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https://www.readbyqxmd.com/read/28331140/management-of-atopic-dermatitis-in-japan
#1
Hidehisa Saeki
The guidelines for the treatment of atopic dermatitis (AD) issued by the Japanese Dermatological Association (JDA), which are basically designed for dermatologists, were first prepared in 2000 and revised in 2016. The guidelines for AD of the Japanese Society of Allergology (JSA), which are basically designed for allergologists, including internists, otorhinolaryngologists, ophthalmologists, and dermatologists, were first prepared in 2009 and revised in 2014. In this article, I review the definition, pathophysiology, etiology, epidemiology, diagnosis, severity classification, examination for diagnosis and severity assessment, and treatments for AD in Japan according to these two guidelines for AD (JDA and JSA)...
2017: Journal of Nippon Medical School, Nippon Ika Daigaku Zasshi
https://www.readbyqxmd.com/read/28293933/unmet-primary-physicians-needs-for-allergic-rhinitis-care-in-korea
#2
Hyeon Jong Yang, Young Hyo Kim, Bora Lee, Do Youn Kong, Dong Kyu Kim, Mi Ae Kim, Bong Seong Kim, Won Young Kim, Jeong Hee Kim, Yang Park, So Yeon Park, Woo Yong Bae, Keejae Song, Min Suk Yang, Sang Min Lee, Young Mok Lee, Hyun Jong Lee, Jae Hong Cho, Hye Mi Jee, Jeong Hee Choi, Young Yoo, Young Il Koh
Allergic rhinitis (AR) is one of the most common chronic allergic respiratory diseases worldwide. Various practical guidelines for AR have been developed and updated to improve the care of AR patients; however, up to 40% patients remain symptomatic. The unmet need for AR care is one of the greatest public health problems in the world. The gaps between guideline and real-world practice, and differences according to the region, culture, and medical environments may be the causes of unmet needs for AR care. Because there is no evidence-based AR practical guideline reflecting the Korean particularity, various needs are increasing...
May 2017: Allergy, Asthma & Immunology Research
https://www.readbyqxmd.com/read/28290817/-diagnosis-prognosis-monitoring-of-cardiac-complications-of-arterial-hypertension-hypertensive-heart-disease
#3
A E Manoilov
AIM: of the study was further investigation of diagnostics and management of cardiac complications of essential hypertension (EH). METHODS: Retrospective analysis of annual reports of cardiological departments for 10 year period was carried out. Internists (n=330) from 6 regions of Russia participated in the study. Anonymous questioning was used for the study of physicians views on diagnosis, prognostication of outcomes, and monitoring of hypertensive heart disease (HHD)...
December 2016: Kardiologiia
https://www.readbyqxmd.com/read/28289113/the-effects-of-training-institution-practice-costs-quality-and-other-characteristics-on-future-practice
#4
Robert L Phillips, Stephen M Petterson, Andrew W Bazemore, Peter Wingrove, James C Puffer
PURPOSE: Medicare beneficiary spending patterns reflect those of the 306 Hospital Referral Regions where physicians train, but whether this holds true for smaller areas or for quality is uncertain. This study assesses whether cost and quality imprinting can be detected within the 3,436 Hospital Service Areas (HSAs), 82.4 percent of which have only 1 teaching hospital, and whether sponsoring institution characteristics are associated. METHODS: We conducted a secondary, multi-level, multivariable analysis of 2011 Medicare claims and American Medical Association Masterfile data for a random, nationally representative sample of family physicians and general internists who completed residency between 1992 and 2010 and had more than 40 Medicare patients (3,075 physicians providing care to 503,109 beneficiaries)...
March 2017: Annals of Family Medicine
https://www.readbyqxmd.com/read/28288254/variation-in-physician-spending-and-association-with-patient-outcomes
#5
Yusuke Tsugawa, Ashish K Jha, Joseph P Newhouse, Alan M Zaslavsky, Anupam B Jena
Importance: While the substantial variation in health care spending across regions and hospitals is well known, key clinical decisions are ultimately made by physicians. However, the degree to which spending varies across physicians and the clinical consequences of that variation are unknown. Objective: To investigate variation in spending across physicians and its association with patient outcomes. Design, Setting, and Participants: For this retrospective data analysis, we analyzed a 20% random sample of Medicare fee-for-service beneficiaries 65 years and older who were hospitalized with a nonelective medical condition and treated by a general internist between January 1, 2011, and December 31, 2014...
