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https://www.readbyqxmd.com/read/29149791/the-dementia-care-coordination-program-engaging-health-systems-in-caregiver-supports
#1
Pamela Nadash, Nina M Silverstein, Frank Porell
This paper reports on a process evaluation using mixed methods to assess a Dementia Care Coordination Program, which is distinctive in using the medical system, rather than direct outreach, to identify and refer families to supports provided by an Alzheimer's Association chapter via dedicated care consultants. One care consultant received referrals from individual physicians, while the other, employed by a health plan, received referrals from health plan case managers. Through key informant interviews, focus groups, and physician and caregiver surveys, we identified key issues, finding high rates of stakeholder satisfaction, but some practical issues around information sharing and data tracking...
January 1, 2017: Dementia
https://www.readbyqxmd.com/read/29149456/effect-of-a-thermal-care-bundle-on-the-prevention-detection-and-treatment-of-perioperative-inadvertent-hypothermia
#2
Jed Duff, Kim Walker, Karen-Leigh Edward, Nicholas Ralph, Jo-Ann Giandinoto, Kimberley Alexander, Jeffrey Gow, John Stephenson
AIMS AND OBJECTIVES: To improve the prevention, detection, and treatment of perioperative inadvertent hypothermia (PIH) in adult surgical patients by implementing a Thermal Care Bundle. BACKGROUND: Keeping patients normothermic perioperatively prevents adverse surgical outcomes. Hypothermia leads to serious complications including increased risk of surgical bleeding, surgical site infections, and morbid cardiac events. The Thermal Care Bundle consists of three elements: 1) assess risk; 2) record temperature; and (3) actively warm...
November 17, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29149395/shaken-baby-syndrome-what-certainty-do-we-have
#3
Matthieu Vinchon
BACKGROUND: Shaken baby syndrome is a common and devastating disease in infants. In spite of its frequency, many controversies persist, regarding the pathophysiology, diagnosis, and management. AIM OF THE STUDY: We reviewed several salient and challenging issues related to SBS, like its pathogenesis, predisposing factors, differential diagnosis, and prevention programs. MATERIAL AND METHODS: We derive arguments from the literature and from our prospective registry of accidental and non-accidental traumas in infants...
October 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/29149359/-preclinical-and-intrahospital-management-of-mass-casualties-and-terrorist-incidents
#4
REVIEW
A Franke, D Bieler, B Friemert, E Kollig, S Flohe
Due to the recent terrorist attacks in Paris, Brussels, Ansbach, Munich, Berlin and more recently Manchester and London, terrorism is realized as a present threat to our society and social life, as well as a challenge for the health care system. Without fueling anxiety, there is a need for sensitization to this subject and to familiarize all concerned with the special kind of terrorist attack-related injuries, the operational priorities and tactics and the individual basic principles of preclinical and hospital care...
October 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/29149155/lower-cutoffs-for-lc-ms-ms-urine-drug-testing-indicates-better-patient-compliance
#5
Kevin Krock, Amadeo Pesce, Dennis Ritz, Richard Thomas, Agnes Cua, Ryan Rogers, Phil Lipnick, Kristen Kilbourn
BACKGROUND: Urine drug testing is used by health care providers to determine a patient's compliance to their prescribed regimen and to detect non-prescribed medications and illicit drugs. However, the cutoff levels used by clinical labs are often arbitrarily set and may not reflect the urine drug concentrations of compliant patients. OBJECTIVES: Our aim was to test the hypothesis that commonly used cutoffs for many prescribed and illicit drugs were set too high, and methods using these cutoffs may yield a considerable number of false-negative results...
November 2017: Pain Physician
https://www.readbyqxmd.com/read/29149151/sacroplasty-a-ten-year-analysis-of-prospective-patients-treated-with-percutaneous-sacroplasty-literature-review-and-technical-considerations
#6
Michael E Frey, Christopher Warner, Samuel M Thomas, Karan Johar, Heathpaul Singh, Maheen S Mohammad, Douglas P Beall
BACKGROUND: The treatment of sacral fractures has evolved since its first description in 1982. Several techniques for sacral augmentation have been developed since 2001, and the rate of improvement is rapid with over 50% reduction in pain achieved prior to post-procedure discharge of the patient. Pain reduction occurs primarily within the first 3 months and is sustained at 12 months; however, the long-term outcomes have not previously been studied. OBJECTIVES: We aim to evaluate the long-term efficacy of sacroplasty versus non-surgical management (NSM) in treating sacral insufficiency fractures (SIFs), including the effect on pain relief, opioid and other analgesic use, patient satisfaction, and complication rates...
November 2017: Pain Physician
https://www.readbyqxmd.com/read/29149150/the-hopeless-case-palliative-cryoablation-and-cementoplasty-procedures-for-palliation-of-large-pelvic-bone-metastases
#7
Tyler M Coupal, Kevin Pennycooke, Paul I Mallinson, Hugue A Ouellette, Paul W Clarkson, Pippa Hawley, Peter L Munk
BACKGROUND: Metastases to the bone are common in cancer patients, and it has been estimated that up to 50% of patients with pelvic bone metastases will not achieve adequate pain control with medications alone. This has led to a paradigm shift over recent years towards the use and development of minimally invasive image-guided treatment options for palliation of bony metastases. Despite these developments, large metastatic lesions are still often considered to be "hopeless cases" that would garner little to no benefit from image-guided intervention...
