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Uri Alkan, Yotam Shkedy, Aviram Mizrachi, Thomas Shpitzer, Aron Popovtzer, Gideon Bachar
OBJECTIVE: To determine the risk of inflammation associated with fine-needle aspiration during evaluation of Warthin's tumour. DESIGN: Retrospective case series. SETTING: Tertiary medical center. PARTICIPANTS: All patients who underwent fine-needle aspiration followed by parotidectomy between1992-2009 for the diagnosis/evaluation of a parotid gland tumour. MAIN OUTCOME MEASURE: Rate of fine-needle-aspiration-related parotitis in patients with Warthin's tumour or other parotid pathologies...
February 24, 2017: Clinical Otolaryngology
Chris A Anthony, Andrew J Pugely, Yubo Gao, Robert R Westermann, Christopher T Martin, Brian R Wolf, Annunziato Amendola
We conducted a study of elective hip arthroscopy patients to determine type and incidence of complications and rates of and risk factors for minor and major morbidity. Retrospectively searching the National Surgical Quality Improvement Program database, we identified 1325 patients who underwent elective hip arthroscopy between 2006 and 2013. Univariate and subsequent multivariate analyses were used to identify risk factors for complications. Of the 1325 patients identified, 16 (1.21%) had at least 1 complication, and 6 (0...
January 2017: American Journal of Orthopedics
Peter A Minchella, Geoffrey Chipungu, Andrea A Kim, Abdoulaye Sarr, Hammad Ali, Reuben Mwenda, John N Nkengasong, Daniel Singer
BACKGROUND: Efforts to reach UNAIDS' treatment and viral suppression targets have increased demand for viral load (VL) testing and strained existing laboratory networks, affecting turnaround time. Longer VL turnaround times delay both initiation of formal adherence counseling and switches to second-line therapy for persons failing treatment and contribute to poorer health outcomes. METHODS: We utilized descriptive statistics and logistic regression to analyze VL testing data collected in Malawi between January 2013 and March 2016...
2017: PloS One
Andrew Schumacher, William M Sikov, Matthew I Quesenberry, Howard Safran, Humera Khurshid, Kristen M Mitchell, Adam J Olszewski
BACKGROUND: Informed consent forms (ICFs) for oncology clinical trials have grown increasingly longer and more complex. We evaluated objective understanding of critical components of informed consent among patients enrolling in contemporary trials of conventional or novel biologic/targeted therapies. METHODS: We evaluated ICFs for cancer clinical trials for length and readability, and patients registered on those studies were asked to complete a validated 14-question survey assessing their understanding of key characteristics of the trial...
2017: PloS One
Ellen T Kurtzman, Burt S Barnow
BACKGROUND: Under the Affordable Care Act, the number and capacity of community health centers (HCs) is growing. Although the majority of HC care is provided by primary care physicians (PCMDs), a growing proportion is delivered by nurse practitioners (NPs) and physician assistants (PAs); yet, little is known about how these clinicians' care compares in this setting. OBJECTIVES: To compare the quality of care and practice patterns of NPs, PAs, and PCMDs in HCs. RESEARCH DESIGN: Using 5 years of data (2006-2010) from the HC subsample of the National Ambulatory Medical Care Survey and multivariate regression analysis, we estimated the impact of receiving NP-delivered or PA-delivered care versus PCMD-delivered care...
February 23, 2017: Medical Care
Marc A Bjurlin, Andrew B Rosenkrantz, Samir S Taneja
PURPOSE OF REVIEW: We review recent literature surrounding the use of prebiopsy prostate MRI and MRI-targeted biopsy in men at risk for prostate cancer. RECENT FINDINGS: Large series have strengthened the case for the use of MRI prior to prostate biopsy to maximize the detection of clinically significant disease, reduce the detection of clinically insignificant disease, and allow for tumor localization during targeted biopsy. Prebiopsy MRI followed by targeted biopsy appears to have the ability to overcome the limitations of the standard 12-core template...
