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https://www.readbyqxmd.com/read/28921707/a-visual-approach-of-care-pathways-from-the-french-nationwide-snds-database-from-population-to-individual-records-the-epeps-toolbox
#1
André Happe, Erwan Drezen
Secondary use of medical and administrative databases has become a powerful tool for epidemiological studies. In that respect, the recent access opening of French nationwide health record database or SNDS (Système National des Données de Santé) is a great opportunity to carry out comprehensive health studies at the country level. However, using this database is far from being straightforward for non-expert data scientists; so, dedicated tools needed to be developed. Our contribution is focused on data management and visualization tools able to query and cope with the complexity of care pathways of patients...
September 16, 2017: Fundamental & Clinical Pharmacology
https://www.readbyqxmd.com/read/28921521/a-paradigm-for-evaluation-and-management-of-the-maxillary-sinus-before-dental-implantation
#2
Yi-Wei Chen, Fu-Ying Lee, Po-Hung Chang, Chi-Che Huang, Chia-Hsiang Fu, Chien-Chia Huang, Ta-Jen Lee
OBJECTIVES: To determine a paradigm for evaluating and managing maxillary sinus conditions before dental implantation via preoperative sinonasal assessment. STUDY DESIGN: Prospective cohort study. METHODS: Eighty-four patients who underwent dental implantation with or without sinus augmentation were included. Maxillary sinus conditions were classified into groups 1 to 6 according to cone-beam computed tomography (CT) findings: 1) nonspecific findings, 2) solitary polyp or cyst, 3) mucosal thickening, 4) air-fluid level or fluid accumulation, 5) near-total opacification of the maxillary or other paranasal sinus, and 6) calcification spots in the maxillary sinus...
September 16, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28919797/quality-of-care-in-inflammatory-bowel-disease-results-of-a-prospective-controlled-cohort-study-in-germany-netibd
#3
Jana Langbrandtner, Angelika Hüppe, Petra Jessen, Jürgen Büning, Susanna Nikolaus, Heiner Raspe, Bernd Bokemeyer
BACKGROUND/AIMS: Patients with inflammatory bowel disease (IBD) need comprehensive, interdisciplinary and cross-sectoral health care. In Germany, evidence-based care pathways have been developed to improve the quality of care of IBD patients. We aimed to evaluate the effects of the implementation of some of these recommendations on patient-related outcomes. METHODS: In a region of North Germany, outpatients with IBD were recruited by gastroenterologists (intervention group)...
2017: Clinical and Experimental Gastroenterology
https://www.readbyqxmd.com/read/28914190/perioperative-considerations-of-herbal-medications
#4
Ryan M Chadha, Brian J Egan
BACKGROUND: A considerable portion of the US population uses herbal supplements on a daily basis for their various proposed beneficial effects. However, the over-the-counter nature of these medications and lack of knowledge of adverse effect profiles can have unexpected serious impact on the perioperative course. The growing list of supplements presents a pharmacologic conundrum to the anesthesiologist. OBJECTIVE: To compile a comprehensive list of vitamins, herbals, and supplements used commonly by patients, describe the risks associated with them, and identify recommendations for perioperative management...
September 13, 2017: Current Clinical Pharmacology
https://www.readbyqxmd.com/read/28913694/emergency-neurological-life-support-traumatic-spine-injury
#5
Deborah M Stein, William A Knight
Traumatic spine injuries (TSIs) carry significantly high risks of morbidity, mortality, and exorbitant health care costs from associated medical needs following injury. For these reasons, TSI was chosen as an ENLS protocol. This article offers a comprehensive review on the management of spinal column injuries using the best available evidence. Though the review focuses primarily on cervical spinal column injuries, thoracolumbar injuries are briefly discussed as well. The initial emergency department (ED) clinical evaluation of possible spinal fractures and cord injuries, along with the definitive early management of confirmed injuries, are also covered...
