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https://www.readbyqxmd.com/read/29160644/how-to-manage-joint-pain-in-children-and-adolescents
#1
Edoardo Marrani, Ilaria Maccora, Teresa Giani, Gabriele Simonini, Rolando Cimaz
In children, joint pain is common complaint and it proves challenging for primary care physicians. The differential possible diagnoses include a wide range of disorders, from the common and benign ones to serious and even lifethreating conditions. An accurate workup of these patients is needed, with thorough patient history and a systematic physical examination as essential tools. Clarifying the nature, the site, and the duration of the pain is fundamental as well as identifying systemic symptoms such as fever, weight loss, and night sweating...
November 21, 2017: Minerva Pediatrica
https://www.readbyqxmd.com/read/29160447/financing-of-pharmaceutical-services-in-the-municipal-management-of-the-brazilian-unified-health-system
#2
Daniel Resende Faleiros, Francisco de Assis Acurcio, Juliana Álvares, Renata Cristina Rezende Macedo do Nascimento, Ediná Alves Costa, Ione Aquemi Guibu, Orlando Mario Soeiro, Silvana Nair Leite, Margô Gomes de Oliveira Karnikowski, Karen Sarmento Costa, Augusto Afonso Guerra
OBJECTIVE: To discuss factors related to the financing of the Basic Component of Pharmaceutical Services within the municipal management of the Brazilian Unified Health System. METHODS: The Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos no Brasil - Serviços (PNAUM - National Survey on Access, Use and Promotion of Rational Use of Medicines - Services) is a cross-sectional, exploratory, and evaluative study that performed an information survey in a representative sample, stratified by Brazilian regions It considered different study populations in the sampling plan, which represent primary health care services in the cities...
November 13, 2017: Revista de Saúde Pública
https://www.readbyqxmd.com/read/29160446/national-survey-on-access-use-and-promotion-of-rational-use-of-medicines-methods
#3
Juliana Álvares, Maria Cecilia Goi Porto Alves, Maria Mercedes Loureiro Escuder, Alessandra Maciel Almeida, Jans Bastos Izidoro, Augusto Afonso Guerra, Karen Sarmento Costa, Ediná Alves Costa, Ione Aquemi Guibu, Orlando Mario Soeiro, Silvana Nair Leite, Margô Gomes de Oliveira Karnikowski, Francisco de Assis Acurcio
The Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos -Serviços (PNAUM - National Survey on Access, Use and Promotion of Rational Use of Medicines - Services) aimed to characterize the organization of pharmaceutical services in the Primary Health Care of the Brazilian Unified Health System (SUS). PNAUM - Services is a cross-sectional and evaluative study, with planned sample of 600 cities, held between 2014 and 2015, composed of a remote phase, with telephone interviews with health managers...
November 13, 2017: Revista de Saúde Pública
https://www.readbyqxmd.com/read/29160381/quality-of-communication-questionnaire-for-copd-patients-receiving-palliative-care-translation-and-cross-cultural-adaptation-for-use-in-brazil
#4
Flávia Del Castanhel, Suely Grosseman
OBJECTIVE: To translate the Quality of Communication Questionnaire (QOC) to Portuguese and adapt it for use in Brazil in COPD patients receiving palliative care. METHODS: After approval from the first author of the original QOC and the local research ethics committee, the original, 13-item version of the questionnaire was independently translated to Brazilian Portuguese by two Brazilian translators fluent in English. The two translations were analyzed by a bilingual physician and the two Brazilian translators, who reached a consensus and produced another Portuguese version of the QOC...
