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Frequent attenders

Kelvin Robertson, Laurence A G Marshman, David Plummer, Elena Downs
Importance: Optimal pharmacologic treatment for chronic sciatica (CS) is currently unclear. While gabapentin (GBP) and pregabalin (PGB) are both used to treat CS, equipoise exists. Nevertheless, pharmaceutical regulation authorities typically subsidize one drug over the other. This hinders interchange wherever the favored drug is either ineffective or ill-tolerated. Objective: To assess GBP vs PGB head to head for the treatment of CS. Design, Setting, and Participants: A preplanned interim analysis of a randomized, double-blind, double-dummy crossover trial of PGB vs GBP for management of CS at half the estimated final sample size was performed in a single-center, tertiary referral public hospital...
October 15, 2018: JAMA Neurology
Shoko Mori, Cristian Navarrete-Dechent, Tatyana A Petukhova, Erica H Lee, Anthony M Rossi, Michael A Postow, Lara A Dunn, Benjamin R Roman, Vivian T Yin, Daniel G Coit, Travis J Hollmann, Klaus J Busam, Kishwer S Nehal, Christopher A Barker
Background: Tumor board conferences (TBCs) are used by oncologic specialists to review patient cases, exchange knowledge, and discuss options for cancer management. These multidisciplinary meetings are often a cornerstone of treatment at leading cancer centers and are required for accreditation by certain groups, such as the American College of Surgeons' Commission on Cancer. Little is known regarding skin cancer TBCs. The objective of this study was to characterize the structure, function, and impact of existing skin cancer TBCs in the United States...
October 2018: Journal of the National Comprehensive Cancer Network: JNCCN
Margaret Louise Phillips, Vijo Kuruvilla, Michael Bailey
BACKGROUND: Pain is a common stressor for ICU patients, necessitating routine assessment. For patients who are unable to communicate, self-report tools are unsuitable, and the use of an observational tool is required to assess pain appropriately. The Critical Care Pain Observation Tool (CPOT) is the most reliable tool currently available to assess pain in these patients. We investigated whether the implementation of the CPOT in one Australian ICU could increase frequency of appropriate pain assessments, and if this would affect the administration of analgesia and sedation...
October 9, 2018: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
Guillermo Martínez-Pérez, Dawoh Peter Lansana, Senga Omeonga, Himanshu Gupta, Bondey Breeze-Barry, Raquel González, Azucena Bardají, Adelaida Sarukhan, James D K Goteh, Edith Tody, Pau Cisteró, Benard Benda, Juwe D Kercula, Fanta D Kibungu, Ana Meyer García-Sípido, Quique Bassat, Christine K Tarr-Attia, Alfredo Mayor
BACKGROUND: Disruption of malaria control strategies during the West African 2014-2016 Ebola epidemic led to an increase in malaria-attributable mortality. However, recent data on malaria infection in vulnerable groups, such as pregnant women, are lacking in this post-Ebola scenario. This cross-sectional study aimed to assess the prevalence of Plasmodium falciparum infection and of molecular markers of drug resistance among pregnant women attending antenatal care in Monrovia, capital of Liberia...
October 11, 2018: Malaria Journal
Mei Gao, Hui Wang
This study aims to retrospectively analyze the potential risk factors for uterine leiomyoma and prospectively examine whether these risk factors can increase the incidence of uterine leiomyoma.Women who attended our outpatient department from January 1, 2010 to December 31, 2010 were enrolled. General demographical characteristics, personal information, and living habits were collected. Univariate and multivariate logistic regression analyses were used to identify the potential risk factors. Follow-up was regularly conducted to complete the prospective analysis...
October 2018: Medicine (Baltimore)
Kate B Carey, Kate M Guthrie, Carla M Rich, Naomi H Krieger, Alyssa L Norris, Clair Kaplan, Michael P Carey
Alcohol use and sexual behavior co-occur frequently in young women, increasing risk for HIV and other sexually transmitted infections. To inform preventive interventions, we used qualitative methods to better understand how women think about the contribution of alcohol use to sexual risk-taking. Young women (N = 25; M = 22.8 years; 64% White) were recruited from a community-based reproductive health clinic to attend focus groups; a semi-structured agenda was used to investigate both a priori explanatory mechanisms as well as participant-driven explanations for the alcohol-sex association...
