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https://www.readbyqxmd.com/read/28719697/diagnosis-and-management-of-asthma-in-adults-a-review
#1
Jennifer L McCracken, Sreenivas P Veeranki, Bill T Ameredes, William J Calhoun
Importance: Asthma affects about 7.5% of the adult population. Evidence-based diagnosis, monitoring, and treatment can improve functioning and quality of life in adult patients with asthma. Observations: Asthma is a heterogeneous clinical syndrome primarily affecting the lower respiratory tract, characterized by episodic or persistent symptoms of wheezing, dyspnea, and cough. The diagnosis of asthma requires these symptoms and demonstration of reversible airway obstruction using spirometry...
July 18, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28718324/physical-health-and-drug-safety-in-individuals-with-schizophrenia
#2
Tamara Pringsheim, Martina Kelly, Doug Urness, Michael Teehan, Zahinoor Ismail, David Gardner
BACKGROUND: While antipsychotic medications are the mainstay of therapy for individuals with schizophrenia and psychotic disorders, their use is associated with adverse effects on physical health that require the attention and care of prescribers. METHODS: We used the ADAPTE process to adapt existing guideline recommendations from the National Institute for Health and Care Excellence (NICE) and Scottish Intercollegiate Guidelines Network (SIGN) guidelines on the dosing of antipsychotics and antipsychotic polypharmacy, screening for adverse effects of antipsychotics, and management of metabolic and extrapyramidal side effects to the Canadian context...
January 1, 2017: Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie
https://www.readbyqxmd.com/read/28716619/attachment-insecurity-in-advanced-cancer-patients-psychometric-properties-of-the-german-version-of-the-brief-experiences-in-close-relationships-scale-ecr-m16-g
#3
Philipp Rebecca, Vehling Sigrun, Scheffold Katharina, Grünke Britta, Härter Martin, Mehnert Anja, Schulz-Kindermann Frank, Lo Christopher
CONTEXT: Attachment insecurity refers to difficulty in trusting and relying on others in times of need. Its underlying factors attachment anxiety and attachment avoidance have been empirically associated with impaired coping in advanced cancer, and therefore should be considered in individually tailored medical and psychosocial treatment. OBJECTIVES: To evaluate the psychometric properties of the German translation of the Brief Experiences in Close Relationships Scale (ECR-M16-G)...
July 14, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28712604/-sometimes-you-feel-like-the-freak-show-a%C3%A2-qualitative-assessment-of-emergency-care-experiences-among-transgender-and-gender-nonconforming-patients
#4
Elizabeth A Samuels, Chantal Tape, Naomi Garber, Sarah Bowman, Esther K Choo
STUDY OBJECTIVE: Transgender, gender-variant, and intersex (trans) people have decreased access to care and poorer health outcomes compared with the general population. Little has been studied and documented about such patients' emergency department (ED) experiences and barriers to care. Using survey and qualitative research methods, this study aims to identify specific areas for improvement and generate testable hypotheses about the barriers and challenges for trans individuals needing acute care...
July 13, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28710111/managing-an-intentional-overdose-in-a-hospice
#5
Toby Dinnen, Hannah Armstrong, Paul Perkins
This case report describes a patient admitted unconscious to a hospice following an intentional overdose of oxycodone. She had previously declined conventional medical treatment for cancer and had made an advance decision stating that she wished to avoid hospital admission and refusing life-prolonging treatment. This case illustrates the practical and ethical challenges of managing an intentional overdose in a palliative care setting.
July 14, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28708679/transpulmonary-pressure-describes-lung-morphology-during-decremental-positive-end-expiratory-pressure-trials-in-obesity
#6
Jacopo Fumagalli, Lorenzo Berra, Changsheng Zhang, Massimiliano Pirrone, Roberta R De Santis Santiago, Susimeire Gomes, Federico Magni, Glaucia A B Dos Santos, Desmond Bennett, Vinicius Torsani, Daniel Fisher, Caio Morais, Marcelo B P Amato, Robert M Kacmarek
OBJECTIVES: Atelectasis develops in critically ill obese patients when undergoing mechanical ventilation due to increased pleural pressure. The current study aimed to determine the relationship between transpulmonary pressure, lung mechanics, and lung morphology and to quantify the benefits of a decremental positive end-expiratory pressure trial preceded by a recruitment maneuver. DESIGN: Prospective, crossover, nonrandomized interventional study. SETTING: Medical and Surgical Intensive Care Units at Massachusetts General Hospital (Boston, MA) and University Animal Research Laboratory (São Paulo, Brazil)...
