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https://www.readbyqxmd.com/read/28938251/critical-illness-related-corticosteroid-insufficiency-circi-a-narrative-review-from-a-multispecialty-task-force-of-the-society-of-critical-care-medicine-sccm-and-the-european-society-of-intensive-care-medicine-esicm
#1
Djillali Annane, Stephen M Pastores, Wiebke Arlt, Robert A Balk, Albertus Beishuizen, Josef Briegel, Joseph Carcillo, Mirjam Christ-Crain, Mark S Cooper, Paul E Marik, Gianfranco Umberto Meduri, Keith M Olsen, Bram Rochwerg, Sophia C Rodgers, James A Russell, Greet Van den Berghe
OBJECTIVE: To provide a narrative review of the latest concepts and understanding of the pathophysiology of critical illness-related corticosteroid insufficiency (CIRCI). PARTICIPANTS: A multi-specialty task force of international experts in critical care medicine and endocrinology and members of the Society of Critical Care Medicine and the European Society of Intensive Care Medicine. DATA SOURCES: Medline, Database of Abstracts of Reviews of Effects (DARE), Cochrane Central Register of Controlled Trials (CENTRAL) and the Cochrane Database of Systematic Reviews...
September 21, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28924527/hepatitis-c-screening-the-downstream-dissemination-of-evolving-guidelines-in-a-resident-continuity-clinic
#2
Kamraan Madhani, Ali Aamar, David Chia
Background In 2012, the Centers for Disease Control and Prevention (CDC) published guidelines supporting one-time screening for hepatitis C (HCV) in all persons born between 1945 and 1965. It is estimated that 75% of adults infected with HCV fall within this cohort. Furthermore, it is projected that this preventative health intervention would lead to the diagnosis of 800,000 unknown cases and the prevention of 120,000 deaths. Objectives The primary objectives are to measure adherence to HCV screening in a continuity practice staffed by internal medicine residents and attending physicians and to measure the effect of educational interventions to enhance HCV screening...
July 7, 2017: Curēus
https://www.readbyqxmd.com/read/28918569/highlights-from-the-ninth-international-symposium-of-thrombosis-and-anticoagulation-ista-ix-october-15-2016-salvador-bahia-brazil
#3
REVIEW
Renato D Lopes, Patricia O Guimarães, Elaine Hylek, Gilson S Feitosa-Filho, Luiz Ritt, Nivaldo Filgueiras, Eduardo Darzé, Mario S Rocha, Luis P Magalhães, Antonio Carlos Sobral Sousa, Luis Claudio Correia, Lucas Hollanda Oliveira, David A Garcia
To discuss and share knowledge about advances in the care of patients with thrombotic disorders, the Ninth International Symposium of Thrombosis and Anticoagulation was held in Salvador, Bahia, Brazil, on October 15, 2016. This scientific program was developed by clinicians for clinicians and was promoted by two major clinical research institutes-the Brazilian Clinical Research Institute and the Duke Clinical Research Institute of the Duke University School of Medicine. Comprising academic presentations and open discussion, the symposium had as its primary goal to educate, motivate, and inspire internists, cardiologists, hematologists, and other physicians by convening national and international visionaries, thought-leaders, and dedicated clinician-scientists...
September 16, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28903746/correlation-between-patients-reasons-for-encounters-health-problems-and-population-density-in-japan-a-systematic-review-of-observational-studies-coded-by-the-international-classification-of-health-problems-in-primary-care-ichppc-and-the-international-classification
#4
Makoto Kaneko, Ryuichi Ohta, Naoki Nago, Motoharu Fukushi, Masato Matsushima
BACKGROUND: The Japanese health care system has yet to establish structured training for primary care physicians; therefore, physicians who received an internal medicine based training program continue to play a principal role in the primary care setting. To promote the development of a more efficient primary health care system, the assessment of its current status in regard to the spectrum of patients' reasons for encounters (RFEs) and health problems is an important step. Recognizing the proportions of patients' RFEs and health problems, which are not generally covered by an internist, can provide valuable information to promote the development of a primary care physician-centered system...
