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https://www.readbyqxmd.com/read/29353337/a-retrospective-analysis-of-5-fluorouracil-plus-cisplatin-as-first-line-chemotherapy-in-the-recent-treatment-strategy-for-patients-with-metastatic-or-recurrent-esophageal-squamous-cell-carcinoma
#1
Shuji Hiramoto, Ken Kato, Hirokazu Shoji, Natsuko Okita, Atsuo Takashima, Yoshitaka Honma, Satoru Iwasa, Tetsuya Hamaguchi, Yasuhide Yamada, Yasuhiro Shimada, Narikazu Boku
BACKGROUND: Patients with metastatic or recurrent esophageal squamous cell carcinoma (ESCC) have a poor prognosis. For decades, the most widely used first-line chemotherapy regimen for these patients has been the combination of 5-fluorouracil + cisplatin (CF). However, prognostic factors of CF as first-line chemotherapy for ESCC have not been clarified. METHODS: A total of 187 patients with metastatic or recurrent esophageal ESCC treated with CF at the National Cancer Center Hospital between January 2001 and December 2012 were enrolled in the study...
January 20, 2018: International Journal of Clinical Oncology
https://www.readbyqxmd.com/read/29352670/poor-outcomes-of-out-of-hospital-cardiac-arrest-at-dinnertime-in-the-elderly-diurnal-and-seasonal-variations
#2
Akira Yamashita, Tetsuo Maeda, Yasuhiro Myojo, Keisuke Ohta, Hideo Inaba
PURPOSE: To investigate differences in chronological variations in characteristics and outcomes of out-of-hospital cardiac arrests (OHCAs) between elderly and non-elderly patients. METHODS: We retrospectively analyzed bystander-witnessed OHCAs without prehospital involvement of physicians between January 2007 and December 2014 in Japan. We considered the following time periods: night-time (23:00-5:59) and non-night-time; we further divided non-night-time into dinnertime (18:00-20:29) and other non-night-time...
January 8, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29352419/a-systematic-review-of-interventions-to-follow-up-test-results-pending-at-discharge
#3
Patrick J Darragh, T Bodley, A Orchanian-Cheff, K G Shojania, J L Kwan, P Cram
BACKGROUND: Patients are frequently discharged from the hospital before all test results have been finalized. Thirty to 40% of tests pending at discharge (TPADs) return potentially actionable results that could necessitate change in the patients' management, often unbeknownst to their physicians. Delayed follow-up of TPADs can lead to patient harm. We sought to synthesize the existing literature on interventions intended to improve the management of TPADs, including interventions designed to enhance documentation of TPADs, increase physician awareness when TPAD results finalize post-discharge, decrease adverse events related to missed TPADs, and increase physician satisfaction with TPAD management...
January 19, 2018: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/29352418/effect-of-patient-experience-on-bypassing-a-primary-care-gatekeeper-a-multicenter-prospective-cohort-study-in-japan
#4
Takuya Aoki, Yosuke Yamamoto, Tatsuyoshi Ikenoue, Makoto Kaneko, Morito Kise, Yasuki Fujinuma, Shunichi Fukuhara
BACKGROUND: To discuss how best to implement the gatekeeping functionality of primary care; identifying the factors that cause patients to bypass their primary care gatekeepers when seeking care should be beneficial. OBJECTIVE: To examine the association between patient experience with their primary care physicians and bypassing them to directly obtain care from higher-level healthcare facilities. DESIGN AND METHODS: This prospective cohort study was conducted in 13 primary care clinics in Japan...
January 19, 2018: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/29351893/a-clinical-decision-support-engine-based-on-a-national-medication-repository-for-the-detection-of-potential-duplicate-medications-design-and-evaluation
#5
Cheng-Yi Yang, Yu-Sheng Lo, Ray-Jade Chen, Chien-Tsai Liu
BACKGROUND: A computerized physician order entry (CPOE) system combined with a clinical decision support system can reduce duplication of medications and thus adverse drug reactions. However, without infrastructure that supports patients' integrated medication history across health care facilities nationwide, duplication of medication can still occur. In Taiwan, the National Health Insurance Administration has implemented a national medication repository and Web-based query system known as the PharmaCloud, which allows physicians to access their patients' medication records prescribed by different health care facilities across Taiwan...
