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Physician fatigue

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https://www.readbyqxmd.com/read/28099277/benefits-of-comprehensive-rehabilitation-therapy-in-thymectomy-for-myasthenia-gravis-a-propensity-score-matching-analysis
#1
Vincenzo Ambrogi, Tommaso Claudio Mineo
OBJECTIVE: To demonstrate the effectiveness of a comprehensive program of rehabilitation therapy in patients undergoing thymectomy for myasthenia gravis (MG). DESIGN: From 2005 to 2010, 46 consecutive patients affected by MG underwent a rehabilitation program both before and after thymectomy. We matched each patient with a "control patient" who underwent thymectomy within the period 1999 to 2004 with no preoperative rehabilitation, who had the closest propensity score matching...
February 2017: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/28095796/a-severe-case-of-visceral-leishmaniasis-and-liposomal-amphotericin-b-treatment-failure-in-an-immunosuppressed-patient-15%C3%A2-years-after-exposure
#2
Anna Eichenberger, Annina E Buechi, Andreas Neumayr, Chistroph Hatz, Andri Rauch, Marc Huguenot, Eva Diamantis-Karamitopoulou, Cornelia Staehelin
BACKGROUND: Visceral leishmaniasis (VL) is a protozoan disease, which is responsible for 200.000-400.000 yearly infections worldwide. If left untreated, the fatality rate can be as high as 100% within 2 years. 90% of cases occur in just six countries: India, Bangladesh, Sudan, South Sudan, Ethiopia and Brazil. It is thus a disease rarely seen by physicians in Europe or North America. We report on the fatal case of VL in an 80-year-old immunosuppressed patient who presented with a latency of over 15 years after having visited an endemic region...
January 17, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28095555/megasessions-for-robotic-hair-restoration
#3
Joa O Carlos Pereira, Joa O Carlos Pereira Filho, Joa O Pedro Cabrera Pereira
A robotic system can select and remove individual hair follicles from the donor area with great precision and without fatigue. This report describes the use of the robotic system in a megasession for hair restoration. Patients were instructed to cut their hair to 1.0 to 1.2 mm before surgery. The robot selected and removed 600 to 800 grafts per hour so the follicular units (FU)s could be transplanted manually to recipient sites. The robot arm consists of a sharp inner punch and a blunt outer punch which together separate FUs from the sur- rounding tissue...
November 1, 2016: Journal of Drugs in Dermatology: JDD
https://www.readbyqxmd.com/read/28087054/care-pathway-of-patients-with-metastatic-pancreatic-cancer-in-daily-practice-in-france-results-from-the-repere-national-survey
#4
Pascal Hammel, Romain Coriat, Gérard Lledo, Mariella de Bausset, Marion Selosse, Stéphane Obled, Franck Bonnetain
Data in the literature regarding the care pathway of pancreatic cancer patients are limited. The objective of the REPERE survey was to identify and describe the initial stages of the care pathway of pancreatic patients in the metastatic phase. From May to October 2015, 62 oncologists (ON) or gastroenterologists specialized in digestive oncology (GESDO) and 300 general practitioners (GP) completed an electronic questionnaire on the pathway of 728 patients recently diagnosed with metastatic pancreatic adenocarcinoma...
January 10, 2017: Bulletin du Cancer
https://www.readbyqxmd.com/read/28075425/management-of-fibromyalgia-practical-guides-from-recent-evidence-based-guidelines
#5
Winfried Häuser, Jacob Ablin, Serge Perrot, Mary-Ann Fitzcharles
Fibromyalgia (FM) is a prevalent and costly condition worldwide, affecting approximately 2% of the general population. Recent evidence- and consensus-based guidelines from Canada, Germany, Israel and the European League Against Rheumatism aim to support physicians in achieving a comprehensive diagnostic work-up of patients with chronic widespread pain (CWP) and to assist patients and physicians in shared decision making on treament options. Every patient with CWP requires at the first medical evaluation a complete history, medical examination and some laboratory tests (complete blood count, C-reactive protein, serum calcium, creatine phosphokinase, thyroid stimulating hormone, 25-OH vitamin D) to screen for metabolic or inflammatory causes of CWP...
