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https://www.readbyqxmd.com/read/27929242/community-acquired-pneumonia-in-adults-diagnosis-and-management
#1
Alexander Kaysin, Anthony J Viera
Community-acquired pneumonia is a leading cause of death. Risk factors include older age and medical comorbidities. Diagnosis is suggested by a history of cough, dyspnea, pleuritic pain, or acute functional or cognitive decline, with abnormal vital signs (e.g., fever, tachycardia) and lung examination findings. Diagnosis should be confirmed by chest radiography or ultrasonography. Validated prediction scores for pneumonia severity can guide the decision between outpatient and inpatient therapy. Using procalcitonin as a biomarker for severe infection may further assist with risk stratification...
November 1, 2016: American Family Physician
https://www.readbyqxmd.com/read/27922797/potential-obstacles-in-the-acquisition-of-oral-anticancer-medications
#2
Jennifer L Niccolai, Danielle L Roman, Justin M Julius, Rachelle W Nadour
PURPOSE: To determine the amount of time elapsed between prescriber order and patient receiving oral anticancer medication. PATIENTS AND METHODS: Adult patients with a diagnosis of cancer were prospectively identified in three outpatient oncology clinics when oral anticancer agents were prescribed during a 4-month observation period. For each patient, time to obtain medication was analyzed by the following time points: date of prescription, date of submission to insurance, date prior authorization was obtained, date financial assistance was received, date prescription was processed by pharmacy, and date patient received medication...
December 6, 2016: Journal of Oncology Practice
https://www.readbyqxmd.com/read/27898208/-design-and-implementation-of-an-outpatient-parenteral-antimicrobial-therapy-program-in-primary-care-the-experience-at-a-second-level-hospital
#3
M Ruiz-Campuzano, E García-Vázquez, J J Hernández-Roca, J Gómez-Gómez, M Canteras-Jordana, E Mené-Fenor, A Hernández-Torres, A Peláez-Ballesta
OBJECTIVE: Outpatient parenteral antimicrobial therapy (OPAT) programs are a good assistance option in a wide variety of infectious diseases. Our aim was to design and implement an OPAT program in the area of influence of a second-level hospital, with no Home Hospitalization Service available, being necessary close collaboration between hospitalization and Primary Care teams, describe our cohort, analyse the antimicrobial treatment indicated and evaluate the prognostic and risk factors associated with readmission and mortality...
November 28, 2016: Revista Española de Quimioterapia: Publicación Oficial de la Sociedad Española de Quimioterapia
https://www.readbyqxmd.com/read/27894459/dsm-5-somatic-symptom-disorder-in-patients-with-vertigo-and-dizziness-symptoms
#4
Karina Limburg, Heribert Sattel, Katharina Radziej, Claas Lahmann
OBJECTIVE: DSM-5 somatic symptom disorder (SSD) could potentially be a highly relevant diagnosis for patients with vertigo and dizziness. The criteria of SSD, particularly the B-criterion with its three components (cognitive, affective, behavioral), have however not yet been investigated in this patient group. METHODS: We evaluated a large sample (n=399) of outpatients presenting in a neurological setting. Physical examinations and a psychometric assessment (SCID-I) were conducted; patients completed self-report questionnaires...
December 2016: Journal of Psychosomatic Research
https://www.readbyqxmd.com/read/27873322/non-medical-prescribing-versus-medical-prescribing-for-acute-and-chronic-disease-management-in-primary-and-secondary-care
#5
REVIEW
Greg Weeks, Johnson George, Katie Maclure, Derek Stewart
BACKGROUND: A range of health workforce strategies are needed to address health service demands in low-, middle- and high-income countries. Non-medical prescribing involves nurses, pharmacists, allied health professionals, and physician assistants substituting for doctors in a prescribing role, and this is one approach to improve access to medicines. OBJECTIVES: To assess clinical, patient-reported, and resource use outcomes of non-medical prescribing for managing acute and chronic health conditions in primary and secondary care settings compared with medical prescribing (usual care)...
