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https://www.readbyqxmd.com/read/28801975/trends-in-aging-related-services-during-nephrectomy-implications-for-surgery-in-an-aging-population
#1
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)...
August 11, 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
#2
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
#3
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
#4
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)...
June 27, 2017: Cancer
https://www.readbyqxmd.com/read/28559411/predictors-of-disruptions-in-breast-cancer-care-for-individuals-with-schizophrenia
#5
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...
May 30, 2017: Oncologist
https://www.readbyqxmd.com/read/28540113/comparison-of-3-different-perioperative-care-models-for-patients-with-hip-fractures-within-1-health-service
#6
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
#7
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
#8
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
#9
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
https://www.readbyqxmd.com/read/28400902/a-novel-neuroscience-intermediate-level-care-unit-model-retrospective-analysis-of-impact-on-patient-flow-and-safety
#10
Alexandra E Quimby, Michel C F Shamy, Deanna M Rothwell, Erin Y Liu, Dar Dowlatshahi, Grant Stotts
BACKGROUND AND PURPOSE: Neurointensive care units have been shown to improve patient outcomes across a variety of neurological and neurosurgical conditions. However, the efficacy of less resource-intensive intermediate-level care units to deliver similar care has not been well studied. The purpose of this study is to evaluate the impact of neurocritical specialist comanagement on patient flow and safety in a neuroscience intermediate-level care unit. METHODS: Our intervention consisted of the addition of a physician with critical care experience as well as training in neurology, anesthesiology, or intensive care to a neuroscience intermediate-level care unit to comanage patients alongside neurology and neurosurgery staff during weekday daytime hours...
April 2017: Neurohospitalist
https://www.readbyqxmd.com/read/28328592/status-asthmaticus-and-central-herniation-a-case-for-multidisciplinary-critical-care
#11
Joelle B Karlik, Tristan Stani, Stephanie Nonas, Aclan Dogan, Ansgar Brambrink
A 24-year-old woman with history of asthma was intubated emergently for acute status asthmaticus triggered by acute respiratory syncytial virus infection and treated with permissive hypercapnia. Her ventilation was complicated by auto-positive end-expiratory pressure and elevated peak airway, plateau, and central venous pressures. On hospital day 2, she was noted to have anisocoria. Imaging showed diffuse cerebral edema with central herniation. Difficult ventilation and hypercapnia directly contributed to her severe cerebral edema...
June 1, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28282334/practitioner-application-using-a-comanagement-model-to-develop-a-hip-fracture-integrated-care-pathway
#12
Nancy Jacoby
No abstract text is available yet for this article.
March 2017: Journal of Healthcare Management / American College of Healthcare Executives
https://www.readbyqxmd.com/read/28282333/using-a-comanagement-model-to-develop-a-hip-fracture-integrated-care-pathway
#13
Gonzalo Barinaga, Zain Sayeed, Afshin Anoushiravani, Steven Scaife, Mouhanad El-Othmani, Khaled Jamal Saleh
Hip fracture care represents a service line that profoundly affects patients' quality of life. As hospitals and physicians are motivated to improve quality, reduce costs, and maximize efficiency of care, several alignment models have been proposed under new healthcare legislation. Evaluation of such models as they pertain to hip fracture care warrants further investigation. In this article, we identify the current model of operations present in large healthcare organizations, examine the reasoning behind hospital-physician alignment, and describe specific comanagement principles that are common in healthcare settings...
March 2017: Journal of Healthcare Management / American College of Healthcare Executives
https://www.readbyqxmd.com/read/28279638/which-pediatricians-comanage-mental-health-conditions
#14
Cori Green, Amy Storfer-Isser, Ruth E K Stein, Andrew S Garner, Bonnie D Kerker, Moira Szilagyi, Karen G O'Connor, Kimberly E Hoagwood, Sarah M Horwitz
OBJECTIVE: Given the prevalence of mental health (MH) conditions (MHC) in children, pediatricians should initiate treatment alone or in collaboration with a specialist for children with MHC. However, the majority of pediatricians do not manage or comanage common MHC even with an on-site MH provider. We examined which physician, practice, and training characteristics are associated with pediatricians' comanaging at least half of their patients with MHC. METHODS: We analyzed responses of general pediatricians (n = 305) from the American Academy of Pediatrics 2013 Periodic Survey...
July 2017: Academic Pediatrics
https://www.readbyqxmd.com/read/28250024/care-system-redesign-for-preterm-children-after-discharge-from-the-nicu
#15
Dennis Z Kuo, Robert E Lyle, Patrick H Casey, Christopher J Stille
Approximately 1 in 8 children in the United States are born preterm. Existing guidelines and research examine the cost of prematurity from the NICU stay and developmental surveillance and outcomes after discharge from the NICU. Preterm children are at greater risk for excess hospitalizations, outpatient visits, and societal costs after NICU discharge. Improved delivery of care and health promotion from the community setting, particularly from the patient-centered medical home, may result in improved growth, health, and development, with accompanying reduction of post-NICU discharge costs and encounters...
