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https://www.readbyqxmd.com/read/28644780/avoiding-racial-essentialism-in-medical-science-curricula
#1
Lundy Braun, Barry Saunders
A wave of medical student activism is shining a spotlight on medical educators' sometimes maladroit handling of racial categories in teaching about health disparities. Coinciding with recent critiques, primarily by social scientists, regarding the imprecise and inappropriate use of race as a biological or epidemiological risk factor in genetics research, medical student activism has triggered new collaborations among students, faculty, and administrators to rethink how race is addressed in the medical curriculum...
June 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/28640946/physicians-non-uniform-approach-to-prescribing-drugs-to-older-patients-a-qualitative-study
#2
Line Due Christensen, Janne Petersen, Ove Andersen, Susanne Kaae
Multi-morbidity and polypharmacy are common in older patients and increase their susceptibility to adverse drug events and hospitalizations. Rational drug prescription is critical, however, little is known about physicians' perspectives on how to prescribe drugs for older patients. The aim of this study was to explore physicians' approach to prescribe drugs to older patients, including identifying the drugs that physicians perceive to be risk drugs for older patients and comparing them with established lists of potentially inappropriate medications...
June 22, 2017: Basic & Clinical Pharmacology & Toxicology
https://www.readbyqxmd.com/read/28636498/a-novel-clinical-simulated-suture-education-for-basic-surgical-skill-suture-on-the-biological-tissue-fixed-on-standardized-patient-evaluated-with-objective-structured-assessment-of-technical-skill-osats-tools
#3
Zhanlong Shen, Fan Yang, Pengji Gao, Li Zeng, Guanchao Jiang, Shan Wang, Yingjiang Ye, Fengxue Zhu
BACKGROUND: Clinical-simulated training has shown benefit in the education of medical students. However, the role of clinical simulation for surgical basic skill training such as suturing techniques remains unclear. MATERIALS AND METHODS: Forty-two medical students were asked to perform specific suturing tasks at three stations with the different settings within four minutes (Station 1: Synthetic suture pad fixed on the bench, Station 2: Synthetic suture pad fixed on the standardized patient, Station 3: Pig skin fixed on the standardized patient); the OSATS (Objective Structured Assessment of Technical Skill) tool was used to evaluate the performance of students...
June 21, 2017: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
https://www.readbyqxmd.com/read/28634909/categorical-risk-perception-drives-variability-in-antibiotic-prescribing-in-the-emergency-department-a-mixed-methods-observational-study
#4
Eili Y Klein, Elena M Martinez, Larissa May, Mustapha Saheed, Valerie Reyna, David A Broniatowski
BACKGROUND: Adherence to evidence-based antibiotic therapy guidelines for treatment of upper respiratory tract infections (URIs) varies widely among clinicians. Understanding this variability is key for reducing inappropriate prescribing. OBJECTIVE: To measure how emergency department (ED) clinicians' perceptions of antibiotic prescribing risks affect their decision-making. DESIGN: Clinician survey based on fuzzy-trace theory, a theory of medical decision-making, combined with retrospective data on prescribing outcomes for URI/pneumonia visits in two EDs...
June 20, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28634655/effect-of-adherence-on-pharmacokinetic-pharmacodynamic-relationships-of-oral-targeted-anticancer-drugs
#5
Evelina Cardoso, Chantal Csajka, Marie P Schneider, Nicolas Widmer
The emergence of oral targeted anticancer agents transformed several cancers into chronic conditions with a need for long-term oral treatment. Although cancer is a life-threatening condition, oncology medication adherence-the extent to which a patient follows the drug regimen that is intended by the prescriber-can be suboptimal in the long term, as in any other chronic disease. Poor adherence can impact negatively on clinical outcomes, notably because most of these drugs are given as a standard non-individualized dosage despite marked inter-individual variabilities that can lead to toxic or inefficacious drug concentrations...
