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https://www.readbyqxmd.com/read/28651124/a-review-of-people-who-did-not-attend-an-epilepsy-clinic-and-their-clinical-outcomes
#1
I Minshall, A Neligan
PURPOSE: To review the clinical outcomes of people who failed to attend or failed subsequent follow up in a Primary Care based specialist epilepsy service. METHOD: The case notes of 200 people who had failed to initially attend the service or subsequent follow up from 2005 to 2013 were reviewed. RESULTS: Clinical outcomes were determined for 152 people, with the remaining 48 having left the area. For those not attending at all, 64% had no further recorded events, a further 22% came under alternative specialist care and were managed appropriately, 6% were already in remission at the time of referral or at follow up and stayed seizure free...
June 17, 2017: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/28640860/the-path-to-specialist-multidisciplinary-care-in-amyotrophic-lateral-sclerosis-a-population-based-study-of-consultations-interventions-and-costs
#2
Miriam Galvin, Padhraig Ryan, Sinead Maguire, Mark Heverin, Caoifa Madden, Alice Vajda, Charles Normand, Orla Hardiman
BACKGROUND: Amyotrophic Lateral Sclerosis (ALS) is a devastating neurological condition that requires coordinated, multidisciplinary clinical management. ALS is prone to misdiagnosis as its signs and symptoms may be non-specific, which may prolong patients' journey to multidisciplinary ALS care. METHODS: Using chart review and national register data, we have detailed the journey of a national cohort of ALS patients (n = 155) from the time of first symptom to presentation at a multidisciplinary clinic (MDC)...
2017: PloS One
https://www.readbyqxmd.com/read/28639719/understanding-indigenous-patient-attendance-a-qualitative-study
#3
Stephen Copeland, Josephine Muir, Angus Turner
OBJECTIVE: To better understand Indigenous patient non-attendance at medical specialty appointments by learning from the patients attending their scheduled outreach ophthalmology clinic appointment. DESIGN, SETTING AND PARTICIPANTS: A qualitative study using face-to-face, semi-structured interviews with 69 Indigenous Australian ophthalmology patients and 8 clinic workers at one urban and one rural Aboriginal Medical Service (AMS) over the period from April 2015 to November 2015...
June 22, 2017: Australian Journal of Rural Health
https://www.readbyqxmd.com/read/28638693/management-of-the-temporomandibular-joint-in-inflammatory-arthritis-involvement-of-surgical-procedures
#4
REVIEW
Rory C O'Connor, Fiona Fawthrop, Rami Salha, Andrew J Sidebottom
Many conditions may affect the temporomandibular joint (TMJ), but its incidence in individual joint diseases is low. However, inflammatory arthropathies, particularly rheumatoid and psoriatic arthritis and ankylosing spondylitis, appear to have a propensity for affecting the joint. Symptoms include pain, restriction in mouth opening, locking, and noises, which together can lead to significant impairment. Jaw rest, a soft diet, a bite splint, and medical therapy, including disease-modifying antirheumatic drugs (DMARDs) and simple analgesia, are the bedrock of initial treatment and will improve most symptoms in most patients...
June 2017: European Journal of Rheumatology
https://www.readbyqxmd.com/read/28638289/diagnosis-and-treatment-of-hereditary-hemorrhagic-telangiectasia
#5
REVIEW
Cameron Grigg, Daniel Anderson, James Earnshaw
BACKGROUND: Hereditary hemorrhagic telangiectasia (HHT) is a rare genetic disorder known for its debilitating symptoms. More than 90% of patients with HHT experience epistaxis, and they average up to 18 bleeds per month. We review the current literature on the pathophysiology, clinical presentation, and management of HHT. METHODS: We searched MEDLINE, EMBASE, and PubMed and identified 19 articles published since 2000 with current information on HHT. RESULTS: HHT is a disease more commonly associated with significant morbidity rather than mortality...
