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https://www.readbyqxmd.com/read/29160167/an-innovative-long-final-year-assistantship-in-general-practice-description-and-evaluation
#1
Robert K McKinley, M Bartlett, S P Gay, S Gibson, A Panesar, M Webb
We describe and evaluate an innovative immersive 15 week final year assistantship in general practice. Evaluation data was taken from five years of routinely collected School data and available national comparative data. The assistantship aims to enable students to consolidate knowledge and hone their skills through central participation in the care of large numbers of patients with acute and long term conditions. We estimate that most students consulted with over 450 patients during the assistantship. Students report that they became useful to their practice teams, had multiple episodes of feedback on their performance which they found useful and, in the school exit survey, reported that they were highly prepared for practice...
November 21, 2017: Education for Primary Care
https://www.readbyqxmd.com/read/29160131/the-views-of-early-intervention-service-staff-on-the-treatment-of-first-episode-bipolar-disorder
#2
Steven Marwaha, Thomas Beirne, Matthew Broome, Rachel Upthegrove, Tobias Rowland, Andrew Thompson
OBJECTIVE: Little is known about how first episode bipolar disorder (BD) is managed in early intervention for psychosis services (EIS). We aimed to investigate the knowledge and views of EIS staff on the assessment and treatment of BD. METHODS: A 27-item anonymised online questionnaire was distributed to EIS mental health professionals in England. Descriptive data analysis was undertaken. RESULTS: Responses were received from 117 EIS staff...
November 21, 2017: International Journal of Psychiatry in Clinical Practice
https://www.readbyqxmd.com/read/29158921/a-nearly-lethal-screw-an-unusual-cause-of-recurrent-bradycardia-and-asystole-episodes-after-fixation-of-the-cervical-spine
#3
Amit Frenkel, Yair Binyamin, Evgeni Brotfain, Leonid Koyfman, Aviel Roy-Shapira, Ilan Shelef, Moti Klein
We present a case of a 51-year-old man who was injured in a bicycle accident. His main injury was an unstable fracture of the cervical and thoracic vertebral column. Several hours after his arrival to the hospital the patient underwent open reduction and internal fixation (ORIF) of the cervical and thoracic spine. The patient was hospitalized in our critical care unit for 99 days. During this time patient had several episodes of severe bradycardia and asystole; some were short with spontaneous return to sinus and some required pharmacological treatment and even Cardiopulmonary Resuscitation (CPR)...
2017: Case Reports in Critical Care
https://www.readbyqxmd.com/read/29156914/palliative-radiotherapy-utilization-within-a-regional-australian-palliative-care-unit
#4
Peter Eastman, Anna Dowd, James Goonan, Helen Farrell, Graham Pitson
BACKGROUND: Palliative radiotherapy has been demonstrated to be efficacious for symptom management in advanced malignancy however there are limited data investigating its use for inpatient palliative care patients. The aim of the current paper was to evaluate the utilization of radiotherapy amongst patients admitted to a regional Australian palliative care unit (PCU). METHODS: A retrospective cohort study was undertaken involving all Barwon Health PCU patients who received radiotherapy whilst an inpatient...
October 1, 2017: Annals of Palliative Medicine
https://www.readbyqxmd.com/read/29155190/use-of-routine-home-health-care-and-deviations-from-an-uncomplicated-recovery-pathway-after-radical-prostatectomy
#5
Deborah R Kaye, John Syrjamaki, Chad Ellimootil, Edward W Schervish, M Hugh Solomon, Susan Linsell, James E Montie, David C Miller, James M Dupree
OBJECTIVE: To evaluate the statistical association between routine home health use after prostatectomy, short-term surgical outcomes, and payments. METHODS: We identified all men who underwent a robotic radical prostatectomy from 04/01/2014 through 10/31/2015 in the Michigan Urological Surgery Improvement Collaborative (MUSIC) with insurance from Medicare or a large commercial payer. We calculated rates of "routine" home care use after prostatectomy by urology practice...