September 2017: Jornal Brasileiro de Pneumologia: Publicaça̋o Oficial da Sociedade Brasileira de Pneumologia e Tisilogia
https://www.readbyqxmd.com/read/29159487/management-of-cardiopulmonary-assist-devices-in-critically-ill-patients-using-point-of-care-transthoracic-echocardiography-a-case-series
#5
Babar Fiza, Michael Tang, Michael Maile
Point-of-care transthoracic echocardiography is increasingly being utilized by the intensive care physicians in the management of hemodynamically unstable patients. However, its use in the management of critically ill patients requiring cardiopulmonary mechanical device support remains to be well described. In this case series, we present two case reports where point-of-care echocardiography was successfully used by the intensive care team in diagnosing and managing problems related to cardiopulmonary assist device malposition...
November 21, 2017: Critical Ultrasound Journal
https://www.readbyqxmd.com/read/29159371/care-planning-for-inpatients-referred-for-palliative-care-consultation
#6
Kara Bischoff, David L O'Riordan, Angela K Marks, Rebecca Sudore, Steven Z Pantilat
Importance: Care planning is a critical function of palliative care teams, but the impact of advance care planning and goals of care discussions by palliative care teams has not been well characterized. Objective: To describe the population of patients referred to inpatient palliative care consultation teams for care planning, the needs identified by palliative care clinicians, the care planning activities that occur, and the results of these activities. Design, Setting, and Participants: This was a prospective cohort study conducted between January 1, 2013, and December 31, 2016...
November 20, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/29158948/the-how-and-why-of-the-movement-system-as-the-identity-of-physical-therapy
#7
Shirley Sahrmann
The Movement System was adopted as the identity of physical therapy as one of the 8 guiding principles accompanying the Vision Statement of 2013. At its inception physical therapy was considered more of a technical field rather than that of a professional field. Physicians were to diagnose the patient's problem and the therapist was to follow the prescription provided by the physician with the primary purpose being to relieve symptoms such as pain or muscle weakness. Even by the 1960's, the prescription became more of a referral and there was recognition that therapists were making decisions about the patient's treatment and discharge disposition...
November 2017: International Journal of Sports Physical Therapy
https://www.readbyqxmd.com/read/29158938/orthodeoxia-without-platypnea-in-hereditary-hemorrhagic-telangiectasia-in-the-presence-of-a-cerebral-abscess-and-multiple-pulmonary-arteriovenous-malformations-unusual-complications-and-transcatheter-endovascular-treatment
#8
Carlos Salazar, Jacky Bruce Blank, Veronica Palmero
Hereditary hemorrhagic telangiectasia is a rare autosomal-dominant condition affecting visceral blood vessel development. Cerebral and most commonly pulmonary arteriovenous malformations are found in the majority of symptomatic patients. The most common complications include embolic strokes and cerebral abscesses, which have been attributed to abnormal vessel communications. Platypnea orthodeoxia is a rare condition that presents dyspnea and oxygen desaturation when adopting an upright position and is relieved on decubitus...
2017: Case Reports in Pulmonology
https://www.readbyqxmd.com/read/29158373/revisiting-expectations-in-an-era-of-precision-oncology
#9
Emily J Marchiano, Andrew C Birkeland, Paul L Swiecicki, Kayte Spector-Bagdady, Andrew G Shuman
As we enter an era of precision medicine and targeted therapies in the treatment of metastatic cancer, we face new challenges for patients and providers alike as we establish clear guidelines, regulations, and strategies for implementation. At the crux of this challenge is the fact that patients with advanced cancer may have disproportionate expectations of personal benefit when participating in clinical trials designed to generate generalizable knowledge. Patient and physician goals of treatment may not align, and reconciliation of their disparate perceptions must be addressed...
November 20, 2017: Oncologist
https://www.readbyqxmd.com/read/29158309/why-the-need-and-how-to-approach-the-functional-diversity-of-extracellular-vesicles
#10
REVIEW
Mercedes Tkach, Joanna Kowal, Clotilde Théry
In the past decade, cell-to-cell communication mediated by exosomes has attracted growing attention from biomedical scientists and physicians, leading to several recent publications in top-tier journals. Exosomes are generally defined as secreted membrane vesicles, or extracellular vesicles (EVs), corresponding to the intraluminal vesicles of late endosomal compartments, which are secreted upon fusion of multi-vesicular endosomes with the cell's plasma membrane. Cells, however, were shown to release other types of EVs, for instance, by direct budding off their plasma membrane...
