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https://www.readbyqxmd.com/read/29154064/living-with-chronic-pain-evaluating-patient-experiences-with-a-medical-group-visit-focused-on-mindfulness-and-non-pharmacological-strategies
#1
Anna Sophia Lestoquoy, Lance D Laird, Suzanne Mitchell, Katherine Gergen-Barnett, N Lily Negash, Kelly McCue, Racquel Enad, Paula Gardiner
OBJECTIVES: Little is known about the acceptance of non-pharmacological group strategies delivered to low income racially diverse patients with chronic pain and depression. This paper examines how the Integrative Medical Group Visit (IMGV) addresses many of the deficits identified with usual care. DESIGN AND SETTING: Six IMGVs cohorts were held at a safety net hospital and two federally funded community health centres. Data was gathered through focus groups. Transcripts were analysed using both a priori codes and inductive coding...
December 2017: Complementary Therapies in Medicine
https://www.readbyqxmd.com/read/29151719/reducing-social-distress-for-chronic-disease-patients-in-primary-care-an-intervention-for-latino-type-2-diabetes-patients-seen-at-community-health-centers
#2
Nancy A Allen, Sofija Zagarins, Garry Welch
Background: Social and behavioral factors have important direct and indirect effects on chronic disease onset and progression. The U.S. health care system is beginning to focus on assessment and management of social and behavioral problems through federal mandates related to meaningful use of electronic health records and improved patient outcomes. Methods: We examined the clinical adoption of a 20-item screening tool to measure social distress focusing on type 2 diabetes...
November 2017: Diabetes Spectrum: a Publication of the American Diabetes Association
https://www.readbyqxmd.com/read/29151441/patients-initial-steps-to-cancer-diagnosis-in-denmark-england-and-sweden-what-can-a-qualitative-cross-country-comparison-of-narrative-interviews-tell-us-about-potentially-modifiable-factors
#3
John MacArtney, Marlene Malmström, Trine Overgaard Nielsen, Julie Evans, Britt-Marie Bernhardson, Senada Hajdarevic, Alison Chapple, Lars E Eriksson, Louise Locock, Birgit Rasmussen, Peter Vedsted, Carol Tishelman, Rikke Sand Andersen, Sue Ziebland
OBJECTIVES: To illuminate patterns observed in International Cancer Benchmarking Programme studies by extending understanding of the various influences on presentation and referral with cancer symptoms. DESIGN: Cross-country comparison of Denmark, England and Sweden with qualitative analysis of in-depth interview accounts of the prediagnostic process in lung or bowel cancer. PARTICIPANTS: 155 women and men, aged between 35 and 86 years old, diagnosed with lung or bowel cancer in 6 months before interview...
November 19, 2017: BMJ Open
https://www.readbyqxmd.com/read/29151439/clopidogrel-or-ticagrelor-in-acute-coronary-syndrome-patients-treated-with-newer-generation-drug-eluting-stents-change-dapt
#4
Paolo Zocca, Liefke C van der Heijden, Marlies M Kok, Marije M Löwik, Marc Hartmann, Martin G Stoel, J W Louwerenburg, Frits H A F de Man, Gerard C M Linssen, Iris L Knottnerus, Carine J M Doggen, K Gert van Houwelingen, Clemens von Birgelen
AIMS: Acute coronary syndrome (ACS) guidelines have been changed, favouring more potent antiplatelet drugs. We aimed to evaluate the safety and efficacy of a ticagrelor- instead of a clopidogrel-based primary dual antiplatelet (DAPT) regimen in ACS patients treated with newer-generation drug-eluting stents (DES). METHODS AND RESULTS: CHANGE DAPT (clinicaltrials.gov: NCT03197298) assessed 2,062 consecutive real-world ACS patients, treated by percutaneous coronary intervention (PCI), the primary composite endpoint being net adverse clinical and cerebral events (NACCE: all-cause death, any myocardial infarction, stroke or major bleeding)...
November 20, 2017: EuroIntervention
https://www.readbyqxmd.com/read/29151365/effectiveness-of-direct-acting-antiviral-therapy-for-hepatitis-c-in-difficult-to-treat-patients-in-a-safety-net-health-system-a-retrospective-cohort-study
#5
Christina Yek, Carolina de la Flor, John Marshall, Cindy Zoellner, Grace Thompson, Lisa Quirk, Christian Mayorga, Barbara J Turner, Amit G Singal, Mamta K Jain
BACKGROUND: Direct-acting antivirals (DAAs) have revolutionized chronic hepatitis C (HCV) treatment, but real-world effectiveness among vulnerable populations, including uninsured patients, is lacking. This study was conducted to characterize the effectiveness of DAAs in a socioeconomically disadvantaged and underinsured patient cohort. METHODS: This retrospective observational study included all patients undergoing HCV treatment with DAA-based therapy between April 2014 and June 2016 at a large urban safety-net health system (Parkland Health and Hospital System, Dallas, TX, USA)...