September 14, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28912390/-osteoporosis-liaison-service-and-multi-medical-staff-cooperation
#6
Satoshi Ikeda
A place of the activity of Osteoporosis Liaison Service (OLS) is classified into the in-hospital and the out-hospital. "Kotsu-Kotsu approach" is performed in our hospital for fracture inpatients as OLS. "Kotsu-Kotsu approach" can be able to performed the various and comprehensive assessment for the patients by multi medical staff, especially Osteoporosis managers. The construction of the cooperation with other facilities is propelled for activity of out-hospital. Ministry of Health, Labour and Welfare impel to establish community-based integrated care systems...
2017: Clinical Calcium
https://www.readbyqxmd.com/read/28910257/between-a-rock-and-a-hard-place-prescription-opioid-restrictions-in-the-time-of-fentanyl-and-other-street-drug-adulterants
#7
Tessa Cheng, Kora DeBeck
Non-medical prescription opioid use (NMPOU) has increased alarmingly across Canada and resulted in strict prescribing restrictions on opioids. Despite a clear need to reduce opioid prescriptions in response to this crisis, few other policies have been implemented and this singular focus is incongruent with the known characteristics of substance use disorders, negative effects of supply reduction policies, and realities of pain management. Given the recent rise of fentanyl and other dangerous adulterants in street drugs, this commentary argues that a comprehensive response to NMPOU that includes improvements to addiction management and harm-reduction services is urgently needed...
September 14, 2017: Canadian Journal of Public Health. Revue Canadienne de Santé Publique
https://www.readbyqxmd.com/read/28905635/developing-a-health-care-system-for-children-in-foster-care
#8
Mary V Greiner, Sarah J Beal
In 2012, the Comprehensive Health Evaluations for Cincinnati's Kids (CHECK) Center was launched at Cincinnati Children's Hospital Medical Center to provide health care for over 1,000 children placed into foster care each year in the Cincinnati community. This consultation model clinical program was developed because children in foster care have been difficult to manage in the traditional health care setting due to unmet health needs, missing medical records, cumbersome state mandates, and transient and impoverished social settings...
September 1, 2017: Health Promotion Practice
https://www.readbyqxmd.com/read/28902700/effectiveness-of-collaboration-between-emergency-department-and-intensive-care-unit-teams-on-mortality-rates-of-patients-presenting-with-critical-illness-a-systematic-review
#9
Kerchelle McDowald, Svetlana Direktor, Elizabeth A Hynes, Anna Sahadeo, Margaret E Rogers
BACKGROUND: The increasing volume of adult patients with critical illness entering emergency departments (EDs) burdens the resources of EDs worldwide. This subpopulation faces a high risk of mortality because they require specialized care which many EDs are not yet poised to deliver. An element crucial to delivering care and decreasing the mortality of critically ill patients in the ED is expert collaborative practice across disciplines. Several ED and intensive care unit (ICU) collaborative models exist including: emergency department intensive care units (EDICU) and medical emergency teams (MET)...
September 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/28900443/hsv-1-encephalitis-high-index-of-clinical-suspicion-prompt-diagnosis-and-early-therapeutic-intervention-are-the-triptych-of-success-report-of-two-cases-and-comprehensive-review-of-the-literature
#10
Dimitrios Patoulias, Georgios Gavriiloglou, Konstantinos Kontotasios, Mairi Tzakri, Petros Keryttopoulos, Christos Koutras
Herpes Simplex Virus (HSV) encephalitis is an acute infectious disease of the Central Nervous System (CNS), usually affecting the limbic structures, the median temporal cortex, and the orbitofrontal regions. Its annual incidence has significantly increased over the last 20 years and the mortality rate is 7%, if early diagnosed and treated, and 70%, if left untreated, while it is associated with high rates of morbidity. It should be noted that even when Cerebrospinal fluid (CSF) analysis seems normal, imaging studies are not specific and HSV Polymerase Chain Reaction (PCR) test is negative; the clinician should be more aggressive, if clinical presentation is indicative for HSV encephalitis, by administrating acyclovir early after patient's admission...
