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https://www.readbyqxmd.com/read/28646952/drug-resistant-tuberculosis-primary-transmission-and-management
#1
Alexander C Outhred, Philip N Britton, Ben J Marais
The DOTS strategy assisted global tuberculosis (TB) control, but was unable to prevent the emergence and spread of drug-resistant strains. Genomic evidence confirms the transmission of drug-resistant Mycobacterium tuberculosis strains in many different settings, indicative of epidemic spread. These findings emphasise the need for enhanced infection control measures in health care and congregate settings. Young children in TB endemic areas are particularly vulnerable. Although advances in TB drug and vaccine development are urgently needed, improved access to currently available preventive therapy and treatment for drug resistant TB could reduce the disease burden and adverse outcomes experienced by children...
June 2017: Journal of Infection
https://www.readbyqxmd.com/read/28646858/reasons-for-encounter-by-different-levels-of-urgency-in-out-of-hours-emergency-primary-health-care-in-norway-a-cross-sectional-study
#2
Guttorm Raknes, Steinar Hunskaar
BACKGROUND: Frequencies of reasons for encounter (RFEs) in emergency primary care out-of-hours (OOH) services are relevant for planning of capacities as well as to target the training of staff at casualty clinics. We aimed to present frequencies of RFEs in the different organ systems, and to identify the most frequent RFEs at different urgency levels. METHODS: We analyzed data on RFEs in Norwegian OOH services. International Classification of Primary Care (ICPC-2) RFE codes were recorded in all contacts to eight representative OOH casualty clinics in 2014 and 2015 covering 20 municipalities with a total population of 260 196...
June 24, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/28645982/a-multicentre-randomised-controlled-non-inferiority-trial-comparing-nasal-high-flow-with-nasal-continuous-positive-airway-pressure-as-primary-support-for-newborn-infants-with-early-respiratory-distress-born-in-australian-non-tertiary-special-care-nurseries
#3
Brett J Manley, Calum T Roberts, Gaston R B Arnolda, Ian M R Wright, Louise S Owen, Kim M Dalziel, Jann P Foster, Peter G Davis, Adam G Buckmaster
INTRODUCTION: Nasal high-flow (nHF) therapy is a popular mode of respiratory support for newborn infants. Evidence for nHF use is predominantly from neonatal intensive care units (NICUs). There are no randomised trials of nHF use in non-tertiary special care nurseries (SCNs). We hypothesise that nHF is non-inferior to nasal continuous positive airway pressure (CPAP) as primary support for newborn infants with respiratory distress, in the population cared for in non-tertiary SCNs. METHODS AND ANALYSIS: The HUNTER trial is an unblinded Australian multicentre, randomised, non-inferiority trial...
June 23, 2017: BMJ Open
https://www.readbyqxmd.com/read/28638444/understanding-the-barriers-and-improving-care-in-type-2-diabetes-brazilian-perspective-in-time-to-do-more-in-diabetes
#4
Sérgio Vencio, Päivi M Paldánius, Matthias Blüher, Daniel Giannella-Neto, Rafael Caiado-Vencio, W David Strain
BACKGROUND: Type 2 diabetes mellitus (T2DM) is a complex disease, particularly in a continental country like Brazil. We attempted to understand and evaluate the perceptions and routines of Brazilians with T2DM and physicians, compared with other countries. METHODS: We compared the results from a 20-min online survey in Brazil with simultaneously collated data from India, Japan, Spain, UK and USA. RESULTS: In total, 652 adults with T2DM and 337 treating physicians were enrolled, of whom 100 patients and 55 physicians were from Brazil...
2017: Diabetology & Metabolic Syndrome
https://www.readbyqxmd.com/read/28634135/outcomes-and-role-of-urgent-endoscopy-in-high-risk-patients-with-acute-nonvariceal-gastrointestinal-bleeding
#5
Soo-Han Cho, Yoon-Seon Lee, Youn-Jung Kim, Chang Hwan Sohn, Shin Ahn, Dong-Woo Seo, Won Young Kim, Jae Ho Lee, Kyoung Soo Lim
BACKGROUND & AIMS: We investigated clinical outcomes in high-risk patients with acute nonvariceal upper gastrointestinal bleeding (UGIB), and determined if urgent endoscopy is effective. METHODS: Consecutive patients with Glasgow-Blatchford score >7 who underwent endoscopy for acute nonvariceal UGIB at the emergency department from January 1, 2005, to December 31, 2014, were included. Urgent (<6 h) and elective (6-48 h) endoscopies were defined according to the time to endoscopy after the initial presentation...
