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Clinical documentation

Justin M Curley, Coleen Crouch, Joshua E Wilk
Introduction: Medical readiness for deployment is arguably the most important component of personnel readiness in the U.S. Army. Administrative documents called profiles provide individualized medical recommendations to the commander regarding how to best provide for a soldier's health and welfare, and contribute to an aggregated enumeration of a unit's overall readiness to deploy. Profiles that convey behavioral health (BH) limitations thus reflect what can be called the "behavioral health readiness" of the force...
March 14, 2018: Military Medicine
Bonita Sasnett, Susie T Harris, Shelly White
Health services management interns become practice facilitators for primary care clinics interested in pursuing patient-centered recognition for their practice. This experience establishes a collaborative relationship between the university and clinic practices where students apply their academic training to a system of documentation to improve the quality of patient care delivery. The case study presents the process undertaken, benefits, challenges, lessons learned, and recommendations for intern, practice mangers, and educators...
March 16, 2018: Health Care Manager
George Grunberger, Yehuda Handelsman, Zachary T Bloomgarden, Vivian A Fonseca, Alan J Garber, Richard A Haas, Victor L Roberts, Guillermo E Umpierrez
This document represents the official position of the American Association of Clinical Endocrinologists and American College of Endocrinology. Where there are no randomized controlled trials or specific U.S. FDA labeling for issues in clinical practice, the participating clinical experts utilized their judgment and experience. Every effort was made to achieve consensus among the committee members. Position statements are meant to provide guidance, but they are not to be considered prescriptive for any individual patient and cannot replace the judgment of a clinician...
March 2018: Endocrine Practice
Reem N Sheikh, Kristina Karlic
Calcifying aponeurotic fibroma is a rare benign fibrous tumor predominantly seen in children and adolescents younger than 20 years. This tumor is often treated with complete surgical excision, although the recurrence rate is approximately 50%. The distal upper and distal lower extremities are most commonly involved, with only three cases published to date involving pedal digits. We discuss a case of calcifying aponeurotic fibroma in a 25-year-old woman localized to the medial aspect of the distal hallux. Clinical, radiographic, and magnetic resonance imaging findings are described...
January 2018: Journal of the American Podiatric Medical Association
Yves Lacasse, Ai-Yui M Tan, François Maltais, Jerry A Krishnan
Two landmark trials conducted more than 35 years ago provided scientific evidence that, under very specific circumstances, long-term oxygen therapy (LTOT) may prolong life. These two trials enrolled 290 patients with chronic obstructive pulmonary disease (COPD) and severe daytime hypoxemia documented by direct arterial blood gas measurement. From this moment, LTOT became a standard of care and the indications for oxygen therapy have expanded to include nocturnal oxygen therapy for isolated nocturnal oxygen desaturation, ambulatory oxygen to correct exercise-induced desaturation, and short-burst oxygen to relieve dyspnea...
March 16, 2018: American Journal of Respiratory and Critical Care Medicine
Iván José Ardila Gómez, Diana Alejandra Ruiz Rodríguez, María Rosalba Pardo Carrero
INTRODUCTION: The Mardini-Nyhan or LACHT association is a clinical condition of low prevalence that presents with pulmonary, cardiac and limb abnormalities, in which genetic etiology is not clearly documented to date. OBJECTIVE: To describe the case of a 4-month-old child and the literature review of cases reported on this association, with the purpose of exposing the alterations found and thus gui de the early diagnosis of this entity. CLINICAL CASE: 4 months old girl, who admitted to intensive care in mixed respiratory failure, with pulmonary, cardiac and limb disorders that meet criteria for LACHT association, additionally documents hypoplasia of the upper airway, which worsens the evolution, increases the difficulty in mechanical ventilation and favors the fatal outcome at 7 days of hospita lization...
December 2017: Revista Chilena de Pediatría
Bettina von Dessauer, Carmen Benavente, Emilia Monje, Jazmina Bongain, Nadia Ordenes
OBJECTIVE: Describe the frequency and characteristics of PICU patients who undergo a process of withholding or withdrawing life-sustaining treatment (LTSV), between 2004 y 2014. PATIENTS AND METHOD: A retrospective, observational descriptive study, using two documents for quality assessment in the PICU of Hospital Roberto del Río: 1) daily individual patient tracking log and 2) daily record of quality indicators, including LTSV, both updated daily at the morning visit...
