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https://www.readbyqxmd.com/read/28445873/pregnancy-outcomes-in-patients-with-glomerular-disease-attending-a-single-academic-center-in-north-carolina
#1
Michelle M O'Shaughnessy, Meghan A Jobson, Katy Sims, Abigail L Liberty, Patrick H Nachman, William F Pendergraft
BACKGROUND: Contemporary data regarding pregnancy outcomes in US patients with primary glomerular diseases are lacking. We aimed to report fetal and maternal outcomes among women with biopsy-proven primary glomerular disease who received obstetric care at a single large academic US center. METHODS: All women with a biopsy-confirmed primary glomerular disease diagnosis and without end-stage kidney disease who received obstetric care at the University of North Carolina (UNC) Hospitals (1996-2015) were identified using the Glomerular Disease Collaborative Network registry and the UNC Hospitals Perinatal Database...
April 27, 2017: American Journal of Nephrology
https://www.readbyqxmd.com/read/28441600/microplastics-in-the-antarctic-marine-system-an-emerging-area-of-research
#2
REVIEW
Catherine L Waller, Huw J Griffiths, Claire M Waluda, Sally E Thorpe, Iván Loaiza, Bernabé Moreno, Cesar O Pacherres, Kevin A Hughes
It was thought that the Southern Ocean was relatively free of microplastic contamination; however, recent studies and citizen science projects in the Southern Ocean have reported microplastics in deep-sea sediments and surface waters. Here we reviewed available information on microplastics (including macroplastics as a source of microplastics) in the Southern Ocean. We estimated primary microplastic concentrations from personal care products and laundry, and identified potential sources and routes of transmission into the region...
April 22, 2017: Science of the Total Environment
https://www.readbyqxmd.com/read/28441225/recognizing-common-parasitic-infestations
#3
Judy Truscott, Alyssa Abebe, Kelly Donkers, Daria Segers
Parasitic infestations commonly are seen in patients in primary care, urgent care, and EDs. These infestations are a common cause of pruritus and may lead to secondary infestations. This article reviews the signs and symptoms of pinworms, lice, bedbug, and scabies infestations, as well as diagnosis and appropriate treatment.
May 2017: JAAPA: Official Journal of the American Academy of Physician Assistants
https://www.readbyqxmd.com/read/28436286/coordinated-asthma-program-improves-asthma-outcomes-in-high-risk-children
#4
Faye Holder-Niles, Linda Haynes, Helen D'Couto, Rebecca S Hehn, Dionne A Graham, Ann Chen Wu, Joanne E Cox
Innovative approaches within primary care are needed to reduce fragmented care, increase continuity of care, and improve asthma outcomes in children with asthma. Our objective was to assess the impact of coordinated team-based asthma care on unplanned asthma-related health care utilization. A multidisciplinary asthma team was developed to provide coordinated care to high-risk asthma patients. Patients received an in-depth diagnostic and family needs assessment, asthma education, and coordinated referral to social and community services...
April 1, 2017: Clinical Pediatrics
https://www.readbyqxmd.com/read/28435501/impact-of-clinical-decision-support-on-radiography-for-acute-ankle-injuries-a-randomized-trial
#5
Shahein Tajmir, Ali S Raja, Ivan K Ip, James Andruchow, Patricia Silveira, Stacy Smith, Ramin Khorasani
INTRODUCTION: While only 15-20% of patients with foot and ankle injuries presenting to urgent care centers have clinically significant fractures, most undergo radiography. We examined the impact of electronic point-of-care clinical decision support (CDS) on adherence to the Ottawa Ankle Rules (OAR), as well as use and yield of foot and ankle radiographs in patients with acute ankle injury. METHODS: We obtained institutional review board approval for this randomized controlled study performed April 18, 2012-December 15, 2013...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28431526/recognition-of-depression-by-primary-care-clinicians-in-rural-ethiopia
#6
Abebaw Fekadu, Girmay Medhin, Medhin Selamu, Tedla W Giorgis, Crick Lund, Atalay Alem, Martin Prince, Charlotte Hanlon
BACKGROUND: Depression is a common health condition affecting up to a third of patients attending primary care, where most of the care for people with depression is provided. Adequate recognition of depression is the critical step in the path to effective care, particularly in low income countries. As part of the Programme for Improving Mental healthcare (PRIME), a project supporting the implementation of integrated mental healthcare in primary care, we evaluated the level of recognition of depression by clinicians working in primary care in rural Ethiopia prior to in service training...
