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https://www.readbyqxmd.com/read/28645556/breast-cancer-liver-metastases-in-a-uk-tertiary-centre-outcomes-following-referral-to-tumour-board-meeting
#1
Hiba Abbas, Simon Erridge, Mikael H Sodergren, Michail Papoulas, Aamir Nawaz, Krishna Menon, Nigel D Heaton, Andreas A Prachalias, Parthi Srinivasan
INTRODUCTION: To assess the outcomes from multidisciplinary board meetings (MDM) for patients with breast cancer liver metastases (BCLM) and identify prognostic factors for survival. MATERIALS AND METHODS: A retrospective review of MDM records for patients referred with BCLM to a tertiary centre between 2005-2016. Patient demographics, clinicopathological factors and intervention type were analysed to find predictive factors for overall survival. RESULTS: 61 patients with BCLM were referred to the MDM...
June 20, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28644736/asymptomatic-microscopic-hematuria-as-a-predictor-of-neoplasia-in-the-urinary-tract
#2
Maria Ordell Sundelin, Jørgen Bjerggaard Jensen
OBJECTIVE: The Danish hematuria guidelines were revised in January 2016. Before revision, it was recommended that asymptomatic microscopic hematuria in patients more than 40 years old should be routinely urologically investigated. In the revised guidelines, patients with asymptomatic microscopic hematuria are not recommended to be investigated, irrespective of age. The purpose of this study was to investigate whether asymptomatic microscopic hematuria was predictive of neoplasia of the urinary tract in a referred cohort of patients...
June 23, 2017: Scandinavian Journal of Urology
https://www.readbyqxmd.com/read/28641316/a-cancer-geography-paradox-poorer-cancer-outcomes-with-longer-travelling-times-to-healthcare-facilities-despite-prompter-diagnosis-and-treatment-a-data-linkage-study
#3
Melanie Turner, Shona Fielding, Yuhan Ong, Chris Dibben, Zhiqianq Feng, David H Brewster, Corri Black, Amanda Lee, Peter Murchie
BACKGROUND: Rurality and distance from cancer treatment centres have been shown to negatively impact cancer outcomes, but the mechanisms remain obscure. METHODS: We analysed the impact of travel time to key healthcare facilities and mainland/island residency on the cancer diagnostic pathway (treatment within 62 days of referral, and within 31 days of diagnosis) and 1-year mortality using a data-linkage study with 12 339 patients. RESULTS: After controlling for important confounders, mainland patients with more than 60 min of travelling time to their cancer treatment centre ((OR 1...
June 22, 2017: British Journal of Cancer
https://www.readbyqxmd.com/read/28640860/the-path-to-specialist-multidisciplinary-care-in-amyotrophic-lateral-sclerosis-a-population-based-study-of-consultations-interventions-and-costs
#4
Miriam Galvin, Padhraig Ryan, Sinead Maguire, Mark Heverin, Caoifa Madden, Alice Vajda, Charles Normand, Orla Hardiman
BACKGROUND: Amyotrophic Lateral Sclerosis (ALS) is a devastating neurological condition that requires coordinated, multidisciplinary clinical management. ALS is prone to misdiagnosis as its signs and symptoms may be non-specific, which may prolong patients' journey to multidisciplinary ALS care. METHODS: Using chart review and national register data, we have detailed the journey of a national cohort of ALS patients (n = 155) from the time of first symptom to presentation at a multidisciplinary clinic (MDC)...
2017: PloS One
https://www.readbyqxmd.com/read/28639719/understanding-indigenous-patient-attendance-a-qualitative-study
#5
Stephen Copeland, Josephine Muir, Angus Turner
OBJECTIVE: To better understand Indigenous patient non-attendance at medical specialty appointments by learning from the patients attending their scheduled outreach ophthalmology clinic appointment. DESIGN, SETTING AND PARTICIPANTS: A qualitative study using face-to-face, semi-structured interviews with 69 Indigenous Australian ophthalmology patients and 8 clinic workers at one urban and one rural Aboriginal Medical Service (AMS) over the period from April 2015 to November 2015...
