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physician impairment

Carol Sinnott, Tony Foley, Justin Forsyth, Kathleen McLoughlin, Linda Horgan, Colin P Bradley
OBJECTIVES: To review the empirical evidence on approaches used by Primary Care Physicians (PCPs) in fitness to drive (FtD) consultations with people living with cognitive impairment. DESIGN: Scoping review of empirical literature focused on primary studies of any design. SETTING: Primary care practice. PARTICIPANTS: PCPs or their equivalent and/ or individuals with cognitive impairment across the spectrum of mild cognitive impairment to dementia...
2018: PloS One
E Iu Iupatov, I M Ignat'ev, E E Fomina
The problem of chronic venous insufficiency in women during pregnancy is of current concern. A total of 115 pregnant women in the first, second and third trimesters of gestation were examined in a stage-wise manner. During the first stage we conducted a comprehensive clinical study with the obligatory consultation by the obstetrician-gynaecologist. At the second stage, all women were subjected to ultrasonographic examination of the venous system of both lower extremities and the small pelvis. Studying the diameters of the deep veins of the right and left lower limbs, as well as the paired veins of the small pelvis demonstrated no statistically significant differences, which made it possible to evaluate these parameters as a whole...
2018: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
Praveen J Patel, David H Steel, Christoph Hirneiß, John Brazier, Abdalla Aly, Benedicte Lescrauwaet
OBJECTIVES: To report the prevalence and severity of metamorphopsia, estimate its impact on vision-related quality of life (VRQoL) and evaluate predictors of VRQoL in patients with vitreomacular traction (VMT). PATIENTS AND METHODS: A prospective, cross-sectional multi-centre study in the United Kingdom of 185 patients with VMT, with or without a full thickness macular hole (FTMH). Self-reported metamorphopsia was determined using the metamorphopsia questionnaire...
October 12, 2018: Eye
Reeta Danni, Claudia Taipale, Lotta Ilveskoski, Raimo Tuuminen
PURPOSE: To study the outcomes of uneventful cataract surgery in diabetic patients without retinal complications. SETTING: Conducted at Kymenlaakso Central Hospital, Kotka, Finland. DESIGN: A post-hoc treatment analysis using data from 2 double-blind RCTs. METHODS: A total of 276 eyes of 266 patients undergoing routine cataract surgery were included in the study. Patients with type I or II diabetes (N=56 eyes) were compared to non-diabetic patients (N=220 eyes)...
October 8, 2018: American Journal of Ophthalmology
Bruno Moulin, Thierry Ponchon
Background and study aims  Colonoscopy is a widely used diagnostic procedure which requires prior cleansing of the bowel. Many different bowel cleansing preparations have been developed, all of which have specific advantages and disadvantages. This review compares two low-volume high-osmolarity bowel cleansing preparations, oral phosphate salts and oral sulphate salts, with a particular focus on risk of nephrotoxicity. Patients and methods  An electronic search of the Medline database was performed using the search terms "(phosphates OR sulfates) AND cathartics [MeSH Term] AND kidney" restricted to humans with a cut-off date of December 31, 2016...
October 2018: Endoscopy International Open
Hanneke Stam, Johannes C van der Wouden, Jacqueline G Hugtenburg, Jos W R Twisk, Henriëtte E van der Horst, Otto R Maarsingh
OBJECTIVES: Dizziness is common in older people. Physicians are often unable to identify a specific cause for dizziness in older people, even after an extensive diagnostic work-up. A prognosis-oriented approach, i.e. treating modifiable risk factors for an unfavourable course of dizziness, may reduce dizziness-related impairment in older people in primary care. DESIGN: Cluster randomized controlled trial. SETTING: 45 primary care practices in The Netherlands...
2018: PloS One
Anne M Rentz, Anne M Skalicky, Zhimei Liu, David W Dunn, Michael D Frost, Jo Anne Nakagawa, Judith Prestifilippo, Qayyim Said, James W Wheless
Background: Tuberous sclerosis complex (TSC) is a rare genetic disorder characterized by benign tumors in multiple organs, including non-cancerous kidney lesions known as renal angiomyolipomas. This study's objective is to describe the age-stratified morbidity, treatment patterns, and health-related quality of life of TSC patients with renal angiomyolipomas in the United States. A cross-sectional, anonymous web-based survey was conducted with a convenience sample of TSC patients and caregivers identified through a patient advocacy organization...