September 13, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28898197/urgent-need-for-improved-mental-health-care-and-a-more-collaborative-model-of-care
#5
James Lake, Mason Spain Turner
Current treatments and the dominant model of mental health care do not adequately address the complex challenges of mental illness, which accounts for roughly one-third of adult disability globally. These circumstances call for radical change in the paradigm and practices of mental health care, including improving standards of clinician training, developing new research methods, and re-envisioning current models of mental health care delivery. Because of its dominant position in the US health care marketplace and its commitment to research and innovation, Kaiser Permanente (KP) is strategically positioned to make important contributions that will shape the future of mental health care nationally and globally...
2017: Permanente Journal
https://www.readbyqxmd.com/read/28889110/european-respiratory-society-guidelines-for-the-management-of-adult-bronchiectasis
#6
Eva Polverino, Pieter C Goeminne, Melissa J McDonnell, Stefano Aliberti, Sara E Marshall, Michael R Loebinger, Marlene Murris, Rafael Cantón, Antoni Torres, Katerina Dimakou, Anthony De Soyza, Adam T Hill, Charles S Haworth, Montserrat Vendrell, Felix C Ringshausen, Dragan Subotic, Robert Wilson, Jordi Vilaró, Bjorn Stallberg, Tobias Welte, Gernot Rohde, Francesco Blasi, Stuart Elborn, Marta Almagro, Alan Timothy, Thomas Ruddy, Thomy Tonia, David Rigau, James D Chalmers
Bronchiectasis in adults is a chronic disorder associated with poor quality of life and frequent exacerbations in many patients. There have been no previous international guidelines.The European Respiratory Society guidelines for the management of adult bronchiectasis describe the appropriate investigation and treatment strategies determined by a systematic review of the literature.A multidisciplinary group representing respiratory medicine, microbiology, physiotherapy, thoracic surgery, primary care, methodology and patients considered the most relevant clinical questions (for both clinicians and patients) related to management of bronchiectasis...
September 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/28877256/medication-and-supplement-use-in-older-people-with-and-without-intellectual-disability-an-observational-cross-sectional-study
#7
Jure Peklar, Mitja Kos, Máire O'Dwyer, Mary McCarron, Philip McCallion, Rose Anne Kenny, Martin C Henman
INTRODUCTION: Understanding the medication and supplement use of aging people is critical to ensuring that health service providers in primary care can optimise use of these agents. An increasing number of people with different levels of intellectual disability (ID) are living in the community and becoming for the first time substantial users of primary health care services. This, however, brings new challenges that need to be addressed at the primary health care level. We quantified the use of medicines and food supplements and described the associated patterns of morbidity in the two comparable cohorts of aging population with and without intellectual disability...
2017: PloS One
https://www.readbyqxmd.com/read/28876427/geographical-distribution-of-medical-graduates-from-a-public-university
#8
Oscarina da Silva Ezequiel, Giancarlo Lucchetti, Alessandra Lamas Granero Lucchetti, Maria Helena Senger, Lucas Braga, Rafael Lacerda, Marlon Filippo, Fernando Colugnati, Danette McKinley, Eliana Amaral
Objective: To evaluate the geographic distribution and career trajectory of medical graduates and the factors associated with their choice of practice location. Method: A cross-sectional study involving graduates from December 2001 to December 2010 was conducted. A self-administered questionnaire collected demographics and geographic information (place of birth, place of residence at the time of medical school admission, place of residency training and practice location), and reason for choosing the current location...
June 2017: Revista da Associação Médica Brasileira
https://www.readbyqxmd.com/read/28876424/evaluation-of-medical-interns-attitudes-towards-relevant-aspects-of-medical-practice
#9
Áquila Talita Lima Santana Alves, Fernando Vinicius Alves, Enaldo Vieira Melo, Edméa Fontes de Oliva-Costa
Introduction: In traditional medical school curriculum, sixth-year is the moment in which students experience medical practice more intensively. Attitudes can be considered predictors of behaviors and actions. Evaluating them contributes to improve medical training. Objective: To evaluate attitudes during medical internship considering medical practice and associated factors in a Brazilian public university. Method: Cross-sectional study that included 69 students, based on a structured questionnaire and an attitude scale (Colares, 2002)...
