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https://www.readbyqxmd.com/read/28725862/what-s-in-a-word-my-journey-toward-empathy-education-and-practice-at-the-cleveland-clinic
#1
Rachel M Taliercio
No abstract text is available yet for this article.
June 2017: Journal of patient experience
https://www.readbyqxmd.com/read/28725326/comparison-of-clopidogrel-with-prasugrel-and-ticagrelor-in-patients-with-acute-coronary-syndrome-clinical-outcomes-from-the-national-cardiovascular-database-action-registry
#2
Mohamed Khayata, Joseph N Gabra, M Farhan Nasser, George I Litman, Shyam Bhakta, Rupesh Raina
BACKGROUND: We aimed to compare the clinical outcomes of clopidogrel, prasugrel, and ticagrelor in clinical practice using the National Cardiovascular Database ACTION Registry(®). Treatment guidelines for patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention recommend dual antiplatelet therapy (DAPT) for 12 months. Few clinical trials have compared the safety and efficacy of clopidogrel with that of newer antiplatelet therapies. METHODS: A retrospective study of patients hospitalized for ACS at Cleveland Clinic Akron General was conducted...
June 2017: Cardiology Research
https://www.readbyqxmd.com/read/28719316/high-mortality-and-coinfection-in-a-prospective-cohort-of-human-immunodeficiency-virus-acquired-immune-deficiency-syndrome-patients-with-histoplasmosis-in-guatemala
#3
Blanca Samayoa, Monika Roy, Angela Ahlquist Cleveland, Narda Medina, Dalia Lau-Bonilla, Christina M Scheel, Beatriz L Gomez, Tom Chiller, Eduardo Arathoon
Histoplasmosis is one of the most common and deadly opportunistic infections among persons living with human immunodeficiency virus (HIV)/acquired immune deficiency syndrome in Latin America, but due to limited diagnostic capacity in this region, few data on the burden and clinical characteristics of this disease exist. Between 2005 and 2009, we enrolled patients ≥ 18 years of age with suspected histoplasmosis at a hospital-based HIV clinic in Guatemala City. A case of suspected histoplasmosis was defined as a person presenting with at least three of five clinical or radiologic criteria...
July 2017: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/28717000/empathy-burnout-and-antibiotic-prescribing-for-acute-respiratory-infections-a-cross-sectional-primary-care-study-in-the-us
#4
Bob Z Sun, Alexander Chaitoff, Bo Hu, Kathleen Neuendorf, Mahesh Manne, Michael B Rothberg
BACKGROUND: The impact of physician-patient relationship factors, such as physician empathy and burnout, on antibiotic prescribing has not been characterised. AIM: To assess associations between physician empathy and burnout and antibiotic prescribing for acute respiratory infections (ARIs) in primary care. DESIGN AND SETTING: Cross-sectional study of primary care practices in the Cleveland Clinic Health System in the US. METHOD: Patient and prescribing data were obtained from the medical record...
July 17, 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/28703936/randomized-clinical-trial-of-percutaneous-tibial-nerve-stimulation-versus-sham-electrical-stimulation-in-patients-with-faecal-incontinence
#5
A A van der Wilt, G Giuliani, C Kubis, B P W van Wunnik, I Ferreira, S O Breukink, P A Lehur, F La Torre, C G M I Baeten
BACKGROUND: The aim was to assess the effects of percutaneous tibial nerve stimulation (PTNS) in the treatment of faecal incontinence (FI) by means of an RCT. METHODS: Patients aged over 18 years with FI were included in a multicentre, single-blinded RCT. The primary endpoint was reduction in the median or mean number of FI episodes per week. Secondary endpoints were changes in measures of FI severity, and disease-specific and generic quality of life. Outcomes were compared between PTNS and sham stimulation after 9 weeks of treatment...