April 21, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28430713/a-national-survey-of-neonatologists-barriers-and-prerequisites-to-introduce-point-of-care-ultrasound-in-neonatal-icus
#7
Hussnain S Mirza, Gregory Logsdon, Anoop Pulickal, Mark Stephens, Rajan Wadhawan
Point-of-care (POC) ultrasound refers to the use of portable imaging. Although POC ultrasound is widely available to the neonatologists in Australia and Europe, neonatologists in the United States report limited availability. Our objective was to seek the US neonatologists' perception of barriers and prerequisites in adopting POC ultrasound in neonatal intensive care units. An online survey link was sent via e-mail to 3000 neonatologists included in the database maintained by the American Academy of Pediatrics...
April 20, 2017: Ultrasound Quarterly
https://www.readbyqxmd.com/read/28427444/interventions-to-reduce-wait-times-for-primary-care-appointments-a-systematic-review
#8
Dominique Ansell, James A G Crispo, Benjamin Simard, Lise M Bjerre
BACKGROUND: Accessibility and availability are important characteristics of efficient and effective primary healthcare systems. Currently, timely access to a family physician is a concern in Canada. Adverse outcomes are associated with longer wait times for primary care appointments and often leave individuals to rely on urgent care. When wait times for appointments are too long patients may experience worse health outcomes and are often left to use emergency department resources. The primary objective of our study was to systematically review the literature to identify interventions designed to reduce wait times for primary care appointments...
April 20, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28421005/autoimmune-aspects-of-neurodegenerative-and-psychiatric-diseases-a-template-for-innovative-therapy
#9
REVIEW
Peter de Haan, Hans C Klein, Bert A 't Hart
Neurodegenerative and psychiatric diseases (NPDs) are today's most important group of diseases, surpassing both atherosclerotic cardiovascular disease and cancer in morbidity incidence. Although NPDs have a dramatic impact on our society because of their high incidence, mortality, and severe debilitating character, remarkably few effective interventions have become available. The current treatments, if available, comprise the lifelong intake of general immunosuppressants to delay disease progression or neurotransmitter antagonists/agonists to dampen undesired behaviors...
2017: Frontiers in Psychiatry
https://www.readbyqxmd.com/read/28416966/an-overview-of-mental-health-care-system-in-kilifi-kenya-results-from-an-initial-assessment-using-the-world-health-organization-s-assessment-instrument-for-mental-health-systems
#10
Mary A Bitta, Symon M Kariuki, Eddie Chengo, Charles R J C Newton
BACKGROUND: Little is known about the state of mental health systems in Kenya. In 2010, Kenya promulgated a new constitution, which devolved national government and the national health system to 47 counties including Kilifi County. There is need to provide evidence from mental health systems research to identify priority areas in Kilifi's mental health system for informing county health sector decision making. We conducted an initial assessment of state of mental health systems in Kilifi County and documented resources, policy and legislation and spectrum of mental, neurological and substance use disorders...
2017: International Journal of Mental Health Systems
https://www.readbyqxmd.com/read/28403871/a-systematic-tale-of-two-differing-reviews-evaluating-the-evidence-on-public-and-private-sector-quality-of-primary-care-in-low-and-middle-income-countries
#11
Jorge Coarasa, Jishnu Das, Elizabeth Gummerson, Asaf Bitton
Systematic reviews are powerful tools for summarizing vast amounts of data in controversial areas; but their utility is limited by methodological choices and assumptions. Two systematic reviews of literature on the quality of private sector primary care in low and middle income countries (LMIC), published in the same journal within a year, reached conflicting conclusions. The difference in findings reflects different review methodologies, but more importantly, a weak underlying body of literature. A detailed examination of the literature cited in both reviews shows that only one of the underlying studies met the gold standard for methodological robustness...
