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https://www.readbyqxmd.com/read/28646467/symptom-management-challenges-in-heart-failure-pharmacotherapy-considerations
#1
REVIEW
Diana Stewart, Mary Lynn McPherson
Heart failure is a chronic, progressive illness that is increasing in prevalence in the USA. Patients with advanced heart failure experience a high symptom burden that is comparable to patients with advanced cancer. Palliative care, however, is underutilized in patients with heart failure, and symptoms may go untreated as the disease progresses. A combination of pharmacologic and non-pharmacologic interventions should be used to address symptoms and maintain quality of life. While there have been significant advances in evidence-based heart failure treatments in recent years, selection of appropriate palliative medications as symptoms progress is challenging due to limited clinical studies in this patient population...
June 24, 2017: Heart Failure Reviews
https://www.readbyqxmd.com/read/28646217/why-do-physicians-lack-engagement-with-smoking-cessation-treatment-in-their-copd-patients-a-multinational-qualitative-study
#2
Eva Anne Marije van Eerd, Mette Bech Risør, Mark Spigt, Maciek Godycki-Cwirko, Elena Andreeva, Nick Francis, Anja Wollny, Hasse Melbye, Onno van Schayck, Daniel Kotz
Smoking cessation is the only effective intervention to slow down the accelerated decline in lung function in smokers with chronic obstructive pulmonary disease. Nevertheless, physicians often do not routinely provide evidence-based smoking cessation treatment to their patients. To understand underlying reasons, we explored how physicians engage in smoking cessation treatment in their chronic obstructive pulmonary disease patients. In total, 21 focus group discussions were held with general practitioners and pulmonologists in seven different countries in Europe and Asia...
June 23, 2017: NPJ Primary Care Respiratory Medicine
https://www.readbyqxmd.com/read/28646002/preparation-for-transition-to-adult-care-among-medicaid-insured-adolescents
#3
Gregory S Sawicki, Katharine C Garvey, Sara L Toomey, Kathryn A Williams, J Lee Hargraves, Thomas James, Jean L Raphael, Angelo P Giardino, Mark A Schuster, Jonathan A Finkelstein
BACKGROUND: Parents of children with chronic illness consistently report suboptimal preparation for transition from pediatric- to adult-focused health care. Little data are available on transition preparation for low-income youth in particular. METHODS: We conducted a mailed survey of youth with chronic illness enrolled in 2 large Medicaid health plans to determine the quality of transition preparation using the Adolescent Assessment of Preparation for Transition (ADAPT)...
June 23, 2017: Pediatrics
https://www.readbyqxmd.com/read/28645736/liver-transplantation-in-the-most-severely-ill-cirrhotic-patients-a-multicenter-study-in-acute-on-chronic-liver-failure-grade-3
#4
Florent Artru, Alexandre Louvet, Isaac Ruiz, Eric Levesque, Julien Labreuche, Jose Ursic-Bedoya, Guillaume Lassailly, Sebastien Dharancy, Emmanuel Boleslawski, Gilles Lebuffe, Eric Kipnis, Philippe Ichai, Audrey Coilly, Eleonora De Martin, Teresa Maria Antonini, Eric Vibert, Samir Jaber, Astrid Herrerro, Didier Samuel, Alain Duhamel, Georges-Philippe Pageaux, Philippe Mathurin, Faouzi Saliba
BACKGROUND & AIMS: Liver transplantation (LT) for the most severely ill patients with cirrhosis with dysfunction of several organs (accurately assessed by the acute-on-chronic liver failure (ACLF) classification) remains controversial. We aimed to report the results of LT in patients with ACL3 and to compare these patients to non-transplanted patients with cirrhosis and multiple organ dysfunction and to patients transplanted with lower ACLF grade. -Methods: All patients with ACLF3 transplanted in 3 liver ICU were retrospectively included...
