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On being a doctor

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https://www.readbyqxmd.com/read/29149366/prescribing-of-noacs-has-outnumbered-warfarin-exploring-how-physicians-choose-anticoagulant-treatments
#1
Anne Katrine Eek, Erik Øie, Anne Gerd Granas
PURPOSE: The development of non-vitamin K-dependent oral anticoagulants (NOACs) is a new alternative to treatment with warfarin. The purpose of this study was to explore drug prescription decisions of NOACs or warfarin from hospital physicians in cardiovascular departments. METHODS: A qualitative study with focus group interviews was conducted in three different hospitals. The interview guide explored the background of prescribing anticoagulants (warfarin, dabigatran, rivaroxaban, and apixaban) and experiences with effect and side-effects they had observed in patients...
November 17, 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29148566/factors-that-influence-the-provision-of-intrapartum-and-postnatal-care-by-skilled-birth-attendants-in-low-and-middle-income-countries-a-qualitative-evidence-synthesis
#2
REVIEW
Susan Munabi-Babigumira, Claire Glenton, Simon Lewin, Atle Fretheim, Harriet Nabudere
BACKGROUND: In many low- and middle-income countries women are encouraged to give birth in clinics and hospitals so that they can receive care from skilled birth attendants. A skilled birth attendant (SBA) is a health worker such as a midwife, doctor, or nurse who is trained to manage normal pregnancy and childbirth. (S)he is also trained to identify, manage, and refer any health problems that arise for mother and baby. The skills, attitudes and behaviour of SBAs, and the extent to which they work in an enabling working environment, impact on the quality of care provided...
November 17, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29148172/quality-of-handwritten-surgical-operative-notes-from-surgical-trainees-a-noteworthy-issue
#3
Tatenda C Nzenza, Todd Manning, Simeon Ngweso, Marlon Perera, Shomik Sengupta, Damien Bolton, Nathan Lawrentschuk
BACKGROUND: Surgical operation notes are crucial for medical record keeping and information flow in continued patient care. In addition to inherent medical implications, the quality of operative notes also has important economic and medico-legal ramifications. Further, well-documented records can also be useful for audit purposes and propagation of research, facilitating the improvement of delivery of care to patients. We aimed to assess the quality of surgical operation notes written by junior doctors and trainees against a set standard, to ascertain whether these standards were met...
November 17, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/29147950/mental-health-consultation-among-ontario-s-immigrant-populations
#4
Farah Islam, Nazilla Khanlou, Alison Macpherson, Hala Tamim
To determine the prevalence rates and characteristics of past-year mental health consultation for Ontario's adult (18 + years old) immigrant populations. The Canadian Community Health Survey (CCHS) 2012 was used to calculate the prevalence rates of past-year mental health consultation by service provider type. Characteristics associated with mental health consultation were determined by carrying out multivariable logistic regression analysis on merged CCHS 2008-2012 data. Adult immigrant populations in Ontario (n = 3995) had lower estimated prevalence rates of past-year mental health consultation across all service provider types compared to Canadian-born populations (n = 14,644)...
November 16, 2017: Community Mental Health Journal
https://www.readbyqxmd.com/read/29146646/cross-sectional-study-of-the-financial-cost-of-training-to-the-surgical-trainee-in-the-uk-and-ireland
#5
John O'Callaghan, Helen M Mohan, Anna Sharrock, Vimal Gokani, J Edward Fitzgerald, Adam P Williams, Rhiannon L Harries
OBJECTIVES: Applications for surgical training have declined over the last decade, and anecdotally the costs of training at the expense of the surgical trainee are rising. We aimed to quantify the costs surgical trainees are expected to cover for postgraduate training. DESIGN: Prospective, cross-sectional, questionnaire-based study. SETTING/PARTICIPANTS: A non-mandatory online questionnaire for UK-based trainees was distributed nationally...