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/28894828/the-role-of-antibiotics-in-pediatric-chronic-rhinosinusitis
#11
REVIEW
Itzhak Brook
OBJECTIVES: Presenting the role of antibiotics in pediatric chronic rhinosinusitis based on its pathophysiology and microbiology. DATA SOURCE: Review of the literature searching PubMed for microbiology and treatment of pediatric chronic rhinosinusitis. RESULTS: Chronic rhinosinusitis (CRS) is an inflammatory condition of the paranasal sinuses that persists for 12 weeks or longer, despite medical management. The microbiology of rhinosinusitis evolves through several stages...
June 2017: Laryngoscope Investigative Otolaryngology
https://www.readbyqxmd.com/read/28894695/which-obstacles-prevent-us-from-recruiting-into-clinical-trials-a-survey-about-the-environment-for-clinical-studies-at-a-german-university-hospital-in-a-comprehensive-cancer-center
#12
Christoph Straube, Peter Herschbach, Stephanie E Combs
BACKGROUND: Prospective clinical studies are the most important tool in modern medicine. The standard in good clinical practice in clinical trials has constantly improved leading to more sophisticated protocols. Moreover, translational questions are increasingly addressed in clinical trials. Such trials must follow elaborate rules and regulations. This is accompanied by a significant increase in documentation issues which require substantial manpower. Furthermore, university-based clinical centers are interested in increasing the amount of patients treated within clinical trials, and this number has evolved to be a key quality criterion...
2017: Frontiers in Oncology
https://www.readbyqxmd.com/read/28892593/much-more-than-prescribing-a-pill-assessment-and-treatment-of-erectile-dysfunction-by-the-general-practitioner
#13
Ohad Shoshany, Darren J Katz, Christopher Love
BACKGROUND: Erectile dysfunction is a common but often neglected condition. Prevalence increases with age, but is not insignificant in younger men. OBJECTIVE: This article will broadly describe the epidemiology, classification and risk factors of erectile dysfunction. It will also discuss assessment and current treatment modalities, with a particular focus on the unique role of the general practitioner (GP). DISCUSSION: Erectile dysfunction may be classified as vasculogenic, neurogenic, endocrinological, drug-related, psychogenic or mixed...
September 2017: Australian Family Physician
https://www.readbyqxmd.com/read/28891393/improving-ambulatory-care-resident-training-preparing-for-opportunities-to-treat-mental-illness-in-the-primary-care-setting
#14
Nada M Farhat, Jolene R Bostwick, Stuart D Rockafellow
PURPOSE: The development of an outpatient psychiatry clinical practice learning experience for PGY2 ambulatory care pharmacy residents in preparation for the treatment of psychiatric disorders in the primary care setting is described. SUMMARY: With the increased prevalence of psychiatric disorders, significant mortality, and limited access to care, integration of mental health treatment into the primary care setting is necessary to improve patient outcomes. Given the majority of mental health treatment occurs in the primary care setting, pharmacists in patient-centered medical homes (PCMHs) are in a unique position with direct access to patients to effectively manage these illnesses...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/28890921/the-doktab%C3%A3-rse-an-innovative-online-platform-for-research-projects-at-the-medical-faculty-of-the-lmu-munich
#15
Leo Nicolai, Maximilian Gradel, Sofia Antón, Tanja Pander, Anke Kalb, Lisa Köhler, Martin R Fischer, Konstantinos Dimitriadis, Philip von der Borch
Introduction: One of the most important extracurricular aspects of medical studies in Germany is a research thesis completed by most students. This research project often times conveys relevant competencies for the physician's role as scientist. Nevertheless, the choice of the right project remains a challenge. Reasons for this are among others, missing structures for a comprehensive overview of research groups and their respective projects. Description of the project: We developed the online platform Doktabörse as an online marketplace for doctoral research projects...
