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https://www.readbyqxmd.com/read/29054049/individual-variability-in-clinical-effect-and-tolerability-of-opioid-analgesics-importance-of-drug-interactions-and-pharmacogenetics
#1
REVIEW
Vigdis Solhaug, Espen Molden
BACKGROUND: As pain is often a comorbid condition, many patients use opioid analgesics in combination with several other drugs. This implies a generally increased risk of drug interactions, which along with inherent pharmacogenetic variability and other factors may cause differences in therapeutic response of opioids. AIM: To provide an overview of interactions and pharmacogenetic variability of relevance for individual differences in effect and tolerability of opioid analgesics, which physicians and other healthcare professionals should be aware of in clinical practice...
October 17, 2017: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/29053736/assessment-of-fitness-for-duty-of-underperforming-physicians-the-importance-of-using-appropriate-norms
#2
Betsy White Williams, Philip Flanders, Elizabeth S Grace, Elizabeth Korinek, Dillon Welindt, Michael V Williams
OBJECTIVE: To determine whether population-specific normative data should be employed when screening neurocognitive functioning as part of physician fitness for duty evaluations. If so, to provide such norms based on the evidence currently available. METHODS: A comparison of published data from four sources was analyzed. Data from the two physician samples were then entered into a meta-analysis to obtain full information estimates and generate provisional norms for physicians...
2017: PloS One
https://www.readbyqxmd.com/read/29053379/the-impact-of-cost-conversations-on-the-patient-physician-relationship
#3
Danielle J Brick, Karen A Scherr, Peter A Ubel
Previous research has suggested that fear of harm to the patient-physician relationship is an important barrier to conversations about cost of care. However, few experimental studies have investigated the effects of cost of care conversations on the patient-physician relationship, particularly from the patient's perspective. In the current research, we take an experimental approach to investigate patients' attitudes and preferences for a hypothetical physician who discusses cost versus one who does not. Across three studies, using data from both the general population and cancer patients, we find that people prefer a hypothetical physician who discusses cost over one who does not (Pilot Study, Studies 1 and 2)...
October 20, 2017: Health Communication
https://www.readbyqxmd.com/read/29052748/-heart-valve-disesases-how-sufficient-is-the-knowledge-of-the-german-population
#4
L Gaede, J Blumenstein, C Liebetrau, O Dörr, W-K Kim, C Hamm, A Elsässer, H Nef, H Möllmann
To evaluate the awareness and knowledge of the German population regarding diseases in general, a survey of 1446 people aged 60 years or older was conducted in 14 German towns. The focus was on heart valve diseases with special emphasis on aortic valve stenosis (AS). While cancer was the disease that respondents were most concerned about (25.2%), only 3.3% were concerned about heart valve diseases. In this respect, the knowledge was broadly limited: only 7.4% of participants claimed to have some familiarity with heart valve diseases and only 12...
October 20, 2017: Herz
https://www.readbyqxmd.com/read/29052659/the-predatory-journal-issue-part-ii
#5
Anne Katz
Every morning when I open my email, it is the same: 5-10 emails inviting me to submit my "valuable and esteemed" research to a journal that is new to me and just sounds off. Added to these invitations are a couple of requests to present at conferences in far-flung locations, often accompanied by photographs of "honored" presenters, mostly physicians; none of these publications or conferences are in my field, and they have generic titles and focus on general themes, such as "Global Nursing 2017." Every morning, I go through the same exercise: I flag them as junk and assume they will be blocked...
November 1, 2017: Oncology Nursing Forum
https://www.readbyqxmd.com/read/29052535/large-cell-neuroendocrine-carcinoma-of-the-kidney-with-cardiac-metastasis-a-case-report
#6
Moeka Shimbori, Kimito Osaka, Takashi Kawahara, Ryo Kasahara, Sayuki Kawabata, Kazuhide Makiyama, Keiichi Kondo, Noboru Nakaigawa, Shoji Yamanaka, Masahiro Yao
BACKGROUND: Primary large cell neuroendocrine carcinoma of the kidney is a rare and generally very aggressive disease. We present a case of a patient with primary large cell neuroendocrine carcinoma of the kidney with cardiac metastasis. CASE PRESENTATION: A 59-year-old Japanese man presented to his previous physician with hematuria. Computed tomography revealed masses in the heart and right kidney, and fluorodeoxyglucose-positron emission tomography showed abnormal uptake in the heart...
