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https://www.readbyqxmd.com/read/28944966/inpatient-management-of-children-with-recessive-dystrophic-epidermolysis-bullosa-a-review
#1
REVIEW
Alvin W Li, Brea Prindaville, Scot T Bateman, Timothy E Gibson, Karen Wiss
Recessive dystrophic epidermolysis bullosa is a disorder marked by skin and mucosal blistering after minimal trauma. Even the most routine procedures in the hospital, if done incorrectly, can precipitate extensive skin loss, pain, and scarring. Most providers have little experience working with patients with this degree of skin fragility. When a person with recessive dystrophic epidermolysis bullosa is admitted to the hospital, there are multiple considerations to keep in mind while strategizing an effective care plan: avoidance of new blisters with a "hands-off" approach; careful consideration of all indwelling devices; symptomatic management of pain, itch, and anxiety; coordination of dressing changes; aggressive treatment of skin infections; environmental and staffing considerations; and awareness of other chronic complications that affect care, such as anemia, malnutrition, and chronic pain...
September 25, 2017: Pediatric Dermatology
https://www.readbyqxmd.com/read/28944728/performance-based-risk-sharing-arrangements-u-s-payer-experience
#2
Joseph A Goble, Brian Ung, Sascha van Boemmel-Wegmann, Robert P Navarro, Andrew Parece
BACKGROUND: As a result of global concern about rising drug costs, many U.S. payers and European agencies such as the National Health Service have partnered with pharmaceutical companies in performance-based risk-sharing arrangements (PBRSAs) by which manufacturers share financial risk with health care purchasing entities and authorities. However, PBRSAs present many administrative and legal challenges that have minimized successful contract experiences in the United States. OBJECTIVE: To (a) identify drug and disease characteristics and contract components that contribute to successful PBRSA experiences and the primary barriers to PBRSA execution and (b) explore solutions to facilitate contract negotiation and execution...
October 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28944630/-coordinating-complex-nursing-care-160-building-a-guidance-tool-for-cancer-patients-to-direct-them-towards-the-coordination-nurse
#3
Raphael Froger, Benoit Allenet, Pascale Guillem
Introduction : following the 2009-2013 Cancer Plan, the experimental oncology nursing coordination (IDEC) showed a positive impact on the fluidity of care pathways. The 2014-2019 cancer plan guides their mission to complex cases. The objective of this study is to build a tool to facilitate the recruitment of patients likely to experience a complex path. Method : two phases have formed this research. The first one collected the elements of the dimensions that can predict the complexity of the care path, by focus group...
April 19, 2017: Recherche en Soins Infirmiers
https://www.readbyqxmd.com/read/28944584/resource-reduction-in-pediatric-chest-pain-standardized-clinical-assessment-and-management-plan
#4
Susan F Saleeb, Sarah R McLaughlin, Dionne A Graham, Kevin G Friedman, David R Fulton
OBJECTIVE: Using a Standardized Clinical Assessment and Management Plan (SCAMP) for pediatric patients presenting to clinic with chest pain, we evaluated the cost impact associated with implementation of the care algorithm. Prior to introduction of the SCAMP, we analyzed charges for 406 patients with chest pain, seen in 2009, and predicted 21% reduction of overall charges had the SCAMP methodology been used. The SCAMP recommended an echocardiogram for history, examination, or ECG findings suggestive of a cardiac etiology for chest pain...
September 24, 2017: Congenital Heart Disease
https://www.readbyqxmd.com/read/28944342/a-rare-case-retrocecal-appendicitis-adherent-to-the-liver-capsule
#5
Hasan Börekçi, Sinan Karacabey, Mesut Sipahi, Zeynep Tuğba Özdemir, Mustafa Fatih Erkoç
The cases of appendicitis take an important place in the hospital emergency departments and it must be kept in mind in the differential diagnosis of patients presenting with abdominal pain. Related to cecum, the appendix can be found in many different positions; however, it is mostly observed descending intraperitoneally (31-74%) and at the retrocecal region (26-65%). In this case report, we present the case of a 26-year-old female patient admitted to the emergency room with a colic pain in the right upper quadrant for about 2 days...