April 12, 2017: Globalization and Health
https://www.readbyqxmd.com/read/28400148/accelerated-re-epithelialization-of-partial-thickness-skin-wounds-by-a-topical-betulin-gel-results-of-a-randomized-phase-iii-clinical-trials-program
#12
Juan P Barret, Fred Podmelle, Břetislav Lipový, Hans-Oliver Rennekampff, Hauke Schumann, Agnes Schwieger-Briel, Tobias R Zahn, Hans-Robert Metelmann
The clinical significance of timely re-epithelialization is obvious in burn care, since delayed wound closure is enhancing the risk of wound site infection and extensive scarring. Topical treatments that accelerate wound healing are urgently needed to reduce these sequelae. Evidence from preliminary studies suggests that betulin can accelerate the healing of different types of wounds, including second degree burns and split-thickness skin graft wounds. The goal of this combined study program consisting of two randomized phase III clinical trials in parallel is to evaluate whether a topical betulin gel (TBG) is accelerating re-epithelialization of split-thickness skin graft (STSG) donor site wounds compared to standard of care...
April 8, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28393128/prevalence-and-predictors-of-mental-health-among-farmworkers-in-southeastern-anatolia-of-turkey
#13
Zeynep Simsek, Ayşana Zehra Keklik, Canan Demir, Kerim M Munir
BACKGROUND: Mental health problems represent a major component of the global burden of disease. The primary objective of this study was to assess the prevalence and predictors of psychological wellbeing among farmworkers and to evaluate their mental health services need for in rural primary health care settings. METHODS: The study sample comprised 1855 farmworkers (918 women, and 937 men) who were selected using probability cluster sampling method at 95% confidence interval (87...
January 2017: Int J Environ Agric Res
https://www.readbyqxmd.com/read/28392599/a-call-to-promote-healthcare-justice-a-summary-of-integrated-outpatient-clinics-exemplifying-principles-of-catholic-social-teaching
#14
Nicole P Waters, Trenton Schmale, Allison Goetz, Jason T Eberl, Jessica H Wells
There is an urgent need to promote healthcare justice for patients as well as members of the healthcare team including physicians. In this article, we explain how principles of Catholic social teaching (i.e., dignity of the individual, common good, destination of goods, solidarity, and subsidiarity) are applied to health care, by featuring various types of outpatient clinics including free, charitable-direct primary care, hybrid, federally qualified health center, and rural health clinic. We describe how attempts have been made to improve the quality and access of health care by creating new medical schools (i...
February 2017: Linacre Quarterly
https://www.readbyqxmd.com/read/28392056/open-conversion-after-endovascular-abdominal-aneurysm-repair-an-8-year-single-centre-experience
#15
I Ben Abdallah, S El Batti, M Abou-Rjeili, J-N Fabiani, P Julia, J-M Alsac
OBJECTIVE: To report experience with open conversion (OC) after previous failed EVAR and to compare outcomes of patients undergoing elective OC with those operated on in an urgent setting. METHODS: Patients undergoing OC after EVAR between August 2008 and September 2016 were included in this retrospective and observational single institution study. Indications, demographic, anatomical, intra-operative and post-operative data were collected prospectively. Primary endpoints were 30 day and in hospital mortality...
