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https://www.readbyqxmd.com/read/28212479/-spinal-tuberculosis-experience-in-a-third-level-medical-facility-in-puebla-mexico
#1
Rolando Joshua Medina-Peñasco, Martha Imelda Rosas-Ramírez, Rodolfo Gregorio Barragán-Hervella, Ivan Alvarado-Ortega, Gerardo López-Cázares, Álvaro José Montiel-Jarquín, María Socorro Romero-Figueroa
BACKGROUND: Pott's disease or spinal tuberculosis (STB) is a serious infectious disease, caused by the migration of the bacterium Mycobacterium tuberculosis to the spine. Knowing this disease is a priority for all the physicians. The objective was to show the experience in patients with STB treated in a third level hospital in Puebla, Mexico. METHODS: Descriptive study. From January to December, 2014, we collected information of patients with STB. The variables were age, gender, length of hospital stay, affected segment of the spine, associated diseases, symptoms, diagnostic methods, type of treatment and complication...
2017: Revista Médica del Instituto Mexicano del Seguro Social
https://www.readbyqxmd.com/read/28212117/validation-of-the-incept-a-multisource-feedback-tool-for-capturing-different-perspectives-on-physicians-professional-performance
#2
Mirja W van der Meulen, Benjamin C M Boerebach, Alina Smirnova, Sylvia Heeneman, Mirjam G A Oude Egbrink, Cees P M van der Vleuten, Onyebuchi A Arah, Kiki M J M H Lombarts
INTRODUCTION: Multisource feedback (MSF) instruments are used to and must feasibly provide reliable and valid data on physicians' performance from multiple perspectives. The "INviting Co-workers to Evaluate Physicians Tool" (INCEPT) is a multisource feedback instrument used to evaluate physicians' professional performance as perceived by peers, residents, and coworkers. In this study, we report on the validity, reliability, and feasibility of the INCEPT. METHODS: The performance of 218 physicians was assessed by 597 peers, 344 residents, and 822 coworkers...
February 15, 2017: Journal of Continuing Education in the Health Professions
https://www.readbyqxmd.com/read/28211341/food-protein-induced-enterocolitis-syndrome
#3
REVIEW
A Nowak-Węgrzyn, E Jarocka-Cyrta, Apb Moschione Castro
Food protein-induced enterocolitis syndrome (FPIES) is a non-IgE-, cell-mediated food allergy of unknown prevalence and pathophysiology. Onset is typically during the first year of life; seafood-induced FPIES may start in adulthood. Acute FPIES manifests within 1-4 hours after ingestion with repetitive emesis, pallor, and lethargy progressing to dehydration and hypovolemic shock in 15% of cases. Chronic FPIES manifests with intermittent emesis, watery diarrhea, and poor growth progressing to dehydration and hypovolemic shock over a period of days to weeks...
2017: Journal of Investigational Allergology & Clinical Immunology
https://www.readbyqxmd.com/read/28211045/walk-in-clinics-versus-physician-offices-and-emergency-rooms-for-urgent-care-and-chronic-disease-management
#4
REVIEW
Connie E Chen, Christopher T Chen, Jia Hu, Ateev Mehrotra
BACKGROUND: Walk-in clinics are growing in popularity around the world as a substitute for traditional medical care delivered in physician offices and emergency rooms, but their clinical efficacy is unclear. OBJECTIVES: To assess the quality of care and patient satisfaction of walk-in clinics compared to that of traditional physician offices and emergency rooms for people who present with basic medical complaints for either acute or chronic issues. SEARCH METHODS: We searched CENTRAL, MEDLINE, Embase, six other databases, and two trials registers on 22 March 2016 together with reference checking, citation searching, and contact with study authors to identify additional studies...
February 17, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28210986/the-role-of-the-pharmacist-in-managing-type-2-diabetes-with-glucagon-like-peptide-1-receptor-agonists-as-add-on-therapy
#5
REVIEW
Jerry Meece
: The prevalence and associated clinical burden of type 2 diabetes (T2D) is increasing in the USA and other countries. As a consequence, the role of the pharmacist in managing T2D is expanding, and it is becoming increasingly important for pharmacists to have a complete understanding of the disease course and treatment options. Pharmacists have a key role in the use of injectable therapies, including incretin-based treatment with glucagon-like peptide-1 receptor agonists (GLP-1RAs). This article discusses the role of the pharmacist in the management of patients with T2D, particularly with respect to the use of GLP-1RAs to achieve glycemic control...
