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https://www.readbyqxmd.com/read/28100982/bilateral-lower-extremity-edema-caused-by-iliopsoas-bursal-distention-after-hip-arthroplasty
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
https://www.readbyqxmd.com/read/28066588/real-world-asthma-management-with-inhaler-devices-in-switzerland-results-of-the-asthma-survey
#7
Christian F Clarenbach, Laurent P Nicod, Malcolm Kohler
BACKGROUND: The aim of the Asthma Survey was to generate insights about the daily practice of physicians with regard to inhaler devices used for treating asthma under real-world conditions in Switzerland. METHODS: A questionnaire was administered to 605 participating hospital- and practice-based Swiss physicians. Areas of interest were practical aspects of patient education, typical difficulties encountered when prescribing pressurized metered-dose inhalers (pMDI) and dry-powder inhalers (DPI), and reasons for physician preferences...
November 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28050709/experiences-with-the-survivorship-care-plan-in-primary-care-providers-of-childhood-cancer-survivors-a-mixed-methods-approach
#8
Neel S Iyer, Hannah-Rose Mitchell, Daniel J Zheng, Wilhelmenia L Ross, Nina S Kadan-Lottick
PURPOSE: Focusing on primary care providers (PCPs) of known childhood cancer survivors, we used a mixed methods approach to understand providers' experiences with the survivorship care plan (SCP), as well as preferences and barriers regarding survivorship care. METHODS: The SCP was sent to 202 eligible PCPs of patients attending a regional survivorship clinic. The PCPs then completed quantitative postal surveys. Sixteen PCPs underwent an additional qualitative interview...
January 3, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28040231/differences-between-pediatricians-and-internists-in-advance-care-planning-for-adolescents-with-cancer
#9
Nobuyuki Yotani, Yoshiyuki Kizawa, Haruo Shintaku
OBJECTIVE: To evaluate differences between pediatricians and internists in the practice of and barriers to advance care planning (ACP) for adolescent patients with cancer. STUDY DESIGN: A self-reported questionnaire was administered to assess the practice of ACP, advance directives, and barriers to ACP for adolescent patients with cancer. All 3392 Japanese board-certified hematologists were surveyed, and 600 hematologists (227 pediatricians, 373 internists) who take care of adolescent patients with cancer with decision-making capacity were analyzed...
December 28, 2016: Journal of Pediatrics
https://www.readbyqxmd.com/read/28035492/factors-influencing-the-use-of-a-mobile-app-for-reporting-adverse-drug-reactions-and-receiving-safety-information-a-qualitative-study
#10
Sieta T de Vries, Lisa Wong, Alastair Sutcliffe, François Houÿez, Carmen Lasheras Ruiz, Peter G M Mol
INTRODUCTION: A mobile app may increase the reporting of adverse drug reactions (ADRs) and improve the communication of new drug safety information. Factors that influence the use of an app for such two-way risk communication need to be considered at the development stage. OBJECTIVE: Our aim was to reveal the factors that may influence healthcare professionals (HCPs) and patients to use an app for two-way risk communication. METHODS: Focus group discussions and face-to-face interviews were conducted in the Netherlands, Spain and the UK...
December 29, 2016: Drug Safety: An International Journal of Medical Toxicology and Drug Experience
https://www.readbyqxmd.com/read/28035215/the-role-and-choice-criteria-of-antihistamines-in-allergy-management-expert-opinion
#11
Piotr Kuna, Dariusz Jurkiewicz, Magdalena M Czarnecka-Operacz, Rafał Pawliczak, Jarosław Woroń, Marcin Moniuszko, Andrzej Emeryk
Allergic diseases are the most common chronic conditions lasting throughout the patient's life. They not only cause significant deterioration in the quality of life of patients but also lead to significant absenteeism and reduced productivity, resulting in very high costs for society. Effective and safe treatment of allergic diseases is therefore one of the main challenges for public health and should be carried out by all the specialists in family medicine, internists and paediatricians in collaboration with allergists, otorhinolaryngologists and dermatologists...
December 2016: Postȩpy Dermatologii i Alergologii
https://www.readbyqxmd.com/read/28029709/increasing-role-of-nurse-practitioners-in-house-call-programs
#12
Nengliang Aaron Yao, Karen Rose, Virginia LeBaron, Fabian Camacho, Peter Boling
OBJECTIVES: Residence-based primary care provides homebound frail patients with a care plan that is individually tailored to manage multiple chronic conditions and functional limitations using a variety of resources. We (1) examine the visit volume and Medicare payments for residence-based health care provided by nurse practitioners (NPs) in the Medicare fee-for-service environment; (2) compare NP's residential visits to those of internists and family physicians; and (3) compare the geographical service area of full-time house call NPs versus NPs who make nursing facility visits a major portion of their work...
December 28, 2016: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28024954/primary-care-physicians-perspective-on-financial-issues-and-adult-immunization-in-the-era-of-the-affordable-care-act
#13
Laura P Hurley, Megan C Lindley, Mandy A Allison, Lori A Crane, Michaela Brtnikova, Brenda L Beaty, Megan Snow, Carolyn B Bridges, Allison Kempe
BACKGROUND: Financial barriers to adult vaccination are poorly understood. Our objectives were to assess among general internists (GIM) and family physicians (FP) shortly after Affordable Care Act (ACA) implementation: (1) proportion of adult patients deferring or refusing vaccines because of cost and frequency of physicians not recommending vaccines for financial reasons; (2) satisfaction with reimbursement for vaccine purchase and administration by payer type; (3) knowledge of Medicare coverage of vaccines; and (4) awareness of vaccine-specific provisions of the ACA...
