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https://www.readbyqxmd.com/read/29231253/internal-venous-anomalies-in-patients-with-a-genital-venous-malformation
#1
Caitlin M Peterman, Patricia S Todd, Anna P Lillis, Steven J Fishman, Marilyn G Liang
BACKGROUND: Cutaneous venous malformation (VM) can be associated with internal vascular anomalies. Our objective was to investigate the frequency of internal vascular anomalies in patients with an isolated genital venous malformation to assess the utility of screening for internal findings. METHODS: We retrospectively reviewed our Vascular Anomalies Center database for patients with a focal genital venous malformation presenting between 1999 and 2016. Abdominal and pelvic imaging reports were reviewed for internal vascular anomalies...
December 12, 2017: Pediatric Dermatology
https://www.readbyqxmd.com/read/29230475/improving-decisions-about-transport-to-the-emergency-department-for-assisted-living-residents-who-fall
#2
Jefferson G Williams, Michael W Bachman, Michael D Lyons, Benjamin B Currie, Lawrence H Brown, A Wooten Jones, Jose G Cabanas, Alan K Kronhaus, J Brent Myers
Background: Residents of assisted living facilities who fall may not be seriously ill or injured, but policies often require immediate transport to an emergency department regardless of the patient's condition. Objective: To determine whether unnecessary transport can be avoided. Design: Prospective cohort study. Setting: One large county with a single system of emergency medical services. Participants: Convenience sample of residents in 22 assisted living facilities served by 1 group of primary care physicians...
December 12, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/29230302/letrozole-induced-hepatitis-with-autoimmune-features-a-rare-adverse-drug-reaction-with-review-of-the-relevant-literature
#3
Bharatsinh Gharia, Karan Seegobin, Satish Maharaj, Noor Marji, Amie Deutch, Lara Zuberi
While aromatase inhibitors (AIs) have been known to cause minor elevations in liver enzymes, severe hepatotoxicity is rare. To the best of our knowledge, this is the first reported case of Letrozole-induced hepatitis with autoimmune features. A 70-year-old female with estrogen positive, invasive ductal carcinoma of the breast, presented with jaundice 3 months after starting letrozole. Hepatic transaminases were markedly elevated and her ANA and anti-smooth muscle antibody was positive. Liver biopsy featured drug-induced hepatitis...
November 2017: Oxford Medical Case Reports
https://www.readbyqxmd.com/read/29230133/invasive-insular-thyroid-carcinoma-presenting-as-nonparalytic-dysphonia
#4
Blake S Raggio, Blair M Barton, Maria C Grant, Judith A Fornadley, Jeffrey P Marino
Background: Patients with suspected thyroid malignancy often undergo preoperative laryngeal examination with a focus on vocal fold mobility. We present the unique case of a patient with invasive thyroid carcinoma who presented with dysphonia despite intact vocal fold motion. Case Report: A 73-year-old female with a remote thyroid lobectomy presented with dysphonia. Thyroid ultrasound and fine-needle aspiration revealed a 1.1-cm nodule consistent with a colloid cyst...
2017: Ochsner Journal
https://www.readbyqxmd.com/read/29229465/diverse-management-of-isolated-calf-deep-venous-thrombosis-in-a-university-hospital
#5
Raudel Garcia, Kristan Probeck, Doreen M Elitharp, Antonios P Gasparis, Nicos Labropoulos
BACKGROUND: The management of patients with isolated deep venous thrombosis (DVT) is controversial, leading to overtreatment and undertreatment with several complications and increased cost. The aim of this study was to describe the management of isolated calf DVT (ICDVT) in a university hospital. METHODS: Data on patients with acute DVT in our hospital are prospectively entered in a database through our venous thromboembolism team. All patients had an objective diagnosis with duplex ultrasound (DU) in our accredited vascular laboratory...
