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https://www.readbyqxmd.com/read/29029240/a-greater-extent-of-insomnia-symptoms-and-physician-recommended-sleep-medication-use-predict-fall-risk-in-community-dwelling-older-adults
#1
Tuo-Yu Chen, Soomi Lee, Orfeu M Buxton
Study Objectives: Cross-sectional studies suggest that insomnia symptoms are associated with falls in later life. This longitudinal study examines the independent and interactive effects of the extent of insomnia symptoms (i.e., multiple co-existing insomnia symptoms) and sleep medications on fall risk over a 2-year follow-up among community-dwelling older adults. Methods: Using data from the Health and Retirement Study (2006-2014, N = 6882, Mage = 74.5 years ± 6...
October 3, 2017: Sleep
https://www.readbyqxmd.com/read/29029109/early-diagnosis-of-acute-coronary-syndrome
#2
Hugo Katus, André Ziegler, Okan Ekinci, Evangelos Giannitsis, Wendy Gattis Stough, Stephan Achenbach, Stefan Blankenberg, Martina Brueckmann, Paul Collinson, Dorin Comaniciu, Filippo Crea, Wilfried Dinh, Grégory Ducrocq, Frank A Flachskampf, Keith A A Fox, Matthias G Friedrich, Kathy A Hebert, Anders Himmelmann, Mark Hlatky, Dominik Lautsch, Bertil Lindahl, Daniel Lindholm, Nicholas L Mills, Giorgio Minotti, Martin Möckel, Torbjørn Omland, Véronique Semjonow
The diagnostic evaluation of acute chest pain has been augmented in recent years by advances in the sensitivity and precision of cardiac troponin assays, new biomarkers, improvements in imaging modalities, and release of new clinical decision algorithms. This progress has enabled physicians to diagnose or rule-out acute myocardial infarction earlier after the initial patient presentation, usually in emergency department settings, which may facilitate prompt initiation of evidence-based treatments, investigation of alternative diagnoses for chest pain, or discharge, and permit better utilization of healthcare resources...
October 3, 2017: European Heart Journal
https://www.readbyqxmd.com/read/29028636/effects-and-unforeseen-consequences-of-accessing-references-on-a-maintenance-of-certification-examination-findings-from-a-national-study
#3
Richard A Feinberg, Daniel Jurich, Lauren M Foster
PURPOSE: Increasing criticism of maintenance of certification (MOC) examinations has prompted certifying boards to explore alternative assessment formats. The purpose of this study was to examine the effect of allowing test takers to access reference material while completing their MOC Part III standardized examination. METHOD: Item response data were obtained from 546 physicians who completed a medical subspecialty MOC examination between 2013 and 2016. To investigate if accessing references was related to better performance, an analysis of covariance was conducted on the MOC examination scores with references (access or no access) as the between-groups factor and scores from the physicians' initial certification examination as a covariate...
October 12, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/29028376/interprofessional-pulmocheck-care-pathway-an-innovative-approach-to-managing-pediatric-asthma-care-in-the-netherlands
#4
J M J E Meuwissen, J Heynens, T Dauven, L Crasborn, F W J M Smeenk, T van der Weijden, J W M Muris
OBJECTIVES: Under-diagnosis and suboptimal asthma control in children persists. An innovative care pathway was developed by a hospital department of pediatrics with the aim to detect pulmonary problems in children and provide appropriate treatment possibilities through systematic feedback towards the referring primary care physician. Primary care physicians can use this pathway to refer children with asthma-like symptoms for a one-day assessment. Goals are to measure the usage of the pathway by primary care general practitioners (GPs), the outcomes in terms of new diagnoses of asthma, the reduction in regular referrals, generated recommendations/therapy and the adequacy of asthma follow-up...
October 13, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/29027127/use-of-supplementary-patient-education-material-increases-treatment-adherence-and-satisfaction-among-acne-patients-receiving-adapalene-0-1-benzoyl-peroxide-2-5-gel-in-primary-care-clinics-a-multicenter-randomized-controlled-clinical-study
#5
Timothy Myhill, Warwick Coulson, Paul Nixon, Simon Royal, Terry McCormack, Nabil Kerrouche
INTRODUCTION: Poor adherence to acne treatment may lead to unnecessary treatments, increased healthcare costs, and reduced quality of life (QoL). This multicenter study evaluated the effect of supplementary patient education material (SEM) (a short video, information card, and additional information available online) on treatment adherence and satisfaction among acne patients treated with the fixed-dose combination adapalene 0.1%/benzoyl peroxide 2.5% gel (A/BPO) in primary care clinics versus (1) standard-of-care patient education (SOCPE) (package insert and oral instruction) and (2) SOCPE plus more frequent clinic visits...