June 17, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28633469/a-framework-illustrating-care-seeking-among-older-adults-in-a-hospital-emergency-department
#6
Barbara J Lutz, Allyson G Hall, Sean B Vanhille, Andrea L Jones, Jessica R Schumacher, Phyllis Hendry, Jeffrey S Harman, Donna L Carden
Background and Objectives: Older adults seeking emergency department (ED) care often have multiple, complex chronic conditions. We sought to understand factors that influence ED care-seeking by older adults and present a theoretical framework illustrating this process. Research Design and Methods: In this grounded theory study, we interviewed 40 older adults with chronic illness within 90 days of an ED visit to explore their decision-making about seeking ED care...
June 17, 2017: Gerontologist
https://www.readbyqxmd.com/read/28632767/how-is-indonesia-coping-with-its-epidemic-of-chronic-noncommunicable-diseases-a-systematic-review-with-meta-analysis
#7
Julia Schröders, Stig Wall, Mohammad Hakimi, Fatwa Sari Tetra Dewi, Lars Weinehall, Mark Nichter, Maria Nilsson, Hari Kusnanto, Ekowati Rahajeng, Nawi Ng
BACKGROUND: Chronic noncommunicable diseases (NCDs) have emerged as a huge global health problem in low- and middle-income countries. The magnitude of the rise of NCDs is particularly visible in Southeast Asia where limited resources have been used to address this rising epidemic, as in the case of Indonesia. Robust evidence to measure growing NCD-related burdens at national and local levels and to aid national discussion on social determinants of health and intra-country inequalities is needed...
2017: PloS One
https://www.readbyqxmd.com/read/28630035/the-effects-of-preoperative-volume-replacement-in-diabetic-patients-undergoing-coronary-artery-bypass-grafting-surgery-protocol-for-a-randomized-controlled-trial-verdict-trial
#8
Madeleine Clout, Tracy Harris, Chris Rogers, Lucy Culliford, Jodi Taylor, Gianni Angelini, Pradeep Narayan, Barnaby Reeves, James Hillier, Kate Ashton, Kunal Sarkar, Raimondo Ascione
BACKGROUND: Diabetes mellitus is a major risk factor for prolonged hospital stays, renal failure, and mortality in patients having coronary artery bypass grafting (CABG). Complications pose a serious threat to patients and prolong intensive care and hospital stays. Low glomerular filtration rate (GFR) due to existing renal impairment or volume depletion may exacerbate acute renal impairment/failure in these patients. Preoperative volume replacement therapy (VRT) is reported to increase the GFR and we hypothesize that VRT will reduce renal impairment and related complications in diabetic patients...
June 19, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28626503/does-a-free-office-visit-affect-primary-care-seeking-behavior-a-study-of-new-exchange-health-plan-enrollees-in-mississippi
#9
Bettina M Beech, Tristan Cordier, Laura E Happe, Laura Trunk, Gilbert S Haugh, Richard Kwong, Vipin Gopal, Roy A Beveridge
BACKGROUND: Given the positive association between primary care and overall health, several health plans are offering doctors' visits without patient copay, with the intent to increase primary care use. However, the effectiveness of these offers has not been established in the literature. OBJECTIVE: To evaluate the impact of a free primary care provider (PCP) office visit offered by a health plan on primary care-seeking behaviors. METHODS: This nonrandomized concurrent control study used event/trials logistic regression to compare the differences in primary care utilization between new exchange enrollees in Mississippi who were offered a free nonpreventive PCP visit and concurrent controls from Georgia and Tennessee who were not offered a free visit, between January 1, 2014, and December 31, 2014, which was the first year of the exchange plans...
