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https://www.readbyqxmd.com/read/28822778/diabetes-care-program-of-nova-scotia-celebrating-25-years-of-improving-diabetes-care-in-nova-scotia
#1
REVIEW
Jennifer I Payne, Margaret J Dunbar, Pamela Talbot, Meng H Tan
The Diabetes Care Program of Nova Scotia (DCPNS)'s mission is "to improve, through leadership and partnerships, the health of Nova Scotians living with, affected by, or at risk of developing diabetes." Working together with local, provincial and national partners, the DCPNS has improved and standardized diabetes care in Nova Scotia over the past 25 years by developing and deploying a resourceful and collaborative program model. This article describes the model and highlights its key achievements. With balanced representation from frontline providers through to senior decision makers in health care, the DCPNS works across the age continuum, supporting the implementation of national clinical practice guidelines and, when necessary, developing provincial guidelines to meet local needs...
August 16, 2017: Canadian Journal of Diabetes
https://www.readbyqxmd.com/read/28822619/experiential-documentation-of-trimad-for-its-anti-obesity-potential-a%C3%A2-survey-of-ayurvedic-physicians-from-pune-city
#2
Megha Salunke, Manasi Deshpande, Supriya Bhalerao
BACKGROUND: Trimad is an Ayurvedic polyherbal formulation consisting of tubers of Mustaka (Cyperus rotundus), fruits of Vidanga (Embelia ribes) and roots of Chitraka (Plumbago zeylanica). It is recommended in Ayurveda for the management of obesity. However, there is no documented evidence about its safety and efficacy. Hence, as a first step, we carried out a survey to find out its usage by Ayurvedic physicians and their personal clinical experiences while using the formulation. METHODOLOGY: A questionnaire was designed which included questions regarding the usage, dosage, formulation, safety and tolerability of Trimad...
August 16, 2017: Journal of Ayurveda and Integrative Medicine
https://www.readbyqxmd.com/read/28822610/evaluation-of-fever-in-the-emergency-department
#3
REVIEW
Sarah DeWitt, Summer A Chavez, Jack Perkins, Brit Long, Alex Koyfman
BACKGROUND: Fever is one of the most common complaints in the emergency department (ED) and is more complex than generally appreciated. The broad differential diagnosis of fever includes numerous infectious and non-infectious etiologies. An essential skill in emergency medicine is recognizing the pitfalls in fever evaluation. OBJECTIVE OF REVIEW: This review provides an overview of the complaint of fever in the ED to assist the emergency physician with a structured approach to evaluation...
August 14, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28822609/transient-vocal-cord-paralysis-following-central-venous-hemodialysis-catheter-insertion
#4
Gül Pamukçu Günaydın, Selahattin Gürü, Elif Aslan Taş, Fatih Tanrıverdi, Gülhan Kurtoğlu Çelik
In this article, we present a case of recurrent laryngeal nerve palsy not caused by nerve injury but due to local anesthetic infiltration that was applied prior to central venous catheterization. A 47-year-old female patient was admitted to emergency room with fatigue and nausea and was diagnosed with acute renal failure. Right jugular venous catheterization was performed for emergency hemodialysis with Seldinger technique using middle approach. Within minutes and immediately after the procedure the patient complained of hoarseness and shortness of breath, and she had stridor in her physical exam...
August 15, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28822528/management-of-obesity-in-adult-asian-indians
#5
REVIEW
S Behl, A Misra
The prevalence of obesity in India is increasing and ranges from 8% to 38% in rural and 13% to 50% in urban areas. Obesity is a risk factor for development of type 2 diabetes mellitus (T2DM), hypertension, dyslipidemia, coronary heart disease and many cancers. In Asian Indians excess abdominal and hepatic fat is associated with increased risk for T2DM and cardiovascular disease. There is higher risk for development of obesity related non-communicable diseases at lower body mass index levels, compared to white Caucasians...
July 2017: Indian Heart Journal
https://www.readbyqxmd.com/read/28822512/implications-of-the-2013-acc-aha-cholesterol-guidelines-on-contemporary-clinical-practice-for-patients-with-atherosclerotic-coronary-and-peripheral-arterial-disease
#6
Prasad Gunasekaran, Vinodh Jeevanantham, Suresh Sharma, Rashmi Thapa, Kamal Gupta
BACKGROUND: Cholesterol management guidelines from the American College of Cardiology/American Heart Association (ACC/AHA-2013) recommend fixed statin dosing (dose depends on age ≤ or >75years) compared to the earlier adult treatment panel III (ATPIII) guidelines which recommended specific low-density lipoprotein-cholesterol (LDL-C) targets. Clinical implications of this recommendation are not known. METHODS: We retrospectively compared cholesterol levels and statin utilization across cohorts with coronary artery disease (CAD) (n=9563), peripheral arterial disease (PAD) (n=596) and CAD+PAD (n=975) by applying both guidelines...
