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Early Patient Contact

Haiyan Wang, Linyi Li, Ling Ling Qin, Yanan Song, Josep Vidal-Alaball, Tong Hua Liu
BACKGROUND: Vitamin B12 deficiency is common, and the incidence increases with age. Most people with vitamin B12 deficiency are treated in primary care with intramuscular (IM) vitamin B12 . Doctors may not be prescribing oral vitamin B12 formulations because they may be unaware of this option or have concerns regarding its effectiveness. OBJECTIVES: To assess the effects of oral vitamin B12 versus intramuscular vitamin B12 for vitamin B12 deficiency. SEARCH METHODS: We searched CENTRAL, MEDLINE, Embase, and LILACS, as well as the WHO ICTRP and ClinicalTrials...
March 15, 2018: Cochrane Database of Systematic Reviews
Robert R Gruhl, Andrew Wu, Micah Niermann, Andrew Olson
BACKGROUND: Eczema coxsackium (EC) can manifest in patients with underlying atopic dermatitis (AD) as a diffuse vesicular rash in a febrile child. The presentation overlaps clinically with the feared diagnosis of eczema herpeticum (EH), which makes differentiating between the conditions very important. CASE PRESENTATION: A 6-month-old girl with known AD presented with fever and rapidly spreading vesicular rash. The patient had multiple exposures including a new antibiotic prescription, introduction of new foods, 6-month vaccinations and a sick contact...
November 27, 2017: Diagnosis
Jean Paul Ten Klooster, Alexandros Sotiriou, Sjef Boeren, Stefan Vaessen, Jacques Vervoort, Raymond Pieters
Currently, there is a worldwide increase of patients with Type 2 diabetes (T2D). During the progression of healthy obese to T2D status, there is an influx of immune cells, in particular macrophages, into visceral adipose tissue, accompanied by an increase of inflammatory cytokines, such as, IL6, TNFα and Hp. To get a better insight in the underlying mechanisms, we performed a quantitative LCMS analysis on a modified in vitro assay, combining 3T3L1 adipocytes and activated RAW264.7 macrophages, thus mimicking inflamed adipose tissue...
March 8, 2018: Archives of Biochemistry and Biophysics
Garth Funston, Helena O'Flynn, Neil A J Ryan, Willie Hamilton, Emma J Crosbie
Early diagnosis of symptomatic gynecological cancer is likely to improve patient outcomes, including survival. The primary care practitioner has a key role to play in this-they must recognize the symptoms and signs of gynecological cancer and make prompt evidence-based decisions regarding further investigation and referral. However, this is often difficult as many of the symptoms of gynecological cancers are nonspecific and are more likely to be caused by benign rather than malignant disease. As primary care is generally the first point of patient contact, those working in this setting usually encounter cancer patients at an earlier, and possibly less symptomatic, stage than practitioners in secondary care...
March 7, 2018: Advances in Therapy
Vanessa Romotzky, Julia Strupp, Alexander Hayn, Jens Ulrich Rüffer, Judith Grümmer, Raymond Voltz
OBJECTIVE: We aimed to elucidate the views on life as narrated by patients in palliative care (PC) to find out what patients deem to be essential in their life, whether something has changed concerning their view of life in light of the disease, and whether interviewees would like to give others something to take with them. METHOD: Data were collected from narrative audio and video interviews with 18 inpatients in a specialized PC unit. Interviews were recorded and transcribed verbatim and analyzed using qualitative content analysis applying MAXQDA software...
March 8, 2018: Palliative & Supportive Care
Philipp Schuster, Markus Geßlein, Michael Schlumberger, Philipp Mayer, Hermann Josef Bail, Jörg Richter
PURPOSE: No systematic studies on optimal treatment of postoperative septic arthritis following arthroscopic meniscus repair are available. The purpose of this study was to retrospectively evaluate the fate of repaired menisci in cases of postoperative septic arthritis, with treatment for infection focused on arthroscopic irrigation and debridement (I&D) and intention to maintain the meniscus. METHODS: Data of two sports orthopedics centers of the last 10 years were pooled (approximately 25,000 arthroscopic procedures of the knee)...
March 6, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Devika Iddawela, Sanura Malinda Pallegoda Vithana, Dhilma Atapattu, Lanka Wijekoon
BACKGROUND: Leishmaniasis, a vector borne tropical/subtropical disease caused by the protozoan Leishmania is transmitted to humans by sandfly vectors Phlebotomus and Lutzomyia. The principal form found in Sri Lanka is cutaneous leishmaniasis (CL) and is caused by Leishmania donovani. A rising trend in disease prevalence has been observed recently in Sri Lanka and the island is in fact the newest endemic focus in South Asia. Determining the prevalence of smear positivity among clinically suspected CL patients, identifying risk factors and specific clinical presentations of CL in order to implement preventive and early treatment strategies were the objectives of this study...
