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Comanagement

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https://www.readbyqxmd.com/read/29332302/preoperative-cognitive-impairment-as-a-predictor-of-postoperative-outcomes-in-a-collaborative-care-model
#1
Kahli Zietlow, Shelley R McDonald, Richard Sloane, Jeffrey Browndyke, Sandhya Lagoo-Deenadayalan, Mitchell T Heflin
OBJECTIVES: To compare postoperative outcomes of individuals with and without cognitive impairment enrolled in the Perioperative Optimization of Senior Health (POSH) program at Duke University, a comanagement model involving surgery, anesthesia, and geriatrics. DESIGN: Retrospective analysis of individuals enrolled in a quality improvement program. SETTING: Tertiary academic center. PARTICIPANTS: Older adults undergoing surgery and referred to POSH (N = 157)...
January 13, 2018: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29319389/top-10-tips-palliative-care-clinicians-should-know-when-caring-for-patients-with-ovarian-cancer
#2
Brittany A Davidson, Haley A Moss, Arif H Kamal
The vast majority of women diagnosed with ovarian cancer present with advanced-stage disease with a five-year survival rate less than 50%. Studies have shown that in the past, gynecologic oncologists were not routinely collaborating with palliative care physicians resulting in goals of care planning often not occurring until the last 30 days before death. In recent years, professional societies have been increasingly more vocal about the importance of incorporating palliative care early in a patient's disease course...
January 10, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29280174/scientific-evidence-on-the-links-between-periodontal-diseases-and-diabetes-consensus-report-and-guidelines-of-the-joint-workshop-on-periodontal-diseases-and-diabetes-by-the-international-diabetes-federation-and-the-european-federation-of-periodontology
#3
Mariano Sanz, Antonio Ceriello, Martin Buysschaert, Iain Chapple, Ryan T Demmer, Filippo Graziani, David Herrera, Søren Jepsen, Luca Lione, Phoebus Madianos, Manu Mathur, Eduard Montanya, Lior Shapira, Maurizio Tonetti, Daniel Vegh
BACKGROUND: Diabetes and periodontitis are chronic non-communicable diseases independently associated with mortality and have a bidirectional relationship. AIMS: To update the evidence for their epidemiological and mechanistic associations and re-examine the impact of effective periodontal therapy upon metabolic control (glycated haemoglobin, HbA1C). EPIDEMIOLOGY: There is strong evidence that people with periodontitis have elevated risk for dysglycaemia and insulin resistance...
August 24, 2017: Journal of Clinical Periodontology
https://www.readbyqxmd.com/read/29189528/incidence-and-diagnostic-evaluation-of-postoperative-fever-in-pediatric-patients-with-neuromuscular-disorders
#4
Mohamed A A Yousef, Darius Dranginis, Scott Rosenfeld
BACKGROUND: Children with neuromuscular disorders have a significant chance of developing scoliosis and/or hip dislocation during childhood and adolescence and often undergo surgical reconstruction. Because of their high rate of medical comorbidities, these patients are at higher risk of postoperative complications and are therefore often comanaged, along with orthopaedics, by pediatric medicine and critical care teams. Fever during the postoperative stay is a frequent occurrence and often prompts extensive diagnostic workup which increases the cost and burden on the health system but have unclear effects on the care of the patient...
November 16, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/29181874/using-a-statewide-survey-methodology-to-prioritize-pediatric-cardiology-core-content
#5
Ashley E Neal, Elizabeth Lehto, Karen Hughes Miller, Craig Ziegler, Erin Davis
OBJECTIVE: Although pediatrician-reported relevance of Canadian cardiology-specific objectives has been studied, similar data are not available for the 2016 American Board of Pediatrics (ABP) cardiology-specific objectives. This study asked Kentucky trainees, pediatricians, and pediatric cardiologists to identify "most important" content within these objectives. DESIGN, METHODS, OUTCOME MEASURES: This cross-sectional study used an original, online survey instrument based on the 2016 ABP cardiology-specific objectives...
November 27, 2017: Congenital Heart Disease
https://www.readbyqxmd.com/read/29167886/payment-reform-to-enhance-collaboration-of-primary-care-and-cardiology-a-review
#6
Steven A Farmer, Paul N Casale, Linda D Gillam, John S Rumsfeld, Shari Erickson, Neil M Kirschner, Kevin de Regnier, Bruce R Williams, R Shawn Martin, Mark B McClellan
Importance: The US health care system faces an unsustainable trajectory of high costs and inconsistent outcomes. The fee-for-service payment model has contributed to inefficiency, and new payment methods are a promising approach to improving value. Health reforms are needed to increase patient access, reduce costs, and improve health care quality, and the landmark Medicare Access and CHIP Reauthorization Act presents a roadmap for reform. The product of a collaboration between primary care and cardiology clinicians, this review describes a conceptual approach to delivery and payment reforms that aim to better support primary care-cardiology comanagement of chronic cardiovascular disease (CVD)...
