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Physician fatigue

Matthew T Koroscil, Andrew Skabelund
Introduction: Blastomyces dermatitidis is a dimorphic fungus endemic to the Mississippi River valley. We describe a rare case of chronic pulmonary blastomycosis complicated by large pulmonary cavitation in a young service member who was misdiagnosed with active pulmonary tuberculosis. Case Presentation: A 25-year-old active duty male presented to his primary care provider with complaints of hemoptysis, fatigue, weight loss, and fever. Computed tomography chest with contrast identified a large cavitary lesion in the right upper lobe (RUL)...
March 14, 2018: Military Medicine
Jeanne M Ferrante, Eric K Shaw, Jennifer E Bayly, Jenna Howard, M Nell Quest, Elizabeth C Clark, Connie Pascal
BACKGROUND: Many primary care practices participating in patient-centered medical home (PCMH) transformation initiatives are expanding the work roles of their medical assistants (MAs). Little is known about attitudes of MAs or barriers and facilitators to these role changes. METHODS: Secondary data analysis of qualitative cross-case comparison study of 15 New Jersey primary care practices participating in a PCMH project during 2012 to 2013. Observation field notes and in-depth and key informant interviews (with physicians, office managers, staff and care coordinators) were iteratively analyzed using grounded theory...
March 2018: Journal of the American Board of Family Medicine: JABFM
Christopher R D'Adamo, James S Novick, Termeh M Feinberg, Valerie J Dawson, Larry E Miller
OBJECTIVE: Iron deficiency is the most common nutrient deficiency in the world. While deficiency can often be resolved through dietary supplementation with iron, adverse events are common and frequently preclude compliance. The objective of this study was to determine whether a food-derived dietary supplement containing a low dose of iron and nutrients that increase iron absorption could resolve iron deficiency with fewer adverse events than reported at higher doses. METHODS: A pilot clinical trial (NCT02683369) was conducted among premenopausal women with nonanemic iron deficiency that was verified by blood screening...
March 13, 2018: Journal of the American College of Nutrition
Vinayak Dev, Antonio T Fernando, Anecita Gigi Lim, Nathan S Consedine
BACKGROUND: Burnout has numerous negative consequences for nurses, potentially impairing their ability to deliver compassionate patient care. However, the association between burnout and compassion and, more specifically, barriers to compassion in medicine is unclear. This article evaluates the associations between burnout and barriers to compassion and examines whether dispositional self-compassion might mitigate this association. HYPOTHESIS: Consistent with prior work, the authors expected greater burnout to predict greater barriers to compassion...
February 21, 2018: International Journal of Nursing Studies
Karen Steindorf, Martina E Schmidt, Philipp Zimmer
A growing number of literature reports positive effects of physical activity and exercise. These effects concern prevention, mortality and progress of cancer. Furthermore they show a reduction of disease- and treatment-specific side effects, which implies a better patients' quality of life. Evidence shows a decreased mortality risk in patients with physically active cancer of colon, breast, ovaries and prostate. Activity recommendations for patients with cancer do not differ from those for healthy persons...
March 2018: Deutsche Medizinische Wochenschrift
Huan Chen, Earlesha Butler, Yi Guo, Thomas George, François Modave, Matthew Gurka, Jiang Bian
A qualitative study was conducted to examine physicians' perception on best practice alerts (BPAs) usage under the theoretical framework of technology acceptance model (TAM). In particular, 20 face-to-face in-depth interviews were conducted from September 2016 to February 2017 to collect data. Four themes emerged from the current set of data: support, de-escalation, management, and enhancement are physicians' perceived motivations of using BPAs; interactivity, timing, and interface design are key factors that influence physicians' perceived experiences of using BPAs; alert fatigue and inaccurate alters are major challenges and issues faced by physicians when using BPAs; and, control and team approach are physicians' perceptions on the future improvement of BPAs...
February 27, 2018: Health Communication
David B Bekelman, Larry A Allen, Connor F McBryde, Brack Hattler, Diane L Fairclough, Edward P Havranek, Carolyn Turvey, Paula M Meek
Importance: Many patients with chronic heart failure experience reduced health status despite receiving conventional therapy. Objective: To determine whether a symptom and psychosocial collaborative care intervention improves heart failure-specific health status, depression, and symptom burden in patients with heart failure. Design, Setting, and Participants: A single-blind, 2-arm, multisite randomized clinical trial was conducted at Veterans Affairs, academic, and safety-net health systems in Colorado among outpatients with symptomatic heart failure and reduced health status recruited between August 2012 and April 2015...
