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https://www.readbyqxmd.com/read/28645202/effects-of-mobility-and-multimorbidity-on-inpatient-and-post-acute-health-care-utilization
#1
Kristine E Ensrud, Li-Yung Lui, Lisa Langsetmo, Tien N Vo, Brent C Taylor, Peggy M Cawthon, Meredith L Kilgore, Charles E McCulloch, Jane A Cauley, Marcia L Stefanick, Kristine Yaffe, Eric S Orwoll, John T Schousboe
Background: This study examines effects of mobility and multimorbidity on hospitalization and inpatient and post-acute care (PAC) facility days among older men. Methods: Prospective study of 1701 men (mean age 79.3 years) participating in MrOS Study Year 7 (Y7) examination (2007-2008) linked with their Medicare claims. At Y7, mobility ascertained by usual gait speed and categorized as poor, intermediate, or good. Multimorbidity quantified by applying Elixhauser algorithm to inpatient and outpatient claims and categorized as none, mild-moderate, or high...
June 22, 2017: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
https://www.readbyqxmd.com/read/28645125/-epidemiology-of-parkinson-s-disease-and-current-concepts%C3%A2-of-outpatient-care-in-germany
#2
Lars Tönges, Reinhard Ehret, Michael Lorrain, Peter Riederer, Martina Müngersdorf
The ambulatory care of patients with Parkinson's disease (PD) in Germany has been established for a long time. As the prevalence of Parkinson's disease continues to increase, the outpatient neurological sector is becoming more and more important and needs to adapt itself to current needs. This includes an optimization of the care structures for Parkinson's patients as well as adequate concepts for the execution of differentiated diagnostics and therapy. For many patients care is provided by non-specialized neurological practices or general practitioners, without exchange of views with neurologists or a specialized university outpatient clinic for movement disorders...
June 2017: Fortschritte der Neurologie-Psychiatrie
https://www.readbyqxmd.com/read/28644736/asymptomatic-microscopic-hematuria-as-a-predictor-of-neoplasia-in-the-urinary-tract
#3
Maria Ordell Sundelin, Jørgen Bjerggaard Jensen
OBJECTIVE: The Danish hematuria guidelines were revised in January 2016. Before revision, it was recommended that asymptomatic microscopic hematuria in patients more than 40 years old should be routinely urologically investigated. In the revised guidelines, patients with asymptomatic microscopic hematuria are not recommended to be investigated, irrespective of age. The purpose of this study was to investigate whether asymptomatic microscopic hematuria was predictive of neoplasia of the urinary tract in a referred cohort of patients...
June 23, 2017: Scandinavian Journal of Urology
https://www.readbyqxmd.com/read/28644313/unique-clinical-features-of-los-angeles-grade-d-esophagitis-suggest-that-factors-other-than-gastroesophageal-reflux-contribute-to-its-pathogenesis
#4
Anh D Nguyen, Stuart J Spechler, Monique N Shuler, Rhonda F Souza, Kerry B Dunbar
BACKGROUND: The Los Angeles (LA) grade of reflux esophagitis (A to D) is assumed to reflect severity of the underlying gastroesophageal reflux disease (GERD). Thus, LA-D esophagitis patients might be expected to have the most conditions predisposing to GERD (eg, obesity, hiatal hernia), and the highest frequency of GERD symptoms. GOALS: The main goal of this study is to compare clinical features of patients with the most severe (LA-D) and mildest (LA-A) grades of esophagitis...
June 21, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28644192/vulvodynia-younger-age-and-combined-therapies-associate-with-significant-reduction-in-self-reported-pain
#5
Anu P Aalto, Silja Vuoristo, Heidi Tuomaala, Riikka J Niemi, Synnöve M Staff, Johanna U Mäenpää
OBJECTIVES: Eight percent of women have vulvodynia (VD), a chronic pain disorder with unknown etiology. The aim of our study was to assess the efficacy of given VD treatments measured by numerical rating scale (NRS) for pain and patients' quality of life. MATERIALS AND METHODS: Study material consisted of a retrospective VD patient cohort (N = 70). Data were collected by postal questionnaires and review of the medical records. RESULTS: We report here a statistically significant reduction in NRS only with combination of therapies (median NRS before treatments 8 vs median NRS 4 after treatments, p < ...
