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https://www.readbyqxmd.com/read/28214994/cancelled-primary-care-appointments-a-prospective-cohort-study-of-diabetic-patients
#1
Sara McComb, Zhiyi Tian, Laura Sands, Ayten Turkcan, Lingsong Zhang, Shree Frazier, Mark Lawley
Patients scheduled for primary care appointments often cancel or no show. For diabetic patients, nonattendance can affect continuity of care and result in higher emergency department (ED) and hospital use. Nonattendance also impacts appointment scheduling, patient access, and clinic work load. While no show has received significant attention, little research has addressed the prevalence and impact of appointment cancellation. Data on 46,710 appointments for 7586 adult diabetic patients was used to conduct a prospective cohort study examining primary care appointment behavior...
April 2017: Journal of Medical Systems
https://www.readbyqxmd.com/read/28214908/-integrated-patient-centered-care-in-community-health-centers-in-italy-performance-evaluation
#2
Piero Salvadori
In Italy, a "Casa della Salute" (or "House of Health"), translated for the purposes of this article as Community Health Center (CHC), is a public center (of the national public healthcare system), where one can find allocated all primary community healthcare services centered on prevention, treatment and rehabilitation of the citizen in the same physical space, including general practitioner offices, outpatient specialist clinics, and social services. CHCs assure patient-centered primary care services and are the ideal place for applying the Chronic Care Model...
November 2016: Igiene e Sanità Pubblica
https://www.readbyqxmd.com/read/28214722/when-high-pressure-system-constraints-and-a-social-justice-mission-collide-a-socio-structural-analysis-of-emergency-department-social-work-services
#3
Megan Moore, Margaret Cristofalo, Danae Dotolo, Nicole Torres, Alexandra Lahdya, Leyna Ho, Mia Vogel, Mollie Forrester, Bonnie Conley, Susan Fouts
The emergency department (ED) can be a critical intervention point for many patients with multifaceted needs. Social workers have long been part of interdisciplinary ED teams. This study aimed to contribute to the limited understanding of social worker-patient interactions and factors influencing social work services in this setting. This paper reports a qualitative content analysis of social work medical record notes (N = 1509) of services provided to trauma patients in an urban, public, level 1 trauma center and an in-depth analysis of semi-structured interviews with ED social workers (N = 10)...
February 11, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28214474/emergency-department-utilisation-by-older-people-in-metropolitan-melbourne-2008-12-findings-from-the-reducing-older-patient
#4
Danielle Mazza, Christopher Pearce, Angela Joe, Lyle R Turner, Bianca Brijnath, Colette Browning, Marianne Shearer, Judy Lowthian
Objective Older patients are over-represented in emergency departments (ED), with many presenting for conditions that could potentially be managed in general practice. The aims of the present study were to examine the characteristics of ED presentations by older patients and to identify patient factors contributing to potentially avoidable general practitioner (PAGP)-type presentations.Methods A retrospective analysis was performed of routinely collected data comprising ED presentations by patients aged ≥70 years at public hospitals across metropolitan Melbourne from January 2008 to December 2012...
February 20, 2017: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/28214369/diagnostic-accuracy-of-history-physical-exam-laboratory-tests-and-point-of-care-ultrasound-for-pediatric-acute-appendicitis-in-the-emergency-department-a-systematic-review-and-meta-analysis
#5
Roshanak Benabbas, Mark Hanna, Jay Shah, Richard Sinert
BACKGROUND: Acute appendicitis (AA) is the most common surgical emergency in children. Accurate and timely diagnosis is crucial but challenging due to atypical presentations and the inherent difficulty of obtaining a reliable history and physical examination in younger children. OBJECTIVES: To determine the utility of history, physical exam, laboratory tests, Pediatric Appendicitis Score (PAS) and Emergency Department-Point-of-Care Ultrasound (ED-POCUS) in the diagnosis of AA in ED pediatric patients...
February 18, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28214273/candidaemia-due-to-candida-parapsilosis-species-complex-at-a-hospital-in-brazil-clinical-characteristics-and-antifungal-susceptibility-profile
#6
Débora de Souza Olartechea de Alencar, Rosianne Assis de Sousa Tsujisaki, Fernanda Luiza Espinosa Spositto, Maína de Oliveira Nunes, Adriana Araújo de Almeida, Marilena Dos Anjos Martins, Marcia de Souza Carvalho Melhem, Marilene Rodrigues Chang
BACKGROUND: Recent decades have seen a global emergence of candidaemia caused by non-Candida albicans Candida species, particularly the Candida parapsilosis complex. AIMS: To evaluate the clinical features and antifungal susceptibility profiles of isolates belonging to the C. parapsilosis species complex in patients with candidaemia in a midwestern Brazilian tertiary-care teaching hospital. METHODS: Yeast identification was performed using an automated Vitek 2 Compact system...