April 2017: Pediatrics
https://www.readbyqxmd.com/read/28228099/impact-of-adding-additional-providers-to-resident-workload-and-the-resident-experience-on-a-medical-consultation-rotation
#16
Michele Fang, Eric Linson, Manish Suneja, Ethan F Kuperman
BACKGROUND: Excellence in Graduate Medical Education requires the right clinical environment with an appropriate workload where residents have enough patients to gain proficiency in medicine with optimal time for reflection. The Accreditation Council for Graduate Medical Education (ACGME) has focused more on work hours rather than workload; however, high resident workload has been associated with lower resident participation in education and fatigue-related errors. Recognizing the potential risks associated with high resident workload and being mindful of the costs of reducing resident workload, we sought to reduce residents' workload by adding an advanced practice provider (APP) to the surgical comanagement service (SCM) and study its effect on resident satisfaction and perceived educational value of the rotation...
February 22, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/28126152/impact-of-a-multidisciplinary-team-approach-including-an-intensivist-on-the-outcomes-of-critically-ill-patients-in-the-cardiac-care-unit
#17
Zaher Fanari, Armin Barekatain, Roger Kerzner, Sumaya Hammami, William S Weintraub, Vinay Maheshwari
OBJECTIVE: To investigate the impact of integrating a medical intensivist into a cardiac care unit (CCU) multidisciplinary team on the outcomes of CCU patients. PATIENTS AND METHODS: We conducted a retrospective cohort study of 2239 CCU admissions between July 1, 2011, and July 1, 2013, which constituted patients admitted in the 12 months before and 12 months after the introduction of intensivists into the CCU multidisciplinary team. This team included a cardiologist, a medical intensivist, medical house staff, nurses, a pharmacist, a dietitian, and physical and respiratory therapists...
December 2016: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/28101033/maximizing-the-benefit-cost-ratio-of-anthracyclines-in-metastatic-breast-cancer-case-report-of-a-patient-with-a-complete-response-to-high-dose-doxorubicin
#18
Kevin Shee, Alan T Kono, Susan P D'Anna, Mark A Seltzer, Xiaoying Lu, Todd W Miller, Mary D Chamberlin
Despite the clinical efficacy of anthracycline agents such as doxorubicin, dose-limiting cardiac toxicities significantly limit their long-term use. Here, we present the case of a 33-year-old female patient with extensive metastatic ER+/PR+/HER2- mucinous adenocarcinoma of the breast, who was started on doxorubicin/cyclophosphamide therapy after progressing on paclitaxel and ovarian suppressor goserelin with aromatase inhibitor exemestane. The patient was comanaged by cardiology, who carefully monitored measures of cardiac function, including EKGs, serial echocardiograms, and profiling of lipids, troponin, and pro-BNP every 2 months...
September 2016: Case Reports in Oncology
https://www.readbyqxmd.com/read/28091432/depression-and-posttraumatic-stress-disorder-among-road-traffic-accident-victims-managed-in-a-tertiary-hospital-in-southern-nigeria
#19
J E Asuquo, B E Edet, I E Abang, E A Essien, O G Osakwe, E J Aigbomain, K C Chigbundu
BACKGROUND: Psychological responses to traumatic events vary widely across different cultures but studies in the developing countries are scant. The objective of this study is to determine prevalence of depression and posttraumatic stress disorder (PTSD) among patients involved in road traffic accident (RTA) compared with that of the general population using a matched control group. MATERIALS AND METHODS: The study design was case control and employed the convenient sampling technique...
February 2017: Nigerian Journal of Clinical Practice
https://www.readbyqxmd.com/read/28056665/the-patient-perspective-on-the-effects-of-medical-record-accessibility-a-systematic-review
#20
Peter Vermeir, Sophie Degroote, Dominique Vandijck, Hanne Van Tiggelen, Renaat Peleman, Rik Verhaeghe, An Mariman, Dirk Vogelaers
BACKGROUND: Health care is shifting from a paternalistic to a participatory model, with increasing patient involvement. Medical record accessibility to patients may contribute significantly to patient comanagement. OBJECTIVES: To systematically review the literature on the patient perspective of effects of personal medical record accessibility on the individual patient, patient-physician relationship and quality of medical care. METHODS: Screening of PubMed, Web of Science, Cinahl, and Cochrane Library on the keywords 'medical record', 'patient record', 'communication', 'patient participation', 'doctor-patient relationship', 'physician-patient relationship' between 1 January 2002 and 31 January 2016; systematic review after assessment for methodological quality...
June 2017: Acta Clinica Belgica
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