August 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28701263/treatment-for-anal-fissure-is-there-a-safe-option
#6
Justin T Brady, Alison R Althans, Ruel Neupane, Eslam M G Dosokey, Murad A Jabir, Harry L Reynolds, Scott R Steele, Sharon L Stein
BACKGROUND: Surgeons often approach anal fissure with chemical denervation (Botulinum toxin, BT) instead of initial lateral internal sphincterotomy (LIS) due to concerns for long-term incontinence. We evaluated the characteristics and outcomes of patients who received BT or LIS. METHODS: We performed a retrospective chart review of patients undergoing LIS and BT for anal fissure between 2009 and 2015. In 2015, a telephone survey was performed to evaluate durability, long-term incontinence and patient satisfaction...
July 5, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28690000/-i-m-not-gonna-pull-the-rug-out-from-under-you-patient-provider-communication-about-opioid-tapering
#7
Marianne S Matthias, Nicole L Johnson, Cleveland G Shields, Matthew J Bair, Palmer MacKie, Monica Huffman, Stewart C Alexander
In response to increases in harms associated with prescription opioids, opioid prescribing has come under greater scrutiny, leading many healthcare organizations and providers to consider or mandate opioid dose reductions (tapering) for patients with chronic pain. Communicating about tapering can be difficult, particularly for patients on long-term opioids who perceive benefits and are using their medications as prescribed. Given the importance of effective patient-provider communication for pain management and recent health system-level initiatives and provider practices to taper opioids, this study used qualitative methods to understand communication processes related to opioid tapering, to identify best practices and opportunities for improvement...
July 6, 2017: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/28687553/development-of-a-pharmacy-resident-rotation-to-expand-decentralized-clinical-pharmacy-services
#8
John D Hill, Jonathan P Williams, Julie F Barnes, Katie M Greenlee, Bcps-Aq Cardiology, Mandy C Leonard
PURPOSE: The development of a pharmacy resident rotation to expand decentralized clinical pharmacy services is described. SUMMARY: In an effort to align with the initiatives proposed within the ASHP Practice Advancement Initiative, the department of pharmacy at Cleveland Clinic, a 1,400-bed academic, tertiary acute care medical center in Cleveland, Ohio, established a goal to provide decentralized clinical pharmacy services for 100% of patient care units within the hospital...
July 15, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28685224/a-retrospective-review-of-1495-patients-with-obstetric-anal-sphincter-injuries-referred-for-assessment-of-function-and-endoanal-ultrasonography
#9
G P Thomas, L E Gould, F Casunuran, D A Kumar
AIM: Obstetric anal sphincter injuries are a significant risk factor for faecal incontinence. Correct identification and successful primary repair are important. The aim of this study was to review the outcome of all patients, with an obstetric anal sphincter injury, referred to our unit. METHOD: This is a retrospective review of 1495 patients over a 12-year period. All had a third or fourth degree tear and were referred at 4-months postpartum. RESULTS: Endoanal ultrasonography demonstrated residual sphincter defect in 792 (53%) and normal sphincters, with no evidence of repair, in 661 (44%)...
July 7, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28682451/outcomes-for-patients-with-apparent-chronic-idiopathic-pelvic-pain-and-associated-pelvic-floor-disorders-undergoing-laparoscopic-ventral-mesh-rectopexy
#10
A Newman, G L Greenslade, K McCarthy, A R Dixon
AIM: To assess the outcomes for patients with chronic idiopathic pelvic pain (CIPP) and associated pelvic floor disorders (PFDs) undergoing laparoscopic ventral mesh rectopexy (LVMR). METHOD: A prospective database identified patients referred from a specialist pain clinic undergoing LVMR. Primary outcomes included numerical rating scale (NRS) for pain, quality of life (QoL), Wexner constipation score, Cleveland Clinic incontinence score (CCIS), bowel and bladder-disturbance visual analogue scale (VAS) pain score and sexual function...
