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https://www.readbyqxmd.com/read/29439347/quantifying-the-diagnostic-pathway-for-patients-with-cognitive-impairment-real-world-data-from-seven-european-and-north-american-countries
#1
Craig W Ritchie, Christopher M Black, Rezaul K Khandker, Robert Wood, Eddie Jones, Xiaohan Hu, Baishali M Ambegaonkar
To ensure that patients with dementia and their caregivers receive appropriate treatment and support, early diagnosis is essential but remains challenging. Real-world data from a multi-national, cross-sectional survey of physicians and their patients were analyzed to quantify the diagnostic pathway for dementia, including a focus on severity of patients' cognitive impairment (CI) at the time of symptom onset, referral and subsequent diagnosis. Data were collected for 7,620 patients with CI. Most patients saw a healthcare professional within 1 year of first symptoms and received a diagnosis within 3-7 months of initial consultation...
2018: Journal of Alzheimer's Disease: JAD
https://www.readbyqxmd.com/read/29438856/the-surgical-management-of-dysphagia-secondary-to-diffuse-idiopathic-skeletal-hyperostosis
#2
Y C Lui Jonathan, P Sayal, G Prezerakos, V Russo, D Choi, A T H Casey
OBJECTIVE: This study reviews the management pathway and surgical outcomes of patients referred to and operated on at a tertiary neurosurgical centre, for dysphagia associated with anterolateral cervical hyperostosis (ACH) in diffuse idiopathic skeletal hyperostosis (DISH). PATIENTS & METHODS: Electronic patient records for 6 patients who had undergone anterior cervical osteophytectomy for dysphagia secondary to ACH were reviewed. ACH diagnosis was made by an Ear, Nose and Throat (ENT) specialist and patients were referred to a neurosurgical-led multidisciplinary team (MDT) for review...
February 7, 2018: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/29436279/integrated-palliative-care-is-about-professional-networking-rather-than-standardisation-of-care-a-qualitative-study-with-healthcare-professionals-in-19-integrated-palliative-care-initiatives-in-five-european-countries
#3
Marlieke den Herder-van der Eerden, Jeroen van Wijngaarden, Sheila Payne, Nancy Preston, Lisa Linge-Dahl, Lukas Radbruch, Karen Van Beek, Johan Menten, Csilla Busa, Agnes Csikos, Kris Vissers, Jelle van Gurp, Jeroen Hasselaar
BACKGROUND: Integrated palliative care aims at improving coordination of palliative care services around patients' anticipated needs. However, international comparisons of how integrated palliative care is implemented across four key domains of integrated care (content of care, patient flow, information logistics and availability of (human) resources and material) are lacking. AIM: To examine how integrated palliative care takes shape in practice across abovementioned key domains within several integrated palliative care initiatives in Europe...
February 1, 2018: Palliative Medicine
https://www.readbyqxmd.com/read/29435357/right-from-the-start-protocol-for-a-pilot-study-for-a-randomised-trial-of-the-new-baby-programme-for-improving-outcomes-for-children-born-to-socially-vulnerable-mothers
#4
Geraldine Macdonald, Fiona Alderdice, Mike Clarke, Oliver Perra, Fiona Lynn, Theresa McShane, Sharon Millen
Background: Children born to mothers who experience social complexity (e.g. substance misuse, intimate partner violence, mental ill health, a history of maltreatment) are at increased risk for a range of adverse outcomes at birth and during development. Home visiting programmes have been advocated as a strategy for improving outcomes for disadvantaged mothers and children, such as the Nurse-Family Partnership for young, socially disadvantaged first-time mothers. However, no evidence-based programme is available for multiparous women or older first-time mothers...
2018: Pilot and Feasibility Studies
https://www.readbyqxmd.com/read/29433610/accuracy-of-the-whooley-questions-and-the-edinburgh-postnatal-depression-scale-in-identifying-depression-and-other-mental-disorders-in-early-pregnancy
#5
Louise Michele Howard, Elizabeth G Ryan, Kylee Trevillion, Fraser Anderson, Debra Bick, Amanda Bye, Sarah Byford, Sheila O'Connor, Polly Sands, Jill Demilew, Jeannette Milgrom, Andrew Pickles
BACKGROUND: There is limited evidence on the prevalence and identification of antenatal mental disorders. Aims To investigate the prevalence of mental disorders in early pregnancy and the diagnostic accuracy of depression-screening (Whooley) questions compared with the Edinburgh Postnatal Depression Scale (EPDS), against the Structured Clinical Interview DSM-IV-TR. METHOD: Cross-sectional survey of women responding to Whooley questions asked at their first antenatal appointment...
