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https://www.readbyqxmd.com/read/29652779/is-the-current-management-of-patients-presenting-with-spinal-trauma-to-district-general-hospitals-fit-for-purpose-our-experience-of-delivering-a-spinal-service-using-an-electronic-referral-platform-in-a-large-district-general-teaching-hospital-without-onsite
#1
Daniel S Hill, Hans Marynissen
STUDY DESIGN: A retrospective cross-sectional analysis. OBJECTIVE: To describe the provision of a spinal service using an electronic platform to direct management from an external spinal unit, and quantify time taken to obtain definitive management plans whilst under prescribed spinal immobilization. SUMMARY OF BACKGROUND DATA: Most attending district general hospitals following spinal trauma will have stable injuries and normal neurology, with only a small proportion requiring urgent transfer to a specialist centre...
April 12, 2018: Spine
https://www.readbyqxmd.com/read/29649672/leading-up-to-saying-yes-a-qualitative-study-on-the-experience-of-patients-with-refractory-epilepsy-regarding-presurgical-investigation-for-resective-surgery
#2
Patti Shih, Armin Nikpour, Andrew Bleasel, Geoffrey Herkes, Rebecca Mitchell, Rebecca Seah, Virginia Mumford, Jeffrey Braithwaite, Sanjyot Vagholkar, Frances Rapport
OBJECTIVES: Adult patients with refractory epilepsy who are potential candidates for resective surgery undergo a period of presurgical investigation in tertiary epilepsy centers (TECs), where they engage extensively with healthcare professionals and receive a range of treatment-related information. This qualitative study aimed to examine the experiences of adult patients with refractory epilepsy leading up to and during presurgical investigation and how their perceptions of resective surgery are shaped...
April 9, 2018: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/29644169/testosterone-replacement-therapy-for-physician-assistants-and-nurse-practitioners
#3
REVIEW
Libert Ramos, Amir Shahreza Patel, Ranjith Ramasamy
Physician assistants (PA) and nurse practitioners have been moving toward specialty practices, like urology. With increased training and education, they manage more complex conditions independently. Whether they are the primary provider or the follow up to a specialist, physician extenders can play a vital role in managing patients undergoing testosterone therapy. Physician extenders should be able to understand the indications, risks and associated adverse effects of administering testosterone in order to proficiently take care of patients with low testosterone...
March 2018: Translational Andrology and Urology
https://www.readbyqxmd.com/read/29625949/optimizing-electronic-consultation-between-primary-care-providers-and-psychiatrists-mixed-methods-study
#4
Jennifer M Hensel, Rebecca Yang, Minnie Rai, Valerie H Taylor
BACKGROUND: The use of electronic consultation (e-consult) between primary care providers (PCPs) and psychiatrists has potential, given the high prevalence of mental health issues in primary care and problematic access to specialist care. Utilization and uptake, however, appears to be lower than would be expected. OBJECTIVE: This study aimed to examine actual utilization of e-consult between PCPs and psychiatrists and investigate the perceptions of PCPs about this form of psychiatric advice to inform how to optimize the utility and thereby the uptake of this service...
April 6, 2018: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/29625732/healthcare-use-patterns-and-economic-burden-of-chronic-musculoskeletal-pain-in-children-before-diagnosis
#5
Frances Tian, Patsy Guittar, Melissa Moore-Clingenpeel, Gloria Higgins, Stacy P Ardoin, Charles H Spencer, Karla Jones, Bethanne Thomas, Shoghik Akoghlanian, Sharon Bout-Tabaku
OBJECTIVES: To evaluate the healthcare use and costs of amplified musculoskeletal pain syndrome (AMPS) in children before diagnosis. STUDY DESIGN: We performed a retrospective study in children with AMPS at a pediatric rheumatology clinic between 2010 and 2014. Data were abstracted on 80 patients after primary rheumatic diseases were excluded. Healthcare visits, medications and diagnostic testing that occurred in the years before diagnosis were collected. The Medical Expenditure Panel Survey was used to estimate visit costs...