January 19, 2018: JMIR Medical Informatics
https://www.readbyqxmd.com/read/29351865/interventions-to-support-effective-communication-between-maternity-care-staff-and-women-in-labour-a-mixed-methods-systematic-review
#6
Yan-Shing Chang, Kirstie Coxon, Anayda Gerarda Portela, Marie Furuta, Debra Bick
OBJECTIVES: the objectives of this review were (1) to assess whether interventions to support effective communication between maternity care staff and healthy women in labour with a term pregnancy could improve birth outcomes and experiences of care; and (2) to synthesize information related to the feasibility of implementation and resources required. DESIGN: a mixed-methods systematic review. SETTING AND PARTICIPANTS: studies which reported on interventions aimed at improving communication between maternity care staff and healthy women during normal labour and birth, with no apparent medical or obstetric complications, and their family members were included...
December 27, 2017: Midwifery
https://www.readbyqxmd.com/read/29351712/-immigrated-physicians-chances-and-challenges
#7
Isabel Hohmann, Heide Glaesmer, Yuriy Nesterko
BACKGROUND AND OBJECTIVE: In the health care infrastructure of Germany a demand for physicians with immigrant background exists. The situation of immigrated physicians is largely unexplored so far. In the framework of a pilot study stressors and resources of physicians with immigrant background have been explored concerning their migration-related experiences at German hospitals, and within the medical team. METHODS: As part of a qualitative analysis 8 physicians with immigrant background have been interviewed (problem-centered interview) from July to September 2014...
January 19, 2018: Psychotherapie, Psychosomatik, Medizinische Psychologie
https://www.readbyqxmd.com/read/29351193/restricted-social-engagement-among-adults-living-with-chronic-conditions
#8
Kayla P Meek, Caroline D Bergeron, Samuel D Towne, SangNam Ahn, Marcia G Ory, Matthew Lee Smith
Background: Social engagement is key to health and quality of life. Little is known about social engagement patterns of middle-aged and older adults who live with one or more chronic illnesses. This study investigated social engagement restrictions among middle-aged and older adults with chronic conditions and factors associated with these restrictions. Methods: Cross-sectional representative data from the National Council on Aging Chronic Care Survey were examined for relationships between social engagement restrictions and chronic conditions, health status, support, quality of life implications, self-care barriers, caregiving, and demographics...
January 19, 2018: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/29350657/an-icet-a-survey-on-hypoparathyroidism-in-patients-with-thalassaemia-major-and-intermedia-a-preliminary-report
#9
Vincenzo De Sanctis, Ashraf T Soliman, Duran Canatan, Heba Elsedfy, Mehran Karimi, Shahina Daar, Hala Rimawi, Soteroula Christou, Nicos Skordis, Ploutarchos Tzoulis, Praveen Sobti, Shruti Kakkar, Yurdanur Kilinc, Doaa Khater, Saif A Alyaarubi, Valeriya Kaleva, Su Han Lum, Mohamed A Yassin, Forough Saki, Maha Obiedat, Salvatore Anastasi, Maria Concetta Galati, Giuseppe Raiola, Saveria Campisi, Nada Soliman, Mohamed Elshinawy, Soad Al Jaouni, Salvatore Di Maio, Yasser Wali, Ihab Zaki Elhakim, Christos Kattamis
Hypoparathyroidism (HPT) is a rare disease with leading symptoms of hypocalcemia, associated with high serum phosphorus levels and absent or inappropriately low levels of parathyroid hormone (PTH). In patients with thalassemias it is mainly attributed to transfusional iron overload, and suboptimal iron chelation therapy. The main objectives of this survey were to provide data on the prevalence, demographic and clinical features of HPT in thalassemia major (TM) and intermedia (TI) patients living in different countries, and to assess its impact in clinical medical practice...