February 14, 2017: Revista Iberoamericana de Micología
https://www.readbyqxmd.com/read/28214236/are-hospital-ed-transfers-less-likely-among-nursing-home-residents-with-do-not-hospitalize-orders
#7
Taeko Nakashima, Yuchi Young, Wan-Hsiang Hsu
OBJECTIVES: This study aims to examine whether an advance directive "Do Not Hospitalize" (DNH) would be effective in reducing hospital/emergency department (ED) transfers. Similar effects in residents with dementia were also examined. DESIGN: Cross-sectional study. SETTING/SUBJECTS: New York State (NYS) nursing home residents (n = 43,024). MEASUREMENTS AND ANALYSIS: The Minimum Data Set 2.0 was used to address the study aims...
February 14, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28214061/open-physeal-fracture-of-the-distal-phalanx-of-the-hallux-case-study-diagnosis-and-management
#8
Brandon Morris, Scott Mullen, Paul Schroeppel, Bryan Vopat
Open physeal fractures of the distal phalanx of the hallux are the lesser described counterpart to the same fracture of the finger, known by its eponym as a "Seymour fracture". Displaced Salter-Harris phalangeal fractures present with a concomitant nailbed or soft tissue injury. Often these fractures occur in the summer months when open-toe footwear can be worn, however, they may occur indoors as well. Frequently, the injury results from direct axial load of the toe, or "stubbing", which causes the fracture and associated soft tissue injury...
February 6, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28213888/transfusion-in-critical-care-a-uk-regional-audit-of-current-practice
#9
J O M Plumb, M G Taylor, E Clissold, M P W Grocott, R Gill
A consistent message within critical care publications has been that a restrictive transfusion strategy is non-inferior, and possibly superior, to a liberal strategy for stable, non-bleeding critically ill patients. Translation into clinical practice has, however, been slow. Here, we describe the degree of adherence to UK best practice guidelines in a regional network of nine intensive care units within Wessex. All transfusions given during a 2-month period were included (n = 444). Those given for active bleeding or within 24 h of major surgery, trauma or gastrointestinal bleeding were excluded (n = 148)...
February 18, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28213620/post-contrast-acute-kidney-injury-in-intensive-care-unit-patients-a-propensity-score-adjusted-study
#10
Jennifer S McDonald, Robert J McDonald, Eric E Williamson, David F Kallmes, Kianoush Kashani
PURPOSE: To examine the association of intravenous iodinated contrast material administration with the subsequent development of post-contrast AKI (PC-AKI), emergent dialysis, and short-term mortality using a propensity score-adjusted analysis of a cohort of intensive care unit (ICU) patients who underwent CT examination. METHODS: All ICU patients at our institution who received a contrast-enhanced (contrast group) or unenhanced (noncontrast group) CT scan from January 2006 to December 2014 were identified...
February 17, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28213587/emergency-extracorporeal-life-support-and-ongoing-resuscitation-a-retrospective-comparison-for-refractory-out-of-hospital-cardiac-arrest
#11
A Schober, F Sterz, H Herkner, C Wallmueller, C Weiser, P Hubner, C Testori
BACKGROUND: In refractory cardiac arrest, with cardiopulmonary resuscitation (CPR) for more than 30 min, chances of survival are small. Extracorporeal cardiopulmonary resuscitation (ECPR) is an option for certain patients with cardiac arrest. The aim of this study was to evaluate characteristics of patients selected for ECPR. METHODS: Anonymised data of adult patients suffering refractory cardiac arrest, transported with ongoing CPR to an ED of a tertiary care centre between 2002 and 2012 were analysed...
February 17, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28213382/pharmacist-involvement-on-a-rapid-response-team
#12
Joel Feih, William J Peppard, Michael Katz
PURPOSE: The effect of a pharmacist on a rapid response team (RRT) was investigated. METHODS: This study evaluated 234 patients before and 157 patients after pharmacist involvement on an RRT. The primary outcome was time to medication administration, with a goal turnaround time of less than 30 minutes. Secondary outcomes included most frequently used medications, readmissions to the intensive care unit (ICU) within 48 hours, number of rapid responses that resulted in ICU admission, length of hospital stay, and survival to hospital discharge...
March 1, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28213377/interventional-treatment-of-pulmonary-embolism
#13
David M Dudzinski, Jay Giri, Kenneth Rosenfield
Pulmonary embolism (PE) is a serious and prevalent cause of vascular disease. Nevertheless, optimal treatment for many phenotypes of PE remains uncertain. Treating PE requires appropriate risk stratification as a first step. For the highest-risk PE, presenting as shock or arrest, emergent systemic thrombolysis or embolectomy is reasonable, while for low-risk PE, anticoagulation alone is often chosen. Normotensive patients with PE but with indicia of right heart dysfunction (by biomarkers or imaging) constitute an intermediate-risk group for whom there is controversy on therapeutic strategy...
February 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28213342/virtual-visits-for-acute-nonurgent-care-a-claims-analysis-of-episode-level-utilization
#14
Aliza S Gordon, Wallace C Adamson, Andrea R DeVries
BACKGROUND: Expansion of virtual health care-real-time video consultation with a physician via the Internet-will continue as use of mobile devices and patient demand for immediate, convenient access to care grow. OBJECTIVE: The objective of the study is to analyze the care provided and the cost of virtual visits over a 3-week episode compared with in-person visits to retail health clinics (RHC), urgent care centers (UCC), emergency departments (ED), or primary care physicians (PCP) for acute, nonurgent conditions...
