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https://www.readbyqxmd.com/read/29768602/comorbidities-potentially-dangerous-and-low-therapeutic-index-medications-factors-linked-to-emergency-visits
#1
Mariana Younes Tramontina, Maria Beatriz Ferreira, Mauro Silveira de Castro, Isabela Heineck
This article aims to investigate the morbidities related to medications, their risk factors and causes detected in patients who seek the Hospital Emergency Service of a University in the South of Brazil. Data collection was based on application of a questionnaire to patients of a minimum age of 18 years, that signing the Term of Free and Informed Consent (TFIC), during the period from October 2013 to March 2014, and analysis of electronic record charts. Cases were evaluated by pharmacists and a doctor to define whether it was a case of medication related morbidity (MRM) and to establish its possible causes...
May 2018: Ciência & Saúde Coletiva
https://www.readbyqxmd.com/read/29765235/fatal-hemoptysis-in-patients-with-advanced-esophageal-cancer-treated-with-apatinib
#2
Wei Wang, Lin Zhang, Yan Xie, Tianchang Zhen, Gongzhang Su, Qi Zang
Targeted therapy is commonly used for treating advanced malignant tumors. Compared with cytotoxic drugs, targeted drugs have the characteristics of good curative results, less adverse effects, and convenient oral administration. Hence, they are especially suitable for patients with cancer who are not able to tolerate chemotherapy. Anti-angiogenic therapy can achieve the objective by inhibiting the formation of new blood vessels in tumors. Apatinib is a novel tyrosine kinase inhibitor targeting the intracellular domain of vascular endothelial growth factor receptor-2...
2018: OncoTargets and Therapy
https://www.readbyqxmd.com/read/29765208/primary-nonadherence-to-chronic-disease-medications-a-meta-analysis
#3
REVIEW
Mark Lemstra, Chijioke Nwankwo, Yelena Bird, John Moraros
Background: Medication nonadherence is a global problem that requires urgent attention. Primary nonadherence occurs when a patient consults with a medical doctor, receives a referral for medical therapy but never fills the first dispensation for the prescription medication. Nonadherence to chronic disease medications costs the USA ~$290 billion (USD) every year in avoidable health care costs. In Canada, it is estimated that 5.4% of all hospitalizations are due to medication nonadherence...
2018: Patient Preference and Adherence
https://www.readbyqxmd.com/read/29760577/perceptions-of-acute-malnutrition-and-its-management-in-infants-under-6-months-of-age-a-qualitative-study-in-rural-bangladesh
#4
Yasir Arafat, M Munirul Islam, Nicki Connell, Golam Mothabbir, Marie McGrath, James A Berkley, Tahmeed Ahmed, Marko Kerac
Background: World Health Organization guidelines advise community-based care (CBC) for "uncomplicated" severe acute malnutrition (SAM) infants <6 months old (u6m), whereas current national protocols refer to inpatient care. Our aim was to inform and shape future management strategies by understanding caregivers' and different stakeholders' perceptions on malnutrition among infants u6m on barriers/facilitators to future CBC. Methods: The methods used in this study are as follows: in-depth interviews and focus group discussions (FGDs) in southern Bangladesh, thematic analysis of transcripts, and sample size by data saturation...
2018: Clinical Medicine Insights. Pediatrics
https://www.readbyqxmd.com/read/29760034/physician-burnout-resilience-training-is-only-part-of-the-solution
#5
Alan J Card
Physicians and physician trainees are among the highest-risk groups for burnout and suicide, and those in primary care are among the hardest hit. Many health systems have turned to resilience training as a solution, but there is an ongoing debate about whether that is the right approach. This article distinguishes between unavoidable occupational suffering (inherent in the physician's role) and avoidable occupational suffering (systems failures that can be prevented). Resilience training may be helpful in addressing unavoidable suffering, but it is the wrong treatment for the organizational pathologies that lead to avoidable suffering- and may even compound the harm doctors experience...