June 22, 2017: Australian Journal of Rural Health
https://www.readbyqxmd.com/read/28639389/implementing-two-nurse-practitioner-models-of-service-at-an-australian-male-prison-a-quality-assurance-study
#6
Ides Wong, Eryn Wright, Damian Santomauro, Raquel How, Christopher Leary, Meredith Harris
AIMS AND OBJECTIVES: To examine the quality and safety of nurse practitioner services of two newly implemented nurse practitioner models of care at a correctional facility. BACKGROUND: Nurse practitioners could help to meet the physical and mental health needs of Australia's growing prison population; however, the nurse practitioner role has not previously been evaluated in this context. DESIGN: A quality assurance study conducted in an Australian prison where a primary health nurse practitioner and a mental health nurse practitioner were incorporated into an existing primary healthcare service...
June 21, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28631129/optimizing-the-deep-brain-stimulation-care-pathway-in-patients-with-parkinson-s-disease
#7
N J Thomas, P Mertens, T Danaila, G Polo, H Klinger, E Broussolle, S Thobois
Management of Parkinson's disease (PD) using deep brain stimulation (DBS) requires complex care in specialized, multidisciplinary centers. A well-organized, efficient patient flow is crucial to ensure that eligible patients can quickly access DBS. Delays or inefficiencies in patient care may impact a center's ability to meet demand, creating a capacity bottleneck. Analysis of the current practices within a center may help identify areas for improvement. After external audit of the DBS workflow of the Lyon Neurological Hospital and comparison with other European centers, manageable steps were suggested to restructure the care pathway...
June 19, 2017: Journal of Neurology
https://www.readbyqxmd.com/read/28631036/practical-recommendations-for-radium-223-treatment-of-metastatic-castration-resistant-prostate-cancer
#8
Yong Du, Ignasi Carrio, Giuseppe De Vincentis, Stefano Fanti, Harun Ilhan, Caroline Mommsen, Egbert Nitzsche, Francis Sundram, Wouter Vogel, Wim Oyen, Val Lewington
PURPOSE: Radium Ra 223 dichloride (radium-223, Xofigo®) is the first targeted alpha therapy for patients with castration-resistant prostate cancer and symptomatic bone metastases. Radium-223 provides a new treatment option for this setting, but also necessitates a new treatment management approach. We provide straightforward and practical recommendations for European nuclear medicine centres to optimize radium-223 service provision. METHODS: An independent research consultancy agency observed radium-223 procedures and conducted interviews with all key staff members involved in radium-223 treatment delivery in 11 nuclear medicine centres across six countries (Germany, Italy, the Netherlands, Spain, Switzerland and the UK) experienced in administering radium-223...
June 19, 2017: European Journal of Nuclear Medicine and Molecular Imaging
https://www.readbyqxmd.com/read/28629475/can-formalizing-links-among-community-health-workers-accredited-drug-dispensing-outlet-dispensers-and-health-facility-staff-increase-their-collaboration-to-improve-prompt-access-to-maternal-and-child-care-a-qualitative-study-in-tanzania
#9
Angel Dillip, Suleiman Kimatta, Martha Embrey, John C Chalker, Richard Valimba, Mariam Malliwah, John Meena, Rachel Lieber, Keith Johnson
BACKGROUND: In Tanzania, progress toward achieving the 2015 Millennium Development Goals for maternal and newborn health was slow. An intervention brought together community health workers, health facility staff, and accredited drug dispensing outlet (ADDO) dispensers to improve maternal and newborn health through a mechanism of collaboration and referral. This study explored barriers, successes, and promising approaches to increasing timely access to care by linking the three levels of health care provision...
June 19, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28629349/relationships-between-dental-personnel-and-non-dental-primary-health-care-providers-in-rural-and-remote-queensland-australia-dental-perspectives
#10
Jackie Stuart, Ha Hoang, Len Crocombe, Tony Barnett
BACKGROUND: Collaboration between dental practitioners and non-dental primary care providers has the potential to improve oral health care for people in rural and remote communities, where access to oral health services is limited. However, there is limited research on collaboration between these professional disciplines. The purpose of this paper was to explore the relationships between dental practitioners and non-dental primary care providers from rural and remote areas of Queensland and to identify strategies that could improve collaboration between these disciplines from the perspective of dental participants...