March 6, 2018: BMC Infectious Diseases
P Chrétien, P Caillet, F Bouazzaoui, N Younes, A Kaladjian, S Sanchez
INTRODUCTION: Depressive disorders affect nearly 350 million people worldwide and are the world's leading cause of incapacity. Patients who are depressed preferentially approach their general practitioner (GP), who is their first point of contact, in 50-60% of cases. The aim of our study is to assess whether the orientation of patients suffering from anxiety-depressive disorder towards a GP in a general emergency is a factor associated with hospitalization when compared to patients who present themselves spontaneously for the same disorders...
March 1, 2018: L'Encéphale
Ya-Hsuan Yu, Sylvia Chao, Yen-Kuang Lin, Yun-Yun Chou, Hsun-Hsiang Liao, El-Wui Loh, Chung-Shun Wong, Ka-Wai Tam
BACKGROUND: A postoperative water-forbidden strategy has been used for many decades. However, evidence shows that early contact with water postoperatively does not increase the infection rate. Our study evaluated the gap between currently available evidence and awareness in clinical practice of postoperative wound care. METHODS: We conducted a systematic review to compare the outcomes between postoperative water-contact and water-forbidden groups. PubMed, EMBASE, and Cochrane databases were searched...
March 1, 2018: Surgery
Neeraj Raizada, Sunil D Khaparde, Virender Singh Salhotra, Raghuram Rao, Aakshi Kalra, Soumya Swaminathan, Ashwani Khanna, Kamal Kishore Chopra, M Hanif, Varinder Singh, K R Umadevi, Sreenivas Achuthan Nair, Sophie Huddart, C H Surya Prakash, Shalini Mall, Pooja Singh, B K Saha, Claudia M Denkinger, Catharina Boehme, Sanjay Sarin
BACKGROUND: Diagnosis of TB in children is challenging, and is largely based on positive history of contact with a TB case, clinical and radiological findings, often without microbiological confirmation. Diagnostic efforts are also undermined by challenges in specimen collection and the limited availability of high sensitivity, rapid diagnostic tests that can be applied with a quick turnaround time. The current project was undertaken in four major cities of India to address TB diagnostic challenges in pediatric population, by offering free of cost Xpert testing to pediatric presumptive TB cases, thereby paving the way for better TB care...
2018: PloS One
Laura J Kleeblad, Todd A Borus, Thomas M Coon, Jon Dounchis, Joseph T Nguyen, Andrew D Pearle
BACKGROUND: Studies have showed improved accuracy of lower leg alignment, precise component position, and soft-tissue balance with robotic-assisted unicompartmental knee arthroplasty (UKA). No studies, however, have assessed the effect on midterm survivorship. Therefore, the purpose of this prospective, multicenter study was to determine midtem survivorship, modes of failure, and satisfaction of robotic-assisted medial UKA. METHODS: A total of 473 consecutive patients (528 knees) underwent robotic-arm-assisted medial UKA surgery at 4 separate institutions between March 2009 and December 2011...
January 31, 2018: Journal of Arthroplasty
K S Funder, L S Rasmussen, V Siersma, N Lohse, R Hesselfeldt, F Pedersen, O M Hendriksen, J Steinmetz
BACKGROUND: Implementation of the first Danish helicopter emergency medical service (HEMS) was associated with reduced time from first medical contact to treatment at a specialized centre for patients with suspected ST elevation myocardial infarction (STEMI). We aimed to investigate effects of HEMS on mortality and labour market affiliation in patients admitted for primary percutaneous coronary intervention (PCI). METHODS: In this prospective observational study, we included patients with suspected STEMI within the region covered by the HEMS from January 1, 2010, to April 30, 2013, transported by either HEMS or ground emergency medical services (GEMS) to the regional PCI centre...
February 27, 2018: Acta Anaesthesiologica Scandinavica
Sally-Ann Ohene, Frank Bonsu, Nii Nortey Hanson-Nortey, Adelaide Sackey, Samuel Danso, Felix Afutu, Paul Klatser, Mirjam Bakker
BACKGROUND: The End TB Strategy calls for systematic screening of selected high-risk groups including contacts of tuberculosis (TB) cases to facilitate early TB case detection. Contact investigation is not usually routinely practiced in low TB burden countries, such as Ghana, with consequent paucity of data on the yield of TB case detection from such interventions. This study's objective was to document the outcomes and feasibility of implementing contact investigation activities under programmatic conditions in Ghana...