April 2017: American Health & Drug Benefits
https://www.readbyqxmd.com/read/28626382/a-symptomatic-coffee-bean-acute-sigmoid-volvulus
#10
Michael Scharl, Luc Biedermann
An acute sigmoid volvulus is due to the torsion of the sigmoid colon around its mesenteric axis. It mainly occurs in elderly patients and represents an abdominal emergency requiring urgent treatment. A 53-year-old male patient with severe craniocerebral injury and traumatic subarachnoidal bleeding 3 weeks prior presented on the ward with distended abdomen without abdominal pain, muscular defense, or resistances. He featured large volume diarrhea within the last few hours without signs of bleeding. A plain abdominal X-ray demonstrated a coffee bean sign indicating a sigmoid volvulus...
May 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28617730/eye-symptom-questionnaire-to-evaluate-anterior-eye-health
#11
Maria A Woodward, Nita G Valikodath, Paula Anne Newman-Casey, Leslie M Niziol, David C Musch, Paul P Lee
OBJECTIVES: Ophthalmologists assess eye complaints with a careful history and eye examination; however, other types of physicians have limited tools to evaluate anterior segment (AS) eye diseases. We identified the eye symptom questions that providers should ask to help determine the presence and urgency of AS eye diseases. METHODS: Persons with and without AS disease completed a self-report eye symptom questionnaire (ESQ) based on the National Institutes of Health Toolbox symptom items in an academic center's corneal and comprehensive eye clinics...
June 14, 2017: Eye & Contact Lens
https://www.readbyqxmd.com/read/28617244/continuity-of-care-in-infancy-and-early-childhood-health-outcomes
#12
Elizabeth Enlow, Molly Passarella, Scott A Lorch
BACKGROUND AND OBJECTIVES: Continuity of care is a key aspect of the patient-centered medical home and improves pediatric outcomes. Health care reform requires high-quality data to demonstrate its continued value. We hypothesized that increased provider continuity in infancy will reduce urgent health care use and increase receipt of preventive services in early childhood. METHODS: Continuity, using the Usual Provider of Care measure, was calculated across all primary care encounters during the first year of life in a prospectively-constructed cohort of 17 773 infants receiving primary care from birth through 3 years at 30 clinics...
June 15, 2017: Pediatrics
https://www.readbyqxmd.com/read/28611111/the-impact-of-interventions-to-improve-the-quality-of-prescribing-and-use-of-antibiotics-in-primary-care-patients-with-respiratory-tract-infections-a-systematic-review-protocol
#13
Nahara Anani Martínez-González, Samuel Coenen, Andreas Plate, Annelies Colliers, Thomas Rosemann, Oliver Senn, Stefan Neuner-Jehle
INTRODUCTION: Respiratory tract infections (RTIs) are the most common reason for primary care (PC) consultations and for antibiotic prescribing and use. The majority of RTIs have a viral aetiology however, and antibiotic consumption is ineffective and unnecessary. Inappropriate antibiotic use contributes greatly to antibiotic resistance (ABR) leading to complications, increased adverse events, reconsultations and costs. Improving antibiotic consumption is thus crucial to containing ABR, which has become an urgent priority worldwide...
June 13, 2017: BMJ Open
https://www.readbyqxmd.com/read/28609594/incidental-adrenal-masses-a-primary-care-approach
#14
Rasha Gendy, Prem Rashid
BACKGROUND: The common use of cross-sectional imaging for the investigation of abdominal and thoracic illness has resulted in the rise of the incidentally identified adrenal mass, or incidentaloma, which presents a diagnostic and management dilemma for the primary care physician. OBJECTIVE: This article provides a framework for the investigation and management of incidental adrenal masses. DISCUSSION: Adrenal incidentalomas are found in approximately 3-4% of abdominal computed tomography (CT) scans...
June 2017: Australian Family Physician
https://www.readbyqxmd.com/read/28602027/assistive-technology-for-memory-support-in-dementia
#15
REVIEW
Henriëtte G Van der Roest, Jennifer Wenborn, Channah Pastink, Rose-Marie Dröes, Martin Orrell
BACKGROUND: The sustained interest in electronic assistive technology in dementia care has been fuelled by the urgent need to develop useful approaches to help support people with dementia at home. Also the low costs and wide availability of electronic devices make it more feasible to use electronic devices for the benefit of disabled persons. Information Communication Technology (ICT) devices designed to support people with dementia are usually referred to as Assistive Technology (AT) or Electronic Assistive Technology (EAT)...