April 3, 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29625232/shared-care-using-an-electronic-consult-form-to-facilitate-pcp-specialty-care-coordination
#6
Corinna J Rea, Larissa M Wenren, Katherine D Tran, Eric Zwemer, Daniel Mallon, Miya Bernson-Leung, Ronald C Samuels, Sara L Toomey
OBJECTIVE: The quality of children's health is compromised by poor care coordination between primary care providers (PCPs) and specialists. Our objective was to determine how an electronic consultation and referral system impacts referral patterns and PCP-specialist communication. METHODS: The primary care clinic at Boston Children's Hospital piloted an electronic referral and consultation system with the Neurology and Gastroenterology departments from 4/1/14-10/31/16...
April 3, 2018: Academic Pediatrics
https://www.readbyqxmd.com/read/29621859/infants-of-emotionally-dysregulated-or-borderline-personality-disordered-mothers-issues-and-management-in-primary-care
#7
Gisèle Apter, Anne E Sved Williams
BACKGROUND: Knowledge has increased regarding the developmental needs and capabilities of infants, and parental behaviours that support optimum infant development. Despite a better understanding of the emotional dysregulation in borderline personality disorder (BPD) and its effects on infants, general practitioners have had few guidelines for how to recognise and help emotionally dysregulated mother-infant dyads. OBJECTIVE: This article focuses on the behaviours and needs of infants whose mothers have BPD, including knowledge and skills for primary care practitioners to help these troubled families...
April 2018: Australian journal of general practice
https://www.readbyqxmd.com/read/29621858/common-neonatal-presentations-to-the-primary-care-physician
#8
Alicia Quach
BACKGROUND: Newborn babies are very vulnerable in their first weeks of life. Timely and appropriate management of neonatal conditions is paramount for health and developmental outcomes. OBJECTIVE: The aim of this article is to provide an overview of common neonatal presentations to general practice, and highlight significant conditions that may require referral to the emergency department and/or other specialist. DISCUSSION: Clinical history and examination are the most important tools in neonatal assessment...
April 2018: Australian journal of general practice
https://www.readbyqxmd.com/read/29620548/age-at-presentation-of-undescended-testicles-a-single-center-study-in-saudi-arabia
#9
Jumanah H Basalelah, Abdullah M Alzahrani, Abdulaziz M Alshaibani, Nasser S Alalyani, Turki A Alsubiani, Maha Khalid AlMadi, Ossamah S Allsowayan
BACKGROUND: The undescended testis (UDT) is the most common genital anomaly encountered in pediatrics with an estimated incidence of 1% to 4% in full-term and 1% to 45% in preterm newborn boys. Over the years, studies on progressive histological deterioration and cancer risk has led to a change in recommendations for when orchidopexy should be done. OBJECTIVES: Determine age at presentation of patients for UDT to a specialist in Saudi Arabia, age of operation and whether the recommended targeted time frame has been met...
March 2018: Annals of Saudi Medicine
https://www.readbyqxmd.com/read/29616408/difference-in-intraocular-pressure-measurements-between-non-contact-tonometry-and-goldmann-applanation-tonometry-and-the-role-of-central-corneal-thickness-in-affecting-glaucoma-referrals
#10
Khalid Kamel, Edward Dervan, Kevin Falzon, Colm O'Brien
BACKGROUND: Patients at glaucoma risk are commonly identified by optometrists and subsequently referred to glaucoma specialists. Optometrists mainly use non-contact tonometry (NCT) for intraocular pressure (IOP) measurement. AIMS: To investigate the role of differences in IOP measurement between NCT and Goldmann applanation tonometry (GAT) and the effect of central corneal thickness (CCT) on these differences in optometrist referrals METHODS: Details of the initial clinical visit of patients referred with IOP > 21 mmHg in either eye as measured by NCT to a consultant glaucoma specialist were retrospectively reviewed...
April 4, 2018: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/29615013/factors-influencing-government-insurance-scheme-beneficiary-acceptance-of-the-gatekeeper-policy-a-cross-sectional-study-in-wuhan-china
#11
Wenzhen Li, Dongming Wang, Yong Gan, Yanfeng Zhou, Yawen Chen, Jing Li, Naomiem Kkandawire, Sai Hu, Yan Qiao, Zuxun Lu
BACKGROUND: Gatekeeper policy, requiring a patient to visit a primary care provider first, and the patient needs to get his or her primary care provider's referral before seeing a specialist or going to a hospital, has been implemented in China for about ten years, and it is necessary to assess the patients' acceptance of gatekeeper policy and to explore the factors influencing patients' acceptance. METHODS: A cross-sectional study with 1162 respondents was conducted between July and September 2015 at four community health centers (CHCs) in Wuhan, China...
