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General internal medicine

Ashley Jaggi, Marcus Drake, Emad Siddiqui, Francis Fatoye
AIMS: Healthcare guidelines are an important vehicle in establishing up-to-date evidence based medicine (EBM) in clinical practice. Due to varying development processes, clinical guidelines created by different institutions can often contain contrasting recommendations. This can have implications for optimal and standardized patient care across management settings. METHODS: The similarities and differences of treatment recommendations made in the National Institute for Health and Care Excellence (NICE), The European Association of Urology (EAU), and the International Consultation on Continence (ICI) guidelines for neurogenic lower urinary tract dysfunction (NLUTD) were assessed...
April 17, 2018: Neurourology and Urodynamics
Henrik Malchau, Göran Garellick, Daniel Berry, William H Harris, Otto Robertson, Johan Kärrlholm, David Lewallen, Charles R Bragdon, Lars Lidgren, Peter Herberts
Local, regional and national registries have played an important role the development of hip and knee arthroplasty and the treatment of patients with various maladies of these joints. Four arthroplasty registries stand out as leading forces behind the drive to popularize the use of registries and pursue the concept of evidence based medicine. The Mayo registry, started by Mark Coventry, is recognized as the oldest continuing registry for arthroplasty. The Harris Registry at Massachusetts General Hospital, along with the Mayo Registry, has greatly contributed to the advancement of arthroplasty surgery and have served an important role of identifying poorly performing implants and techniques in the United States...
April 16, 2018: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
Adriana Zarovska, Andrea Evangelista, Tiziana Boccia, Giovannino Ciccone, Daniela Coggiola, Antonio Scarmozzino, Daniela Corsi
BACKGROUND: Discharge planning is an important component of hospital care. The Blaylock Risk Assessment Screening Score (BRASS) index is an instrument used to identify patients requiring complex discharge planning. OBJECTIVES: (1) Evaluate the ability of the original BRASS index to predict the risk of complex discharge and hospital mortality. (2) Develop and validate a simplified BRASS index by eliminating redundant variables and re-estimating the predictor weights...
April 16, 2018: Journal of General Internal Medicine
Kyle Morawski, Craig Monsen, Sukhjit Takhar, Adam Landman
BACKGROUND: Hospital communication among members of a patient's care team is a central part of clinical workflow and consumes a large amount of a health care provider's time. Oftentimes the complexity of hospital care leads to difficulty in finding the appropriate contact, which can lead to inefficiencies and frustration. Squire is a Web-based information retrieval app created to improve the speed and efficiency in reaching the appropriate team member during the care of a hospitalized patient...
April 16, 2018: JMIR Human Factors
Jiancong Wang, Fangfei Liu, Ermira Tartari, Jianan Huang, Stephan Harbarth, Didier Pittet, Walter Zingg
OBJECTIVETo assess the prevalence of healthcare-associated infections (HAIs) in mainland China.DESIGNSystematic review and meta-analysis.SETTINGAdults and children from secondary and tertiary acute-care hospitals in mainland China.METHODSWe searched PubMed, the China National Knowledge Infrastructure, and Wan Fang for multicenter point-prevalence surveys of acute-care hospitals in mainland China from January 2006 to August 2016. All reports related to HAI, using a point-prevalence methodology and published either in English or Chinese were eligible...
April 15, 2018: Infection Control and Hospital Epidemiology
Mahboob Ali, Sameh Girgis, Atif Hassan, Steven Rudick, Richard C Becker
The worldwide prevalence of cardiovascular disease in general and atherosclerotic coronary artery disease in particular is a health and economic concern of unparalleled proportion. Despite a long history of astute observations beginning in 1575 made by Fallopius, followed by those of von Rokatansky, Virchow, Osler, and Ross, and incremental knowledge of the pathobiology of atherosclerosis to include varying stages of inflammation, response to internally and externally mediated vascular injury, and impaired homeostasis, gaps in the field's understanding persist...
April 12, 2018: Coronary Artery Disease
Jolanda Turley, Jaclyn Vanek, Sharon Johnston, Doug Archibald
OBJECTIVE: To describe and compare well-child care (WCC) in Australia, the Netherlands, and the United Kingdom (UK), focusing on the role of nurses and their interactions with other primary care providers in order to derive relevant lessons for Canada's interprofessional primary care teams. DATA SOURCES: Ovid MEDLINE, EMBASE, and CINAHL were searched broadly using the search terms well child care, nursing role, and delivery of care and other synonymous terms. In addition, Google Scholar was used to search for gray literature, and reference mining revealed a few other relevant articles...