November 2017: Pain Physician
https://www.readbyqxmd.com/read/29149134/financial-toxicity-management-as-an-adverse-effect-of-cancer-treatment%C3%A2
#8
Kristen L Fessele
Along with many physical and emotional adverse effects associated with cancer therapy, attention has been directed to defining and identifying interventions to manage financial strain that can occur because of high medical payments and reduced income from employment interruption. Nurses can support patients and families by encouraging open communication during shared treatment decision making and throughout the cancer experience.
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December 1, 2017: Clinical Journal of Oncology Nursing
https://www.readbyqxmd.com/read/29149119/pain-management-strategies-for-screening-and-monitoring-patients-receiving-chronic-opioid-therapy%C3%A2
#9
Karen Hande
The current state of pain management within the oncology setting, effectiveness of opioids for the relief of pain, and limited alternatives for chronic pain management have produced reliance on opioid medications with an inherent risk for aberrant behavior. Although standardization is lacking among prescribers who manage cancer-related pain, advanced practice RNs must act according to the available evidence that suggests assessing and monitoring for abuse and misuse. 
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December 1, 2017: Clinical Journal of Oncology Nursing
https://www.readbyqxmd.com/read/29149020/role-of-transforming-growth-factor-%C3%AE-in-uterine-fibroid-biology
#10
REVIEW
Michał Ciebiera, Marta Włodarczyk, Małgorzata Wrzosek, Błażej Męczekalski, Grażyna Nowicka, Krzysztof Łukaszuk, Magdalena Ciebiera, Aneta Słabuszewska-Jóźwiak, Grzegorz Jakiel
Uterine fibroids (UFs) are benign tumors of the female genital tract made of the smooth muscle of the uterus. UF growth depends mostly on the influence of the steroid hormones and selected growth factors. Transforming growth factor β (TGF-βs) is a polypeptide that consists of three isoforms: TGF-β1, TGF-β2, and TGF-β3. At present, TGF-β is considered to be one of the key factors in the pathophysiology of UFs. It plays a major role in cellular migration within the tumor, stimulates tumor growth, and enhances tumor metabolism...
November 17, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/29148955/experience-of-tubo-ovarian-abscess-a-retrospective-clinical-analysis-of-318-patients-in-a-single-tertiary-center-in-middle-turkey
#11
Zeynep Ozturk Inal, Hasan Ali Inal, Umit Gorkem
BACKGROUND: The objective was to identify the clinical and laboratory parameters, ultrasonographic (USG) morphology, and to predict surgical treatment for patients with tubo-ovarian abscess (TOA). PATIENTS AND METHODS: Data for a total of 318 patients with a diagnosis of TOA between January 2005 and December 2016 were analyzed retrospectively at a referral center in Turkey. Patients requiring surgical treatment were compared with those who did not with respect to demographic characteristics and clinical, USG, and laboratory findings...
November 17, 2017: Surgical Infections
https://www.readbyqxmd.com/read/29148899/patients-with-cranial-dural-arteriovenous-fistulas-may-benefit-from-expanded-hypercoagulability-and-cancer-screening
#12
Sean P Polster, Hussein A Zeineddine, Joseph Baron, Seon-Kyu Lee, Issam A Awad
OBJECTIVE Cranial dural arteriovenous fistulas (DAVFs) have been associated with dural sinus occlusion, and previous reports have suggested the association of hypercoagulability with some cases. But the prevalence of a hypercoagulable state has not been systematically analyzed in conjunction with laboratory markers and clinical manifestations, including history of thromboembolism or systemic malignancy. The authors hypothesize that laboratory or clinical evidence of a hypercoagulable state, including cancer, is commonly identifiable in consecutively identified patients with DAVFs, with implications for clinical management...
November 17, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29148856/novel-applications-for-serum-procalcitonin-testing-in-clinical-practice
#13
Justin J Choi, Matthew W McCarthy
Procalcitonin has emerged as a reliable marker of acute bacterial infection in hospitalized patients and the assay has recently been incorporated into several clinical algorithms to reduce antimicrobial overuse, but its use in patients with end-organ dysfunction is controversial. Areas covered: In this review, the authors examine what is known about procalcitonin testing in patients with organ dysfunction, including those with end-stage renal disease, congestive heart failure, chronic obstructive pulmonary disease, and cirrhosis, and explore how the assay is now being used in the management of non-infectious diseases...