January 4, 2017: Polskie Archiwum Medycyny Wewnętrznej
https://www.readbyqxmd.com/read/28068212/immunogenicity-and-safety-of-an-adjuvanted-herpes-zoster-subunit-candidate-vaccine-in-adults-%C3%A2-50%C3%A2-years-of-age-with-a-prior-history-of-herpes-zoster-a-phase-iii-non-randomized-open-label-clinical-trial
#6
Olivier Godeaux, Martina Kovac, Daniel Shu, Katrijn Grupping, Laura Campora, Martine Douha, Thomas C Heineman, Himal Lal
This phase III, non-randomized, open-label, multi-center study (NCT01827839) evaluated the immunogenicity and safety of an adjuvanted recombinant subunit herpes zoster (HZ) vaccine (HZ/su) in adults aged ≥50 years with prior physician-documented history of HZ. Participants (stratified by age: 50-59, 60-69 and ≥70 years) received 2 doses of HZ/su 2 months apart and were followed-up for another 12 months. Anti-glycoprotein E (gE) antibodies were measured by enzyme-linked immunosorbent assay before vaccination and 1 month after the second dose (Month 3)...
January 9, 2017: Human Vaccines & Immunotherapeutics
https://www.readbyqxmd.com/read/28063462/going-digital-a-narrative-overview-of-the-clinical-and-organisational-impacts-of-ehealth-technologies-in-hospital-practice
#7
Justin Keasberry, Ian A Scott, Clair Sullivan, Andrew Staib, Richard Ashby
Objective The aim of the present study was to determine the effects of hospital-based eHealth technologies on quality, safety and efficiency of care and clinical outcomes.Methods Systematic reviews and reviews of systematic reviews of eHealth technologies published in PubMed/Medline/Cochrane Library between January 2010 and October 2015 were evaluated. Reviews of implementation issues, non-hospital settings or remote care or patient-focused technologies were excluded from analysis. Methodological quality was assessed using a validated appraisal tool...
January 9, 2017: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/28062342/barriers-to-medical-compassion-as-a-function-of-experience-and-specialization-psychiatry-pediatrics-internal-medicine-surgery-and-general-practice
#8
Antonio T Fernando, Nathan S Consedine
CONTEXT: Compassion is an expectation of patients, regulatory bodies, and physicians themselves. Most research has, however, studied compassion fatigue rather than compassion itself and has concentrated on the role of the physician. The Transactional Model of Physician Compassion suggests that physician, patient, external environment, and clinical factors are all relevant. Because these factors vary both across different specialties and among physicians with differing degrees of experience, barriers to compassion are also likely to vary...
January 3, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28052111/8-way-randomized-controlled-trial-of-doxylamine-pyridoxine-and-dicyclomine-for-nausea-and-vomiting-during-pregnancy-restoration-of-unpublished-information
#9
Rujun Zhang, Navindra Persaud
OBJECTIVES: We report information about an unpublished 1970s study ("8-way" Bendectin Study) that aimed to evaluate the relative therapeutic efficacy of doxylamine, pyridoxine, and dicyclomine in the management of nausea and vomiting during pregnancy. We are publishing the trial's findings according to the restoring invisible and abandoned trials (RIAT) initiative because the trial was never published. DESIGN: Double blinded, multi-centred, randomized placebo-controlled study...