February 26, 2018: JAMA Internal Medicine
Michael Chavarria, Larry Lutwick, Bonny L Dickinson
Mycobacterium celatum is a slow-growing, non-tuberculous mycobacterium (NTM) and a rare cause of infection in humans. Infection occurs primarily by inhalation or direct inoculation from environmental sources, and this pathogen has been reported to cause localized infections in the lungs and lymph nodes of both immunocompetent and immunocompromised patients, and disseminated disease in immunocompromised patients. Here, we present a case of pulmonary infection with M. celatum in an immunocompetent 68-year-old male with clinical features similar to tuberculosis...
2018: IDCases
R Furie, L Wang, G Illei, J Drappa
A post-hoc analysis of pooled data from two Phase IIb trials (sifalimumab; NCT01283139, anifrolumab; NCT01438489) assessed the clinical significance of a Systemic Lupus Erythematosus (SLE) Responder Index (SRI(4)) response (Week 52) for 736 patients with moderate to severe SLE disease activity (study entry). SRI(4) responders achieved significantly greater improvements in clinical outcome measures (including percentages of patients with a ≥ 7-point reduction in SLE Disease Activity Index (SLEDAI)-2000 (2K), British Isles Lupus Assessment Group "A" or "2B" flare rate, and oral corticosteroid reduction to ≤7...
January 1, 2018: Lupus
Sang Wan Chung, Jaehyung Hur, You-Jung Ha, Eun Ha Kang, Joon Young Hyon, Hyo-Jung Lee, Yeong Wook Song, Yun Jong Lee
Background/Aims: This study aimed to investigate the inf luence of poor sleep quality on clinical features of primary Sjögren's syndrome (pSS). Methods: Sleep quality was cross-sectionally assessed using the Pittsburgh Sleep Quality Index (PSQI), and demographic, clinical, and laboratory data were collected from 115 Korean patients with pSS. The patients completed questionnaires on the European League Against Rheumatism (EULAR) SS Patient Reported Index (ESSPRI), quality of life (EuroQOL five dimensions questionnaire [EQ-5D]), fatigue (fatigue severity score [FSS]), and depression (Beck Depression Inventory [BDI] II])...
February 20, 2018: Korean Journal of Internal Medicine
Rami Fakih, Mahmoud Rahal, Lara Hilal, Lana Hamieh, Mohammed Dany, Simone Karam, Latifa Shehab, Nagi S El Saghir, Arafat Tfayli, Ziad Salem, Hazem Assi, Sally Temraz, Ali Shamseddine, Deborah Mukherji
Context: Data regarding health-related quality of life in breast cancer patients in the Middle East are limited with fatigue and sleep disturbance being the most distressing symptoms reported by patients treated for early breast cancer. Aims: The aim of this study was to examine the prevalence and incidence of insomnia among patients with early-stage breast cancer patients treated with chemotherapy. Subjects and Methods: This was a prospective cohort study...
January 2018: Indian Journal of Palliative Care
Maja Račić, Aleksandra Virijević, Nedeljka Ivković, Bojan N Joksimović, Vedrana R Joksimović, Biljana Mijovic
AIMS: The aim of this study was to examine self-perceived compassion fatigue and compassion satisfaction among family physicians in Bosnia and Herzegovina and to describe potential contributing factors. MATERIAL AND METHODS: The cross-sectional study enrolled 120 family physicians. Professional Quality of Life Compassion Satisfaction and Fatigue, Version 5 (ProQOL5) was used to assess compassion satisfaction, and two components of compassion fatigue, secondary traumatic stress and burnout...
February 13, 2018: International Journal of Occupational Safety and Ergonomics: JOSE
Paul Crawford, Ethan E Zimmerman
Tremor is an involuntary, rhythmic, oscillatory movement of a body part. It is the most common movement disorder encountered in primary care. The diagnosis of tremor is based on clinical information obtained from the history and physical examination. The most common tremors in patients presenting to primary care physicians are enhanced physiologic tremor, essential tremor, and parkinsonian tremor. All persons have low-amplitude, high-frequency physiologic tremors at rest and during action that are not reported as symptomatic, but can be enhanced by anxiety, medication use, caffeine intake, or fatigue...