August 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28708203/medical-treatment-of-erectile-dysfunction-too-many-medical-prescriptions
#7
Paolo Capogrosso, Eugenio Ventimiglia, Davide Oreggia, Andrea Salonia, Francesco Montorsi
Erectile dysfunction (ED) is a worldwide commonly reported condition; epidemiological data showed a prevalence ranging from 2.3 to 53.4% within different population subsets. In this context, the advent of phosphodiesterase type 5 inhibitors (PDE5is) in the second mid of 1990s has deeply changed the treatment scenario of this bothersome condition. Being user-friendly compounds with an excellent overall safety profile, PDE5is emerged as the first-line treatment for ED, thus overcoming topical alprostadil and intracavernous injections (ICIs)...
July 5, 2017: Urologia
https://www.readbyqxmd.com/read/28707460/the-effect-of-hospice-consultation-on-aggressive-treatment-of-lung-cancer
#8
Shin Hye Yoo, Bhumsuk Keam, Miso Kim, Tae Min Kim, Dong-Wan Kim, Dae Seog Heo
Purpose: The aims of this study were to investigate trends of aggressive treatment of non-small cell lung cancer (NSCLC) patients at the end-of-life (EOL) during the recent five years and examine the relationship between hospice consultation (HC) and aggressive care. Materials and Methods: The medical records of 789 patients with stage IIIB-IV NSCLC at SNUH who received palliative chemotherapy and died from 2010 to 2014 were retrospectively reviewed. Indicators of aggressive treatment were evaluated, and the association of HC with these indicators was analyzed...
July 14, 2017: Cancer Research and Treatment: Official Journal of Korean Cancer Association
https://www.readbyqxmd.com/read/28706101/low-value-clinical-practices-in-injury-care-a-scoping-review-protocol
#9
Lynne Moore, Khadidja Malloum Boukar, Pier-Alexandre Tardif, Henry T Stelfox, Howard Champion, Peter Cameron, Belinda Gabbe, Natalie Yanchar, John Kortbeek, François Lauzier, France Légaré, Patrick Archambault, Alexis F Turgeon
INTRODUCTION: Preventable injuries lead to 200 000 hospital stays, 60 000 disabilities, and 13 000 deaths per year in Canada with direct costs of $20 billion. Overall, potentially unnecessary medical interventions are estimated to consume up to 30% of healthcare resources and may expose patients to avoidable harm. However, little is known about overuse for acute injury care. We aim to identify low-value clinical practices in injury care. METHODS AND ANALYSIS: We will perform a scoping review of peer-reviewed and non-peer-reviewed literature to identify research articles, reviews, recommendations and guidelines that identify at least one low-value clinical practice specific to injury populations...
July 12, 2017: BMJ Open
https://www.readbyqxmd.com/read/28704010/-smarter-medicine-in-ambulatory-care-beliefs-and-practices-of-family-doctors-and-training-of-future-clinicians
#10
Christine Cohidon, Kevin Selby, Jacques Cornuz, Jean-Michel Gaspoz, Nicolas Senn
Following an American and then international initiative, the Swiss Society of Internal Medicine launched the « Smarter Medicine » campaign in 2014 with five recommendations of activities to be avoided, focusing on low back pain, antibiotic prescriptions, pre-operative chest x-rays, prostate cancer screening and treatment with proton pump inhibitors. In 2016, 69 % of family physicians reported that they knew the recommendations and levels of agreement were very high. However, physicians reported differences between recommendations in how often they are followed in practice, and there remains room for improvement...