October 20, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/29052231/audit-of-appropriate-use-of-platelet-transfusions-validation-of-adjudication-criteria
#7
M Etchells, J Spradbrow, R Cohen, Y Lin, C Armali, L Lieberman, C Cserti-Gazdewich, J Pendergrast, J Callum
BACKGROUND AND OBJECTIVES: Platelet (PLT) transfusions must be used appropriately, as they are in chronic short supply, costly and risky to patients. The goals of this audit were to: (1) validate preset adjudication criteria through an audit of appropriateness at four large academic hospitals; (2) identify variability in appropriateness across medical services, physician specialties or hospital locations; and (3) inform logistical or educational interventions that may reduce inappropriate use...
October 19, 2017: Vox Sanguinis
https://www.readbyqxmd.com/read/29051324/corneal-complications-after-orbital-radiotherapy-for-primary-epithelial-malignancies-of-the-lacrimal-gland
#8
Sri K Gore, Nicholas P Plowman, Aruna Dharmasena, David H Verity, Geoffrey E Rose
PURPOSE: To review the long-term corneal complications after high-dose external beam orbital radiotherapy given to patients for lacrimal gland carcinomas. The impact of prophylactic measures to improve long-term ocular surface health is also assessed. DESIGN: Retrospective case series. PARTICIPANTS: Patients under the care of Moorfields Eye Hospital and receiving external beam radiotherapy for primary epithelial lacrimal gland carcinoma between 1975 and 2014...
October 19, 2017: British Journal of Ophthalmology
https://www.readbyqxmd.com/read/29051143/health-care-costs-associated-with-aki
#9
David Collister, Neesh Pannu, Feng Ye, Matthew James, Brenda Hemmelgarn, Betty Chui, Braden Manns, Scott Klarenbach
BACKGROUND AND OBJECTIVES: An understanding of the health care resource use associated with AKI is needed to frame the investment and cost-effectiveness of strategies to prevent AKI and promote kidney recovery. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We assembled population-based cohort of adults hospitalized in Alberta between November of 2002 and March of 2009 without ESRD or an eGFR<15 ml/min per 1.73 m(2). Outpatient serum creatinine measurements 6 months preceding admission defined baseline kidney function, and serum creatinine during the first 14 days of hospitalization defined Acute Kidney Injury Network stage; kidney recovery defined as serum creatinine within 25% of baseline and independence from dialysis was assessed at 90 days after AKI...
October 19, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/29050058/-ambulant-anesthesia-limits-and-possibilities
#10
Harald Hofer, Frank Vescia
The number of operations carried out on an outpatient basis is increasing in Germany. This trend has been observed for years. The prerequisite is an infrastructure that is in line with guidelines. The competence of the anesthetist must not be restricted to that of a standard specialist anesthetist, but the physician should have experience in ambulatory anesthesia. Well-adjusted comorbidities of the patient are generally not a contraindication for an outpatient procedure. The heavily overweight patient can also be operated on an outpatient basis if he is compliant, comorbidities are well adjusted and intensive postoperative care is ensured...
October 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/29050054/indication-criteria-for-total-knee-arthroplasty-in-patients-with-osteoarthritis-a-multi-perspective-consensus-study
#11
Jochen Schmitt, Toni Lange, Klaus-Peter Günther, Christian Kopkow, Elisabeth Rataj, Christian Apfelbacher, Martin Aringer, Eckhardt Böhle, Hartmut Bork, Karsten Dreinhöfer, Niklaus Friederich, Karl-Heinz Frosch, Sascha Gravius, Erika Gromnica-Ihle, Karl-Dieter Heller, Stephan Kirschner, Bernd Kladny, Hendrik Kohlhof, Michael Kremer, Nicolai Leuchten, Maike Lippmann, Jürgen Malzahn, Heiko Meyer, Rainer Sabatowski, Hanns-Peter Scharf, Johannes Stoeve, Richard Wagner, Jörg Lützner
Background and Objectives Knee osteoarthritis (OA) is a significant public health burden. Rates of total knee arthroplasty (TKA) in OA vary substantially between geographical regions, most likely due to the lack of standardised indication criteria. We set out to define indication criteria for the German healthcare system for TKA in patients with knee OA, on the basis of best evidence and transparent multi-stakeholder consensus. Methods We undertook a complex mixed methods study, including an iterative process of systematic appraisal of existing evidence, Delphi consensus methods and stakeholder conferences...