December 2018: Journal of patient-reported outcomes
Magali Fortané, Philippe Bensaid, Serge Resnikoff, Kali Seini, Nathalie Landreau, Jean-Michel Paugam, Nicolas Nagot, Thibault Mura, Chris Serrand, Max Villain, Vincent Daien
OBJECTIVE: To report the outcomes of cataract surgery performed by non-physician cataract surgeons due to lack of ophthalmologists in remote areas of North Cameroon. DESIGN: Prospective cohort study. SETTING: The main centre of the non-governmental organisation Ophtalmo Sans Frontières in Lagdo. PARTICIPANTS AND INTERVENTIONS: Age-related cataract surgery performed between 28 November 2016 and 17 May 2017. MAIN OUTCOMES MEASURES: The main outcome measure was presenting visual acuity (PVA) 1-4 weeks after surgery, classified according to the WHO as good (PVA ≥6/18), borderline (PVA 6/60-6/18) and poor (PVA <6/60)...
October 5, 2018: British Journal of Ophthalmology
Giorgio Cozzi, Egidio Barbi
Somatic symptom disorder is a condition in which a patient's subjective report of physical symptoms is associated with distress; disruption of day-to-day functioning; or disproportionate thoughts, feelings and behaviours regarding the symptoms, whether or not they are associated with an identified medical condition. While somatic symptom disorder affects a considerable proportion of children and adolescents presenting to the emergency department (ED), it has not been well investigated in the ED literature, nor is there much formal training in, or guidelines for, how to care for affected patients in the ED...
October 4, 2018: Journal of Paediatrics and Child Health
Eric R Friedman, Kenneth H Butler
BACKGROUND: Compartment syndrome is often considered in patients with long-bone fractures and soft-tissue injuries, but is not as commonly associated with a period of unconsciousness. CASE REPORT: A 65-year-old man was brought to our emergency department (ED) because he had lost consciousness for an unknown amount of time after snorting heroin. He had severe pain in his upper right arm. Physical examination revealed right arm edema, paresthesia, tenderness, and firmness to palpation...
October 1, 2018: Journal of Emergency Medicine
Matthew R Weir, Reinhold Kreutz
With the growing integration of non-vitamin K antagonist oral anticoagulants (NOACs) into clinical practice, questions have arisen regarding their use in special populations, including groups that may have been underrepresented in clinical trials. Patients with renal impairment, particularly in the lower echelons of renal function, are one such group. In an effort to elucidate the current evidence regarding the use of NOACs in patients with renal impairment, a systematic assessment of the literature was performed...
October 2018: Mayo Clinic Proceedings
Pelin Kuteyla Can, Pırıl Etikan, Utkan Kızıltaç, Kübra Kızıltaç, Ralfi Singer, Emek Kocaturk
BACKGROUND: Fric test is a useful tool for the diagnosis and threshold testing for symptomatic dermographism. When threshold testing is not available, Urticaria Control Test (UCT) and Dermatology Life Quality Index (DLQI) might be used to assess disease control and quality of life (QoL) impairment, respectively. OBJECTIVES: In this study, we aimed to describe a new scoring system for the Fric test and evaluate the correlations of Fric scores with UCT, DLQI, and other disease activity assessment scores...
October 4, 2018: International Archives of Allergy and Immunology
Li-Xia Pei, Hao Geng, Hao Chen, Xiao-Liang Wu, Lu Chen, Jun-Ling Zhou, Lu Ju, Gao Lu, Wan-Li Xu, Shan Qin, Jing Guo, Eun Mee Yang, Jian-Hua Sun
BACKGROUND: Irritable bowel syndrome (IBS) is a chronic gastrointestinal disorder characterized by abdominal pain and change of bowel habit without organic disease. A global perspective given by the World Gastroenterology Organization (WGO) points out that IBS can impact the quality of an individual's daily life, cause socioeconomic problems and potentially impair the patient-physician relationship. It remains a problem to treat IBS due to the complicated pathophysiology. Acupuncture is an alternative therapy recommended for IBS...
October 1, 2018: Trials
Katsuhiro Masago, Fumiko Imamichi, Yoshio Masuda, Noriko Ariga, Kiyomi Fujitomi, Yoko Fukumine, Kana Hatakenaka, Shiro Fujita, Nobuyuki Katakami
Objective: The aim of this study was to evaluate the effectiveness of a rash team management intervention designed by certified nurses, medical physicians, and certified pharmacists. The quality of life (QOL) of patients administered epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitors (TKIs) was assessed using the dermatology life quality index (DLQI) and Skindex-29 QOL questionnaires. Methods: A total of 51 patients with nonsmall cell lung cancer who were treated using EGFR-TKIs were examined between November 1, 2014, and October 31, 2015, at the Institute of Biomedical Research and Innovation in Kobe city, Japan...