February 16, 2017: Advances in Therapy
https://www.readbyqxmd.com/read/28210646/pain-assessment-after-anterior-cruciate-ligament-reconstruction-bone-patellar-tendon-bone-versus-hamstring-tendon-autograft
#6
Kelechi R Okoroha, Robert A Keller, Edward K Jung, Lafi Khalil, Nathan Marshall, Patricia A Kolowich, Vasilios Moutzouros
BACKGROUND: Anterior cruciate ligament (ACL) reconstruction is a common outpatient procedure that is accompanied by significant postoperative pain. PURPOSE: To determine differences in acute pain levels between patients undergoing ACL reconstruction with bone-patellar tendon-bone (BTB) versus hamstring tendon (HS) autograft. STUDY DESIGN: Cohort study; Level of evidence, 2. METHODS: A total of 70 patients who underwent primary ACL reconstruction using either BTB or HS autografts consented to participate...
December 2016: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/28210563/neoadjuvant-therapy-for-treatment-of-breast-cancer-the-way-forward-or-simply-a-convenient-option-for-patients
#7
COMMENT
Abhishek Chatterjee, John K Erban
The complexity of managing early stage breast cancer is well known. Optimal treatment is increasingly multidisciplinary and in the modern era informed by sophisticated molecular tools to help select and guide therapy. Major phase III trials have determined that the order of systemic therapy relative to surgery does not influence important endpoints such as event free survival and overall survival (OS), but questions remain as to how best to utilize these most essential services. For example, there is still uncertainty regarding the ideal timing, intensity, and duration of proposed therapy...
February 2017: Gland Surgery
https://www.readbyqxmd.com/read/28210525/ransomware-minimizing-the-risks
#8
Justin Pope
This ongoing column is dedicated to providing information to our readers on managing legal risks associated with medical practice. We invite questions from our readers. The answers are provided by PRMS, Inc. (www.prms.com), a manager of medical professional liability insurance programs with services that include risk management consultation, education and onsite risk management audits, and other resources to healthcare providers to help improve patient outcomes and reduce professional liability risk. The answers published in this column represent those of only one risk management consulting company...
November 2016: Innovations in Clinical Neuroscience
https://www.readbyqxmd.com/read/28210521/the-right-to-die-in-chronic-disorders-of-consciousness-can-we-avoid-the-slippery-slope-argument
#9
REVIEW
Rocco Salvatore Calabrò, Antonino Naro, Rosaria De Luca, Margherita Russo, Lory Caccamo, Alfredo Manuli, Alessia Bramanti, Placido Bramanti
Managing individuals with chronic disorders of consciousness raises ethical questions about the appropriateness of maintaining life-sustaining treatments and end-of-life decisions for those who are unable to make decisions for themselves. For many years, the positions fostering the "sanctity" of human life (i.e., life is inviolable in any case) have led to maintaining life-sustaining treatments (including artificial nutrition and hydration) in patients with disorders of consciousness, allowing them to live for as long as possible...
November 2016: Innovations in Clinical Neuroscience
https://www.readbyqxmd.com/read/28210350/use-of-physician-in-triage-model-in-the-management-of-abdominal-pain-in-an-emergency-department-observation-unit
#10
John R Marshall, Robert Katzer, Shahram Lotfipour, Bharath Chakravarthy, Siri Shastry, Jessica Andrusaitis, Craig L Anderson, Erik D Barton
INTRODUCTION: Given the nationwide increase in emergency department (ED) visits it is of paramount importance for hospitals to find efficient ways to manage patient flow. The purpose of this study was to determine whether there is a significant difference in success rates, length of stay (LOS), and other demographic factors in two cohorts of patients admitted directly to an ED observation unit (EDOU) under an abdominal pain protocol by a physician in triage (bypassing the main ED) versus those admitted via the traditional pathway (evaluated and treated in the main ED prior to EDOU admission)...
