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https://www.readbyqxmd.com/read/28822512/implications-of-the-2013-acc-aha-cholesterol-guidelines-on-contemporary-clinical-practice-for-patients-with-atherosclerotic-coronary-and-peripheral-arterial-disease
#1
Prasad Gunasekaran, Vinodh Jeevanantham, Suresh Sharma, Rashmi Thapa, Kamal Gupta
BACKGROUND: Cholesterol management guidelines from the American College of Cardiology/American Heart Association (ACC/AHA-2013) recommend fixed statin dosing (dose depends on age ≤ or >75years) compared to the earlier adult treatment panel III (ATPIII) guidelines which recommended specific low-density lipoprotein-cholesterol (LDL-C) targets. Clinical implications of this recommendation are not known. METHODS: We retrospectively compared cholesterol levels and statin utilization across cohorts with coronary artery disease (CAD) (n=9563), peripheral arterial disease (PAD) (n=596) and CAD+PAD (n=975) by applying both guidelines...
July 2017: Indian Heart Journal
https://www.readbyqxmd.com/read/28821888/risk-factors-for-epistaxis-in-patients-followed-in-general-practices-in-germany
#2
D U Seidel, L Jacob, K Kostev, A M Sesterhenn
<p>BACKGROUND: The goal of the present study was to analyze the risk factors for epistaxis in patients followed in general practices in Germany.</p> <p>METHODS: The current study sample included patients aged 18 years or older who received a first epistaxis diagnosis between January 2012 and December 2016 (index date). Epistaxis patients and controls without epistaxis were matched (1:1) on the basis of age, gender, insurance status and physician. </p> <p>RESULTS: A total of 16,801 patients with epistaxis and 16,801 control subjects were included in this study...
August 19, 2017: Rhinology
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
#3
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/28821577/ethical-behaviour-of-physicians-and-psychologists-similarities-and-differences
#4
Michall Ferencz Kaddari, Meni Koslowsky, Michael A Weingarten
OBJECTIVE: To compare the coping patterns of physicians and clinical psychologists when confronted with clinical ethical dilemmas and to explore consistency across different dilemmas. POPULATION: 88 clinical psychologists and 149 family physicians in Israel. METHOD: Six dilemmas representing different ethical domains were selected from the literature. Vignettes were composed for each dilemma, and seven possible behavioural responses for each were proposed, scaled from most to least ethical...
August 18, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28821508/a-novel-income-security-intervention-to-address-poverty-in-a-primary-care-setting-a-retrospective-chart-review
#5
Marcella K Jones, Gary Bloch, Andrew D Pinto
OBJECTIVE: To examine the development and implementation of a novel income security intervention in primary care. DESIGN: A retrospective, descriptive chart review of all patients referred to the Income Security Heath Promotion service during the first year of the service (December 2013-December 2014). SETTING: A multisite interdisciplinary primary care organisation in inner city Toronto, Canada, serving over 40 000 patients. PARTICIPANTS: The study population included 181 patients (53% female, mean age 48 years) who were referred to the Income Security Health Promotion service and engaged in care...
August 17, 2017: BMJ Open
https://www.readbyqxmd.com/read/28821277/the-feasibility-analysis-of-omission-of-elective-irradiation-to-level-ib-lymph-nodes-in-low-risk-nasopharyngeal-carcinoma-based-on-the-2013-updated-consensus-guideline-for-neck-nodal-levels
#6
Xiaomin Ou, Yibing Miao, Xiaoshen Wang, Jianhui Ding, Xiayun He, Chaosu Hu
BACKGROUND: Level IB metastasis is rare in nasopharyngeal carcinoma (NPC). The purpose of this study is to investigate the high-risk factors for level IB metastasis and evaluate the feasibility of omission of elective irradiation to level IB in the low-risk subgroups in NPC. METHODS: This retrospective study identified 532 patients with NPC treated by definitive radiation in our institution from 2009 to 2010. Level IB nodes were electively irradiated based on the physician's decision...
August 18, 2017: Radiation Oncology
https://www.readbyqxmd.com/read/28821256/-provoking-conversations-case-studies-of-organizations-where-option-grid%C3%A2-decision-aids-have-become-normalized
#7
Peter Scalia, Glyn Elwyn, Marie-Anne Durand
BACKGROUND: Implementing patient decision aids in clinic workflow has proven to be a challenge for healthcare organizations and physicians. Our aim was to determine the organizational strategies, motivations, and facilitating factors to the routine implementation of Option Grid™ encounter decision aids at two independent settings. METHOD: Case studies conducted by semi-structured interview, using the Normalization Process Theory (NPT) as a framework for thematic analysis...
