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https://www.readbyqxmd.com/read/28647951/complexities-of-care-in-klinefelter-syndrome-an-aprn-perspective
#1
Sharron Close, Amy Talboy, Ilene Fennoy
47,XXY (Klinefelter Syndrome) is associated with a spectrum of complex clinical needs that are associated with variable physical, neurocognitive and psychosocial aspects. For patients and families affected by this sex chromosome trisomy, navigation of health care services is difficult due to lack of 47,XXY awareness among many health care providers and little evidence to support endocrine and additional treatment plans. While endocrine management of androgen deficiency has been the mainstay of treatment for patients from puberty through adulthood, testosterone replacement, alone, fails to mitigate many symptoms and issues...
June 2017: Pediatric Endocrinology Reviews: PER
https://www.readbyqxmd.com/read/28647944/management-of-type-1-diabetes-in-children-in-the-first-5-years-of-life
#2
Melissa Rearson, Susan Sullivan-Bolyai
A significant increase in children <6 years of age being diagnosed with type 1 diabetes (T1D) is occurring. The parents (caregivers) of these children have full responsibility for the complex and individualized management while having to deal with the emotional stress of caring for a child with a chronic condition. This article will provide a summary of the diagnosis and recommended medical treatment for this special age group of children. Also presented will be common day-to-day family management issues for health care providers to consider as they provide care for this most common endocrine chronic condition...
June 2017: Pediatric Endocrinology Reviews: PER
https://www.readbyqxmd.com/read/28647844/digital-health-technologies-to-promote-lifestyle-change-and-adherence
#3
REVIEW
Numan Khan, Francoise A Marvel, Jane Wang, Seth S Martin
Cardiovascular disease is the leading cause of morbidity and mortality worldwide with an estimated 17.5 million deaths annually, or 31% of all global deaths, according to the World Health Organization. The majority of these deaths are preventable by addressing lifestyle modification (i.e., smoking cessation, diet, obesity, and physical inactivity) and promoting medication adherence. At present, initiatives to develop cost-effective modalities to support self-management, lifestyle modification, and medication adherence are a leading priority...
August 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28647693/recognition-investigation-and-management-of-mitochondrial-disease
#4
REVIEW
James E Davison, Shamima Rahman
Mitochondria are dynamic organelles present in virtually all human cells that are needed for a multitude of cellular functions, including energy production, control of cell apoptosis and numerous biochemical catabolic and synthetic pathways that are critical for cellular health. Primary mitochondrial disorders are a group of greater than 200 single gene defects arising from two genomes (nuclear and mitochondrial) leading to mitochondrial dysfunction, and are associated with extremely heterogeneous phenotypes...
June 24, 2017: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/28647679/factors-impacting-on-psychological-wellbeing-of-international-students-in-the-health-professions-a-scoping-review
#5
REVIEW
Lisa McKenna, Eddie Robinson, Joy Penman, Danny Hills
BACKGROUND: There are increasing numbers of international students undertaking health professional courses, particularly in Western countries. These courses not only expose students to the usual stresses and strains of academic learning, but also require students to undertake clinical placements and practice-based learning. While much is known about general issues facing international students, less is known about factors that impact on those studying in the health professions. OBJECTIVES: To explore what is known about factors that influence the psychological wellbeing of international students in the health professions...
June 17, 2017: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/28647578/regular-source-of-care-for-the-elderly-a-cross-national-comparative-study-of-hong-kong-with-11-developed-countries
#6
Samuel Yeung-Shan Wong, Dan Zou, Roger Y Chung, Regina W Sit, Dexing Zhang, Dicken Chan, Eng Kiong Yeoh, Jean W Woo
OBJECTIVE: This study aimed to give an international perspective of health service gaps for caring for elderly individuals and explore the role of primary care for caring for elderly individuals with chronic conditions in Hong Kong. DESIGN: Cross-sectional, telephone survey. SETTING: Hong Kong. PARTICIPANT: A sample of 1000 Chinese participants in Hong Kong aged 60 or older. MEASUREMENTS: Questionnaire extracted from the Commonwealth Fund 2014 International Health Policy Survey of Older Adults...
June 21, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28647442/the-impact-of-the-transition-from-volume-to-value-on-heart-failure-care-implications-of-novel-payment-models-and-quality-improvement-initiatives
#7
REVIEW
Dushyanth Srinivasan, Nihar R Desai
In response to wide variation in quality and outcomes as well as escalating health care costs, the U.S. health care system is transitioning away from a volume based payment system to a quality- and value-based system. Medicare, the largest insurer and payer of healthcare, has accelerated the movement towards value-based care with the development and implementation of myriad alternative payment models and pay for performance programs as part of the Affordable Care Act. Given that heart failure affects a significant number of Medicare patients and these patients account for a disproportionate amount of healthcare utilization and spending, heart failure has become a focal point for these initiatives...