January 2018: British Journal of Psychiatry: the Journal of Mental Science
https://www.readbyqxmd.com/read/29431135/challenges-of-diagnosis-and-management-of-giant-cell-arteritis-in-general-practice-a-multimethods-study
#6
Toby Helliwell, Sara Muller, Samantha L Hider, James A Prior, Jane C Richardson, Christian D Mallen
BACKGROUND: In the UK, general practitioners (GPs) are usually the first medical contact for patients with suspected giant cell arteritis (GCA). While rare, it is critical not to miss, as delayed treatment can lead to significant complications including permanent visual loss. To date, little is known about the approach and challenges to diagnosis and management of GCA by GPs. OBJECTIVE: To investigate the diagnosis and management of patients with suspected GCA in UK general practice...
February 3, 2018: BMJ Open
https://www.readbyqxmd.com/read/29428231/bcl9-upregulation-in-adrenocortical-carcinoma-a-novel-wnt-%C3%AE-catenin-activating-event-driving-adrenocortical-malignancy
#7
Taylor C Brown, Norman G Nicolson, Reju Korah, Tobias Carling
BACKGROUND: B-Cell CLL/Lymphoma 9 (BCL9) is a recently described oncogene that promotes tumorigenesis via activation of the Wnt/β-Catenin signaling cascade. Though constitutively active Wnt/β-Catenin signaling is a molecular hallmark of adrenocortical carcinoma (ACC), a potential role for BCL9 to promote Wnt/β-Catenin pathway dysregulation in adrenocortical tumorigenesis remains to be elucidated. STUDY DESIGN: This study involved a retrospective analysis at a tertiary academic referral center of 27 patients with adrenocortical tumors, including in vitro investigation of BCL9...
February 8, 2018: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29420713/symptoms-in-primary-care-with-time-to-diagnosis-of-brain-tumours
#8
Mio Ozawa, Paul M Brennan, Karolis Zienius, Kathreena M Kurian, William Hollingworth, David Weller, Willie Hamilton, Robin Grant, Yoav Ben-Shlomo
Background: Brain tumours often present with varied, non-specific features with other diagnoses usually being more likely. Objective: To examine how different symptoms and patient demographics predict variations in time to brain tumour diagnosis. Methods: We conducted a secondary analysis of brain tumour cases from National Audit of Cancer Diagnosis in Primary Care. We grouped neurological symptoms into six domains (headache, behavioural/cognitive change, focal neurology, 'fits, faints or falls', non-specific neurological, and other/non-specific) and calculated times for patient presentation, GP referral, specialist consultation and total pathway interval...
February 6, 2018: Family Practice
https://www.readbyqxmd.com/read/29420706/risk-of-cancer-and-repeated-urgent-referral-after-negative-investigation-for-cancer
#9
Ninna Nielsen, Peter Vedsted, Henry Jensen
Introduction: Many countries have implemented cancer patient pathways (CPPs) for organ-specific cancers. However, due to high symptom diversity, it can be difficult for the General Practitioner (GP) to decide on the appropriate CPP. Objective: The aim of this study was to estimate the proportion of patients who were referred to a second CPP, were diagnosed with cancer or died within 6 months after receiving a negative result from clinical investigation through an initial CPP...
February 6, 2018: Family Practice
https://www.readbyqxmd.com/read/29415799/healthpathways-improving-access-to-care
#10
Stephen D Gill, Sarah Mansfield, Margie McLeod, Kathryn von Treuer, Matthew Dunn, Frances Quirk
Objective HealthPathways (HPW) is an international web-based information portal that provides health practitioners with guidelines and referral pathways to specialists and services. The present study explored usage of HPW by general practitioners (GPs) in the Barwon region, south-west Victoria, and any benefits and barriers to its use.Methods Approximately 421 GPs provide services in 86 clinics across the Barwon region, south-west Victoria and Barwon Health is the public health service providing acute, subacute, residential aged care and community health services to approximately 350000 people...
