuyotoshi Tsuji, Masafumi Komatsu, Takeshi Sugawara
CONTEXT: Plant-based diets (PBDs) are a healthy alternative to westernized diets. A semivegetarian diet, a PBD, has been shown to prevent a relapse in Crohn disease. However, there is no way to measure adherence to PBDs. OBJECTIVE: To develop a simple way of evaluating adherence to a PBD for Japanese patients with inflammatory bowel disease (IBD). DESIGN: PBD scores were assigned according to the frequency of consumption provided on a food-frequency questionnaire, obtained on hospitalization for 159 patients with ulcerative colitis and 70 patients with Crohn disease...
2016: Permanente Journal
https://www.readbyqxmd.com/read/27768565/accreditation-council-for-graduate-medical-education-core-competencies-at-a-community-teaching-hospital-is-there-a-gap-in-awareness
#20
Mohammed Al-Temimi, Michael Kidon, Samir Johna
CONTEXT: Reports evaluating faculty knowledge of the Accreditation Council for Graduate Medical Education (ACGME) core competencies in community hospitals without a dedicated residency program are uncommon. OBJECTIVE: Faculty evaluation regarding knowledge of ACGME core competencies before a residency program is started. DESIGN: Physicians at the Kaiser Permanente Fontana Medical Center (N = 480) were surveyed for their knowledge of ACGME core competencies before starting new residency programs...
2016: Permanente Journal
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