June 21, 2017: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/28646966/a-systematic-approach-to-diagnosing-intra-thoracic-tuberculosis-in-children
#8
Carlos M Perez-Velez, Claudia L Roya-Pabon, Ben J Marais
Children suffer a huge and often underappreciated burden of disease in tuberculosis (TB) endemic countries. Major hurdles include limited awareness among health care workers, poor integration of TB into maternal and child health approaches, diagnostic difficulties and a lack of child-friendly treatment options. Accurate disease diagnosis is particularly difficult in young and vulnerable children who tend to develop paucibacillary disease and are unable to produce an expectorated sputum sample. In addition, access to chest radiography is problematic in resource-limited settings...
June 2017: Journal of Infection
https://www.readbyqxmd.com/read/28646952/drug-resistant-tuberculosis-primary-transmission-and-management
#9
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/28646857/overview-of-post-discharge-predictors-for-psychiatric-re-hospitalisations-a-systematic-review-of-the-literature
#10
R Sfetcu, S Musat, P Haaramo, M Ciutan, G Scintee, C Vladescu, K Wahlbeck, H Katschnig
BACKGROUND: High levels of hospital readmission (rehospitalisation rates) is widely used as indicator of a poor quality of care. This is sometimes also referred to as recidivism or heavy utilization. Previous studies have examined a number of factors likely to influence readmission, although a systematic review of research on post-discharge factors and readmissions has not been conducted so far. The main objective of this review was to identify frequently reported post-discharge factors and their effects on readmission rates...
June 24, 2017: BMC Psychiatry
https://www.readbyqxmd.com/read/28646442/variability-of-adverse-events-in-the-public-health-care-service-of-the-tuscany-region
#11
Sara Albolino, Riccardo Tartaglia, Tommaso Bellandi, Elisa Bianchini, Giancarlo Fabbro, Silvia Forni, Giulia Cernuschi, Annibale Biggeri
The objective of the study is to analyze the variation of adverse events (AEs) according to the different structure of hospitals. The study is a multicenter, retrospective study. It involves 4 teaching hospitals (THs) and 32 community hospitals, distributed in 12 local trusts (LTs), of the Tuscany Regional Healthcare Service (RHS). A random sample of the clinical records of patients admitted in LTs and THs in 2008 was selected from the database of the hospital discharge records of the centers. Among 11,293 clinical records included, a total of 354 adverse events were identified...
June 23, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28646340/clinical-management-of-ebola-virus-disease-patients-in-low-resource-settings
#12
Armand Sprecher, Michel Van Herp, Pierre E Rollin
The low-resource environment deprives healthcare providers caring for patients with Ebola virus disease (EVD) of many of the means employed for the critically ill that are available in better resourced settings, such as advanced therapeutic interventions and abundant staff. In addition to these limitations may be added those imposed by the remote tropical locations, where EVD outbreaks occur. In this setting, a safe environment is created where healthcare workers may care for their patients over the evolving course of their acute illness into their convalescent period...
June 24, 2017: Current Topics in Microbiology and Immunology
https://www.readbyqxmd.com/read/28646264/magnitude-and-temporal-trends-in-avoidable-blindness-in-children-abc-in-india
#13
Venkata S Murthy Gudlavalleti
The World Health Organization estimates that 19 million children are visually impaired, among whom, 1.4 million are blind. Childhood blindness is an excellent indicator of the state of child health and primary care services in a country. Childhood blindness is important not just due to the number of children blind but also because the number of years that the surviving child has to live with blindness (blind years lived). Childhood blindness is next only to adult cataract in terms of the number of blind person years lived...
June 23, 2017: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/28646002/preparation-for-transition-to-adult-care-among-medicaid-insured-adolescents
#14
Gregory S Sawicki, Katharine C Garvey, Sara L Toomey, Kathryn A Williams, J Lee Hargraves, Thomas James, Jean L Raphael, Angelo P Giardino, Mark A Schuster, Jonathan A Finkelstein
BACKGROUND: Parents of children with chronic illness consistently report suboptimal preparation for transition from pediatric- to adult-focused health care. Little data are available on transition preparation for low-income youth in particular. METHODS: We conducted a mailed survey of youth with chronic illness enrolled in 2 large Medicaid health plans to determine the quality of transition preparation using the Adolescent Assessment of Preparation for Transition (ADAPT)...
