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Age Management Medicine

Rieke Schnakenberg, Lukas Radbruch, Christine Kersting, Friederike Frank, Stefan Wilm, Denise Becka, Klaus Weckbecker, Markus Bleckwenn, Johannes M Just, Michael Pentzek, Birgitta Weltermann
BACKGROUND: Although general practitioners (GPs) are among the preferred contact persons for discussing end-of-life issues including advance directives (ADs), there is little data on how GPs manage such consultations. OBJECTIVES: This postal survey asked German GPs about their counselling for end-of-life decisions. METHODS: In 2015, a two-sided questionnaire was mailed to 959 GPs. GPs were asked for details of their consultations on ADs: frequency, duration, template use, and whether they have own ADs...
December 2018: European Journal of General Practice
Ruwan Weerakkody, David Ross, David A Parry, Bulat Ziganshin, Jana Vandrovcova, Piyush Gampawar, Abdulshakur Abdullah, Jennifer Biggs, Julia Dumfarth, Yousef Ibrahim, Colin Bicknell, Mark Field, John Elefteriades, Nick Cheshire, Timothy J Aitman
PurposeThoracic aortic aneurysm/aortic dissection (TAAD) is a disorder with highly variable age of onset and phenotype. We sought to determine the prevalence of pathogenic variants in TAAD-associated genes in a mixed cohort of sporadic and familial TAAD patients and identify relevant genotype-phenotype relationships.MethodsWe used a targeted polymerase chain reaction and next-generation sequencing-based panel for genetic analysis of 15 TAAD-associated genes in 1,025 unrelated TAAD cases.ResultsWe identified 49 pathogenic or likely pathogenic (P/LP) variants in 47 cases (4...
March 15, 2018: Genetics in Medicine: Official Journal of the American College of Medical Genetics
Dafina Ilijazi, Mohammad Abufaraj, Melanie R Hassler, Iris E Ertl, David D'Andrea, Shahrokh F Shariat
Bladder cancer (BCa) is the fifth most frequently diagnosed cancer worldwide and is, in fact, the most expensive cancer on a per-patient to treat basis. There is a critical need to implement new tests into clinical practice to improve the quality of clinical care, decrease unnecessary invasive therapies and ultimately save costs. Currently, no molecular or genetic biomarker has been widely integrated into daily clinical practice. However, major milestones have been achieved in our understanding of the molecular alterations in BCa that will provide the basis for integrating molecular and genetic biomarkers into clinical decision making to guide management...
March 15, 2018: Expert Review of Molecular Diagnostics
Eleonore V Grant, Adam H Skolnick, Joshua Chodosh, Michael H Perskin, Nicole M Orr, Caroline Blaum, John A Dodson
More than 13 million persons in the United States aged 65 and older have cardiovascular disease (CVD), and this population is expected to increase exponentially over the next several decades. In the absence of clinical studies that would inform how best to manage this population, there is an urgent need for collaborative, thoughtful approaches to their care. Although cardiologists are traditionally regarded as leaders in the care of older adults with CVD, these individuals have multiple comorbidities, physiological differences, and distinct goals of care than younger patients that require a specialized geriatric lens...
March 15, 2018: Journal of the American Geriatrics Society
F Pietrantonio, F Di Nicolantonio, A B Schrock, J Lee, F Morano, G Fucà, P Nikolinakos, A Drilon, J F Hechtman, J Christiansen, K Gowen, G M Frampton, P Gasparini, D Rossini, C Gigliotti, S T Kim, M Prisciandaro, J Hodgson, A Zaniboni, V K Chiu, M Milione, R Patel, V Miller, A Bardelli, L Novara, L Wang, S Pupa, G Sozzi, J Ross, M Di Bartolomeo, A Bertotti, S Ali, L Trusolino, A Falcone, F de Braud, C Cremolini
Background: Recognition of rare molecular subgroups is a challenge for precision oncology and may lead to tissue-agnostic approval of targeted agents. Here we aimed to comprehensively characterize the clinical, pathological and molecular landscape of RET rearranged metastatic colorectal cancer (mCRC). Patients and methods: In this case series, we compared clinical, pathological and molecular characteristics of 24 RET rearranged mCRC patients with those of a control group of 291 patients with RET negative tumors...
March 10, 2018: Annals of Oncology: Official Journal of the European Society for Medical Oncology
Mackensie A Yore, Matthew C Strehlow, Lily D Yan, Elizabeth A Pirrotta, Joan L Woods, Koy Somontha, Yim Sovannra, Lauren Auerbach, Rebecca Backer, Christophe Grundmann, Swaminatha V Mahadevan
BACKGROUND: Emergency medicine is a young specialty in many low- and middle-income countries (LMICs). Although many patients seeking emergency or acute care are children, little information is available about the needs and current treatment of this group in LMICs. In this observational study, we sought to describe characteristics, chief complaints, management, and outcomes of children presenting for unscheduled visits to two Cambodian public hospitals. METHODS: Children enrolled in the study presented without appointment for treatment at one of two Cambodian public referral hospitals during a 4-week period in 2012...
