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Gregory P Beehler, Paul R King, Christina L Vair, Julie Gass, Jennifer S Funderburk
The VA has integrated psychologists and other licensed mental health providers, known collectively as co-located collaborative care (CCC) providers, into patients' primary care medical homes to improve mental health services for veterans. However, it is unclear if CCC providers are routinely using mental health measures as part of evidence-based, coordinated care. This study aimed to determine the prevalence and predictors of CCC provider utilization of brief, validated measures. A retrospective review of VA electronic medical records from 8403 veterans diagnosed with depression, posttraumatic stress disorder, or anxiety disorder was conducted...
October 21, 2016: Journal of Clinical Psychology in Medical Settings
Magaly Rodriguez de Bittner, Viktor V Chirikov, Ian M Breunig, Roxanne W Zaghab, Fadia Tohme Shaya
OBJECTIVE: To determine the effectiveness and cost savings of a real-world, continuous, pharmacist-delivered service with an employed patient population with diabetes over a 5-year period. SETTING: The Patients, Pharmacists Partnerships (P(3) Program) was offered as an "opt-in" benefit to employees of 6 public and private self-insured employers in Maryland and Virginia. Care was provided in ZIP code-matched locations and at 2 employers' worksites. PRACTICE DESCRIPTION: Six hundred two enrolled patients with type 1 and 2 diabetes were studied between July 2006 and May 2012 with an average follow-up of 2...
October 18, 2016: Journal of the American Pharmacists Association: JAPhA
Lars Bjørndal, Catharina Amaloo, Merete Markvart, Vibe Rud, Klaus Qvortrup, Camilla Stavnsbjerg, Thomas Bjarnsholt
INTRODUCTION: The aim was to present a case report of a full-length extrusion of an obturator's core carrier into the maxillary sinus, causing clinical symptoms from the nose region with differential diagnostics aspects, which, in turn, led to several surgical treatments of the nostrils before diagnosis and correct endodontic retreatment of a maxillary right first molar. A 36-year-old man presented in 2012 with complaints from the right nostril region. Medical treatment with antibiotics and surgical procedures because of nasal stenosis resulted only in partial improvement...
October 18, 2016: Journal of Endodontics
Jane Bleasel, Annette Burgess, Ruth Weeks, Inam Haq
BACKGROUND: The evidence for the positive impact of an electronic Portfolio (ePortfolio) on feedback in medicine is mixed. An ePortfolio for medical long cases in a Graduate Medical Program was developed. The purpose of this study was to explore the perceptions of medical students and faculty of the impact of the ePortfolio on the feedback process. METHODS: In total, 130 Year 3 medical students, and six faculty participated in the study. This is a mixed methods study, using a combination of both quantitative and qualitative approaches...
October 21, 2016: BMC Medical Education
Michèle M Kislan, Adam T Bernstein, Loretta R Fearrington, Timothy J Ives
BACKGROUND: Clinical Pharmacist Practitioners are advanced practicing pharmacists in North Carolina that provide disease-specific management. The purpose of this retrospective cohort study was to compare the efficacy and charges from referrals to a Clinical Pharmacist Practitioner by the primary care provider, to those managed by a primary care provider alone. METHODS: Patients were separated into cohorts depending if they had at least two appointments with a Clinical Pharmacist Practitioner from November 2008 to November 2011...
October 21, 2016: BMC Health Services Research
David C Classen, William Munier, Nancy Verzier, Noel Eldridge, David Hunt, Mark Metersky, Chesley Richards, Yun Wang, P Jeffrey Brady, Amy Helwig, James Battles
The explicit declaration in the landmark 1999 Institute of Medicine report "To Err Is Human" that, in the United States, 44,000 to 98,000 patients die each year as a consequence of "medical errors" gave widespread validation to the magnitude of the patient safety problem and catalyzed a number of U.S. federal government programs to measure and improve the safety of the national healthcare system. After more than 10 years, one of those federal programs, the Medicare Patient Safety Monitoring System (MPSMS), has reached a level of maturity and stability that has made it useful for the consistent measurement of the safety of inpatient care...
October 20, 2016: Journal of Patient Safety
Brent M Egan, Bo Kai, C Shaun Wagner, Douglas O Fleming, Joseph H Henderson, Archie H Chandler, Angelo Sinopoli
Apparent treatment-resistant hypertension (aTRH) may confound the reported relationship between low blood pressure (BP) and increased cardiovascular disease (CVD) in treated hypertensive patients. Incident CVD was assessed in treated hypertensive patients with and without aTRH (BP ≥140 and/or ≥90 mm Hg on ≥3 medications or <140/<90 mm Hg on ≥4 BP medications) at three BP levels: 1: <120 and/or <70 mm Hg and <140/<90 mm Hg; 2: 120-139/70-89 mm Hg; and 3: ≥140 and/or ≥90 mm Hg. Electronic health data were matched to emergency and hospital claims for incident CVD in 118 356 treated hypertensive patients...