November 16, 2017: Urology
https://www.readbyqxmd.com/read/29153005/screening-for-delirium-development-and-validation-of-the-buffalo-delirium-scale-for-use-in-a-home-based-hospice-setting
#6
Jennifer M Breier, Scott T Meier, Christopher W Kerr, Scott T Wright, Pei C Grant, Rachel M Depner
BACKGROUND: Delirium is a challenging occurrence among people at end of life. It can be difficult to detect and treat because of its episodic nature. The Buffalo Delirium Scale (BDS) was designed to identify risk factors for hospice patients in the prodromal stage of delirium. OBJECTIVE: This study evaluated the psychometric properties of items assessing delirium risk factors related to cognitive problems, psychological distress, and sleep problems. METHODS: Hospice nursing staff assessed patients with the 11-item BDS over a 6-month period as part of standard weekly visits to monitor for emerging signs of delirium, for example, sleep patterns, cognition, and behavior...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/29151192/impact-of-oral-ketamine-augmentation-on-hospital-admissions-in-treatment-resistant-depression-and-ptsd-a-retrospective-study
#7
John Hartberg, Simone Garrett-Walcott, Angelo De Gioannis
RATIONALE: Depressive episodes are the leading cause of mental health-related hospital admissions in Australia, and 44% of those admitted have a previous history of hospitalisations for depression (Admitted patient mental health-related care: (Australian Institute of Health and Welfare Aust Hospital Stat 2011-12, 2013). Despite numerous available antidepressant treatments, many patients do not respond to conventional therapy, having what is called 'treatment resistance' (Fava Biol Psychiatry 53:649-659, 2003)...
November 18, 2017: Psychopharmacology
https://www.readbyqxmd.com/read/29151129/one-novel-and-two-uncommon-mefv-mutations-in-japanese-patients-with-familial-mediterranean-fever-a-clinicogenetic-study
#8
Dai Kishida, Masahide Yazaki, Akinori Nakamura, Fumio Nomura, Takeshi Kondo, Takanori Uehara, Masatomi Ikusaka, Akira Ohya, Norihiko Watanabe, Ryuta Endo, Satoshi Kawaai, Yasuhiro Shimojima, Yoshiki Sekijima
Familial Mediterranean fever (FMF) is an autoinflammatory disease caused by mutations in the MEFV gene and characterized by recurrent episodes of fever and polyserositis. To date, over 317 MEFV mutations have been reported, only nine of which account for almost all Japanese patients with FMF. Therefore, the prevalence of rare MEFV variants and their clinical characteristics remains unclear. This study identified MEFV mutations previously unreported in the Japanese population and described their clinical features...
November 18, 2017: Rheumatology International
https://www.readbyqxmd.com/read/29151022/quality-of-care-for-people-with-multimorbidity-a-case-series
#9
Michaela L Schiøtz, Dorte Høst, Mikkel B Christensen, Helena Domínguez, Yasmin Hamid, Merete Almind, Kim L Sørensen, Thomas Saxild, Rikke Høgsbro Holm, Anne Frølich
BACKGROUND: Multimorbidity is becoming increasingly prevalent and presents challenges for healthcare providers and systems. Studies examining the relationship between multimorbidity and quality of care report mixed findings. The purpose of this study was to investigate quality of care for people with multimorbidity in the publicly funded healthcare system in Denmark. METHODS: To investigate the quality of care for people with multimorbidity different groups of clinicians from the hospital, general practice and the municipality reviewed records from 23 persons with multimorbidity and discussed them in three focus groups...
November 18, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/29150711/epidemiology-of-peritonitis-following-maintenance-peritoneal-dialysis-catheter-placement-during-infancy-a-report-of-the-scope-collaborative
#10
Joshua Jacob Zaritsky, Coral Hanevold, Raymond Quigley, Troy Richardson, Cynthia Wong, Jennifer Ehrlich, John Lawlor, Jonathan Rodean, Alicia Neu, Bradley A Warady
BACKGROUND: Maintenance peritoneal dialysis (PD) is the dialysis modality of choice for infants and young children. However, there are limited outcome data for those who undergo PD catheter insertion and initiate maintenance PD within the first year of life. METHODS: Using data from the Children's Hospital Association's Standardizing Care to Improve Outcomes in Pediatric End Stage Renal Disease (ESRD) Collaborative (SCOPE), we examined peritonitis rates and patient survival in 156 infants from 29 North American pediatric dialysis centers who had a chronic PD catheter placed prior to their first birthday...