March 13, 2018: International Journal of Emergency Medicine
Barbara P Yawn, Peter C Wollan, Matthew A Rank, Susan L Bertram, Young Juhn, Wilson Pace
PURPOSE: The purpose of this study was to assess patient and practice outcomes after introducing the Asthma APGAR (Activities, Persistent, triGGers, Asthma medications, Response to therapy) tools into primary care practices. METHODS: We used a pragmatic cluster-randomized controlled design in 18 US family medicine and pediatric practices to compare outcomes in patients with persistent asthma aged 5 to 45 years after introduction of the Asthma APGAR tools vs usual care...
March 2018: Annals of Family Medicine
M Colinart-Thomas, V Noël, G Roques, S Gordes-Grosjean, M Abely, C Pluchart
Sickle cell disease, a hemoglobin disorder with autosomal recessive transmission, is one of the most common genetic diseases screened in France. Thanks to early management, 95% of sickle cell patients reach adulthood and require transition from pediatric care to adult care. Through a retrospective study of records from serious sickle cell patients over 17 years old, followed in the hematology-oncology pediatric unit of Reims University Hospital Center in France, we analyzed transition conditions, compared pediatric and adult management, and proposed a plan for transition care...
March 9, 2018: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
Caroline C Swift, Meryle J Eklund, Jacqueline M Kraveka, Adina L Alazraki
Neuroblastoma is an embryonic tumor of the peripheral sympathetic nervous system. It is the most common extracranial solid tumor of childhood and accounts for up to 15% of all pediatric cancer fatalities. The manifestation of neuroblastoma is variable depending on the location of the tumor and on the presence or absence of paraneoplastic syndromes. The prognosis of neuroblastoma is also highly variable, ranging from spontaneous regression to widespread metastatic disease that is unresponsive to treatment. The age of the patient, stage of disease, histopathologic results, and multiple biologic factors contribute to the presurgical and pretreatment risk stratification of a patient with neuroblastoma...
March 2018: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Dilek D Altınörs, Leyla Asena
OBJECTIVES: We aimed to report the clinical outcomes of Descemet membrane endothelial keratoplasty in our first year of experience. MATERIALS AND METHODS: Patients who underwent Descemet membrane endothelial keratoplasty at the Baskent University Faculty of Medicine, Department of Ophthalmology, between 2015 and 2016 were included in the study. Patient demographics, cause of endothelial dysfunction, best-corrected visual acuity, central corneal thickness, graft survival, follow-up duration, and intraoperative and postoperative complications were recorded...
March 2018: Experimental and Clinical Transplantation
Charu C Garg, Sarmila Mazumder, Sunita Taneja, Medha Shekhar, Sanjana Brahmawar Mohan, Anuradha Bose, Sharad D Iyengar, Rajiv Bahl, Jose Martines, Nita Bhandari
Trial design: Three feeding regimens-centrally produced ready-to-use therapeutic food, locally produced ready-to-use therapeutic food, and augmented, energy-dense, home-prepared food-were provided in a community setting for children with severe acute malnutrition (SAM) in the age group of 6-59 months in an individually randomised multicentre trial that enrolled 906 children. Foods, counselling, feeding support and treatment for mild illnesses were provided until recovery or 16 weeks. Methods: Costs were estimated for 371 children enrolled in Delhi in a semiurban location after active survey and identification, enrolment, diagnosis and treatment for mild illnesses, and finally treatment with one of the three regimens, both under the research and government setting...
2018: BMJ Global Health
Jong Joo Lee, Dong Ah Shin, Seong Yi, Keung Nyun Kim, Do Heum Yoon, Hyun Chul Shin, Yoon Ha
BACKGROUND CONTEXT: Despite the fact that ossification of posterior longitudinal ligament (OPLL) is a three-dimensional disease, conventional studies have mainly focused on a two-dimensional measurement, and it is difficult to accurately determine the volume of OPLL growth and analyze the factors affecting OPLL growth after posterior decompression (laminoplasty or laminectomy and fusion). PURPOSE: This study aimed to investigate the factors affecting OPLL volume growth using a three-dimensional measurement...
March 8, 2018: Spine Journal: Official Journal of the North American Spine Society
Lu Yang, Wenbo Peng, Jon Adams, David William Sibbritt
INTRODUCTION: Emerging evidence has shown that traditional Chinese medicine (TCM) has a positive effect on arthritis. This research provides the first critical, systematic examination of TCM practitioners' perceptions of TCM use for people with arthritis. METHODS: An online survey was distributed to all TCM professionals including acupuncturists and Chinese herbal medicine practitioners registered with the Practitioner Research and Collaborate Initiative (PRACI) practitioner database...