February 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28209705/patients-experiences-of-diabetes-education-teams-integrated-into-primary-care
#11
Barbara Grohmann, Sherry Espin, Enza Gucciardi
OBJECTIVE: To explore patients' perspectives on care received from diabetes education teams (a registered nurse and a registered dietitian) integrated into primary care. DESIGN: Qualitative study using semistructured, one-on-one interviews. SETTING: Three diabetes education programs operating in 11 primary care sites in one region of Ontario. PARTICIPANTS: Twenty-three patients with diabetes. METHODS: Purposeful sampling was used to recruit participants from each site for interviews...
February 2017: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/28209676/what-is-hidradenitis-suppurativa
#12
REVIEW
Erika Yue Lee, Raed Alhusayen, Perla Lansang, Neil Shear, Jensen Yeung
OBJECTIVE: To provide family physicians with an understanding of the epidemiology, clinical features, diagnosis, and management of hidradenitis suppurativa (HS). SOURCES OF INFORMATION: A PubMed literature search was performed using the MeSH term hidradenitis suppurativa. MAIN MESSAGE: Hidradenitis suppurativa is a chronic, recurrent, and debilitating skin condition. It is an inflammatory disorder of the follicular epithelium, but secondary bacterial infection can often occur...
February 2017: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/28209298/utidelone-plus-capecitabine-versus-capecitabine-alone-for-heavily-pretreated-metastatic-breast-cancer-refractory-to-anthracyclines-and-taxanes-a-multicentre-open-label-superiority-phase-3-randomised-controlled-trial
#13
Pin Zhang, Tao Sun, Qingyuan Zhang, Zhongyu Yuan, Zefei Jiang, Xiao Jia Wang, Shude Cui, Yuee Teng, Xi-Chun Hu, Junlan Yang, Hongming Pan, Zhongsheng Tong, Huiping Li, Qiang Yao, Yongsheng Wang, Yongmei Yin, Ping Sun, Hong Zheng, Jing Cheng, Jinsong Lu, Baochun Zhang, Cuizhi Geng, Jian Liu, Roujun Peng, Min Yan, Shaohua Zhang, Jian Huang, Li Tang, Rongguo Qiu, Binghe Xu
BACKGROUND: Utidelone, a genetically engineered epothilone analogue, has shown promise as a potential treatment for breast cancer in phase 1 and 2 trials. The aim of this phase 3 trial was to compare the efficacy and safety of utidelone plus capecitabine versus capecitabine alone in patients with metastatic breast cancer. METHODS: We did a multicentre, open-label, superiority, phase 3, randomised controlled trial in 26 hospitals in China. Eligible participants were female patients with metastatic breast cancer refractory to anthracycline and taxane chemotherapy regimens...
February 10, 2017: Lancet Oncology
https://www.readbyqxmd.com/read/28209267/assessment-of-volume-status-and-appropriate-fluid-replenishment-in-the-setting-of-nephrotic-syndrome
#14
Pierluigi Marzuillo, Stefano Guarino, Andrea Apicella, Rosaria Marotta, Vincenzo Tipo, Laura Perrone, Angela La Manna, Giovanni Montini
BACKGROUND: When the permeability of the glomerular filtration barrier increases, leading to proteinuria, nephrotic syndrome (NS) occurs. First episodes or relapses of NS can be concurrent with acute gastroenteritis (AGE) infections. This condition can cause further deterioration of the hypovolemic state, as intravascular water is lost through both AGE-related vomiting/diarrhea and NS-related fluid shifting into the interstitium. In this case report, we wish to raise the issues about the difficult management of children presenting with both NS and AGE...