June 19, 2017: BMC Oral Health
https://www.readbyqxmd.com/read/28628487/do-toddler-s-fractures-of-the-tibia-require-evaluation-and-management-by-an-orthopaedic-surgeon-routinely
#11
John S Adamich, Mark W Camp
OBJECTIVE: The majority of uncomplicated toddler fractures of the tibia (toddler's fractures) do not need an orthopaedic surgeon's intervention or follow-up. However, inexperienced emergency room physicians, general practitioners and orthopaedic trainees and surgeons understandably defer to a cautious approach of referral and subsequent frequent clinical and radiographic follow-up. An evidence-based pathway can help prevent this overtreatment, reduce unnecessary radiation exposure and decrease the financial burden on families and the healthcare system...
June 16, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28624980/emerging-biomarkers-of-chronic-kidney-disease-in-children
#12
REVIEW
Jason H Greenberg, Aadil Kakajiwala, Chirag R Parikh, Susan Furth
Chronic kidney disease (CKD) has become a significant public health concern, as it is associated with substantial morbidity. Prior research has evaluated multiple novel CKD biomarkers to supplement serum creatinine and proteinuria. The ultimate goal of this research is to find biomarkers that can be used to accurately predict CKD progression and to better time outpatient follow-up, and referral for transplant. Also, an optimal panel of biomarkers can augment the predictive value of proteinuria and serum creatinine by enriching patient enrollment in clinical trials...
June 17, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28614247/meld-score-as-a-predictor-of-mortality-length-of-hospital-stay-and-disease-burden-a-single-center-retrospective-study-in-39-323-inpatients
#13
Jan A Roth, Carl Chrobak, Sabine Schädelin, Balthasar L Hug
The laboratory-based model for end-stage liver disease (MELD) score reflects the function of the kidney, liver, and extrinsic coagulation pathway and might be used as a general prognostic tool for the assessment of patients. We therefore aimed to investigate a potential association of the MELD score with mortality, length of hospital stay (LOS), and disease burden in a general patient population.We performed a retrospective observational study at a tertiary referral center. From January 2012 through December 2013, all consecutive inpatients aged 18 years were eligible for the study; patients with missing MELD parameters on hospital admission and/or treatments influencing the international normalized ratio, that is, novel oral anticoagulants and vitamin K antagonists, were excluded...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28613245/population-characteristics-in-a-tertiary-pain-service-cohort-experiencing-chronic-non-cancer-pain-weight-status-comorbidities-and-patient-goals
#14
Katherine Brain, Tracy Burrows, Megan E Rollo, Chris Hayes, Fiona J Hodson, Clare E Collins
We describe the characteristics of patients attending an Australian tertiary multidisciplinary pain service and identify areas for nutrition interventions. This cross-sectional study targets patients experiencing chronic pain who attended the service between June-December 2014. Self-reported data was captured from: (1) an Electronic Persistent Pain Outcomes Collaboration (ePPOC) referral questionnaire, incorporating demographics, pain status, and mental health; (2) a Pain Assessment and Recovery Plan (PARP), which documents patients' perceived problems associated with pain and personal treatment goals...
June 14, 2017: Healthcare (Basel, Switzerland)
https://www.readbyqxmd.com/read/28612298/comparing-strategies-for-providing-child-and-youth-mental-health-care-services-in-canada-the-united-states-and-the-netherlands
#15
Scott T Ronis, Amanda K Slaunwhite, Kathryn E Malcom
This paper reviews how child and youth mental health care services in Canada, the United States, and the Netherlands are organized and financed in order to identify systems and individual-level factors that may inhibit or discourage access to treatment for youth with mental health problems, such as public or private health insurance coverage, out-of-pocket expenses, and referral requirements for specialized mental health care services. Pathways to care for treatment of mental health problems among children and youth are conceptualized and discussed in reference to health insurance coverage and access to specialty services...