October 2017: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/29049612/long-term-change-in-the-risk-of-skin-cancer-after-organ-transplantation-a-population-based-nationwide-cohort-study
#12
Syed Mohammad Husain Rizvi, Bjarte Aagnes, Hallvard Holdaas, Einar Gude, Kristin Muri Boberg, Øystein Bjørtuft, Per Helsing, Torbjørn Leivestad, Bjørn Møller, Petter Gjersvik
Importance: The high risk of skin cancer after organ transplantation is a major clinical challenge and well documented, but reports on temporal trends in the risk of posttransplant cutaneous squamous cell carcinoma (SCC) are few and appear contradictory. Objective: To study temporal trends for the risk of skin cancer, particularly SCC, after organ transplantation. Design, Setting, and Participants: Population-based, nationwide, prospective cohort study of 8026 patients receiving a kidney, heart, lung, or liver transplant in Norway from 1968 through 2012 using patient data linked to a national cancer registry...
October 18, 2017: JAMA Dermatology
https://www.readbyqxmd.com/read/29049530/risk-of-venous-thromboembolism-among-otolaryngology-patients-vs-general-surgery-and-plastic-surgery-patients
#13
John D Cramer, Amanda E Dilger, Alex Schneider, Stephanie Shintani Smith, Sandeep Samant, Urjeet A Patel
Importance: Venous thromboembolism (VTE), which includes deep venous thrombosis or pulmonary embolism, is the number 1 cause of preventable death in surgical patients. Current guidelines from the American College of Chest Physicians provide VTE prevention recommendations that are specific to individual surgical subspecialties; however, no guidelines exist for otolaryngology. Objective: To examine the rate of VTE for various otolaryngology procedures compared with an established average-risk field (general surgery) and low-risk field (plastic surgery)...
October 19, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/29049425/comparison-of-internal-medicine-and-general-surgery-residents-assessments-of-risk-of-postsurgical-complications-in-surgically-complex-patients
#14
James M Healy, Kimberly A Davis, Kevin Y Pei
Importance: Anticipating postsurgical complications is a vital physician skill, particularly when counseling surgically complex patients on their risks of intervention. Although internists and surgeons both counsel patients on surgical risks, it is uncertain who is better equipped to accurately anticipate surgical complications. Objective: To examine how internal medicine and general surgery trainees compare in their assessment of risk of surgically complex patients...
October 11, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/29049357/associations-of-health-status-with-subsequent-blood-donor-behavior-an-alternative-perspective-on-the-healthy-donor-effect-from-donor-insight
#15
Katja van den Hurk, Saurabh Zalpuri, Femmeke J Prinsze, Eva-Maria Merz, Wim L A M de Kort
INTRODUCTION: In donor health research, the 'Healthy Donor Effect' (HDE) often biases study results and hampers their interpretation. This refers to the fact that donors are a selected 'healthier' subset of a population due to both donor selection procedures and self-selection. Donors with long versus short donor careers, or with high versus low donation intensities are often compared to avoid this HDE, but underlying health differences might also cause these differences in behaviour...
