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https://www.readbyqxmd.com/read/28445324/nurse-practitioner-physician-comanagement-of-primary-care-patients-the-promise-of-a-new-delivery-care-model-to-improve-quality-of-care
#1
Allison Andreno Norful, Kyleen Swords, Mickaela Marichal, Hwayoung Cho, Lusine Poghosyan
BACKGROUND: The U.S. primary care system is under tremendous strain to deliver care to an increased volume of patients with a concurrent primary care physician shortage. Nurse practitioner (NP)-physician comanagement of primary care patients has been proposed by some policy makers to help alleviate this strain. To date, no collective evidence demonstrates the effects of NP-physician comanagement in primary care. PURPOSE: This is the first review to synthesize all available studies that compare the effects of NP-physician comanagement to an individual physician managing primary care...
April 25, 2017: Health Care Management Review
https://www.readbyqxmd.com/read/28442312/expert-statements-on-the-standard-of-care-in-critically-ill-adult-patients-with-atypical-haemolytic-uraemic-syndrome
#2
REVIEW
Elie Azoulay, Paul Knoebl, José Garnacho-Montero, Katerina Rusinova, Gennadii Galstian, Philippe Eggimann, Fekri Abroug, Dominique Benoit, Michael von Bergwelt-Baildon, Julia Wendon, Marie Scully
BACKGROUND: Atypical haemolytic uraemic syndrome (aHUS) presents similarly to thrombotic thrombocytopenic purpura (TTP), and other causes or conditions with thrombotic microangiopathy (TMA) such as DIC or sepsis. Similarity in clinical presentation may hinder diagnosis and optimal treatment selection in the urgent setting in the ICU. However, there is currently no consensus on the diagnosis or treatment of aHUS for ICU specialists. This review aims to summarise available data on the diagnosis and treatment strategies of aHUS in the ICU in order to enhance the understanding of aHUS diagnosis and outcomes in patients managed in the ICU...
April 22, 2017: Chest
https://www.readbyqxmd.com/read/28439927/antithrombotic-therapy-and-platelet-transfusions-in-hematologic-malignancy-patients-presenting-chemotherapy-induced-thrombocytopenia-a-french-survey
#3
Emilie Chalayer, Doriane Cavalieri, Jean Alain Martignoles, Alexis Genthon, Emmanuelle Tavernier, Bernard Tardy
BACKGROUND: Patients with hematologic malignancies are at high risk for both thrombosis and bleeding. During the prolonged periods of thrombocytopenia experienced by patients who are receiving intensive chemotherapy, clinicians often hesitate to prescribe any protection against thrombosis. In case of anticoagulant prescription, it is the prescribers' responsibility to weigh risks and benefits for each patient. Current guidelines exist but do not take into account types of thrombosis, patients' comorbidities, or previous bleeding events...
April 25, 2017: Transfusion
https://www.readbyqxmd.com/read/28435313/evidence-and-consensus-recommendations-for-the-pharmacological-management-of-pain-in-india
#4
REVIEW
Gur Prasad Dureja, Rajagopalan N Iyer, Gautam Das, Jaishid Ahdal, Prashant Narang
Despite enormous progress in the field of pain management over the recent years, pain continues to be a highly prevalent medical condition worldwide. In the developing countries, pain is often an undertreated and neglected aspect of treatment. Awareness issues and several misconceptions associated with the use of analgesics, fear of adverse events - particularly with opioids and surgical methods of analgesia - are major factors contributing to suboptimal treatment of pain. Untreated pain, as a consequence, is associated with disability, loss of income, unemployment and considerable mortality; besides contributing majorly to the economic burden on the society and the health care system in general...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28421332/the-statin-associated-muscle-symptom-clinical-index-sams-ci-revision-for-clinical-use-content-validation-and-inter-rater-reliability
#5
Robert S Rosenson, Kate Miller, Martha Bayliss, Robert J Sanchez, Marie T Baccara-Dinet, Daniela Chibedi-De-Roche, Beth Taylor, Irfan Khan, Garen Manvelian, Michelle White, Terry A Jacobson
PURPOSE: The Statin-Associated Muscle Symptom Clinical Index (SAMS-CI) is a method for assessing the likelihood that a patient's muscle symptoms (e.g., myalgia or myopathy) were caused or worsened by statin use. The objectives of this study were to prepare the SAMS-CI for clinical use, estimate its inter-rater reliability, and collect feedback from physicians on its practical application. METHODS: For content validity, we conducted structured in-depth interviews with its original authors as well as with a panel of independent physicians...