November 15, 2017: BMJ Open
https://www.readbyqxmd.com/read/29146534/systematic-review-for-the-2017-acc-aha-aapa-abc-acpm-ags-apha-ash-aspc-nma-pcna-guideline-for-the-prevention-detection-evaluation-and-management-of-high-blood-pressure-in-adults-a-report-of-the-american-college-of-cardiology-american-heart-association-task
#6
David M Reboussin, Norrina B Allen, Michael E Griswold, Eliseo Guallar, Yuling Hong, Daniel T Lackland, Edgar Pete R Miller, Tamar Polonsky, Angela M Thompson-Paul, Suma Vupputuri
OBJECTIVE: To review the literature systematically and perform meta-analyses to address these questions: 1) Is there evidence that self-measured blood pressure (BP) without other augmentation is superior to office-based measurement of BP for achieving better BP control or for preventing adverse clinical outcomes that are related to elevated BP? 2) What is the optimal target for BP lowering during antihypertensive therapy in adults? 3) In adults with hypertension, how do various antihypertensive drug classes differ in their benefits and harms compared with each other as first-line therapy? METHODS: Electronic literature searches were performed by Doctor Evidence, a global medical evidence software and services company, across PubMed and EMBASE from 1966 to 2015 using key words and relevant subject headings for randomized controlled trials that met eligibility criteria defined for each question...
November 7, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29145863/assessing-quality-of-maternity-care-in-hungary-expert-validation-and-testing-of-the-mother-centered-prenatal-care-mcpc-survey-instrument
#7
Nicholas Rubashkin, Imre Szebik, Petra Baji, Zsuzsa Szántó, Éva Susánszky, Saraswathi Vedam
BACKGROUND: Instruments to assess quality of maternity care in Central and Eastern European (CEE) region are scarce, despite reports of poor doctor-patient communication, non-evidence-based care, and informal cash payments. We validated and tested an online questionnaire to study maternity care experiences among Hungarian women. METHODS: Following literature review, we collated validated items and scales from two previous English-language surveys and adapted them to the Hungarian context...
November 16, 2017: Reproductive Health
https://www.readbyqxmd.com/read/29143688/investigating-management-choices-for-canine-heartworm-disease-in-northern-mississippi
#8
Tobi N Ku
BACKGROUND: There are concerns that the chronic use of macrocyclic lactone preventives to kill adult heartworms ("soft-" or "slow-kill") may have contributed to the development of macrocyclic lactone resistance. This prospective analysis was designed to expand our understanding of currently employed treatment decisions, protocols utilized in a "slow-kill" methodology, and trends in heartworm prevention in a region with concerns about macrocyclic lactone resistance. We tested the hypothesis that practitioners underestimate the actual percentage of heartworm-positive dogs treated with "slow-kill" therapy...
November 9, 2017: Parasites & Vectors
https://www.readbyqxmd.com/read/29143643/subcutaneous-dirofilariosis-dirofilaria-repens-an-infection-spreading-throughout-the-old-world
#9
REVIEW
Claudio Genchi, Laura Kramer
BACKGROUND: Two main Dirofilaria species infect dogs: D. immitis and D. repens. While D. immitis has a worldwide distribution, D. repens is currently found only in Europe, Asia, and Africa. Adult D. repens are located in subcutaneous tissues of natural hosts where they survive for long periods of time. First-stage larvae, microfilariae, circulate in the peripheral bloodstream, where they are taken up by the mosquito intermediate hosts. Infected mosquitoes then transmit infective third-stage (L3) larvae to new hosts through the blood meal...
November 9, 2017: Parasites & Vectors
https://www.readbyqxmd.com/read/29143101/candidate-biomarkers-in-the-cervical-vaginal-fluid-for-the-self-diagnosis-of-cervical-precancer
#10
REVIEW
Xaveer Van Ostade, Martin Dom, Wiebren Tjalma, Geert Van Raemdonck
PURPOSE: Despite improvement in vaccines against human papilloma virus (HPV), the causative agent of cervical cancer, screening women for cervical precancer will remain indispensable in the coming 30-40 years. A simple test that could be performed at home or at a doctor's practice and that informs the woman whether she is at risk would significantly help make a broader group of patients who aware that they need medical treatment. Cervical vaginal fluid (CVF) is a body fluid that is very well suited for such a test...
