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https://www.readbyqxmd.com/read/28436256/clinical-and-economic-impact-of-hyperkalemia-in-patients-with-chronic-kidney-disease-and-heart-failure
#1
Michael Polson, Todd C Lord, Anne Kangethe, Lindsay Speicher, Carolyn Farnum, Melanie Brenner, Nina Oestreicher, Paula Alvarez
BACKGROUND: Hyperkalemia (HK) is a concern for patients with chronic kidney disease (CKD) and heart failure (HF), and for those receiving treatments that inhibit the renin-angiotensin-aldosterone system (RAASi). An analysis of 1.7 million medical records of patients in the United States revealed that among individuals with more than 2 potassium values during 2007 to 2012, HK was detected in 34.6% of patients with CKD and 30.0% of patients with HF. OBJECTIVE: To evaluate the association of HK and use of RAASi therapies at optimal and suboptimal doses in patients with CKD and/or HF with health care resource utilization and overall cost of care in a diverse cohort of commercially insured patients...
April 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28426287/pregnancy-and-the-acceptability-of-computer-based-versus-traditional-mental-health-treatments
#2
Liisa Hantsoo, Jessica Podcasy, Mary Sammel, Cynthia Neill Epperson, Deborah R Kim
BACKGROUND: Recent recommendations urge increased depression screening in pregnant and postpartum women, potentially increasing demand for treatment. Computer-based psychotherapy treatments may address some of perinatal women's unique mental health treatment needs and barriers. MATERIALS AND METHODS: We conducted a quantitative survey of pregnant women (≥12 weeks of gestation) on preferences regarding computer-based therapies compared with traditional therapies (psychotherapy and medication)...
April 20, 2017: Journal of Women's Health
https://www.readbyqxmd.com/read/28422795/trial-design-and-endpoint-evaluation-in-clinical-studies-addressing-chronic-back-pain
#3
Peter Staats
STUDY DESIGN: A review of the literature evaluating clinical trials of chronic back pain. OBJECTIVE: To assist physicians in assessing the quality of clinical trial data to make the most informed treatment decisions. SUMMARY OF BACKGROUND DATA: Chronic pain is a tremendous public health issue, affecting close to 100 million adults in the United States, and costs the American people billions of dollars. One traditional treatment approach, the long-term use of opiate medications, has recently come under intense scrutiny for problems with complications, diversion, abuse, addiction and lack of efficacy...
April 18, 2017: Spine
https://www.readbyqxmd.com/read/28420803/comparison-of-the-american-college-of-cardiology-american-heart-association-and-the-european-society-of-cardiology-guidelines-for-the-management-of-patients-with-valvular-heart-disease
#4
Aya J Alame, Aris Karatasakis, Judit Karacsonyi, Barbara A Danek, Paul Sorajja, Mario Gössl, Santiago Garcia, Hani Jneid, Nikolaos Kakouros, Jose Roberto Martinez-Parachini, Erica Resendes, Pratik Kalsaria, Michele Roesle, Bavana V Rangan, Subhash Banerjee, Emmanouil S Brilakis
BACKGROUND: The American College of Cardiology/American Heart Association (ACC/AHA) and the European Society of Cardiology (ESC) have developed guidelines to assist clinicians in making evidence-based decisions. This study compares the ACC/AHA and ESC guidelines for the management of patients with valvular heart disease (VHD). METHODS: The current ACC/AHA and ESC guidelines for VHD, last updated in 2014 and 2012, respectively, were compared by class of recommendation (COR), level of evidence (LOE), and content...
April 15, 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28419875/falls-in-people-with-parkinson-s-disease-a-prospective-comparison-of-community-and-home-based-falls
#5
Robyn M Lamont, Meg E Morris, Hylton B Menz, Jennifer L McGinley, Sandra G Brauer
BACKGROUND: Falls are common and debilitating in people with Parkinson's disease (PD) and restrict participation in daily activities. Understanding circumstances of falls in the community and at home may assist clinicians to target therapy more effectively. OBJECTIVE: To compare the characteristics of community and home fallers and the circumstances that contribute to falls in people living with PD. METHODS: People with mild-moderately severe PD (n=196) used a daily falls diary and telephone hotline to report prospectively the occurrence, location and circumstances of falls over 14 months...