April 18, 2017: Cardiovascular Drugs and Therapy
https://www.readbyqxmd.com/read/28420262/impact-of-an-educational-intervention-to-improve-physician-adherence-to-bronchiolitis-clinical-practice-guidelines-a-pre-post-intervention-study
#6
Marquita C Genies, Julia M Kim, Kristina Pyclik, Suzanne Rossi, Natalie Spicyn, Janet R Serwint
Bronchiolitis is the leading cause of infant hospitalizations in the United States. Despite clinical practice guidelines discouraging the utilization of non-evidence-based therapies, there continues to be wide variation in care and resource utilization. A pre-post physician focused educational intervention was conducted with the aims to reduce the use of non-evidence-based medical therapies, including bronchodilators, among patients admitted for bronchiolitis. Among patients meeting inclusion criteria (pre: n = 45; post: n = 47), bronchodilator use decreased by 50% ( P < ...
April 1, 2017: Clinical Pediatrics
https://www.readbyqxmd.com/read/28420034/a-fluorescence-in-situ-hybridization-based-screen-allows-rapid-detection-of-adverse-cytogenetic-alterations-in-patients-with-acute-myeloid-leukemia
#7
Nadine Sandhöfer, Klaus H Metzeler, Purvi M Kakadia, Zlatana Pasalic, Wolfgang Hiddemann, Michaela Neusser, Ortrud Steinlein, Michael Fiegl, Marion Subklewe, Karsten Spiekermann, Stefan K Bohlander, Stephanie Schneider, Jan Braess
In adult acute myeloid leukemia (AML), the karyotype of the leukemic cell is among the strongest prognostic factors. The Medical Research Council (MRC) and the European LeukemiaNet (ELN) classifications distinguish between favorable, intermediate and adverse cytogenetic risk patients who differ in their treatment response and overall survival. Conventional cytogenetic analyses are a mandatory component of AML diagnostics but they are time-consuming; therefore, therapeutic decisions in elderly patients are often delayed...
April 18, 2017: Genes, Chromosomes & Cancer
https://www.readbyqxmd.com/read/28419487/the-effect-of-medicaid-physician-fee-increases-on-health-care-access-utilization-and-expenditures
#8
Kevin Callison, Binh T Nguyen
OBJECTIVE: To evaluate the effect of Medicaid fee changes on health care access, utilization, and spending for Medicaid beneficiaries. DATA SOURCE: We use the 2008 and 2012 waves of the Medical Expenditure Panel Survey linked to state-level Medicaid-to-Medicare primary care reimbursement ratios obtained through surveys conducted by the Urban Institute. We also incorporate data from the Current Population Survey and the Area Resource Files. STUDY DESIGN: Using a control group made up of the low-income privately insured, we conduct a difference-in-differences analysis to assess the relationship between Medicaid fee changes and access to care, utilization of health care services, and out-of-pocket medical expenditures for Medicaid enrollees...
April 16, 2017: Health Services Research
https://www.readbyqxmd.com/read/28415679/a-feasibility-study-of-returning-clinically-actionable-somatic-genomic-alterations-identified-in-a-research-laboratory
#9
Natalia Paez Arango, Lauren Brusco, Kenna R Mills Shaw, Ken Chen, Agda Karina Eterovic, Vijaykumar Holla, Amber Johnson, Beate Litzenburger, Yekaterina B Khotskaya, Nora Sanchez, Ann Bailey, Xiaofeng Zheng, Chacha Horombe, Scott Kopetz, Carol J Farhangfar, Mark Routbort, Russell Broaddus, Elmer V Bernstam, John Mendelsohn, Gordon B Mills, Funda Meric-Bernstam
PURPOSE: Molecular profiling performed in the research setting usually does not benefit the patients that donate their tissues. Through a prospective protocol, we sought to determine the feasibility and utility of performing broad genomic testing in the research laboratory for discovery, and the utility of giving treating physicians access to research data, with the option of validating actionable alterations in the CLIA environment. EXPERIMENTAL DESIGN: 1200 patients with advanced cancer underwent characterization of their tumors with high depth hybrid capture sequencing of 201 genes in the research setting...
March 8, 2017: Oncotarget
https://www.readbyqxmd.com/read/28411354/preventing-the-complications-associated-with-the-use-of-dermal-fillers-in-facial-aesthetic-procedures-an-expert-group-consensus-report
#10
REVIEW
Fernando Urdiales-Gálvez, Nuria Escoda Delgado, Vitor Figueiredo, José V Lajo-Plaza, Mar Mira, Francisco Ortíz-Martí, Rosa Del Rio-Reyes, Nazaret Romero-Álvarez, Sofía Ruiz Del Cueto, María A Segurado, Cristina Villanueva Rebenaque
BACKGROUND: The use of dermal fillers in minimally invasive facial aesthetic procedures has become increasingly popular of late, yet as the indications and the number of procedures performed increase, the number of complications is also likely to increase. Paying special attention to specific patient characteristics and to the technique used can do much to avoid these complications. Indeed, a well-trained physician can also minimize the impact of such problems when they do occur. METHODS: A multidisciplinary group of experts in aesthetic treatments reviewed the main factors associated with the complications that arise when using dermal fillers...