February 1, 2018: American Family Physician
Champica K Bodinayake, L Gayani Tillekeratne, Ajith Nagahawatte, Vasantha Devasiri, Wasantha Kodikara Arachchi, John J Strouse, October M Sessions, Ruvini Kurukulasooriya, Anna Uehara, Shiqin Howe, Xin Mei Ong, Sharon Tan, Angelia Chow, Praveen Tummalapalli, Aruna D De Silva, Truls Østbye, Christopher W Woods, Duane J Gubler, Megan E Reller
BACKGROUND: Dengue is a leading cause of fever and mimics other acute febrile illnesses (AFI). In 2009, the World Health Organization (WHO) revised criteria for clinical diagnosis of dengue. METHODOLOGY/PRINCIPAL FINDINGS: The new WHO 2009 classification of dengue divides suspected cases into three categories: dengue without warning signs, dengue with warning signs and severe dengue. We evaluated the WHO 2009 classification vs physicians' subjective clinical diagnosis (gestalt clinical impression) in a large cohort of patients presenting to a tertiary care center in southern Sri Lanka hospitalized with acute febrile illness...
February 9, 2018: PLoS Neglected Tropical Diseases
E H Pieter van Dijkhuizen, Tsipi Egert, Yona Egert, Wendy Costello, Casper Schoemaker, Marlous Fernhout, Mirjam Kepic, Alberto Martini, Silvia Scala, Ingrid Rotstein-Grein, Sebastiaan J Vastert, Nico M Wulffraat
BACKGROUND: To assess the views of juvenile idiopathic arthritis (JIA) patients and their parents on the care and treatment they receive in referral pediatric rheumatology centers throughout Europe. METHODS: In a collaboration between physicians and patient associations, a questionnaire was developed, covering various domains of JIA care, including demographics, diagnosis, referrals to various health care professionals, access to pain and fatigue management and support groups, information they received about the disease and awareness of and participation in research...
February 8, 2018: Pediatric Rheumatology Online Journal
G Oskay-Özcelik, S Alavi, R Richter, M Keller, S C Cecere, G Cormio, F Joly, J E Kurtz, A du Bois, M Maciejewski, M Jedryka, I Vergote, E Van Nieuwenhuysen, A Casado, C Mendiola, P Achimas-Cadariu, C Vlad, D Reimer, A G Zeimet, M Friedlander, J Sehouli
Backround: The primary aim of this study was to investigate information needs and treatment preferences of patients with ovarian cancer, focusing especially on physician-patient relationship and treatment. Patients and methods: A questionnaire was developed based on the experiences of the national German survey Expression II, and was provided to patients with ovarian cancer either at initial diagnosis or with recurrent disease via Internet (online-version) or as print-out-version...
February 5, 2018: Annals of Oncology: Official Journal of the European Society for Medical Oncology
Anirudh Aron, Khawaja Muddassir, Muthiah P Muthiah, Muhammad K Zaman
A 74-year-old white male farmer was admitted from his primary care physician's office after he presented with symptoms of cough productive of clear sputum, malaise, weakness, fatigue, and shortness of breath on exertion for 3 weeks. He was an ex-smoker with a history of hypertension, hyperlipidemia, and coronary artery bypass graft surgery. He did not report any chills, night sweats, or fevers during this presentation.
February 2018: Chest
S Wilk, L Siegl, K Siegl, C Hohenstein
BACKGROUND: In an analysis of a critical incident reporting system (CIRS) in out-of-hospital emergency medicine, it was demonstrated that in 30% of cases deficient communication led to a threat to patients; however, the analysis did not show what exactly the most dangerous work processes are. Current research shows the impact of poor communication on patient safety. OBJECTIVES: An out-of-hospital workflow analysis collects data about key work processes and risk areas...
February 5, 2018: Der Anaesthesist
Felippe O Marcondes, Rebecca A Gourevitch, Robert E Schoen, Seth D Crockett, Michele Morris, Ateev Mehrotra
BACKGROUND: There is concern that mental and physical fatigue among endoscopists over the course of the day will lead to lower adenoma detection rate (ADR). There are mixed findings in the prior literature on whether such an association exists. AIMS: The aim of this study was to measure the association between the number of colonoscopies performed in a day and ADR and withdrawal time. METHODS: We analyzed 86,624 colonoscopy and associated pathology reports between October 2013 and September 2015 from 131 physicians at two medical centers...
February 3, 2018: Digestive Diseases and Sciences
Mark D Kovacs, Maximilian Y Cho, Philip F Burchett, Michael Trambert
With integration of the Radiological Information Systems (RIS), Picture Archiving and Communication systems (PACS), and reporting systems, patient identifiers and examination information can automatically map into examination reports. There are many potential benefits of report automation to radiologists including improvements in efficiency, accuracy, and fatigue. In this article we describe a 2 part study, with the first part being an anonymous survey of radiologists concerning report automation. A total of 13 staff radiologists and 9 radiology residents at a single institution completed an anonymous survey...
January 6, 2018: Current Problems in Diagnostic Radiology
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