June 20, 2017: Clinical Pharmacokinetics
https://www.readbyqxmd.com/read/28632283/the-impact-of-whole-genome-sequencing-on-the-primary-care-and-outcomes-of-healthy-adult-patients-a-pilot-randomized-trial
#6
Jason L Vassy, Kurt D Christensen, Erica F Schonman, Carrie L Blout, Jill O Robinson, Joel B Krier, Pamela M Diamond, Matthew Lebo, Kalotina Machini, Danielle R Azzariti, Dmitry Dukhovny, David W Bates, Calum A MacRae, Michael F Murray, Heidi L Rehm, Amy L McGuire, Robert C Green
Background: Whole-genome sequencing (WGS) in asymptomatic adults might prevent disease but increase health care use without clinical value. Objective: To describe the effect on clinical care and outcomes of adding WGS to standardized family history assessment in primary care. Design: Pilot randomized trial. (ClinicalTrials.gov: NCT01736566). Setting: Academic primary care practices. Participants: 9 primary care physicians (PCPs) and 100 generally healthy patients recruited at ages 40 to 65 years...
June 27, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28630771/polypharmacy-among-underserved-older-african-american-adults
#7
Mohsen Bazargan, James Smith, Masoud Movassaghi, David Martins, Hamed Yazdanshenas, Seyede Salehe Mortazavi, Gail Orum
The purpose of the present study was to examine correlates of polypharmacy among underserved community-dwelling older African American adults. Methods. This study recruited 400 underserved older African Americans adults living in South Los Angeles. The structured face-to-face interviews collected data on participants' characteristics and elicited data pertaining to the type, frequency, dosage, and indications of all medications used by participants. Results. Seventy-five and thirty percent of participants take at least five and ten medications per day, respectively...
2017: Journal of Aging Research
https://www.readbyqxmd.com/read/28630690/incidence-and-risk-factors-for-surgical-site-infections-in-obstetric-and-gynecological-surgeries-from-a-teaching-hospital-in-rural-india
#8
Ashish Pathak, Kalpana Mahadik, Manmat B Swami, Pulak K Roy, Megha Sharma, Vijay K Mahadik, Cecilia Stålsby Lundborg
BACKGROUND: Surgical site infections (SSI) are one of the most common healthcare associated infections in the low-middle income countries. Data on incidence and risk factors for SSI following surgeries in general and Obstetric and Gynecological surgeries in particular are scare. This study set out to identify risk factors for SSI in patients undergoing Obstetric and Gynecological surgeries in an Indian rural hospital. METHODS: Patients who underwent a surgical procedure between September 2010 to February 2013 in the 60-bedded ward of Obstetric and Gynecology department were included...
2017: Antimicrobial Resistance and Infection Control
https://www.readbyqxmd.com/read/28629675/misdiagnosis-is-an-important-factor-for-diagnostic-delay-in-mcardle-disease
#9
Renata Siciliani Scalco, Jasper M Morrow, Suzanne Booth, Sherryl Chatfield, Richard Godfrey, Ros Quinlivan
Diagnosis of McArdle disease is frequently delayed by many years following the first presentation of symptoms to a health professional. The aim of this study was to investigate the importance of misdiagnosis in delaying diagnosis of McArdle disease. The frequency of misdiagnosis, duration of diagnostic delay, categories of misdiagnoses and inappropriate medical interventions were assessed in 50 genetically confirmed patients. The results demonstrated a high frequency of misdiagnosis (90%, n = 45/50) most commonly during childhood years (67%; n = 30/45) compared with teenage years and adulthood (teenage: n = 7/45; adult n = 5/45; not known n = 3/45)...
May 3, 2017: Neuromuscular Disorders: NMD
https://www.readbyqxmd.com/read/28625936/do-medical-french-students-know-how-to-properly-score-a-mini-mental-state-examination
#10
Intza Hernandorena, Sophie Chauvelier, Jean-Sébastien Vidal, Matthieu Piccoli, Joséphine Coulon, Laurence Hugonot-Diener, Anne-Sophie Rigaud, Olivier Hanon, Emmanuelle Duron
The mini mental state examination (MMSE) is a validated tool to assess global cognitive function. Training is required before scoring. Inaccurate scoring can lead to inappropriate medical decisions. In France, MMSE is usually scored by medical students. To assess if medical French students know how to properly score a mini mental state examination. Two « physician-patient » role playings performed by 2 specialized physicians, were performed in front of University Paris V medical students. Role playing A: Scoring of a MMSE according to a script containing five tricks; Role playing B: Find the 5 errors committed in a pre-filled MMSE form, according to the second script...