July 6, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28679344/survey-based-assessment-of-the-relationship-between-cognitive-impairment-and-mentally-stimulating-activity-in-multiple-sclerosis
#11
Briana C Prager, Amy S Nowacki, Devon S Conway
OBJECTIVES: Cognitive impairment (CI) is a common and potentially debilitating component of the disease course in multiple sclerosis (MS). However, therapeutic options remain limited. It is unknown whether cognitively enriching activities reduce the burden of CI in patients with MS, as is found in other neurologic diseases affecting cognition. The aim of this study was to determine whether participation in cognitively enriching activities decreased self-reported CI in MS patients. METHODS: CI and activity levels were reported through electronic surveys completed by MS patients at the Cleveland Clinic...
July 5, 2017: Neurological Research
https://www.readbyqxmd.com/read/28673042/independent-prognostic-value-of-left-ventricular-contractile-reserve-and-chronotropic-response-in-patients-with-reduced-left-ventricular-ejection-fraction-undergoing-vasodilator-stress-myocardial-perfusion-imaging-with-rb-82-positron-emission-tomography
#12
Balaji K Tamarappoo, Lee Fong Ling, Manuel Cerqueira, Rory Hachamovitch
Objectives: We evaluated the prognostic value of heart rate reserve (ΔHR) and left ventricular ejection fraction reserve (ΔLVEF) among patients with systolic dysfunction. Background: Inadequate ΔHR (maximal stress HR - resting HR) and ΔLVEF (LVEF at stress - LVEF at rest) in response to stress are associated with adverse cardiac events. However, the significance of an abnormal ΔHR and ΔLVEF in patients with systolic dysfunction has not been described. Methods and results: We performed a retrospective analysis of patients with rest LVEF < 45% who underwent dipyridamole stress-rest gated Rb-82 PET myocardial perfusion imaging (PET-MPI) at the Cleveland Clinic between 2006 and 2009...
June 29, 2017: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/28638303/the-use-of-gabapentin-for-pain-and-agitation-in-neonates-and-infants-in-a-neonatal-icu
#13
Gretchen L Sacha, Maria G Foreman, Kay Kyllonen, Ricardo J Rodriguez
OBJECTIVES: Limited data support how to safely and effectively treat refractory pain and agitation in neonates and infants. Gabapentin has been used in this patient population and has shown promising results, yet there is still a paucity of data about its clinical efficacy. There is a need for a larger evaluation to determine its effectiveness. This study describes one institution's experience with gabapentin for the treatment of refractory pain and agitation in the neonatal intensive care unit (NICU)...
May 2017: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/28636421/analysis-of-origins-of-admission-for-solid-tumor-oncology-inpatients-disease-severity-and-outcomes
#14
Christopher E Wee, Lindsey M Goodman, Leticia Varella, Lisa A Rybicki, Alberto J Montero, Bassam N Estfan, Carolyn H Best, James P Stevenson
PURPOSE: Hospital transfers may affect clinical outcomes. Evaluation of admission by source of transfer, time of admission, and provider type may identify opportunities to improve inpatient outcomes. METHODS: We reviewed charts of patients admitted to the solid tumor oncology service between July and December 2014 from the Cleveland Clinic Foundation (CCF) Main Campus emergency department (ED), CCF Regional EDs, outside hospital (OSH) ED, OSH inpatient services, and CCF outpatient clinics...
July 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28633225/patient-specific-simulation-of-endovascular-thoracic-aortic-repair-initial-experience
#15
Liesbeth M Desender, Isabelle Van Herzeele, Zoran Rancic, Colin Bicknell, Ignatios Zairis, Frank E Vermassen, John H Rundback
PURPOSE: Endovascular thoracic aortic repair (TEVAR) has become the treatment modality of diverse aortic pathology. We report the use of patient-specific simulation using a dedicated PROcedure Rehearsal Studio (PRS) platform (Simbionix USA Corp, Cleveland, OH) before TEVAR and evaluate the feasibility and realism of this technology. DESCRIPTION: Virtual three-dimensional models of the patient's relevant anatomy were reconstructed from computed tomography data. PRS was used in 2 patients before TEVAR...
