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Specialist referrals

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https://www.readbyqxmd.com/read/27924753/referral-criteria-for-outpatient-specialty-palliative-cancer-care-an-international-consensus
#1
REVIEW
David Hui, Masanori Mori, Sharon M Watanabe, Augusto Caraceni, Florian Strasser, Tiina Saarto, Nathan Cherny, Paul Glare, Stein Kaasa, Eduardo Bruera
Although outpatient specialty palliative-care clinics improve outcomes, there is no consensus on who should be referred or the optimal timing for referral. In response to this issue, we did a Delphi study to develop consensus on a list of criteria for referral of patients with advanced cancer at secondary or tertiary care hospitals to outpatient palliative care. 60 international experts (26 from North America, 19 from Asia and Australia, and 11 from Europe) on palliative cancer care rated 39 needs-based criteria and 22 time-based criteria in three iterative rounds...
December 2016: Lancet Oncology
https://www.readbyqxmd.com/read/27921127/pre-authorization-processes-have-no-effect-on-patients-undergoing-knee-mri-in-a-pediatric-setting-when-evaluated-by-specialists
#2
Drew Pierce, J Herman Kan, Megan May, George S Bisset
OBJECTIVE: Pre-authorization processes are often used by medical insurance companies to reduce costs by managing the utilization of advanced diagnostic imaging, and their impact on patient care is unclear. The purpose of our study is to determine if a pre-authorization process increases the rate of surgically significant abnormal knee MRI and surgical referrals compared with patients referred from pediatric orthopedic specialists who do not undergo a pre-authorization process. MATERIALS AND METHODS: A retrospective study was performed; 124 patients were identified who were referred for knee MRI by a pediatric orthopedist...
December 5, 2016: Skeletal Radiology
https://www.readbyqxmd.com/read/27921036/acute-kidney-injury-in-asia
#3
REVIEW
Li Yang
BACKGROUND: Acute kidney injury (AKI) is a common disorder and is associated with a high morbidity and mortality worldwide. The diversity of the climate and of the socioeconomic and developmental status in Asia has a great influence on the etiology and presentation of AKI in different regions. In view of the International Society of Nephrology's 0by25 initiative, more and more attention has been paid to AKI in Asian countries. SUMMARY: In this review, we summarize the recent achievements with regard to the prevalence and clinical patterns of AKI in Asian countries...
October 2016: Kidney Diseases
https://www.readbyqxmd.com/read/27920283/what-can-we-do-for-people-with-drug-resistant-epilepsy-the-2016-wartenberg-lecture
#4
Jerome Engel
Treatment goals for epilepsy are no seizures, no side effects, as soon as possible, but these goals are too often unmet. Approximately 1 million people in the United States continue to have seizures despite adequate treatment with antiseizure drugs, representing 40% of those with epilepsy, and 80% of the cost of epilepsy. Drug-resistant epilepsy (DRE) can be associated with developmental delay in infants and young children, and severe disability and morbidity in older children and adults, as well as a mortality rate 5-10 times that of the general population...
December 6, 2016: Neurology
https://www.readbyqxmd.com/read/27918334/challenges-of-anesthesia-in-low-and-middle-income-countries-a-cross-sectional-survey-of-access-to-safe-obstetric-anesthesia-in-east-africa
#5
Isabella Epiu, Jossy Verel Bahe Tindimwebwa, Cephas Mijumbi, Thomas M Chokwe, Edwin Lugazia, Francois Ndarugirire, Theogene Twagirumugabe, Gerald Dubowitz
BACKGROUND: The United Nations 2015 Millennium Development Goals targeted a 75% reduction in maternal mortality. However, in spite of this goal, the number of maternal deaths per 100,000 live births remains unacceptably high across Sub-Saharan Africa. Because many of these deaths could likely be averted with access to safe surgery, including cesarean delivery, we set out to assess the capacity to provide safe anesthetic care for mothers in the main referral hospitals in East Africa. METHODS: A cross-sectional survey was conducted at 5 main referral hospitals in East Africa: Uganda, Kenya, Tanzania, Rwanda, and Burundi...