June 23, 2017: Pediatrics
https://www.readbyqxmd.com/read/28645968/development-of-a-meta-algorithm-for-guiding-primary-care-encounters-for-patients-with-multimorbidity-using-evidence-based-and-case-based-guideline-development-methodology
#15
Cathleen Muche-Borowski, Dagmar Lühmann, Ingmar Schäfer, Rebekka Mundt, Hans-Otto Wagner, Martin Scherer
OBJECTIVE: The study aimed to develop a comprehensive algorithm (meta-algorithm) for primary care encounters of patients with multimorbidity. We used a novel, case-based and evidence-based procedure to overcome methodological difficulties in guideline development for patients with complex care needs. STUDY DESIGN: Systematic guideline development methodology including systematic evidence retrieval (guideline synopses), expert opinions and informal and formal consensus procedures...
June 22, 2017: BMJ Open
https://www.readbyqxmd.com/read/28645890/tailored-communication-within-mobile-apps-for-diabetes-self-management-a-systematic-review
#16
Heidi Holmen, Astrid Klopstad Wahl, Milada Cvancarova Småstuen, Lis Ribu
BACKGROUND: The prevalence of diabetes is increasing and with the requirements for self-management and risk of late complications, it remains a challenge for the individual and society. Patients can benefit from support from health care personnel in their self-management, and the traditional communication between patients and health care personnel is changing. Smartphones and apps offer a unique platform for communication, but apps with integrated health care personnel communication based on patient data are yet to be investigated to provide evidence of possible effects...
June 23, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28645320/acromegaly-discovered-during-a-routine-out-patient-surgical-procedure-a-case-report
#17
Chukwudi O Chiaghana, Julia M Bauerfeind, Cheri A Sulek, J Christopher Goldstein, Caleb A Awoniyi
BACKGROUND: Acromegaly is a rare syndrome in which there is unregulated hypersecretion of growth hormone. The anesthetic management of patients with this disorder is particularly challenging due to pre-existing cardiovascular and respiratory dysfunction, as well as recognized difficulties with airway management. Because of the insidious progression of the disease and the presence of nonspecific signs and symptoms, diagnosis is often made late when characteristic acromegalic features become apparent...
June 24, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28645301/the-sternal-management-accelerated-recovery-trial-s-m-a-r-t-standard-restrictive-versus-an-intervention-of-modified-sternal-precautions-following-cardiac-surgery-via-median-sternotomy-study-protocol-for-a-randomised-controlled-trial
#18
Md Ali Katijjahbe, Linda Denehy, Catherine L Granger, Alistair Royse, Colin Royse, Rebecca Bates, Sarah Logie, Sandy Clarke, Doa El-Ansary
BACKGROUND: The routine implementation of sternal precautions to prevent sternal complications that restrict the use of the upper limbs is currently worldwide practice following a median sternotomy. However, evidence is limited and drawn primarily from cadaver studies and orthopaedic research. Sternal precautions may delay recovery, prolong hospital discharge and be overly restrictive. Recent research has shown that upper limb exercise reduces post-operative sternal pain and results in minimal micromotion between the sternal edges as measured by ultrasound...
June 23, 2017: Trials
https://www.readbyqxmd.com/read/28644930/trends-in-open-and-endoscopic-cubital-tunnel-release-in-the-medicare-patient-population
#19
Tsun Yee Law, Zachary S Hubbard, Lee Onn Chieng, Harvey W Chim
BACKGROUND: Cubital tunnel syndrome (CUT) is the second most common peripheral neuropathy with an annual incidence of 24.7 per 100 000, affecting nearly twice as many men as women. With increasing focus on cost-effectiveness and cost-containment in medicine, a critical understanding of utilization of health care resources for open and endoscopic approaches for cubital tunnel release is of value. The purpose of this study was to evaluate the costs and utilization trends of open and endoscopic cubital tunnel release...
July 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28644822/the-effect-of-a-lay-led-group-based-self-management-program-for-patients-with-chronic-pain-a-randomized-controlled-trial-of-the-danish-version-of-the-chronic-pain-self-management-programme
#20
Mimi Mehlsen, Lea Hegaard, Eva Ørnbøl, Jens Søndergaard Jensen, Per Fink, Lisbeth Frostholm
The Stanford Chronic Pain Self-Management Programme (CPSMP) consists of six 2½-hour weekly workshops focusing on how to manage pain in daily life. The workshops are facilitated by two workshop leaders of whom at least one must suffer from a long-term pain condition. The program is highly structured and manualized. Only few controlled trials testing the effect of CPSMP exist.Enrolled in the study were 424 adults from 19 Danish municipalities, (72% women; age: 25-93 years) with pain of any etiology and great variation in pain history (0-50 yrs)...
June 22, 2017: Pain
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