November 17, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/29150405/cirrhosis-with-ascites-in-the-last-year-of-life-a-nationwide-analysis-of-factors-shaping-costs-health-care-use-and-place-of-death-in-england
#11
Benjamin Hudson, Jeff Round, Brendan Georgeson, Andrew Pring, Karen Forbes, Catherine Anne McCune, Julia Verne
BACKGROUND: Liver disease mortality increased by 400% in the UK between 1970 and 2010, resulting in rising pressures on acute hospital services, and an increasing need for end-of-life care. We aimed to assess the effect of demographic, clinical, and health-care factors on costs, patterns of health-care use, and place of death in a national cohort of patients with cirrhosis and ascites in their last year of life. METHODS: We did a retrospective, nationwide analysis of all patients who died from cirrhosis in England between 2013 and 2015, who required large-volume paracentesis in their last year of life...
November 14, 2017: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29150233/management-of-first-depression-or-generalized-anxiety-disorder-episode-in-adults-in-primary-care-a-systematic-metareview
#12
Damien Driot, Michel Bismuth, Adrien Maurel, Julie Soulie-Albouy, Jordan Birebent, Stéphane Oustric, Julie Dupouy
CONTEXT: General Practitioners (GPs) are the leading antidepressants prescribers in Europe and in France. Difficulties in implementing existing recommendations in daily practice have been described. OBJECTIVE: The objective of this study was to elaborate two algorithms to guide GPs in the patient management for a first major depressive disorder (MDD) or generalized anxiety disorder (GAD) episode in primary care. DATA SOURCES: PubMed, Cochrane, and ISI Web of Science were explored using mainly the following keywords: depressive disorder, anxiety disorders, antidepressive agents or antidepressant...
November 14, 2017: La Presse Médicale
https://www.readbyqxmd.com/read/29149478/hospital-quality-patient-risk-and-medicare-expenditures-for-cancer-surgery
#13
Sarah P Shubeck, Jyothi R Thumma, Justin B Dimick, Hari Nathan
BACKGROUND: Surgical resection is a cornerstone of curative-intent therapy for patients with solid organ malignancies. With increasing attention paid to the costs of surgical care, there is a new focus on variations in the costs of cancer surgery. This study evaluated the potential interactive effect of hospital quality and patient risk on expenditures for cancer resections. METHODS: With 100% Medicare claim data for 2010-2013, patients aged 65 to 99 years who had undergone cancer resection were identified...
November 17, 2017: Cancer
https://www.readbyqxmd.com/read/29148179/clinical-implications-of-de-barsy-syndrome
#14
Lindsay L Warner, David A Olsen, Hugh M Smith
BACKGROUND: De Barsy syndrome is a rare, autosomal recessive syndrome characterized by cutis laxa, progeroid appearance, ophthalmic opacification, skeletal malformations, growth delays, and intellectual disability. AIMS: The aim of this case series is to identify the anesthetic considerations in the clinical management of patients with de Barsy syndrome. METHODS: A retrospective case review from 1968 to 2016 was performed at a single tertiary medical center to identify patients with de Barsy syndrome who underwent anesthesia for diagnostic and surgical procedures...
November 17, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29146635/antibiotic-use-and-bacterial-complications-following-upper-respiratory-tract-infections-a-population-based-study
#15
Thomas Cars, Irene Eriksson, Anna Granath, Björn Wettermark, Jenny Hellman, Christer Norman, Anders Ternhag
OBJECTIVES: To investigate if use of antibiotics was associated with bacterial complications following upper respiratory tract infections (URTIs). DESIGN: Ecological time-trend analysis and a prospective cohort study. SETTING: Primary, outpatient specialist and inpatient care in Stockholm County, Sweden. All analyses were based on administrative healthcare data on consultations, diagnoses and dispensed antibiotics from January 2006 to January 2016...