February 27, 2018: Infectious Diseases of Poverty
Mathilde Ledoux, Colombe Tricou, Maxime Roux, Soazic Dreano-Hartz, Murielle Ruer, Marilène Filbet
BACKGROUND: In France, cancer has become the leading cause of death. Intensive care units (ICU) focus on survival, which may not be an appropriate setting to provide palliative care (PC) as needed by cancer patients and families. OBJECTIVE: To describe the cancer patients who died in the ICU in 2010 in a French academic medical center. DESIGN: Retrospective study Measurements: We reviewed medical records of all cancer patients who died in the ICU in 2010...
February 26, 2018: Journal of Palliative Medicine
Stéphane Manzo-Silberman, Francis Couturaud, Sandrine Charpentier, Vincent Auffret, Carlos El Khoury, Hervé Le Breton, Loïc Belle, Stéphanie Marlière, Marianne Zeller, Yves Cottin, Nicolas Danchin, Tabassome Simon, François Schiele, Martine Gilard
BACKGROUND: Women show greater mortality after acute myocardial infarction. We decided to investigate whether gender affects delays and impacts in-hospital mortality in a large population. METHODS AND RESULTS: We performed a patient-level analysis of 7 French MI registries from different regions from January 2005 to December 2012. All patients with acute STEMI were included within 12 h from symptom onset and a first medical contact with a mobile intensive care unit an emergency department of a hospital with percutaneous coronary intervention facility...
February 13, 2018: International Journal of Cardiology
Soran AminiAghdam, Reinhard Blickhan
BACKGROUND: Although alteration in trunk orientation and ground level potentially affects gait pattern individually, it is plausible to examine the interaction effects of such factors. OBJECTIVE: The interaction effects between trunk-flexed gait and uneven ground on able-bodied gait pattern. METHODS: For twelve able-bodied participants, we compared the adaptive mechanisms in kinematics, kinetics and spatial-temporal parameters of gait (STPG) with bent postures (30° and 50° of sagittal trunk flexion) across uneven surface (10-cm visible drop at the sight of the second ground contact) with that of upright posture on even ground surface...
February 17, 2018: Gait & Posture
J Nicholas Dionne-Odom, Richard Taylor, Gabrielle Rocque, Carol Chambless, Thomas Ramsey, Andres Azuero, Nataliya Ivankova, Michelle Y Martin, Marie A Bakitas
CONTEXT: There is a scarcity of early palliative care interventions to support family caregivers of persons with advanced cancer living in the rural Southern U.S.. OBJECTIVE: Adapt the content, format, and delivery of a six session, palliative care, telehealth intervention with monthly follow-up for rural family caregivers to enhance their own self-care and caregiving skills. METHODS: Qualitative formative evaluation consisting of one-on-one, semi-structured interviews with rural-dwelling persons with metastatic cancer (n=18), their primary family caregiver (n=20), and lay patient navigators (n=26) were conducted to elicit feedback on a family caregiver intervention outline based on published evidence-based interventions...
February 20, 2018: Journal of Pain and Symptom Management
Uyanga Adam, Helmut Habazettl, Katharina Graefe, Hermann Kuppe, Maximilian Wundram, Stephan Dominik Kurz
OBJECTIVES: Acute Type A aortic dissection (ATAAD) and the ensuing surgical therapy may be experienced as a traumatic event by patients. This study aimed at analysing the prevalence of post-traumatic stress disorder (PTSD) and the physical and mental well-being of survivors of surgically treated ATAAD. METHODS: A total of 393 survivors were contacted and asked to fill in various health questionnaires. RESULTS: Two hundred and ten (53%) patients returned the questionnaires...
February 20, 2018: Interactive Cardiovascular and Thoracic Surgery
Sarah Filiatreault, Marilyn Hodgins, Richelle Witherspoon
AIM: The aim of this review was to locate, retrieve and critically appraise practice guidelines for the management of hip fractures. Given increasing evidence that the early recognition and management of these fractures is integral to achieving optimal outcomes, recommendations for the pre-operative period were synthesised and compared. BACKGROUND: Hip fractures are associated with high rates of adverse outcomes and high healthcare costs which has resulted in the development of multiple practice guidelines to inform clinical decision-making...
February 23, 2018: Journal of Advanced Nursing
Eva Björnelius, Britta Krynitz
Syphilis - an old imitator is back on the stage Syphilis is one of the oldest sexually transmitted infections and caused by the spirochete Treponema pallidum. The incubation time is 10-90 days and patients are contagious for approximately one year. In Sweden all blood donors and pregnant women are screened. By law, individuals with early syphilis (primary and secondary stages) are reported and contact tracing is performed. The syphilis incidence is increasing in Europe, USA and many other countries. The main drivers are men having sex with men...
February 15, 2018: Läkartidningen
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