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https://www.readbyqxmd.com/read/29679728/magnetic-resonance-imaging-of-the-lumbar-spine-determining-clinical-impact-and-potential-harm-from-overuse
#1
Nathan M Wnuk, Tarik K Alkasab, Daniel I Rosenthal
BACKGROUND: Lumbar spine MRI is frequently said to be "overused" in the evaluation of low-back pain, yet data concerning the extent of overuse and on potential harmful effects are lacking. PURPOSE: To determine the proportion of examinations with a detectable impact on patient care (actionable outcomes). STUDY DESIGN: Retrospective cohort study PATIENT SAMPLE: 5,365 outpatient lumbar spine MR examinations OUTCOME MEASURES: Actionable outcomes included: 1) findings leading to an intervention making use of anatomical information such as surgery; 2) new diagnoses of cancer, infection, or fracture; or 3) following known lumbar spine pathology...
April 18, 2018: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29679167/hot-joints-myth-or-reality-a-thermographic-joint-assessment-of-inflammatory-arthritis-patients
#2
Britney Jones, Imran Hassan, Ross T Tsuyuki, Marla Francisca Dos Santos, A S Russell, Elaine Yacyshyn
Rheumatoid arthritis is a common inflammatory disease that causes destruction of joints. Accurate recognition of active disease has significant implications in determining appropriate treatment; however, there is significant inter-rater variability in clinical joint assessment. This study aimed to assess the utility of thermographic imaging in the evaluation of inflammatory arthritis activity as an adjunct to clinical assessment. This was a cross-sectional study of 79 subjects recruited from the University of Alberta Outpatient Rheumatology clinic comparing the hand joints of 49 patients with rheumatoid arthritis (RA) diagnosed by American College of Rheumatology (ACR) criteria to 30 healthy volunteers...
April 20, 2018: Clinical Rheumatology
https://www.readbyqxmd.com/read/29678564/prescription-medication-use-among-community-based-us-adults-with-chronic-low-back-pain-a-cross-sectional-population-based-study
#3
Anna Shmagel, Linh Ngo, Kristine Ensrud, Robert Foley
Many classes of medications have been evaluated in chronic low back pain (cLBP), however their utilization in the community remains unclear. We examine patterns of prescription medication use among Americans with cLBP in a nationally representative, community-based sample. The Back Pain Survey was administered to a representative sample of US adults aged 20-69 (N = 5103) during the 2009-2010 cycle of the National Health and Nutrition Examination Survey (NHANES). cLBP was defined as self-reported pain in the area between the lower posterior margin of the ribcage and the horizontal gluteal fold on most days for at least 3 months (N = 700)...
April 17, 2018: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/29677401/opportunistic-journals-in-the-clinical-pharmacology-space-a-policy-statement-from-the-publications-and-public-policy-committees-of-the-american-college-of-clinical-pharmacology
#4
David J Greenblatt, Joseph S Bertino
No abstract text is available yet for this article.
May 2018: Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29677400/opportunistic-journals-in-the-clinical-pharmacology-space-a-policy-statement-from-the-publications-and-public-policy-committees-of-the-american-college-of-clinical-pharmacology
#5
David J Greenblatt, Joseph S Bertino
No abstract text is available yet for this article.
May 2018: Clinical Pharmacology in Drug Development
https://www.readbyqxmd.com/read/29677265/addressing-social-determinants-to-improve-patient-care-and-promote-health-equity-an-american-college-of-physicians-position-paper
#6
Hilary Daniel, Sue S Bornstein, Gregory C Kane
Social determinants of health are nonmedical factors that can affect a person's overall health and health outcomes. Where a person is born and the social conditions they are born into can affect their risk factors for premature death and their life expectancy. In this position paper, the American College of Physicians acknowledges the role of social determinants in health, examines the complexities associated with them, and offers recommendations on better integration of social determinants into the health care system while highlighting the need to address systemic issues hindering health equity...
April 17, 2018: Annals of Internal Medicine
https://www.readbyqxmd.com/read/29676663/perceived-environmental-barriers-and-behavioral-factors-as-possible-mediators-between-acculturation-and-leisure-time-physical-activity-among-mexican-american-adults
#7
Carla L Dellaserra, Noe C Crespo, Michael Todd, Jennifer Huberty, Sonia Vega-López
BACKGROUND: The association between acculturation and physical activity (PA) among Mexican American (MA) adults is not understood. This study assessed potential mediating factors that may explain these associations among 75 healthy MA adults [age: 37.5 (9.3) y; 65.3% female]. METHODS: Secondary data analysis using hierarchical logistic regression examined whether perceived environmental barriers, social support, and intention to exercise potentially mediated relationships between acculturation level, and total and leisure-time moderate to vigorous PA (MVPA)...