June 1, 2017: Gériatrie et Psychologie Neuropsychiatrie du Vieillissement
https://www.readbyqxmd.com/read/28625935/evaluation-of-prescription-along-three-health-care-periods-in-the-elderly
#11
Fannie Santoni, Valéry Antoine, Alberto di Castri, Maurice Viala, Laetitia Geronimi-Robelin, Cédric LeGuillou, Christine de Taddeo, Sophie Bastide, Claude Jeandel, Benoit de Wazieres
Polypharmacy, potentially inappropriate prescriptions and inadequate coordination between prescribers are among main factors explaining the occurrence of adverse drug events in elderly patients. Prospective and descriptive study of medication prescriptions for elderly patients during a continuous period of health-care: entry in an acute geriatric unit (T1), at discharge (T2) and two months after hospitalization (T3). A global iatrogenic risk was defined: presence of poly-pharmacy and/or PPI (Laroche criteria) and/or absence of quality indicators for prescription according to the French health authority...
June 1, 2017: Gériatrie et Psychologie Neuropsychiatrie du Vieillissement
https://www.readbyqxmd.com/read/28624864/the-clinical-significance-of-pneumonia-in-patients-with-respiratory-specimens-harbouring-multidrug-resistant-pseudomonas-aeruginosa-a-5-year-retrospective-study-following-5667-patients-in-four-general-icus
#12
B Borgatta, S Gattarello, C A Mazo, A T Imbiscuso, M N Larrosa, M Lujàn, J Rello
Pseudomonas aeruginosa is the leading cause of pneumonia in intensive care units (ICUs), with multidrug-resistant (MDR) strains posing a serious threat. The aim of this study was to assess the clinical relevance of MDR Pseudomonas isolates in respiratory clinical specimens. A 5-year retrospective observational study in four medical-surgical ICUs from a referral hospital was carried out. Of 5667 adults admitted to the ICU, 69 had MDR-PA in respiratory samples: 31 were identified as having pneumonia (HAP/VAP): 21 ventilator-associated pneumonia (VAP) and ten hospital-acquired pneumonia (HAP)...
June 17, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28622741/characterization-of-guideline-evidence-for-off-label-medication-use-in-the-intensive-care-unit
#13
Bethany R Shoulders, Pamela L Smithburger, Stephanie Tchen, Mitchell Buckley, Ishaq Lat, Sandra L Kane-Gill
BACKGROUND: Non-Food and Drug Administration (FDA) or off-label medication prescribing occurs commonly in the intensive care unit (ICU). Off-label medication use creates a concern for untoward adverse effects; however, this worry may be alleviated by supportive literature. OBJECTIVE: To evaluate the evidence behind off-label medication use by determining the presence of guideline support and compare graded recommendations to an online tertiary resource, DRUGDEX...
July 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28622159/weeding-out-the-justification-for-marijuana-treatment-in-patients-with-developmental-and-behavioral-conditions
#14
Theodora Nelson, Yi Hui Liu, Kara S Bagot, Martin T Stein
Alex is a 13-year-old adolescent with high-functioning autism spectrum disorder, attention-deficit/hyperactivity disorder (ADHD)-combined type, anxiety, and depression. He has been resistant to engaging in therapy and treatment with various medications has been unsuccessful. Alex's parents are concerned about his anxiety, isolation, oppositional behaviors, academic underachievement, truancy, and substance use. A recent altercation with his stepfather led to a police intervention and a brief removal of Alex from the home...
