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Primary care internal medicine

Martha A Monson, Karen J Gibbons, M Sean Esplin, Michael W Varner, Tracy A Manuck
OBJECTIVE: To characterize subsequent pregnancy outcomes among women with a history of previable, preterm prelabor rupture of membranes (PROM) and assess factors associated with recurrent preterm birth. METHODS: This was a retrospective cohort study of women cared for with a history of one or more singleton pregnancy complicated by preterm PROM at less than 24 weeks of gestation between 2002 and 2013 who were cared for in two tertiary care health systems by a single group of maternal-fetal medicine specialists...
October 6, 2016: Obstetrics and Gynecology
Grigoriy E Gurvits, Gloria Lan, Amy Tan, Arlene Weissman
BACKGROUND: Increasing prevalence of inflammatory bowel disease (IBD) poses significant challenges to medical community. Preventive medicine, including vaccination against opportunistic infections, is important in decreasing morbidity and mortality in patients with IBD. We conduct first study to evaluate general awareness and adherence to immunisation guidelines by primary care physicians in the USA. METHODS: We administered an electronic questionnaire to the research panel of the American College of Physicians (ACP) assessing current vaccination practices, barriers to vaccination and provider responsibility for administering vaccinations and compared responses with the European Crohn's and Colitis Organization consensus guidelines and expert opinion from the USA...
October 12, 2016: Postgraduate Medical Journal
Paraskevas Vezyridis, Stephen Timmons
OBJECTIVE: To identify publication and citation trends, most productive institutions and countries, top journals, most cited articles and authorship networks from articles that used and analysed data from primary care databases (CPRD, THIN, QResearch) of pseudonymised electronic health records (EHRs) in UK. METHODS: Descriptive statistics and scientometric tools were used to analyse a SCOPUS data set of 1891 articles. Open access software was used to extract networks from the data set (Table2Net), visualise and analyse coauthorship networks of scholars and countries (Gephi) and density maps (VOSviewer) of research topics co-occurrence and journal cocitation...
October 11, 2016: BMJ Open
Maria Asunción García Gonzalo, María Isabel Santamaría Mas, Lidia Pascual Tomé, Maialen Ibarguren Pinilla, Francisco Rodríguez-Arrondo
AIM: To assess the prevalence of comorbidities, concomitant therapies and adverse effects associated with the medication in a cohort of patients with HIV infection. DESIGN: Multicentre cross-sectional study. SETTINGS: Infectious Diseases or Internal Medicine outpatient Clinics of 3 hospitals in the Basque Country. PARTICIPANTS: During a 3 month period, patients with the following inclusion criteria were randomly selected: HIV infection, age>18years, antiretroviral treatment (ART) for at least 6months, and no changes in ART in the previous 4weeks...
October 5, 2016: Atencion Primaria
David A Fessler, Grace C Huang, Jennifer Potter, Joseph J Baker, Howard Libman
BACKGROUND: Declining mortality has led to a rising number of persons living with HIV (PLWH) and concerns about a future shortage of HIV practitioners. AIM: To develop an HIV Primary Care Track for internal medicine residents. SETTING: Academic hospital and community health center with a history of caring for PLWH and lesbian, gay, bisexual, and transgender (LGBT) patients. PARTICIPANTS: Internal medicine residents. PROGRAM DESCRIPTION: We enrolled four residents annually in a 3-year track with the goal of having each provide continuity care to at least 20 PLWH...
October 4, 2016: Journal of General Internal Medicine
Onur Asan, Jeanne Tyszka, Kathlyn E Fletcher
OBJECTIVES: To understand (1) the perceptions of patients regarding use of EHR during clinic visits, (2) the impact of the presence of EHR on patient interactions with physicians, and (3) the ways in which EHR usage might increase patient engagement. METHODS: We conducted semi-structured interviews of a convenience sample of patients of internal medicine resident doctors from three primary care clinics. Interviews were audio-recorded and transcribed verbatim. We used thematic analysis to identify themes from the transcripts...
November 2016: International Journal of Medical Informatics
Joseph A Boscarino, H Lester Kirchner, James M Pitcavage, Vijay R Nadipelli, Naoko A Ronquest, Michael H Fitzpatrick, John J Han
OBJECTIVE: Opioid overdoses (ODs) have been increasing, and harm reduction efforts are a priority. The success of these efforts will be dependent on the identification of at-risk patients and improved access to the antidote naloxone. Therefore, to identify access to naloxone and factors associated with negative health outcomes, we conducted a retrospective study of patients with OD to identify those at highest risk of adverse outcomes and to assess the use of naloxone. METHODS: We conducted a study of electronic health records for patients admitted to the largest multihospital system in the region - the Geisinger Health System (GHS) for ODs - from April 2005 through March 2015...