August 18, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/28820439/efficacy-and-safety-of-letibotulinum-toxin-a-for-the-treatment-of-dynamic-equinus-foot-deformity-in-children-with-cerebral-palsy-a-randomized-controlled-trial
#8
Hyun Jung Chang, Bo Young Hong, Sang-Jee Lee, Soyoung Lee, Joo Hyun Park, Jeong-Yi Kwon
The objective of this clinical trial was to compare the efficacy and safety of letibotulinum toxin A and onabotulinum toxin A for improving dynamic equinus foot deformity in children with cerebral palsy (CP). In total, 144 children with spastic CP who had dynamic equinus foot deformity were assigned randomly to the Botulax group (injection of letibotulinum toxin A) or the Botox group (injection of onabotulinum toxin A). The Physician's Rating Scale (PRS), ankle plantar flexor spasticity using the Modified Tardieu Scale, the Gross Motor Function Measure (GMFM)-88, and the GMFM-66 were completed before injection and at 6, 12, and 24 weeks after injection...
August 18, 2017: Toxins
https://www.readbyqxmd.com/read/28820084/the-effectiveness-of-healthy-meals-at-work-on-reaction-time-mood-and-dietary-intake-a-randomised-cross-over-study-in-daytime-and-shift-workers-at-an-university-hospital
#9
Eva Leedo, Anne Marie Beck, Arne Astrup, Anne D Lassen
Our dietary habits affect both cognitive performance and mood. The aim of the study was to examine the effect of increased availability of healthy meals and water at work on healthcare staff. The study used an 8-week randomised cross-over design. A total of sixty physicians, nurses and nursing assistants, including sixteen working on shifts, were recruited. The participants received a self-selected keyhole-labelled (Nordic nutrition label) lunch, snack and bottled water during each shift throughout the intervention period...
July 2017: British Journal of Nutrition
https://www.readbyqxmd.com/read/28818821/patient-participation-at-health-care-conferences-engaged-patients-increase-information-flow-expand-propagation-and-deepen-engagement-in-the-conversation-of-tweets-compared-to-physicians-or-researchers
#10
Audun Utengen, Dara Rouholiman, Jamison G Gamble, Francisco Jose Grajales Iii, Nisha Pradhan, Alicia C Staley, Liza Bernstein, Sean D Young, Kevin A Clauson, Larry F Chu
BACKGROUND: Health care conferences present a unique opportunity to network, spark innovation, and disseminate novel information to a large audience, but the dissemination of information typically stays within very specific networks. Social network analysis can be adopted to understand the flow of information between virtual social communities and the role of patients within the network. OBJECTIVE: The purpose of this study is to examine the impact engaged patients bring to health care conference social media information flow and how they expand dissemination and distribution of tweets compared to other health care conference stakeholders such as physicians and researchers...
August 17, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28818632/the-views-of-clergy-regarding-ethical-controversies-in-care-at-the-end-of-life
#11
Michael J Balboni, Adam Sullivan, Patrick T Smith, Danish Zaidi, Christine Mitchell, James A Tulsky, Daniel Sulmasy, Tyler J VanderWeele, Tracy A Balboni
CONTEXT: While religion often informs ethical judgments, little is known about the views of American clergy regarding controversial end-of-life ethical issues including allowing to die and physician-aid in dying or physician-assisted suicide (PAD/PAS). OBJECTIVE: To describe the views of U.S. clergy concerning allowing to die and PAD/PAS. METHODS: A survey was mailed to 1665 nationally representative clergy between 8/2014 to 3/2015 (60% response rate)...
August 14, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28818507/optimizing-quality-of-endoscopy-in-inflammatory-bowel-disease-focus-on-surveillance-and-management-of-colorectal-dysplasia-using-interactive-image-and-video-based-teaching
#12
Tonya R Kaltenbach, Roy M Soetikno, Rebecca DeVivo, Loren A Laine, Alan Barkun, Kenneth R McQuaid
BACKGROUND & AIMS: Varying recommendations regarding the detection and management of dysplasia can lead to uncertainty and may have impeded the uptake of strategies that could improve surveillance in patients with inflammatory bowel disease (IBD). As such, an educational event was held to assist in disseminating the recently published Surveillance for Colorectal Endoscopic Neoplasia Detection and Management in Inflammatory Bowel Disease Patients: International Consensus Recommendations (SCENIC)...
August 14, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28818473/effectiveness-of-23-valent-pneumococcal-polysaccharide-vaccine-and-seasonal-influenza-vaccine-for-pneumonia-among-the-elderly-selection-of-controls-in-a-case-control-study
#13
Kyoko Kondo, Kanzo Suzuki, Masakazu Washio, Satoko Ohfuji, Wakaba Fukushima, Akiko Maeda, Yoshio Hirota
We conducted a case-control study to elucidate associations between pneumonia in elderly individuals and 23-valent pneumococcal polysaccharide vaccine (PPSV23) and seasonal influenza vaccine (influenza vaccine). Here, we examined selection of controls in our study using an analytic epidemiology approach. The study period was from October 1, 2009 through September 30, 2014. Cases comprised ≥65-year-old patients newly diagnosed with pneumonia. For every case with pneumonia, two patients with other diseases (one respiratory medicine, one non-respiratory medicine) who were sex-, age-, visit date- and visit hospital-matched were selected as controls...