June 13, 2017: Administration and Policy in Mental Health
https://www.readbyqxmd.com/read/28610680/intimate-personal-violence-and-caregiving-influences-on-physical-and-mental-health-in-middle-aged-women
#16
Pablo Ferreira, Deborah Loxton, Leigh R Tooth
OBJECTIVES: To investigate if women with a history of having experienced intimate partner violence (IPV) who undertook caregiving would experience worse mental and physical health compared to those without caregiving roles. STUDY DESIGN AND MAIN OUTCOME MEASURES: IPV, caregiving history and data on covariates were collected between 1996 and 2010 from 8453 participants in the Australian Longitudinal Study on Women's Health aged between 45 and 65 over the course of the study...
August 2017: Maturitas
https://www.readbyqxmd.com/read/28605040/acute-hepatic-porphyrias-recommendations-for-evaluation-and-long-term-management
#17
Manisha Balwani, Bruce Wang, Karl E Anderson, Joseph R Bloomer, D Montgomery Bissell, Herbert L Bonkovsky, John D Phillips, Robert J Desnick
The acute hepatic porphyrias (AHPs) are a group of four inherited disorders, each resulting from the deficient activity of a specific enzyme in the heme biosynthetic pathway. They present clinically with acute neurovisceral symptoms which may be sporadic or recurrent, and which, when severe, can be life-threatening. The diagnosis is often missed or delayed as the clinical features resemble other more common medical conditions. There are four major subgroups: symptomatic patients with sporadic or recurrent acute attacks, asymptomatic high porphyrin precursor excretors, and asymptomatic latent patients without symptoms or porphyrin precursor elevations...
June 12, 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/28600231/the-two-week-wait-referral-pathway-is-not-associated-with-improved-survival-for-patients-with-colorectal-cancer
#18
Muhammad Imran Aslam, Sanjay Chaudhri, Baljit Singh, John Stuart Jameson
AIM: To improve survival rates in patients diagnosed with cancer in the UK, a two-week wait (2ww) referral to first appointment target and a 62 day referral to treatment target were introduced in 2004. This study analyses survival rates for patients diagnosed with colorectal cancer (CRC) by mode of referral and referral to treatment time. METHOD: A prospectively maintained database of CRC outcomes at the University Hospitals of Leicester NHS Trust was analysed. Data for patients diagnosed with CRC was analysed for survival...
June 6, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28589870/-making-better-use-of-the-clinical-geneticist-s-expertise-treating-physician-could-request-a-dna-test-for-most-cancer-patients
#19
C M Aalfs, A M Westermann, C G van El
Eight university medical centres in the Netherlands have established clinical genetic services. Patients receive intensive, and therefore costly, genetic counselling before genetic testing takes place. In recent years the number of patients referred to clinical genetic services has risen dramatically, creating waiting-list backlogs. Knowing your carrier status in hereditary cancers, for instance for a BRCA1/2 mutation, can have consequences for surveillance, treatment, and prevention; however, 90% of patients with breast cancer do not have a mutation...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28586707/consensus-based-guidelines-for-video-eeg-monitoring-in-the-pre-surgical-evaluation-of-children-with-epilepsy-in-the-uk
#20
Ronit M Pressler, Stefano Seri, Nick Kane, Tim Martland, Sushma Goyal, Anand Iyer, Elliott Warren, Lesley Notghi, Peter Bill, Rachel Thornton, Richard Appleton, Sarah Doyle, Sarah Rushton, Alan Worley, Stewart G Boyd
PURPOSE: Paediatric Epilepsy surgery in the UK has recently been centralised in order to improve expertise and quality of service available to children. Video EEG monitoring or telemetry is a highly specialised and a crucial component of the pre-surgical evaluation. Although many Epilepsy Monitoring Units work to certain standards, there is no national or international guideline for paediatric video telemetry. METHODS: Due to lack of evidence we used a modified Delphi process utilizing the clinical and academic expertise of the clinical neurophysiology sub-specialty group of Children's Epilepsy Surgical Service (CESS) centres in England and Wales...
May 12, 2017: Seizure: the Journal of the British Epilepsy Association
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