June 20, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/28645552/mortality-following-augmentation-cystoplasty-a-transitional-urologist-s-viewpoint
#5
REVIEW
D A Husmann
INTRODUCTION: Three complications have been hypothesized to increase patient mortality following enterocystoplasty: spontaneous bladder perforation, bladder neoplasia, and chronic renal failure (CRF). The present study examined risk of their occurrence and discussed ways to improve the quality of care. MATERIALS AND METHODS: The present transitional clinic followed 385 patients with a history of bladder augmentation using either ileal, sigmoid, or ascending colon...
June 3, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28645227/diabetic-and-obese-patient-clinical-outcomes-improve-during-a-care-management-implementation-in-primary-care
#6
Jodi Summers Holtrop, Zhehui Luo, Gretchen Piatt, Lee A Green, Qiaoling Chen, John Piette
BACKGROUND: To address the increasing burden of chronic disease, many primary care practices are turning to care management and the hiring of care managers to help patients coordinate their care and self-manage their conditions. Care management is often, but not always, proving effective at improving patient outcomes, but more evidence is needed. METHODS: In this pair-matched cluster randomized trial, 5 practices implemented care management and were compared with 5 comparison practices within the same practice organization...
June 1, 2017: Journal of Primary Care & Community Health
https://www.readbyqxmd.com/read/28644822/the-effect-of-a-lay-led-group-based-self-management-program-for-patients-with-chronic-pain-a-randomized-controlled-trial-of-the-danish-version-of-the-chronic-pain-self-management-programme
#7
Mimi Mehlsen, Lea Hegaard, Eva Ørnbøl, Jens Søndergaard Jensen, Per Fink, Lisbeth Frostholm
The Stanford Chronic Pain Self-Management Programme (CPSMP) consists of six 2½-hour weekly workshops focusing on how to manage pain in daily life. The workshops are facilitated by two workshop leaders of whom at least one must suffer from a long-term pain condition. The program is highly structured and manualized. Only few controlled trials testing the effect of CPSMP exist.Enrolled in the study were 424 adults from 19 Danish municipalities, (72% women; age: 25-93 years) with pain of any etiology and great variation in pain history (0-50 yrs)...
June 22, 2017: Pain
https://www.readbyqxmd.com/read/28644350/lack-of-knowledge-and-low-readiness-for-health-care-transition-in-eosinophilic-esophagitis-and-eosinophilic-gastroenteritis
#8
Swathi Eluri, Wendy M Book, Ellyn Kodroff, Mary Jo Strobel, Jessica H Gebhart, Patricia D Jones, Paul Menard-Katcher, Maria E Ferris, Evan S Dellon
OBJECTIVES: A growing population of adolescents/young adults with eosinophilic esophagitis (EoE) and eosinophilic gastroenteritis (EGE) will need to transition from pediatric to adult health providers. Measuring health care transition (HCT) readiness is critical, but no studies have evaluated this process in EoE/EGE. We determined the scope and predictors of HCT knowledge in patients and parents with EoE/EGE and measured HCT readiness in adolescents/young adults. METHODS: We conducted an online survey of patients 13 years or older and parents of patients with EoE/EGE who were diagnosed when 25 years or younger...
July 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28643820/does-wealth-make-health-cherchez-la-renal-replacement-therapy
#9
COMMENT
Maria D Sanchez-Niño, Alberto Ortiz
In this issue of CKJ, McQuarrie et al. have explored the relationship between socioeconomic status and outcomes among Scottish patients with a renal biopsy diagnosis of primary glomerulonephritis. Patients in the lower socioeconomic category had a twofold higher risk of death. No significant differences were observed on progression to end-stage renal disease (ESRD) requiring renal replacement therapy (RRT), suggesting that overall medical management was appropriate for all socioeconomic categories. The findings are significant since they come from an ethnically homogeneous population with free access to healthcare; they also relate to a specific aetiology of chronic kidney disease (CKD) expected to be less dependent on unhealthy lifestyles than other more frequent aetiologies that dominate studies of CKD in general, such as diabetic or hypertensive nephropathy...
