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Primary care update

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https://www.readbyqxmd.com/read/28231607/position-in-the-second-stage-of-labour-for-women-with-epidural-anaesthesia
#1
REVIEW
Marion Kibuka, Jim G Thornton
BACKGROUND: Epidural analgesia for pain relief in labour prolongs the second stage of labour and results in more instrumental deliveries. It has been suggested that a more upright position of the mother during all or part of the second stage may counteract these adverse effects. This is an update of a Cochrane review first published in 2013. OBJECTIVES: To assess the effects of different birthing positions (upright and recumbent) during the second stage of labour, on important maternal and fetal outcomes for women with epidural analgesia...
February 24, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28230899/shared-care-across-the-interface-between-primary-and-specialty-care-in-management-of-long-term-conditions
#2
REVIEW
Susan M Smith, Gráinne Cousins, Barbara Clyne, Shane Allwright, Tom O'Dowd
BACKGROUND: Shared care has been used in the management of many chronic conditions with the assumption that it delivers better care than primary or specialty care alone; however, little is known about the effectiveness of shared care. OBJECTIVES: To determine the effectiveness of shared care health service interventions designed to improve the management of chronic disease across the primary/specialty care interface. This is an update of a previously published review...
February 23, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28225422/clinical-updates-in-women-s-health-care-summary-structural-heart-disease-primary-and-preventive-care-review
#3
Tiberio Frisoli, Michele Doughty Voeltz
Reproductive-aged women with structural heart disease who become pregnant as well as postreproductive-aged women with this condition represent a significant proportion of patients seen by obstetrician- gynecologists. Usually, their conditions are complex, and a basic knowledge of the anatomy and physiology of the heart is required. Additionally, understanding the effect of pregnancy on women with structural heart disease is critically important to optimizing maternal and fetal outcomes. This monograph addresses the pathophysiology, signs and symptoms, screening and diagnosis, basic management, and suggested counseling for an obstetric-gynecologic patient with structural heart disease...
March 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28213597/retrospective-examination-of-lipid-lowering-treatment-patterns-in-a-real-world-high-risk-cohort-in-the-uk-in-2014-comparison-with-the-national-institute-for-health-and-care-excellence-nice-2014-lipid-modification-guidelines
#4
Dylan L Steen, Irfan Khan, David Ansell, Robert J Sanchez, Kausik K Ray
BACKGROUND: In 2014, guidelines from the National Institute for Health and Care Excellence (NICE) provided updated recommendations on lipid-modifying therapy (LMT). We assessed clinical practice contemporaneous to release of these guidelines in a UK general practice setting for secondary and high-risk primary-prevention populations, and extrapolated the findings to UK nation level. METHODS: Patients from The Health Improvement Network database with the following criteria were included: lipid profile in 2014 (index date); ≥20 years of age; ≥2 years representation in database prior to index; ≥1 statin indication either for atherosclerotic cardiovascular disease (ASCVD) or the non-ASCVD conditions high-risk diabetes mellitus and/or chronic kidney disease...
February 17, 2017: BMJ Open
https://www.readbyqxmd.com/read/28211937/patterns-of-computed-tomography-surveillance-in-survivors-of-colorectal-cancer-at-veterans-health-administration-facilities
#5
Amikar Sehdev, Eric A Sherer, Siu L Hui, Jingwei Wu, David A Haggstrom
BACKGROUND: Annual computed tomography (CT) scans are a component of the current standard of care for the posttreatment surveillance of survivors of colorectal cancer (CRC) after curative-intent resection. The authors conducted a retrospective study with the primary aim of assessing patient, physician, and organizational characteristics associated with the receipt of CT surveillance among veterans. METHODS: The Department of Veterans Affairs Central Cancer Registry was used to identify patients diagnosed with AJCC collaborative stage I to III CRC between 2001 and 2009...