January 5, 2018: Philosophical Transactions of the Royal Society of London. Series B, Biological Sciences
https://www.readbyqxmd.com/read/29157519/inferior-vena-cava-filters-current-and-future-concepts
#11
REVIEW
John Andrew Kaufman
The inferior vena cava filter clinical environment is notable for the degree of controversy, uncertainty, and fear associated with these devices by both physicians and the public. This article reviews some of the more important current issues with these devices as well as emerging and future trends.
January 2018: Interventional cardiology clinics
https://www.readbyqxmd.com/read/29157447/the-usefulness-and-actual-use-of-wearable-devices-among-the-elderly-population
#12
Shwetambara Kekade, Chung-Ho Hseieh, Md Mohaimenul Islam, Suleman Atique, Abdulwahed Mohammed Khalfan, Yu-Chuan Li, Shabbir Syed Abdul
BACKGROUND AND OBJECTIVE: Elderly populations are more prone to diseases and need continuous monitoring of parameters to ensure good health. Wearable devices (WDs) can be helpful in the early detection and management of medical conditions. However, less is known about the use of currently available WDs among elderly populations. The objectives of this study were to determine the usefulness and actual use of wearable devices among the elderly population. METHODS: Our methodology was based on a systematic review and a survey questionnaire...
January 2018: Computer Methods and Programs in Biomedicine
https://www.readbyqxmd.com/read/29155688/characteristics-of-visits-to-primary-care-physicians-by-adults-diagnosed-with-hypertension
#13
Jill J Ashman, Pinyao Rui, Susan M Schappert, Alexander Strashny
Objective-This report describes the demographic, state, and regional differences in hypertension control and pharmaceutical treatment among visits to primary care physicians made by hypertensive adults during 2013-2014. Methods-Data are from the 2013-2014 National Ambulatory Medical Care Survey (NAMCS), a nationally representative survey of visits to nonfederal, office-based physicians. The sample design for the 2013-2014 NAMCS included oversampling in selected states. Estimates are provided for the 18 states oversampled in both years...
September 2017: National Health Statistics Reports
https://www.readbyqxmd.com/read/29153357/choosing-wisely-%C3%A2-klug-entscheiden-begriffliche-und-ethische-%C3%A3-berlegungen
#14
Bettina Schöne-Seifert
Choosing Wisely and Klug Entscheiden are recent physician-triggered campaigns that aim at identifying and reducing blatant over-treatment as well as - a specialty of KE - occurring under-treatment. This paper provides some conceptual and normative analyses of these campaigns' goals and justifications.
November 15, 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/29153353/-something-humane-has-been-lost-re-evaluation-of-the-attitudes-of-senior-physicians-towards-the-g-drg-system-a-qualitative-normative-analysis
#15
Marco Knoll, Ina Otte, Sabine Salloch, Caroline Ruiner, Esta Kruppa, Jochen Vollmann
Only a few years after the implementation of the G-DRG (German Diagnosis Related Group) system physicians already began to complain of its negative effects on the quality of inpatient healthcare. The present study examines the recent experiences senior physicians have made with regard to the impact of the G-DRG system on the quality of healthcare and medical professionalism. Nine qualitative guided expert interviews were conducted focusing on the experiences of physicians in leading positions dealing with the G-DRG system in their everyday work...
November 15, 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/29152230/rare-fungal-infectious-agents-a-lurking-enemy
#16
REVIEW
Anna Skiada, Ioannis Pavleas, Maria Drogari-Apiranthitou
In the expanding population of immunocompromised patients and those treated in intensive care units, rare fungal infectious agents have emerged as important pathogens, causing invasive infections associated with high morbidity and mortality. These infections may present either as de novo or as breakthrough invasive infections in high-risk patients with hematologic malignancies receiving prophylactic or empirical antifungal therapy or in patients with central venous catheters. Diagnosis and treatment are challenging...