January 16, 2018: Acta Bio-medica: Atenei Parmensis
https://www.readbyqxmd.com/read/29350222/a-prescription-for-note-bloat-an-effective-progress-note-template
#10
Daniel Khan, Elizabeth Stewart, Mark Duncan, Edward Lee, Wendy Simon, Clement Lee, Jodi Friedman, Hilary Mosher, Katherine Harris, John Bell, Bradley Sharpe, Neveen El-Farra
BACKGROUND: United States hospitals have widely adopted electronic health records (EHRs). Despite the potential for EHRs to increase efficiency, there is concern that documentation quality has suffered. OBJECTIVE: To examine the impact of an educational session bundled with a progress note template on note quality, length, and timeliness. DESIGN: A multicenter, nonrandomized prospective trial. SETTING: Four academic hospitals across the United States...
January 19, 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29349645/the-incidence-and-the-prognostic-impact-of-acute-kidney-injury-in-acute-myocardial-infarction-patients-current-preventive-strategies
#11
Evangelos Kaltsas, George Chalikias, Dimitrios Tziakas
Acute kidney injury (AKI) is one of the most common complications during hospitalization in various clinical settings. The goal of this review was to assess the incidence of AKI in acute myocardial infarction patients (AMI), how this incidence is affected by the diverse definitions, and if there is variability in the reported rates over recent years. Additionally, we sought to appraise the impact of AKI on short- and long-term prognosis of these patients. Finally, we report on the current preventive measures as they are suggested in the current guidelines of various societies, we comment on the evidence that support them, and we review the literature for other proposed therapeutic strategies, which either failed to prove their efficacy or they are not adequately confirmed yet...
January 19, 2018: Cardiovascular Drugs and Therapy
https://www.readbyqxmd.com/read/29347873/students-with-an-autonomous-role-in-hospital-care-patients-perceptions
#12
Christian Scheffer, Maria Paula Valk-Draad, Diethard Tauschel, Arndt Büssing, Knut Humbroich, Alfred Längler, Tycho Zuzak, Wolf Köster, Friedrich Edelhäuser, Gabriele Lutz
BACKGROUND: There have been calls to enhance clinical education by strengthening supported active participation (SAP) of medical students in patient care. This study examines perceived quality of care when final-year medical students are integrated in hospital ward teams with an autonomous relationship toward their patients. METHODS: We established three clinical education wards (CEWs) where final-year medical students were acting as "physician under supervision"...
January 18, 2018: Medical Teacher
https://www.readbyqxmd.com/read/29346570/implementation-status-of-morbidity-and-mortality-conferences-in-swiss-hospitals-a-national-cross-sectional-survey-study
#13
Isabelle Praplan-Rudaz, Yvonne Pfeiffer, David L B Schwappach
Objective: To determine the implementation status and current practice of morbidity and mortality conferences (M&MCs) in Switzerland. Design: A national cross-sectional online survey was conducted in spring 2017. The questionnaire focused on overall goals, structure and procedures of hospital M&MCs. Further topics included satisfaction, perceived effectiveness and support requirements. Setting: A total of 913 chief physicians of surgery and internal medicine, and specialist fields of obstetrics and gynaecology, anaesthesiology and intensive care from Swiss acute care hospitals were invited to the survey...
January 16, 2018: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/29346233/video-recordings-to-analyze-preventable-management-errors-in-pediatric-resuscitation-bay
#14
Julia Borns, Jörg Ersch, Milana Dobrovoljac, Georg Staubli, Barbara Brotschi
OBJECTIVE: In treating patients of different ages and diseases in the pediatric resuscitation bay, management errors are common. This study aimed to analyze the adherence to advanced trauma life support and pediatric advanced life support guidelines and identify management errors in the pediatric resuscitation bay by using video recordings. METHODS: Video recording of all patients admitted to the pediatric resuscitation bay at University Children's Hospital Zurich during a 13-month period was performed...
January 16, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29345234/current-approaches-to-epistaxis-treatment-in-primary-and-secondary-care
#15
Rafael Beck, Martin Sorge, Antonius Schneider, Andreas Dietz
BACKGROUND: The lifetime prevalence of epistaxis is approximately 60%, and 6-10% of the affected persons need medical care. In rare cases, severe bleeding calls for the rapid initiation of effective treatment. METHODS: This review is based on pertinent articles that were retrieved by a selective search PubMed, and on the authors' clinical experience. RESULTS: There are no German guidelines for the management of epistaxis. The available evidence consists mainly of retro spective analyses and expert opinions...