April 5, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28388310/exploring-barriers-to-primary-care-for-migrants-in-greece-in-times-of-austerity-perspectives-of-service-providers
#16
Maria Papadakaki, Christos Lionis, Aristoula Saridaki, Christopher Dowrick, Tomas de Brún, Mary O'Reilly-de Brún, Catherine A O'Donnell, Nicola Burns, Evelyn van Weel-Baumgarten, Maria van den Muijsenbergh, Wolfgang Spiegel, Anne MacFarlane
BACKGROUND: Migration in Europe is increasing at an unprecedented rate. There is an urgent need to develop 'migrant-sensitive healthcare systems'. However, there are many barriers to healthcare for migrants. Despite Greece's recent, significant experiences of inward migration during a period of economic austerity, little is known about Greek primary care service providers' experiences of delivering care to migrants. OBJECTIVES: To identify service providers' views on the barriers to migrant healthcare...
December 2017: European Journal of General Practice
https://www.readbyqxmd.com/read/28385671/the-safety-and-utility-of-magnetic-resonance-imaging-on-patients-with-cardiovascular-implantable-electronic-devices
#17
Jordan B Strom, Jill B Whelan, Changyu Shen, ShuangQi Zheng, Koenraad J Mortele, Daniel B Kramer
BACKGROUND: Off-label magnetic resonance imaging (MRI) for patients with cardiac implantable electrical devices (CIEDs) has been limited due to concerns about safety and unclear diagnostic and prognostic utility. OBJECTIVE: To define major and minor adverse events with off-label MRIs. METHODS: We prospectively evaluated patients with non-MRI-conditional CIEDs referred for MRIs under a strict clinical protocol. The primary safety outcome was incidence of major adverse events (loss of pacing, inappropriate shock or anti-tachycardia pacing, need for system revision, or death), or minor adverse events (inappropriate pacing, arrhythmias, power on reset events, heating at the generator site, or changes in device parameters at baseline or at 6 months)...
March 31, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28382415/the-case-for-the-genetic-nurse-in-south-africa
#18
REVIEW
Helen L Malherbe, Arnold L Christianson, David Woods, Colleen Aldous
The care and prevention of congenital disorders (CDs) is an emerging but unprioritised health need in South Africa (SA). Inadequate empirical data and underreporting conceal the true burden of CDs while medical genetic services to confront the problem have regressed. Positive epidemiological transition in the country now demands these services are improved to significantly further reduce child mortality. Current sector capacity in SA is inadequate and required personnel targets will not be reached quickly enough to meet the growing health need even if relevant posts are designated...
April 2017: Journal of Community Genetics
https://www.readbyqxmd.com/read/28379818/building-a-sustainable-primary-care-workforce-where-do-we-go-from-here
#19
Mark Linzer, Sara Poplau
The article by Puffer et al in this month's JABFM confirms a high burnout rate (25%) among family physicians renewing their credentials, with a higher rate among young and female doctors. Recent reports confirm high burnout rates among general internists. Thus, mechanisms to monitor and improve worklife in primary care are urgently needed. We describe the Mini Z (for "zero burnout program") measure, designed for these purposes, and suggest interventions that might improve satisfaction and sustainability in primary care, including longer visits, clinician control of work schedules, scribe support for electronic medical record work, team-based care, and an explicit emphasis on work-home balance...
March 2017: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/28378965/comparison-of-the-quality-of-night-paediatric-urgent-care-in-rural-and-urban-areas-of-lublin-province-eastern-poland-appraisals-by-parents-of-children-requiring-medical-attention
#20
Barbara Kołłątaj, Witold Kołłątaj, Katarzyna Wrzołek, Irena Dorota Karwat, Maria Klatka
 Introduction. The quality of primary medical care for children in Poland is unsatisfactory. In the ranking known as 'the European Health Consumer Index', Poland (taking the patient point of view on healthcare quality) is classified on the 27th position out of the 33 possible. The unsolved problems concern inter alia the quality and availability of night paediatric urgent care. OBJECTIVE: The aim was assessing the quality as well as the level of satisfaction with the night paediatric urgent care in the Lublin Province of eastern Poland...
March 31, 2017: Annals of Agricultural and Environmental Medicine: AAEM
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