August 24, 2017: Vaccine
https://www.readbyqxmd.com/read/28818417/referral-for-expert-physical-activity-counseling-a-pragmatic-rct
#14
Erica L James, Ben D Ewald, Natalie A Johnson, Fiona G Stacey, Wendy J Brown, Elizabeth G Holliday, Mark Jones, Fan Yang, Charlotte Hespe, Ronald C Plotnikoff
INTRODUCTION: Primary care physicians are well placed to offer physical activity counseling, but insufficient time is a barrier. Referral to an exercise specialist is an alternative. In Australia, exercise specialists are publicly funded to provide face-to-face counseling to patients who have an existing chronic illness. This trial aimed to (1) determine the efficacy of primary care physicians' referral of insufficiently active patients for counseling to increase physical activity, compared with usual care, and (2) compare the efficacy of face-to-face counseling with counseling predominantly via telephone...
August 14, 2017: American Journal of Preventive Medicine
https://www.readbyqxmd.com/read/28818227/impact-of-an-educational-program-on-the-quality-of-life-of%C3%A2-patients-with-lymphedema-a-preliminary-evaluation
#15
Sophie Blaise, Bernadette Satger, Gilles Pernod, Cécile Richaud, Béatrice Villemur, Patrick H Carpentier
OBJECTIVE: We report on the preliminary evaluation of a well-designed program, Living with Lymphedema. This longitudinal cohort study assessed patients' quality of life using questionnaires. Our main objective was to evaluate the satisfaction of the patients and their adherence to the program. This was done using a specific questionnaire of satisfaction as well as by noting patients' adherence to the program (number of patients attending all three consultations). The secondary objective was to assess the effect of the program on the patient's quality of life...
September 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/28817861/population-health-management-and-cancer-screening
#16
Bradley Kamstra, Mark K Huntington
Population health management (PHM) is a new health care model being implemented. It has been defined as "the health outcomes of a group of individuals, including the distribution of such outcomes within the group." This includes health outcomes and patterns of health determinants, and policies and interventions that link these two. Moving from a fee-for-service payment system to a quality- or value-based system, this model places on the clinician more responsibility for the costs of health care and its reimbursements...
2017: South Dakota Medicine: the Journal of the South Dakota State Medical Association
https://www.readbyqxmd.com/read/28817451/relative-temperature-maximum-in-wound-infection-and-inflammation-as-compared-with-a-control-subject-using-long-wave-infrared-thermography
#17
Arjun Chanmugam, Diane Langemo, Korissa Thomason, Jaimee Haan, Elizabeth A Altenburger, Aletha Tippett, Linda Henderson, Todd A Zortman
OBJECTIVE: The purpose of this retrospective case series was to determine whether a long-wave infrared thermography (LWIT, or thermal imaging) camera can detect specific temperature changes that are associated with wound infection and inflammation as compared with normal control subjects with similar anatomical wound locations. DESIGN: A retrospective, observational, collective, multiple case series of patients who underwent digital and thermal imaging of wounds in various states...
September 2017: Advances in Skin & Wound Care
https://www.readbyqxmd.com/read/28817392/minimum-operational-standards-for-24-7-available-emergency-departments-in-the-netherlands-a-first-step-taken-by-emergency-physicians-using-an-e-delphi-approach
#18
Menno I Gaakeer, Rebekka Veugelers, Peter Patka, Robbert Huijsman
OBJECTIVE: The objective of this study was to effectuate a consensus of emergency physicians on minimum requirements for facility, diagnostic, and medical specialist availability as a first step toward minimum operational standards for 24/7 available emergency departments (EDs) in the Netherlands. PATIENTS AND METHODS: A two-part e-Delphi through online survey was performed between January 2015 and May 2016, using a panel of 20 experts in emergency medicine. The aim of part I was to reach an agreement on a list of possible ED elements and their definitions...
August 16, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28817162/determining-when-it-is-safe-to-remove-the-external-fixator-results-from-a-survey-of-the-limb-lengthening-and-reconstruction-society
#19
Christopher A Iobst, Waleed Mohammed, Ryan Colley
Thousands of external fixators are applied for distraction osteogenesis each year. Determining when it is safe to remove the fixator can be difficult. The purpose of this study was to survey an international group of external fixation surgeons to determine their current practice patterns surrounding external fixator removal. A 10-question, open-ended survey was emailed to members of the Limb Lengthening and Reconstruction Society. Responses were recorded, and statistical analysis was performed. Pearson's chi-square test and likelihood ratio were used when indicated...
August 17, 2017: Orthopedics
https://www.readbyqxmd.com/read/28816913/influence-of-written-informed-consent-for-methylphenidate-on-medicine-persistence-rates-in-children-with-attention-deficit-hyperactivity-disorder
#20
Kristian Naenen-Hernani, Antonio Palazón-Bru, Francisco Colomina-Climent, Vicente F Gil-Guillén
OBJECTIVE: To assess the influence of written informed consent on nonpersistence with methylphenidate treatment in children with attention-deficit hyperactivity disorder (ADHD). METHODS: We undertook a cohort study including 141 children with ADHD who started treatment with methylphenidate, with a follow-up of 6 months. The main outcome variable was nonpersistence, defined as discontinuation of treatment by the patient. Two groups were analyzed with and without written informed consent...
August 9, 2017: Journal of Developmental and Behavioral Pediatrics: JDBP
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