July 2017: Journal of Lower Genital Tract Disease
https://www.readbyqxmd.com/read/28644184/noninvasive-fecal-immunochemical-testing-and-fecal-calprotectin-predict-mucosal-healing-in-inflammatory-bowel-disease-a-prospective-cohort-study
#6
Christopher Ma, Rowan Lumb, Emily V Walker, Rae R Foshaug, ThucNhi T Dang, Sanam Verma, Vivian W Huang, Karen I Kroeker, Karen Wong, Levinus A Dieleman, Richard N Fedorak, Brendan P Halloran
BACKGROUND: The noninvasive biomarkers fecal immunochemical testing (FIT) and fecal calprotectin (FCP) are sensitive for prediction of mucosal inflammation in inflammatory bowel disease. However, neither test has yet been shown to independently and accurately predict mucosal healing (MH). We aimed to assess the specificity of noninvasive FIT and FCP for MH prediction. METHODS: In this prospective cohort study of adult inflammatory bowel disease outpatients presenting for colonoscopy, stool samples for FIT and FCP were collected 48 hours before endoscopy...
June 20, 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28643875/prediction-of-severe-pre-eclampsia-by-a-combination-of-sflt-1-ct-pro-et1-and-blood-pressure-exploratory-study
#7
Anne Lind Malte, Niels Uldbjerg, David Wright, Niels Tørring
OBJECTIVES: To evaluate the performance of a combination of clinical-, angiogenic- and vasoactive biomarkers to predict the development of severe preeclampsia (PE) and HELLP syndrome in the third trimester METHODS: We included 221 women with suspected- , light- , moderate - or severe PE/HELLP (mean gestational age 35(+6) weeks) attending the obstetrical outpatient clinic, and 99 with normal pregnancies. RESULTS: In a group of patients presenting with mild to moderate symptoms of preeclampsia, a combination of C-terminal Pro Endothelin 1 (CT-Pro-ET1), sFlt-1 and systolic blood pressure reached an Area under Curve (AUC) of 0...
June 23, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28643671/-health-literacy-and-diabetes-control-in-patients-attending-a-university-outpatient-clinic-in-argentina
#8
Alexander Ariza Bolivar, Martín E Lanteri, Carla Y Cícero, Adriana Pérez, Félix M Puchulu, Raúl Mejía
Health literacy (HL) is a measure of a patient ability to read, understand and to take decisions on medical instructions. Patients with inadequate HL have poorer health outcomes than those with adequate HL. There is little information on HL levels in diabetic patients in Argentina. The aim of this study was to explore the association between HL and glycemic control in diabetic patients from a university hospital in Argentina. HL was assessed with the Short Assessment of Health Literacy for Spanish-speaking Adults (SAHLSA), glycemic control through glycosylated hemoglobin A1c (HbA1c); 156 patients (58% women) took part in the study...
2017: Medicina
https://www.readbyqxmd.com/read/28643427/correlation-between-residual-volume-of-male-patients-after-uroflowmetry-and-random-residual-volume
#9
Sezgin Okçelik, Hasan Soydan, Ferhat Ateş, Ömer Yilmaz, Ercan Malkoç, Temuçin Şenkul, Kenan Karademir
OBJECTIVES: Our aim was to examine correlation between Post-void residual urine (PVR) after uroflowmetry and random PVR. METHODS: Male patients reporting to the Urology outpatient clinic with LUTS were selected. Patients' age, prostate volume, bladder capacity, voided volume, maximum flow rate, average flow rate, random PVR and PVR after uroflowmetry were recorded. We evaluated the correlations between these parameters. Also we assessed if there was a difference between random PVR and PVR after uroflowmetry...
June 23, 2017: Lower Urinary Tract Symptoms
https://www.readbyqxmd.com/read/28642666/shoulder-disorders-in-an-outpatient-clinic-an-epidemiological-study
#10
Eduardo Angeli Malavolta, Mauro Emilio Conforto Gracitelli, Jorge Henrique Assunção, Gustavo de Mello Ribeiro Pinto, Arthur Zorzi Freire da Silveira, Arnaldo Amado Ferreira
OBJECTIVE: To describe shoulder disorders in patients evaluated by two shoulder and elbow surgeons. METHODS: This cross-sectional study analyzed patients evaluated by two authors, excluding acute fractures and dislocations and patients with symptoms not involving the shoulder. Age and sex distribution was determined for the different diagnoses. RESULTS: We evaluated 1001 patients. Mean age was 51.43±15.15 years and 51.0% were female. Disorders of the rotator cuff occurred in 64...