June 15, 2017: Journal of Developmental and Behavioral Pediatrics: JDBP
https://www.readbyqxmd.com/read/28619704/applying-stopp-guidelines-in-primary-care-through-electronic-medical-record-decision-support-randomized-control-trial-highlighting-the-importance-of-data-quality
#15
Morgan Price, Iryna Davies, Raymond Rusk, Mary Lesperance, Jens Weber
BACKGROUND: Potentially Inappropriate Prescriptions (PIPs) are a common cause of morbidity, particularly in the elderly. OBJECTIVE: We sought to understand how the Screening Tool of Older People's Prescriptions (STOPP) prescribing criteria, implemented in a routinely used primary care Electronic Medical Record (EMR), could impact PIP rates in community (non-academic) primary care practices. METHODS: We conducted a mixed-method, pragmatic, cluster, randomized control trial in research naïve primary care practices...
June 15, 2017: JMIR Medical Informatics
https://www.readbyqxmd.com/read/28619632/enhancing-prostate-cancer-survivorship-care-through-self-management
#16
REVIEW
Ted A Skolarus, Daniela Wittmann, Sarah T Hawley
The lack of clear roles for prostate cancer survivorship care providers places prostate cancer survivors at significant risk of inappropriate use of services delivered piecemeal by different providers, persistent bothersome symptoms, and silent suffering. Optimizing quality of care for prostate cancer survivors hinges on decreasing fragmentation of care, and providing quality symptom management. This is achieved through comprehensive, appropriate medical, surgical, pharmacological and psychosocial care, coupled with self-management, as highlighted in several recent resources addressing long-term and late effects of treatment...
June 13, 2017: Urologic Oncology
https://www.readbyqxmd.com/read/28618875/implementation-of-guideline-based-therapy-for-chronic-obstructive-pulmonary-disease-differences-between-men-and-women-veterans
#17
Seppo T Rinne, A Rani Elwy, Chuan-Fen Liu, Renda Soylemez Wiener, Lisa Thayer, Alexandra Gerity, Lori A Bastian
Chronic obstructive pulmonary disease (COPD) is common among both men and women, and guidelines recommend the same therapy for both sexes. While previous studies have identified gender differences in other chronic disease management, few studies have examined how implementation of COPD guidelines differs between men and women. We performed a cross-sectional study of veterans admitted to Veterans Affairs (VA) hospitals for COPD during October 1, 2008, to September 30, 2011. We collected information on baseline COPD medications during the 6 months prior to hospitalization and categorized therapies as "appropriate" or "inappropriate" based on current guidelines...
January 1, 2017: Chronic Respiratory Disease
https://www.readbyqxmd.com/read/28618696/re-effect-of-potentially-inappropriate-use-of-antimuscarinic-medications-on-healthcare-use-and-cost-in-individuals-with-overactive-bladder
#18
Tomas L Griebling
No abstract text is available yet for this article.
July 2017: Journal of Urology
https://www.readbyqxmd.com/read/28618134/potentially-inappropriate-use-of-furosemide-in-a-very-elderly-population-an-observational-study
#19
Carla Rodriguez-Cillero, Didier Menu, Philippe d'Athis, Sophie Perrin, Mélanie Dipanda, Sanaa Asgassou, Hélène Guepet, Emmanuel Mazen, Patrick Manckoundia, Alain Putot
OBJECTIVE: Little is known about furosemide prescription modalities in elderly people. We describe furosemide prescription in ambulatory elderly patients. METHODS: All patients aged over 80 years, affiliated to Mutualité Sociale Agricole de Bourgogne, a French regional health insurance plan, with a medical prescription delivered in March 2015, were retrospectively included. RESULTS: Among 15 141 patients with a median age of 86 years, comprising 61...
June 15, 2017: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/28618102/factors-contributing-to-serious-adverse-events-in-nursing-homes
#20
Åsa Andersson, Catharina Frank, Ania M L Willman, Per-Olof Sandman, Görel Hansebo
AIMS AND OBJECTIVES: The aim of this study was to identify the most common serious adverse events that occurred in nursing homes and their most frequent contributing factors to contribute to improvement of safe nursing care. BACKGROUND: There is a need to improve safe nursing care in nursing homes. Residents are often frail and vulnerable with extensive needs for nursing care. A relatively minor adverse event in nursing care can cause serious injury that could have been preventable...
June 15, 2017: Journal of Clinical Nursing
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