2017: GMS Journal for Medical Education
https://www.readbyqxmd.com/read/28890909/patient-provider-and-system-factors-associated-with-failure-to-follow-up-elevated-glucose-results-in-patients-without-diagnosed-diabetes
#16
Michael E Bowen, Zahra Merchant, Kazeen Abdullah, Deepa Bhat, Jason Fish, Ethan A Halm
BACKGROUND: Although elevated glucose values are strongly associated with undiagnosed diabetes, they are frequently overlooked. Patient, provider, and system factors associated with failure to follow-up elevated glucose values in electronic medical records (EMRs) are not well described. METHODS: We conducted a chart review in a comprehensive EMR with a patient portal and results management features. Established primary care patients with no known diagnosis of diabetes and ≥ 1 glucose value >125 mg/dL were included...
January 2017: Health Services Research and Managerial Epidemiology
https://www.readbyqxmd.com/read/28890183/radiomics-analysis-on-ultrasound-for-prediction-of-biologic-behavior-in-breast-invasive-ductal-carcinoma
#17
Yi Guo, Yuzhou Hu, Mengyun Qiao, Yuanyuan Wang, Jinhua Yu, Jiawei Li, Cai Chang
INTRODUCTION: In current clinical practice, invasive ductal carcinoma is always screened using medical imaging techniques and diagnosed using immunohistochemistry. Recent studies have illustrated that radiomics approaches provide a comprehensive characterization of entire tumors and can reveal predictive or prognostic associations between the images and medical outcomes. To better reveal the underlying biology, an improved understanding between objective image features and biologic characteristics is urgently required...
August 18, 2017: Clinical Breast Cancer
https://www.readbyqxmd.com/read/28887348/population-health-management-in-a-small-health-system-impact-of-controlled-substance-stewardship-in-a-patient-centered-medical-home
#18
Felicity A E Homsted, Chelsea E Magee, Noah Nesin
PURPOSE: The success of a patient-centered medical home in providing population health management (PHM) services through controlled substance stewardship is described. SUMMARY: In 2013, Penobscot Community Health Care (PCHC), in Bangor, Maine, was fully engulfed in the prescription opioid crisis. At PCHC, patients' opioid doses were startlingly high. Within the organization, measures to ensure that prescriptions were being used as prescribed, and not diverted, were underutilized...
September 15, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28887347/pharmacists-supporting-population-health-in-patient-centered-medical-homes
#19
Antoinette B Coe, Hae Mi Choe
PURPOSE: The integral role of pharmacists in supporting population health initiatives in the patient-centered medical home (PCMH) model of care is described. SUMMARY: Population health initiatives focus on the health outcomes of a group of patients; in the PCMH model, such groups of patients, known as panels, may be defined as patients assigned to a care team or provider. The basic characteristics of the PCMH model include physician-led, team-based practice; coordinated and integrated care within the PCMH and in the patient's community; provision of safe, evidence-based, high-quality care; incorporation of health information technology and continuous quality improvement strategies into panel identification, documentation, and care processes; improved access to care (e...
September 15, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28885970/essential-medications-for-patients-with-suspected-or-confirmed-ebola-virus-disease-in-resource-limited-environments
#20
William F Pierce, Selena D Ready, John Tyson Chapman, Corrinne Kulick, Anastasia Shields, Jialynn Wang, Kimberly Andrews, Richard W Childs, Carlos Bell, Alexandr Kosyak, Jade Pham
BACKGROUND: In 2014, the U.S. Public Health Service (USPHS) Commissioned Corps deployed to Monrovia, Liberia, to operate a 25-bed Ebola treatment unit (ETU) constructed by the U.S. Military. The ETU was named the Monrovia Medical Unit (MMU) and was constructed from an U.S. Air Force Expeditionary Medical Support (EMEDS) unit with modifications on the basis of consultation from Médecins Sans Frontières, the World Health Organization, and expert panels from the U.S. Department of Defense and Department of Health and Human Services...
September 2017: Military Medicine
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