November 17, 2017: Expert Review of Molecular Diagnostics
https://www.readbyqxmd.com/read/29148329/the-implementation-of-performance-management-systems-in-u-s-physician-organizations
#14
Alexander F Pimperl, Hector P Rodriguez, Julie A Schmittdiel, Stephen M Shortell
Performance management systems (PMSYS) aid in improving the quality and efficiency of care, but little is known about factors that influence more robust PMSYS among physician organizations. Using a nationally representative survey of U.S. medical practices, we examined the extent to which organizational capabilities and external factors were associated with more developed PMSYS. Linear regression estimated the relative impact of these factors on PMSYS. On average, practices implemented a minority (32 points out of 100) of the PMSYS processes assessed...
March 1, 2017: Medical Care Research and Review: MCRR
https://www.readbyqxmd.com/read/29148179/clinical-implications-of-de-barsy-syndrome
#15
Lindsay L Warner, David A Olsen, Hugh M Smith
BACKGROUND: De Barsy syndrome is a rare, autosomal recessive syndrome characterized by cutis laxa, progeroid appearance, ophthalmic opacification, skeletal malformations, growth delays, and intellectual disability. AIMS: The aim of this case series is to identify the anesthetic considerations in the clinical management of patients with de Barsy syndrome. METHODS: A retrospective case review from 1968 to 2016 was performed at a single tertiary medical center to identify patients with de Barsy syndrome who underwent anesthesia for diagnostic and surgical procedures...
November 17, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29148155/identifying-biomechanical-gait-parameters-in-adolescent-boys-with-haemophilia-using-principal-component-analysis
#16
L B Suckling, D Stephensen, M C Cramp, R Mahaffey, W I Drechsler
INTRODUCTION: Improvements in the medical management for those with haemophilia have resulted in improved clinical outcomes. However, current treatment regimens do not alleviate all joint haemarthroses with the potential for long-term joint deterioration remaining. The evaluation of functional activities such as gait, using standardized tools to monitor children with haemophilia is emerging. AIM: This study explored differences in sagittal plane biomechanics of walking in adolescent boys aged 11-18 years with haemophilia and an age-matched group of typically developing boys...
November 17, 2017: Haemophilia: the Official Journal of the World Federation of Hemophilia
https://www.readbyqxmd.com/read/29147890/food-allergy-in-children-an-overview
#17
REVIEW
Jaidev M Devdas, Christopher Mckie, Adam T Fox, Vinod H Ratageri
The estimated prevalence of food allergy amongst children in the west is around 6-8% but there is paucity of data in the Indian population. There is a complex interplay of environmental influences and genetic factors in the immuno-pathogenesis and manifestations of food allergy. A reliable thorough clinical history, combined with positive skin prick tests or food-specific IgE, is essential for a more precise diagnosis of food allergy. Currently there is no cure for food allergy. The management of food allergy usually includes strict avoidance, patient education and provision of emergency medication (adrenaline-autoinjectors)...
November 17, 2017: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/29147878/knowledge-gaps-in-the-management-of-postoperative-crohn-s-disease-a-us-national-survey
#18
Vu Q Nguyen, Jessica L Mays, Marissa Lang, Yingxing Wu, Themistocles Dassopoulos, Miguel Regueiro, Alan Moss, Deborah D Proctor, Dario Sorrentino
BACKGROUND: Postoperative recurrence (POR) of Crohn's disease (CD) is common. Guidelines on POR management have recently been issued, but clinical practice may vary. AIMS: To examine the current clinical practice of POR management in the USA METHODS: A web-based survey was sent to all members of the American Gastroenterological Association and the American College of Gastroenterology. The survey consisted of multiple-choice questions with clinical scenarios to assess how participants manage POR...
November 17, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/29147757/prospective-evaluation-of-co2-laser-assisted-sclerectomy-surgery-class-with-mitomycin-c
#19
Carlo Alberto Cutolo, Alessandro Bagnis, Riccardo Scotto, Chiara Bonzano, Carlo Enrico Traverso
PURPOSE: Our purpose was to evaluate the clinical safety and efficacy of CO2 laser-assisted sclerectomy surgery (CLASS) with Mitomycin C (MMC) in open angle glaucoma (OAG). METHODS: This was a prospective, uncontrolled, interventional case series. All subjects underwent CLASS procedure by a single surgeon. After the dissection of a partial thickness scleral flap, topical MMC 0.2 mg/ml was applied to the sclera and the conjunctiva for 3 min. The CO2 laser with a beam-manipulating system was used to ablate the scleral tissue and expose the Schlemm's canal area...
November 17, 2017: Graefe's Archive for Clinical and Experimental Ophthalmology
https://www.readbyqxmd.com/read/29147676/characteristics-of-very-young-hispanic-children-referred-for-obesity-management
#20
Liliana Aguayo, Alicia Olave-Pichon, Adolfo J Ariza, Helen J Binns
Information on risks associated with obesity during infancy specific to Hispanic children is scarce. This retrospective medical record review describes characteristics and parenting practices of Hispanic children age <2 years referred for obesity care at a tertiary hospital over a 6-year period. Data on 29 Hispanic children collected from parent-completed assessment forms and clinician documentation were analyzed. Children were of mean age 16.2 ± 4.9 months; body mass index z scores ranged from 1.5 to 9...
2017: Global Pediatric Health
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