October 21, 2016: Journal of Clinical Hypertension
Ahmed Al-Imam, Rita Santacroce, Andres Roman-Urrestarazu, Robert Chilcott, Giuseppe Bersani, Giovanni Martinotti, Ornella Corazza
BACKGROUND: Fenetheylline, a psychostimulant drug, often branded as Captagon, is a combination of amphetamine and theophylline. Since the cessation of its legal production in 1986, counterfeited products have been produced illicitly in south-east Europe and far-east Asia. Its profitable trade has been linked to terrorist organizations, including Islamic State of Iraq and the Levant. This study aims to reach up-to-date data, concerning the Captagon e-commerce and use in the Middle East...
October 21, 2016: Human Psychopharmacology
T Apaydin, H M Ozkaya, F E Keskin, O A Haliloglu, K Karababa, S Erdem, P Kadioglu
PURPOSE: To determine the differences in acromegaly diagnosis, treatment, and follow-up among Turkish endocrinologists, and to investigate how the published guidelines are applied in clinical practice. METHODS: The questionnaire was formatted as an electronic survey, conducted between November and December 2015, and sent weekly for 6 weeks via e-mail to 528 endocrinologists in Turkey. RESULTS: The questionnaire was answered by 37.4 % of endocrinologists...
October 20, 2016: Journal of Endocrinological Investigation
Nathalie L Maitre, Olena Chorna, Domenico M Romeo, Andrea Guzzetta
BACKGROUND: High-risk infant follow-up programs provide early identification and referral for treatment of neurodevelopmental delays and impairments. In these programs, a standardized neurological examination is a critical component of evaluation for clinical and research purposes. METHODS: To address primary challenges of provider educational diversity and standardized documentation, we designed an approach to training and implementation of the Hammersmith Infant Neurological Examination with precourse materials, a workshop model, and adaptation of the electronic medical record...
September 21, 2016: Pediatric Neurology
Kenneth F Baker, Sharmila Jandial, Ben Thompson, David Walker, Ken Taylor, Helen E Foster
BACKGROUND: Structured examination routines have been developed as educational resources for musculoskeletal clinical skills teaching, including Gait-Arms-Legs-Spine (GALS), Regional Examination of the Musculoskeletal System (REMS) and paediatric GALS (pGALS). In this study, we aimed to assess the awareness and use of these examination routines in undergraduate medical teaching in UK medical schools and UK postgraduate clinical practice. METHODS: Electronic questionnaires were distributed to adult and paediatric musculoskeletal teaching leads at UK medical schools and current UK doctors in training...
October 21, 2016: BMC Medical Education
C L Barron, Jessica L Moore, Grayson Baird, Amy P Goldberg
BACKGROUND: Domestic minor sex trafficking (DMST) victims have unique medical and mental health needs and present frequently for medical attention. Little is known about the reported training, screening, comfort and knowledge of DMST among pediatricians in Rhode Island who likely encounter these patient victims without knowing. METHODS: An anonymous electronic survey sent to Rhode Island Hospital staff physicians from November 2014 through January 2015. RESULTS: Of the 109 participants, the majority reported no training, screened no patients for DMST in the past year, did not know any resources available and had limited knowledge and comfort with this pediatric patient population...
October 4, 2016: Rhode Island Medical Journal
Ronald E Domen, Kristen Johnson, Richard Michael Conran, Robert D Hoffman, Miriam D Post, Jacob J Steinberg, Mark D Brissette, Dita A Gratzinger, Cindy B McCloskey, Patricia M Raciti, Cory Anthony Roberts, Amyn M Rojiani, Suzanne Zein-Eldin Powell
CONTEXT: -Professionalism issues in residency training can be difficult to assess and manage. Generational or role-based differences may also exist between faculty and residents as to what constitutes unprofessional behavior and how to manage it. OBJECTIVE: -To examine and compare how faculty and residents would approach the same 5 case scenarios detailing various aspects of unprofessional behavior. DESIGN: -Five case scenarios highlighting various unprofessional behaviors were presented in a workshop at an annual meeting of pathology department chairs, residency program directors, and undergraduate pathology medical educators (ie, pathologists involved in medical student pathology education)...