March 8, 2018: Acupuncture in Medicine: Journal of the British Medical Acupuncture Society
Filippo Baldacci, Simone Lista, Sid E O'Bryant, Roberto Ceravolo, Nicola Toschi, Harald Hampel
The discovery, development, and validation of novel candidate biomarkers in Alzheimer's disease (AD) and other neurodegenerative diseases (NDs) are increasingly gaining momentum. As a result, evolving diagnostic research criteria of NDs are beginning to integrate biofluid and neuroimaging indicators of pathophysiological mechanisms. More than 10% of people aged over 65 suffer from NDs. There is an urgent need for a refined two-stage diagnostic model to first initiate an early, sensitive, and noninvasive process in primary care settings...
2018: Methods in Molecular Biology
Tristan Monchal, Amina Ndiaye, Blandine Gadegbeku, Etienne Javouhey, Olivier Monneuse
Objective Road traffic accidents (RTA) are the first cause of abdominopelvic injuries (API). The objective of this study was to describe the characteristics and severity of API due to traffic accidents in a large French trauma registry and to identify risk factors for API. Methods All victims from the French Rhône registry of victims of RTA were analyzed from 1996 to 2013. This registry contained data that were issued over a 20-year period from 245 medical departments, from prehospital care until re-adaptation, and forensic medicine departments...
March 6, 2018: Traffic Injury Prevention
Charlotte Vaysse, Elodie Chantalat, Odile Beyne-Rauzy, Louise Morineau, Fabien Despas, Jean-Marc Bachaud, Nathalie Caunes, Muriel Poublanc, Elie Serrano, Roland Bugat, Marie-Eve Rougé Bugat, Anne-Laure Fize
BACKGROUND: Oncology involves complex care and multidisciplinary management of patients; however, misinformation and ineffective communication remain problematic. OBJECTIVE: The educational objective of our study was to develop a new teaching method to improve cancer treatment and management by emphasizing the link between hospitals (inpatients) and their surrounding communities (outpatients). METHODS: A team of 22 professionals from public and private institutions developed a small private online course (SPOC)...
March 5, 2018: JMIR Medical Education
Shahrooz Tabrizi, Amir Nejati, Saharnaz Nedjat, Seyed Mojtaba Aghili
Introduction: The present study is a survey to assess the pros and cons of emergency medicine (EM) from the viewpoint of the scholars from other medicine disciplines to improve the efficiency of EM in the healthcare system. Methods: This is a semi-structured qualitative study. Face-to-face interviews with various physicians with different specialties were performed to gather information on their viewpoints. Study population was selected mainly based on their history of collaboration with emergency medicine specialists in several educational hospitals in Tehran, Iran...
2018: Emergency (Tehran, Iran)
Junjun Xu, Arletha Williams-Livingston, Anne Gaglioti, Calvin McAllister, George Rust
The use of value metrics is often dependent on payer-initiated health care management incentives. There is a need for practices to define and manage their own patient panels regardless of payer to participate effectively in population health management. A key step is to define a panel of primary care patients with high comorbidity profiles. Our sample included all patients seen in an urban academic family medicine clinic over a two-year period. The simplified risk stratification was built using internal electronic health record and billing system data based on ICD-9 codes...
2018: Journal of Health Care for the Poor and Underserved
Tara J Schapmire, Barbara A Head, Whitney A Nash, Pamela A Yankeelov, Christian D Furman, R Brent Wright, Rangaraj Gopalraj, Barbara Gordon, Karen P Black, Carol Jones, Madri Hall-Faul, Anna C Faul
A fragmented workforce consisting of multiple disciplines with varying levels of training and limited ability to work as a team often provides care to older adults. Interprofessional education (IPE) is essential for preparing practitioners for the effective teamwork required for community-based, holistic, person-centered care of the older adults. Despite numerous programs and offerings to advance education and interdisciplinary patient care, there is an unmet need for geriatric IPE, especially as it relates to community-dwelling older adults and caregivers in medically underserved areas...
2018: Advances in Medical Education and Practice
Marita Barrett, Anna Keating, Deirdre Lynch, Geraldine Scanlon, Mary Kigathi, Fidelma Corcoran, Laura J Sahm
Patients receiving clozapine must undergo routine blood monitoring to screen for neutropenia, and to monitor for potential agranulocytosis. In Cork University Hospital, Cork, Ireland, clozapine is dispensed in the hospital pharmacy and the pharmacists are not aware of co-prescribed medicines, potentially impacting upon patient safety. The aim of this study was to examine the continuity of care of patients prescribed clozapine. A retrospective audit was conducted on patients attending the clozapine clinic at Cork University Hospital and assessed patients' (i) independent living, (ii) co-prescribed medicines and (iii) knowledge of their community pharmacists regarding co-prescribed clozapine...
February 26, 2018: Pharmacy (Basel, Switzerland)
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