April 20, 2018: Journal of Physical Activity & Health
https://www.readbyqxmd.com/read/29676517/impact-of-changes-in-inflammation-on-estimated-10-year-cardiovascular-risk-in-rheumatoid-arthritis
#8
Zhi Yu, Nicole Yang, Brendan M Everett, Michelle Frits, Christine Iannaccone, Jonathan Coblyn, Michael Weinblatt, Nancy Shadick, Daniel H Solomon, Katherine P Liao
BACKGROUND: Validated cardiovascular (CV) risk estimates were developed in populations with relatively stable inflammatory levels. In rheumatoid arthritis (RA), patients routinely experience significant changes in inflammation. We tested whether changes in inflammation impact estimated CV risk as measured using validated population-based risk calculators. METHODS: We studied participants in a prospective RA cohort. We included participants who experienced a decrease (CRP decrease group) or increase (CRP increase group) of ≥10mg/L in C-reactive protein (CRP) at 2 consecutive time points, 1 year apart...
April 20, 2018: Arthritis & Rheumatology
https://www.readbyqxmd.com/read/29674110/resident-specific-morbidity-reduced-following-acs-nsqip-data-driven-quality-program
#9
Florence E Turrentine, John B Hanks, Megan C Tracci, R Scott Jones, Bruce D Schirmer, Philip W Smith
BACKGROUND: The Accreditation Council for Graduate Medical Education Milestone Project for general surgery provided a more robust method for developing and tracking residents' competence. This framework enhanced systematic and progressive development of residents' competencies in surgical quality improvement. STUDY DESIGN: A 22-month interactive, educational program based on resident-specific surgical outcomes data culminated in a quality improvement project for postgraduate year 4 surgery residents...
April 16, 2018: Journal of Surgical Education
https://www.readbyqxmd.com/read/29674107/the-economics-of-private-practice-versus-academia-in-surgery
#10
Maria Baimas-George, Brian Fleischer, James R Korndorffer, Douglas Slakey, Christopher DuCoin
OBJECTIVE: Residents often make career decisions regarding future practice without adequate knowledge to the realities of professional life. Currently there is a paucity of data regarding economic differences between practice models. This study seeks to illuminate the financial differences of surgical subspecialties between academic and private practice. DESIGN: Data were collected from the Association of American Medical College (AAMC) and the Medical Group Management Association's (MGMA) 2015 reports of average annual salaries...
April 16, 2018: Journal of Surgical Education
https://www.readbyqxmd.com/read/29673997/breast-lesion-shape-and-margin-evaluation-bi-rads-based-metrics-understate-radiologists-actual-levels-of-agreement
#11
Mohammad Rawashdeh, Sarah Lewis, Maha Zaitoun, Patrick Brennan
BACKGROUND: While there is much literature describing the radiologic detection of breast cancer, there are limited data available on the agreement between experts when delineating and classifying breast lesions. The aim of this work is to measure the level of agreement between expert radiologists when delineating and classifying breast lesions as demonstrated through Breast Imaging Reporting and Data System (BI-RADS) and quantitative shape metrics. METHODS: Forty mammographic images, each containing a single lesion, were presented to nine expert breast radiologists using a high specification interactive digital drawing tablet with stylus...
April 13, 2018: Computers in Biology and Medicine
https://www.readbyqxmd.com/read/29673571/the-effect-of-hospital-acuity-on-severe-maternal-morbidity-in-high-risk-patients
#12
Mark A Clapp, Kaitlyn E James, Anjali J Kaimal
BACKGROUND: In 2015, the Society for Maternal-Fetal Medicine and the American College of Obstetricians and Gynecologists published guidelines that established levels of maternal care. These guidelines outline the nursing, provider, and facility requirements for hospitals to be designated a birthing center or one of four levels of care. To-date, these levels of maternal care have not been widely adopted, and currently, no data exists on how these designations may affect maternal or neonatal outcomes...
April 16, 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29673570/pregnancy-and-parental-leave-among-obstetrics-and-gynecology-residents-results-of-a-nationwide-survey-of-program-directors
#13
Eduardo Hariton, Benjamin Matthews, Abigail Burns, Chitra Akileswaran, Lori R Berkowitz
INTRODUCTION: The health and economic benefits of paid parental leave have been well documented. In 2016, the American College of Obstetrics and Gynecology (ACOG) released a policy statement on recommended parental leave for trainees, yet, data on adoption of said guidelines is nonexistent and published data on parental leave policies in Ob-Gyn is outdated. The objective of our study is to understand existing parental leave policies in Ob-Gyn training programs and to evaluate program director opinions on these policies and on parenting in residency...