November 15, 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/29142758/ethnic-differences-in-patients-perceptions-towards-isolated-orthopedic-injuries-a-pilot-study
#11
Boris A Zelle, Gurpreet Singh, Deanna L Kitchen, Roberto J Fajardo, Mohit Bhandari, Melissa A Valerio
Background: Patients' perceptions of their healthcare have been reported to influence clinical outcomes following orthopedic trauma. Findings across clinical outcomes have demonstrated significant differences in perceptions towards healthcare between Hispanics and non-Hispanic whites. However, ethnic disparities in perceptions towards orthopedic injuries have not been examined in the literature. Aim of study: The aim of this pilot study is to explore whether Hispanic patients with isolated orthopedic injuries will demonstrate different perceptions towards their injury as compared to non-Hispanic white patients...
2017: Pilot and Feasibility Studies
https://www.readbyqxmd.com/read/29142543/career-choices-of-medical-doctors-at-graduate-level-a-multicenter-study
#12
Sadaf Zia, Maisam Abbas, Mehreen Sulaiman, Salman Matiullah Sheikh
Objective: To find out the specialty choices being taken by Final year Medical students and graduate Doctors. Method: This is a cross sectional survey study which was conducted over two months from 1(st) November to 31(st) December 2016. Final year students and house job doctors were asked for the filling of Performa, after filling the consent form. A self-developed, anonymous questionnaire was used to conduct the study using close ended type of questions. This was a multi-center study conducted at Dow International Medical College and Jinnah Medical and Dental College...
September 2017: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/29139190/a-man-before-his-time-russell-s-insights-into-nicotine-smoking-treatment-and-curbing-the-smoking-problem
#13
Ann McNeill, Debbie Robson
BACKGROUND AND AIMS: This narrative review aimed to provide a brief overview of five key research 'classics' produced by the innovative and radical thought leader, Professor Michael Anthony Hamilton Russell (1932-2009), drawing upon his other work wherever feasible. METHODS: Narrative review. From more than 250 publications, we selected papers we considered seminal texts, published in 1971, 1976, 1978, 1979 and 1991. RESULTS: Russell was among the first researchers to explain that smoking was a dependence disorder caused by the drug nicotine decades before this was recognized formally...
November 15, 2017: Addiction
https://www.readbyqxmd.com/read/29138131/reducing-symptom-distress-in-patients-with-advanced-cancer-using-an-e-alert-system-for-caregivers-pooled-analysis-of-two-randomized-clinical-trials
#14
David H Gustafson, Lori L DuBenske, Amy K Atwood, Ming-Yuan Chih, Roberta A Johnson, Fiona McTavish, Andrew Quanbeck, Roger L Brown, James F Cleary, Dhavan Shah
BACKGROUND: Symptom distress in patients toward the end of life can change rapidly. Family caregivers have the potential to help patients manage those symptoms, as well as their own stress, if they are equipped with the proper resources. Electronic health (eHealth) systems may be able to provide those resources. Very sick patients may not be able to use such systems themselves to report their symptoms but family caregivers could. OBJECTIVE: The aim of this paper was to assess the effects on cancer patient symptom distress of an eHealth system that alerts clinicians to significant changes in the patient's symptoms, as reported by a family caregiver...
November 14, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/29137701/the-correlation-between-atls-and-junior-doctors-anatomical-knowledge-of-central-venous-catheter-insertion-at-a-major-trauma-service-in-south-africa
#15
V Y Kong, J J Odendaal, R Weale, M Liu, C M Keene, B Sartorius, D L Clarke
OBJECTIVE: To review the ability of junior doctors (JDs) in identifying the correct anatomical site for central venous catheterization (CVC) and whether prior Advanced Trauma Life Support (ATLS) training influences this. DESIGN: We performed a prospective, observational study using a structured survey and asked a group of JDs (postgraduate year 1 [PGY1] or year 2 [PGY2]) to indicate on a photograph the exact site for CVC insertion via the internal jugular (IJV) and the subclavian (SCV) approach...