April 2018: Canadian Family Physician Médecin de Famille Canadien
Anupam B Jena, Andrew R Olenski, Dhruv Khullar, Adam Bonica, Howard Rosenthal
OBJECTIVES: To compare the delivery of end of life care given to US Medicare beneficiaries in hospital by internal medicine physicians with Republican versus Democrat political affiliations. DESIGN: Retrospective observational study. SETTING: US Medicare. PARTICIPANTS: Random sample of Medicare beneficiaries, who were admitted to hospital in 2008-12 with a general medical condition, and died in hospital or shortly thereafter...
April 11, 2018: BMJ: British Medical Journal
A Daumas, E Garros, H Mendizabal, S Gayet, F Bernard, D Bagnères, A-L Demoux, P Rossi, P Villani, B Granel
INTRODUCTION: Proton pump inhibitors (PPI) are widely prescribed for unrecognized indications, at high a dose and for a long duration, in spite of side effects and numerous drug interactions. In 2009, the HAS (French Health Authority) published recommendations of good prescription but the latter are poorly respected. In this context of over prescription and additional cost for the society, we performed a professional practice evaluation of on the model of the Deming wheel. The objective of this work was to optimize the relevance of the prescriptions of the IPP in two services of internal medicine and geriatrics through an evaluation of the professional practices...
April 5, 2018: La Revue de Médecine Interne
Maurizio Dondi, Diana Paez, Leonel Torres, Mario Marengo, Angelika Bischof Delaloye, Kishor Solanki, Annare Van Zyl Ellmann, Enrique Estrada Lobato, Rodolfo Nunez Miller, Francesco Giammarile, Thomas Pascual
The International Atomic Energy Agency (IAEA) developed a comprehensive program-Quality Management Audits in Nuclear Medicine (QUANUM). This program covers all aspects of nuclear medicine practices including, but not limited to, clinical practice, management, operations, and services. The QUANUM program, which includes quality standards detailed in relevant checklists, aims at introducing a culture of comprehensive quality audit processes that are patient oriented, systematic, and outcome based. This paper will focus on the impact of the implementation of QUANUM on daily routine practices in audited centers...
May 2018: Seminars in Nuclear Medicine
Qi Chen, Xueyan Lu, Xiaorui Guo, Yajie Pan, Bofan Yu, Zhonghua Tang, Qingxi Guo
Cd(II) is one of the most widespread and toxic heavy metals and seriously threatens plant growth, furthermore negatively affecting human health. For survival from this metal stress, plants always fight with Cd(II) toxicity by themselves or using other external factors. The effects of second metals copper (Cu(II)), zinc (Zn(II)) and calcium (Ca(II)) on the Cd(II)-affected root morphology, Cd(II) translocation and metabolic responses in Catharanthus roseus were investigated under hydroponic conditions. We found that the Cd-stressed plants displayed the browning and rot root symptom, excess H2 O2 content, lipid peroxidation and Cd(II) accumulation in plants...
April 4, 2018: Ecotoxicology and Environmental Safety
Huai-Hsuan Chiu, Hsiao-Wei Liao, Yu-Yun Shao, Yen-Shen Lu, Ching-Hung Lin, I-Lin Tsai, Ching-Hua Kuo
Monoclonal antibody (mAb) drugs have generated much interest in recent years for treating various diseases. Immunoglobulin G (IgG) represents a high percentage of mAb drugs that have been approved by the Food and Drug Administration (FDA). To facilitate therapeutic drug monitoring and pharmacokinetic/pharmacodynamic studies, we developed a general liquid chromatography-tandem mass spectrometry (LC-MS/MS) method to quantify the concentration of IgG-based mAbs in human plasma. Three IgG-based drugs (bevacizumab, nivolumab and pembrolizumab) were selected to demonstrate our method...
August 17, 2018: Analytica Chimica Acta
Kurt Kroenke, Tasneem L Talib, Timothy E Stump, Jacob Kean, David A Haggstrom, Paige DeChant, Kittie R Lake, Madison Stout, Patrick O Monahan
BACKGROUND: Symptoms account for more than 400 million clinic visits annually in the USA. The SPADE symptoms (sleep, pain, anxiety, depression, and low energy/fatigue) are particularly prevalent and undertreated. OBJECTIVE: To assess the effectiveness of providing PROMIS (Patient-Reported Outcome Measure Information System) symptom scores to clinicians on symptom outcomes. DESIGN: Randomized clinical trial conducted from March 2015 through May 2016 in general internal medicine and family practice clinics in an academic healthcare system...