2017: Ochsner Journal
https://www.readbyqxmd.com/read/28637654/implementation-of-instrument-based-vision-screening-for-preschool-age-children-in-primary-care
#6
Jonathan R Modest, Katherine M Majzoub, Bruce Moore, Vijeta Bhambhani, Sarah R McLaughlin, Louis Vernacchio
BACKGROUND: Vision screening is an essential element of well-child care for young children. Recently, several professional groups have recommended the use of instrument-based screening; however, studies demonstrating the effectiveness of this technique in pediatric primary care settings are lacking. METHODS: We designed a cluster randomized quality improvement project to test the implementation of instrument-based vision screening for 3- to 5-year-old children within a pediatric primary care network...
June 21, 2017: Pediatrics
https://www.readbyqxmd.com/read/28637535/routine-hospital-management-of-self-harm-and-risk-of-further-self-harm-propensity-score-analysis-using-record-based-cohort-data
#7
S Steeg, R Emsley, M Carr, J Cooper, N Kapur
BACKGROUND: The care received by people presenting to hospital following self-harm varies and it is unclear how different types of treatment affect risk of further self-harm. METHOD: Observational cohort data from the Manchester Self-Harm Project, UK, included 16 456 individuals presenting to an Emergency Department with self-harm between 2003 and 2011. Individuals were followed up for 12 months. We also used data from a smaller cohort of individuals presenting to 31 hospitals in England during a 3-month period in 2010/2011, followed up for 6 months...
June 22, 2017: Psychological Medicine
https://www.readbyqxmd.com/read/28637449/task-shifting-interpersonal-counseling-for-depression-a-pragmatic-randomized-controlled-trial-in-primary-care
#8
Camila T Matsuzaka, Milton Wainberg, Andrea Norcini Pala, Elis V Hoffmann, Bruno M Coimbra, Rosaly F Braga, Annika C Sweetland, Marcelo F Mello
BACKGROUND: Task shifting approaches (rational redistribution of tasks among health workforce teams) to train lay professionals to assist with integrating mental health treatment in primary care has been recommended to close the mental health treatment gap for depression in low- and middle-income countries. This study aims to examine the a new model for depression care in a low-resource environment compared to enhanced treatment at usual (E-TAU). METHODS: We trained non-specialist community health workers (local lay employees of the public health system) to provide Interpersonal Counseling (IPC) to treat depressive symptoms in the Brazilian, São Paulo city, family health strategy (FHS)...
June 21, 2017: BMC Psychiatry
https://www.readbyqxmd.com/read/28636740/initial-experience-of-a-hereditary-hemorrhagic-telangiectasia-center-of-excellence
#9
Christopher F Thompson, Jeffrey D Suh, Justin McWilliams, Gary Duckwiler, Marilene B Wang
Our objectives in reviewing the initial experience of a hereditary hemorrhagic telangiectasia center of excellence (HHT COE) were to better understand the interventions being performed in the comprehensive care of these patients and to present the early data as a reference for other tertiary centers considering starting an HHT COE. We conducted a retrospective review of consecutive patients referred to our newly developed HHT COE for evaluation and treatment between May 2010 and June 2013. Clinical presentation, otolaryngologic treatments, and other operative interventions were analyzed...
June 2017: Ear, Nose, & Throat Journal
https://www.readbyqxmd.com/read/28636076/prevalence-and-impact-of-obesity-in-people-with-haemophilia-review-of-literature-and-expert-discussion-around-implementing-weight-management-guidelines
#10
REVIEW
S Kahan, A Cuker, R F Kushner, J Maahs, M Recht, T Wadden, T Willis, S Majumdar, D Ungar, D Cooper
Obesity affects more than 35% of Americans, increasing the risk of more than 200 comorbid conditions, impaired quality of life and premature mortality. This review aimed to summarize literature published over the past 15 years regarding the prevalence and impact of obesity in people with haemophilia (PWH) and to discuss implementing general guidelines for weight management in the context of the haemophilia comprehensive care team. Although few studies have assessed the effects of obesity on haemophilia-specific outcomes, existing evidence indicates an important impact of weight status on lower extremity joint range of motion and functional disability, with potentially important effects on overall quality of life...
