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https://www.readbyqxmd.com/read/28217821/physicians-experiences-as-patients-with-statin-side-effects-a-case-series
#1
Hayley J Koslik, Athena Hathaway Meskimen, Beatrice Alexandra Golomb
Physicians are among those prescribed statins and therefore, subject to potential statin adverse effects (AEs). There is little information on the impact of statin AEs on physicians affected by them. We sought to assess the character and impact of statin AEs occurring in physicians and retired physicians, and to ascertain whether/how personal experience of AEs moderated physicians' attitude toward statin use. Seven active or retired physicians from the United States communicated with the Statin Effects Study group regarding their personal experience of statin AEs...
December 2017: Drug Safety—Case Reports
https://www.readbyqxmd.com/read/28214182/opportunistic-autoimmunity-secondary-to-cancer-immunotherapy-oasi-an-emerging-challenge
#2
M Kostine, L Chiche, E Lazaro, P Halfon, C Charpin, D Arniaud, F Retornaz, P Blanco, N Jourde-Chiche, C Richez, C Stavris
With "checkpoint inhibitors" targeting PD1/PD-1-ligands or CTLA-4/CD28 pathways, immunotherapy has profoundly modified therapeutic strategies in oncology. First approved in refractory metastatic neoplasms (melanoma and lung adenocarcinoma), it is now being tested broadly in other cancers and/or as adjuvant treatment. For a significant proportion of patients, immunotherapy is responsible for "immunological" events, identified as Immune-Related Adverse Events (irAEs). Owing to the increasing number of prescriptions, identification and management of specific immunological side effects is crucial and requires close collaboration between oncologists and internists and/or other organ specialists...
February 14, 2017: La Revue de Médecine Interne
https://www.readbyqxmd.com/read/28202052/primary-care-focus-and-utilization-in-the-medicare-shared-savings-program-accountable-care-organizations
#3
Lindsey A Herrel, John Z Ayanian, Scott R Hawken, David C Miller
BACKGROUND: Although Accountable Care Organizations (ACOs) are defined by the provision of primary care services, the relationship between the intensity of primary care and population-level utilization and costs of health care services has not been examined during early implementation of Medicare Shared Savings Program (MSSP) ACOs. Our objective was to evaluate the association between primary care focus and healthcare utilization and spending in the first performance period of the Medicare Shared Savings Program (MSSP) Accountable Care Organizations (ACOs)...
February 15, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28196967/coxsackie-myocarditis-and-hepatitis-with-reactivated-epstein-bar-virus-ebv-a-case-report
#4
Varunsiri Atti, Nathan M Anderson, Mathew B Day
BACKGROUND Myocarditis, defined as inflammation of myocardial tissue of the heart, is an uncommon cardiac presentation and is due to a variety of causes. It affects 1% of the US population, 50% of which is caused by coxsackie B virus. Cardiac tissue is the prime target, and destruction of myocardium results in cardiac failure with fluid overload. CASE REPORT Our patient was a 57-year-old woman with fever, headache, neck pain, and generalized malaise. Her white blood cell count was 13×10³ cells/mm³. Interestingly, lumbar puncture ruled out meningitis...
February 15, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28191610/italian-intersociety-consensus-on-doac-use-in-internal-medicine
#5
Domenico Prisco, Walter Ageno, Cecilia Becattini, Armando D'Angelo, Giovanni Davì, Raimondo De Cristofaro, Francesco Dentali, Giovanni Di Minno, Anna Falanga, Gualberto Gussoni, Luca Masotti, Gualtiero Palareti, Pasquale Pignatelli, Roberto M Santi, Francesca Santilli, Mauro Silingardi, Antonella Tufano, Francesco Violi
The direct oral anticoagulants (DOACs) are drugs used in clinical practice since 2009 for the prevention of stroke or systemic embolism in non-valvular atrial fibrillation, and for the treatment and secondary prevention of venous thromboembolism. The four DOACs, including the three factor Xa inhibitors (rivaroxaban, apixaban and edoxaban) and one direct thrombin inhibitor (dabigatran) provide oral anticoagulation therapy alternatives to Vitamin K antagonists (VKAs). Despite their clear advantages, the DOACs require on the part of the internist a thorough knowledge of their pharmacokinetic and pharmacodynamic characteristics to ensure their correct use, laboratory monitoring and the appropriate management of adverse events...