October 12, 2018: AIDS and Behavior
Elizabeth R Wolf, Camille J Hochheimer, Roy T Sabo, Jennifer DeVoe, Richard Wasserman, Erik Geissal, Douglas J Opel, Nate Warren, Jon Puro, Jennifer O'Neil, James Pecsok, Alex H Krist
BACKGROUND AND OBJECTIVES: It is unclear which specific well-child visits (WCVs) are most frequently missed and whether age-specific patterns of attendance differ by race or insurance type. METHODS: We conducted a retrospective cohort study of children 0 to 6 years old between 2011 and 2016 within 2 health networks spanning 20 states. WCVs were identified by using International Classification of Diseases, Ninth and 10th Revisions and Current Procedural Terminology codes...
October 10, 2018: Pediatrics
Giancarlo Marra, Guillaume Ploussard, Piet Ost, Pieter J L De Visschere, Alberto Briganti, Giorgio Gandaglia, Derya Tilki, Christian I Surcel, Igor Tsaur, Roderick C N Van Den Bergh, Alexander Kretschmer, Hendrik Borgmann, Paolo Gontero, Hashim U Ahmed, Massimo Valerio
INTRODUCTION: The urological community's opinion over focal therapy (FT) for prostate cancer (PCa) has never been assessed. Our aim was to investigate the current opinion on FT in the European urological community. METHODS: A 25-item questionnaire was devised according to the Cherries checklist and distributed through SurveyMonkey using a web link from November 2016 to October 2017. After a pilot validation (n = 40 urologists), the survey was sent through EAU and 9 other national European urological societies mailing list...
October 6, 2018: Urologic Oncology
Anna Lövgren, Linnea Karlsson Wirebring, Birgitta Häggman-Henrikson, Anders Wänman
Temporomandibular disorders (TMDs) are common, but many patients with such disorders go undetected and under-treated. Our aim was to evaluate the outcome of using a screening tool (5 yr after it was first implemented), on the clinical decision-making for patients with TMDs. Adults who attended for a dental check-up at the Public Dental Health Services in Västerbotten, Sweden, answered three screening questions (3Q/TMD) on frequent jaw pain, pain on jaw function, and catching/locking of the jaw. The dental records of a random sample of 200 individuals with at least one positive response to 3Q/TMD (3Q screen-positive patients) and 200 individuals with all negative responses (3Q screen-negative patients) were reviewed for TMD-related treatment decisions...
October 8, 2018: European Journal of Oral Sciences
Jane Edwards
Background: Committing to attendance at personal therapy sessions is frequently either mandated or encouraged in many different types of therapeutic trainings across allied health, psychotherapy, social work and counseling. The small number of published accounts have indicated that student experiences of personal therapy can be mixed. Methods: The project examined contemporary interview based research about student experience of personal therapy during training using Critical Interpretive Synthesis method. Ten papers were found which met the search criteria...
2018: Frontiers in Psychology
Gordon W Macdonald
AimTo determine the responsiveness of primary care chaplaincy (PCC) to the current variety of presenting symptoms seen in primary care. This was done with a focus on complex and undifferentiated illness. BACKGROUND: Current presentations to primary care are often complex, undifferentiated and display risk factors for social isolation and loneliness. These are frequently associated with loss of well-being and spiritual issues. PCC provides holistic care for such patients but its efficacy is unknown in presentations representative of such issues...
October 8, 2018: Primary Health Care Research & Development
Arianna Mazzotti, Maria Turchese Caletti, Lucia Brodosi, Silvia Di Domizio, Maria Luisa Forchielli, Salvatore Petta, Elisabetta Bugianesi, Giampaolo Bianchi, Giulio Marchesini
BACKGROUND & AIMS: Interventions aimed at lifestyle changes are pivotal for the treatment of non-alcoholic fatty liver disease (NAFLD), and web-based programs might help remove barriers in both patients and therapists. METHODS: In the period 2010-15, 716 consecutive NAFLD cases (mean age, 52; type 2 diabetes, 33%) were treated in our Department with structured programs. The usual protocol included motivational interviewing and a group-based intervention (GBI), chaired by physicians, dietitians and psychologists (five weekly meetings, n = 438)...
September 22, 2018: Journal of Hepatology
Jackeline Nogueira de Paula Barros, Thayssa Augusto Assis de Araújo, Thais Rodrigues Campos Soares, Michele Machado Lenzi, Patrícia de Andrade Risso, Tatiana Kelly da Silva Fidalgo, Lucianne Cople Maia
This retrospective study aimed to evaluate the dental trauma profile in primary and permanent teeth from patients between 0 and 15 years old who attended the Faculty of Dentistry of the Federal University of Rio de Janeiro. Data regarding gender, age, trauma classification, tooth type, and affected tissues were obtained from dental records. The data were analyzed descriptively and by the χ2 test (p < 0.05). Data associated with 333 traumatized teeth (70% primary and 30% permanent teeth) were included. The mean ages of children with affected primary and permanent teeth were 3...