December 2017: Revista Chilena de Pediatría
Steve Taylor, Kimberly Eisenstein, Vanessa Gildenstern, Harper Price, Pooja Hingorani, Apurvi Patel, Nathan Page, Smita Bailey, David Carpentieri
Infantile choriocarcinoma (ICC) is a rare, highly malignant form of gestational trophoblastic neoplasia. Rapid diagnosis and initiation of treatment are paramount in reaching a successful outcome. Patients with these tumors typically present with a triad of anemia, hepatomegaly, and precocious puberty. Cutaneous manifestations of ICC are extraordinarily rare with few documented cases. Here, we describe a male neonate who presented to our Dermatology clinic with a rapidly growing, markedly vascular glabellar mass associated with abnormal laboratory values suggestive of Kasabach-Merritt phenomenon...
January 1, 2018: Pediatric and Developmental Pathology
Jesús Escrivá Muñoz, Y Pan, S Ge, E W Jensen, M Vallverdú
The purpose of this document is to describe a methodology to select the most adequate time-frequency distribution (TFD) kernel for the characterization of impedance cardiography signals (ICG). The predominant ICG beat was extracted from a patient and was synthetized using time-frequency variant Fourier approximations. These synthetized signals were used to optimize several TFD kernels according to a performance maximization. The optimized kernels were tested for noise resistance on a clinical database. The resulting optimized TFD kernels are presented with their performance calculated using newly proposed methods...
March 16, 2018: Medical & Biological Engineering & Computing
S Hemmer, H Almansour, W Pepke, M M Innmann, M Akbar
BACKGROUND: In the light of the increasingly aging population and the widespread understanding of the sagittal profile of symptomatic patients with adult spinal deformity (ASD), pervasive utilization of osteotomies on the vertebral column should be expected. These surgeries are accompanied with relatively high complication rates. However, there is no uniform definition or classification in terms of grading the severity or chronological incidence of complications after ASD surgery. OBJECTIVES: The aim of this work is to give an overview of the different classifications described in the literature hitherto and to propose a standardized, clinically utile classification of complications after ASD surgery...
March 15, 2018: Der Orthopäde
Gregory Fant, Lisa Backus
Introduction: It is important to monitor the use of optometric services by Veterans and consider the implications for other optometric and vision rehabilitation services. We did not find public health reports documenting the recent utilization of Veterans Health Administration (VHA) optometric eye exam services. Methods: A cross-sectional study design was used in this secondary data analysis report. We were interested in reporting on the number of Veterans using the VHA system with at least one VHA optometric eye exam service in 2014, 2015, or 2016 within a VHA optometry clinic...
March 13, 2018: Military Medicine
Muhammad Khairi Ahmad, Nur Ainina Abdollah, Nurul Husna Shafie, Narazah Mohd Yusof, Siti Razila Abdul Razak
Mitogen-activated protein kinases (MAPKs) are the main regulators of cellular proliferation, growth, and survival in physiological or pathological conditions. Aberrant MAPK signaling plays a pivotal role in carcinogenesis, which leads to development and progression of human cancer. Dual-specificity phosphatase 6 (DUSP6), a member of the MAPK phosphatase family, interacts with specifically targeted extracellular signal-regulated kinase 1/2 via negative feedback regulation in the MAPK pathway of mammalian cells...
February 2018: Cancer Biology & Medicine
Shuangshuang Lu, Jiayi Wu, Yan Fang, Wei Wang, Yu Zong, Xiaosong Chen, Ou Huang, Jian-Rong He, Weiguo Chen, Yafen Li, Kunwei Shen, Li Zhu
Introduction: Approximately 5% of primary breast cancer patients present de novo stage IV breast cancer, for whom systematic therapy is the mainstream treatment. The role of surgical excision of the primary tumor has been controversial due to inconsistent results of relevant studies. Recently, with the reports of some relevant preclinical data, retrospective studies and randomized clinical trials, we've got more evidence to reexamine the issue. Based on those above, a literature review and meta-analysis was performed to determine whether surgery of the primary tumor could improve overall survival in the setting of stage IV breast cancer...
February 20, 2018: Oncotarget
Xiaohui Chen, Yujie Deng, Yi Shi, Weifeng Zhu, Yibin Cai, Chunwei Xu, Kunshou Zhu, Xiongwei Zheng, Gang Chen, Qi Xie, Guoxing Weng
Functional inactivation of human runt-related transcription factor 3 (RUNX3) through mutation or epigenetic silencing has been well-documented in many cancerous entities. In addition to gene mutation and promoter hypermethylation, cytoplasmic mislocalization has emerged as another major manifestation of RUNX3 dysfunction in malignancies including breast, colorectal and gastric cancers. The aim of the present study was to investigate whether patients with non-small cell lung cancer (NSCLC) and different RUNX3 expression patterns would have different overall survival (OS), and the associations between different patterns of clinicopathological parameters and clinical outcome...