October 12, 2017: Dermatology and Therapy
https://www.readbyqxmd.com/read/29026889/study-design-of-real-world-evidence-for-treatment-of-hyperkalemia-in-the-emergency-department-reveal-ed-a-multicenter-prospective-observational-study
#6
Zubaid Rafique, Mikhail Kosiborod, Carol L Clark, Adam J Singer, Stewart Turner, Joseph Miller, Douglas Char, W Frank Peacock
OBJECTIVE: Hyperkalemia affects up to 10% of hospitalized patients and, if left untreated, can lead to serious cardiac arrhythmias or death. Although hyperkalemia is frequently encountered in the emergency department (ED), and is potentially life-threatening, standard of care for the treatment is poorly defined, with little supporting evidence. The main objectives of this observational study are to define the overall burden of hyperkalemia in the ED setting, describe its causes, the variability in treatment patterns and characterize the effectiveness and safety of ED standard of care therapies used in the United States...
September 2017: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/29026841/causes-of-medication-errors-in-intensive-care-units-from-the-perspective-of-healthcare-professionals
#7
Sedigheh Farzi, Alireza Irajpour, Mahmoud Saghaei, Hamid Ravaghi
OBJECTIVE: This study was conducted to explore and to describe the causes of medication errors in Intensive Care Units (ICUs) from the perspective of physicians, nurses, and clinical pharmacists. METHODS: The study was conducted using a descriptive qualitative method in 2016. We included 16 ICUs of seven educational hospitals affiliated to Isfahan University of Medical Sciences. Participants included 19 members of the healthcare team (physician, nurse, and clinical pharmacist) with at least 1 year of work experience in the ICUs...
July 2017: Journal of Research in Pharmacy Practice
https://www.readbyqxmd.com/read/29026630/sinister-seafood-bacteraemia-secondary-to-non-o1-o139-vibrio-cholerae-infection
#8
Maxime J Billick, Philip W Lam, Isaac I Bogoch
Introduction.Vibrio species are curved, motile Gram-negative bacilli found in estuarine and marine environments, and are known to cause to gastroenteritis, skin and soft tissue infections, and septicaemia. While not responsible for cholera epidemics, non-O1/O139 Vibrio cholerae (NOVC) is increasingly reported as a cause of gastroenteritis. Case presentation. A 66-year-old man presented to an emergency department with a 1 week history of epigastric pain, emesis and fever. Blood cultures drawn on admission initially demonstrated Gram-negative bacilli, and ultimately grew NOVC, which was later confirmed by matrix-assisted laser desorption ionization-time of flight MS...
July 2017: JMM Case Reports
https://www.readbyqxmd.com/read/29026591/irritable-bowel-syndrome-diagnosis-and-management-a-simplified-algorithm-for-clinical-practice
#9
REVIEW
Paul Moayyedi, Fermín Mearin, Fernando Azpiroz, Viola Andresen, Giovanni Barbara, Maura Corsetti, Anton Emmanuel, A Pali S Hungin, Peter Layer, Vincenzo Stanghellini, Peter Whorwell, Frank Zerbib, Jan Tack
BACKGROUND: Effective management of irritable bowel syndrome (IBS), a common functional gastrointestinal disorder, can be challenging for physicians because of the lack of simple diagnostic tests and the wide variety of treatment approaches available. OBJECTIVE: The objective of this article is to outline a simple algorithm for day-to-day clinical practice to help physicians navigate key stages to reaching a positive IBS diagnosis and guidance on how to prioritise the use of specific management strategies...