February 13, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28185306/antimicrobial-use-guidelines-for-treatment-of-respiratory-tract-disease-in-dogs-and-cats-antimicrobial-guidelines-working-group-of-the-international-society-for-companion-animal-infectious-diseases
#6
M R Lappin, J Blondeau, D Booth, E B Breitschwerdt, L Guardabassi, D H Lloyd, M G Papich, S C Rankin, J E Sykes, J Turnidge, J S Weese
Respiratory tract disease can be associated with primary or secondary bacterial infections in dogs and cats and is a common reason for use and potential misuse, improper use, and overuse of antimicrobials. There is a lack of comprehensive treatment guidelines such as those that are available for human medicine. Accordingly, the International Society for Companion Animal Infectious Diseases convened a Working Group of clinical microbiologists, pharmacologists, and internists to share experiences, examine scientific data, review clinical trials, and develop these guidelines to assist veterinarians in making antimicrobial treatment choices for use in the management of bacterial respiratory diseases in dogs and cats...
February 10, 2017: Journal of Veterinary Internal Medicine
https://www.readbyqxmd.com/read/28153977/quality-of-care-delivered-by-general-internists-in-us-hospitals-who-graduated-from-foreign-versus-us-medical-schools-observational-study
#7
Yusuke Tsugawa, Anupam B Jena, E John Orav, Ashish K Jha
OBJECTIVE:  To determine whether patient outcomes differ between general internists who graduated from a medical school outside the United States and those who graduated from a US medical school. DESIGN:  Observational study. SETTING:  Medicare, USA. PARTICIPANTS:  20% national sample of data for Medicare fee-for-service beneficiaries aged 65 years or older admitted to hospital with a medical condition in 2011-14 and treated by international or US medical graduates who were general internists...
February 2, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28152805/a-multidisciplinary-team-approach-to-efficient-breast-cancer-diagnosis
#8
Melissa Shelby, Shefali Birdi, Stephanie Costa Byrum, Julie Annie Yee Billar, Kevin McCabe, Jignesh Patel, Vilert A Loving
: 88 Background: System inefficiencies result in delayed breast cancer diagnoses. Inefficiencies include any non-value added steps between symptom onset/imaging abnormality to cancer diagnosis and treatment. Diagnostic delays can lead to more advanced disease and may negatively impact survival. Further, optimizing the efficiency of diagnostic evaluation models can reduce barriers to care and improve patient satisfaction. To achieve these efficiency goals, Banner MD Anderson Cancer Center (BMDACC) instituted the Undiagnosed Breast Clinic (UBC)...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28141776/acute-illness-protocol-for-organic-acidemias-methylmalonic-acidemia-and-propionic-acidemia
#9
Saud H Aldubayan, Lance H Rodan, Gerard T Berry, Harvey L Levy
Inborn errors of metabolism (IEM) are genetic disorders that disrupt enzyme activity, cellular transport, or energy production. They are individually rare, but collectively have an incidence of 1:1000. Most patients with IEMs are followed by a physician with expertise in Biochemical Genetics (Metabolism), but may present outside of this setting. Because IEMs can present acutely with life-threatening crises that require specific interventions, it is critical for the emergency medicine physicians, pediatricians, internists, and critical care physicians as well as biochemical geneticists to be familiar with the initial assessment and management of patients with these disorders...
February 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28138874/publication-rates-of-abstracts-presented-at-the-society-of-general-internal-medicine-annual-meeting
#10
Heidi M Egloff, Colin P West, Amy T Wang, Katie M Lowe, Jithinraj Edakkanambeth Varayil, Thomas J Beckman, Adam P Sawatsky
BACKGROUND: Abstracts accepted at scientific meetings are often not subsequently published. Data on publication rates are largely from subspecialty and surgical studies. OBJECTIVE: The aims of this study were to 1) determine publication rates of abstracts presented at a general internal medicine meeting; 2) describe research activity among academic general internists; 3) identify factors associated with publication and with the impact factor of the journal of publication; and 4) evaluate for publication bias...