January 25, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28695558/rehabilitation-in-patients-with-pulmonary-arterial-hypertension
#11
Stephan Keusch, Alexander Turk, Stéphanie Saxer, Nicola Ehlken, Ekkehard Grunig, Silvia Ulrich, On Behalf Of The Swiss Society Of Pulmonary Hypertension
Exertional dyspnoea is a leading symptom in patients with pulmonary arterial hypertension (PAH). Patients suffering from PAH report poor quality of life, have skeletal muscle dysfunction and in the absence of advanced medical therapy deteriorate progressively due to right heart failure which can lead to death. For decades, patients with PAH were advised to avoid exercise in fear of exacerbated right heart failure. Recently, it has been shown that a highly supervised rehabilitation programme in expert centres leads to significant improvements in symptoms, quality of life, exercise capacity and may even enhance haemodynamics in selected stable patients treated with advanced regimens of PAH-targeted drugs...
July 11, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/28695412/-basis-for-the-treatment-of-eczematous-diseases-in-otorhinolaryngology
#12
REVIEW
R Fölster-Holst, A Sperl, T Albrecht, L Klimek
According to Coombs and Gell, cell-mediated immune responses belong to type IV reactions and are borne mainly by T lymphocytes. The eliciting allergens are usually so-called haptens. Haptens are substances which develop to whole antigens only by binding to protein carriers. In otorhinolaryngology, delayed allergic hypersensitivities are apparent mainly as contact eczemata. Facial dermatitis, auricle and ear canal eczema as well as perioral eczema belong to the most common forms of contact dermatitis in ENT patients...
July 10, 2017: HNO
https://www.readbyqxmd.com/read/28694704/health-care-provider-experience-with-canagliflozin-in-real-world-clinical-practice-favorability-treatment-patterns-and-patient-outcomes
#13
Susan C Bolge, Natalia M Flores, Shu Huang, Jennifer Cai
PURPOSE: This study describes how health care providers approach canagliflozin for the treatment of patients with type 2 diabetes mellitus (T2DM) in the real world. PATIENTS AND METHODS: An Internet-based questionnaire was completed by 101 endocrinologists, 101 primary care physicians, and 100 nurse practitioners/physician assistants (NP/PAs). Health care providers were required to have experience prescribing or managing patients using canagliflozin to be included in the study...
2017: International Journal of General Medicine
https://www.readbyqxmd.com/read/28694270/swimming-against-the-tide-primary-care-physicians-views-on-deprescribing-in-everyday-practice
#14
Katharine A Wallis, Abby Andrews, Michelle Henderson
PURPOSE: Avoidable hospitalizations due to adverse drug events and high-risk prescribing are common in older people. Primary care physicians prescribe most on-going medicines. Deprescribing has long been essential to best prescribing practice. We sought to explore the views of primary care physicians on the barriers and facilitators to deprescribing in everyday practice to inform the development of an intervention to support safer prescribing. METHODS: We used a snowball sampling technique to identify potential participants...
July 2017: Annals of Family Medicine
https://www.readbyqxmd.com/read/28692617/impact-of-pharmacy-students-on-a-level-ii-trauma-center
#15
Lindsey Smith, Kathryn Samai, Stephanie Peshek, Brian Kimbrell
This study aims to quantify the benefits of allowing advanced pharmacy practice experience (APPE) students to make medical interventions while on rotation by analyzing their interventions made and the resulting cost avoidance. This retrospective, observational cohort study was completed using self-reported data of APPE student interventions made at a Level II trauma center, under the supervision of a clinical pharmacist. Interventions were analyzed for their impact on patient care and cost avoidance through a comprehensive literature search and online Quantifi reference...