2017: PloS One
https://www.readbyqxmd.com/read/29048753/medication-errors-at-hospital-admission-and-discharge-in-type-1-and-2-diabetes
#16
C Breuker, V Macioce, T Mura, Y Audurier, C Boegner, A Jalabert, M Villiet, A Castet-Nicolas, A Avignon, A Sultan
AIMS: To assess the prevalence and characteristics of medication errors at hospital admission and discharge in people with Type 1 and Type 2 diabetes, and identify potential risk factors for these errors. METHODS: This prospective observational study included all people with Type 1 (n = 163) and Type 2 diabetes (n = 508) admitted to the Diabetology-Department of the University Hospital of Montpellier, France, between 2013 and 2015. Pharmacists conducted medication reconciliation within 24 h of admission and at hospital discharge...
October 19, 2017: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/29048456/an-evaluation-of-attitude-toward-vaccines-among-healthcare-workers-of-a-university-hospital-in-southern-italy
#17
R Squeri, C Genovese, G Trimarchi, M A R Palamara, V La Fauci
BACKGROUND: Vaccination is an effective and safe health technology. Despite this vaccine coverage falls short of national and international targets. Study design. The aim of the study was to evaluate the views of medical staff at Messina University Hospital regarding vaccinations, their current and future vaccination status and whether they recommend it to their patients. METHODS: The study was conducted from April 2016 to March 2017 by an anonymous face-to-face questionnaire submitted to HCWs...
November 2017: Annali di Igiene: Medicina Preventiva e di Comunità
https://www.readbyqxmd.com/read/29045235/the-aqueous-tuber-extract-of-pueraria-tuberosa-willd-d-c-caused-cytotoxic-effect-on-ht-29-cell-lines-with-down-regulation-of-nuclear-factor-kappa-b-nf-%C3%AE%C2%BAb
#18
Adeolu Alex Adedapo, Olusegun A Fagbohun, Christianah Dawurung, Ademola Adetokunbo Oyagbemi, Temidayo Olutayo Omobowale, Momoh Audu Yakubu
Background Pueraria tuberosa (Willd) D.C. (Fabaceae) tubers are already used in traditional medicine by Ayurvedic physicians for the management of fertility disorders, general weakness, and also as anti-ageing therapies. Other known pharmacological properties include: anti-hyperglycemics, hepatoprotective, anti-hyperlipidemic, diuretic, nutritive, and anti-fertility agents in male rats. Methods The anti-proliferative effect of the aqueous tuberous root extract of Pueraria tuberosa on vascular smooth muscle cells (VSMCs) and Human Colorectal Adenocarcinoma Cell lines (HT-29) was investigated using the Cell Titer 96 MTT Proliferation Assay where the viable cells were seeded at a density of 5 × 104 (100 µL/well)...
October 18, 2017: Journal of Complementary & Integrative Medicine
https://www.readbyqxmd.com/read/29042867/the-impact-of-an-educational-intervention-on-parents-decisions-to-vaccinate-their-60-month-old-children-against-influenza
#19
Aery Choi, Dong Ho Kim, Yun Kyung Kim, Byung Wook Eun, Dae Sun Jo
PURPOSE: Seasonal influenza can be prevented by vaccination. Disease prevention in children aged <60 months is of particular importance because of the associated familial and societal burden. Considering that caretakers make the decision to vaccinate their children, the identification of drivers and barriers to vaccination is essential to increase influenza vaccination coverage. METHODS: A total of 639 parents participated in the pre- and posteducational survey and 450 parents participated in the study via telephone interviews...
August 2017: Korean Journal of Pediatrics
https://www.readbyqxmd.com/read/29042808/first-visit-patients-without-a-referral-to-the-department-of-internal-medicine-at-a-medium-sized-acute-care-hospital-in-japan-an-observational-study
#20
Nobuyuki Kajiwara, Kazuyuki Hayashi, Masahiro Misago, Shinichiro Murakami, Takato Ueoka
PURPOSE: We sought to profile first-time patients without a referral who sought medical care at the Department of Internal Medicine at a medium-sized acute care hospital in Japan. We anticipated that the analysis would highlight the demand for medical care needs from acute care hospitals and help confirm one of the problems associated with primary care in Japan. PATIENTS AND METHODS: The study population comprised 765 patients who sought outpatient consultation without a referral at "the Department of General Internal Medicine" at the Ikeda City Hospital on Fridays over 4 years...
2017: International Journal of General Medicine
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