May 2018: Annals of Family Medicine
https://www.readbyqxmd.com/read/29754977/use-of-the-long-term-quality-of-life-assessment-in-the-decision-to-indicate-surgery-in-patients-with-chronic-rhinosinusitis
#6
Pablo Pinillos Marambaia, Manuela Garcia Lima, Hélder Macario, Amaury de Machado Gomes, Leonado Marques Gomes, Melina Pinillos Marambaia, Otávio Marambaia Dos Santos
INTRODUCTION: Quality-of-life questionnaires have been used to support decision-making in patients with chronic rhinosinusitis in the past decade. The choice of treatment in practice, however, also considers the patient's decision. OBJECTIVE: To assess the long-term quality of life of patients with chronic rhinosinusitis who decided to avoid surgery. METHODS: This is a prospective longitudinal study with a group of patients with chronic rhinosinusitis, with and without indication for surgery, with application of the questionnaire SNOT-22 in two periods: between 2011 and 2012 and between June and August 2016, via email...
April 22, 2018: Brazilian Journal of Otorhinolaryngology
https://www.readbyqxmd.com/read/29753557/how-interpreters-influence-patient-participation-in-medical-consultations-the-confluence-of-verbal-and-nonverbal-dimensions-of-interpreter-mediated-clinical-communication
#7
Demi Krystallidou, Peter Pype
OBJECTIVE: To investigate i) how the patient's participation in interaction occurs in interpreter-mediated consultations (IMCs) when the doctor provides information to the patient or tries to elicit information from them; ii) how the interpreter's presence in the consultation influences the patient's participation. METHOD: We analyzed 20 authentic video-recorded IMCs using the A.R.T. framework, an analytical tool for the study of participation in video recorded interpreter-mediated interactions...
May 5, 2018: Patient Education and Counseling
https://www.readbyqxmd.com/read/29742331/youth-with-autism-spectrum-disorder-in-the-emergency-department
#8
Sarah Lytle, Andrew Hunt, Sonal Moratschek, Marcie Hall-Mennes, Martha Sajatovic
OBJECTIVE: This comprehensive literature review summarizes reports on emergency department (ED) use by youth with autism spectrum disorder (ASD). DATA SOURCES: We conducted a systematic search of the PubMed, PsycINFO, CINAHL, and EMBASE databases (1985-2016), limited to studies published in English. The following search terms were used: autism, autistic, Asperger, emergency department/room/physician/doctor/treatment/medicine, childhood developmental disorders (pervasive), and emergencies...
May 8, 2018: Journal of Clinical Psychiatry
https://www.readbyqxmd.com/read/29731402/-how-can-we-explain-the-crimes-of-nazis-doctors-in-auschwitz
#9
Bruno Halioua
The Nazi doctors committed crimes in the camp of Auschwitz which constitute the darkest page in the history of medicine of the twentieth century. They were largely directly involved in the murder of the 1.1 million Jewish majority and about 21,000 gypsies who were transported from all over Europe. How can we explain the intellectual journey of those men who had embraced the medical career to relieve their neighbors? How could these cultivated and refined men, from the most prestigious faculties of medicine, have been able to achieve activities ethically unacceptable? Eight factors help to explain the crimes committed by these educated and cultivated SS doctors: indoctrination fervent to Nazism, adherence to racial hygiene, a false sense of participation in a "public health enterprise", virulent anti-Semitism, unreserved obedience to orders, the opportunity to avoid the danger of fighting areas, the ambition to carry out medical research and the desire to improve surgical knowledge...
May 3, 2018: La Presse Médicale
https://www.readbyqxmd.com/read/29724808/why-charlie-gard-s-parents-should-have-been-the-decision-makers-about-their-son-s-best-interests
#10
Raanan Gillon
This paper argues that Charlie Gard's parents should have been the decision-makers about their son's best interests and that determination of Charlie's best interests depended on a moral decision about which horn of a profound moral dilemma to choose. Charlie's parents chose one horn of that moral dilemma and the courts, like Charlie Gard's doctors, chose the other horn. Contrary to the first UK court's assertion, supported by all the higher courts that considered it, that its judgement was 'objective', this paper argues that the judgement was not and could not be 'objective' in the sense of objectively correct but was instead a value judgement based on the judge's choice of one horn of the moral dilemma...