November 22, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27865327/indwelling-pleural-catheters-a-clinical-option-in-trapped-lung
#6
REVIEW
Luca Bertolaccini, Andrea Viti, Simona Paiano, Carlo Pomari, Luca Rosario Assante, Alberto Terzi
Malignant pleural effusion (MPE) symptoms have a real impact on quality of life. Surgical approach through video-assisted thoracic surgery provides a first step in palliation. In patients unfit for general anesthesia, awake pleuroscopy represents an alternative. Sclerosing agents can be administered at the bedside through a chest tube. Ideal treatment of MPE should include adequate long-term symptom relief, minimize hospitalization, and reduce adverse effects. Indwelling pleural catheter (IPC) allows outpatient management of MPE through periodic ambulatory fluid drainage...
February 2017: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/27863486/costs-of-conservative-management-of-early-stage-prostate-cancer-compared-to-radical-prostatectomy-a-claims-data-analysis
#7
Alina Brandes, Florian Koerber, Larissa Schwarzkopf, Matthias Hunger, Wolf H Rogowski, Raphaela Waidelich
BACKGROUND: Due to widespread PSA testing incidence rates of localized prostate cancer increase but curative treatment is often not required. Overtreatment imposes a substantial economic burden on health care systems. We compared the direct medical costs of conservative management and radical therapy for the management of early-stage prostate cancer in routine care. METHODS: An observational study design is chosen based on claims data of a German statutory health insurance fund for the years 2008-2011...
November 18, 2016: BMC Health Services Research
https://www.readbyqxmd.com/read/27855562/associations-between-lower-order-anxiety-sensitivity-dimensions-and-dsm-5-posttraumatic-stress-disorder-symptoms
#8
Amanda M Raines, Jessica L Walton, Eliza S McManus, Lisa-Ann J Cuccurullo, Jessica Chambliss, Madeline Uddo, C Laurel Franklin
Anxiety sensitivity (AS), a well-established individual difference variable reflecting a tendency to fear bodily sensations associated with arousal, has been implicated in the development and maintenance of posttraumatic stress disorder (PTSD). Despite these associations, little research has examined the relations between AS subfactors (eg physical, cognitive, and social) and PTSD symptoms and none have examined these associations in the context of DSM-5 (Diagnostic Statistical Manual of Mental Disorders, Fifth Edition) PTSD clusters (ie intrusion, avoidance, negative alterations in cognitions/mood, and arousal)...
November 18, 2016: Cognitive Behaviour Therapy
https://www.readbyqxmd.com/read/27827517/using-robot-fully-assisted-functional-movements-in-upper-limb-rehabilitation-of-chronic-stroke-patients-preliminary-results
#9
Marco Caimmi, Andrea Chiavenna, Alessandro Scano, Giulio Gasperini, Chiara Giovanzana, Lorenzo Molinari Tosatti, Franco Molteni
BACKGROUND: Robotic rehabilitation is promising to promote function in stroke patients. The assist as needed training paradigm has shown to stimulate neuroplasticity but often cannot be used because stroke patients are too impaired to actively control the robot against gravity. AIM: To verify whether a rehabilitation intervention based on robot fully assisted Reaching against gravity (RCH) and Hand-to-Mouth (HTM) can promote upper-limb function in chronic stroke...
November 9, 2016: European Journal of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/27816043/smartphone-based-support-system-soberdiary-coupled-with-a-bluetooth-breathalyser-for-treatment-seeking-alcohol-dependent-patients
#10
Chuang-Wen You, Yen-Chang Chen, Chun-Hsin Chen, Chao-Hui Lee, Po-Hsiu Kuo, Ming-Chyi Huang, Hao-Hua Chu
BACKGROUND: Relapse prevention in patients with alcohol dependence (AD) has long been a clinical challenge. It is vital to provide services with minial restrictions for patients to have access to continuous after-treatment care. The study was aimed to examine the benefits of a smartphone application (SoberDiary) coupled to a Bluetooth breathalyser to assist patients recovering from alcohol dependence (AD). METHODS: This study recruited 38 patients that fulfilled the DSM-IV-TR criteria for AD and who were undergoing an outpatient maintenance program for abstinence...