October 20, 2016: Archives of Pathology & Laboratory Medicine
Christopher Rowe, Eric Vittinghoff, Glenn-Milo Santos, Emily Behar, Caitlin Turner, Phillip Coffin
OBJECTIVES: Opioid overdose mortality has tripled in the USA since 2000 and opioids are responsible for more than half of all drug overdose deaths, which reached an all-time high in 2014. Opioid overdoses resulting in death, however, represent only a small fraction of all opioid overdose events and efforts to improve surveillance of this public health problem should include tracking nonfatal overdose events. International Classification of Disease (ICD) diagnosis codes, increasingly used for the surveillance of nonfatal drug overdose events, have not been rigorously assessed for validity in capturing overdose events...
October 20, 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Frank A Scannapieco, Summar Amin, Marc Salme, Mine Tezal
PURPOSE: To describe factors associated with the utilization of dental services in a long-term care facility (LTCF) in Western New York. METHODS AND MATERIALS: A descriptive cross-sectional study reviewed the dental and medical records of residents of an LTCF discharged between January 1, 2008 and December 30, 2012. Information on demographic and health variables at admission was extracted from electronic health records. Information on oral health variables was extracted from patient charts...
October 20, 2016: Special Care in Dentistry
A E Cullen, L Bowers, M Khondoker, S Pettit, E Achilla, L Koeser, L Moylan, J Baker, A Quirk, F Sethi, D Stewart, P McCrone, A D Tulloch
AIMS: Within acute psychiatric inpatient services, patients exhibiting severely disturbed behaviour can be transferred to a psychiatric intensive care unit (PICU) and/or secluded in order to manage the risks posed to the patient and others. However, whether specific patient groups are more likely to be subjected to these coercive measures is unclear. Using robust methodological and statistical techniques, we aimed to determine the demographic, clinical and behavioural predictors of both PICU and seclusion...
October 20, 2016: Epidemiology and Psychiatric Sciences
Ailbhe C O'Neill, Sree Harsha Tirumani, Woo S Do, Abhishek R Keraliya, Jason L Hornick, Atul B Shinagare, Nikhil H Ramaiya
OBJECTIVE: The objective of our study was to evaluate the metastatic patterns and imaging features of solitary fibrous tumors (SFTs). MATERIALS AND METHODS: This retrospective study included 139 patients with pathologically proven SFT, 49 of whom developed metastases. Electronic medical records and all available images were reviewed to record the pattern and imaging appearances of metastatic disease, and comparisons of thoracic SFTs and extrathoracic SFTs were also performed...
October 20, 2016: AJR. American Journal of Roentgenology
Theodore Pincus
RAPID3 (routine assessment of patient index data) is an index found within a multi-dimensional health assessment questionnaire (MDHAQ) for routine clinical care, composed only of 3 self-report scores for physical function, pain, and patient global estimate, each scored 0-10, for a total of 0-30. RAPID3 is correlated significantly with DAS28 (Disease Activity Score) and CDAI (Clinical Disease Activity Index), and distinguishes active from control treatments as efficiently as these indices in clinical trials involving adalimumab, abatacept, certolizumab, infliximab, and rituximab...
September 2016: Clinical and Experimental Rheumatology
Melissa Francisco, Tracy Johansson, Salahuddin Kazi
The Rheumatology Informatics System for Effectiveness (RISE) Registry was developed by the American College of Rheumatology (ACR) to serve US rheumatologists for the significant challenges of a rapidly changing healthcare environment. More than 400 rheumatologists have sent data from more than 3 million encounters of more than 650,000 patients as of August 11, 2016, through their electronic medical records (EMRs), with no additional work or interference with workflow on the part of the rheumatologists. RISE includes patients with all diagnoses seen by participating rheumatologists, at no cost to the rheumatologist...
September 2016: Clinical and Experimental Rheumatology
Theodore Pincus
An MDHAQ/RAPID3 (multidimensional health assessment questionnaire/routine assessment of patient index data) was developed from the HAQ over 25 years, based on observations made from completion by every patient (with all diagnoses) at every routine rheumatology visit since 1980. Modification of the HAQ was viewed as similar to improving a laboratory test, with a primary focus on clinical value for diagnosis, prognosis, and/or management, as well as feasibility for minimal effect on clinical workflow. Rigorous attention, was also directed to validity, reliability, other methodologic and technological considerations, but after clinical value and feasibility were established...
September 2016: Clinical and Experimental Rheumatology
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