December 8, 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/29229208/assessment-and-treatment-at-a-pain-clinic-a-one-year-follow-up-of-patients-with-chronic-pain
#6
Andrea Hållstam, Monika Löfgren, Lina Benson, Christer Svensén, Britt-Marie Stålnacke
BACKGROUND AND AIMS: Pain is one of the most common reasons for patients to seek primary health care. Pain relief is likely to be achieved for patients suffering from acute pain, but for individuals with chronic pain it is more likely that the condition will persist. These patients have the option of being referred to specialised pain clinics. However, the complexity surrounding chronic pain patients is not well studied in these settings. This study aimed to describe patients with chronic pain referred to a pain clinic by using the information submitted during their first visit and one year later and also to identify associations between baseline characteristics and improvements in health-related quality of life in the follow-up...
October 2017: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/29226222/learning-processes-and-learning-problems-in-german-postgraduate-medical-education
#7
Hendrik van den Bussche, Lea Krause-Solberg, Martin Scherer, Stine Ziegler
Objective: In order to evaluate the quality of postgraduate medical education in Germany, we examined how the learning of theoretical and practical competencies is conceptualized and how the learning process takes place in real terms. The training conditions, as perceived by medical residents, are compared with the learning objectives, as stated by the Federal Chamber of Physicians in its regulation on postgraduate education. The analysis is based on the data of the "KarMed" study (abbreviation of "career progression and career breaks among physicians during postgraduate education"), a multicentre cohort study of medical school graduates from seven universities who arre followed until they receive their licenses as specialist physicians...
2017: GMS Journal for Medical Education
https://www.readbyqxmd.com/read/29226221/male-and-female-residents-in-postgraduate-medical-education-a-gender-comparative-analysis-of-differences-in-career-perspectives-and-their-conditions-in-germany
#8
Stine Ziegler, Thomas Zimmermann, Lea Krause-Solberg, Martin Scherer, Hendrik van den Bussche
Aim: This article focuses on the gender-specific career differences of residents in their postgraduate medical education in Germany. In particular the structural obstacles female physicians have to overcome during residency are investigated. Moreover, the study examines the position preferences of male and female physicians in the hospital and in how far occupational self-efficacy corresponds to the interest in a hospital leading position. Methods: The KarMed-Study's database consists of annual postal surveys throughout the entire residency of medical students, who were in their "Practical Year" in 2008/2009...
2017: GMS Journal for Medical Education
https://www.readbyqxmd.com/read/29226050/determinants-of-computed-tomography-head-scan-ordering-for-patients-with-low-risk-headache-in-the-emergency-department
#9
Meaghan J Mackenzie, Rashi Hiranandani, Dongmei Wang, Tak Fung, Eddy Lang
Background Many specialty societies have found that neuroimaging in headache is a low-value intervention for benign presentations. This study describes factors that influence Emergency Room (ER) physicians' adherence to Choosing Wisely (CW) recommendations for low-risk headache patients presenting to Calgary's Emergency Departments (EDs). Emergency medicine has yet to address imaging in headache as a CW topic; however, this study may inform that decision. Methods Data were retrospectively collected for all patients presenting to Calgary EDs with headaches from April 1, 2014 to March 31, 2016...
October 9, 2017: Curēus
https://www.readbyqxmd.com/read/29224646/association-of-insurance-type-with-receipt-of-oral-anticoagulation-in-insured-patients-with-atrial-fibrillation-a-report-from-the-american-college-of-cardiology-ncdr-pinnacle-registry
#10
Celina M Yong, Yuyin Liu, Patricia Apruzzese, Gheorghe Doros, Christopher P Cannon, Thomas M Maddox, Anil Gehi, Jonathan C Hsu, Steven A Lubitz, Salim Virani, Mintu P Turakhia
BACKGROUND: It is poorly understood whether insurance type may be a major contributor to the underuse of oral anticoagulation (OAC) among patients with atrial fibrillation (AF), particularly for novel oral anticoagulants (NOACs). METHODS: We performed a retrospective cohort registry study of patients with insurance, AF, CHA2DS2-VASc ≥2, and at least one outpatient encounter recorded in the ACC NCDR's PINNACLE Registry between January 1, 2011 and December 31, 2014...
