Read by QxMD icon Read

Medical care avoidance

Fauzia A Khan, Alan F Merry
The safety of anesthesia characteristic of high-income countries today is not matched in low-resource settings with poor infrastructure, shortages of anesthesia providers, essential drugs, equipment, and supplies. Health care is delivered through complex systems. Achieving sustainable widespread improvement globally will require an understanding of how to influence such systems. Health outcomes depend not only on a country's income, but also on how resources are allocated, and both vary substantially, between and within countries...
April 2018: Anesthesia and Analgesia
Celia B Fisher, Adam L Fried, Kathryn Macapagal, Brian Mustanski
Adolescent males who have sex with males (AMSM) are at increased risk of contracting HIV/AIDS and other sexually transmitted infections (STIs). Healthcare providers are a critical source of HIV/STI prevention, yet little is known about AMSM patient-provider sexual health communications and services. To explore this issue, we surveyed a national sample of 198 AMSM 14-17 years. Four online psychometrically validated scales indicated over half the youth avoided communicating their sexual orientation and sexual health concerns to providers due to fear of heterosexist bias, concern their sexual health information would be disclosed to parents, and a general belief that sexual minority youth do not receive equitable treatment in health care settings...
March 15, 2018: AIDS and Behavior
Justin S Merkow, Erik J Nelson
BACKGROUND Providing anesthesia to immunocompromised patients introduces unique challenges, including difficulty in detecting respiratory infections. Detailed preoperative evaluation and preparation for perioperative complications is crucial. Human metapneumovirus is a common but lesser known respiratory virus that can lead to pneumonia and respiratory compromise and is challenging to detect in the immunocompromised patient. CASE REPORT We present a case of an immunocompromised individual scheduled for umbilical hernia repair who developed severe bronchospasm and intraoperative respiratory failure after induction of general anesthesia...
March 16, 2018: American Journal of Case Reports
Noemia Teixeira de Siqueira-Filha, Maria de Fatima Militao de Albuquerque, Laura Cunha Rodrigues, Rosa Legood, Andreia Costa Santos
OBJECTIVE: The objective of this study was to measure the costs of people living with HIV (PLHIV) as well as active tuberculosis (TB/HIV), latent tuberculosis infection (LTBI/HIV) or without TB (HIV/AIDS). METHODS: We analysed the costs through the entire pathway of care during the prediagnosis and treatment periods from the Brazilian public health system perspective. We applied a combination of bottom-up and top-down approaches to capture and estimate direct medical and non-medical costs...
March 15, 2018: Sexually Transmitted Infections
Gladstone C McDowell, Joseph Winchell
OBJECTIVES: The majority of patients seeking medical care for chronic pain consult a primary care physician (PCP). Because systemic opioids are commonly prescribed to patients with chronic pain, PCPs are attempting to balance the competing priorities of providing adequate pain relief while reducing risks for opioid misuse and overdose. It is important for PCPs to be aware of pain management strategies other than systemic opioid dose escalation when patients with chronic pain fail to respond to conservative therapies and to initiate a multimodal treatment plan...
March 15, 2018: Postgraduate Medicine
Sara Johnsdotter
Purpose of Review: The purpose of this review was to explore current research on the impact of migration on issues related to female genital cutting and sexuality. Recent Findings: There is growing evidence that migration results in a broad opposition to female genital cutting among concerned migrant groups in western countries. In addition, after migration, affected women live in the midst of a dominant discourse categorizing them as "mutilated" and sexually disfigured...
2018: Current Sexual Health Reports
Sameer Shaikh, Mohammad Aljanakh, Ibrahim Khalil Al Ibrahim, Mohammad Sohail Memon
Numerous substances may have an adverse influence on the oral region by virtue of their potentially harmful effects. Dental practitioners are often the first to see these effects in the head and neck region. Knowledge of the damaging consequences of agents such as alcohol, tobacco, areca nut, medications, alcohol-containing mouthwashes, dental devices and materials can assist the practitioners in clinical decision-making and accurate diagnosis of associated lesions. More importantly, timely diagnosis and prompt reporting of such harmful effects improve the quality of care...