November 7, 2017: Injury
https://www.readbyqxmd.com/read/29137508/health-professional-education-and-universal-health-coverage-a-summary-of-challenges-and-selected-case-studies
#16
Arthika Sripathy, Joachim Marti, Hannah Patel, Javaid I Sheikh, Ara W Darzi
Low- and middle-income countries are experiencing serious shortages in meeting health workforce requirements for universal health coverage. We examine how national-level policies can address these deficiencies and support the development of an appropriately skilled health workforce in line with population needs. We discuss three innovative, government-led solutions that are designed to align health workforce training with the demands of universal health coverage. Specifically, we discuss two initiatives to train and retain doctors in rural areas of Thailand, the large-scale training of community health workers within multidisciplinary primary health care teams in Brazil, and the introduction of a postgraduate diploma program in primary care for nurses in India...
November 2017: Health Affairs
https://www.readbyqxmd.com/read/29137058/anemia-and-thrombocytopenia-as-initial-symptoms-of-occult-breast-cancer-with-bone-marrow-metastasis-a-case-report
#17
Lulu Liu, Jingjing Zhang, Mingtai Chen, Saisai Ren, Haihui Liu, Hao Zhang
RATIONALE: Occult breast cancer (OBC) is a rare type of breast cancer without any symptoms in the breast and is often presented with initial symptoms of axillary lymph node metastasis or other metastases. The low incidence rates of OBC make it a great challenge to diagnose and cure. PATIENT CONCERNS: Our case was a 58-year-old female affected by dizziness and fatigue for nearly a month. Blood tests revealed anemia and thrombocytopenia, and pathological results of a bone marrow biopsy confirmed the metastatic carcinoma...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29136725/-the-china-expert-consensus-of-clinical-practice-for-magnetically-controlled-capsule-gastroscopy-2017-shanghai
#18
(no author information available yet)
Gastric diseases are very common in China, especially gastric cancer with a continuous high level of morbidity and mortality. As an important screening method of gastric diseases, magnetically-controlled-capsule-gastroscopy (MCCG) has already been widely used in medical institutions worldwide. Several clinical trials have already showed that MCCG has comparable accuracy in diagnosing gastric diseases compared with conventional gastroscopy. Furthermore, MCCG has the advantages of anesthesia free, no risks of cross infection, and excellent compliance...
November 1, 2017: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/29136044/-women-and-work-with-a-specific-focus-on-doctors-and-dentists
#19
A van Doorne-Huiskes
The differences between men and women in their participation in the labour force and education are diminishing: in 2015, 71% of all women between the ages of 20 and 65 had a paid job (in comparison with 82% of men) and the Emancipation monitor 2016 reveals that women more often receive higher education than men. In the study of medicine, this expresses itself in the fact that 68% of new students in 2015 were women. As a consequence the number of women doctors is increasing. The numbers for 2013 show that 65% of active dentists are men and 35% women...
November 2017: Nederlands Tijdschrift Voor Tandheelkunde
https://www.readbyqxmd.com/read/29134571/optimizing-residents-performance-of-lumbar-puncture-an-rct-comparing-the-effect-of-preparatory-interventions-on-performance-and-self-confidence
#20
Mikael Johannes Vuokko Henriksen, Troels Wienecke, Helle Thagesen, Rikke Borre Vita Jacobsen, Yousif Subhi, Ryan Brydges, Charlotte Ringsted, Lars Konge
BACKGROUND: Lumbar puncture is often associated with uncertainty and limited experience on the part of residents; therefore, preparatory interventions can be essential. There is growing interest in the potential benefit of videos over written text. However, little attention has been given to whether the design of the videos impacts on subsequent performance. OBJECTIVE: To investigate the effect of different preparatory interventions on learner performance and self-confidence regarding lumbar puncture (LP)...
November 13, 2017: Journal of General Internal Medicine
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