2017: Turk J Surg
https://www.readbyqxmd.com/read/28943985/the-impact-of-pharmacist-led-medication-therapy-management-on-medication-adherence-in-patients-with-type-2-diabetes-mellitus-a-randomized-controlled-study
#6
Daniel A Erku, Asnakew A Ayele, Abebe B Mekuria, Sewunet A Belachew, Bisrat Hailemeskel, Henok G Tegegn
BACKGROUND: Poor adherence to antidiabetic medications leads to a higher rate of hospital admissions and adverse health outcomes in type 2 diabetes mellitus patients. OBJECTIVE: This study aims to evaluate whether a pharmacist-led medication therapy management, compared to the usual care, could enhance medication adherence and reduce hospital admission in patients with type 2 diabetes mellitus. METHODS: A prospective randomized controlled study was conducted in patients with type 2 diabetes mellitus from February 1 to July 30, 2016...
July 2017: Pharmacy Practice
https://www.readbyqxmd.com/read/28943360/advance-care-planning-documentation-practices-and-accessibility-in-the-electronic-health-record-implications-for-patient-safety
#7
Evan Walker, Ryan McMahan, Deborah Barnes, Mary Katen, Daniela Lamas, Rebecca Sudore
CONTEXT: Documenting patients' advance care planning wishes is essential to providing value-aligned care, as is having this documentation readily accessible. Little is known about advance care planning documentation practices in the electronic health record. OBJECTIVES: Describe advance care planning documentation practices and the accessibility of documented discussions in the electronic health record. METHODS: Participants were primary care patients at the San Francisco VA Medical Center, were ≥60 years old, and had ≥2 chronic/serious health conditions...
September 21, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28943359/how-well-do-current-measures-assess-the-impact-of-advance-care-planning-on-concordance-between-patient-preferences-for-end-of-life-care-and-the-care-received-a-methodological-review
#8
REVIEW
Stephanie B Johnson, Phyllis N Butow, Ian Kerridge, Melanie L Bell, Martin Tattersall
No abstract text is available yet for this article.
September 21, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28943114/hba1c-outcomes-in-patients-treated-with-canagliflozin-versus-sitagliptin-in-us-health-plans
#9
Sarah Thayer, Richard Aguilar, Stephanie Korrer, Wing Chow
PURPOSE: Clinical trial evidence supports greater glycemic control with canagliflozin than with sitagliptin. The objective of this study was to provide real-world evidence comparing outcomes in routine clinical practice among patients initiating each medication. METHODS: With the use of a health care administrative database, patients initiating canagliflozin were compared with patients initiating sitagliptin (first prescription fill as index date). Baseline (6 months before index date) demographic and clinical (eg, comorbidities and diabetes-related complications) characteristics were compared, and propensity score matching was used to control for baseline differences between cohorts...
September 21, 2017: Clinical Therapeutics
https://www.readbyqxmd.com/read/28942913/a-focused-review-of-safety-considerations-in-cancer-rehabilitation
#10
REVIEW
Susan Maltser, Adrian Cristian, Julie K Silver, G Stephen Morris, Nicole L Stout
Cancer and its treatments introduce various adverse effects that may affect survivors' physical, cognitive and psychological functioning. Frequently both tolerance to activity and exercise are affected as well. Rehabilitation providers should have substantive knowledge about the effect of cancer progression and common side effects associated with antineoplastic treatment to safely integrate rehabilitation interventions. Rehabilitation may mitigate loss of function and disability; however, these patients are among the most medically complex that providers treat...