April 4, 2017: Gait & Posture
https://www.readbyqxmd.com/read/28419149/mobile-health-treatment-support-intervention-for-hiv-and-tuberculosis-in-mozambique-perspectives-of-patients-and-healthcare-workers
#6
José António Nhavoto, Åke Grönlund, Gunnar O Klein
BACKGROUND: Studies have been conducted in developing countries using SMS to communicate with patients to reduce the number of missed appointments and improve retention in treatment, however; very few have been scaled up. One possible reason for this could be that patients or staff are dissatisfied with the method in some way. This paper reports a study of patients' and healthcare workers' (HCW) views on an mHealth intervention aiming to support retention in antiretroviral therapy (ART) and tuberculosis (TB) treatment in Mozambique...
2017: PloS One
https://www.readbyqxmd.com/read/28414666/just-a-puff-of-smoke
#7
A Leonard
CASE: A 44 year old woman with a history of stroke s/p aneurysm clipping, seizure, and substance abuse was brought to the hospital after a family member received a call from her friend saying she was acting unusual and may have had a seizure while hanging out on the street. At her baseline, she needed modest assistance in daily activities after her CVA and conversed without issue. Her mother died of a stroke. On exam the patient was afebrile, normotensive with mild tachycardia to 110...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28413581/robotic-assisted-inferior-vena-cava-filter-retrieval
#8
Shahin Owji, Tony Lu, Thomas M Loh, Adeline Schwein, Alan B Lumsden, Jean Bismuth
Although anticoagulation remains the mainstay of therapy for patients with venous thromboembolism, guidelines recommend the use of inferior vena cava (IVC) filters in those who fail anticoagulation or have contraindications to its use. Short-term use of filters has proven effective in reducing the rate of pulmonary embolism. However, their extended use is associated with a variety of complications such as thrombosis, filter migration, or caval perforation, thus making a case for timely filter retrieval. This is the case of a 68-year-old female with a history of chronic oral anticoagulation use for multiple deep venous thrombi (DVT) and pulmonary emboli (PE) who required cervical and thoracic spinal intervention for spondylosis and foramina stenosis...
January 2017: Methodist DeBakey Cardiovascular Journal
https://www.readbyqxmd.com/read/28412431/3d-morphological-changes-in-lv-and-rv-during-lvad-ramp-studies
#9
Karima Addetia, Nir Uriel, Francesco Maffessanti, Gabriel Sayer, Sirtaz Adatya, Gene H Kim, Nitasha Sarswat, Savitri Fedson, Diego Medvedofsky, Eric Kruse, Keith Collins, Daniel Rodgers, Takayoshi Ota, Valluvan Jeevanandam, Victor Mor-Avi, Daniel Burkhoff, Roberto M Lang
OBJECTIVES: The purpose of this study was to investigate the differential impact of the 2 most commonly available left ventricular assist device (LVAD) types on the right (RV) and left (LV) ventricles using 3-dimensional (3D) echocardiography-based analysis of ventricular morphology. BACKGROUND: LVADs have emerged as common therapy for advanced heart failure. Recent data suggest that the heart responds differently to speed settings in the 2 main devices available (HeartMate II [HMII], St Jude Medical, Pleasanton, California, and HVAD, HeartWare International, Framingham, Massachusetts)...
April 7, 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28412054/community-pharmacy-transition-of-care-services-and-rural-hospital-readmissions-a-case-study
#10
Allison P Patton, Yifei Liu, D Matthew Hartwig, Justin R May, Jessica Moon, Steven C Stoner, Kendall D Guthrie
OBJECTIVES: To explore community pharmacist involvement in the transition of care (TOC) process for patients discharged with acute myocardial infarction (AMI), heart failure (HF), pneumonia, chronic obstructive pulmonary disease (COPD), or elective total hip or knee arthroplasty (THA/TKA). SETTING: Patients discharged from a 60-bed acute care hospital located in rural Missouri were seen by a community pharmacist in 2 independent community pharmacy chain locations...