February 17, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28213305/risk-of-suicide-according-to-the-level-of-psychiatric-contact-in-the-older-people-analysis-of-national-health-insurance-databases-in-taiwan
#15
Shin-Ting Yeh, Yee-Yung Ng, Shiao-Chi Wu
PURPOSE: Suicide in the older people is a serious problem worldwide; however the effect of psychiatric contact on the risk of suicide has not been fully explored. The aim of this study was to investigate the relationship between psychiatric contact and suicide in the older people in Taiwan. METHODS: A population-based database was used in this national case-control study. Propensity score matching was used to match older people who did and did not commit suicide from 2010 to 2012 by calendar year, gender, age, and area of residence...
February 1, 2017: Comprehensive Psychiatry
https://www.readbyqxmd.com/read/28213082/-collaboration-between-nursing-teams-and-users-to-improve-the-quality-of-the-care-provision
#16
Véronique Ghadi
The place of users in the health care system has evolved towards their greater involvement in health institutions. International models have led France to recognise patients' experience and to develop a partnership with caregivers. Adapted methods favour the emergence and consideration of the opinion of those receiving the care, help to open up the debate and develop actions more in line with patients' needs.
January 2017: Soins; la Revue de Référence Infirmière
https://www.readbyqxmd.com/read/28212963/clinician-reported-outcome-assessments-of-treatment-benefit-report-of-the-ispor-clinical-outcome-assessment-emerging-good-practices-task-force
#17
John H Powers, Donald L Patrick, Marc K Walton, Patrick Marquis, Stefan Cano, Jeremy Hobart, Maria Isaac, Spiros Vamvakas, Ashley Slagle, Elizabeth Molsen, Laurie B Burke
A clinician-reported outcome (ClinRO) assessment is a type of clinical outcome assessment (COA). ClinRO assessments, like all COAs (patient-reported, observer-reported, or performance outcome assessments), are used to 1) measure patients' health status and 2) define end points that can be interpreted as treatment benefits of medical interventions on how patients feel, function, or survive in clinical trials. Like other COAs, ClinRO assessments can be influenced by human choices, judgment, or motivation. A ClinRO assessment is conducted and reported by a trained health care professional and requires specialized professional training to evaluate the patient's health status...
January 2017: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/28212836/point-of-care-ultrasonography-for-evaluation-of-acute-dyspnea-in-the-emergency-department
#18
Maurizio Zanobetti, Margherita Scorpiniti, Chiara Gigli, Peiman Nazerian, Simone Vanni, Francesca Innocenti, Valerio T Stefanone, Caterina Savinelli, Alessandro Coppa, Sofia Bigiarini, Francesca Caldi, Irene Tassinari, Alberto Conti, Stefano Grifoni, Riccardo Pini
BACKGROUND: Acute dyspnea is a common symptom in the emergency department (ED). Standard approach to dyspnea often relies on radiologic and laboratoristic results, causing excessive delay before adequate therapy is started; an integrated point-of-care ultrasonography (PoCUS) approach can shorten the time needed to formulate a diagnosis maintaining an acceptable safety profile. METHODS: Consecutive adult patients presenting with dyspnea and admitted after ED evaluation were prospectively enrolled...
February 14, 2017: Chest
https://www.readbyqxmd.com/read/28212760/psoriasis-and-comorbid-diseases-implications-for-management
#19
REVIEW
Junko Takeshita, Sungat Grewal, Sinéad M Langan, Nehal N Mehta, Alexis Ogdie, Abby S Van Voorhees, Joel M Gelfand
As summarized in the first article in this continuing medical education series, the currently available epidemiologic data suggest that psoriasis may be a risk factor for cardiometabolic disease. Emerging data also suggest associations between psoriasis and other comorbidities beyond psoriatic arthritis, including chronic kidney disease, inflammatory bowel disease, hepatic disease, certain malignancies, infections, and mood disorders. Recognizing the comorbid disease burden of psoriasis is essential for ensuring comprehensive care of patients with psoriasis...
March 2017: Journal of the American Academy of Dermatology
https://www.readbyqxmd.com/read/28212759/psoriasis-and-comorbid-diseases-epidemiology
#20
REVIEW
Junko Takeshita, Sungat Grewal, Sinéad M Langan, Nehal N Mehta, Alexis Ogdie, Abby S Van Voorhees, Joel M Gelfand
Psoriasis is a common chronic inflammatory disease of the skin that is increasingly being recognized as a systemic inflammatory disorder. Psoriatic arthritis is a well-known comorbidity of psoriasis. A rapidly expanding body of literature in various populations and settings supports additional associations between psoriasis and cardiometabolic diseases, gastrointestinal diseases, kidney disease, malignancy, infection, and mood disorders. The pathogenesis of comorbid disease in patients with psoriasis remains unknown; however, shared inflammatory pathways, cellular mediators, genetic susceptibility, and common risk factors are hypothesized to be contributing elements...
March 2017: Journal of the American Academy of Dermatology
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