2016: Substance Abuse and Rehabilitation
K Rammohan, Shyma M Mundayadan, Robert Mathew
CONTEXT: Nummular headache (NH) is a primary disorder characterized by head pain exclusively felt in a small-rounded area typically 2-6 cm in diameter. AIMS: The aim of this review is to study the clinical and epidemiological features of NH in a patient population of South India and to compare this with that of described in the international literature. SETTINGS AND DESIGN: A prospective, observational study conducted in a tertiary care center...
October 2016: Journal of Neurosciences in Rural Practice
Shelby R Hayes, Ashley J Vargas
: Goldenberg JZ, Lytvyn L, Steurich J, Parkin P, Mahant S, Johnston BC. Probiotics for the prevention of pediatric antibiotic-associated diarrhea.Cochrane Database Syst Rev2015, Issue 12. Art. No.: CD004827. BACKGROUND: Antibiotics are frequently prescribed in children. They alter the microbial balance within the gastrointestinal tract, commonly resulting in antibiotic-associated diarrhea (AAD). Probiotics may prevent AAD via restoration of the gut microflora...
August 26, 2016: Explore: the Journal of Science and Healing
Paula Godoy-Ruiz, Jamie Rodas, Yves Talbot, Katherine Rouleau
PURPOSE: In a global context of growing health inequities, international learning experiences have become a popular strategy for equipping health professionals with skills, knowledge, and competencies required to work with the populations they serve. This study sought to analyse the Chilean Interprofessional Programme in Primary Health Care (CIPPHC), a 5 week international learning experience funded by the Ministry of Health in Chile targeted at Chilean primary care providers and delivered in Toronto by the Department of Family and Community Medicine at the University of Toronto...
September 2016: Education for Primary Care
Johann Beaudreuil, Jean Marie Coudreuse, Christelle N Guyen, Philippe Deat, Aurore Chabaud, Bruno Pereira, Alain Lorenzo, Frédéric Sailhan, François Rannou, Emmanuel Coudeyre
OBJECTIVE: To develop an algorithm to help orthosis prescription for knee osteoarthritis patients. MATERIAL/PATIENTS AND METHODS: Systematic review of the literature using a qualitative analysis on Pubmed databases, Cochrane Library and Pedro from 1966 to 2015, using the keywords "knee osteoarthritis", "orthosis" with recommendations and highest quality trials. Development of a preliminary version of the algorithm using data from the literature and taking into account experience of different health professionals involved in the management of osteoarthritis patients...
September 2016: Annals of Physical and Rehabilitation Medicine
John K Triantafillidis, Constantine Vagianos, Aristofanis Gikas, Maria Korontzi, Apostolos Papalois
In recent years, the role of primary care physicians (PCPs) in the diagnosis and management of gastrointestinal disorders, including screening for colorectal cancer (CRC), has been recognized as very important. The available data indicate that PCPs are not adequately following CRC screening guidelines because a number of factors have been identified as significant barriers to the proper application of CRC screening guidelines. These factors include lack of time, patient reluctance, and challenges related to scheduling colonoscopy...
October 12, 2016: European Journal of Gastroenterology & Hepatology
Abigail Ford Winkel, Nathalie Feldman, Haley Moss, Holli Jakalow, Julia Simon, Stephanie Blank
OBJECTIVE: To determine whether a workshop Narrative Medicine curriculum can improve burnout among obstetrics and gynecology residents. METHODS: A Narrative Medicine curriculum was conducted at three obstetrics and gynecology training programs. An explanatory research design examined correlation between Narrative Medicine attendance and changes in survey responses. Residents completed a pretest and 1-year posttest survey that included validated measures of burnout and empathy...
October 2016: Obstetrics and Gynecology
Mariusz Gąsior, Damian Pres, Wojciech Wojakowski, Paweł Buszman, Zbigniew Kalarus, Michał Hawranek, Marek Gierlotka, Andrzej Lekston, Katarzyna Mizia-Stec, Marian Zembala, Lech Poloński, Michał Tendera
INTRODUCTION    Despite the progress that occurred in cardiology in the recent years, cardiovascular (CV) diseases still remain the main cause of death in European countries. The knowledge concerning the structure of hospital admissions for CV  diseases and clinical outcomes is fragmentary. OBJECTIVES    To analyse the characteristics and outcome of patients hospitalised with a CV diagnosis between 2006 and 2014, included in the Silesian Cardiovascular Database (SILCARD). PATIENTS AND METHODS    SILCARD is based on the data from the Regional Department of National Health Fund...
