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Electronic Medical Records

Wei-Hsin Yuan, Anna Fen-Yau Li, Yi-Hong Chou, Hui-Chen Hsu, Ying-Yuan Chen
OBJECTIVE: The purpose of this study was to determine clinical and ultrasonographic characteristics of male breast tumors. METHODS: The medical records of male patients with breast lesions were retrieved from an electronic medical record database and a pathology database and retrospectively reviewed. A total of 112 men (125 breast masses) with preoperative breast ultrasonography (US) were included (median age, 59.50 years; age range, 15-96 years). Data extracted included patient age, if the lesions were bilateral, palpable, and tender, and the presence of nipple discharge...
2018: PloS One
Carol H Wysham, Dominic Pilon, Mike Ingham, Marie-Hélène Lafeuille, Bruno Emond, Rhiannon Kamstra, Michael Pfeifer, Patrick Lefebvre
OBJECTIVE: To compare achievement of quality goals (HbA1c, weight loss/body mass index[BMI], systolic blood pressure[SBP]), including maintaining HbA1c, between patients with type 2 diabetes mellitus (T2DM) treated with canagliflozin 300mg (CANA) or a GLP-1 in an actual practice setting. METHODS: Adults with T2DM newly initiated on CANA or a GLP-1 were identified from the IQVIATM Real-World Data Electronic Medical Records - US database (2012Q2-2016Q1). To account for differences in baseline characteristics, inverse probability of treatment weighting was used...
March 20, 2018: Current Medical Research and Opinion
Fiona M Baumer, Brenda E Porter
BACKGROUND: Sunflower Syndrome describes reflex seizures - typically eyelid myoclonia with or without absence seizures - triggered when patients wave their hands in front of the sun. While valproate has been recognized as the best treatment for photosensitive epilepsy, many clinicians now initially treat with newer medications; the efficacy of these medications in Sunflower Syndrome has not been investigated. We reviewed all cases of Sunflower Syndrome seen at our institution over 15 years to describe the clinical course, electroencephalogram (EEG), and treatment response in these patients...
March 3, 2018: Epilepsy Research
Marc L Martel, Lauren R Klein, Andrew J Lichtenheld, Allan M Kerandi, Brian E Driver, Jon B Cole
BACKGROUND: Altered mental status is a commonly evaluated problem in the ED. Ethanol intoxication is common, and prehospital history may bias emergency physicians to suspect this as the cause of altered mental status. Quantitative ethanol measurement can rapidly confirm the diagnosis, or if negative, prompt further evaluation. Our objective was to identify the etiologies of altered mental status in ED patients initially presumed to be intoxicated with ethanol but found to have negative quantitative ethanol levels...
March 12, 2018: American Journal of Emergency Medicine
Denise Yeo, Ihtimam Hossain, Soon Thye Lim, Mohamad Farid, Miriam Tao, Richard Quek, Tiffany Tang, Alexandre Chan
Background Currently, a standardized approach to prevent and manage hepatitis B reactivation in lymphoma patients with past hepatitis exposure receiving rituximab in Singapore is lacking. This study is designed to report the current management approach and outcomes associated with hepatitis B reactivation. Objectives The primary objective was to report 6-, 12-, 24-month cumulative hepatitis B reactivation-related outcomes. Secondary objectives were to report monitoring frequencies of hepatitis B DNA and liver function tests performed in lymphoma patients with resolved hepatitis B receiving rituximab, and anti-viral prophylaxis use...
January 1, 2018: Journal of Oncology Pharmacy Practice
Li-Tzy Wu, Udi E Ghitza, He Zhu, Susan Spratt, Marvin Swartz, Paolo Mannelli
BACKGROUND: The majority of the U.S. healthcare resources are utilized by a small population characterized as high-risk, high-need persons with complex care needs (e.g., adults with multiple chronic conditions). Substance use disorders (SUDs) and mental health disorders (MHDs) are a driver of poor health and additional healthcare costs, but they are understudied among high-need patients. OBJECTIVE: We examine the prevalence and correlates of SUDs and MHDs among adults with high-risk diabetes, who are patients at the top 10% risk score for developing poor outcomes (hospital admission or death)...
March 3, 2018: Drug and Alcohol Dependence
Angelica G Mancone, Alyssa R Dickey, Brian M Fitzgerald, Gregory P Kraus, Sandeep T Dhanjal
Introduction: Wrong site peripheral nerve blocks are included in the National Quality Forum and Joint Commission's category of "never event." Multiple attempts have been made by various groups in an effort to eliminate these events. Prior attempts to eliminate these never events include the Regional Block Preprocedural Checklist provided by the American Society of Regional Anesthesia (ASRA) taskforce. Following a series of errors involving anticoagulation prior to regional anesthesia, our department saw a need for a more comprehensive checklist...