April 5, 2018: Journal of General Internal Medicine
Alastair Miller, Zoë Fleet
A new 3-year curriculum for training in internal medicine was approved by the General Medical Council in December 2017. This will replace core medical training in August 2019. It mandates specific experiences and introduces a novel assessment strategy that hopefully will lessen the perceived 'burden of assessment' on trainees (and trainers). It is hoped that it will improve the experience of and enthusiasm for training in internal medicine.
April 2, 2018: British Journal of Hospital Medicine
Godpower C Michael, Bukar A Grema, Ibrahim Aliyu, Mohammed A Alhaji, Teslim O Lawal, Haliru Ibrahim, Aminu G Fikin, Fatima S Gyaran, Kennedy N Kane, Thomas D Thacher, Abba K Badamasi, Emmanuel Ogwuche
Background: Snakebite envenoming causes considerable morbidity and mortality in northern Nigeria. The clinician's knowledge of snakebite impacts outcome. We assessed clinicians' knowledge of snakebite envenoming to highlight knowledge and practice gaps for possible intervention to improve snakebite outcomes. Methods: This was a cross-sectional multicentre study of 374 doctors selected from the accident and emergency, internal medicine, family medicine/general outpatient, paediatrics and surgery departments of nine tertiary hospitals in northern Nigeria using a multistage sampling technique...
March 29, 2018: Transactions of the Royal Society of Tropical Medicine and Hygiene
A Gnassingbe, A Flahault, A Geissbuhler, D Sprumont, A Awesso
The extent of medicines sales and consumption in the informal market in Togo raises many ethical and public health issues. In order to report on the situation of public action in the fight against this practice, we conducted a qualitative survey from 15 to 25 February 2016 in the commune of Lomé and in the Maritime Region among the actors of control system and resource people in the general population. This was supplemented by an analysis of Togo's pharmaceutical and health policy documents and a literature review on the illicit drug market issues relating to public health, political science, the social sciences applied to health...
February 1, 2018: Médecine et Santé Tropicales
Ralf Forsbach, Hans-Georg Hofer
At the end of the 1960 s, the German Society for Internal Medicine faced a period of intensifying factional struggles. Traditional conservative views increasingly met with critics demanding reform efforts. These debates covered, among other things, the self-definition of the society, doctor-patient relationship, medical studies, hospital regulations, and the relationship between doctors and nursing staff. In 1972/73, these opposing opinions within the society became particularly obvious, when the former NS-Gaustudentenführer Gotthard Schettler, who felt strong resentments towards the members of the 1968 movement, was followed by the reform willing, politically left wing Herbert Begemann in the DGIM presidency...
April 2018: Deutsche Medizinische Wochenschrift
Cynthia M Boyd, Bruce Leff, Julia Bellantoni, Navpreet Rana, Jennifer L Wolff, David L Roth, Kim Carl, Orla C Sheehan
Background: Physicians are required to certify a plan of care for patients who receive Medicare skilled home health care (SHHC) services. The Centers for Medicare & Medicaid Services form 485 (CMS-485) is typically used for certification of SHHC plans of care and for interactions between SHHC agencies and physicians. Little is known about how physicians use the CMS-485 or their perceptions of its usefulness with respect to coordinating care with SHHC agencies. Objective: To determine how physicians interact with SHHC agencies and use the CMS-485 in care coordination for patients receiving SHHC services...
April 3, 2018: Annals of Internal Medicine
Faye Ioannou, Cindy Burnsteel, David K J Mackay, Cyril G Gay
Effective alternatives to antibiotics (ATA) such as vaccines, antibodies, phage therapies, prebiotics, probiotics and herbal medicines can be used in place of traditional antibiotics in a way that does not compromise animal health as means of tackling the growing threat to both animal and human health from antimicrobial resistance (AMR). This paper reflects the key points on the approaches that were discussed during the 2nd International Symposium on ATA between regulatory agencies, veterinary product companies representing largely the pharmaceutical and feed-additive sectors, academia and other stakeholders on regulatory pathways to enable the licensing of alternatives to antibiotics for food producing animals...
March 30, 2018: Biologicals: Journal of the International Association of Biological Standardization
Joanne Goldman, Kathleen MacMillan, Simon Kitto, Robert Wu, Ivan Silver, Scott Reeves
Collaboration among nurses and other healthcare professionals is needed for effective hospital discharge planning. However, interprofessional interactions and practices related to discharge vary within and across hospitals. These interactions are influenced by the ways in which healthcare professionals' roles are being shaped by hospital discharge priorities. This study explored the experience of bedside nurses' interprofessional collaboration in relation to discharge in a general medicine unit. An ethnographic approach was employed to obtain an in-depth insight into the perceptions and practices of nurses and other healthcare professionals regarding collaborative practices around discharge...
April 1, 2018: Nursing Inquiry
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