January 30, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28129956/-medically-unexplained-symptoms-care-in-internal-medicine-a-paradigm-of-doctor-patient-relationship-in-situation-of-uncertainty
#11
B Ranque, O Nardon
Medically unexplained symptoms (MUS) are extremely common in general practice as in all medical specialties, but their designation is not unambiguous and the approaches to take care of the patients differ from conventional therapeutic approaches. The difficulty is not to confirm the diagnosis, which is rapidly obvious with some experience, but to establish a genuinely human therapeutic relationship, without any technical help, which pushes the doctor to the edge of his empathy and communication skills. The discomfort or even distress regularly encountered by physicians in front of a patient with MUS shows that the foundations of the doctor-patient relationship under uncertainty are poorly mastered...
January 24, 2017: La Revue de Médecine Interne
https://www.readbyqxmd.com/read/28118412/whole-blood-donation-affects-the-interpretation-of-hemoglobin-a1c
#12
Angelique Dijkstra, Erna Lenters-Westra, Wim de Kort, Arlinke G Bokhorst, Henk J G Bilo, Robbert J Slingerland, Michel J Vos
INTRODUCTION: Several factors, including changed dynamics of erythrocyte formation and degradation, can influence the degree of hemoglobin A1c (HbA1c) formation thereby affecting its use in monitoring diabetes. This study determines the influence of whole blood donation on HbA1c in both non-diabetic blood donors and blood donors with type 2 diabetes. METHODS: In this observational study, 23 non-diabetic blood donors and 21 blood donors with type 2 diabetes donated 475 mL whole blood and were followed prospectively for nine weeks...
2017: PloS One
https://www.readbyqxmd.com/read/28105067/current-state-and-future-prospects-for-psychosomatic-medicine-in-japan
#13
REVIEW
Masato Murakami, Yoshihide Nakai
In this article, we describe the history and current state of psychosomatic medicine (PSM) in Japan and propose measures that could be considered based on our view of the future prospects of PSM in Japan. The Japanese Society of PSM (JSPM) was established in 1959, and the first Department of Psychosomatic Internal Medicine in Japan was established at Kyushu University In 1963. PSM in Japan has shown a prominent, unique development, with 3,300 members (as of March 2016), comprised of 71.6% of medical doctors including psychosomatic internal medicine (PIM) specialists, general internists, psychiatrists, pediatricians, obstetricians and gynecologists, dentists, dermatologists, and others...
2017: BioPsychoSocial Medicine
https://www.readbyqxmd.com/read/28104808/training-mid-career-internists-to-perform-high-quality-colonoscopy-a-pilot-training-programme-to-meet-increasing-demands-for-colonoscopy
#14
Nicole K Shah-Ghassemzadeh, Christian S Jackson, David Juma, Richard M Strong
BACKGROUND: Colorectal cancer (CRC) is the second leading cause of cancer deaths in the USA. Despite a recent rise in CRC screening there remains an increasing demand for colonoscopy, yet a limited supply of gastroenterologists who can meet this need. OBJECTIVE: To determine if a mid-career general internist (GIN) could be trained to perform high-quality colonoscopes via an intensive training programme. DESIGN: A GIN trained 2-3 days/week, 4-5 hours/day, for 7 months with an experienced gastroenterologist...
January 19, 2017: Postgraduate Medical Journal
https://www.readbyqxmd.com/read/28100982/bilateral-lower-extremity-edema-caused-by-iliopsoas-bursal-distention-after-hip-arthroplasty
#15
Sameer K Avasarala, Syed T Ahsan
Lower-extremity edema is encountered by internists, nephrologists, vascular specialists, and many others. We report a case of an elderly woman who presented with a painful, swollen left leg. Without a clear diagnosis, she had been taking diuretics for the past 8 years for swelling in both legs. After extensive investigation, we found that her lower-extremity edema was due to bilateral iliopsoas bursal distention secondary to degeneration of her hip prostheses. Chronic breakdown of the polyethylene component of the hip prostheses had led to a communication between the artificial joints and the iliopsoas bursae...