March 13, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28288248/a-transgender-military-internist-s-perspective-on-readiness-for-treating-patients-with-gender-dysphoria
#6
Jamie L Henry
No abstract text is available yet for this article.
March 13, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28281018/primary-palliative-care-for-heart-failure-what-is-it-how-do-we-implement-it
#7
REVIEW
Laura P Gelfman, Dio Kavalieratos, Winifred G Teuteberg, Anuradha Lala, Nathan E Goldstein
Heart failure (HF) is a chronic and progressive illness, which affects a growing number of adults, and is associated with a high morbidity and mortality, as well as significant physical and psychological symptom burden on both patients with HF and their families. Palliative care is the multidisciplinary specialty focused on optimizing quality of life and reducing suffering for patients and families facing serious illness, regardless of prognosis. Palliative care can be delivered as (1) specialist palliative care in which a palliative care specialist with subspecialty palliative care training consults or co-manages patients to address palliative needs alongside clinicians who manage the underlying illness or (2) as primary palliative care in which the primary clinician (such as the internist, cardiologist, cardiology nurse, or HF specialist) caring for the patient with HF provides the essential palliative domains...
March 9, 2017: Heart Failure Reviews
https://www.readbyqxmd.com/read/28274905/a-learning-health-care-system-using-computer-aided-diagnosis
#8
Amos Cahan, James J Cimino
Physicians intuitively apply pattern recognition when evaluating a patient. Rational diagnosis making requires that clinical patterns be put in the context of disease prior probability, yet physicians often exhibit flawed probabilistic reasoning. Difficulties in making a diagnosis are reflected in the high rates of deadly and costly diagnostic errors. Introduced 6 decades ago, computerized diagnosis support systems are still not widely used by internists. These systems cannot efficiently recognize patterns and are unable to consider the base rate of potential diagnoses...
March 8, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28273405/heart-rhythm-society-expert-consensus-statements-part-2
#9
REVIEW
Susie Sennhauser, Rishi Anand, Fred Kusumoto, Nora Goldschlager
One of the most important roles for professional societies in medicine is assembling multiple stakeholders and experts to develop documents that can help guide and define policies and strategies for best medical care. Each year the Heart Rhythm Society (HRS) develops several consensus documents that address critical clinical subjects that have been identified by input from HRS members and HRS committees. Over the past 5 years, HRS has produced documents with multiple professional societies from around the world, and although the topics chosen for exploration center around arrhythmia management, the reviews and recommendations made in the documents are important for clinical cardiologists and generalists who are not arrhythmia specialists...
March 8, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28273360/heart-rhythm-society-expert-consensus-statements-part-1
#10
REVIEW
Susie Sennhauser, Rishi Anand, Fred Kusumoto, Nora Goldschlager
One of the most important roles for professional societies in medicine is assembling multiple stakeholders and experts to develop documents that can help guide and define policies and strategies for best medical care. Each year the Heart Rhythm Society (HRS) develops several consensus documents that address critical clinical subjects that have been identified by input from HRS members and HRS committees. Over the past 5 years, HRS has produced documents with multiple professional societies from around the world, and although the topics chosen for exploration center around arrhythmia management, the reviews and recommendations made in the documents are important for clinical cardiologists and generalists who are not arrhythmia specialists...