February 2017: Addictive Behaviors
https://www.readbyqxmd.com/read/27785036/usability-of-a-novel-digital-medicine-system-in-adults-with-schizophrenia-treated-with-sensor-embedded-tablets-of-aripiprazole
#11
Timothy Peters-Strickland, Linda Pestreich, Ainslie Hatch, Shashank Rohatagi, Ross A Baker, John P Docherty, Lada Markovtsova, Praveen Raja, Peter J Weiden, David P Walling
OBJECTIVE: Digital medicine system (DMS) is a novel drug-device combination that objectively measures and reports medication ingestion. The DMS consists of medication embedded with an ingestible sensor (digital medicine), a wearable sensor, and software applications. This study evaluated usability of the DMS in adults with schizophrenia rated by both patients and their health care providers (HCPs) during 8-week treatment with prescribed doses of digital aripiprazole. METHODS: Six US sites enrolled outpatients into this Phase IIa, open-label study (NCT02219009)...
2016: Neuropsychiatric Disease and Treatment
https://www.readbyqxmd.com/read/27783555/integrated-pharmacies-at-community-mental-health-centers-medication-adherence-and-outcomes
#12
W Abel Wright, Jack M Gorman, Melissa Odorzynski, Mark J Peterson, Carol Clayton
BACKGROUND: Patients receiving psychiatric services at community mental health centers (CMHCs) are often prescribed medication that is critical to the treatment of behavioral health conditions, including schizophrenia, bipolar disorder, anxiety, and depression. Previous studies have shown correlation between rates of medication adherence and risk of hospitalization, but potential differences in medication adherence and other outcomes for patients of CMHCs by pharmacy type have not been widely studied...
November 2016: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/27777274/involuntary-outpatient-commitment-and-the-elusive-pursuit-of-violence-prevention-a-view-from-the-united-states
#13
Marvin S Swartz, Sayanti Bhattacharya, Allison G Robertson, Jeffrey W Swanson
OBJECTIVE: Involuntary outpatient commitment (OPC)-also referred to as 'assisted outpatient treatment' or 'community treatment orders'-are civil court orders whereby persons with serious mental illness and repeated hospitalisations are ordered to adhere to community-based treatment. Increasingly, in the United States, OPC is promoted to policy makers as a means to prevent violence committed by persons with mental illness. This article reviews the background and context for promotion of OPC for violence prevention and the empirical evidence for the use of OPC for this goal...
October 24, 2016: Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie
https://www.readbyqxmd.com/read/27745539/-restricted-community-members-research-protections-and-opportunities-for-individuals-committed-to-assisted-outpatient-treatment
#14
Andrea G Segal, Dominic A Sisti
Several forms of mandated community treatment exist in the United States. One mechanism, assisted outpatient treatment (AOT), has become both more common and more controversial in recent years. The status of individuals committed to AOT remains unclear within regulatory guidelines aimed at protecting research participants. Should individuals on AOT be considered psychiatric inpatients, prisoners, community members, or something else? The authors argue that persons on AOT inhabit a gray area wherein they should be given some of the ethical protections afforded to involuntary inpatients and prisoners, but they should also enjoy freedoms as members of the community...
October 17, 2016: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/27736837/unmet-needs-for-ancillary-services-among-hispanics-latinos-receiving-hiv-medical-care-united-states-2013-2014
#15
Lauren C Korhonen, Nicholas P DeGroote, R Luke Shouse, Linda A Valleroy, Joseph Prejean, Heather Bradley
The prevalence of diagnosed human immunodeficiency virus (HIV) infection in Hispanics/Latinos in the United States is more than twice as high as the prevalence among non-Hispanic whites (1). Services that support retention in HIV medical care and assist with day-to-day living, referred to here as ancillary services, help persons living with HIV access HIV medical care, adhere to HIV treatment, and attain HIV viral suppression. The needs for these ancillary services among Hispanics/Latinos are not well described (2)...