November 20, 2017: BMC Medicine
https://www.readbyqxmd.com/read/29146439/risk-stratification-after-paracetamol-overdose-using-mechanistic-biomarkers-results-from-two-prospective-cohort-studies
#6
James W Dear, Joanna I Clarke, Ben Francis, Lowri Allen, Jonathan Wraight, Jasmine Shen, Paul I Dargan, David Wood, Jamie Cooper, Simon H L Thomas, Andrea L Jorgensen, Munir Pirmohamed, B Kevin Park, Daniel J Antoine
BACKGROUND: Paracetamol overdose is common but patient stratification is suboptimal. We investigated the usefulness of new biomarkers that have either enhanced liver specificity (microRNA-122 [miR-122]) or provide mechanistic insights (keratin-18 [K18], high mobility group box-1 [HMGB1], and glutamate dehydrogenase [GLDH]). The use of these biomarkers could help stratify patients for their risk of liver injury at hospital presentation. METHODS: Using data from two prospective cohort studies, we assessed the potential for biomarkers to stratify patients who overdose with paracetamol...
November 13, 2017: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29136390/assurance-of-myeloid-growth-factor-administration-in-an-infusion-center-pilot-quality-improvement-initiative
#7
Pamela Maree Ramirez, Barry Peterson, Christine Holtshopple, Kristina Borja, Vincent Torres, Lucille Valdivia-Peppers, Julio Harriague, Melanie D Joe
PURPOSE: Four incident reports involving missed doses of myeloid growth factors (MGFs) triggered the need for an outcome-driven initiative. From March 1, 2015, to February 29, 2016, at University of California Irvine Health Chao Infusion Center, 116 of 3,300 MGF doses were missed (3.52%), including pegfilgrastim, filgrastim, and sargramostim. We hypothesized that with the application of Lean Six Sigma methodology, we would achieve our primary objective of reducing the number of missed MGF doses to < 0...
November 14, 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/29134632/heterogeneous-relationships-between-labor-income-and-health-by-race-ethnicity
#8
Abdulkarim M Meraya, Nilanjana Dwibedi, Kim Innes, Sophie Mitra, Xi Tan, Usha Sambamoorthi
OBJECTIVE: To examine the race-stratified relationships between labor income and health among working-age adults in the United States. DATA SOURCES: Data from eight waves of the Panel Study of Income Dynamics from 1999 through 2013 were used for this study. STUDY DESIGN: The study utilized a retrospective observational longitudinal design with repeated measures of labor income and health measures. System-generalized method of moment and heteroscedasticity-based instrument regressions were used to examine the relationships between labor income and physical and mental health measures, respectively...
November 13, 2017: Health Services Research
https://www.readbyqxmd.com/read/29132991/attitudes-about-adult-vaccines-and-reminder-recall-in-a-safety-net-population
#9
Karen Albright, Laura P Hurley, Steven Lockhart, Dennis Gurfinkel, Brenda Beaty, L Miriam Dickinson, Anne Libby, Allison Kempe
Little is known about adult patients' attitudes toward vaccination and preferences for reminder/recall. The objective of this study was to determine patient perspectives on adult vaccines generally; attitudes about Tdap, pneumococcal polysaccharide (PPSV-23), and seasonal influenza vaccines specifically; and preferences for adult reminder/recall delivery. Twelve focus groups were conducted with 68 patients in a safety net health system. The sample was stratified by preferred language (English or Spanish), age (18-64 or 65+), and health status (with or without chronic conditions)...
November 10, 2017: Vaccine
https://www.readbyqxmd.com/read/29130378/the-experiences-of-patients-with-advanced-cancer-and-caregivers-presenting-to-emergency-departments-a-qualitative-study
#10
Jennifer Philip, Cheryl Remedios, Sibilah Breen, Tracey Weiland, Lisa Willenberg, Mark Boughey, George Jelinek, Heather Lane, Claudia Marck, Jennifer Weil
BACKGROUND: Despite being a common event in the course of an advanced cancer illness, there is little understanding of patients' perceptions of hospital Emergency Department presentations. AIM: To explore the experiences and perceptions of Emergency Departments held by patients with advanced cancer and their informal caregivers. DESIGN: Cross-sectional study involving semi-structured interviews with advanced cancer patients and their informal caregivers...