June 2017: Revista da Associação Médica Brasileira
https://www.readbyqxmd.com/read/28874939/rapid-primary-care-follow-up-from-the-ed-to-reduce-avoidable-hospital-admissions
#10
Amanda S Carmel, Peter Steel, Robert Tanouye, Aleksey Novikov, Sunday Clark, Sanjai Sinha, Judy Tung
INTRODUCTION: Hospital admissions from the emergency department (ED) now account for approximately 50% of all admissions. Some patients admitted from the ED may not require inpatient care if outpatient care could be optimized. However, access to primary care especially immediately after ED discharge is challenging. Studies have not addressed the extent to which hospital admissions from the ED may be averted with access to rapid (next business day) primary care follow-up. We evaluated the impact of an ED-to-rapid-primary-care protocol on avoidance of hospitalizations in a large, urban medical center...
August 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28861552/internal-medicine-resident-attitudes-prior-education-comfort-and-knowledge-regarding-delivering-comprehensive-primary-care-to-transgender-patients
#11
Carrie D Johnston, Lee S Shearer
Transgender patients face a multitude of health disparities and often a lack of understanding by healthcare professionals. A survey was undertaken of internal medicine residents in a large urban academic training program to determine prior education, attitudes, comfort, and knowledge in providing care for transgender individuals in a primary care setting. Total N=67 respondents (52% of those eligible). A full 97% of residents believe transgender medical issues are relevant to their practice, but only 45% had prior education about the care of transgender patients...
2017: Transgender Health
https://www.readbyqxmd.com/read/28852991/is-feedback-to-medical-learners-associated-with-characteristics-of-improved-patient-care
#12
REVIEW
Victoria Hayes, Robert Bing-You, Kalli Varaklis, Robert Trowbridge, Heather Kemp, Dina McKelvy
PURPOSE: To investigate the association of medical learner feedback with patient management and outcomes. METHODS: The authors investigated 27 articles that utilized patient data or chart reviews as a subset of a prior feedback scoping review. Data extraction was completed by two authors and all authors reviewed the descriptive data analysis. RESULTS: The studies were predominantly short-term investigations conducted in the US at academic teaching hospitals (89%) with one medical discipline (78%), most commonly internal medicine (56%)...
August 29, 2017: Perspectives on Medical Education
https://www.readbyqxmd.com/read/28846483/palliative-care-needs-in-an-acute-internal-medicine-ward-in-mexico
#13
Tania Zertuche-Maldonado, Rodrigo Tellez-Villarreal, Antonio Pascual, Salvador B Valdovinos-Chavez, Abel Jesus Barragan-Berlanga, Maria Teresa Sanchez-Avila, Leonardo Bracho-Vela, Adria Tinoco-Aranda, Eduardo Bruera
BACKGROUND: Palliative care is an evolving but underdeveloped practice in Mexico. OBJECTIVE: The primary end point of this prospective observational study was to identify internal medicine inpatients fulfilling advanced criteria within a second-level hospital. Secondary end points were symptom burden, treatment, resource utilization, and one-year survival. DESIGN AND MEASUREMENTS: The 390-sample size calculation was based on previous studies where 15% of inpatients fulfilled palliative care needs...
August 28, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28836974/insulin-prices-availability-and-affordability-a-cross-sectional-survey-of-pharmacies-in-hubei-province-china
#14
Chenxi Liu, Xinping Zhang, Chaojie Liu, Margaret Ewen, Zinan Zhang, Guoqin Liu
BACKGROUND: Poor access to affordable insulin results in serious and needless complications and premature deaths for those with diabetes who need this essential medicine. To help address this issue, we assessed insulin availability, prices, affordability and price components in Hubei Province as China has the heaviest burden of diabetes globally. METHODS: In 2016, insulin availability and price data was collected in the capital and five other cities. A total of 30 public sector outlets (hospitals and primary care institutions) and 30 private pharmacies were sampled, using an adaptation of the World Health Organization/Health Action International methodology, Data was collected for all human and analogue insulins in stock, then analyzed by type (prandial, basal or pre-mixed) and duration of action...
August 24, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28834845/primary-care-residents-in-teaching-health-centers-their-intentions-to-practice-in-underserved-settings-after-residency-training
#15
Zohray Talib, Mariellen Malloy Jewers, Julia H Strasser, David K Popiel, Debora Goetz Goldberg, Candice Chen, Hayden Kepley, Fitzhugh Mullan, Marsha Regenstein
PURPOSE: To describe the residents who chose to train in teaching health centers (THCs), which are community-based ambulatory patient care sites that sponsor primary care residencies, and their intentions to practice in underserved settings. METHOD: The authors surveyed all THC residents training in academic years 2013-2014, 2014-2015, and 2015-2016, comparing their demographic characteristics with data available for residents nationally, and examined THC residents' intentions to practice in underserved settings using logistic regression analysis...