January 2018: American Heart Journal
https://www.readbyqxmd.com/read/29223594/femoral-neck-fractures-after-removal-of-hardware-in-healed-trochanteric-fractures
#11
REVIEW
Antonio Barquet, Peter V Giannoudis, Andrés Gelink
INTRODUCTION: Hardware removal in healed trochanteric fractures (TF) in the absence of infection or significant mechanical complications is rarely indicated. However, in patients with persistent pain, prominent material and discomfort in the activities of daily living, the implant is eventually removed. Publications of ipsilateral femoral neck fracture after removal of implants from healed trochanteric fractures (FNFARIHTF) just because of pain or discomfort are rare. The purpose of this systematic review of the literature is to report on the eventual risk factors, the mechanisms, the clinical presentation, and frequency, and to pay special emphasis in their prevention...
December 2017: Injury
https://www.readbyqxmd.com/read/29223304/the-relationship-between-perceived-gender-judgment-and-well-being-among-surgical-residents
#12
Arghavan Salles, Laurel Milam, Geoffrey Cohen, Claudia Mueller
BACKGROUND: Physician well-being is a significant problem. Here we explore whether one factor, a resident's concern for being judged by one's gender, influences well-being. METHODS: Over two years at one institution, we surveyed surgical residents on validated measures of well-being as well as the extent to which they felt they were judged because of their gender (gender judgment). We used correlations and linear regression to investigate the relationships between gender judgment and well-being...
November 6, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/29223172/association-between-the-use-of-benzodiazepines-and-opioids-with-the-risk-of-falls-and-hip-fractures-in-older-adults
#13
Manuel E Machado-Duque, Juan Pablo Castaño-Montoya, Diego A Medina-Morales, Alejandro Castro-Rodríguez, Alexandra González-Montoya, Jorge E Machado-Alba
BACKGROUND: To determine the association between the use of opioids and benzodiazepines and the risk of falls with hip fracture in populations older than 65 years in Colombia. METHODS: A case-control study with patients older than 65 years with diagnosis of hip fracture. Two controls were obtained per case. The drugs dispensed in the previous 30 days were identified. Sociodemographic, diagnostic, pharmacological (opioids and benzodiazepines), and polypharmacy variables were analyzed...
December 10, 2017: International Psychogeriatrics
https://www.readbyqxmd.com/read/29222628/one-year-clinical-effectiveness-comparison-of-prasugrel-with-ticagrelor-results-from-a-retrospective-observational-study-using-an-integrated-claims-database
#14
Mark B Effron, Kavita V Nair, Cliff Molife, Stuart Y Keller, Robert L Page, Jason C Simeone, Brian Murphy, Beth L Nordstrom, Yajun Zhu, Patrick L McCollam, George W Vetrovec
BACKGROUND: No direct comparisons of ticagrelor and prasugrel with 1-year clinical follow-up have been reported. OBJECTIVES: Our objective was to compare 1-year clinical outcomes among patients with acute coronary syndrome (ACS) managed with percutaneous coronary intervention (PCI) and treated with either ticagrelor or prasugrel in a real-world setting. METHODS: This retrospective study included patients from a payer database who were aged ≥18 years and had ACS managed with PCI with no history of transient ischemic attack (TIA)/stroke...
December 8, 2017: American Journal of Cardiovascular Drugs: Drugs, Devices, and Other Interventions
https://www.readbyqxmd.com/read/29221846/prevailing-ethical-dilemmas-encountered-by-physicians-in-terminal-cancer-care-changed-after-the-enactment-of-the-natural-death-act-fifteen-years-follow-up-survey
#15
Hsien-Liang Huang, Chien-An Yao, Wen-Yu Hu, Shao-Yi Cheng, Shinn-Jang Huang, Chih-Dao Chen, Wen-Yuan Lin, Yen-Chun Lin, Tai-Yuan Chiu
CONTEXT: Advance directive laws have influences on ethical dilemmas encountered by physicians caring for terminal cancer patients. OBJECTIVES: To identify the prevailing ethical dilemmas among terminal care physicians fifteen years after the Natural Death Act was enacted in Taiwan. METHODS: This study is a cross-sectional survey from April 2014 to February 2015 using the clustering sampling method and a well-structured questionnaire. Targeted participants included physicians at oncology and related wards or palliative care units where terminal cancer care may be provided in Taiwan...