April 14, 2017: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28410248/ce-venous-thromboembolism-updated-management-guidelines
#11
Sarah Hudson Roberts, Sherry Motes Lawrence
: Venous thromboembolism (VTE) is a leading cause of death and disability worldwide. Each year, more than 10 million cases of VTE are diagnosed; studies suggest there are as many as 900,000 cases per year in the United States. The condition is estimated to cost the U.S. health care system between $7 billion and $10 billion annually. In February 2016, the American College of Chest Physicians released the 10th edition of the Antithrombotic Therapy for VTE Disease: CHEST Guideline and Expert Panel Report. After providing an overview of VTE pathophysiology, risk factors, signs, symptoms, and key clinical assessments, this article details recommendations from the new guideline, which incorporates the most up-to-date treatment options for patients with VTE...
May 2017: American Journal of Nursing
https://www.readbyqxmd.com/read/28406719/structured-expert-consensus-on-actinic-keratosis-treatment-algorithm-focusing-on-daylight-pdt
#12
Piergiacomo Calzavara-Pinton, Merete Hædersdal, Kirk Barber, Nicole Basset-Seguin, María Emilia Del Pino Flores, Peter Foley, Gaston Galimberti, Rianne Gerritsen, Yolanda Gilarbete, Sally Ibbotson, Ketty Peris, Sheetal Sapra, Eleni Sotiriou, Luis Torezan, Claas Ulrich, Jonathan Guillemot, Janek Hendrich, Rolf-Markus Szeimies
BACKGROUND: A practical and up-to-date consensus among experts is paramount to further improve patient care in actinic keratosis (AK). OBJECTIVES: To develop a structured consensus statement on the diagnosis, classification, and practical management of AK based on up-to-date information. METHODS: A systematic review of AK clinical guidelines was conducted. This informed the preparation of a 3-round Delphi procedure followed by a consensus meeting, which combined the opinions of 16 clinical experts from 13 countries, to construct a structured consensus statement and a treatment algorithm positioning daylight photodynamic therapy (dl-PDT) among other AK treatment options...
April 1, 2017: Journal of Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/28406042/attributes-of-nuclear-imaging-centers-impacting-physician-referrals-for-single-photon-emission-computed-tomography-myocardial-perfusion-imaging-tests
#13
Junlong Li, Christy R Houle, James R Spalding, Hongbo Yang, Cheryl Q Xiang, Therese M Kitt, Rita M Kristy, Eric Q Wu
AIM: To evaluate nuclear imaging center attributes that cardiologists and primary care physicians (PCPs) consider when referring patients for single-photon emission computed tomography myocardial perfusion imaging (SPECT-MPI) tests, and how these attributes impact physician referral decisions in the United States. METHODS: A targeted literature review and seven one-to-one interviews with physicians and imaging center directors were conducted to identify attributes that could impact physicians' referral decisions...
April 13, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28405953/angioedema-in-the-emergency-department-a-practical-guide-to-differential-diagnosis-and-management
#14
REVIEW
Jonathan A Bernstein, Paolo Cremonesi, Thomas K Hoffmann, John Hollingsworth
BACKGROUND: Angioedema is a common presentation in the emergency department (ED). Airway angioedema can be fatal; therefore, prompt diagnosis and correct treatment are vital. OBJECTIVE OF THE REVIEW: Based on the findings of two expert panels attended by international experts in angioedema and emergency medicine, this review aims to provide practical guidance on the diagnosis, differentiation, and management of histamine- and bradykinin-mediated angioedema in the ED...
December 2017: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28401122/quality-indicators-for-the-detection-and-management-of-chronic-kidney-disease-in-primary-care-in-canada-derived-from-a-modified-delphi-panel-approach
#15
Karen Tu, Lindsay Bevan, Katie Hunter, Jess Rogers, Jacqueline Young, Gihad Nesrallah
BACKGROUND: The detection and management of chronic kidney disease lies within primary care; however, performance measures applicable in the Canadian context are lacking. We sought to develop a set of primary care quality indicators for chronic kidney disease in the Canadian setting and to assess the current state of the disease's detection and management in primary care. METHODS: We used a modified Delphi panel approach, involving 20 panel members from across Canada (10 family physicians, 7 nephrologists, 1 patient, 1 primary care nurse and 1 pharmacist)...