October 14, 2016: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/27733666/the-impacts-of-a-pharmacist-managed-outpatient-clinic-and-chemotherapy-directed-electronic-order-sets-for-monitoring-oral-chemotherapy
#16
Brandon Battis, Linda Clifford, Mostaqul Huq, Edrick Pejoro, Scott Mambourg
OBJECTIVES: Patients treated with oral chemotherapy appear to have less contact with the treating providers. As a result, safety, adherence, medication therapy monitoring, and timely follow-up may be compromised. The trend of treating cancer with oral chemotherapy agents is on the rise. However, standard clinical guidance is still lacking for prescribing, monitoring, patient education, and follow-up of patients on oral chemotherapy across the healthcare settings. The purpose of this project is to establish an oral chemotherapy monitoring clinic, to create drug and lab specific provider order sets for prescribing and lab monitoring, and ultimately to ensure safe and effective treatment of the veterans we serve...
October 12, 2016: Journal of Oncology Pharmacy Practice
https://www.readbyqxmd.com/read/27723697/-treatment-of-rectal-foreign-bodies
#17
D A Khubezov, S N Trushin, K V Puchkov, D K Puchkov, A Yu Ogorel'tsev
AIM: to present the results of treatment of rectal foreign bodies. MATERIAL AND METHODS: 15-year outcomes of 112 patients with rectal foreign bodies were analyzed. RESULTS: Outpatient and hospital care were applied in 52 (46%) and 60 (54%) of cases respectively. Transanal removal was made in 97 (87%) patients including 28 (25%) cases of general anaesthesia. 14 (13%) patients underwent surgery. Colostomy was performed in 7 (6%) cases. We presented cases of foreign bodies removal through laparotomy, colotomy and SILS-assisted transanal approach...
2016: Khirurgiia
https://www.readbyqxmd.com/read/27721774/utilization-of-behavioral-medicine-services-to-refine-medical-diagnostic-formulation-in-the-face-of-uncertain-symptom-presentation
#18
David A Moore, Elisabeth S Markman, Cori E McMahon, Maurie Markman
In the ever expanding realm of cancer care, the psychosocial impact of disease and medical treatments has been garnering increased attention. To address these needs, the integration of behavioral medicine services into inpatient and outpatient medical settings has added a unique resource available to oncologists. Psycho-oncologists may assist providers via the provision of psychological assessment and intervention, supplying valuable consultation to members of the medical team and much needed clinical services to patients...
May 2016: Case Reports in Oncology
https://www.readbyqxmd.com/read/27705965/high-prognostic-value-of-mini-laparoscopy-for-advanced-liver-disease-related-complications-in-patients-with-hcv-infection
#19
Eugen Zizer, Johanna Backhus, Stephan Bohl, Anette Braun, Irina Baturina, Dietmar Klass, Nektarios Dikopoulos, Thomas Seufferlein, Matthias Dollinger
BACKGROUND/AIM: The assessment of advanced chronic liver disease (ACLD) is a prerequisite for therapy and surveillance in patients with chronic hepatitis C infection. Mini-laparoscopy-assisted liver biopsies facilitate both histological and macroscopical evaluation of liver fibrosis. This study is aimed at investigating the prognostic significance of the laparoscopic assessment for the cumulative incidence of ACLD-related events. PATIENTS AND METHODS: We performed a single center, retrospective analysis of 94 patients with either macroscopically or/and microscopically assessed advanced fibrosis/cirrhosis caused by chronic hepatitis C infection...
October 6, 2016: Digestion
https://www.readbyqxmd.com/read/27692348/-follow-up-interventions-after-suicide-attempt-what-tools-what-effects-and-how-to-assess-them
#20
E Castaigne, P Hardy, F Mouaffak
After attempting suicide, 60 to 70% of patients are discharged from emergency departments and referred to outpatient treatment which entails psychosocial strategies, pharmacological strategies or a combination. The main objective of outpatient care consists in preventing recurrent suicidal behavior. Yet suicide attempters have been found to be very difficult to engage in treatment. Between 11% and 50% of attempters refuse outpatient treatment or drop out of outpatient therapy very quickly. In order to address this extremely serious issue, for the past 20 years monitoring or follow up interventions has been presented as a promising approach...
September 27, 2016: L'Encéphale
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