June 11, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28596150/pain-improvement-with-novel-combination-analgesic-regimens-pain-care-randomized-controlled-trial-protocol
#16
Ian Gilron, Dongsheng Tu, Ronald Holden, Alan C Jackson, Nader Ghasemlou, Scott Duggan, Elizabeth Vandenkerkhof, Roumen Milev
BACKGROUND: Neuropathic pain (NP) (including painful diabetic neuropathy, postherpetic neuralgia, etc) affects approximately 7% to 8% of the population and is associated with a devastating symptom burden as well as a profound economic impact for patients, their families, and the health care system. Current therapies have limited efficacy and dose-limiting adverse effects (AEs). Rational combination therapy with carefully selected NP drugs has shown potential for measurable improvements in pain relief, quality of life, and health care use...
June 8, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28592922/development-and-evaluation-of-a-modified-brief-assertiveness-training-for-nurses-in-the-workplace-a-single-group-feasibility-study
#17
Yohei Nakamura, Naoki Yoshinaga, Hiroki Tanoue, Sayaka Kato, Sayoko Nakamura, Keiko Aoishi, Yuko Shiraishi
BACKGROUND: Effective communication has a great impact on nurses' job satisfaction, team relationships, as well as patient care/safety. Previous studies have highlighted the various beneficial effects of enhancing communication through assertiveness training programs for nurses. However, most programs take a long time to implement; thus, briefer programs are urgently required for universal on-the-job-training in the workplace. The purpose of this feasibility study was to develop and evaluate a modified brief assertiveness training program (with cognitive techniques) for nurses in the workplace...
2017: BMC Nursing
https://www.readbyqxmd.com/read/28591975/an-overview-of-home-based-primary-care-learning-from-the-field
#18
Sarah Klein, Martha Hostetter, Douglas McCarthy
ISSUE: Homebound and functionally limited individuals are often unable to access office-based primary care, leading to unmet needs and increased health care spending. GOAL: Show how home-based primary care affects outcomes and costs for Medicare and Medicaid beneficiaries with complex care needs. METHODS: Qualitative synthesis of expert perspectives and the experiences of six case-study sites. FINDINGS AND CONCLUSIONS: Successful home-based primary care practices optimize care by: fielding interdisciplinary teams, incorporating behavioral care and social supports into primary care, responding rapidly to urgent and acute care needs, offering palliative care, and supporting family members and caregivers...
June 2017: Issue Brief of the Commonwealth Fund
https://www.readbyqxmd.com/read/28587274/parent-perspective-on-care-coordination-services-for-their-child-with-medical-complexity
#19
Rhonda G Cady, John L Belew
The overarching goal of care coordination is communication and co-management across settings. Children with medical complexity require care from multiple services and providers, and the many benefits of care coordination on health and patient experience outcomes have been documented. Despite these findings, parents still report their greatest challenge is communication gaps. When this occurs, parents assume responsibility for aggregating and sharing health information across providers and settings. A new primary-specialty care coordination partnership model for children with medical complexity works to address these challenges and bridge communication gaps...
June 6, 2017: Children
https://www.readbyqxmd.com/read/28584002/differences-in-characteristics-and-outcomes-between-asian-and-non-asian-patients-in-the-tiaregistry-org
#20
Takao Hoshino, Shinichiro Uchiyama, Lawrence K S Wong, Leila Sissani, Gregory W Albers, Natan M Bornstein, Louis R Caplan, Geoffrey A Donnan, José M Ferro, Michael G Hennerici, Julien Labreuche, Philippa C Lavallée, Carlos Molina, Peter M Rothwell, Philippe Gabriel Steg, Pierre-Jean Touboul, Éric Vicaut, Pierre Amarenco
BACKGROUND AND PURPOSE: This study provides the contemporary causes and prognosis of transient ischemic attack (TIA) and minor stroke in Asians and the direct comparisons with non-Asians. METHODS: The TIAregistry.org enrolled 4789 patients (1149 Asians and 3640 non-Asians) with a TIA or minor ischemic stroke within 7 days of onset. Every participating facility had systems dedicated to urgent intervention of TIA/stroke patients by specialists. The primary outcome was a composite of cardiovascular death, nonfatal stroke, and nonfatal acute coronary syndrome...
June 5, 2017: Stroke; a Journal of Cerebral Circulation
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