September 20, 2016: Polskie Archiwum Medycyny Wewnętrznej
Ernesto Schiffrin
Clinical practice guidelines, which are systematically developed statements aimed at helping people make clinical, policy-related and system-related decisions, frequently vary widely in quality. A strategy is needed to differentiate among guidelines and ensure that those of the highest quality are implemented. Hypertension Canada provides annually updated standardized recommendations and clinical practice guidelines to detect, treat and control hypertension. The annual, evidence-based recommendations are developed through intense discussion of the clinical implications via a systematic review of the literature followed by critical appraisals of all the new clinical research, taking into account the assessment criteria in the Appraisal of Guidelines for Research & Evaluation (AGREE) II instrument that evaluates the process of practice guideline development and the quality of reporting...
September 2016: Journal of Hypertension
Mahmoud Ait Kaci Ahmed, Monia Haddad, Beugré Kouassi, Hamid Ouhabi, Alain Serrie
Migraine is a primary headache disorder (according to the latest International Headache Society criteria) affecting approximately 8% of African population. Women are more often affected than men and attacks usually occur before the age of 40 years Although some treatments, hygienic-dietary measures and other non-pharmacological methods can reduce the intensity and frequency of attacks, medicinal treatment of migraine attack is often necessary. Availability of treatments and access to care differ in Africa and led to the implementation of the first expert consensus recommendations for the management of the migraine in african adult patients...
2016: Pan African Medical Journal
R Douglas Wilson, Isabelle De Bie, Christine M Armour, Richard N Brown, Carla Campagnolo, June C Carroll, Nan Okun, Tanya Nelson, Rhonda Zwingerman, Francois Audibert, Jo-Ann Brock, Richard N Brown, Carla Campagnolo, June C Carroll, Isabelle De Bie, Jo-Ann Johnson, Nan Okun, Melanie Pastruck, Karine Vallée-Pouliot, R Douglas Wilson, Rhonda Zwingerman, Christine Armour, David Chitayat, Isabelle De Bie, Sara Fernandez, Raymond Kim, Josee Lavoie, Norma Leonard, Tanya Nelson, Sherry Taylor, Margot Van Allen, Clara Van Karnebeek
OBJECTIVE: This guideline was written to update Canadian maternity care and reproductive healthcare providers on pre- and postconceptional reproductive carrier screening for women or couples who may be at risk of being carriers for autosomal recessive (AR), autosomal dominant (AD), or X-linked (XL) conditions, with risk of transmission to the fetus. Four previous SOGC- Canadian College of Medical Geneticists (CCMG) guidelines are updated and merged into the current document. INTENDED USERS: All maternity care (most responsible health provider [MRHP]) and paediatric providers; maternity nursing; nurse practitioner; provincial maternity care administrator; medical student; and postgraduate resident year 1-7...
August 2016: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
Steven Koslov, Elizabeth Trowbridge, Sandra Kamnetz, Sally Kraft, Jeffrey Grossman, Nancy Pandhi
BACKGROUND: Primary care is considered the foundation of an effective health care system. However, primary care departments at academic health centers have numerous challenges to overcome when trying to achieve the Triple Aim. METHODS: As part of an organizational initiative to redesign primary care at a large academic health center, departments of internal medicine, general pediatrics and adolescent medicine, and family medicine worked together to comprehensively redesign primary care...
September 2016: Healthcare
Maria Friedrichsen, Yvonne Hajradinovic, Maria Jakobsson, Per Milberg, Anna Milberg
: ᅟ: There is little evidence regarding primary healthcare team members' perceptions concerning palliative care consultation team (PCCT) and palliative care (PC) issues on their own wards. PURPOSE: This study aimed to study whether a PCCT can influence and change primary healthcare team members' perceptions regarding the palliative care at the end of life they are providing to patients in their own acute wards. METHODS: The intervention was a PCCT visiting surgical and internal medicine wards in 1 year...
September 16, 2016: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
Neha S Singh, Luis Huicho, Hoviyeh Afnan-Holmes, Theopista John, Allisyn C Moran, Tim Colbourn, Chris Grundy, Zoe Matthews, Blerta Maliqi, Matthews Mathai, Bernadette Daelmans, Jennifer Requejo, Joy E Lawn
BACKGROUND: Evaluating health systems and policy (HSP) change and implementation is critical in understanding reproductive, maternal, newborn and child health (RMNCH) progress within and across countries. Whilst data for health outcomes, coverage and equity have advanced in the last decade, comparable analyses of HSP changes are lacking. We present a set of novel tools developed by Countdown to 2015 (Countdown) to systematically analyse and describe HSP change for RMNCH indicators, enabling multi-country comparisons...
2016: BMC Public Health
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