February 17, 2017: Cancer
https://www.readbyqxmd.com/read/28211595/pharmacy-education-in-jordan-updates
#6
Qais Alefan, Mo'tasem M Alsmadi
OBJECTIVE: To describe the increasing number of pharmacy schools in Jordan. METHOD: A review for numbers of schools and their curricula was conducted. KEY FINDINGS: To date, there are 18 pharmacy schools in Jordan. PharmD program is offered by two public schools. PhD program is offered by one school; while MSc program is offered by seven schools. Public pharmacy schools have two similar programs in terms of curricula, 'regular' and 'parallel'...
February 17, 2017: International Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/28211177/visual-impairment-in-older-institutionalised-canadian-seniors-with-dementia
#7
Estefania Chriqui, Caroline Law, Marie-Jeanne Kergoat, Bernard-Simon Leclerc, Hélène Kergoat
PURPOSE: To estimate the prevalence of visual impairment (VI) in a sub-population of Canadian long-term care facilities, i.e. residents affected by dementia. METHODS: This study was conducted in the long-term care facility units at the Institut universitaire de gériatrie de Montréal. All residents ≥65 years old (y.o.), having a clinical diagnosis of dementia, and able to understand French or English, were eligible for participation in the study. All residents participating in the study received a complete eye exam by an experienced optometrist...
March 2017: Ophthalmic & Physiological Optics: the Journal of the British College of Ophthalmic Opticians (Optometrists)
https://www.readbyqxmd.com/read/28205208/skin-to-skin-care-for-procedural-pain-in-neonates
#8
REVIEW
Celeste Johnston, Marsha Campbell-Yeo, Timothy Disher, Britney Benoit, Ananda Fernandes, David Streiner, Darlene Inglis, Rebekah Zee
BACKGROUND: Skin-to-skin care (SSC), often referred to as 'kangaroo care' (KC) due to its similarity with marsupial behaviour of ventral maternal-infant contact, is one non-pharmacological intervention for pain control in infants. OBJECTIVES: The primary objectives were to determine the effect of SSC alone on pain from medical or nursing procedures in neonates compared to no intervention, sucrose or other analgesics, or additions to simple SSC such as rocking; and to determine the effects of the amount of SSC (duration in minutes), method of administration (e...
February 16, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28202032/cost-effectiveness-analysis-for-a-tele-based-health-coaching-program-for-chronic-disease-in-primary-care
#9
Erja Oksman, Miika Linna, Iiris Hörhammer, Johanna Lammintakanen, Martti Talja
BACKGROUND: The burden of chronic disease and multimorbidity is rapidly increasing. Self-management support interventions are effective in reduce cost, especially when targeted at a single disease group; however, economical evidence of such complex interventions remains scarce. The objective of this study was to evaluate a cost-effectiveness analysis of a tele-based health-coaching intervention among patients with type 2 diabetes (T2D), coronary artery disease (CAD) and congestive heart failure (CHF)...
February 15, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28192846/-how-do-primary-care-physicians-manage-their-patients-with-helicobacter-pylori-infection-results-of-a-survey-and-their-implementation-into-the-german-s2k-guideline-2016
#10
Wolfgang Fischbach, Annemarie Zerl, Christine Klassert
Background The German S3 guideline "H. pylori and gastroduodenal ulcer disease" clearly recommends how to diagnose H. pylori infection. It also states when and how eradication therapy should be done. However, there are only few data available on the management of these patients in daily routine. With this survey, we wanted to gather information on how primary care physicians are involved in the management of H. pylori infection and how they follow the guideline recommendations. From this, consequences for the update of the new S2k guideline 2016 and their communication should be derived...