June 21, 2017: Haemophilia: the Official Journal of the World Federation of Hemophilia
https://www.readbyqxmd.com/read/28634285/frequency-of-chest-pain-in-primary-care-diagnostic-tests-performed-and-final-diagnoses
#11
Beatrijs Bn Hoorweg, Robert Ta Willemsen, Lotte E Cleef, Tom Boogaerts, Frank Buntinx, Jan Fc Glatz, Geert Jan Dinant
OBJECTIVE: Observational study of patients with chest pain in primary care: determination of incidence, referral rate, diagnostic tests and (agreement between) working and final diagnoses. METHODS: 118 general practitioners (GPs) in the Netherlands and Belgium recorded all patient contacts during  2weeks. Furthermore, patients presenting with chest pain were registered extensively. A follow-up form was filled in after 30 days. RESULTS: 22 294 patient contacts were registered...
June 20, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28630770/knowledge-on-irradiation-medical-imaging-prescriptions-and-clinical-imaging-referral-guidelines-among-physicians-in-a-sub-saharan-african-country-cameroon
#12
Boniface Moifo, Ulrich Tene, Jean Roger Moulion Tapouh, Odette Samba Ngano, Justine Tchemtchoua Youta, Augustin Simo, Joseph Gonsu Fotsin
BACKGROUND: Clinical imaging guidelines (CIGs) are suitable tools to enhance justification of imaging procedures. OBJECTIVE: To assess physicians' knowledge on irradiation, their self-perception of imaging prescriptions, and the use of CIGs. MATERIALS AND METHODS: A questionnaire of 21 items was self-administered between July and August 2016 to 155 referring physicians working in seven university-affiliated hospitals in Yaoundé and Douala (Cameroon)...
2017: Radiology Research and Practice
https://www.readbyqxmd.com/read/28629763/delayed-referral-to-specialist-centre-increases-morbidity-in-patients-with-bile-duct-injury-bdi-after-laparoscopic-cholecystectomy-lc
#13
S Martinez-Lopez, V Upasani, S Pandanaboyana, M Attia, G Toogood, P Lodge, E Hidalgo
BACKGROUND: There is still a debate regarding the optimal management of bile duct injury following cholecystectomy. Our aim was to ascertain if delayed referral influenced clinical outcomes for patients with BDI treated in our institution. MATERIALS AND METHODS: We interrogated a prospectively maintained database, including all patients with BDI (Bismuth and Strasberg classifications) post LC managed in our unit from 2000-2014. Referrals were arbitrarily defined as early (<96 h from the injury) and delayed (>96 h)...
June 16, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28629510/screening-strategies-for-atrial-fibrillation-a-systematic-review-and-cost-effectiveness-analysis
#14
Nicky J Welton, Alexandra McAleenan, Howard Hz Thom, Philippa Davies, Will Hollingworth, Julian Pt Higgins, George Okoli, Jonathan Ac Sterne, Gene Feder, Diane Eaton, Aroon Hingorani, Christopher Fawsitt, Trudie Lobban, Peter Bryden, Alison Richards, Reecha Sofat
BACKGROUND: Atrial fibrillation (AF) is a common cardiac arrhythmia that increases the risk of thromboembolic events. Anticoagulation therapy to prevent AF-related stroke has been shown to be cost-effective. A national screening programme for AF may prevent AF-related events, but would involve a substantial investment of NHS resources. OBJECTIVES: To conduct a systematic review of the diagnostic test accuracy (DTA) of screening tests for AF, update a systematic review of comparative studies evaluating screening strategies for AF, develop an economic model to compare the cost-effectiveness of different screening strategies and review observational studies of AF screening to provide inputs to the model...
May 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28622635/management-of-parturients-with-factor-xi-deficiency-10year-case-series-and-review-of-literature
#15
REVIEW
Lynda Verghese, Efterpi Tingi, Jecko Thachil, Charles Hay, Louise Byrd
This is an article reviewing the management of pregnant women with factor XI (FXI) deficiency. Retrospective review of the electronic records of 67 pregnancies in 25 women with FXI deficiency over a ten-year period was undertaken. All women received care at St Mary's Tertiary Referral Obstetric/Haematology Clinic for some or all of their pregnancies. Outcome measures included antenatal complications, mode of delivery, anaesthesia provided and postpartum haemorrhage (PPH) and management required. A positive bleeding history was identified in 50% of women prior to pregnancy...