April 12, 2017: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/28411013/physician-reported-factors-that-encourage-collaboration-with-community-pharmacists
#11
Nicole C Pezzino, Macary Weck Marciniak, Megan G Smith, Stefanie P Ferreri
OBJECTIVE: To determine factors that encourage physicians to establish collaborative practice agreements with community pharmacists. METHODS: A 20-item cross-sectional survey was mailed to a random sample of 1000 family medicine physicians practicing in North Carolina. Two weeks after the initial mailing, a reminder was sent to physicians. Physicians were entered into a drawing to receive a gift card as an incentive for survey completion. The questionnaire collected demographic information, factors important to physicians for collaboration with a community pharmacist, and physician perceptions of pharmacist qualifications...
April 12, 2017: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/28410689/photoneutron-depth-dose-equivalent-distributions-in-high-energy-x-ray-medical-accelerators-by-a-novel-position-sensitive-dosimeter
#12
Amir Hakimi, Mehdi Sohrabi
PURPOSE: The purpose of this study was to; (1) investigate employing a novel position-sensitive mega-size polycarbonate (MSPC) dosimeter for photoneutron (PN) depth, profile and dose equivalent distributions studies in a multilayer polyethylene phantom in a Siemens ONCOR accelerator, and (2) develop depth dose equivalent distribution matrix data at different depths and positions of the phantom for patient PN dose equivalent determination and in particular for PN secondary cancer risk estimation...
April 2017: Physica Medica: PM
https://www.readbyqxmd.com/read/28409731/a-direct-aspiration-first-pass-technique-vs-stentriever-thrombectomy-in-emergent-large-vessel-intracranial-occlusions
#13
Christopher J Stapleton, Thabele M Leslie-Mazwi, Collin M Torok, Reza Hakimelahi, Joshua A Hirsch, Albert J Yoo, James D Rabinov, Aman B Patel
OBJECTIVE Endovascular thrombectomy in patients with acute ischemic stroke caused by occlusion of the proximal anterior circulation arteries is superior to standard medical therapy. Stentriever thrombectomy with or without aspiration assistance was the predominant technique used in the 5 randomized controlled trials that demonstrated the superiority of endovascular thrombectomy. Other studies have highlighted the efficacy of a direct aspiration first-pass technique (ADAPT). METHODS To compare the angiographic and clinical outcomes of ADAPT versus stentriever thrombectomy in patients with emergent large vessel occlusions (ELVO) of the anterior intracranial circulation, the records of 134 patients who were treated between June 2012 and October 2015 were reviewed...
April 14, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28408620/oncofertility-fertile-ground-for-conflict-between-patient-autonomy-and-medical-values
#14
Sarah K Walsh, Elizabeth S Ginsburg, Lisa Soleymani Lehmann, Ann H Partridge
Oncofertility is a unique, multidisciplinary field that serves to bridge the gap between available fertility resources and the special reproductive needs of cancer patients. Oncofertility is a growing field due to the increasing number of survivors, development of new oncologic therapies, extension of duration of therapies, and development and refinement of reproductive therapies. While the technologies and demand for services expand, clinicians need to be appropriately prepared for dealing with various clinical scenarios that may require ethical deliberation...
April 13, 2017: Oncologist
https://www.readbyqxmd.com/read/28408171/evaluation-of-the-impact-of-a-residency-in-an-independent-pharmacy-in-rural-mississippi
#15
Meagan Brown, Laurie Fleming, Mary Jean Sewell, Leigh Ann Ross
OBJECTIVES: To evaluate the impact of a postgraduate year 1 (PGY1) community pharmacy residency program on clinical pharmacy service implementation and enhancement in a rural Mississippi community. SETTING: An independent rural community pharmacy in Canton, MS. PRACTICE DESCRIPTION AND INNOVATION: Delivery of clinical pharmacy services provided by PGY1 community residents 1 day a week to an underserved population during an 18-month period...