April 16, 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29673304/asian-american-women-s-victimization-history-and-in-the-moment-responses-to-partner-violence
#14
Hong V Nguyen, Rebecca L Schacht, Joyce P Yang, William H George, David W Pantalone
Between 20% and 50% of Asian American women report experiencing partner violence (PV). Furthermore, nearly half of PV victims experience their first assault between the age of 18 and 24 years, suggesting that Asian American college women may be particularly at risk of PV. Experiencing childhood abuse (CA) may impair women's capacity to perceive risk during a potential PV situation, increasing their risk for revictimization. The purpose of the current study was to examine differences among Asian American college women's ( N = 324) in-the-moment behavioral intention, risk perception, and likelihood to stay in an abusive relationship during a progressively threatening PV scenario, based on victimization history and posttraumatic stress disorder (PTSD) symptoms...
April 1, 2018: Journal of Interpersonal Violence
https://www.readbyqxmd.com/read/29673080/systemic-sclerosis-and-malignancy
#15
Gokhan Sargin, Taskin Senturk, Songul Cildag
BACKGROUND: Systemic sclerosis (SSc) has increased risk of morbidity and mortality due to pulmonary fibrosis, pulmonary arterial hypertension, renal crisis, infections and malignancies. Chemical exposure, smoking and cytotoxic drugs increase the malignancy risk in rheumatic diseases including SSc. We aim to evaluate characteristics, identify risk factors and mortality in SSc patients with malignancies. METHODS: One hundred and fifty-three patients with SSc (24 male, 129 female, with mean age of 56...
April 19, 2018: International Journal of Rheumatic Diseases
https://www.readbyqxmd.com/read/29672748/biopsychosocial-profiles-and-functional-correlates-in-older-adults-with-chronic-low-back-pain-a-preliminary-study
#16
Debra K Weiner, Angela Gentili, Katherine Coffey-Vega, Natalia Morone, Michelle Rossi, Subashan Perera
Objective: To describe key peripheral and central nervous system (CNS) conditions in a group of older adults with chronic low back pain (CLBP) and their association with pain severity and self-reported and performance-based physical function. Design: Cross-sectional. Setting: Outpatient VA clinics. Subjects: Forty-seven community-dwelling veterans with CLBP (age 68.0 ± 6.5 years, range = 60-88 years, 12.8% female, 66% white) participated...
April 16, 2018: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29672441/six-month-follow-up-of-the-injured-trauma-survivor-screen-itss-clinical-implications-and-future-directions
#17
Joshua C Hunt, Samantha A Chesney, Karen Brasel, Terri A deRoon-Cassini
BACKGROUND: The Injured Trauma Survivor Screen (ITSS) has been shown to predict PTSD and depression risk at one-month after traumatic injury. This study explored the ability of the ITSS to predict chronic distress after injury, as well as the impact of combining the ITSS with an additional screening measure. METHOD: Patients were enrolled following admission to a Level 1 trauma center. Baseline measurements were collected during initial hospitalization, and follow-up measures were collected an average of 6...
April 17, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29672380/the-american-college-of-surgeons-children-s-surgery-verification-and-quality-improvement-program-be-careful-what-you-wish-for
#18
James A DiNardo, Peter J Davis
No abstract text is available yet for this article.
May 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29672245/intimate-partner-violence-trauma-and-mental-health-need-among-female-community-college-students
#19
Rachel J Voth Schrag, Tonya E Edmond
The impact of interpersonal violence on college students has received considerable recent attention, yet no studies have been conducted among community college students. These students comprise over 40% of all American college students, and may have unique risk factors and needs. These students are more likely than their peers at 4 year institutions to be women, people of color, working, parenting, and first generation college students. The current study uses a simple random sample of students from four campuses (n = 435) to assess the extent of intimate partner violence, trauma exposure, sexual violence victimization, and associated mental health consequences among female students attending community college...
April 19, 2018: Journal of American College Health: J of ACH
https://www.readbyqxmd.com/read/29672234/transgender-college-students-academic-resilience-and-striving-to-cope-in-the-face-of-marginalized-health
#20
Jenna B Messman, Leigh A Leslie
OBJECTIVE: To examine health behavior and outcome disparities between transgender, female, and male participants in a national sample of US college students. Participants and Method Summary: Analyses utilized secondary data from 32,964 undergraduate and graduate students responding to the Fall 2013 American College Health Association-National College Health Assessment; 65.8% were female, 0.4% were transgender, 67.9% were white, and 90.4% were heterosexual. RESULTS: Transgender students reported more mental health diagnoses, trauma, and suicidality; experienced more violence and less safety, reported more sex partners and sexually transmitted infections (STIs); higher rates of illicit and non-prescription substance use and binge drinking use while engaging in less harm reduction behavior; and reported more barriers to academic success...
April 19, 2018: Journal of American College Health: J of ACH
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