November 15, 2017: BMJ Open
https://www.readbyqxmd.com/read/29146633/comparison-of-outcomes-of-antibiotic-drugs-and-appendectomy-coda-trial-a-protocol-for-the-pragmatic-randomised-study-of-appendicitis-treatment
#16
Giana H Davidson, David R Flum, David A Talan, Larry G Kessler, Danielle C Lavallee, Bonnie J Bizzell, Farhood Farjah, Skye D Stewart, Anusha Krishnadasan, Erin E Carney, Erika M Wolff, Bryan A Comstock, Sarah E Monsell, Patrick J Heagerty, Annie P Ehlers, Daniel A DeUgarte, Amy H Kaji, Heather L Evans, Julianna T Yu, Katherine A Mandell, Ian C Doten, Kevin S Clive, Karen M McGrane, Brandon C Tudor, Careen S Foster, Darin J Saltzman, Richard C Thirlby, Erin O Lange, Amber K Sabbatini, Gregory J Moran
INTRODUCTION: Several European studies suggest that some patients with appendicitis can be treated safely with antibiotics. A portion of patients eventually undergo appendectomy within a year, with 10%-15% failing to respond in the initial period and a similar additional proportion with suspected recurrent episodes requiring appendectomy. Nearly all patients with appendicitis in the USA are still treated with surgery. A rigorous comparative effectiveness trial in the USA that is sufficiently large and pragmatic to incorporate usual variations in care and measures the patient experience is needed to determine whether antibiotics are as good as appendectomy...
November 15, 2017: BMJ Open
https://www.readbyqxmd.com/read/29145819/recurrent-tuberculosis-in-finland-1995-2013-a-clinical-and-epidemiological-cohort-study
#17
Virve Korhonen, Hanna Soini, Tuula Vasankari, Jukka Ollgren, Pieter W Smit, Petri Ruutu
BACKGROUND: We investigated the epidemiology and prevalence of potential risk factors of tuberculosis (TB) recurrence in a population-based registry cohort of 8084 TB cases between 1995 and 2013. METHODS: An episode of recurrent TB was defined as a case re-registered in the National Infectious Disease Register at least 360 days from the date of the initial registration. A regression model was used to estimate risk factors for recurrence in the national cohort...
November 16, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/29145584/critical-lessons-from-high-value-oncology-practices
#18
Douglas W Blayney, Melora K Simon, Beatrice Podtschaske, Scott Ramsey, Margaret Shyu, Craig Lindquist, Arnold Milstein
Importance: Cancer care is expensive. Cancer care provided by practice organizations varies in total spending incurred by patients and payers during treatment episodes and in quality of care, and this unnecessary variation contributes to the high cost. Objective: To use the variation in total spending and quality of care to assess oncology practice attributes distinguishing "high value" that may be tested and adopted by others to produce similar results. Design, Setting, and Participants: "Positive deviance" was used in this exploratory mixed-methods (quantitative and qualitative) analysis of interview results...
November 16, 2017: JAMA Oncology
https://www.readbyqxmd.com/read/29145465/hospital-associated-methicillin-resistant-staphylococcus-aureus-a-cross-sectional-analysis-of-risk-factors-in-south-african-tertiary-public-hospitals
#19
Liliwe L Shuping, Lazarus Kuonza, Alfred Musekiwa, Samantha Iyaloo, Olga Perovic
INTRODUCTION: Hospital-associated methicillin-resistant S. aureus (HA-MRSA) remains a significant cause of morbidity and mortality worldwide. We conducted a study to determine risk factors for HA-MRSA in order to inform control strategies in South Africa. METHODS: We used surveillance data collected from five tertiary hospitals in Gauteng and Western Cape provinces during 2014 for analysis. A case of HA-MRSA was defined as isolation of MRSA from a blood culture 48 hours after admission and/or if the patient was hospitalised in the six months prior to the current culture...
2017: PloS One
https://www.readbyqxmd.com/read/29144720/cost-effectiveness-of-gammacore-non-invasive-vagus-nerve-stimulation-for-acute-treatment-of-episodic-cluster-headache
#20
Mkaya Mwamburi, Eric J Liebler, Andrew T Tenaglia
Cluster headache is a debilitating disease characterized by excruciatingly painful attacks that affects 0.15% to 0.4% of the US population. Episodic cluster headache manifests as circadian and circannual seasonal bouts of attacks, each lasting 15 to 180 minutes, with periods of remission. In chronic cluster headache, the attacks occur throughout the year with no periods of remission. While existing treatments are effective for some patients, many patients continue to suffer. There are only 2 FDA-approved medications for episodic cluster headache in the United States, while others, such as high-flow oxygen, are used off-label...
November 2017: American Journal of Managed Care
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