March 8, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28259629/structured-reporting-of-ct-examinations-in-acute-pulmonary-embolism
#11
Bastian O Sabel, Jessica L Plum, Nikolaus Kneidinger, Gabriela Leuschner, Leandra Koletzko, Bijan Raziorrouh, Regina Schinner, Wolfgang G Kunz, Franziska Schoeppe, Kolja M Thierfelder, Wieland H Sommer, Felix G Meinel
OBJECTIVES: To evaluate the effect of structured reporting of CT pulmonary angiography (CTPA) studies on the content, clarity and clinical usefulness of radiology reports in acute pulmonary embolism (PE). METHODS: Conventional and structured reports were generated for 41 patients with a CTPA positive for acute PE. Conventional reports were dictated in a free-text form using speech recognition; structured reports contained a consistent ordering of observations with standardized subheadings...
February 22, 2017: Journal of Cardiovascular Computed Tomography
https://www.readbyqxmd.com/read/28253048/an-internist-listens-on-pediatric-rounds
#12
J Trig Brown
No abstract text is available yet for this article.
March 2, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28242319/white-paper-aga-power-practice-guide-on-obesity-and%C3%A2-weight-management-education-and-resources
#13
REVIEW
Andres Acosta, Sarah Streett, Mathew D Kroh, Lawrence J Cheskin, Katherine H Saunders, Marina Kurian, Marsha Schofield, Sarah E Barlow, Louis Aronne
The epidemic of obesity continues at alarming rates, with a high burden to our economy and society. The American Gastroenterological Association understands the importance of embracing obesity as a chronic, relapsing disease and supports a multidisciplinary approach to the management of obesity. Because gastrointestinal disorders resulting from obesity are more frequent and often present sooner than type 2 diabetes mellitus and cardiovascular disease, gastroenterologists have an opportunity to address obesity and provide an effective therapy early...
February 24, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28231425/practice-patterns-regarding-multidisciplinary-cancer-management-and-suggestions-for-further-refinement-results-from-a-national-survey-in-korea
#14
Yun-Gyoo Lee, Sukjoong Oh, Heejin Kimm, Dong-Hoe Koo, Do Yeun Kim, Bong-Seog Kim, Seung-Sei Lee
Purpose: This study was conducted to explore the process and operation of a cancer multidisciplinary team (MDT) after the reimbursement decision in Korea, and to identify ways to overcome the major barriers to effective and sustainable MDTs. Materials and Methods: Approximately 1000 cancer specialists, including medical oncologists, surgical oncologists, radiation oncologists, pathologists, and radiologists in general hospitals in Korea were invited to complete the survey...
February 22, 2017: Cancer Research and Treatment: Official Journal of Korean Cancer Association
https://www.readbyqxmd.com/read/28225495/the-multimorbidity-interaction-severity-index-misi-a-proof-of-concept-study
#15
Dimitri Gassmann, Marcus Cheetham, Klarissa Siebenhuener, Barbara M Holzer, Claudine Meindl-Fridez, Florian F Hildenbrand, Vanessa Virgini, Mike Martin, Edouard Battegay
Therapeutic decision-making for patients with multimorbidity (MM) is challenging. Clinical practice guidelines inadequately address harmful interactions and resulting therapeutic conflicts within and among diseases. A patient-specific measure of MM severity that takes account of this conflict is needed.As a proof of concept, we evaluated whether the new Multimorbidity Interaction Severity Index (MISI) could be used to reliably differentiate patients in terms of lower versus higher potential for harmful interactions...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28225206/a-great-imitator-in-adult-cardiology-practice-congenitally-corrected-transposition-of-the-great-arteries
#16
Anushree Agarwal, Fatima Samad, Lindsey Kalvin, Michelle Bush, A Jamil Tajik
INTRODUCTION: Congenitally corrected transposition of the great arteries (ccTGA) is a rare congenital disease that frequently remains undiagnosed until adulthood, especially when there is an absence of other congenital anomalies. Adults with ccTGA may remain asymptomatic and their diagnosis could be missed on initial evaluation, or it could be diagnosed incidentally as an evaluation of murmur. We aim to report the different presentations of ccTGA in eight adult patients and review the key features required to suspect the diagnosis during an initial visit...
February 22, 2017: Congenital Heart Disease
https://www.readbyqxmd.com/read/28217821/physicians-experiences-as-patients-with-statin-side-effects-a-case-series
#17
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
#18
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
#19
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
#20
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
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