July 2017: Indian Heart Journal
https://www.readbyqxmd.com/read/28821508/a-novel-income-security-intervention-to-address-poverty-in-a-primary-care-setting-a-retrospective-chart-review
#7
Marcella K Jones, Gary Bloch, Andrew D Pinto
OBJECTIVE: To examine the development and implementation of a novel income security intervention in primary care. DESIGN: A retrospective, descriptive chart review of all patients referred to the Income Security Heath Promotion service during the first year of the service (December 2013-December 2014). SETTING: A multisite interdisciplinary primary care organisation in inner city Toronto, Canada, serving over 40 000 patients. PARTICIPANTS: The study population included 181 patients (53% female, mean age 48 years) who were referred to the Income Security Health Promotion service and engaged in care...
August 17, 2017: BMJ Open
https://www.readbyqxmd.com/read/28820788/community-health-workers-and-the-management-of-noncommunicable-diseases-among-rural-health-clinics-in-limpopo-province-south-africa-a-pilot-study
#8
Aubrey L Doede, Taylor E Allen, JaʼLynn S Gray, Austin G Herbst, Madala C Hlungwani, Nditsheni J Ramakuela, Alice X Xie, Cathy L Campbell
South Africa's rise in noncommunicable diseases (NCDs) and health care provider shortages has generated the need for community health workers (CHWs) in rural areas. However, roles and interactions with clinic staff are not well understood. Interviews with health care workers at community clinics in Limpopo Province revealed common themes, including resource scarcity, clinic-patient partnerships, management of NCDs, and collaboration between professionals. The data did not support CHW-physician interactions, necessitating further research to describe these practices and to evaluate CHWs' impact on patient outcomes...
October 2017: Family & Community Health
https://www.readbyqxmd.com/read/28820610/asthma-treatment-and-outcomes-for-children-in-the-emergency-department-and-hospital
#9
Rupali Drewek, Lucia Mirea, Peter Touresian, Philip David Adelson
OBJECTIVE: To describe and compare the treatment of acute asthma exacerbations in children seen in the emergency department (ED) and admitted to acute care floor in the hospital or intensive care unit (ICU). METHODS: Retrospective chart review of visits for acute exacerbation of asthma treated at Phoenix Children's Hospital between January 1, 2014 and December 31, 2016. RESULTS: A total of 287 asthma exacerbation cases were identified including 106 (37%) ED visits, 134 (47%) hospital floor and 47 (16%) ICU admissions...
August 18, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/28820418/pathological-adherence-of-placenta-case-reports
#10
R Sulukhia, L Melia, N Pirtskhalava, A Sukhiashvili
Major obstetric hemorrhage is the leading cause of maternal morbidity and mortality. In rare cases, life-threatening hemorrhage in pregnant women may result from abnormal adherence of placenta. Three grades of abnormal placental attachment are defined according to the depth of invasion: placenta accreta, placenta increta, and placenta percreta. An important risk factor for placenta abnormal adherence of placenta is placenta previa in the presence of a uterine scar. The increased prevalence of cesarean section, uterine surgery, and increasing parturient age and parity have led to an increased incidence of abnormal placentation, from one in 2,500 a quarter century ago, to one in 533 deliveries currently...
July 2017: Georgian Medical News
https://www.readbyqxmd.com/read/28820404/responding-professionally-to-requests-for-cesarean-delivery
#11
F Chervenak, L McCullough
Patients' requests for non-indicated cesarean delivery challenge the professionalism of obstetricians. This is because physicians should not provide clinical management in the absence of an evidence-based indication for it. The ethics of responding professionally to requests for non-indicated cesarean delivery would appear to be simple: just say "No." This paper presents an ethically and clinically more nuanced approach, on the basis of the professional responsibility model of obstetric ethics, emphasizinga preventive ethics approach...
July 2017: Georgian Medical News
https://www.readbyqxmd.com/read/28819046/tuberculous-tales-an-east-london-experience
#12
REVIEW
Apeksha M Shah, Dominika Raciborska, Matthew Stevens, Sharmilee Gnanapavan, Veronica L C White, Benjamin Turner
Tuberculous meningitis presents a diagnostic and therapeutic challenge, and considering its long history and increasing global incidence, the evidence base for its treatment is relatively scanty. Many UK neurologists will have little first-hand experience of this deadly condition, and if faced with a patient with possible tuberculous meningitis will find decision making less than straightforward. In parts of East London (UK) the rates of tuberculosis and tuberculous meningitis are among the highest in Western Europe, and so the neurologists and respiratory physicians at the Royal London Hospital have encountered many such patients over the years...
August 17, 2017: Practical Neurology
https://www.readbyqxmd.com/read/28818844/conservative-treatment-versus-surgery-for-uncomplicated-appendicitis-in-children-a-systematic-review-and-meta-analysis
#13
Ulf Kessler, Selim Mosbahi, Benedict Walker, Eva M Hau, Michael Cotton, Barbara Peiry, Steffen Berger, Bernhard Egger
OBJECTIVES: To compare conservative treatment with index admission appendicectomy in children with acute uncomplicated appendicitis. DESIGN: Systematic review and meta-analysis. DATA SOURCES: Medline, Embase and the Cochrane Library (CENTRAL) from 1950 to 18 February 2017. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Studies that assessed both appendicectomy and non-operative management of acute uncomplicated appendicitis in children of less than 18 years of age...