March 15, 2018: Military Medicine
Aderaldo Costa Alves Junior, Pedro Tadao Hamamoto Filho, Marcelo Pacheco Gonçalves, Aristides Augusto Palhares Neto, Marco Antonio Zanini
Cranioplasty is a common procedure in neurosurgical practice, but associated with high complication rates. In the current study, the authors describe surgical characteristics and results of cranioplasty performed in a tertiary teaching hospital in Brazil. Data were obtained from electronic medical records of cranioplasties performed between January 2013 and November 2016. The sample comprised of 33 patients, and the mean follow-up time was 16 months. Patients presented most of the times a good preoperative status, with 84...
March 16, 2018: Journal of Craniofacial Surgery
Aditya Kanesa-Thasan, Amani A Fawzi, Manjot K Gill
PURPOSE: Central serous chorioretinopathy (CSC) is a disease in which serous detachment of the neurosensory retina occurs over an area of leakage from the choriocapillaris through the retinal pigment epithelium. Associations have been drawn between high-stress personality types and steroid exposure. This article aims to describe a unique case series of two husband and wife couples with CSC. METHODS: All methods were approved by the authors' institution's institutional review board...
April 2018: Retinal Cases & Brief Reports
Giulia Canali, Victoria Tittle, Akihiro Seita
BACKGROUND: The United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) estimated that in 2016, 11% of Palestine refugees older than 40 years living in Jordan were diagnosed with diabetes and that the disease is controlled in only 45% of Palestine refugees with diabetes. As medication adherence is one of the most important modifiable self-care behaviours to achieve adequate metabolic control, the aims of this study were to measure medication adherence and to review the factors associated with different levels of medication adherence in patients with diabetes...
February 21, 2018: Lancet
Nathan D Shippee, Michael Finch, Douglas R Wholey
OBJECTIVES: Patient-centered medical homes (PCMHs) represent a widespread model of healthcare transformation. Despite evidence that PCMHs can improve care quality, the mechanisms by which they improve outcomes are relatively unexamined. We aimed to assess the mechanisms linking certification as a Health Care Home (HCH), a statewide PCMH initiative, with asthma care quality and outcomes. We compared direct certification effects versus indirect clinical effects (via improved care process)...
March 1, 2018: American Journal of Managed Care
Dina Hafez, Laurence F McMahon, Linda Balogh, Floyd John Brinley, John Crump, Mark Ealovega, Audrey Fan, Yeong Kwok, Kristen Krieger, Thomas O'Connor, Elisa Ostafin, Heidi Reichert, Jennifer Meddings
OBJECTIVES: To characterize patterns of emergency department (ED) utilization for ambulatory care-sensitive conditions (ACSCs) among patients with established care within a patient-centered medical home. STUDY DESIGN: Retrospective chart review using Michigan Medicine's (formerly University of Michigan Health System) electronic health record. METHODS: Ten general medicine (GM) physicians reviewed 256 ambulatory care-sensitive ED encounters that occurred between January 1, 2014, and December 31, 2014, among patients of a GM medical home...
March 1, 2018: American Journal of Managed Care
Christine M Gunn, Barbara Bokhour, Tracy A Battaglia, Rebecca A Silliman, Amresh Hanchate
OBJECTIVES: A false-positive mammogram can result in anxiety, distress, and increased perceptions of breast cancer risk, potentially changing how women utilize healthcare. This study examined whether having an abnormal mammogram, considered a proxy for elevated risk perception, was associated with greater future health service use (outpatient visits and referrals). STUDY DESIGN: A retrospective cohort study using electronic health record data, spanning 2008 to 2012, from Boston Medical Center, a safety-net hospital...
March 2018: American Journal of Managed Care
Ida K Fox, Christine B Novak, Emily M Krauss, Gwendolyn M Hoben, Craig Zaidman, Rimma Ruvinskaya, Neringa Juknis, Anke C Winter, Susan E Mackinnon
BACKGROUND: Nerve transfer surgery to restore upper extremity (UE) function in cervical spinal cord injury (SCI) is novel and may transform treatment. Determining candidacy even years post-SCI is ill-defined and deserves investigation. OBJECTIVE: To develop a diagnostic algorithm, focusing on electrodiagnostic studies (EDX), to determine eligibility for nerve transfer surgery. DESIGN: Retrospective descriptive case series SETTING: Tertiary university-based institution PATIENTS: Individuals with cervical SCI (n = 45) METHODS: The electronic medical records of people referred to the Plastic and Reconstructive Surgery UE Surgery in SCI clinic from 2010-2015 were reviewed...