December 1, 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27918311/determinants-of-patient-satisfaction-in-celiac-disease-care
#6
Adam S Faye, SriHari Mahadev, Benjamin Lebwohl, Peter H R Green
BACKGROUND AND GOALS: There are little data examining patient satisfaction with celiac disease (CD) care. We sought to assess how satisfied patients are with their CD care, and to determine the influencing factors. STUDY: We distributed an online questionnaire to adults receiving programmatic updates from a CD referral center, querying aspects of CD care and using disease-specific validated instruments to measure quality of life and dietary adherence. The univariable and multivariable analyses were performed using satisfaction as a binary outcome comparing grouped "satisfied" and "very satisfied" respondents to "neutral," "dissatisfied," and "very dissatisfied" respondents...
December 1, 2016: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/27913262/neurosurgeons-in-japan-are-exclusively-brain-surgeons
#7
REVIEW
Shunji Asamoto
In Japan, neurosurgeons have mainly treated brain diseases, with most cases involving the spine and spinal diseases historically being treated by orthopedists. Nowadays, spinal surgery is just one of the many subspecialties in the neurosurgical field in Japan. Most patients with neurological deficits or suspected neurological diseases are taken to board-certified neurosurgeons or go to them directly in Japan, not through referrals from family doctors or specialists in other fields. Problems originating in the spine and spinal cord have been overlooked or misdiagnosed in these situations...
November 29, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27912990/cancer-rehabilitation-an-overview-of-current-need-delivery-models-and-levels-of-care
#8
REVIEW
Andrea L Cheville, Karen Mustian, Kerri Winters-Stone, David S Zucker, Gail L Gamble, Catherine M Alfano
The relevance of cancer rehabilitation as a public health issue grows steadily as cancer incidence, survival, and mean patient age increase. Reported rates of physical impairment and disability are already high, prior to the anticipated influx of aged cancer survivors. Despite the high prevalence of cancer-related disablement, treatment rates, even for readily remediable physical impairments, are as low as 1-2%. In addition to low referral rates, a challenge to patient-centric cancer rehabilitation is a fractured system that requires multiple visits to a range of specialists to address even a single issue, and cancer survivors generally have several...
February 2017: Physical Medicine and Rehabilitation Clinics of North America
https://www.readbyqxmd.com/read/27908650/musculoskeletal-conditions-in-a-pediatric-population-with-ehlers-danlos-syndrome
#9
Courtney M Stern, Michael J Pepin, Joan M Stoler, Dennis E Kramer, Samantha A Spencer, Cynthia J Stein
OBJECTIVE: To describe musculoskeletal conditions in children with Ehlers-Danlos syndrome (EDS). STUDY DESIGN: A retrospective medical record review was performed, which evaluated 205 patients with EDS (ages 6-19 years) seen in sports medicine or orthopedic clinic at a large pediatric hospital over a 5-year period. RESULTS: Female (n = 147) and male (n = 57) patients were identified (mean age 12.7 years). The most common EDS subtype (55...
November 28, 2016: Journal of Pediatrics
https://www.readbyqxmd.com/read/27902560/assessing-different-partner-notification-methods-for-assuring-partner-treatment-for-gonorrhea-looking-for-the-best-mix-of-options
#10
Eleanor Fleming, Matthew Hogben
CONTEXT: Partner notification for gonorrhea is intended to interrupt transmission and to bring people exposed to infection to care. Partner notification may be initiated through public health professionals (disease intervention specialist: DIS referral) or patients (patient referral). In some cases, patients may carry medications or prescriptions for partners (patient-delivered partner therapy: PDPT). OBJECTIVE: To examine how patterns of notifying and treating partners of persons with gonorrhea differ by partner notification approach...