February 2017: Zeitschrift Für Gastroenterologie
https://www.readbyqxmd.com/read/28187730/adherence-to-treatment-guidelines-the-association-between-stroke-risk-stratified-comparing-chads2-and-cha2ds2-vasc-score-levels-and-warfarin-prescription-for-adult-patients-with-atrial-fibrillation
#11
Scott A Chapman, Catherine A St Hill, Meg M Little, Michael T Swanoski, Shellina R Scheiner, Kenric B Ware, M Nawal Lutfiyya
BACKGROUND: Ischemic stroke is a risk associated with atrial fibrillation (AF) and is estimated to occur five times more often in afflicted patients than in those without AF. Anti-thrombotic therapy is recommended for the prevention of ischemic stroke. Risk stratification tools, such as the CHADS2, and more recently the CHA2DS2-VASc, for predicting stroke in patients with AF have been developed to determine the level of stroke risk and assist clinicians in the selection of antithrombotic therapy...
February 11, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28185665/-rapid-diagnosis-in-serology
#12
Isabel García-Bermejo, Fernando de Ory
Serological diagnosis of acute phase infections implies the detection of IgM specific response, an effective marker of primary infection, but with less clinical significance in reactivations or reinfections. The aim of this article is to provide an updated view of the rapid diagnosis in serology by detecting the IgM isotype and reviewing its applications and limitations. Point-of-care (PoC) tests are analyzed. PoC tests are used in geographical areas where traditional tests are not available, as well as in other circumstances where their use brings the diagnosis directly to the target population...
February 6, 2017: Enfermedades Infecciosas y Microbiología Clínica
https://www.readbyqxmd.com/read/28180041/update-on-surgical-outcomes-of-lateral-temporal-bone-resection-for-ear-and-temporal-bone-malignancies
#13
Sumi Sinha, Matthew M Dedmon, Matthew R Naunheim, Jennifer C Fuller, Stacey T Gray, Derrick T Lin
Objectives Review outcomes of lateral temporal bone resections for ear and temporal bone malignancy. Design, Setting, and Participants Retrospective review of all lateral temporal bone resections performed from 2008 to 2015 at a single tertiary care center. Main Outcome Measures Patient demographics, perioperative variables, overall survival, disease-free survival (DFS), and comparison of Kaplan-Meier curves. Results Overall, 56 patients were identified with a mean follow-up period of 2.3 ± 1.8 years...
February 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28166765/optitrain-a-randomised-controlled-exercise-trial-for-women-with-breast-cancer-undergoing-chemotherapy
#14
Y Wengström, K A Bolam, S Mijwel, C J Sundberg, M Backman, M Browall, J Norrbom, H Rundqvist
BACKGROUND: Women with breast cancer undergoing chemotherapy suffer from a range of detrimental disease and treatment related side-effects. Exercise has shown to be able to counter some of these side-effects and improve physical function as well as quality of life. The primary aim of the study is to investigate and compare the effects of two different exercise regimens on the primary outcome cancer-related fatigue and the secondary outcomes muscle strength, function and structure, cardiovascular fitness, systemic inflammation, skeletal muscle gene activity, health related quality of life, pain, disease and treatment-related symptoms in women with breast cancer receiving chemotherapy...
February 6, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28157274/strategies-for-improving-adherence-to-antiepileptic-drug-treatment-in-people-with-epilepsy
#15
REVIEW
Sinaa Al-Aqeel, Olga Gershuni, Jawza Al-Sabhan, Mickael Hiligsmann
BACKGROUND: Poor adherence to antiepileptic medication is associated with increased mortality, morbidity and healthcare costs. In this review, we focus on interventions designed and tested in randomised controlled trials and quasi-randomised controlled trials to assist people with adherence to antiepileptic medication. This is an updated version of the original Cochrane review published in the Cochrane Library, Issue 1, 2010. OBJECTIVES: To determine the effectiveness of interventions aimed at improving adherence to antiepileptic medication in adults and children with epilepsy...