January 2017: CMAJ Open
https://www.readbyqxmd.com/read/28397312/3lessons-from-the-cagi-4-hopkins-clinical-panel-challenge
#16
John-Marc Chandonia, Aashish Adhikari, Marco Carraro, Aparna Chhibber, Garry R Cutting, Yao Fu, Alessandra Gasparini, David T Jones, Andreas Kramer, Kunal Kundu, Hugo Y K Lam, Emanuela Leonardi, John Moult, Lipika R Pal, David B Searls, Sohela Shah, Shamil Sunyaev, Silvio C E Tosatto, Yizhou Yin, Bethany A Buckley
The CAGI-4 Hopkins clinical panel challenge was an attempt to assess state of the art methods for clinical phenotype prediction from DNA sequence. Participants were provided with exonic sequences of 83 genes for 106 patients from the Johns Hopkins DNA Diagnostic Laboratory. Five groups participated in the challenge, predicting both the probability that each patient had each of fourteen possible classes of disease, as well as one or more causal variants. In cases where the Hopkins laboratory reported a variant, at least one predictor correctly identified the disease class in 36 of 43 patients (84%)...
April 11, 2017: Human Mutation
https://www.readbyqxmd.com/read/28395008/derivation-and-validation-of-a-serum-biomarker-panel-to-identify-infants-with-acute-intracranial-hemorrhage
#17
Rachel Pardes Berger, Brian J Pak, Mariya D Kolesnikova, Janet Fromkin, Richard Saladino, Bruce E Herman, Mary Clyde Pierce, David Englert, Paul T Smith, Patrick M Kochanek
Importance: Abusive head trauma is the leading cause of death from physical abuse. Missing the diagnosis of abusive head trauma, particularly in its mild form, is common and contributes to increased morbidity and mortality. Serum biomarkers may have potential as quantitative point-of-care screening tools to alert physicians to the possibility of intracranial hemorrhage. Objective: To identify and validate a set of biomarkers that could be the basis of a multivariable model to identify intracranial hemorrhage in well-appearing infants using the Ziplex System...
April 10, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28390419/which-potential-harms-and-benefits-of-using-ginger-in-the-management-of-nausea-and-vomiting-of-pregnancy-should-be-addressed-a-consensual-study-among-pregnant-women-and-gynecologists
#18
Ramzi Shawahna, Assim Taha
BACKGROUND: Nausea and vomiting of pregnancy (NVP) affect approximately 80-90% of the pregnant women. Ginger (Zingiber officinale Roscoe) is the most widely used herbal therapy in the management of NVP. Like conventional therapies, herbal therapies have potential harms and benefits that patients need to be informed about in order to develop their therapy preferences. The aim of this study was to achieve consensus among women who suffered NVP and physicians often consulted by pregnant women on a core list of potential harms and benefits of using ginger to manage NVP to be addressed during clinical consultations...
April 8, 2017: BMC Complementary and Alternative Medicine
https://www.readbyqxmd.com/read/28379914/treatment-of-hip-fractures-in-the-elderly
#19
Robert H Quinn, Pekka A Mooar, Jayson N Murray, Ryan Pezold, Kaitlyn S Sevarino
Evidence-based information, in conjunction with the clinical expertise of physicians, was used to develop the Appropriate Use Criteria (AUC) document Treatment of Hip Fractures in the Elderly to improve patient care and obtain optimal outcomes while considering the subtleties and distinctions necessary in making clinical decisions. The AUC clinical patient scenarios were derived from indications typical of patients commonly presenting with hip fractures in clinical practice, as well as from current evidence-based clinical practice guidelines and supporting literature...
May 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28377932/understanding-preferences-for-treatment-after-hypothetical-first-time-anterior-shoulder-dislocation-surveying-an-online-panel-utilizing-a-novel-shared-decision-making-tool
#20
Ben Streufert, Shelby D Reed, Lori A Orlando, Dean C Taylor, Joel C Huber, Richard C Mather
BACKGROUND: Although surgical management of a first-time anterior shoulder dislocation (FTASD) can reduce the risk of recurrent dislocation, other treatment characteristics, costs, and outcomes are important to patients considering treatment options. While patient preferences, such as those elicited by conjoint analysis, have been shown to be important in medical decision-making, the magnitudes or effects of patient preferences in treating an FTASD are unknown. PURPOSE: To test a novel shared decision-making tool after sustained FTASD...
March 2017: Orthopaedic Journal of Sports Medicine
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