November 22, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/29132667/complementary-and-alternative-medicine-for-treatment-of-food-allergy
#7
REVIEW
Xiu-Min Li
The prevalence of food allergy is increasing. Food allergy can be life threatening and there is no approved treatment available. Allergen avoidance and rescue medication remain the sole management tools. Complementary and alternative medicine (CAM) use is common in the United States. However, research into safety and efficacy for food allergy is limited. Continued scientific research into food allergy herbal formula 2 (FAHF-2), refined methods of formulation, purified compounds, and other modalities are needed...
February 2018: Immunology and Allergy Clinics of North America
https://www.readbyqxmd.com/read/29064837/comanagement-of-cataract-and-glaucoma-in-the-era-of-minimally-invasive-glaucoma-surgery
#8
Richard L Rabin, Arnold R Rabin, Amy D Zhang, Edward N Burney, Douglas J Rhee
PURPOSE OF REVIEW: This review discusses the options available to be used in conjunction with phacoemulsification cataract surgery to control intraocular pressure. We present a strategy for planning which surgery should be performed based on goals of care. RECENT FINDINGS: New clinical evidence for using the CyPass, Kahook and Xen45 devices has been published recently and is summarized. SUMMARY: Cataract and glaucoma frequently exist together...
October 23, 2017: Current Opinion in Ophthalmology
https://www.readbyqxmd.com/read/29049425/comparison-of-internal-medicine-and-general-surgery-residents-assessments-of-risk-of-postsurgical-complications-in-surgically-complex-patients
#9
James M Healy, Kimberly A Davis, Kevin Y Pei
Importance: Anticipating postsurgical complications is a vital physician skill, particularly when counseling surgically complex patients on their risks of intervention. Although internists and surgeons both counsel patients on surgical risks, it is uncertain who is better equipped to accurately anticipate surgical complications. Objective: To examine how internal medicine and general surgery trainees compare in their assessment of risk of surgically complex patients...
October 11, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28960161/geriatric-comanagement-reduces-perioperative-complications-and-shortens-duration-of-hospital-stay-after-lumbar-spine-surgery-a-prospective-single-institution-experience
#10
Owoicho Adogwa, Aladine A Elsamadicy, Victoria D Vuong, Jessica Moreno, Joseph Cheng, Isaac O Karikari, Carlos A Bagley
OBJECTIVE Geriatric patients undergoing lumbar spine surgery have unique needs due to the physiological changes of aging. They are at risk for adverse outcomes such as delirium, infection, and iatrogenic complications, and these complications, in turn, contribute to the risk of functional decline, nursing home admission, and death. Whether preoperative and perioperative comanagement by a geriatrician reduces the incidence of in-hospital complications and length of in-hospital stay after elective lumbar spine surgery remains unknown...
September 29, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28882849/pediatric-hospitalist-comanagement-survey-of-clinical-and-billing-practices
#11
Katherine M O'Connor, David G Zipes, Joshua K Schaffzin, Rebecca Rosenberg
Surgical comanagement is an increasingly common practice in pediatric hospital medicine. Information about the structure and financing of such care is limited. The aim of the researchers for this study was to investigate pediatric hospitalist surgical comanagement models and to assess pediatric hospitalist familiarity with and patterns of billing for surgical patients. We conducted a cross-sectional cohort web-based survey of pediatric hospitalists using the American Academy of Pediatrics' Section on Hospital Medicine listserv...
September 7, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28801975/trends-in-aging-related-services-during-nephrectomy-implications-for-surgery-in-an-aging-population
#12
Hung-Jui Tan, Mark S Litwin, Karim Chamie, Debra Saliba, Jim C Hu
OBJECTIVES: To characterize the extent to which geriatric and related healthcare services are provided to older adults undergoing surgery for kidney cancer, a potential growth area in geriatrics and oncology. DESIGN: Population-based observational study. SETTING: Surveillance, Epidemiology, and End Results cancer data linked with Medicare claims. PARTICIPANTS: Adults aged 65 and older with kidney cancer treated surgically from 2000 to 2009 (N = 19,129)...
October 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28800799/emergency-department-medical-clearance-of-patients-with-psychiatric-or-behavioral-emergencies-part-2-special-psychiatric-populations-and-considerations
#13
REVIEW
Al Alam, James Rachal, Veronica Theresa Tucci, Nidal Moukaddam
Patients who present to the emergency department (ED) with mental illness or behavioral complaints merit workup for underlying physical conditions that can trigger, mimic, or worsen psychiatric symptoms. However, there are wide variations in quality of care for these individuals. Psychiatry and emergency medicine specialty guidelines support a tailored, customized approach to patients. Our group has long advocated a dynamic comanagement approach for medical clearance in the ED, and this article summarizes best-practice approaches to the medical clearance of patients with psychiatric illness, tips on history taking, system reviews, clinical/physical examination, and common pitfalls in the medical clearance process...