April 2018: Oncology Letters
Stephen Noblett, Jane Beenstock, James Noblett, Joanne Ireland, Sarah Ormiston
Aims and method The increased rates of smoking in people with mental illness is well documented, and establishing smoke-free mental health environments has been emphasised over recent years. This article examines the financial costs of implementing smoke free guidance and assesses the cost associated with patients who were prescribed clozapine and who committed to stopping smoking cigarettes for the duration of the study period. RESULTS: Patients (38) who were prescribed clozapine were included in the study...
April 2018: BJPsych Bulletin
Antonia-Sophie Skierka, Karin B Michels
BACKGROUND: In October 2013, the Declaration of Helsinki was revised a seventh time in its 50 year history. While it is the most widely accepted set of ethical principles for the protection of patients participating in medical research, the Declaration of Helsinki has also been subject of constant controversy. In particular, its paragraph on the use of placebo controls in clinical trials divides the research community into active-control and placebo orthodox proponents, both continuously demanding revisions of the Declaration of Helsinki in favour of their position...
March 15, 2018: BMC Medical Ethics
Amanda N Seddon, Joshua Chaim, Oguz Akin, Esther Drill, Angela G Michael, Nelly Adel, Martin S Tallman
BACKGROUND: The current standard of care for the treatment of patients with newly diagnosed acute myeloid leukemia (AML) is an anthracycline plus cytarabine. Both anthracyclines and cytarabine have been associated with the development of typhlitis, a serious adverse event characterized by inflammation of the bowel wall in patients with profound neutropenia, diagnosed by abdominal CT imaging and clinical symptoms. Given the paucity of available data, the aim of our study was to determine the incidence of typhlitis among AML patients receiving induction chemotherapy with idarubicin 12 mg/m2 (IDA), daunorubicin 60 mg/m2 (DNA60), or daunorubicin 90 mg/m2 (DNA90)...
March 8, 2018: Leukemia Research
Urmi Bajpai, Abhishek Kumar Mehta, Kandasamy Eniyan, Avni Sinha, Ankita Ray, Simran Virdi, Shazeb Ahmad, Aridni Shah, Deepanksha Arora, Devyani Marwaha, Gunjan Chauhan, Prarthna Saraswat, Punita Bathla, Ruchi Singh
Bacteriophages are being considered as a promising natural resource for the development of alternative strategies against mycobacterial diseases, especially in the context of the wide spread occurrence of drug-resistance amongst the clinical isolates of M. tuberculosis. However, there isn't much information documented on mycobacteriophages from India. Here, we report the isolation of 17 mycobacteriophages using M. smegmatis as the bacterial host where 9 phages also lyse M. tuberculosis H37Rv. We present detailed analysis of one of these mycobacteriophage (PDRPv)...
March 15, 2018: Canadian Journal of Microbiology
Vanesa Alende-Castro, Cristina Macía-Rodríguez, Ignacio Novo-Veleiro, Xana García-Fernández, Mercedes Treviño-Castellano, Sergio Rodríguez-Fernández, Arturo González-Quintela
BACKGROUND: Forms of presentation of Q fever vary widely across Spain, with differences between the north and south. In the absence of reported case series from Galicia (north-west Spain), this study sought to describe a Q-fever case series in this region for the first time, and conduct a systematic review to analyse all available data on the disease in Spain. METHODS: Patients with positive serum antibodies to Coxiella burnetii from a single institution over a 5-year period (January 2011-December 2015) were included...
March 15, 2018: PLoS Neglected Tropical Diseases
Renata C Gallagher, Laura Pollard, Anna I Scott, Suzette Huguenin, Stephen Goodman, Qin Sun
Disclaimer: These ACMG Standards are intended as an educational resource for clinical laboratory geneticists to help them provide quality clinical laboratory genetic services. Adherence to these Standards is voluntary and does not necessarily assure a successful medical outcome. These Standards should not be considered inclusive of all proper procedures and tests, or exclusive of others that are reasonably directed to obtaining the same results. In determining the propriety of any specific procedure or test, clinical laboratory geneticists should apply their professional judgment to the specific circumstances presented by the patient or specimen...
March 15, 2018: Genetics in Medicine: Official Journal of the American College of Medical Genetics
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