October 2017: United European Gastroenterology Journal
https://www.readbyqxmd.com/read/29026590/eosinophilic-esophagitis-what-can-we-learn-from-crohn-s-disease
#10
REVIEW
Javier Molina-Infante, Alain M Schoepfer, Alfredo J Lucendo, Evan S Dellon
Eosinophilic esophagitis (EoE) is an emerging esophageal inflammatory disorder affecting children and young adults. As a relatively new disease, EoE is still burdened by frequent diagnostic and therapeutic pitfalls in clinical practice. This manuscript posits a number of similarities with Crohn's disease, which may help optimize EoE patient management. Commonalities include epidemiologic trends (Westernized diseases, rising incidence, early-life risk factors), diagnostic considerations (symptoms are poor predictors of disease activity, difficulties in disease activity assessment) and therapeutic issues (similar natural history and therapeutic goals, induction and maintenance phases, combination of drug and endoscopic treatment, potential drug interchangeability, long-term unsolved issues)...
October 2017: United European Gastroenterology Journal
https://www.readbyqxmd.com/read/29026483/hospital-charges-and-continuity-of-care-for-outpatients-with-hypertension-in-south-korea-a-nationwide-population-based-cohort-study-from-2002-to-2013
#11
Jae-Hyun Kim, Eun-Cheol Park, Tae Hyun Kim, Yunhwan Lee
BACKGROUND: Continuity of care (COC) has received attention over the past decade. COC has also become increasingly important for hospital managers and policy makers because of competitive health care market conditions. The purpose of this study was to assess the association between hospital charges and patients' continuity of care-assessed by three indices of continuity of care-among outpatients with hypertension in South Korea. METHODS: This study used the National Health Insurance Service-Cohort Sample Database from 2002 to 2013...
September 2017: Korean Journal of Family Medicine
https://www.readbyqxmd.com/read/29025820/well-being-of-family-medicine-graduates
#12
Olga Szafran, Wayne Woloschuk, Jacqueline M I Torti, Douglas Myhre
OBJECTIVE: To determine family medicine graduates' professional and personal well-being, general health status, stress levels, coping strategies, and the degree to which they felt supported or isolated in professional life; and to compare findings by sex, practice location, and location of medical school (Canadian medical graduates [CMGs] vs international medical graduates [IMGs]). DESIGN: Retrospective, cross-sectional survey. SETTING: University of Alberta in Edmonton and the University of Calgary in Alberta...
October 2017: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/29025354/cell-bound-complement-activation-products-as-lupus-biomarkers-diagnosis-monitoring-and-stratification
#13
Joseph M Ahearn, Chau-Ching Liu, Susan Manzi
Cell-bound complement activation products (CB-CAPs) were first reported in 2004, since which time multiple laboratories have demonstrated their value as biomarkers for diagnosis, monitoring, and stratification of patients with systemic lupus erythematosus. Areas Covered: This review summarizes the highlights of these 14 years of CB-CAPs discovery and validation, concluding with a view toward their future potential for precision medicine. Expert Commentary: The practice of medicine is both art and science and each physician can be considered both artist and scientist with a variable blend of the two skill sets...
October 13, 2017: Expert Review of Clinical Immunology
https://www.readbyqxmd.com/read/29025302/medical-student-healthcare-consulting-groups-a-novel-way-to-train-the-next-generation-of-physician-executives
#14
Esther Y Hsiang, Andrew G Breithaupt, Peiyi Su, Andrew T Rogers, Niv Milbar, Sanjay V Desai
Meeting the challenges of the evolving healthcare environment requires leadership of physicians well-trained in clinical medicine and healthcare management. However, many physicians lack training in business and leadership. While some residency programs have management tracks, training at the medical school level is currently lacking. We developed the Hopkins Health Management Advisory Group, an extracurricular program at Johns Hopkins University School of Medicine that exposes medical students to healthcare management and fosters development of leadership skills...
October 12, 2017: Medical Teacher
https://www.readbyqxmd.com/read/29025298/twelve-tips-for-using-applied-improvisation-in-medical-education
#15
Krista Hoffmann-Longtin, Jonathan P Rossing, Elizabeth Weinstein
Future physicians will practice medicine in a more complex environment than ever, where skills of interpersonal communication, collaboration and adaptability to change are critical. Applied improvisation (or AI) is an instructional strategy which adapts the concepts of improvisational theater to teach these types of complex skills in other contexts. Unique to AI is its very active teaching approach, adapting theater games to help learners meet curricular objectives. In medical education, AI is particularly helpful when attempting to build students' comfort with and skills in complex, interpersonal behaviors such as effective listening, person-centeredness, teamwork and communication...