November 28, 2016: Journal of Public Health Management and Practice: JPHMP
https://www.readbyqxmd.com/read/27899029/treatment-compliance-in-patients-with-aggressive-periodontitis-a-retrospective-case-control-study
#11
Carolina Modin, Denise Abadji, Lottie Adler, Leif Jansson
OBJECTIVE: To investigate if differences according to discontinuation of treatment could be identified between patients with aggressive periodontitis and chronic periodontitis at two specialist clinics of periodontology irrespective of the effects of background factors. MATERIALS AND METHODS: This is a retrospective case-control study. The variables were registered from dental records. The population consisted of patients referred to two specialist clinics of periodontology during three years...
November 29, 2016: Acta Odontologica Scandinavica
https://www.readbyqxmd.com/read/27895510/the-psychological-profile-of-women-presenting-to-a-multidisciplinary-clinic-for-chronic-pelvic-pain-high-levels-of-psychological-dysfunction-and-implications-for-practice
#12
Christina Bryant, Rebecca Cockburn, Anne-Florence Plante, Angela Chia
OBJECTIVE: Chronic pelvic pain (CPP) is widely acknowledged as a common problem with significant consequences for those diagnosed with this condition. There is a lack of studies with good sample size that provide a comprehensive psychological profile of women presenting to specialist chronic pain clinics. Therefore, the objective of this study was to describe the psychological profile of a representative sample of women presenting with CPP at a tertiary referral center. DESIGN: This was a cross-sectional study...
2016: Journal of Pain Research
https://www.readbyqxmd.com/read/27895068/impact-of-a-dedicated-cancer-associated-thrombosis-service-on-clinical-outcomes-a-mixed-methods-evaluation-of-a-clinical-improvement-exercise
#13
Simon Noble, Nikki Pease, Jessica Sui, James Davies, Sarah Lewis, Usman Malik, Raza Alikhan, Hayley Prout, Annmarie Nelson
OBJECTIVES: Cancer-associated thrombosis (CAT) complex condition, which may present to any healthcare professional and at any point during the cancer journey. As such, patients may be managed by a number of specialties, resulting in inconsistent practice and suboptimal care. We describe the development of a dedicated CAT service and its evaluation. SETTING: Specialist cancer centre, district general hospital and primary care. PARTICIPANTS: Patients with CAT and their referring clinicians...
November 28, 2016: BMJ Open
https://www.readbyqxmd.com/read/27893765/improving-standards-of-care-in-obstructed-labour-a-criteria-based-audit-at-a-referral-hospital-in-a-low-resource-setting-in-tanzania
#14
Andrew H Mgaya, Hussein L Kidanto, Lennarth Nystrom, Birgitta Essén
OBJECTIVE: In low-resource settings, obstructed labour is strongly associated with severe maternal morbidity and intrapartum asphyxia, and consequently maternal and perinatal deaths. This study evaluated the impact of a criteria-based audit of the diagnosis and management of obstructed labour in a low-resource setting. METHODS: A baseline criteria-based audit was conducted from October 2013 to March 2014, followed by a workshop in which stakeholders gave feedback on interventions agreed upon to improve obstetric care...
2016: PloS One
https://www.readbyqxmd.com/read/27893070/contingent-valuation-analysis-of-an-otolaryngology-and-ophthalmology-emergency-department-the-value-of-acute-specialty-care
#15
Matthew R Naunheim, Elliot D Kozin, Rosh K Sethi, H G Ota, Stacey T Gray, Mark G Shrime
Importance: Specialty emergency departments (EDs) provide a unique mechanism of health care delivery, but the value that they add to the medical system is not known. Evaluation of patient preferences to determine value can have a direct impact on resource allocation and direct-to-specialist care. Objective: To assess the feasibility of contingent valuation (CV) methodology using a willingness-to-pay (WTP) survey to evaluate specialty emergency services, in the context of an ophthalmology- and otolaryngology-specific ED...