May 2017: Acta Ortopedica Brasileira
https://www.readbyqxmd.com/read/28642638/laparoscopic-surgery-for-focal-adenomyosis
#11
Jae-Young Kwack, Yong-Soon Kwon
BACKGROUND AND OBJECTIVES: For conservative surgical treatment of focal uterine adenomyosis, laparoscopic adenomyomectomy has been increasingly performed, so that reassessment to determine the safety and efficacy of the laparoscopic surgical technique in a larger number of cases and reevaluation for reproducibility for laparoscopic adenomyomectomy is needed. We evaluate the clinical outcomes of laparoscopic adenomyomectomy with transient occlusion of uterine arteries (TOUA) for focal uterine adenomyosis performed by a single surgeon at a single institute...
April 2017: JSLS: Journal of the Society of Laparoendoscopic Surgeons
https://www.readbyqxmd.com/read/28642335/carcinoid-syndrome-and-costs-of-care-during-the-first-year-after-diagnosis-of-neuroendocrine-tumors-among-elderly-patients
#12
Chan Shen, Yiyi Chu, Daniel M Halperin, Arvind Dasari, Shouhao Zhou, Ying Xu, James C Yao, Ya-Chen Tina Shih
BACKGROUND: Neuroendocrine tumors (NETs) can secrete hormonal peptides that lead to additional symptom burdens. However, it is largely unknown whether and to what extent the additional symptom burdens translate into higher costs of care. This study aimed to examine the cost pattern of elderly NET patients during the first year of diagnosis, taking into account of the carcinoid syndrome status. METHODS: We used Surveillance, Epidemiology, and End Results Medicare data to identify elderly NET patients diagnosed between January 2003 and December 2011...
June 22, 2017: Oncologist
https://www.readbyqxmd.com/read/28642209/acceptability-and-feasibility-of-a-randomized-clinical-trial-of-oral-naltrexone-vs-placebo-for-women-living-with-hiv-infection-study-design-challenges-and-pilot-study-results
#13
Robert L Cook, Kathleen M Weber, Dao Mai, Kathleen Thoma, Xingdi Hu, Babette Brumback, Manju Karki, Kendall Bryant, Mobeen Rathore, Mary Young, Mardge Cohen
BACKGROUND: Women living with HIV/AIDS who drink alcohol are at increased risk for adverse health outcomes, but there is little evidence on best methods for reducing alcohol consumption in this population. We conducted a pilot study to determine the acceptability and feasibility of conducting a larger randomized clinical trial of naltrexone vs. placebo to reduce alcohol consumption in women living with HIV/AIDS. METHODS: We designed the trial with input from community and scientific review...
June 19, 2017: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/28642208/assessing-the-efficacy-of-imagery-enhanced-cognitive-behavioral-group-therapy-for-social-anxiety-disorder-study-protocol-for-a-randomized-controlled-trial
#14
Peter M McEvoy, Michelle L Moulds, Jessica R Grisham, Emily A Holmes, David A Moscovitch, Delia Hendrie, Lisa M Saulsman, Ottmar V Lipp, Robert T Kane, Ronald M Rapee, Matthew P Hyett, David M Erceg-Hurn
Cognitive behavior group therapy (CBGT) is effective for social anxiety disorder (SAD), but a substantial proportion of patients do not typically achieve normative functioning. Cognitive behavioral models of SAD emphasize negative self-imagery as an important maintaining factor, and evidence suggests that imagery is a powerful cognitive mode for facilitating affective change. This study will compare two group CBGT interventions, one that predominantly uses verbally-based strategies (VB-CBGT) and another that predominantly uses imagery-enhanced strategies (IE-CBGT), in terms of (a) efficacy, (b) mechanisms of change, and (c) cost-effectiveness...
June 19, 2017: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/28641914/interactive-home-telehealth-and-burns-a-pilot-study
#15
Sean Hickey, Jason Gomez, Benjamin Meller, Jeffery C Schneider, Meredith Cheney, Shamim Nejad, John Schulz, Jeremy Goverman
OBJECTIVE: The objective of this study is to review our experience incorporating Interactive Home Telehealth (IHT) visits into follow-up burn care. METHODS: A retrospective review of all burn patients participating in IHT encounters over the course of 15 months was performed. Connections were established through secure video conferencing and call-routing software. Patients connected with a personal computer or tablet and providers connected with a desktop computer with a high-definition web camera...