September 2017: Psychiatric Clinics of North America
https://www.readbyqxmd.com/read/28682046/upper-gastrointestinal-conditions-nonmalignant-conditions-of-the-esophagus
#14
David S Estores, Ku-Lang Chang
Eosinophilic esophagitis (EE) is an allergic disorder of the esophagus. This diagnosis requires the presence of specific symptoms and a significantly elevated number of eosinophils in the esophageal lining as determined by endoscopic biopsies. Symptoms tend to be nonspecific among patients younger than 15 years. Among adults, dysphagia is the most common symptom. Comanagement with a gastroenterology subspecialist is essential, particularly for EE patients with a stricture. EE is commonly misdiagnosed as gastroesophageal reflux disease (GERD)...
July 2017: FP Essentials
https://www.readbyqxmd.com/read/28654153/survivorship-and-the-chronic-cancer-patient-patterns-in-treatment-related-effects-follow-up-care-and-use-of-survivorship-care-plans
#15
Melissa A Frick, Carolyn C Vachani, Christina Bach, Margaret K Hampshire, Karen Arnold-Korzeniowski, James M Metz, Christine E Hill-Kayser
BACKGROUND: The survivorship needs of patients living with chronic cancer (CC) and their use of survivorship care plans (SCPs) have been overlooked and underappreciated. METHODS: A convenience sample of 39,088 SCPs completed for cancer survivors with an Internet-based SCP tool was examined; it included 5847 CC survivors (15%; CC was defined as chronic leukemia and/or recurrent/metastatic cancer of another nature). Patient-reported treatment effects and follow-up care patterns were compared between CC survivors and survivors treated with curative intent (CI)...
November 1, 2017: Cancer
https://www.readbyqxmd.com/read/28559411/predictors-of-disruptions-in-breast-cancer-care-for-individuals-with-schizophrenia
#16
Kelly E Irwin, Elyse R Park, Jennifer A Shin, Lauren E Fields, Jamie M Jacobs, Joseph A Greer, John B Taylor, Alphonse G Taghian, Oliver Freudenreich, David P Ryan, William F Pirl
BACKGROUND: Patients with schizophrenia experience markedly increased breast cancer mortality, yet reasons for this disparity are poorly understood. We sought to characterize disruptions in breast cancer care for patients with schizophrenia and identify modifiable predictors of those disruptions. MATERIALS AND METHODS: We performed a medical record review of 95 patients with schizophrenia and breast cancer treated at an academic cancer center between 1993 and 2015...
November 2017: Oncologist
https://www.readbyqxmd.com/read/28540113/comparison-of-3-different-perioperative-care-models-for-patients-with-hip-fractures-within-1-health-service
#17
Lillian Sarah Coventry, Austin Nguyen, Amalia Karahalios, Sasha Roshan-Zamir, Phong Tran
INTRODUCTION: Orthogeriatric care models have been introduced within many health-care facilities to improve outcomes for hip fracture patients. This study aims to evaluate differences in care between 3 models, an orthopedic model, a geriatric model, and a comanaged model. MATERIALS AND METHODS: A retrospective analysis was conducted for hip fracture patients treated at Western Health between November 2012 and March 2014. All patients aged 65 years or older were included in the analysis...
June 2017: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/28488991/geriatric-hip-fracture-care-fixing-a-fragmented-system
#18
Mary E Anderson, Kelly Mcdevitt, Ethan Cumbler, Heather Bennett, Zachary Robison, Bryan Gomez, Jason W Stoneback
CONTEXT: Fragmentation in geriatric hip fracture care is a growing concern because of the aging population. Patients with hip fractures at our institution historically were admitted to multiple different services and units, leading to unnecessary variation in inpatient care. Such inconsistency contributed to delays in surgery, discharge, and functional recovery; hospital-acquired complications; failure to adhere to best practices in osteoporosis management; and poor coordination with outpatient practitioners...
2017: Permanente Journal
https://www.readbyqxmd.com/read/28445324/nurse-practitioner-physician-comanagement-of-primary-care-patients-the-promise-of-a-new-delivery-care-model-to-improve-quality-of-care
#19
Allison Andreno Norful, Kyleen Swords, Mickaela Marichal, Hwayoung Cho, Lusine Poghosyan
BACKGROUND: The U.S. primary care system is under tremendous strain to deliver care to an increased volume of patients with a concurrent primary care physician shortage. Nurse practitioner (NP)-physician comanagement of primary care patients has been proposed by some policy makers to help alleviate this strain. To date, no collective evidence demonstrates the effects of NP-physician comanagement in primary care. PURPOSE: This is the first review to synthesize all available studies that compare the effects of NP-physician comanagement to an individual physician managing primary care...
April 25, 2017: Health Care Management Review
https://www.readbyqxmd.com/read/28437056/psychotic-and-bipolar-disorders-schizophrenia
#20
REVIEW
Alaina L Edmunds
Schizophrenia is the most common psychotic illness, typically appearing between the late teenage years and the mid-30s. The first episode of psychosis may be preceded by a prodromal period. Schizophrenia symptoms fall into six common symptom clusters: delusions and hallucinations, disorganization of speech, cognitive dysfunction, negative symptoms, affective symptoms, and motor system abnormalities. The diagnosis is based on criteria in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, including exclusion of other possible medical or psychiatric etiologies of psychosis...
April 2017: FP Essentials
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