June 6, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28619025/evaluating-the-effectiveness-of-a-healthy-lifestyle-clinician-in-addressing-the-chronic-disease-risk-behaviours-of-community-mental-health-clients-study-protocol-for-a-randomised-controlled-trial
#16
Caitlin Fehily, Kate Bartlem, John Wiggers, Paula Wye, Richard Clancy, David Castle, Sonia Wutzke, Chris Rissel, Andrew Wilson, Paul McCombie, Fionna Murphy, Jenny Bowman
BACKGROUND: People with a mental illness experience a greater morbidity and mortality from chronic diseases relative to the general population. A higher prevalence of modifiable health risk behaviours such as smoking, poor nutrition, physical inactivity and harmful alcohol consumption contribute substantially to this disparity. Despite clinical practice guidelines recommending that mental health services routinely provide care to address these risk behaviours, the provision of such care is consistently reported to be low internationally and in Australia...
June 15, 2017: Trials
https://www.readbyqxmd.com/read/28615391/practical-approach-to-evaluating-testicular-status-in-infants-and-children
#17
REVIEW
Elke E Mau, Michael P Leonard
OBJECTIVE: To review the differences between normal, retractile, ectopic, ascended, and undescended testes and to describe the optimal way to perform a testicular examination to distinguish one from the other, as well as to demonstrate that ultrasound imaging is not necessary and to clarify when to consider specialist referral. SOURCES OF INFORMATION: This paper is based on selected findings from a MEDLINE search on undescended testes and orchiopexy referrals, and on our experience at the Urology Clinic at the Children's Hospital of Eastern Ontario in Ottawa, including review of referrals to our clinic for undescended testes and the resultant findings of normal variants versus surgical cases...
June 2017: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/28609594/incidental-adrenal-masses-a-primary-care-approach
#18
Rasha Gendy, Prem Rashid
BACKGROUND: The common use of cross-sectional imaging for the investigation of abdominal and thoracic illness has resulted in the rise of the incidentally identified adrenal mass, or incidentaloma, which presents a diagnostic and management dilemma for the primary care physician. OBJECTIVE: This article provides a framework for the investigation and management of incidental adrenal masses. DISCUSSION: Adrenal incidentalomas are found in approximately 3-4% of abdominal computed tomography (CT) scans...
June 2017: Australian Family Physician
https://www.readbyqxmd.com/read/28607659/evaluation-of-the-referral-system-in-iran-s-rural-family-physician-program-a-study-of-jiroft-university-of-medical-sciences
#19
Reza Dehnavieh, Ehsan Movahed, Hamed Rahimi, Morad Ali Zareipour, Kheir Mohamad Jadgal, Somayeh Alizadeh, Rabea Agh Atabay, Ahmad Haghiri Dehbarez
BACKGROUND AND OBJECTIVE: Referral systems are relatively easy in terms of design, but implementing them is extremely difficult. Considering the three levels of primary healthcare, access of people to specialized services through a referral system is possible. With regard to the importance of a referral system in a family physician program, this study was performed to assess the function of the referral system in the family physician program in Jiroft University of Medical Sciences. METHODS: This cross-sectional study was performed in the first half of 2014...
April 2017: Electronic Physician
https://www.readbyqxmd.com/read/28601689/epilepsy-management-in-older-people-lessons-from-national-audit-of-seizure-management-in-hospitals-nash
#20
B Ziso, P A Dixon, A G Marson
PURPOSE: Epilepsy is the third most common diagnosis in older people, however management in this group remains variable. National Audit of Seizure management in Hospitals (NASH) set out to assess care provided to patients attending hospitals in England following a seizure. METHOD: 154 Emergency Departments (EDs) across the UK took part. 1256 patients aged 60 years or over were included for analysis (median age 74 years, 54% men). 51% were known to have epilepsy, 17% had history of previous seizure or blackout and 32% presented with a suspected first seizure...
May 30, 2017: Seizure: the Journal of the British Epilepsy Association
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