December 5, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29221454/must-we-remain-blind-to-undergraduate-medical-ethics-education-in-africa-a-cross-sectional-study-of-nigerian-medical-students
#16
Onochie Okoye, Daniel Nwachukwu, Ferdinand C Maduka-Okafor
BACKGROUND: As the practice of medicine inevitably raises both ethical and legal issues, it had been recommended since 1999 that medical ethics and human rights be taught at every medical school. Most Nigerian medical schools still lack a formal undergraduate medical ethics curriculum. Medical education remains largely focused on traditional medical science components, leaving the medical students to develop medical ethical decision-making skills and moral attitudes passively within institutions noted for relatively strong paternalistic traditions...
December 8, 2017: BMC Medical Ethics
https://www.readbyqxmd.com/read/29219827/venous-thrombosis-and-coagulation-parameters-in-patients-with-pure-venous-malformations
#17
J van Es, N A Kappelhof, R A Douma, J C M Meijers, V E A Gerdes, C M A M van der Horst
INTRODUCTION: Venous malformations (VMs) are ubiquitous, low-flow vascular anomalies known to be occasionally painful due to thrombotic episodes within the lesion. The prevalence of superficial or deep vein thrombosis is unclear. METHODS: A cross-sectional study among outpatients aged ≥ 12 years with pure VMs was performed, quantifying the prevalence of thrombosis by screening all patients with compression ultrasonography (CUS). Additionally, we evaluated whether coagulation alterations were related to thrombosis observed with CUS...
October 2017: Netherlands Journal of Medicine
https://www.readbyqxmd.com/read/29218698/risk-factors-of-overactive-bladder-syndrome-and-its-relation-to-sexual-function-in-menopausal-women
#18
Sevil Hakimi, Elham Aminian, Sakineh Mohammad- Alizadeh Charandabi, Parvin Bastani, Marzieh Mohammadi
BACKGROUND: Overactive bladder syndrome is a common and annoying complication worldwide that could negatively affect the quality of life of afflicted individuals. We aimed to determine the prevalence and risk factors of overactive bladder syndrome and its relation to sexual function in healthy menopausal women. METHODS: This cross-sectional study was done on 340 women aged 45-60 years in Tabriz, northwest Iran, during 2015-2016. Data were collected using a demographic data questionnaire, the Overactive Bladder Syndrome Score, and the McCoy Female Sexuality Questionnaire...
December 4, 2017: Urologia
https://www.readbyqxmd.com/read/29217924/types-of-cancers-diagnosed-and-the-preference-of-families-of-adult-patients-with-cancer-about-disclosing-diagnosis-to-the-patients
#19
Engida Abebe, Hana Abebe
Background: Cancer has become one of the top causes of death in developing nations killing more people than the common infectious diseases do. For several reasons, disclosing cancer diagnosis to the patient is a challenging job for physicians and family members. Materials and Methods: A cross-sectional study was done to determine the common cancer diagnosis and the preference about disclosing cancer diagnosis to the patients among attendants of adult cancer patients seen at the regular surgical OPD of St...
May 2017: Ethiopian Journal of Health Sciences
https://www.readbyqxmd.com/read/29217445/factors-that-predict-failure-to-meet-mips-quality-measures-for-asymptomatic-carotid-endarterectomy
#20
Anahita Dua, Steven Koprowski, Fadwa Ali, Sapan S Desai
INTRODUCTION: The Physician Quality Reporting System (PQRS) created by the Centers for Medicare and Medicaid Services (CMS) financially penalizes providers who fail to meet expected quality of care measures. The purpose of this study is to evaluate the factors that predict failure to meet PQRS measures for carotid endarterectomy (CEA). METHODS: PQRS measures 260 (discharge by postoperative day 2 following CEA in asymptomatic patients) and 346 (rate of postoperative stroke or death following CEA in asymptomatic patients) were evaluated using hospital records from the state of Florida from 2008-2012...
December 4, 2017: Annals of Vascular Surgery
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