2017: PloS One
https://www.readbyqxmd.com/read/28050004/interstitial-lung-disease-induced-by-pazopanib-treatment
#10
Shotaro Ide, Noriho Sakamoto, Shintaro Hara, Atsuko Hara, Tomoyuki Kakugawa, Yoichi Nakamura, Yoji Futsuki, Koichi Izumikawa, Yuji Ishimatsu, Katsunori Yanagihara, Hiroshi Mukae
Although pneumothorax has been reported to be a major pulmonary adverse event in patients treated with pazopanib, a multikinase inhibitor, drug-induced interstitial lung disease (DILD) has not been reported. A 74-year-old Japanese man who received pazopanib for the treatment of femoral leiomyosarcoma and lung metastasis presented with dyspnea and fatigue. He had mild interstitial pneumonia when pazopanib treatment was initiated. Chest computed tomography revealed progressive bilateral ground-glass opacity (GGO) and traction bronchiectasis...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28045650/reduction-in-alert-fatigue-in-an-assisted-electronic-prescribing-system-through-the-lean-six-sigma-methodology
#11
Mª Jesús Cuéllar Monreal, Jorge Reig Aguado, Isabel Font Noguera, José Luis Poveda Andrés
OBJECTIVE: To reduce the alert fatigue in our Assisted Electronic Prescribing System (AEPS), through the Lean Six Sigma (LSS) methodology. METHOD: An observational (transversal) and retrospective study, in a general hospital with 850 beds and AEPS. The LSS methodology was followed in order to evaluate the alert fatigue situation in the AEPS system, to implement improvements, and to assess outcomes. The alerts generated during two trimesters studied (before and after the intervention) were analyzed...
January 1, 2017: Farmacia Hospitalaria
https://www.readbyqxmd.com/read/28043581/common-features-of-tuberculosis-and-sarcoidosis
#12
Esmaeil Mortaz, Mohammad Reza Masjedi, Atefeh Abedini, Soheila Matroodi, Arda Kiani, Dina Soroush, Ian M Adcock
Tuberculosis (TB) is a disease caused by Mycobacterium tuberculosis. Despite the availability of novel therapeutic approaches, TB is considered as one of the leading causes of death due to infectious diseases worldwide. Alveolar macrophages are the first line of defense against M. tuberculosis; they ingest and sequester the bacilli within granulomatous structures. Control and resolution of the infection requires activated T lymphocytes as well as Th1 cytokines. There are two forms of TB: active TB and latent TB...
December 2016: International Journal of Mycobacteriology
https://www.readbyqxmd.com/read/28027071/covert-hepatic-encephalopathy-can-my-patient-drive
#13
Jawaid Shaw, Jasmohan S Bajaj
Liver cirrhosis is a public health problem and hepatic encephalopathy is one of its main complications, which can be either overt meaning thereby evident and readily diagnosed, or covert/minimal (covert hepatic encephalopathy-CHE) needing psychometric testing for diagnosis. Patients with CHE hepatic encephalopathy have deficits in multiple domains including visuospatial assessment, attention, response inhibition, working memory, along with psychomotor speed to name a few areas. These patients have poor navigational skills, get fatigued easily, and demonstrate poor insight into their driving deficits...
February 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28007118/rapidly-progressive-cataract-formation-associated-with-non-small-cell-lung-cancer-therapy
#14
Erica Liu, Kamden Kopani
: We report 6 patients who developed rapidly progressive hypermature cataracts after starting treatment with rociletinib, a non-small-cell lung cancer therapy with known side effects of hyperglycemia, fatigue, and prolonged QT. Early cataract detection and surgery may prevent complications during future cataract removal. Although rociletinib development has been suspended, there are patients who have been treated and will continue to be treated with this medication based on their physician's judgment...
December 2016: Journal of Cataract and Refractive Surgery
https://www.readbyqxmd.com/read/28002154/the-role-of-25-hydroxyvitamin-d-as-a-predictor-of-clinical-and-radiological-outcomes-in-early-onset-rheumatoid-arthritis
#15
Mario Andrés Quintana-Duque, Jorge Eduardo Caminos, Adriana Varela-Nariño, Enrique Calvo-Paramo, Juan José Yunis, Antonio Iglesias-Gamarra
OBJECTIVE: The aims of this study were to compare the levels of 25-hydroxyvitamin D (25(OH)D) in patients with early-onset rheumatoid arthritis (EORA) versus a healthy control group and to assess the association of 25(OH)D deficiency and the BsmI polymorphism of the vitamin D receptor gene with clinical, radiological, and laboratory parameters. METHODS: Early-onset RA Colombian patients were enrolled in a 3-year follow-up study. Vitamin D deficiency was diagnosed for 25(OH)D levels of less than 20 ng/mL...