February 8, 2018: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/29415230/factors-influencing-early-referral-early-diagnosis-and-management-in-patients-with-diffuse-cutaneous-systemic-sclerosis
#11
Oliver Distler, Yannick Allanore, Christopher P Denton, Marco Matucci-Cerinic, Janet E Pope, Barbara Hinzmann, Siobhan Davies, Janethe de Oliveira Pena, Dinesh Khanna
Objective: To gain insight into clinical practice regarding referral, early diagnosis and other aspects of the management of patients with dcSSc in Europe and the USA. Methods: Semi-structured interviews were conducted with 84 rheumatologists (or internal medicine physicians) and 40 dermatologists in different countries (the UK, France, Germany, Italy, Spain and the USA). Physicians were asked to identify key steps in the patient pathway relating to patient presentation, diagnosis and referral, in addition to other treatment and follow-up processes...
February 2, 2018: Rheumatology
https://www.readbyqxmd.com/read/29415024/identifying-evidence-practice-gaps-and-strategies-for-improvement-in-aboriginal-and-torres-strait-islander-maternal-health-care
#12
Melanie E Gibson-Helm, Jodie Bailie, Veronica Matthews, Alison F Laycock, Jacqueline A Boyle, Ross S Bailie
INTRODUCTION: Adverse pregnancy outcomes are more common among Aboriginal and Torres Strait Islander populations than non-Indigenous populations in Australia. Later in life, most of the difference in life expectancy between Aboriginal and Torres Strait Islander women and non-Indigenous women is due to non-communicable diseases (NCDs). Most Aboriginal and Torres Strait Islander women attend health services regularly during pregnancy. Providing high-quality care within these appointments has an important role to play in improving the current and future health of women and babies...
2018: PloS One
https://www.readbyqxmd.com/read/29413484/tackling-cancer-burden-in-low-income-and-middle-income-countries-morocco-as-an-exemplar
#13
REVIEW
Farida Selmouni, Ahmed Zidouh, Latifa Belakhel, Catherine Sauvaget, Maria Bennani, Youssef Chami Khazraji, Abdellatif Benider, Christopher P Wild, Rachid Bekkali, Ibtihal Fadhil, Rengaswamy Sankaranarayanan
Examples of successful implementations of national cancer control plans in low-income or middle-income countries remain rare. Morocco, a country where cancer is already the second leading cause of death after cardiovascular diseases, is one exception in this regard. Population ageing and lifestyle changes are the major drivers that are further increasing the cancer burden in the country. Facing this challenge, the Moroccan Ministry of Health has developed a we l planned and pragmatic National Plan for Cancer Prevention and Control (NPCPC) that, since 2010, has been implemented with government financial support to provide basic cancer care services across the entire range of cancer control...
February 2018: Lancet Oncology
https://www.readbyqxmd.com/read/29410951/a-review-of-the-integrated-model-of-care-an-opportunity-to-respond-to-extensive-palliative-care-needs-in-pediatric-intensive-care-units-in-under-resourced-settings
#14
REVIEW
Michelle Grunauer, Caley Mikesell
It is estimated that 6.3 million children who die annually need pediatric palliative care (PPC) and that only about 10% of them receive the attention they need because about 98% of them live in under-resourced settings where PPC is not accessible. The consultative model and the integrated model of care (IMOC) are the most common strategies used to make PPC available to critically ill children. In the consultative model, the pediatric intensive care unit (PICU) team, the patient, or their family must request a palliative care (PC) consultation with the external PC team for a PICU patient to be evaluated for special care needs...
2018: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/29410534/reimagining-the-diagnostic-pathway-for-gastrointestinal-cancer
#15
REVIEW
Greg Rubin, Fiona Walter, Jon Emery, Niek de Wit
A crisis is looming for the diagnosis of gastrointestinal cancers, one grounded only partly in the steady increase in their overall incidence. Public demand for diagnostic tests to be undertaken early and at lower levels of risk is reflected in early diagnosis being a widely held policy objective for reasons of both clinical outcome and patient experience. In the UK, urgent referrals for suspected lower gastrointestinal cancer have increased by 78% in the past 6 years, with parallel increases in endoscopy and imaging activity...