March 15, 2018: PM & R: the Journal of Injury, Function, and Rehabilitation
John L Schomburg, Suprita Krishna, Katherine J Cotter, Ayman Soubra, Amrita Rao, Badrinath Konety
OBJECTIVES: To determine the pre-operative incidence of subclinical lower-extremity deep vein thrombosis (DVT), as well as to evaluate the utility of preoperative DVT screening in bladder cancer patients prior to undergoing radical cystectomy. MATERIALS AND METHODS: Beginning in 2014, we prospectively instituted a policy of obtaining a screening lower-extremity duplex ultrasound on all patients within 7 days prior to undergoing radical cystectomy. We reviewed the electronic medical records of all patients at our institution who underwent radical cystectomy for bladder cancer from January 2012 through December 2015...
March 15, 2018: Urology
Kimberly Joseph, Sameer Gupta, James Yon, Renee Partida, Lee Cartagena, John Kubasiak, Vanessa Buie, Jared Miller, Dorion Wiley, Kimberly Nagy, Frederic Starr, Andrew Dennis, Matthew Kaminsky, Faran Bokhari
BACKGROUND: Checklists have been advocated to improve quality outcomes/communication in the critical care setting, but results have been mixed. A new checklist process, "TRAUMA LIFE", was implemented in our Trauma Intensive Care Unit (TICU) to replace prior checklists. The purpose of this study was to evaluate the impact of the "TRAUMA LIFE" process implementation on quality metrics and on patient/family communication in the TICU. METHODS: "TRAUMA LIFE" was considered maturely implemented by 2016...
March 9, 2018: American Journal of Surgery
Erin S Rogers, Steven S Fu, Paul Krebs, Siamak Noorbaloochi, Sean M Nugent, Amy Gravely, Scott E Sherman
INTRODUCTION: Veterans with a mental health diagnosis have high rates of tobacco use but encounter low rates of treatment from providers. This study tested whether a proactive tobacco treatment approach increases treatment engagement and abstinence rates in Department of Veterans Affairs mental health patients. STUDY DESIGN: RCT. SETTING/PARTICIPANTS: The study was performed from 2013 to 2017 and analyses were conducted in 2017. Investigators used the electronic medical record at four Veterans Administration facilities to identify patients documented as current smokers and who had a mental health clinic visit in the past 12 months...
March 15, 2018: American Journal of Preventive Medicine
Narges Safai, Bendix Carstensen, Henrik Vestergaard, Martin Ridderstråle
OBJECTIVES: To investigate the impact of a multifactorial treatment programme in a real-life setting on clinical outcomes and estimated cardiovascular disease (CVD) risk. DESIGN: A retrospective observational cohort study, using data from the electronic medical records and national registers. SETTING: Tertiary diabetes centre in Denmark. PARTICIPANTS: Patients with type 2 diabetes (n=4299) referred to a programme with focus on treatment of hyperglycaemia, hypertension and dyslipidaemia between 1 January 2001 and 1 April 2016...
March 17, 2018: BMJ Open
Ryan C Kruse, Zhuo Li, Cara C Prideaux, Allen W Brown
BACKGROUND: Depression and traumatic brain injury (TBI) substantially contribute to the United States healthcare burden. Depression is a known risk factor for prolonged recovery after TBI. However, the effect of depression treatment on health care utilization has yet to be studied. OBJECTIVE: To examine whether an association exists between pharmacologic treatment of depression at the time of mild or concussive TBI and the number of subsequent clinician visits for persistent injury-related symptoms...
March 14, 2018: PM & R: the Journal of Injury, Function, and Rehabilitation
Helmut Trimmel, Christoph Beywinkler, Sonja Hornung, Janett Kreutziger, Wolfgang G Voelckel
BACKGROUND: Competence in emergency airway management is key in order to improve patient safety and outcome. The scope of compulsory training for emergency physicians or paramedics is quite limited, especially in Austria. The purpose of this study was to review the difficult airway management performance of an emergency medical service (EMS) in a region that has implemented a more thorough training program than current regulations require, comprising 3 months of initial training and supervised emergency practice and 3 days/month of on-going in-hospital training as previously reported...
March 16, 2018: International Journal of Emergency Medicine
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