September 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/28942911/making-cancer-rehabilitation-services-work-for-cancer-patients-recommendations-for-research-and-practice-to-improve-employment-outcomes
#11
REVIEW
Catherine M Alfano, Erin E Kent, Lynne S Padgett, Melvin Grimes, Janet S de Moor
Cancer and its treatment can result in impairments that limit physical, psychosocial, and cognitive functioning, interfering with patients' ability to perform work-related functions. Because these work limitations can carry significant personal and societal costs, there is a timely need to identify and refer patients to cancer rehabilitation services to manage adverse consequences of treatment and to preserve employment. Coordinated efforts in 3 key areas will better connect patients to rehabilitation interventions that will help optimize employment...
September 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/28942701/feeding-tubes-and-health-care-service-utilization-in-amyotrophic-lateral-sclerosis-benefits-and-limits-to-a-retrospective-multicenter-study-using-big-data
#12
Keith M Swetz, Stephanie M Peterson, Lindsey R Sangaralingham, Ryan T Hurt, Shannon M Dunlay, Nilay D Shah, Jon C Tilburt
Amyotrophic lateral sclerosis (ALS) is a progressive, fatal neurologic disorder with predictable challenges regarding disease progression and end-of-life care. These include need for respiratory and nutritional support. Little is known about how such choices impact end-of-life health service utilization for these patients. Using OptumLabs Data Warehouse, a large administrative claims database with more than 150 million privately insured, geographically diverse enrollees, we sought to explore outcomes associated with the use of enteral nutrition (EN)...
January 1, 2017: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/28941964/unmet-palliative-care-needs-among-patients-with-end-stage-kidney-disease-a-national-registry-study-about-the-last-week-of-life
#13
Lena Axelsson, Anette Alvariza, Jenny Lindberg, Joakim Öhlén, Cecilia Håkanson, Helene Reimertz, Carl-Johan Fürst, Kristofer Årestedt
CONTEXT: End-stage kidney disease (ESKD) is characterized by high physical and psychological burden and therefore, more knowledge about the palliative care provided close to death is needed. OBJECTIVES: To describe symptom prevalence, relief and management during the last week of life, as well as end-of-life communication, in patients with ESKD. METHODS: This study was based on data from the Swedish Register of Palliative Care. Patients aged 18 or older who died from a chronic kidney disease, with or without dialysis treatment (ICD-10-SE; N18...
September 20, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28941502/neurosurgical-considerations-in-craniofacial-trauma
#14
REVIEW
Robert Glenn Oxford, Randall Matther Chesnut
Spinal and traumatic brain injuries (TBIs) often accompany craniofacial trauma. Neurosurgical considerations can range from initial emergent surgery to conservative management of closed head injuries in patients with craniofacial injuries. This article discusses the most common disorders managed by neurosurgeons in the setting of craniofacial trauma, and reviews the usual timing and setting for various treatments that patients with TBI encounter throughout the course of treatment. It also highlights the consequences of TBI on the timing and planning of craniofacial repairs and the importance of multidisciplinary cooperation to provide comprehensive care to survivors of trauma...
November 2017: Facial Plastic Surgery Clinics of North America
https://www.readbyqxmd.com/read/28940229/patient-participation-in-mental-health-care-perspectives-of-healthcare-professionals-an-integrative-review
#15
REVIEW
Kim Jørgensen, Jacob Dahl Rendtorff
BACKGROUND: In contemporary Western liberal society, patient participation has become a key goal in psychiatric healthcare treatment. Health professionals must encourage patients to play an active and involved part in their treatment. According to Danish health law, patients have the right to participate in their treatment, and the mental health system therefore needs to be reformed in order to ensure that treatment is based on individual, liberal, values. However, patient participation is not clearly defined, and it is therefore a challenge to transfer it to clinical practice...