February 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/28643551/provider-advice-about-weight-loss-in-a-primary-care-sample-of-obese-and-overweight-patients
#10
Chanita Hughes Halbert, Melanie Jefferson, Cathy L Melvin, LaShanta Rice, Kemi M Chukwuka
OBJECTIVE: Primary care providers play an important role in obesity prevention and reduction by advising patients about weight loss strategies. This study examined receipt of provider advice to lose weight among primary care patients who were overweight and obese. METHODS: Observational study conducted among primary care patients (n = 282) who completed a survey that measured receipt of provider advice about weight loss/management, chronic health conditions, perceived weight status, and perceptions about shared decision making about weight loss/management...
June 1, 2017: Journal of Primary Care & Community Health
https://www.readbyqxmd.com/read/28643273/chronic-constipation-in-rome-iv-era-the-indian-perspective
#11
REVIEW
Uday C Ghoshal
Chronic constipation (CC) is a common problem in the community and in gastroenterology practice all over the world including India. After release of Rome IV guidelines in April 2016, there is increasing interest among gastroenterologists and physicians in India to look into special issues on CC in the Indian perspective. There are important differences in the bowel habit, definition, epidemiology, and pathophysiology including dietary factors and management of CC in India as compared to the West. As severity and frequency of abdominal pain, a symptom essential to diagnose constipation-predominant irritable bowel syndrome (IBS-C) rather than functional constipation (FC), is less common among Indian patients, FC is commoner than IBS-C in India...
June 23, 2017: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
https://www.readbyqxmd.com/read/28642866/evaluation-of-serum-for-pathophysiological-effects-of-prolonged-low-salinity-water-exposure-in-displaced-bottlenose-dolphins-tursiops-truncatus
#12
Ruth Y Ewing, Blair Mase-Guthrie, Wayne McFee, Forrest Townsend, Charles A Manire, Michael Walsh, Rose Borkowski, Gregory D Bossart, Adam M Schaefer
We conducted a retrospective study of serum biochemistry and hematologic findings from displaced, out-of-habitat bottlenose dolphins (Tursiops truncatus) exposed to various low salinity environments in waters along the southern United States including southeastern Atlantic and northern Gulf of Mexico. Serum sodium, chloride, and calculated osmolality were significantly lower and below reference ranges in displaced animals compared to free-ranging case control animals. This suggests clinical hyponatremia, hypochloremia, and hypo-osmolality due to an uptake of low saline water from the environment...
2017: Frontiers in Veterinary Science
https://www.readbyqxmd.com/read/28641445/subcutaneous-botulinum-toxin-injection-for-post-thoracotomy-pain-syndrome-in-palliative-care-a-case-report
#13
Saima Rashid, Amanda R Fields, Steven J Baumrucker
Post-thoracotomy pain syndrome (PTPS) is a traumatic neuropathy that can affect as many as 50% of patients undergoing thoracotomy. Patients are often refractory to conservative management and may require multiple analgesics for adequate pain control. Botulinum toxin, derived from Clostridium botulinum, has many uses in treating conditions involving spasticity, dystonia, chronic migraine, and a variety of pain disorders including neuropathies. Botulinum toxin type A injections may provide an alternative or adjunct to improve symptom management in patients with PTPS...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28641166/care-coordination-at-a-pediatric-accountable-care-organization-aco-a-qualitative-analysis
#14
Baria Hafeez, Sophia Miller, Anup D Patel, Zachary M Grinspan
OBJECTIVE: Care coordinators may help manage care for children with chronic illness. Their role in pediatric epilepsy care is understudied. We aimed to qualitatively describe the content of a care coordination intervention for children with epilepsy. METHODS: We conducted nine semi-structured interviews and one focus group with care coordinators at a pediatric accountable care organization (ACO) in Ohio. The care coordinators used a modified version of a published care coordination checklist for children with epilepsy (Patel AD, 2014)...
June 19, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28640698/pediatric-gliomas-current-concepts-on-diagnosis-biology-and-clinical-management
#15
Dominik Sturm, Stefan M Pfister, David T W Jones
Gliomas are the most common CNS tumors in children and adolescents, and they show an extremely broad range of clinical behavior. The majority of pediatric gliomas present as benign, slow-growing lesions classified as grade I or II by the WHO classification of CNS tumors. These pediatric low-grade gliomas (LGGs) are fundamentally different from IDH-mutant LGGs occurring in adults, because they rarely undergo malignant transformation and show excellent overall survival under current treatment strategies. However, a significant fraction of gliomas develop over a short period of time and progress rapidly and are therefore classified as WHO grade III or IV high-grade gliomas (HGGs)...