April 4, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29606638/epinephrine-in-severe-allergic-reactions-the-european-anaphylaxis-register
#12
Linus B Grabenhenrich, Sabine Dölle, Franziska Ruëff, Jean-Marie Renaudin, Kathrin Scherer, Claudia Pföhler, Regina Treudler, Alice Koehli, Vera Mahler, Thomas Spindler, Lars Lange, Maria Beatrice Bilò, Nikolaos G Papadopoulos, Jonathan O B Hourihane, Roland Lang, Montserrat Fernández-Rivas, George Christoff, Ewa Cichocka-Jarosz, Margitta Worm
BACKGROUND: Current guidelines recommend intramuscular administration of epinephrine as the first-line drug for the emergency treatment of severe allergic reactions (anaphylaxis), but no randomized trial evidence supports this consensus. OBJECTIVE: We aimed to assess anaphylaxis treatment practices over 10 years, covering several European regions, all allergen sources, and all age groups. METHODS: The European Anaphylaxis Register tracks elicitors, symptoms, emergency treatment, diagnostic workups, and long-term counseling for anaphylaxis incidents through web-based data entry from tertiary allergy specialists, covering information from the emergency respondent, patient, tertiary referral, and laboratory/clinical test results...
March 29, 2018: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/29599610/successful-combination-of-direct-antiviral-agents-in-liver-transplanted-patients-with-recurrent-hepatitis-c-virus
#13
Christian Rupp, Theresa Hippchen, Manuel Neuberger, Peter Sauer, Jan Pfeiffenberger, Wolfgang Stremmel, Daniel Nils Gotthardt, Arianeb Mehrabi, Karl-Heinz Weiss
AIM: To analyze the safety and efficiency of direct-acting antiviral (DAA) regimens in liver-transplanted patients with hepatitis C virus (HCV) reinfection. METHODS: Between January 2014 and December 2016, 39 patients with HCV reinfection after liver transplantation were treated at our tertiary referral center with sofosbuvir (SOF)-based regimens, including various combinations with interferon (IFN), daclatasvir (DAC), simeprivir (SIM) and/or ledipasvir (LDV). Thirteen patients were treated with SOF + IFN ± RBV...
March 28, 2018: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/29595437/understanding-patient-referral-wait-times-for-specialty-care-in-ontario-a-retrospective-chart-audit
#14
Clare Liddy, Nikhat Nawar, Isabella Moroz, Shelagh Mcrae, Christopher Russell, Ariana Mihan, Fanny Mckellips, Derek McLellan, Lois Crowe, Amir Afkham, Erin Keely
CONTEXT: When examining wait times for specialist care, the duration between a patient's referral and specialist visit (wait time one) is poorly understood. OBJECTIVES: To calculate wait time one in primary care clinics across Ontario using chart audit. METHODS: We conducted a retrospective chart audit at five Ontario-based primary care clinics in 2014-2015. RESULTS: We analyzed 461 referrals. Median wait time one for non-urgent and urgent referrals was 79 and 49 days, respectively...
February 2018: Healthcare Policy, Politiques de Santé
https://www.readbyqxmd.com/read/29594240/skull-base-or-cervical-vertebral-osteomyelitis-following-chemoradiotherapy-for-pharyngeal-carcinoma-a-serious-but-treatable-complication
#15
Nafisha Lalani, Shao Hui Huang, Coleman Rotstein, Eugene Yu, Jonathan Irish, Brian O'Sullivan
Osteomyelitis, infection of the bone and marrow, following high dose (chemo-)radiotherapy for head and neck cancer is uncommon and rarely seen in the cervical spine or temporal bone. Due to its proximity to critical structures, osteomyelitis in the latter regions could carry potentially important consequences. Furthermore, involvement near the skull base (e.g. temporal bone and high cervical vertebrae) presents unique challenges in diagnosis (especially in the differentiation from disease recurrence) and treatment, making early detection and timely intervention critical...