September 22, 2017: Scandinavian Journal of Caring Sciences
https://www.readbyqxmd.com/read/28940032/the-impact-of-22q11-2-microdeletion-on-cardiac-surgery-postoperative-outcome
#16
Goran Cuturilo, Danijela Drakulic, Ida Jovanovic, Slobodan Ilic, Jasna Kalanj, Irena Vulicevic, Misela Raus, Dejan Skoric, Marija Mijovic, Biljana Medjo, Snezana Rsovac, Milena Stevanovic
22q11.2 microdeletion is the most common microdeletion in humans. The purpose of this study was to evaluate postoperative outcome in children with 22q11.2 microdeletion who had undergone complete surgical correction of a congenital heart defect. The study included 34 patients who underwent complete correction of conotruncal heart defects. Of these, 17 patients diagnosed with 22q11.2 microdeletion represent the investigated group. Another 17 patients without 22q11.2 microdeletion represent the control group...
September 22, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28939708/the-decisions-interventions-and-goals-in-implantable-cardioverter-defibrillator-therapy-dignity-pilot-study
#17
Daniel B Kramer, Daniel Habtemariam, Yaw Adjei-Poku, Michelle Samuel, Diane Engorn, Matthew R Reynolds, Susan L Mitchell
BACKGROUND: Implantable cardioverter-defibrillators (ICDs) are commonly implanted in older patients, including those with multiple comorbidities. There are few prospective studies assessing the clinical course and end-of-life circumstances for these patients. METHODS AND RESULTS: We prospectively followed 51 patients with ICDs for up to 18 months to longitudinally assess in terms of (1) advance care planning, (2) health status, (3) healthcare utilization, and (4) end-of-life circumstances through quarterly phone interviews and electronic medical record review...
September 22, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28939446/next-generation-terminology-infrastructure-to-support-interprofessional-care-planning
#18
Sarah Collins, Stephanie Klinkenberg-Ramirez, Kira Tsivkin, Perry L Mar, Dina Iskhakova, Hari Nandigam, Lipika Samal, Roberto A Rocha
OBJECTIVE: Develop a prototype of an interprofessional terminology and information model infrastructure that can enable care planning applications to facilitate patient-centered care, learn care plan linkages and associations, provide decision support, and enable automated, prospective analytics. DESIGN: The study steps included a 3 step approach: 1) Process model and clinical scenario development, and 2) Requirements analysis, and 3) Development and validation of information and terminology models...
September 19, 2017: Journal of Biomedical Informatics
https://www.readbyqxmd.com/read/28939351/standardization-of-nodal-radiation-therapy-through-changes-to-a-breast-cancer-clinical-pathway-throughout-a-large-integrated-cancer-center-network
#19
Brian J Gebhardt, Joel Thomas, Zachary D Horne, Colin E Champ, Gretchen M Ahrendt, Emilia Diego, Dwight E Heron, Sushil Beriwal
BACKGROUND: Studies demonstrate safety of omitting axillary nodal dissection for early-stage breast cancer with positive sentinel lymph node (+SLN) biopsy, although trial designs differed in radiation therapy (RT) fields. Regional nodal irradiation was separately shown to improve outcomes in high-risk patients. This led to lack of consensus in RT volumes. Clinical pathways (CPs) standardize care where practice varies unnecessarily. We evaluated the impact of changes to a CP guiding postoperative RT in women with +SLNs on practice patterns throughout a network...
July 20, 2017: Practical Radiation Oncology
https://www.readbyqxmd.com/read/28939061/chemoradiotherapy-for-locally-advanced-squamous-cell-carcinoma-of-the-oropharynx-does-completion-of-systemic-therapy-affect-outcomes
#20
Michael Baine, Tim Dorius, Nathan Bennion, Morshed Alam, Lynette Smith, Weining Zhen, Apar Ganti
INTRODUCTION: Current standard of care for locally advanced squamous cell carcinoma of the oropharynx (LA-OPC) consists of concurrent chemoradiotherapy. Due to toxicities associated with this treatment, a significant portion of patients are unable to complete the systemic therapy portion of their treatment course. The impact of incomplete systemic therapy on patient outcomes remains unclear. METHODS: Demographic, treatment, and outcome data were retrospectively collected for patients with LA-OPC treated definitively with concurrent chemoradiotherapy between 2007 and 2014...
October 2017: Oral Oncology
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