October 5, 2018: Journal of Clinical Pediatric Dentistry
Katie Newman, Kelly O'Donovan, Natasha Bear, Annie Robertson, Raewyn Mutch, Sarah Cherian
AIM: Nutritional deprivation, inadequate diet and food insecurity are common refugee experiences. The growth and nutritional status of paediatric refugees following resettlement in developed countries and the related interplay with socio-economic factors remain less defined; this study aims to describe these features. METHODS: Standardised dietary, medical and socio-demographic health assessments of new refugee patients attending a multidisciplinary paediatric Refugee Health Service (RHS) in Western Australia between 2010 and 2015 were analysed...
October 5, 2018: Journal of Paediatrics and Child Health
Euijoon Ahn, Jinman Kim, Khairunnessa Rahman, Tanya Baldacchino, Christine Baird
OBJECTIVE: To examine the characteristics of frequent visitors (FVs) to emergency departments (EDs) and develop a predictive model to identify those with high risk of a future representations to ED among younger and general population (aged ≤70 years). DESIGN AND SETTING: A retrospective analysis of ED data targeting younger and general patients (aged ≤70 years) were collected between 1 January 2009 and 30 June 2016 from a public hospital in Australia. PARTICIPANTS: A total of 343 014 ED presentations were identified from 170 134 individual patients...
October 4, 2018: BMJ Open
Patrick Roigk, Clemens Becker, Claudia Schulz, Hans-Helmut König, Kilian Rapp
BACKGROUND: Falls and fractures are extremely frequent in long-term care facilities (LTCFs). Therefore, a fall and fracture prevention program was started in nearly 1000 LTCFs in Bavaria/Germany between 2007 and 2010. The components of the program were exercise classes, the documentation of falls, environmental adaptations, medication reviews, the recommendation to use hip protectors and education of staff. The present study aimed to provide a comprehensive evaluation of the implementation process of the program regarding results of the implementation phase and the follow-up of 3-9 years after start of implementation...
October 1, 2018: BMC Geriatrics
Eriko Tsukada, Shingo Kitamura, Minori Enomoto, Aiko Moriwaki, Yoko Kamio, Takashi Asada, Tetsuaki Arai, Kazuo Mishima
OBJECTIVES: To investigate childhood obstructive sleep apnea syndrome (OSAS) and its role in daytime sleepiness among school-age children. METHODS: A questionnaire survey was conducted with 25,211 children aged 6-15 (mean, 10.39) years attending 148 elementary and 71 middle schools in 10 prefectures across Japan and their parents. Questions concerned 4 sleep habit items (bedtime, sleep onset latency, wake time after sleep onset, wake-up time) and 4 sleep disorder items (loud snoring, snorts/gasps, breathing pauses, seems very sleepy in the daytime)...
2018: PloS One
I Martínez Ríos, S R López Alonso, S Martín Carabante, L Morales Infante, S I Soriano Ruiz, A I Martínez García
BACKGROUND: Identification of patients susceptible to palliative care (SPC) in the community is essential for improving their clinical management. The objective is to explore the SPC population and their typology of illness, according to sex. METHODS: Cross-sectional study, performed on the population of Malaga who died at home during 2015. Association between type of patient (SCP or identified as palliative by inclusion in the integrated care process (ICP)). Age, sex and type of disease were analyzed with Chi square and t-Student's test...
October 2, 2018: Anales del Sistema Sanitario de Navarra
Stephen Gauthier, Lindsay Melvin, Maria Mylopoulos, Nadine Abdullah
OBJECTIVES: Direct observation is the foundation of assessment and learning in competency-based medical education (CBME). Despite its importance, there is significant uncertainty about how to effectively implement frequent and high-quality direct observation. This is particularly true in specialties where observation of non-procedural skills is highly valued and presents unique challenges. It is therefore important to understand perceptions of direct observation to ensure successful acceptance and implementation...
October 1, 2018: Medical Education
L Antonio, S Pauwels, M R Laurent, D Vanschoubroeck, I Jans, J Billen, F Claessens, B Decallonne, Diane De Neubourg, P Vermeersch, D Vanderschueren
Background: Diagnosing polycystic ovary syndrome (PCOS) is based on ovulatory dysfunction, ovarian ultrasound data, and androgen excess. Total testosterone is frequently used to identify androgen excess, but testosterone is mainly bound to sex hormone-binding globulin (SHBG) and albumin. Only 1-2% of nonprotein-bound testosterone (so-called free testosterone) is biologically active and responsible for androgen action. Moreover, automated immunoassays which are frequently used for female testosterone measurements are inaccurate...
2018: International Journal of Endocrinology
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