January 2018: Clinical and Translational Radiation Oncology
https://www.readbyqxmd.com/read/29590445/atlantoaxial-instability-in-a-patient-with-neck-pain-and-ankylosing-spondylitis
#16
Christian Lyons, Michael Ross, Ryan Elliott, Michael Tall
The purpose of this report is to describe the evaluation and treatment of a patient with neck pain and ankylosing spondylitis who had underlying atlantoaxial instability. The patient was a 31-yr-old man diagnosed with ankylosing spondylitis 1 yr prior who was referred to a physical therapist for the treatment of chronic, worsening low back and hip pain. He also had secondary complaints of neck, upper back, and shoulder pain. The patient worked as a military pilot. As part of the patient's physical examination, a Sharp-Purser test was performed, which was positive for excessive motion...
March 26, 2018: Military Medicine
https://www.readbyqxmd.com/read/29588847/impact-and-cost-effectiveness-of-formal-gastroenterology-outpatient-referral-clinical-assessment-service
#17
Stavroula Pelitari, Charlotte Hathaway, Dean Gritton, Andrea Smith, David Bush, Shyam Menon, Brian McKaig
Objective: The aim was to assess the financial and operational impact of our new gastroenterology referral pathway model on our services. Design: An electronic 'Clinical Assessment Service' (CAS) proforma and an information platform were developed, and all data were analysed retrospectively. Setting: Royal Wolverhampton NHS Trust. Patients: 14 245 general practitioner (GP) referrals were received during January 2014-December 2016 with 9773 of them being triaged via our CAS...
April 2018: Frontline Gastroenterology
https://www.readbyqxmd.com/read/29588272/integration-of-a-technology-based-mental-health-screening-program-into-routine-practices-of-primary-health-care-services-in-peru-the-allillanchu-project-development-and-implementation
#18
Francisco Diez-Canseco, Mauricio Toyama, Alessandra Ipince, Silvana Perez-Leon, Victoria Cavero, Ricardo Araya, J Jaime Miranda
BACKGROUND: Despite their high prevalence and significant burden, mental disorders such as depression remain largely underdiagnosed and undertreated. OBJECTIVE: The aim of the Allillanchu Project was to design, develop, and test an intervention to promote early detection, opportune referral, and access to treatment of patients with mental disorders attending public primary health care (PHC) services in Lima, Peru. METHODS: The project had a multiphase design: formative study, development of intervention components, and implementation...
March 15, 2018: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/29582633/cancer-related-pain-prevalence-severity-and-management-in-a-tertiary-care-center-in-the-middle-east
#19
Nadine M Hamieh, Reem Akel, Bilal Anouti, Cindy Traboulsi, Iman Makki, Lana Hamieh, Arafat Tfayli
Background: Despite pain awareness and the development of treatment guidelines, cancer-related pain assessment and management remain suboptimal. Our objectives were to estimate the prevalence and severity of pain and its interference with daily activities, and evaluate adequacy of treatment in cancer patients in Lebanon. Methods: A total of 400 cancer patients aged 18 and above were interviewed at the American University of Beirut Medical Center surgical and medical oncology floors, outpatient clinics and chemotherapy units from March 2016-February 2017...
March 27, 2018: Asian Pacific Journal of Cancer Prevention: APJCP
https://www.readbyqxmd.com/read/29573158/chemotherapy-in-patients-with-unresected-pancreatic-cancer-in-australia-a-population-based-study-of-uptake-and-survival
#20
Monica I Dumbrava, Elizabeth A Burmeister, David Wyld, David Goldstein, Dianne L O'Connell, Vanessa L Beesley, Helen M Gooden, Monika Janda, Susan J Jordan, Neil D Merrett, Madeleine E Payne, Mary A Waterhouse, Rachel E Neale
AIM: Palliative chemotherapy improves symptom control and prolongs survival in patients with unresectable pancreatic cancer, but there is a paucity of data describing its use and effectiveness in everyday practice. We explored patterns of chemotherapy use in patients with unresected pancreatic cancer in Australia and the impact of use on survival. METHODS: We reviewed the medical records of residents of New South Wales or Queensland, Australia, diagnosed with unresectable pancreatic adenocarcinoma between July 2009 and June 2011...
March 23, 2018: Asia-Pacific Journal of Clinical Oncology
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