February 23, 2017: Current Opinion in Urology
Kimberly M Ramonell, Shuyang Fang, Sebastian D Perez, Jahnavi K Srinivasan, Patrick S Sullivan, John R Galloway, Charles A Staley, Edward Lin, Jyotirmay Sharma, John F Sweeney, Virginia O Shaffer
Postoperative acute renal failure is a major cause of morbidity and mortality in colon and rectal surgery. Our objective was to identify preoperative risk factors that predispose patients to postoperative renal failure and renal insufficiency, and subsequently develop a risk calculator. Using the National Surgical Quality Improvement Program Participant Use Files database, all patients who underwent colorectal surgery in 2009 were selected (n = 21,720). We identified renal complications during the 30-day period after surgery...
December 1, 2016: American Surgeon
(no author information available yet)
In this study, the question of health literacy in adult patient population in the Czech Republic is explored in the context of healthcare, particularly in the South Bohemian Region. The study is based on the analysis of qualitative data which were collected during the first half of 2016. The study included 34 adult participants at the age range between 18 and 64 years. The study is focused on the involvement of adult patients in the process of decision making concerning the healthcare provided. The views of this sort of problems were recorded by the technique of semi-structured dialogues...
December 24, 2016: Neuro Endocrinology Letters
Daya Ram Parajuli, Julie Franzon, Ross A McKinnon, Sepehr Shakib, Robyn A Clark
PURPOSE OF REVIEW: This review highlights the current and emerging approaches for the role of the pharmacist for improving self-care and outcomes in heart failure management. RECENT FINDINGS: Pharmacists are contributing to heart failure management in a variety of settings, including hospitals, clinics, and communities. Different interventions which may be mediated by the pharmacist include drug adherence, discharge counseling, medication reconciliation, telephone follow-up, and recommendation of evidence-based medicines...
February 23, 2017: Current Heart Failure Reports
Amanpreet Sethi, Meena Joshi, Anu Thukral, Jagjit Singh Dalal, Ashok Kumar Deorari
This study is a single center quality improvement (QI) initiative in a tertiary care neonatal intensive care unit which was done with an objective to increase the proportion of neonates receiving mother's own milk (at postnatal age of 7 d) from the current rate of 12.5% to 30% over a period of six weeks. Additional objectives were to evaluate the proportion of mothers' expressing breast milk within 3 h of birth, on day one and three and the amount of expressed breast milk (EBM) on day one and day seven. A team was formulated to evaluate the reasons for inadequate breast milk expression and to plan the steps for promoting the same...
February 24, 2017: Indian Journal of Pediatrics
Naveen F Sangji, Jordan D Bohnen, Elie P Ramly, George C Velmahos, David C Chang, Haytham M A Kaafarani
BACKGROUND: We present a novel and abbreviated Physiological Emergency Surgery Acuity Score (PESAS) that assesses the severity of disease at presentation in patients undergoing Emergency Surgery (ES). METHODS: Using the 2011 ACS-NSQIP database, we identified all patients who underwent "emergent" surgery. The following methodology was designed: (1) identification of independent predictors of 30-day mortality that are markers of acuity; (2) derivation of PESAS based on the relative impact (i...
February 23, 2017: World Journal of Surgery
C N Lang, J Steinfurt, K E Odening
For the past few years, children affected by an inherited channelopathy have been counseled to avoid (recreational) sports activities and all competitive sports so as to prevent exercise-induced arrhythmia and sudden cardiac death. An increased understanding of the pathophysiological mechanisms, better anti-arrhythmic strategies, and, in particular, more epidemiological data on exercise-induced arrhythmia in active athletes with channelopathies have changed the universal recommendation of "no sports," leading to revised, less strict, and more differentiated guidelines (published by the American Heart Association/American College of Cardiology in 2015)...
February 23, 2017: Herz
Pierre Halteh, Richard Scher, Amanda Artis, Shari Lipner
IMPORTANCE: Subungual melanoma (SM) is a rare subtype of cutaneous melanoma but carries a worse prognosis than similarly staged cutaneous melanomas. Assessing patient knowledge of melanonychia is integral to early diagnosis of SM. OBJECTIVES: The aim of this paper is to determine patient knowledge of longitudinal melanonychia (LM) and warning signs for SM, frequency of nail self-examinations, and satisfaction of patients with their physician's nail examinations...