May 3, 2018: Journal of Medical Ethics
https://www.readbyqxmd.com/read/29720112/emotional-predictors-of-bowel-screening-the-avoidance-promoting-role-of-fear-embarrassment-and-disgust
#11
Lisa M Reynolds, Ian P Bissett, Nathan S Consedine
BACKGROUND: Despite considerable efforts to address practical barriers, colorectal cancer screening numbers are often low. People do not always act rationally, and investigating emotions may offer insight into the avoidance of screening. The current work assessed whether fear, embarrassment, and disgust predicted colorectal cancer screening avoidance. METHODS: A community sample (N = 306) aged 45+ completed a questionnaire assessing colorectal cancer screening history and the extent that perceptions of cancer risk, colorectal cancer knowledge, doctor discussions, and a specifically developed scale, the Emotional Barriers to Bowel Screening (EBBS), were associated with previous screening behaviours and anticipated bowel health decision-making...
May 3, 2018: BMC Cancer
https://www.readbyqxmd.com/read/29716565/flu-vaccination-among-patients-with-diabetes-motives-perceptions-trust-and-risk-culture-a-qualitative-survey
#12
Pierre Verger, Aurélie Bocquier, Chantal Vergélys, Jeremy Ward, Patrick Peretti-Watel
BACKGROUND: Vaccination against seasonal influenza (SIV) is recommended for patients with diabetes, but their vaccination coverage is unsatisfactory in France and elsewhere. This qualitative survey of people with diabetes sought to explore 1) the extent to which SIV-related behaviour is more or less automatic; 2) reasons they choose/reject SIV; 3) their trust/distrust in authorities, science, and medicine. METHODS: We conducted semi-structured in-depth interviews of 19 adults with diabetes in 2014...
May 2, 2018: BMC Public Health
https://www.readbyqxmd.com/read/29678055/fine-tuning-neural-patient-question-retrieval-model-with-generative-adversarial-networks
#13
Guoyu Tang, Yuan Ni, Keqiang Wang, Qin Yong
The online patient question and answering (Q&amp;A) system attracts an increasing amount of users in China. Patient will post their questions and wait for doctors' response. To avoid the lag time involved with the waiting and to reduce the workload on the doctors, a better method is to automatically retrieve the semantically equivalent question from the archive. We present a Generative Adversarial Networks (GAN) based approach to automatically retrieve patient question. We apply supervised deep learning based approaches to determine the similarity between patient questions...
2018: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/29677921/implementation-and-effect-of-a-novel-electronic-medical-record-format-for-patient-allergy-information
#14
Masaharu Nakayama, Ryusuke Inoue
Adverse drug events (ADEs) are critical. Approximately 10% of fatal ADEs are believed to be allergic reactions. Therefore, sharing patient allergy information is beneficial to medical staff members in avoiding potentially lethal complications. We previously performed a nationwide study of patient allergy information in Japanese hospitals. The report showed that most of the responding hospitals needed a standard format for reporting the information. To establish this, we implemented a novel format for recording patient allergy information into the hospital information system at Tohoku University Hospital; this format was created through vigorous discussion among medical staff members with a variety of specialties, including doctors, nurses, pharmacists, nutritionists, and medical safety managers...
2018: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/29674390/consumption-of-sugars-sugary-foods-and-sugary-beverages-in-relation-to-adiposity-related-cancer-risk-in-the-framingham-offspring-cohort-1991-2013
#15
Nour Makarem, Elisa V Bandera, Yong Lin, Paul Jacques, Richard B Hayes, Niyati Parekh
BACKGROUND: Higher sugar consumption may increase cancer risk by promoting insulin-glucose dysregulation, oxidative stress, hormonal imbalances, and excess adiposity. This prospective study investigates the association between dietary sugars(fructose and sucrose) and sugary foods and beverages in relation to combined and site-specific (breast, prostate, colorectal) adiposity-associated cancers. METHODS: The analytic sample consisted of 3,184 adults, aged 26-84y, from the Framingham Offspring cohort...