2017: F1000Research
https://www.readbyqxmd.com/read/29151319/patients-attitudes-and-knowledge-about-drug-use-a-survey-in-turkish-family-healthcare-centres-and-state-hospitals
#17
Ahmet Akıcı, Salih Mollahaliloğlu, Başak Dönertaş, Şenay Özgülcü, Ali Alkan, Nesrin Filiz Başaran
Background/aim: Irrational drug use is a common problem. This study aimed to evaluate patients' knowledge and habits concerning drug use, and compare them in terms of some sociodemographic characteristics. Materials and methods: A face-to-face questionnaire was given to outpatients from family healthcare centres (FHCs) and state hospitals (SHs) in 12 provinces in Turkey during May 2010. A total of 4470 patients (FHCs: 2209; SHs: 2261) responded to the questionnaire (response rate: 93.1%). Results: Getting prescriptions without a physical examination was common (second place in FHCs; third place in SHs); 51...
November 13, 2017: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/29150468/prevalence-and-recognition-of-obesity-and-its-associated-comorbidities-cross-sectional-analysis-of-electronic-health-record-data-from-a-large-us-integrated-health-system
#18
Kevin M Pantalone, Todd M Hobbs, Kevin M Chagin, Sheldon X Kong, Brian J Wells, Michael W Kattan, Jonathan Bouchard, Brian Sakurada, Alex Milinovich, Wayne Weng, Janine Bauman, Anita D Misra-Hebert, Robert S Zimmerman, Bartolome Burguera
OBJECTIVE: To determine the prevalence of obesity and its related comorbidities among patients being actively managed at a US academic medical centre, and to examine the frequency of a formal diagnosis of obesity, via International Classification of Diseases, Ninth Revision (ICD-9) documentation among patients with body mass index (BMI) ≥30 kg/m(2). DESIGN: The electronic health record system at Cleveland Clinic was used to create a cross-sectional summary of actively managed patients meeting minimum primary care physician visit frequency requirements...
November 16, 2017: BMJ Open
https://www.readbyqxmd.com/read/29150143/life-after-endometrial-cancer-a-systematic-review-of-patient-reported-outcomes
#19
Robert Shisler, Jennifer A Sinnott, Vivian Wang, Courtney Hebert, Ritu Salani, Ashley S Felix
BACKGROUND: Women with endometrial cancer (EC) are the second largest population of female cancer survivors in the United States. However, the outcomes of EC survivors, from the patient perspective, are not well-understood. Therefore, we conducted a systematic review of patient-reported outcomes (PROs) following an EC diagnosis. METHODS: We searched MEDLINE, EMBASE, Scopus, CINAHL, and reference lists to identify published observational studies that examined PROs among women with EC...
November 14, 2017: Gynecologic Oncology
https://www.readbyqxmd.com/read/29149875/prevalence-of-antibiotic-prescription-in-pediatric-outpatients-in-italy-the-role-of-local-health-districts-and-primary-care-physicians-in-determining-variation-a-multilevel-design-for-healthcare-decision-support
#20
Mirko Di Martino, Adele Lallo, Ursula Kirchmayer, Marina Davoli, Danilo Fusco
BACKGROUND: According to scientific literature, antibacterials are prescribed for common pediatric conditions that do not benefit from antibiotic therapy. The link between antibiotic use and bacterial resistance is well known. Antibiotic overprescribing generates high social costs and severe consequences for children. Our objectives were to analyze antibiotic prescription patterns in pediatric outpatients residing in the Lazio region (Italy), to identify physicians' characteristics associated with increased propensity for prescription, to identify the priority axes for action to improve the rational use of antibiotics...
November 17, 2017: BMC Public Health
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