June 19, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28641574/intermittent-low-platelet-counts-hampering-diagnosis-of-x-linked-thrombocytopenia-in-children-report-of-two-unrelated-cases-and-a-novel-mutation-in-the-gene-coding-for-the-wiskott-aldrich-syndrome-protein
#16
Samuel Souza Medina, Lúcia Helena Siqueira, Marina Pereira Colella, Gabriela Goes Yamaguti-Hayakawa, Bruno Kosa Lino Duarte, Maria Marluce Dos Santos Vilela, Margareth Castro Ozelo
BACKGROUND: Thrombocytopenia can occur in different circumstances during childhood and although immune thrombocytopenia is its most frequent cause, it is important to consider other conditions, especially when there is a persistent or recurrent low platelet count. We report two cases of intermittent thrombocytopenia, previously misdiagnosed as immune thrombocytopenia. CASES PRESENTATION: Both cases described were boys who presented with an intermittent pattern of thrombocytopenia, with a persistently low mean platelet volume...
June 22, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28641281/complementary-and-alternative-medicine-a-clinical-study-in-1-016-hematology-oncology-patients
#17
Marina Hierl, Jochen Pfirstinger, Reinhard Andreesen, Ernst Holler, Stephanie Mayer, Daniel Wolff, Martin Vogelhuber
INTRODUCTION: Surveys state a widespread use of complementary and alternative medicine (CAM) in patients with malignant diseases. CAM methods might potentially interfere with the metabolization of tumor-specific therapy. However, there is little communication about CAM use in hematology/oncology patients between patients, CAM providers, and oncologists. PATIENTS AND METHODS: A self-administered questionnaire was handed out to all patients attending to the hematology/oncology outpatient clinic of Regensburg University Hospital...
June 23, 2017: Oncology
https://www.readbyqxmd.com/read/28640159/transcranial-direct-current-stimulation-effects-on-menopausal-vasomotor-symptoms
#18
Mônia Steigleder Bianchi, Charles Francisco Ferreira, Felipe Fregni, Pedro Schestatsky, Wolnei Caumo, Maria Celeste Osório Wender
OBJECTIVE: To assess the effects of transcranial direct current stimulation (tDCS) compared with tDCS-sham on vasomotor symptoms of postmenopausal women. METHODS: Postmenopausal women (N = 30), aged between 45 and 68 years, with at least four episodes of vasomotor symptoms per day, were recruited from a specialized outpatient clinic at a tertiary hospital in the south of Brazil and through a media call after inclusion and exclusion criteria were ensured. Active and tDCS-sham were administered over the motor cortex position (anode electrode) and contralateral supraorbital region (cathode electrode) for 10 consecutive days, except weekends...
June 19, 2017: Menopause: the Journal of the North American Menopause Society
https://www.readbyqxmd.com/read/28640151/a-case-report-of-hyperosmolar-hyperglycemic-state-in-a-7-year-old-child-an-unusual-presentation-of-first-appearance-of-type-1-diabetes-mellitus
#19
Young Min Cho, Byung Sung Park, Min Jae Kang
RATIONALE: A hyperosmolar hyperglycemic state (HHS) is a rare presentation of a hyperglycemic crisis in children with diabetes mellitus. As this condition can be fatal and has high morbidity, early recognition and proper management are necessary for a better outcome. Here, we report a rare case of HHS as the first presentation of type 1 diabetes mellitus (T1DM) in a 7-year-old girl. PATIENT CONCERNS: The patient was admitted due to polyuria and weight loss in the past few days...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28639841/effects-of-a-mindfulness-based-intervention-on-symptoms-and-signs-in-chronic-heart-failure-a-feasibility-study
#20
Jonna Norman, Michael Fu, Inger Ekman, Lena Björck, Kristin Falk
AIMS: Despite treatment recommended by guidelines, many patients with chronic heart failure remain symptomatic. Evidence is accumulating that mindfulness-based interventions (MBIs) have beneficial psychological and physiological effects. The aim of this study was to explore the feasibility of MBI on symptoms and signs in patients with chronic heart failure in outpatient clinical settings. METHODS: A prospective feasibility study. Fifty stable but symptomatic patients with chronic heart failure, despite optimized guideline-recommended treatment, were enrolled at baseline...
June 1, 2017: European Journal of Cardiovascular Nursing
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