April 19, 2018: Cancer Prevention Research
https://www.readbyqxmd.com/read/29666797/development-and-implementation-of-a-perianesthetic-safety-checklist-in-a-veterinary-university-small-animal-teaching-hospital
#16
Gwennaëlle Menoud, Shannon Axiak Flammer, Claudia Spadavecchia, Mathieu Raillard
Introduction: The use of a surgical safety checklist is recommended by the World Health Organization and is associated with advantages: improved communication and reduced complications and mortality. Adapting checklists to the environment in which they are used improves their efficiency, but their implementation can be challenging. The aim of this study was to develop and implement a perianesthetic safety checklist for a small animal hospital. Materials and methods: A panel of eight anesthesia diplomates and seven residents and doctoral students were gathered...
2018: Frontiers in Veterinary Science
https://www.readbyqxmd.com/read/29657178/doctor-in-and-for-the-family-physicians-reflect-on-care-for-loved-ones
#17
John C Moskop
This commentary examines themes identified in twelve physicians' narratives recounting their experiences in caring for seriously ill family members. In these narratives, physicians describe heavy emotional burdens and other impediments to sound medical decision-making with and for their loved ones. The physicians struggled to balance their roles as physicians and as loving family members, and they employed their professional role in a variety of different ways. Several physicians became personal physicians to their family members, and others deliberately avoided that role...
2018: Narrative Inquiry in Bioethics
https://www.readbyqxmd.com/read/29605233/-usefulness-and-reliability-of-abdominal-clinical-ultrasound-in-family-medicine-1-liver-biliary-tract-and-pancreas
#18
Ignacio Manuel Sánchez Barrancos, Tomás Vegas Jiménez, Rafael Alonso Roca, Daniel Domínguez Tristancho, Francisco José Guerrero García, María Del Carmen Rico López, Vicente Fernández Rodríguez
Ultrasound is a safe and reliable way to increase diagnosis capabilities, as well as an improving and speed up method for taking decisions for healthcare professionals of every medical specialty. Family doctor, who must be ready to address all kind of health problems for his patients, is the key person to incorporate this tool to his daily activity, acquiring the best managing skill, unknown nowadays, being quite large the clinical situations in the day by day practice, in which he can obtain benefit in a reliable and effective way...
March 28, 2018: Atencion Primaria
https://www.readbyqxmd.com/read/29596513/bad-manners-in-the-emergency-department-incivility-among-doctors
#19
Karsten Klingberg, Khaled Gadelhak, Sabrina N Jegerlehner, Adam D Brown, Aristomenis K Exadaktylos, David S Srivastava
INTRODUCTION: Negative workplace behaviour, especially negative communication is a recognised problem in many organisations and is known to have serious impact on workplace performance, productivity and personal wellbeing. Emergency Departments (ED) can be high stress environments in which communication and perceptions of respect between physicians and other staff may underlie individual functioning. We conducted a study to estimate the influence of incivility (ICV) among physicians in the ED...
2018: PloS One
https://www.readbyqxmd.com/read/29567385/-a-structured-case-analysis-from-the-critical-incident-reporting-system-of-the-german-medical-association-and-the-national-association-of-statutory-health-insurance-physicians
#20
Thomas Schrader, Laura Tetzlaff, Katharina Löwe, Cornelia Schröder, Eberhard Beck
BACKGROUND: Reporting systems for near misses are necessary to improve patient safety. In Germany, different systems are publicly available on both a national and regional level or as systems related to various medical domains. In contrast with the British Registry, our reporting systems still lack systematic evaluation. Using the Open-Task-Process Model (OPT model) one case of CIRSmedical (www.cirsmedical.de) was selected for a systematic analysis. METHOD: Case 148384 reports on a patient with a tentative diagnosis of pulmonary embolism with an oxygen saturation of 71 %...
March 19, 2018: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
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