March 2018: JPMA. the Journal of the Pakistan Medical Association
Amber Hoffman, Ingrid A Larson
It can be difficult to assist children with medical complexities (CMC) in maintaining wellness outside of hospital and emergency department settings. This growing population, with high use of medical technology and specialty care, has created a challenge for community providers who may infrequently care for children with these rare disorders and needs. CMCs have increased hospitalization rates and emergency care use. It is not realistic to believe that emergency health providers will know how to manage every type of CMC when they present for emergency care...
March 1, 2018: Pediatric Annals
Ahmed Hassan Al-Ghamdi, Abdelhameed Ahmed Fureeh
BACKGROUND: The objectives were to describe the frequency of clinical presentation at the onset of type 1 diabetes mellitus (T1DM) and to estimate the prevalence of T1DM among children and adolescents in the AL-Baha region, Saudi Arabia, aiming for early diagnosis of T1DM. METHODS: The clinical and laboratory data of 471 children and adolescents who presented with T1DM and received medical care at an AL-Baha diabetic center during the period from 2007 to 2016 were retrospectively analyzed based on the records...
March 28, 2018: Journal of Pediatric Endocrinology & Metabolism: JPEM
Toye Gabriel Olajide, Kayode Shuaib Aremu, Olaide T Esan, Adepeju Oluwatona Dosunmu, Mustapha Muhammad Raji
Background: Self-medication is a common habit in our country; Nigeria, especially among patients with otorhinolaryngological disorders. Medication when taken wrongly may bring dire consequences to the individual, such as masking developing diseases and may cause many other undesirable effects. The aim of this study was to determine the prevalence and to analyze topical ear drop self-medication practices among respondents attending the Ear, Nose, and Throat Clinic of Federal Teaching Hospital Ido Ekiti, Nigeria...
April 2018: Annals of African Medicine
Nancy Byatt, Lucille Cox, Tiffany A Moore Simas, Nisha Kini, Kathleen Biebel, Padma Sankaran, Holly A Swartz, Linda Weinreb
To elucidate (1) the challenges associated with under-recognition of bipolar disorder in obstetric settings, (2) barriers pregnant and postpartum women with bipolar disorder face when trying to access psychiatric care, and (3) how obstetric settings can identify such women and connect them with mental health services. Structured, in-depth interviews were conducted with 25 pregnant and postpartum women recruited from obstetric practices who scored ≥ 10 on the Edinburgh Postnatal Depression Scale and met DSM-IV criteria for bipolar disorder I, II, or not otherwise specified using the Mini International Neuropsychiatric Interview...
March 13, 2018: Archives of Women's Mental Health
Ellen M McCreedy, Robert L Kane, Sarah E Gollust, Nathan D Shippee, Kirby D Clark
BACKGROUND: Clinicians strive to deliver individualized, patient-centered care. However, these intentions are understudied. This research explores how patient characteristics associated with an high risk-to-benefit ratio with hypoglycemia medications affect decision making by primary care clinicians. METHODS: Using a vignette-based survey, we queried primary care clinicians on their intended management of geriatric patients with diabetes. The patients' ages, disease durations, and comorbidities were systematically varied...
March 2018: Journal of the American Board of Family Medicine: JABFM
John W Wax, Amy W An, Nicole Kosier, Timothy E Quill
Voluntary stopping of eating and drinking (VSED) is a deliberate, self-initiated attempt to hasten death in the setting of suffering refractory to optimal palliative interventions or prolonged dying that a person finds intolerable. Individuals who consider VSED tend to be older, have a serious but not always imminently terminal illness, place a high value on independence, and have significant illness burden. VSED can theoretically be performed independent of clinician assistance and therefore avoids many of the ethical and legal concerns associated with physician-assisted dying or other palliative measures of last resort, However, VSED is an intense process fraught with new sources of somatic and emotional suffering for individuals and their caregivers, so VSED is best supervised by an experienced, well-informed clinician who can provide appropriate pre-intervention assessment, anticipatory guidance, medical treatment of symptoms, and emotional support...
March 2018: Journal of the American Geriatrics Society
Venkataramana Kandi, Parimala Reddy Basireddy
Introduction Medical education involves training necessary to become a physician or a surgeon. This includes various levels of training like undergraduate, internship, and postgraduate training. Medical education can be quite complex, since it involves training in pre-clinical subjects (anatomy, physiology, biochemistry), the para-clinical subjects (microbiology, pathology, pharmacology, and forensic medicine), and a discrete group of clinical subjects that include general medicine, surgery, obstetrics and gynaecology, ear, nose and throat specialization, paediatrics, cardiology, pulmonology, dermatology, ophthalmology, and orthopaedics, and many other clinical specializations and super specialities (cardio-thoracic surgery, neurosurgery, etc...