November 23, 2016: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/27891213/uk-guidelines-for-the-management-of-soft-tissue-sarcomas
#16
REVIEW
Adam Dangoor, Beatrice Seddon, Craig Gerrand, Robert Grimer, Jeremy Whelan, Ian Judson
Soft tissue sarcomas (STS) are rare tumours arising in mesenchymal tissues, and can occur almost anywhere in the body. Their rarity, and the heterogeneity of subtype and location means that developing evidence-based guidelines is complicated by the limitations of the data available. However, this makes it more important that STS are managed by teams, expert in such cases, to ensure consistent and optimal treatment, as well as recruitment to clinical trials, and the ongoing accumulation of further data and knowledge...
2016: Clinical Sarcoma Research
https://www.readbyqxmd.com/read/27884852/diagnostic-and-prognostic-biomarkers-in-the-rational-assessment-of-mesothelioma-diaphragm-study-protocol-of-a-prospective-multicentre-observational-study
#17
Selina Tsim, Caroline Kelly, Laura Alexander, Carol McCormick, Fiona Thomson, Rosie Woodward, John E Foster, David B Stobo, Jim Paul, Nick A Maskell, Anthony Chalmers, Kevin G Blyth
INTRODUCTION: Malignant pleural mesothelioma (MPM) is an asbestos-related cancer, which is difficult to diagnose. Thoracoscopy is frequently required but is not widely available. An accurate, non-invasive diagnostic biomarker would allow early specialist referral, limit diagnostic delays and maximise clinical trial access. Current markers offer insufficient sensitivity and are not routinely used. The SOMAmer proteomic classifier and fibulin-3 have recently demonstrated sensitivity and specificity exceeding 90% in retrospective studies...
November 24, 2016: BMJ Open
https://www.readbyqxmd.com/read/27884420/referral-for-specialist-follow-up-and-its-association-with-post-discharge-mortality-among-patients-with-systolic-heart-failure-from-the-national-heart-failure-audit-for-england-and-wales
#18
Connor A Emdin, Allan J Hsiao, Amit Kiran, Nathalie Conrad, Gholamreza Salimi-Khorshidi, Mark Woodward, Simon G Anderson, Hamid Mohseni, John J V McMurray, John G F Cleland, Henry Dargie, Suzanna Hardman, Theresa McDonagh, Kazem Rahimi
For patients admitted with worsening heart failure (HF), early follow-up after discharge is recommended. Whether outcomes can be improved when follow-up is done by cardiologists is uncertain. We aimed to determine the association between cardiology follow-up and risk of death for patients with HF discharged from hospital. Using data from the National Heart Failure Audit (England and Wales), we investigated the effect of referral to cardiology follow-up on 30-day and 1-year mortality in 68,772 patients with HF and a reduced left ventricular ejection fraction discharged from 185 hospitals from 2007 to 2013...
November 1, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/27883298/how-should-physicians-refer-when-referral-options-are-limited-for-transgender-patients
#19
Elizabeth Dietz, Jessica Halem
Transgender people encounter many barriers to health care, and recommendations about where their treatment would best be offered can promote or thwart good care. This case examines the care setting from the perspective of a patient whose experiences with specialists have been negative. We argue that an ethos of harm reduction and informed consent, with a strong emphasis on continuity of care within a primary care setting, should guide questions about how to refer transgender patients to caregivers and to good care settings...
November 1, 2016: AMA Journal of Ethics
https://www.readbyqxmd.com/read/27881247/pain-management-in-ckd-a-guide-for-nephrology-providers
#20
Holly M Koncicki, Mark Unruh, Jane O Schell
Although pain is one of the most commonly experienced symptoms by patients with chronic kidney disease, it is under-recognized, the severity is underestimated, and the treatment is inadequate. Pain management is one of the general primary palliative care competencies for medical providers. This review provides nephrology providers with basic skills for pain management. These skills include recognition of types of pain (nociceptive and neuropathic) syndromes and appropriate history-taking skills. Through this history, providers can identify clinical circumstances in which specialist referral is beneficial, including those who are at high risk for addiction, at risk for adverse effects to medications, and those with complicated care needs such as patients with a limited prognosis...
November 20, 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
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