February 7, 2018: Nature Reviews. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29398419/the-endometrial-stem-cell-markers-notch-1-and-numb-are-associated-with-endometriosis
#16
Andreas N Schüring, Beatrice Dahlhues, Anna Korte, Ludwig Kiesel, Ulf Titze, Birthe Heitkötter, Christian Ruckert, Martin Götte
Previous studies reported increased expression of the notch pathway-associated protein Musashi-1 in endometriosis. This case-control study investigates an association of the endometrial stem cell markers notch-1 and numb with endometriosis. Fifty-one endometriosis patients and 76 controls were recruited in the IVF unit and tertiary endometriosis referral centre of a university hospital. All subjects underwent transcervical endometrial biopsy and diagnostic laparoscopy. Expression of endometrial notch-1 and numb was assessed by immunostaining and correlated with clinical data...
December 28, 2017: Reproductive Biomedicine Online
https://www.readbyqxmd.com/read/29398262/eau-guidelines-on-assessment-and-nonsurgical-management-of-urinary-incontinence
#17
Arjun K Nambiar, Ruud Bosch, Francisco Cruz, Gary E Lemack, Nikesh Thiruchelvam, Andrea Tubaro, Dina A Bedretdinova, David Ambühl, Fawzy Farag, Riccardo Lombardo, Marc P Schneider, Fiona C Burkhard
CONTEXT: The European Association of Urology guidelines on urinary incontinence (UI) have been updated in cyclical fashion with successive major chapters being revised each year. The sections on assessment, diagnosis, and nonsurgical treatment have been updated as of mid-2016. OBJECTIVE: We present a condensed version of the full guideline on assessment and nonsurgical management of UI, with the aim of improving accessibility and increasing their dissemination. EVIDENCE ACQUISITION: Our literature search was updated from the previous cut-off of July 2010 up to April 2016...
February 2, 2018: European Urology
https://www.readbyqxmd.com/read/29394260/healthcare-resource-use-and-costs-of-managing-children-and-adults-with-lysosomal-acid-lipase-deficiency-at-a-tertiary-referral-centre-in-the-united-kingdom
#18
Julian F Guest, Andy Ingram, Nadia Ayoub, Christian J Hendriksz, Elaine Murphy, Yusof Rahman, Patrick McKiernan, Helen Mundy, Patrick Deegan
OBJECTIVE: To estimate clinical progression and resource utilisation together with the associated costs of managing children and adults with LAL Deficiency, at a tertiary referral centre in the UK. METHODS: A retrospective chart review was undertaken of patients in the UK with a confirmed diagnosis of LAL Deficiency who were managed at a LAL Deficiency tertiary referral treatment centre. Patients' pathways, treatment patterns, health outcomes and resource use were quantified over differing lengths of time for each patient enabling the NHS cost of patient management in tertiary care to be estimated...
2018: PloS One
https://www.readbyqxmd.com/read/29382455/can-a-supervised-algorithmic-assessment-of-men-for-prostate-cancer-improve-the-quality-of-care-a-retrospective-evaluation-of-a-prostate-assessment-pathway-in-saskatchewan
#19
Bonnie Liu, Kunal Jana, Gary Groot
INTRODUCTION: The Saskatoon Prostate Assessment Pathway (SPAP) was developed in 2013 in part to decrease the wait times between physician referral and biopsy for patients with suspected prostate cancer. Using an algorithm carefully designed to optimize appropriate prostate biopsy rates, physicians can directly refer patients for biopsy through the SPAP without seeing a urologist. All other patients are referred to the Saskatoon Urology Associates (SUA). The present study evaluates the performance of the algorithm...
September 2017: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
https://www.readbyqxmd.com/read/29382343/evidence-to-service-gap-cardiac-rehabilitation-and-secondary-prevention-in-rural-and-remote-western-australia
#20
Sandra Hamilton, Belynda Mills, Shelley McRae, Sandra Thompson
BACKGROUND: Cardiovascular disease (CVD), a leading cause of morbidity and mortality, has similar incidence in metropolitan and rural areas but poorer cardiovascular outcomes for residents living in rural and remote Australia. Cardiac Rehabilitation (CR) is an evidence-based intervention that helps reduce subsequent cardiovascular events and rehospitalisation. Unfortunately CR attendance rates are as low as 10-30% with rural/remote populations under-represented. This in-depth assessment investigated the provision of CR and secondary prevention services in Western Australia (WA) with a focus on rural and remote populations...
January 30, 2018: BMC Health Services Research
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