January 5, 2018: Curēus
Cynthia Cheng, Fatima Mithoowani, Thomas Ungar, Monica Lee
Background: Interaction between alcohol and certain medications can lead to adverse consequences. Individuals with mental health disorders are particularly vulnerable because of their psychotropic medications, which are typically taken over extended periods and which are known to have pharmacokinetic and pharmacodynamic interactions with alcohol. It is unknown what education these patients receive from their health care providers and how such interactions are managed. Objectives: To determine whether individuals with mental health disorders are aware of alcohol-drug interactions and if so, how they use such information...
January 2018: Canadian Journal of Hospital Pharmacy
Clare Liddy, Isabella Moroz, Amir Afkham, Erin Keely
PURPOSE: Excessive wait times for specialist appointments pose a serious barrier to patient care. To improve access to specialist care and reduce wait times, we launched the Champlain BASE (Building Access to Specialists through eConsultation) eConsult service in April 2011. The objective of this study is to report on the impact of our multiple specialty eConsult service during the first 5 years of use after implementation, with a focus on growth and sustainability. METHODS: We conducted a cross-sectional study of all eConsult cases submitted between April 1, 2011 and April 30, 2016, and measured impact with system utilization data and mandatory close-out surveys completed at the end of each eConsult...
March 2018: Annals of Family Medicine
Isabel Atencio, Max Beushausen, John J Kowalczyk, Andres Flores-Hidalgo, Nora Fitzgerald, Dale A Baur
PURPOSE: Currently, there is a concern at the national level of the overuse of both prescription and nonprescription opioid use. The purpose of this study was to identify whether the use of the intravenous (IV) formulation of acetaminophen (Ofirmev; Mallinckrodt Pharmaceuticals, Staines-upon-Thames, United Kingdom) is an effective tool in the reduction of postoperative pain, with a secondary goal of reduction of postoperative narcotic use. MATERIALS AND METHODS: A total of 72 patients with previously diagnosed either partial bony or complete bony impacted third molars were selected with care to avoid long-acting local anesthetics or dissociative anesthetic agents...
February 20, 2018: Journal of Oral and Maxillofacial Surgery
Matthew P Kelly, Heather A Prentice, Wei Wang, Brian H Fasig, Dhiren S Sheth, Elizabeth W Paxton
BACKGROUND: Previous studies evaluating reasons for 30-day readmissions following total joint arthroplasty (TJA) may underestimate hospital-based utilization of healthcare resources during a patient's episode-of-care. We sought to identify common reasons for 90-day emergency department (ED) visits and hospital readmissions following primary elective unilateral TJA. METHODS: Patients from July 1, 2012 through June 30, 2015 having primary elective TJA and at least one 90-day postoperative ED-only visit and/or readmission for any reason were identified using the Kaiser Permanente Total Joint Replacement Registry...
February 12, 2018: Journal of Arthroplasty
Neil Blumberg, Jill M Cholette, Anthony P Pietropaoli, Richard Phipps, Sherry L Spinelli, Michael P Eaton, Suzie A Noronha, Jerard Seghatchian, Joanna M Heal, Majed A Refaai
Crystalloid infusion is widely employed in patient care for volume replacement and resuscitation. In the United States the crystalloid of choice is often normal saline. Surgeons and anesthesiologists have long preferred buffered solutions such as Ringer's Lactate and Plasma-Lyte A. Normal saline is the solution most widely employed in medical and pediatric care, as well as in hematology and transfusion medicine. However, there is growing concern that normal saline is more toxic than balanced, buffered crystalloids such as Plasma-Lyte and Lactated Ringer's...
February 21, 2018: Transfusion and Apheresis Science
Claire Todd, Sue Woodward
PURPOSE: The purpose of this study was to explore the experience and perceptions of nurses providing bowel care to patients after spinal cord injury. DESIGN: Qualitative study using thematic analysis of semistructured interviews. SUBJECTS AND SETTING: Eleven RNs who provided bowel care to patients following spinal cord injury and were deemed competent to do so by their employer were invited to participate. The study setting was a large, London NHS Trust providing acute hospital care to a population of around 1 million people...
March 2018: Journal of Wound, Ostomy, and Continence Nursing
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"