August 22, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28830683/implementation-of-point-of-care-testing-in-a-general-internal-medicine-practice-a-confirmation-study
#16
Elizabeth-Lee Lewandrowski, Sunu Yeh, Jason Baron, J Benjamin Crocker, Kent Lewandrowski
BACKGROUND: In a previous study we reported on the impact of point-of-care testing (POCT) on practice efficiency in an academic primary care practice that was established to develop new models of care delivery. Here we report a follow-on confirmation study in a more typical primary care practice in the community. METHODS: In this observational study with a retrospective comparison analysis we measured metrics of practice efficiency on two patient cohorts: those that did not receive POCT and those that did...
October 2017: Clinica Chimica Acta; International Journal of Clinical Chemistry
https://www.readbyqxmd.com/read/28828981/the-primary-mechanism-of-cellular-internalization-for-a-short-cellpenetrating-peptide-as-a-nano-scale-delivery-system
#17
Betty R Liu, Yue-Wern Huang, Mallikarjuna Korivi, Shih-Yen Lo, Robert S Aronstam, Han-Jung Lee
BACKGROUND: Development of effective drug delivery systems (DDS) is a critical issue in health care and medicine. Advances in molecular biology and nanotechnology have allowed the introduction of nanomaterial-based drug delivery systems. Cell-penetrating peptides (CPPs) can form the basis of drug delivery systems by virtue of their ability to support the transport of cargoes into the cell. Potential cargoes include proteins, DNA, RNA, liposomes, and nanomaterials. These cargoes generally retain their bioactivities upon entering cells...
August 22, 2017: Current Pharmaceutical Biotechnology
https://www.readbyqxmd.com/read/28821597/a-randomised-controlled-trial-assessing-the-efficacy-of-an-electronic-discharge-communication-tool-for-preventing-death-or-hospital-readmission
#18
Maria J Santana, Jayna Holroyd-Leduc, Danielle A Southern, Ward W Flemons, Maeve O'Beirne, Michael D Hill, Alan J Forster, Deborah E White, William A Ghali
OBJECTIVE: To assess the efficacy of an electronic discharge communication tool (e-DCT) for preventing death or hospital readmission, as well as reducing patient-reported adverse events after hospital discharge. The e-DCT assessed has already been shown to yield high-quality discharge summaries with high levels of patient and physician satisfaction. METHODS: This two-arm randomised controlled trial was conducted in a Canadian tertiary care centre's internal medicine medical teaching units...
August 18, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/28817394/drivers-of-continuing-education-learning-preferences-for-veterans-affairs-women-s-health-primary-care-providers
#19
Jessica L Zuchowski, Alison B Hamilton, Donna L Washington, Arthur G Gomez, Laure Veet, Kristina M Cordasco
INTRODUCTION: Documented gaps in health professionals' training in women's health are a special concern for continuing education (CE). In the Veterans Affairs (VA) health care system, women veterans are a numerical minority, preferably assigned to designated women's health primary care providers (DWHPs). DWHPs need to maintain their knowledge and skills in women's health topics, in addition to general internal medicine topics. We explored drivers of VA DWHPs' learning preferences for women's health topics-ie, factors which influence greater and lesser learning interest...
August 16, 2017: Journal of Continuing Education in the Health Professions
https://www.readbyqxmd.com/read/28813762/the-impact-of-a-rural-training-track-on-medical-students-specialty-choice
#20
Brooke Jensen, Susan M Anderson, Edward Simanton
BACKGROUND: Compare the expectations and outcomes of students involved in rural medical training versus those of urban trainees. METHODS: Survey items relating to primary care interest were added to program evaluation surveys already being sent at the beginning and end of the primary clinical year. Students from the graduating class of 2016 and the class of 2017 responded to the surveys (N=115). Responses from students trained in rural sites were compared with students trained in medium or large communities...
June 2017: South Dakota Medicine: the Journal of the South Dakota State Medical Association
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