April 10, 2017: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/28403462/medicaid-coverage-of-smoking-cessation-counseling-and-medication-is-underutilized-for-pregnant-women
#16
Taneisha S Scheuermann, Kimber P Richter, Lisette T Jacobson, Theresa I Shireman
Introduction: Policies to promote smoking cessation among Medicaid-insured pregnant women have the potential to assist a significant proportion of pregnant smokers. In 2010, Kansas Medicaid began covering smoking cessation counseling for pregnant smokers. Our aim was to evaluate the use of smoking cessation benefits provided to pregnant women as a result of the Kansas Medicaid policy change that provided reimbursement for physician-provided smoking cessation counseling. Methods: We examined Kansas Medicaid claims data to estimate rates of delivery of smoking cessation treatment to Medicaid-insured pregnant women in Kansas from fiscal year 2010 through 2013...
May 1, 2017: Nicotine & Tobacco Research: Official Journal of the Society for Research on Nicotine and Tobacco
https://www.readbyqxmd.com/read/28402533/caregiver-perspectives-about-using-antipsychotics-and-other-medications-for-symptoms-of-dementia
#17
John William Kerns, Jonathan D Winter, Katherine M Winter, Christine C Kerns, Rebecca S Etz
Background and Objectives: To avoid "chemical restraints," policies and guidelines have been implemented to curb the use of medications for behavioral and psychological symptoms of dementia (BPSD). Antipsychotics have been particularly targeted because of their rare severe side effects. Consequently, caregiver directed non-pharmacologic therapies have increased while medication use for BPSD has diminished. Despite such initiatives, however, antipsychotics continue to be prescribed "off-label" for roughly 20% of nursing home patients...
April 11, 2017: Gerontologist
https://www.readbyqxmd.com/read/28400222/self-reported-health-and-safety-awareness-improves-prediction-of-level-of-care-needs-in-veterans-discharged-from-a-post-acute-unit
#18
Julija Stelmokas, Linas A Bieliauskas, Katherine A Kitchen Andren, Robert Hogikyan, Neil B Alexander
OBJECTIVES: Evaluate the differential value of a self-reported health and safety awareness measure relative to other medical, psychosocial, and cognitive factors in predicting level of care (LOC) needs following hospital discharge. DESIGN: Retrospective medical record review. SETTING: Community Living Center Post-Acute Care (CLC-PAC) unit at a Veterans Affairs (VA) hospital. PARTICIPANTS: 175 Veterans admitted to the VA hospital or directly to the CLC-PAC from home...
April 8, 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/28399932/guideline-recommendations-for-diagnosis-and-clinical-management-of-ring14-syndrome-first-report-of-an-ad-hoc-task-force
#19
REVIEW
Berardo Rinaldi, Alessandro Vaisfeld, Sergio Amarri, Chiara Baldo, Giuseppe Gobbi, Pamela Magini, Erto Melli, Giovanni Neri, Francesca Novara, Tommaso Pippucci, Romana Rizzi, Annarosa Soresina, Laura Zampini, Orsetta Zuffardi, Marco Crimi
BACKGROUND: Ring chromosome 14 syndrome is a rare chromosomal disorder characterized by early onset refractory epilepsy, intellectual disability, autism spectrum disorder and a number of diverse health issues. RESULTS: The aim of this work is to provide recommendations for the diagnosis and management of persons affected by ring chromosome 14 syndrome based on evidence from literature and experience of health professionals from different medical backgrounds who have followed for several years subjects affected by ring chromosome 14 syndrome...
April 11, 2017: Orphanet Journal of Rare Diseases
https://www.readbyqxmd.com/read/28396932/comparison-of-analgaesia-with-lumbar-epidurals-and-lumbar-plexus-nerve-blocks-in-patients-receiving-multimodal-analgaesics-following-primary-total-hip-arthroplasty-a-retrospective-analysis
#20
N Robert Harvey, Bethany J Wolf, Eric D Bolin, Sylvia H Wilson
PURPOSE: Significant post-operative pain occurs after hip arthroplasty. In a prior study, lumbar plexus nerve blocks provided comparable analgaesia to lumbar epidurals; however, multimodal analgaesics were not used consistently. METHODS: This study assessed a randomly selected cohort of 48 patients undergoing primary hip arthroplasty who received a regional anaesthesia technique for post-operative pain. Twenty-four patients with lumbar epidurals and 24 with single-injection lumbar plexus nerve blocks were reviewed using electronic medical records...
April 11, 2017: International Orthopaedics
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