December 2016: Texas Heart Institute Journal
https://www.readbyqxmd.com/read/28095816/awareness-and-knowledge-among-internal-medicine-house-staff-for-dose-adjustment-of-commonly-used-medications-in-patients-with-ckd
#16
Sikander Surana, Neeru Kumar, Amita Vasudeva, Gulvahid Shaikh, Kenar D Jhaveri, Hitesh Shah, Deepa Malieckal, Joshua Fogel, Gurwinder Sidhu, Sofia Rubinstein
BACKGROUND: Drug dosing errors result in adverse patient outcomes and are more common in patients with chronic kidney disease (CKD). As internists treat the majority of patients with CKD, we study if Internal Medicine house-staff have awareness and knowledge about the correct dosage of commonly used medications for those with CKD. METHODS: A cross-sectional survey was performed and included 341 participants. The outcomes were the awareness of whether a medication needs dose adjustment in patients with CKD and whether there was knowledge for the level of glomerular filtration rate (GFR) a medication needs to be adjusted...
January 17, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28095380/polycythemia-vera-management-and-challenges-in-the-community-health-setting
#17
Aaron T Gerds, Kim-Hien Dao
Patients with polycythemia vera (PV) experience shortened survival, increased risk of thromboembolic and hemorrhagic events, and burdensome symptoms. For all patients with PV, treatment with aspirin and hematocrit control with phlebotomy are recommended. In addition, patients with high-risk status or poor hematocrit control benefit from cytoreductive therapy with hydroxyurea, although approximately 1 in 4 patients develops resistance or intolerance. For patients who are resistant to or intolerant of hydroxyurea, studies have shown that ruxolitinib, a Janus kinase 1/2 inhibitor, provides hematocrit control, reduces spleen size, normalizes blood counts, and improves PV-related symptoms...
January 18, 2017: Oncology
https://www.readbyqxmd.com/read/28076263/-a-paradox-persists-when-the-paradigm-is-wrong-pisacano-scholars-reflections-from-the-inaugural-starfield-summit
#18
Noemi Doohan, Anastasia J Coutinho, Jennifer Lochner, Diana Wohler, Jennifer DeVoe
The inaugural Starfield Summit was hosted in April 2016 by the Robert Graham Center for Policy Studies in Family Medicine and Primary Care with additional partners and sponsors, including the Pisacano Leadership Foundation (PLF). The Summit addressed critical topics in primary care and health care delivery, including payment, measurement, and team-based care. Invited participants included an interdisciplinary group of pediatricians, family physicians, internists, behaviorists, trainees, researchers, and advocates...
November 2016: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/28074588/care-under-the-influence
#19
Joseph J Fins, Samantha F Knowlton
A forty-year-old man is brought to the emergency room by his wife at five in the morning, two hours after he fell down the stairs at home, hitting his head and injuring his arm. He tells the ER physician that he got up to get a drink of water and tripped in the dark. His speech is slurred, and he smells strongly of alcohol. Lab results reveal elevated liver enzymes, and his blood alcohol level is 0.1. His medical history is unremarkable. When asked about his alcohol consumption, he says he usually has one or two drinks a night with dinner but that he drinks more on holidays and special occasions...
January 2017: Hastings Center Report
https://www.readbyqxmd.com/read/28070877/idiopathic-retroperitoneal-fibrosis-and-its-overlap-with-igg4-related-disease
#20
REVIEW
Giovanni Maria Rossi, Rossana Rocco, Eugenia Accorsi Buttini, Chiara Marvisi, Augusto Vaglio
Retroperitoneal fibrosis (RPF) is a rare disease characterised by fibrous tissue proliferation in the retroperitoneum, with encasement of the ureters and large vessels of the abdomen as the most destructive of potentially severe complications. It can either be idiopathic, or secondary to infections, malignancies, or the use of certain drugs. The idiopathic form accounts for approximately 75% of the cases, and is usually responsive to immunosuppressive therapy. In recent years, the emergence of a new clinical entity, IgG4-related disease (IgG4-RD), shed light on many fibro-inflammatory disorders once thought to be separate clinical entities, although frequently associated in the so-called multifocal fibrosclerosis...
January 9, 2017: Internal and Emergency Medicine
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