October 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/29130267/long-term-impact-of-a-postdischarge-community-health-worker-intervention-on-health-care-costs-in-a-safety-net-system
#11
Alison A Galbraith, David J Meyers, Dennis Ross-Degnan, Marguerite E Burns, Catherine E Vialle-Valentin, Marc R Larochelle, Sharon Touw, Fang Zhang, Meredith Rosenthal, Richard B Balaban
OBJECTIVE: Patient navigators (PNs) may represent a cost-effective strategy to improve transitional care and reduce hospital readmissions. We evaluated the impact of a PN intervention on health system costs in the 180 days after discharge for high-risk patients in a safety-net system. DATA SOURCE/SETTING: Primary and secondary data from an academic safety-net health system. STUDY DESIGN: We compared per-patient utilization and costs, overall and by age, for high-risk, medical service patients randomized to the PN intervention relative to usual care between October 2011 and April 2013...
December 2017: Health Services Research
https://www.readbyqxmd.com/read/29126138/-those-conversations-in-my-experience-don-t-go-well-a-qualitative-study-of-primary-care-provider-experiences-tapering-long-term-opioid-medications
#12
Laura C Kennedy, Ingrid A Binswanger, Shane R Mueller, Cari Levy, Daniel D Matlock, Susan L Calcaterra, Stephen Koester, Joseph W Frank
Objective: Given the risks of long-term opioid therapy, patients may benefit from tapering these medications. There is little evidence to guide providers' approach to this process. We explored primary care providers' experiences discussing and implementing opioid tapering with patients on long-term opioid therapy. Design: Qualitative study using six semistructured, in-person focus groups. Subjects: Primary care providers (N = 40). Setting: Six academically affiliated primary care clinics in university, urban safety net, and Veterans Health Administration medical centers in Colorado...
November 4, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29122906/safety-netting-versus-overtreatment-in-paediatrics-viral-infection-or-incomplete-kawasaki-disease
#13
Jennifer Michelle Charlesworth, Bernadette Power, Edina Moylett
Kawasaki disease (KD) is the most common systemic vasculitis of childhood. The following presentation of a 4-year-old Irish boy referred to a secondary care paediatric service from the community with prolonged fever, oral mucous membrane changes and painless blistering lesions of the hands and feet in the presence of elevated inflammatory markers serves as an opportunity to discuss the diagnostic criteria and treatment for KD and incomplete KD, an often missed diagnosis with significant paediatric morbidity outside an academic paediatric centre...
November 8, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29121530/an-ecological-momentary-intervention-for-smoking-cessation-the-associations-of-just-in-time-tailored-messages-with-lapse-risk-factors
#14
Emily T Hébert, Elise M Stevens, Summer G Frank, Darla E Kendzor, David W Wetter, Michael J Zvolensky, Julia D Buckner, Michael S Businelle
BACKGROUND: Smartphone apps can provide real-time, tailored interventions for smoking cessation. The current study examines the effectiveness of a smartphone-based smoking cessation application that assessed risk for imminent smoking lapse multiple times per day and provided messages tailored to current smoking lapse risk and specific lapse triggers. METHODS: Participants (N=59) recruited from a safety-net hospital smoking cessation clinic completed phone-based ecological momentary assessments (EMAs) 5 times/day for 3 consecutive weeks (1week pre-quit, 2weeks post-quit)...
October 28, 2017: Addictive Behaviors
https://www.readbyqxmd.com/read/29119588/an-early-pregnancy-unit-in-the-united-states-an-effective-method-for-evaluating-first-trimester-pregnancy-complications
#15
Polina Rovner, Elaine Stickrath, Meredith Alston, Kirsten Lund
In the United Kingdom, early pregnancy assessment clinics have existed since the early 1990s and have become the reference standard for evaluating and treating women with first-trimester pregnancy complications. These units have now been established in many countries and have been found to be effective and efficient, saving money and unnecessary emergency department visits and hospital admissions. To our knowledge, no such model has been described in the United States. A PubMed search using a combination of "early pregnancy unit," "early pregnancy assessment clinic," and "United States," "U...