June 22, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28640065/effectiveness-of-an-integrated-approach-to-hiv-and-hypertension-care-in-rural-south-africa-controlled-interrupted-time-series-analysis
#16
Soter Ameh, Kerstin Klipstein-Grobusch, Eustasius Musenge, Kathleen Kahn, Stephen Tollman, Francesc Xavier Gómez-Olivé
BACKGROUND: South Africa faces a dual burden of HIV/AIDS and non-communicable diseases. In 2011, a pilot Integrated Chronic Disease Management (ICDM) model was introduced by the National Health Department into selected primary health care (PHC) facilities. The objective of this study was to assess the effectiveness of the ICDM model in controlling patients' CD4 counts (>350 cells/mm) and blood pressure [BP (<140/90 mm Hg)] in PHC facilities in the Bushbuckridge municipality, South Africa...
May 16, 2017: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/28636296/-follow-up-of-the-long-term-cancer-survivor
#17
Francesco Sciotto, Céline Py, Petros Tsantoulis
Improvements in diagnosis and treatments explain the notable increase in patients chronically affected or recovering from cancer. This is a fragile population, who is physically, psychologically and socially affected by the consequences of the disease and the associated treatments. In addition to detecting a possible relapse, oncologists and primary care physicians have to deal with a variety of issues like psychological distress, sexual dysfunction, cardiotoxicity, cognitive impairment, fatigue and, in some cases, a second primary cancer...
May 17, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28635440/adding-an-accredited-exercise-physiologist-role-to-a-new-model-of-care-at-a-secure-extended-care-mental-health-service-a-qualitative-study
#18
Trentham Furness, Jude Hewavasam, Jakqui Barnfield, Brian McKenna, Corey Joseph
BACKGROUND: Accredited exercise physiologists (AEPs) are emerging as essential members of allied health in the management of non-communicable chronic diseases. People diagnosed with severe mental illness (SMI) are at greater risk of cardiovascular diseases. Secure extended care units (SECUs) provide treatment, supervision and support for people with SMI whose needs cannot be met adequately in the community. However, the role of AEPs in SECUs has not been described. AIM: Describe the processes and outcomes of adding an AEP to a new model of care at a SECU...
March 1, 2017: Journal of Mental Health
https://www.readbyqxmd.com/read/28635188/the-financial-and-quality-of-life-cost-to-patients-living-with-a-chronic-wound-in-the-community
#19
Suzanne Kapp, Nick Santamaria
Chronic wounds are associated with financial and personal costs. The system level expense associated with chronic wounds has been established, however, the out-of-pocket cost incurred by individuals who self-fund has not been the focus of extensive investigation. Recently, there has been renewed interest in evaluating quality of life, in line with the shift to patient enablement and self-care in chronic disease management. The objectives of this research were to describe the out-of-pocket wound treatment costs and the quality of life of people who have chronic wounds...
June 20, 2017: International Wound Journal
https://www.readbyqxmd.com/read/28635159/nutrition-in-renal-supportive-care-patient-driven-and-flexible
#20
REVIEW
Jessica Stevenson, Anthony Meade, Ann-Maree Randall, Karen Manley, Stephanie Notaras, Susan Heaney, Maria Chan, Alison Smyth, Elizabeth Josland, Frank Brennan, Mark A Brown
Renal Supportive Care is an alternative treatment pathway in advanced Chronic Kidney Disease (CKD) that is being increasingly adopted, particularly in the elderly. RSC utilises principles of palliative care and has been developed to enhance the care for dialysis patients with a high symptom burden and those being managed on a non-dialysis pathway. Nutrition management is often an under-recognised component of care, and can play an important role in improving patients' quality of life to reduce symptom burden, support physical function and independence and provide appropriate counselling to patients and their families to ensure the goals of RSC are met...
June 20, 2017: Nephrology
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