July 2017: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/28691551/who-decides-me-or-we-family-involvement-in-medical-decision-making-in-eastern-and-western-countries
#16
Dana L Alden, John Friend, Ping Yein Lee, Yew Kong Lee, Lyndal Trevena, Chirk Jenn Ng, Sorapop Kiatpongsan, Khatijah Lim Abdullah, Miho Tanaka, Supanida Limpongsanurak
BACKGROUND: Research suggests that desired family involvement (FI) in medical decision making may depend on cultural values. Unfortunately, the field lacks cross-cultural studies that test this assumption. As a result, providers may be guided by incomplete information or cultural biases rather than patient preferences. METHODS: Researchers developed 6 culturally relevant disease scenarios varying from low to high medical seriousness. Quota samples of approximately 290 middle-aged urban residents in Australia, China, Malaysia, India, South Korea, Thailand, and the USA completed an online survey that examined desired levels of FI and identified individual difference predictors in each country...
July 1, 2017: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/28690076/patient-non-adherence-to-guideline-recommended-care-in-acute-low-back-pain
#17
Jasper D Bier, Steven J Kamper, Arianne P Verhagen, Christopher G Maher, Christopher M Williams
OBJECTIVE: To describe the magnitude of patient reported non-adherence with guideline-recommended care for acute low back pain. DESIGN: Secondary analysis of data from participants enrolled in the PACE trial, a randomised controlled trial evaluating the effectiveness of paracetamol for acute low back pain. PARTICIPANTS: Data from 1643 participants with acute low back pain. INTERVENTIONS: Guideline recommendend care including; reassurance, simple analgesia, and the advice to stay active and avoid bed rest...
July 6, 2017: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/28688550/a-quality-study-of-family-centered-care-coordination-to-improve-care-for-children-undergoing-tracheostomy-and-the-quality-of-life-for-their-caregivers
#18
Christopher Hartnick, Gillian Diercks, Vanessa De Guzman, Elizabeth Hartnick, Jeanne Van Cleave, Kevin Callans
IMPORTANCE: Approximately 4000 U.S. children undergo tracheostomy yearly [1], and these surgeries often result in hospital re-admissions that have definite cost and caregiver burdens due to complications that are avoidable with proper training and support. OBJECTIVE: To assess the impact of a Family-Centered Care Coordination (FCCC) program on the quality of care received by children undergoing tracheostomy and their caregivers. DESIGN: Caregivers of children undergoing tracheostomies from January 2012 to January 2013 and then a different set of caregivers of children undergoing tracheostomies from January 2015 to January 2016 completed both the Pediatric Tracheostomy Health Status Instrument (PTHSI) 1 month after discharge and the Medical Complications Associated with Pediatric Tracheostomy (MCAT) questionnaire 6 months after initial tracheostomy...
August 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28686529/identifying-cognitive-impairment-in-hospitalized-older-adults-to-prevent-readmission-two-case-studies
#19
Sabrina Pickens, Lisa Boss, Hyochol Ahn, Felicia Jefferson
OBJECTIVE: To describe two patient outcomes post-discharge from an acute hospital admission. Both patients underwent cognitive testing during hospitalization. METHODS: A battery of cognitive tests was administered to two hospitalized older adult patients. Both patients were evaluated in their homes within 72 hours of discharge and again at 14- and 30-days by a nurse practitioner. RESULTS: One of the patients was readmitted within 30 days of hospital discharge due to complications from an amputation...
May 25, 2017: Clinical Gerontologist
https://www.readbyqxmd.com/read/28685395/what-families-need-and-physicians-deliver-contrasting-communication-preferences-between-surrogate-decision-makers-and-physicians-during-outcome-prognostication-in-critically-ill-tbi-patients
#20
Thomas Quinn, Jesse Moskowitz, Muhammad W Khan, Lori Shutter, Robert Goldberg, Nananda Col, Kathleen M Mazor, Susanne Muehlschlegel
BACKGROUND: Surrogate decision-makers ("surrogates") and physicians of incapacitated patients have different views of prognosis and how it should be communicated, but this has not been investigated in neurocritically ill patients. We examined surrogates' communication preferences and physicians' practices during the outcome prognostication for critically ill traumatic brain injury (ciTBI) patients in two level-1 trauma centers and seven academic medical centers in the USA. METHODS: We used qualitative content analysis and descriptive statistics of transcribed interviews to identify themes in surrogates (n = 16) and physicians (n = 20)...
July 6, 2017: Neurocritical Care
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