October 12, 2017: Medical Teacher
https://www.readbyqxmd.com/read/29025135/current-perspective-on-the-use-of-opioids-in-perioperative-medicine-an-evidence-based-literature-review-national-survey-of-70-000-physicians-and-multidisciplinary-clinical-appraisal
#16
Jonathan S Jahr, Sergio D Bergese, Ketan R Sheth, Nicholas M Bernthal, Hung S Ho, Nicoleta Stoicea, Christian C Apfel
Objective: Opioids represent an important analgesic option for physicians managing acute pain in surgical patients. Opioid management is not without its drawbacks, however, and current trends suggest that opioids might be overused in the United States. An expert panel was convened to conduct a clinical appraisal regarding the use of opioids in the perioperative setting. Methods: The clinical appraisal consisted of the review, presentation, and assessment of current published evidence as it relates to the statement "Opioids are not overused in the United States, even though opioid adjunct therapy achieves greater pain control with less risk...
August 16, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29025132/most-relevant-neuropathic-pain-treatment-and-chronic-low-back-pain-management-guidelines-a-change-pain-latin-america-advisory-panel-consensus
#17
Cesar Amescua-Garcia, Frantz Colimon, Carlos Guerrero, Aziza Jreige Iskandar, Maria Berenguel Cook, Patricia Bonilla, Durval Campos Kraychete, William Delgado Barrera, Jose Alberto Flores Cantisani, John Jairo Hernandez-Castro, Argelia Lara-Solares, Concepcion Perez Hernandez, Maria Antonieta Rico, Maria Del Rocio Guillen Nunez, Manuel Sempertegui Gallegos, Joao Batista Santos Garcia
Objective: Chronic pain conditions profoundly affect the daily living of a significant number of people and are a major economic and social burden, particularly in developing countries. The Change Pain Latin America (CPLA) advisory panel aimed to identify the most appropriate guidelines for the treatment of neuropathic pain (NP) and chronic low back pain (CLBP) for use across Latin America. Methods: Published systematic reviews or practice guidelines were identified by a systematic search of PubMed, the Guidelines Clearinghouse, and Google...
August 24, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29023634/improved-knowledge-of-and-difficulties-in-palliative-care-among-physicians-during-2008-and-2015-in-japan-association-with-a-nationwide-palliative-care-education-program
#18
Yoko Nakazawa, Ryo Yamamoto, Masashi Kato, Mitsunori Miyashita, Yoshiyuki Kizawa, Tatsuya Morita
BACKGROUND: Palliative care education for health care professionals is a key element in improving access to quality palliative care. The Palliative Care Emphasis Program on Symptom Management and Assessment for Continuous Medical Education (PEACE) was designed to provide educational opportunities for all physicians in Japan. As of 2015, 57,764 physicians had completed it. The objective of this study was to estimate the effects of the program. METHODS: This study was an analysis of 2 nationwide observational studies from 2008 and 2015...
October 12, 2017: Cancer
https://www.readbyqxmd.com/read/29022766/a-solution-focused-approach-to-understanding-patient-motivation-in-diabetes-self-management-gender-differences-and-implications-for-primary-care
#19
Tajudaullah Bhaloo, Michael Juma, Christine Criscuolo-Higgins
Objective Healthcare providers often neglect to recognize the role they play in motivating patients with diabetes to perform self-management. Our aims were to understand what motivates patients with diabetes to implement recommended self-management practices and understand the role of the primary care team in patient motivation. Methods We use a solution-focused qualitative approach, supplemented with a quantitative scale. We used a purposive sampling strategy to invite patients with uncontrolled diabetes. Semi-structured telephone interviews were conducted and analyzed using content and thematic analysis...
January 1, 2017: Chronic Illness
https://www.readbyqxmd.com/read/29021727/analgesia-sedation-and-arousal-status-in-burn-patients-the-gap-between-recommendations-and-current-practices
#20
A Lavrentieva, N Depetris, I Rodini
Assessment and treatment of pain, agitation and delirium are integral parts of the management of critically ill patients. The purpose of this review is to describe how pain, delirium and agitation are managed in general intensive care units and in burn units, and to address whether management of these issues is compatible with internationally accepted recommendations. A substantial gap exists between the conception of the guidelines, clinical practice and physicians' statements regarding pain, sedation and delirium management...
June 30, 2017: Annals of Burns and Fire Disasters
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