November 9, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/29119147/betrixaban-a-direct-oral-inhibitor-of-activated-factor-x-for-the-prophylaxis-of-venous-thromboembolism-in-patients-hospitalized-for-acute-medical-illness
#16
G Escolar, M Díaz-Ricart, E Arellano-Rodrigo
Venous thromboembolism (VTE), comprising deep vein thrombosis and pulmonary embolism, is a serious clinical and public health concern. Hospitalization is a major risk factor for developing VTE. Hospital-associated events account for more than 50% of all cases of VTE. Heparins have demonstrated to be efficacious in the prevention of VTE in medically ill patients. Despite the demonstrated efficacy and safety of the available direct oral anticoagulants in the prevention and treatment of different thromboembolic conditions, their net benefit in the prevention of VTE in hospitalized medically ill patients has not been fully confirmed...
August 2017: Drugs of Today
https://www.readbyqxmd.com/read/29117725/experiencing-financial-hardship-associated-with-medical-bills-and-its-effects-on-health-care-behavior-a-2-year-panel-study
#17
Sunha Choi
Using 2-year panel data, this study examined (1) whether experiencing financial hardship associated with out-of-pocket medical expenditures affected delaying/missing necessary health care in the following year; (2) whether such financial hardship mediated the effects of predisposing, enabling, and need characteristics on timely health care access (i.e., significant indirect effects); and (3)whether such mediating effects are different by chronic health status (i.e., moderated mediation) among U.S. adults. The 2011 National Health Interview Survey was linked to the 2012 Medical Expenditure Panel Survey...
November 1, 2017: Health Education & Behavior: the Official Publication of the Society for Public Health Education
https://www.readbyqxmd.com/read/29113840/extended-venous-thromboembolism-prophylaxis-after-radical-cystectomy-a-call-for-adherence-to-current-guidelines
#18
REVIEW
Zachary Klaassen, Karan Arora, Hanan Goldberg, Thenappan Chandrasekar, Christopher J D Wallis, Rashid K Sayyid, Neil E Fleshner, Antonio Finelli, Alexander Kutikov, Philippe D Violette, Girish S Kulkarni
PURPOSE: Radical cystectomy (RC) is an inherently morbid procedure. The purpose of this review is to assess the timing and incidence of venous thromboembolism (VTE), review current guideline recommendations, and provide evidence for considering extended VTE prophylaxis among all patients undergoing RC. MATERIALS AND METHODS: We conducted a PubMed search of available literature for RC and VTE, focusing on: incidence and timing, evidence supporting extended VTE prophylaxis (among RC and abdominal surgical oncology patients), current guideline recommendations, safety considerations, and direct oral anticoagulants...
November 4, 2017: Journal of Urology
https://www.readbyqxmd.com/read/29112329/in-vitro-and-in-vivo-investigation-of-potential-for-complex-cyp3a-interaction-for-pf-00251802-dagrocorat-a-novel-dissociated-agonist-of-the-glucocorticoid-receptor
#19
Sharon L Ripp, Arnab Mukherjee, Heather Eng, Thomas Stock, Dona Fleishaker, Tina Checchio, Brinda Tammara
The dissociated agonists of the glucocorticoid receptor are a novel class of agents in clinical development for rheumatoid arthritis. PF-04171327 (fosdagrocorat) is a phosphate ester prodrug of PF-00251802 (dagrocorat), a selective high-affinity partial agonist of the glucocorticoid receptor, which is further metabolized to PF-04015475. This study evaluated the cytochrome P450 (CYP)-mediated drug-drug interaction (DDI) potential of PF-00251802 and PF-04015475 in vitro and used model-based prediction approaches to estimate clinical impact...
November 7, 2017: Clinical Pharmacology in Drug Development
https://www.readbyqxmd.com/read/29105843/the-liver-recipient-with-acute-renal-dysfunction-a-single-institution-evaluation-of-the-simultaneous-liver-kidney-transplant-candidate
#20
Kunal Yadav, Oscar K Serrano, Kent J Peterson, Timothy L Pruett, Raja Kandaswamy, Ananta Bangdiwala, Hassan Ibrahim, Ajay Israni, John Lake, Srinath Chinnakotla
The Organ Procurement Transplant Network (OPTN) listing criteria for simultaneous liver-kidney transplant (SLK) are not well defined. Concerns remain about rising numbers of SLKs, which divert quality kidneys from candidates awaiting kidney transplants (KT). We performed a retrospective review of liver transplants (LT) at our center from 2004-14; 127 recipients (Liver transplant alone; 102 LTA, 25 SLK) were identified with short-term preoperative kidney dysfunction (creatinine >4 mg/dL or preoperative hemodialysis [HD] for <6 wks)...
November 4, 2017: Clinical Transplantation
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