August 17, 2017: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/28818507/optimizing-quality-of-endoscopy-in-inflammatory-bowel-disease-focus-on-surveillance-and-management-of-colorectal-dysplasia-using-interactive-image-and-video-based-teaching
#14
Tonya R Kaltenbach, Roy M Soetikno, Rebecca DeVivo, Loren A Laine, Alan Barkun, Kenneth R McQuaid
BACKGROUND & AIMS: Varying recommendations regarding the detection and management of dysplasia can lead to uncertainty and may have impeded the uptake of strategies that could improve surveillance in patients with inflammatory bowel disease (IBD). As such, an educational event was held to assist in disseminating the recently published Surveillance for Colorectal Endoscopic Neoplasia Detection and Management in Inflammatory Bowel Disease Patients: International Consensus Recommendations (SCENIC)...
August 14, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28818320/-use-of-a-delphi-survey-to-assess-the-hospital-economic-impact-of-innovative-products-the-example-of-idarucizumab-a-dabigatran-specific-reversal-agent
#15
N Jamet, A P Thivilliers, P Paubel, D Chevalier, S Bourguignon, Y Bézie
OBJECTIVES: The economic impact of therapeutic innovations on the hospital patient management cannot be easily estimated. The objective of this study is to illustrate the use of a Delphi survey as a support tool to identify the changes following the use of idarucizumab in dabigatran-treated patients with uncontrolled/life-threatening bleeding or who required emergency surgery/urgent procedures. METHODS: The Delphi questionnaires have been administrated to 8 emergency physicians or anesthetists from 6 different hospital centers...
August 14, 2017: Annales Pharmaceutiques Françaises
https://www.readbyqxmd.com/read/28818317/reconsidering-the-gatekeeper-paradigm-for-percutaneous-coronary-intervention-in-stable-coronary-disease-management
#16
EDITORIAL
Joshua Schulman-Marcus, William S Weintraub, William E Boden
Major randomized clinical trials over the last decade support the role of optimal medical therapy for the initial management approach for patients with stable coronary artery disease (CAD), whereas percutaneous coronary intervention (PCI) ought to be reserved for patients with persistent symptoms despite optimal medical therapy. Likewise, several studies have continued to demonstrate the superiority of coronary artery bypass grafting surgery over PCI in many patients with extensive multivessel CAD, especially those with diabetes...
July 24, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28818187/ileus-in-adults
#17
Tim O Vilz, Burkhard Stoffels, Christian Strassburg, Hans H Schild, Jörg C Kalff
BACKGROUND: Ileus is one of the more common suspected diagnoses in everyday clinical practice. The term can refer either to mechanical or to functional ileus. Any physician who takes care of patients can be confronted with these entities; thus, all should be familiar with them and competent in their management. METHODS: Recommendations are summarized for the diagnostic evaluation and treatment of ileus of various causes on the basis of a selective literature review...
July 24, 2017: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/28817861/population-health-management-and-cancer-screening
#18
Bradley Kamstra, Mark K Huntington
Population health management (PHM) is a new health care model being implemented. It has been defined as "the health outcomes of a group of individuals, including the distribution of such outcomes within the group." This includes health outcomes and patterns of health determinants, and policies and interventions that link these two. Moving from a fee-for-service payment system to a quality- or value-based system, this model places on the clinician more responsibility for the costs of health care and its reimbursements...
2017: South Dakota Medicine: the Journal of the South Dakota State Medical Association
https://www.readbyqxmd.com/read/28817856/back-to-basics-the-effect-of-healthy-diet-and-exercise-on-chronic-disease-management
#19
Robert L Allison
INTRODUCTION: The increase in obesity rates in the U.S. and other less developed industrial countries have led to a worldwide epidemic of chronic disease states. Increased obesity rates are implicated in the treatment failures for illnesses such as coronary artery disease, diabetes, heart failure, hypertension and cancer. Effective prevention of obesity through diet and exercise contributes to the successful medical management of multiple chronic disease states. OBJECTIVE: Review the last 10 years of literature (2006-2016) on the effects of diet and exercise as they relate to the prevention of chronic disease...
2017: South Dakota Medicine: the Journal of the South Dakota State Medical Association
https://www.readbyqxmd.com/read/28817750/the-surgeon-on-service-model-for-timely-economically-viable-inpatient-care-of-tracheostomy-patients-in-academic-pediatric-otolaryngology
#20
Jennifer M Lavin, James W Schroeder, Dana M Thompson
Importance: The traditional practice model for pediatric otolaryngologists at high-volume academic centers is to simultaneously balance outpatient care responsibilities with those of the inpatient service, emergency department, and ambulatory care clinics. This model leads to challenges with care coordination, timeliness of nonemergency operative care, and consistent participation in care and consultation at the attending surgeon level. The "surgeon on service" (SOS) model-where faculty members rotate to manage the inpatient service in lieu of outpatient responsibilities-has been described as one method to address this conundrum...
August 17, 2017: JAMA Otolaryngology—Head & Neck Surgery
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