February 3, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28152890/utilizing-information-and-telehealth-technology-to-enhance-clinical-ethics-education-outreach
#16
Jessica Anne Moore, Brittany C Campbell
: 149 Background: Integrated Ethics provides continuing education monthly for physicians, nurses, social workers, and others to enhance knowledge and understanding of ethical challenges associated with patient care and research. These are offered live at the main campus. There are four regional centers within a thirty-five mile radius of the main campus. Participants from those locations used to have to come to the main campus to participate. This project was initiated to help alleviate rising financial costs associated with the online recording/redistributing of continuing education credit presentations, travel expenses for regional center employees, removal of employees for 4+ hours from the regional centers daily clinical operations to attend presentations, and payment to outside institutions to obtain required ethics CME and CEU credits...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152785/engaging-patients-with-their-self-reported-symptom-outcomes-trended-data
#17
Diane Denny, Carmon Greene, Morgan Hannaford, Maurie Markman
: 69 Background: Cancer Treatment Centers of America, Inc. (CTCA) is a national network of hospitals that specialize in the treatment of patients fighting complex or advanced-stage cancer. The Symptom Inventory Tool (SIT) is an assessment tool that captures the patients' perceived symptom burden for real-time clinical intervention. Patients take a baseline SIT assessment at new patient intake and are eligible to take the SIT every 21 days. The SIT is comprised of the M.D. Anderson Symptom Inventory tool, a validated assessment instrument, along with additional questions and a free text box that were created by CTCA...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152695/improving-anti-emetics-in-chemotherapy-induced-nausea-and-vomiting
#18
Ron Fung, Katherine Enright
: 220 Background: Chemotherapy induced nausea and vomiting (CINV) remains one of the most feared treatment-related toxicities in cancer patients. CINV has been shown to decrease quality of life and to increase dose modifications and unplanned hospital visits. Cancer Care Ontario (CCO) and the American Society of Clinical Oncology (ASCO) updated their CINV guidelines in 2013. These changes included a reclassification of many regimens from moderate (MEC) to highly emetogenic (HEC) and a decrease in the duration of serotonin inhibitors (5HT3i)...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28151871/antihypertensive-medications-and-risk-of-death-and-hospitalizations-in-us-hemodialysis-patients-evidence-from-a-cohort-study-to-inform-hypertension-treatment-practices
#19
Tariq Shafi, Stephen M Sozio, Jason Luly, Karen J Bandeen-Roche, Wendy L St Peter, Patti L Ephraim, Aidan McDermott, Charles A Herzog, Deidra C Crews, Julia J Scialla, Navdeep Tangri, Dana C Miskulin, Wieneke M Michels, Bernard G Jaar, Philip G Zager, Klemens B Meyer, Albert W Wu, L Ebony Boulware
Antihypertensive medications are commonly prescribed to hemodialysis patients but the optimal regimens to prevent morbidity and mortality are unknown. The goal of our study was to compare the association of routinely prescribed antihypertensive regimens with outcomes in US hemodialysis patients.We used 2 datasets for our analysis. Our primary cohort (US Renal Data System [USRDS]) included adult patients initiating in-center hemodialysis from July 1, 2006 to June 30, 2008 (n = 33,005) with follow-up through December 31, 2009...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28141912/high-volume-haemofiltration-for-sepsis-in-adults
#20
REVIEW
Emma Mj Borthwick, Christopher J Hill, Kannaiyan S Rabindranath, Alexander P Maxwell, Danny F McAuley, Bronagh Blackwood
BACKGROUND: Severe sepsis and septic shock are leading causes of death in the intensive care unit (ICU), despite advances in the treatment of patients with severe sepsis and septic shock, including early recognition, appropriate treatment with antibiotics and support of organs that may have been affected by the illness. High-volume haemofiltration (HVHF) is a blood purification technique that may improve outcomes in severe sepsis or septic shock. The technique of HVHF has evolved from renal replacement therapies used in the ICU to treat critically ill patients with acute kidney injury (AKI)...
January 31, 2017: Cochrane Database of Systematic Reviews
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