January 2017: Journal of Clinical Rheumatology: Practical Reports on Rheumatic & Musculoskeletal Diseases
https://www.readbyqxmd.com/read/28000358/a-feasibility-study-for-a-clinical-decision-support-system-prompting-hiv-testing
#16
D R Chadwick, C Hall, C Rae, Ml Rayment, M Branch, J Littlewood, A Sullivan
OBJECTIVES: Levels of undiagnosed HIV infection and late presentation remain high globally despite attempts to increase testing. The objective of this study was to evaluate a risk-based prototype application to prompt HIV testing when patients undergo routine blood tests. METHODS: Two computer physician order entry (CPOE) systems were modified using the application to prompt health care workers (HCWs) to add an HIV test when other tests selected suggested that the patient was at higher risk of HIV infection...
December 21, 2016: HIV Medicine
https://www.readbyqxmd.com/read/27998026/determinants-of-patient-physician-discordance-in-global-assessment-in-psoriatic-arthritis-a-multicenter-european-study
#17
Carole Desthieux, Benjamin Granger, Andra Rodica Balanescu, Peter Balint, Jürgen Braun, Juan Canete, Turid Heiberg, Philip S Helliwell, Umut Kalyoncu, Tore K Kvien, Uta Kiltz, Dora Niedermayer, Kati Otsa, Rossana Scrivo, Josef Smolen, Tanja A Stamm, Douglas J Veale, Kurt de Vlam, Maarten de Wit, Laure Gossec
OBJECTIVE: Patient-physician discordance in global assessment of disease activity concerned one third of patients but what does it reflect? We aimed to assess patient-physician discordance in psoriatic arthritis (PsA) and patient-reported domains of health (physical and psychological) associated to discordance. METHODS: The PsAID (Psoriatic Arthritis Impact of Disease) cross-sectional multicenter European study of patients with PsA according to expert opinion was analysed...
December 20, 2016: Arthritis Care & Research
https://www.readbyqxmd.com/read/27995044/a-concise-drug-alerting-rule-set-for-chinese-hospitals-and-its-application-in-computerized-physician-order-entry-cpoe
#18
Yinsheng Zhang, Xin Long, Weihong Chen, Haomin Li, Huilong Duan, Qian Shang
BACKGROUND: A minimized and concise drug alerting rule set can be effective in reducing alert fatigue. OBJECTIVES: This study aims to develop and evaluate a concise drug alerting rule set for Chinese hospitals. The rule set covers not only western medicine, but also Chinese patent medicine that is widely used in Chinese hospitals. SETTING: A 2600-bed general hospital in China. METHODS: In order to implement the drug rule set in clinical information settings, an information model for drug rules was designed and a rule authoring tool was developed accordingly...
2016: SpringerPlus
https://www.readbyqxmd.com/read/27989537/delayed-cardiac-tamponade-a-rare-but-life-threatening-complication-of-catheter-ablation
#19
Elizabeth Yetter, Jared Brazg, Diane Del Valle, Laura Mulvey, Eitan Dickman
Delayed cardiac tamponade (DCT) is a rare and life-threatening complication of catheter ablation performed as a treatment of atrial fibrillation, with few cases described in the medical literature. We present the case of a 57year-old man presenting with DCT 61days following a catheter ablation procedure. To the best of our knowledge, this is the most delayed case of cardiac tamponade (CT) following catheter ablation described in the literature. We also discuss the importance of point of care ultrasound (POCUS) in the diagnosis and treatment of CT...
November 17, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27981495/chronic-obstructive-pulmonary-disease-individualized-therapy-tailored-approach-to-symptom-management
#20
REVIEW
Dave Singh, Marc Miravitlles, Claus Vogelmeier
Chronic obstructive pulmonary disease (COPD) is associated with high morbidity and mortality. COPD is typified by persistent, progressive airflow limitation and a range of respiratory and systemic symptoms such as breathlessness, coughing, wheezing, depression, anxiety, general fatigue, and sleeping difficulties. Despite receiving treatment for COPD, many patients suffer from regular symptoms that affect their daily lives and lead to increased morbidity. These symptoms vary in severity, frequency, and type, and can occur at any time throughout the 24-h day, with over half of patients with COPD experiencing symptoms in the morning, during the day, and at nighttime...
December 15, 2016: Advances in Therapy
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