February 10, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28208986/atypical-pityriasis-rosea-with-unilateral-presentation
#15
Hoda Badakhsh, Fahameh Fadaei, Mahin Badakhsh, Abbas Balouchi
Pityriasis Rosea (PR) is a common skin disease and characterized by generalized scaly eruptions typically on the trunk and proximal extremities. Atypical presentations of PR are common and can be a diagnostic challenge for clinicians. Here we present a case of a 26-year-old female who presented with a sudden onset of several asymptomatic, erythematous and scaly plaques on her trunk. Plaques sized 0.5-1cm in diameter that were distributed unilaterally (right side) on her chest, back and axilla. Atypical cases of PR are fairly common and less readily recognized...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28208907/current-practice-of-hypertension-in-india-focus-on-blood-pressure-goals
#16
Jagdish S Hiremath, Vijay M Katekhaye, Vijay S Chamle, Rishi M Jain, Amit I Bhargava
INTRODUCTION: Recommended Blood Pressure (BP) goals in elderly and those with co-morbid conditions like Diabetes Mellitus (DM) and Chronic Kidney Disease (CKD) vary in different Hypertension (HTN) management guidelines. AIM: To understand currently followed BP goals and practices among the physicians involved in management of HTN in India. MATERIALS AND METHODS: A cross-sectional, observational survey was conducted at 66(th) annual conference of Cardiological Society of India (CSICON-2014, Hyderabad)...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28208220/allergic-respiratory-disease-different-allergens-different-symptoms
#17
Antonio Valero, Santiago Quirce, Ignacio Dávila, Julio Delgado, Javier Domínguez-Ortega
BACKGROUND: Spanish population is rather homogeneous in its genetic and socio-cultural characteristics, but allergen sensitization shows wide geographical variations. We aimed at assessing whether sensitization to different allergens in the diverse geographical areas induced different clinical and quality of life characteristics in adult patients with a first-time diagnosis of rhinitis and/or asthma. METHODS: Two sequential, identically designed studies were carried out to evaluate such associations (PERFILAR I and II)...
February 16, 2017: Allergy
https://www.readbyqxmd.com/read/28208197/reversal-of-direct-oral-anticoagulants-current-status-and-future-directions
#18
Jeffrey I Weitz
Direct oral anticoagulants (DOACs) are increasingly used for prevention and treatment of venous thromboembolism and for prevention of stroke in patients with nonvalvular atrial fibrillation. In phase III clinical trials that included more than 100,000 patients, the DOACs were at least as effective as vitamin K antagonists (VKAs) and were associated with less serious bleeding, particularly less intracranial bleeding. Real-world evidence supports these outcomes. Despite this, some physicians and patients are concerned about serious bleeding or emergencies unless specific reversal agents for the DOACs are available...
February 2017: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28208046/mycobacterium-chimaera-and-cardiac-surgery
#19
Andrew J Stewardson, Rhonda L Stuart, Allen C Cheng, Paul Dr Johnson
There is an ongoing investigation into infections with non-tuberculous mycobacteria associated with contaminated heater-cooler units used in cardiac surgery. The overall risk is low, but surgical site and disseminated infections have been reported, including one possible case in Australia, mainly with surgery involving implantation of prosthetic material. Mycobacterium chimaera infection should be considered in patients who have previously undergone surgery with cardiopulmonary bypass and who present with cardiac or disseminated infection or sternal wound infection unresponsive to standard antibiotic therapy...
February 20, 2017: Medical Journal of Australia
https://www.readbyqxmd.com/read/28207841/barriers-and-enablers-to-the-implementation-of-the-6-pack-falls-prevention-program-a-pre-implementation-study-in-hospitals-participating-in-a-cluster-randomised-controlled-trial
#20
Darshini R Ayton, Anna L Barker, Renata T Morello, Caroline A Brand, Jason Talevski, Fiona S Landgren, Mayer M Melhem, Evelyn Bian, Sandra G Brauer, Keith D Hill, Patricia M Livingston, Mari Botti
Evidence for effective falls prevention interventions in acute wards is limited. One reason for this may be suboptimal program implementation. This study aimed to identify perceived barriers and enablers of the implementation of the 6-PACK falls prevention program to inform the implementation in a randomised controlled trial. Strategies to optimise successful implementation of 6-PACK were also sought. A mixed-methods approach was applied in 24 acute wards from 6 Australian hospitals. Participants were nurses working on participating wards and senior hospital staff including Nurse Unit Managers; senior physicians; Directors of Nursing; and senior personnel involved in quality and safety or falls prevention...
2017: PloS One
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