July 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28631827/one-year-results-of-the-scandiv-randomized-clinical-trial-of-laparoscopic-lavage-versus-primary-resection-for-acute-perforated-diverticulitis
#16
J K Schultz, C Wallon, L Blecic, H M Forsmo, J Folkesson, P Buchwald, H Kørner, F A Dahl, T Øresland, S Yaqub
BACKGROUND: Recent randomized trials demonstrated that laparoscopic lavage compared with resection for Hinchey III perforated diverticulitis was associated with similar mortality, less stoma formation but a higher rate of early reintervention. The aim of this study was to compare 1-year outcomes in patients who participated in the randomized Scandinavian Diverticulitis (SCANDIV) trial. METHODS: Between February 2010 and June 2014, patients from 21 hospitals in Norway and Sweden presenting with suspected perforated diverticulitis were enrolled in a multicentre RCT comparing laparoscopic lavage and sigmoid resection...
June 20, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28630049/comparison-of-electroacupuncture-and-medical-treatment-for-functional-constipation-a-systematic-review-and-meta-analysis
#17
Sheng-Li Zhou, Xiu-Lai Zhang, Jing-Hua Wang
OBJECTIVES: To assess the effectiveness of electroacupuncture (EA) relative to conventional medication in functional constipation (FC). DESIGN: Systematic review and meta-analysis SETTING: To be included, studies needed to: (1) have been randomised controlled trials; (2) have recruited adult patients diagnosed with FC according to the Rome II/III criteria or the American Gastroenterological Association guideline for chronic FC; and (3) have randomised patients to be treated with EA or anti-constipation medication...
June 19, 2017: Acupuncture in Medicine: Journal of the British Medical Acupuncture Society
https://www.readbyqxmd.com/read/28620573/clinical-characteristics-and-outcomes-of-patients-with-ischemic-and-non-ischemic-complete-heart-block
#18
Murtaza Sundhu, Mehmet Yildiz, Mubbasher Syed, Bhavan Shah, Sajjad Gul, Omer Afzal, Lon Castle
INTRODUCTION: Third degree or complete heart block (CHB) is a medical emergency and usually requires permanent pacemaker placement. CHB can be caused by cardiac ischemia or non-ischemic conditions such as infiltrative diseases or fibrosis. The purpose of this study is to identify the baseline clinical characteristics associated with ischemic versus non-ischemic causes of complete heart block and compare their outcomes. MATERIALS AND METHODS: An institutional review broad approval was granted by the Cleveland Clinic Health System...
May 12, 2017: Curēus
https://www.readbyqxmd.com/read/28616442/human-coronavirus-hku1-infection-among-adults-in-cleveland-ohio
#19
Anubhav Kanwar, Suresh Selvaraju, Frank Esper
BACKGROUND: Human coronaviruses (CoV) have been long recognized as a common cause of respiratory tract disease including severe respiratory tract illness. Coronavirus-HKU1 has been described predominantly among children less than 5 years of age in the United States with few studies characterizing the disease spectrum among adults. METHODS: Nasopharyngeal specimens of patients with respiratory symptoms were analyzed for CoV-HKU1 by NxTAG Respiratory Pathogen Panel multiplex assay from February 7, 2016 to April 30, 2016...
2017: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/28614683/single-nephron-glomerular-filtration-rate-in-healthy-adults
#20
Aleksandar Denic, Jerry Mathew, Lilach O Lerman, John C Lieske, Joseph J Larson, Mariam P Alexander, Emilio Poggio, Richard J Glassock, Andrew D Rule
BACKGROUND: The glomerular filtration rate (GFR) assesses the function of all nephrons, and the single-nephron GFR assesses the function of individual nephrons. How the single-nephron GFR relates to demographic and clinical characteristics and kidney-biopsy findings in humans is unknown. METHODS: We identified 1388 living kidney donors at the Mayo Clinic and the Cleveland Clinic who underwent a computed tomographic (CT) scan of the kidney with the use of contrast material and an iothalamate-based measurement of the GFR during donor evaluation and who underwent a kidney biopsy at donation...
June 15, 2017: New England Journal of Medicine
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