January 2017: Skin Appendage Disorders
Eva Burke, Judy Gold, Lalaina Razafinirinasoa, Anna Mackay
BACKGROUND: Young people often express a preference for seeking family planning information and services from the private sector. However, in many Marie Stopes International (MSI) social franchise networks, the proportion of young clients, and particularly those under 20 years of age, remains low. Marie Stopes Madagascar (MSM) piloted a youth voucher program that joins a supply-side intervention-youth-friendly social franchisee training and quality monitoring-with a corresponding demand-side-component, free vouchers that reduce financial barriers to family planning access for young people...
February 23, 2017: Global Health, Science and Practice
Stephanie L Fitzpatrick, Victor J Stevens
In the U.S., the occurrence of weight counseling in primary care for patients with obesity decreased by 10% between 1995 and 1996 and 2007-2008. There have been several national recommendations and policies to improve obesity management since 2008. The purpose of this study was to examine the rates of body mass index (BMI) screening, obesity diagnosis, and weight management counseling in the U.S. from 2008 to 2013. The National Ambulatory Medical Care Survey visit-level data for adults 18 and over with a primary care visit during survey years 2008-2009, 2010-2011, and 2012-2013 was included in the analyses using SAS v9...
February 20, 2017: Preventive Medicine
Mina Darooei, Subhadra Poornima, Bibi Umae Salma, Gayatri R Iyer, Akhilesh N Pujar, Srirambhatla Annapurna, Ashwin Shah, Srinivas Maddali, Qurratulain Hasan
Global burden of breast cancer is expected to increase to >2 million new cases every year by 2030 and 10% of these are likely to have hereditary breast and ovarian cancer syndrome. Identifying these individuals by pedigree and BRCA1/2 mutation analyses will enable us to offer targeted mutation testing and appropriate counseling. This study from a tertiary care hospital showed that of the 127 breast cancer patients on treatment during 2014-2015, 24 of them fulfilled the criteria of hereditary breast and ovarian cancer syndrome after detailed verbal autopsy and pedigree analysis, and BRCA1 and 2 next-generation sequencing done after pre-test counseling revealed mutations in 13 cases (54%), these included 9 BRCA1 mutations (69%) and 4 BRCA2 mutation (31%)...
February 2017: Tumour Biology: the Journal of the International Society for Oncodevelopmental Biology and Medicine
Chunhua Ma
AIMS AND OBJECTIVES: The study aimed to evaluate the proportion of Chinese patients with hypertension who meet the Chinese Hypertension Management Guideline recommendations for weekly physical activity and to determine possible associated factors that impact meeting the weekly physical activity recommendation. BACKGROUND: Accurate evaluation of physical activity levels for hypertensive patients is important to determine patients' health outcomes and intervention measures...
February 23, 2017: Journal of Clinical Nursing
J Jungbauer, T Krieger, M Floren
This paper presents the pilot project "The Caregivers' Guide", which is financed by the German Federal Ministry of Education and Research (BMBF). The project's concept is outreach-oriented and personal, giving constant support to relatives of stroke patients throughout rehabilitation. Its effects were reviewed in an accompanying study. A combination of qualitative and quantitative methods was chosen to gather data on the experiences and assessments of the caregivers, as well as changes during the counselling process...
February 23, 2017: Die Rehabilitation
Amanda J Abraham, Grace Bagwell-Adams, Jayani Jayawardhana
OBJECTIVE: Given the high prevalence of smoking among substance use disorder (SUD) patients, the specialty SUD treatment system is an important target for adoption and implementation of tobacco cessation (TC) services. While research has addressed the impact of tobacco control on individual tobacco consumption, largely overlooked in the literature is the potential impact of state tobacco control policies on availability of services for tobacco cessation. This paper examines the association between state tobacco control policy and availability of TC services in SUD treatment programs in the United States...
February 9, 2017: Addictive Behaviors
Umang Jain, Jessica Somerville, Sujata Saha, Jon P Ver Halen, Anuja K Antony, Sandeep Samant, John Y Kim
While neck dissection is an important primary and adjunctive procedure in the treatment of head and neck cancer, there is a paucity of studies evaluating outcomes. A retrospective review of the National Surgical Quality Improvement Program (NSQIP) database was performed to identify factors associated with adverse events (AEs) in patients undergoing neck dissection. A total of 619 patients were identified, using CPT codes specific to neck dissection. Of the 619 patients undergoing neck dissection, 142 (22.9%) experienced an AE within 30 days of the surgical procedure...
February 2017: Ear, Nose, & Throat Journal
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