October 2018: Asia-Pacific Journal of Oncology Nursing
Keiko Minamoto, Thomas L Diepgen, Keiko Sato, Hiromitsu Noguchi, Naoko Yamashita, Kazuko Yoshimura, Robert F Ofenloch
Hand eczema (HE) is a common skin disease that impairs health-related quality of life (HRQOL). Impairments in HRQOL have already been reported in Japanese HE patients using the Skindex-16. Recently, an instrument to measure disease-specific HRQOL in HE patients was developed by an international expert group, consisting of domains for: (i) symptoms; (ii) emotions; (iii) functioning; and (iv) treatment and prevention. The objective of this study is to translate the English-language version of the Quality of Life Hand Eczema Questionnaire (QOLHEQ) to Japanese and then to validate the Japanese version...
September 28, 2018: Journal of Dermatology
Carly E Guss, Tracy K Richmond, Sara Forman
Background: Avoidant/restrictive food intake disorder (ARFID) was added to the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition in 2013. ARFID can result in impaired growth and significant nutritional deficiency; individuals with ARFID may be so nutritionally compromised that they require medical stabilization in a hospital. Prior to the new diagnostic criteria, it is unclear how patients now diagnosed with ARFID may have been medically stabilized when hospitalized...
2018: Journal of Eating Disorders
Vinaya Mulkareddy, Susan B Racette, Andrew R Coggan, Linda R Peterson
Heart failure with reduced ejection fraction (HFrEF) is a deadly and disabling disease. A key derangement contributing to impaired exercise performance in HFrEF is decreased nitric oxide (NO) bioavailability. Scientists recently discovered the inorganic nitrate pathway for increasing NO. This has advantages over organic nitrates and NO synthase production of NO. Small studies using beetroot juice as a source of inorganic nitrate demonstrate its power to improve exercise performance in HFrEF. A larger-scale trial is now underway to determine if inorganic nitrate may be a new arrow for physicians' quiver of HFrEF treatments...
September 24, 2018: Biochimica et biophysica acta. Molecular basis of disease
Moinay Kim, Suk Kyung Hong, Sang Ryong Jeon, Sung Woo Roh, Seungjoo Lee
OBJECTIVES: Surgical management of spinal cord injury (SCI) is challenging. There is no standard guideline regarding the timing of surgery, although physicians have prioritized early surgery over the past decades. Although better outcomes have been observed from these studies, the definition of early surgery has been controversial, although mostly limited to 24-hours after injury. For some hospitals, this early surgery could be difficult to implement in practice. Hence, we re-evaluated the timing of early surgery as surgery within 48 hours and investigated the surgical outcomes of SCI depending on whether surgery was performed early (≤48 hours) or late (>48 hours)...
October 2018: World Neurosurgery
Alison G Lee, Seyram Kaali, Ashlinn Quinn, Rupert Delimini, Katrin Burkart, Jones Opoku-Mensah, Blair J Wylie, Abena Konadu Yawson, Patrick L Kinney, Kenneth A Ae-Ngibise, Steven Chillrud, Darby Jack, Kwaku Poku Asante
RATIONALE: Approximately 2.8 billion people are exposed daily to household air pollution from polluting cookstoves. The effects of prenatal household air pollution on lung development are unknown. OBJECTIVES: We prospectively examined associations between prenatal household air pollution and infant lung function and pneumonia in rural Ghana. METHODS: Prenatal household air pollution exposure was indexed by serial maternal carbon monoxide personal exposure measurements...
September 26, 2018: American Journal of Respiratory and Critical Care Medicine
Andrea Williams, Amber Cadick
As the population ages, more Americans are moving into nursing homes/long-term care facilities. Per Accreditation Council for Graduate Medical Education 2017 guidelines, family medicine residents are required to gain experience and competence working in long-term care facilities; however, this unique environment poses several challenges for residents to hear the wishes of their patients over the demands of the patient's medical care team and family members. Also, many patients in long-term care facilities have sensory impairments (e...
November 2018: International Journal of Psychiatry in Medicine
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