January 8, 2018: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/29342479/time-spent-on-dedicated-patient-care-and-documentation-tasks-before-and-after-the-introduction-of-a-structured-and-standardized-electronic-health-record
#16
Erik Joukes, Ameen Abu-Hanna, Ronald Cornet, Nicolette F de Keizer
BACKGROUND:  Physicians spend around 35% of their time documenting patient data. They are concerned that adopting a structured and standardized electronic health record (EHR) will lead to more time documenting and less time for patient care, especially during consultations. OBJECTIVE:  This study measures the effect of the introduction of a structured and standardized EHR on documentation time and time for dedicated patient care during outpatient consultations...
January 2018: Applied Clinical Informatics
https://www.readbyqxmd.com/read/29341963/role-of-the-anesthesiologist-intensivist-outside-the-icu-opportunity-to-add-value-for-the-hospital-or-an-unnecessary-distraction
#17
Suzanne Bennett, Erin Grawe, Courtney Jones, Sean A Josephs, Maggie Mechlin, William E Hurford
PURPOSE OF REVIEW: Given the extremely expensive nature of critical care medicine, it seems logical that intensivists should play an active role in designing efficient systems of care. The true value of intensivists, however, is not well defined. RECENT FINDINGS: Anesthesiologists have taken key roles in improving patient safety in the operating room. Anesthesia-related mortality rates have decreased from 20 deaths per 100 000 anesthetics in the early 1980s to less than one death per 100 000 currently...
January 15, 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29341529/-when-the-ward-overflows%C3%A2-the-impact-of-outlying-beds-on-patient-care
#18
Valérie Mosimann, Olivier Lamy, Julien Castioni
Due to the chronic lack of beds in hospitals, patients are often hospitalized in other departments (outlier patients), with a responsible physician working in another department. This causes increased thromboembolics risks, nosocomial infections, falls and delirium in the elderly, morbidity and mortality. Outlier patients, compared to standard patients, stay longer in the emergency department and their discharge documents are available later. Outlying is used daily in the CHUV hospital and new strategies are elaborated to manage patient flow, especially during the flu epidemic...
January 17, 2018: Revue Médicale Suisse
https://www.readbyqxmd.com/read/29341157/minimizing-inequality-in-access-to-precision-medicine-in-breast-cancer-by-real-time-population-based-molecular-analysis-in-the-scan-b-initiative
#19
L Rydén, N Loman, C Larsson, C Hegardt, J Vallon-Christersson, M Malmberg, H Lindman, A Ehinger, L H Saal, Å Borg
BACKGROUND: Selection of systemic therapy for primary breast cancer is currently based on clinical biomarkers along with stage. Novel genomic tests are continuously being introduced as more precise tools for guidance of therapy, although they are often developed for specific patient subgroups. The Sweden Cancerome Analysis Network - Breast (SCAN-B) initiative aims to include all patients with breast cancer for tumour genomic analysis, and to deliver molecular subtype and mutational data back to the treating physician...
January 2018: British Journal of Surgery
https://www.readbyqxmd.com/read/29341069/reliability-and-validity-of-iscoreb-instrument-for-scoring-clinical-outcomes-of-research-for-epidermolysis-bullosa
#20
A L Bruckner, D L Fairclough, J A Feinstein, I Lara-Corrales, Anne W Lucky, Jakub Tolar, Elena Pope
BACKGROUND: Epidermolysis bullosa (EB) is a group of rare and currently incurable genetic blistering disorders. As more pathogenic driven therapies are being developed, the need for EB-specific validated outcomes measures designed for use in clinical trials is becoming important. OBJECTIVES: We previously reported on development of an instrument for scoring clinical outcomes of research for Epidermolysis Bullosa (iscorEB), a new combined clinician and patient reported outcomes tool...
January 17, 2018: British Journal of Dermatology
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