December 23, 2016: Vaccine
https://www.readbyqxmd.com/read/28019044/severity-of-nasal-inflammatory-disease-questionnaire-for-canine-idiopathic-rhinitis-control-instrument-development-and-initial-validity-evidence
#14
L M Greene, K D Royal, J M Bradley, B D X Lascelles, L R Johnson, E C Hawkins
BACKGROUND: Effective treatments are needed for idiopathic chronic rhinitis in dogs, but assessment of efficacy requires a practical, quantifiable method for assessing severity of disease. OBJECTIVES: To develop and perform initial validity and reliability testing of an owner-completed questionnaire for assessing clinical signs and dog and owner quality of life (QOL) in canine chronic rhinitis. ANIMALS: Twenty-two dogs with histopathologically confirmed chronic rhinitis and 72 healthy dogs...
December 25, 2016: Journal of Veterinary Internal Medicine
https://www.readbyqxmd.com/read/28003785/central-retinal-vein-occlusion-associated-with-high-blood-levels-of-lipoprotein-a-is-lipoprotein-a-a-reliable-marker-for-identification-of-predisposed-individuals
#15
Piergiacomo Grassi, Alberto Salicone, Lorenzo Motta, Mario Salvatore Motta
To report a case of central retinal vein occlusion (CRVO) associated with abnormal elevation of Lipoprotein (a) [Lp(a)] plasma levels, without local or systemic risk factors. A 74-year-old man was referred to our department for cataract surgery in his left eye, and his anamnesis was negative for systemic diseases. Two months later, the patient presented with sudden visual loss in his operated eye, and comprehensive ophthalmic examination was performed, including Fluorescein Angiography (FA) and Optical Coherent Tomography (OCT)...
October 2016: Saudi Journal of Ophthalmology: Official Journal of the Saudi Ophthalmological Society
https://www.readbyqxmd.com/read/27993410/consensus-document-for-the-use-of-the-polypill-in-the-secondary-prevention-of-cardiovascular-disease
#16
José Ramón González-Juanatey, José María Mostaza, José María Lobos, Benjamín Abarca, José Luis Llisterri, Gonzalo Baron-Esquivias, Enrique Galve, Rosa María Lidón, Francisco Xavier Garcia-Moll, Pedro Luis Sánchez, Carmen Suárez, Jesús Millán, Vicente Pallares, José Juan Alemán, Isabel Egocheaga
Cardiovascular disease is a chronic disorder which is usually already at an advanced stage when the first symptoms develop. The fact that the initial clinical presentation can be lethal or highly incapacitating emphasizes the need for primary and secondary prevention. It is estimated that the ratio of patients with good adherence to secondary prevention of cardiovascular disease is low and also decreases gradually over time. The Polypill for secondary prevention of cardiovascular disease is the first fixed-dose combination therapy of salicylic acid, atorvastatin and ramipril approved in Spain...
December 16, 2016: Medicina Clínica
https://www.readbyqxmd.com/read/27992617/comparison-of-hospital-mortality-and-readmission-rates-for-medicare-patients-treated-by-male-vs-female-physicians
#17
Yusuke Tsugawa, Anupam B Jena, Jose F Figueroa, E John Orav, Daniel M Blumenthal, Ashish K Jha
Importance: Studies have found differences in practice patterns between male and female physicians, with female physicians more likely to adhere to clinical guidelines and evidence-based practice. However, whether patient outcomes differ between male and female physicians is largely unknown. Objective: To determine whether mortality and readmission rates differ between patients treated by male or female physicians. Design, Setting, and Participants: We analyzed a 20% random sample of Medicare fee-for-service beneficiaries 65 years or older hospitalized with a medical condition and treated by general internists from January 1, 2011, to December 31, 2014...
December 19, 2016: JAMA Internal Medicine
https://www.readbyqxmd.com/read/27988232/for-the-improvement-of-heart-failure-treatment-in-portugal-consensus-statement
#18
Cândida Fonseca, Dulce Brito, Rui Cernadas, Jorge Ferreira, Fátima Franco, Teresa Rodrigues, João Morais, José Silva Cardoso
Heart failure is a syndrome with high prevalence, morbidity and mortality, but awareness of the disease is poor among the general public and policy makers. This document, which was prepared by a group of experts consisting of cardiologists, internists and general practitioners, aims to set out in detail the problem of heart failure in Portugal at several levels: burden of the disease, diagnosis, treatment and monitoring. To this aim, different aspects of the management of the various stages of the disease are identified and discussed in detail, covering both outpatients and hospitalized patients...
January 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/27987572/-changing-to-a-career-in-general-practice-a-qualitative-study-reveals-motives-of-specialists
#19
Simon Schwill, Julia Magez, Cornelia Jäger, Wolfgang Cg von Meißner, Joachim Szecsenyi, Elisabeth Flum
BACKGROUND: In 2011, the national German Medical Association (Bundesärztekammer) published guidelines for a slim-lined training program in general practice (Quereinstieg) for qualified medical specialists in other fields (e. g., surgeons, internists or anesthesiologists). This step is part of a strategy to prevent further shortages of general practitioners in Germany. In the state of Baden-Wuerttemberg, qualified medical specialists are allowed to complete their general practice training in approximately two years instead of five...
December 2016: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/27986199/direct-medical-costs-of-chronic-urticaria-in-a-private-health-organization-of-buenos-aires-argentina
#20
Claudio Alberto Salvador Parisi, Carla Ritchie, Natalia Petriz, Christian Morelo Torres
BACKGROUND: Scarce studies address the issue of resource consumption and direct health care costs of patients diagnosed with adult-onset chronic urticaria (CU). OBJECTIVES: To estimate medical resource consumption and direct health care costs of affected patients in a private health maintenance organization in Buenos Aires, Argentina. METHODS: Patients diagnosed with adult-onset CU (International Classification of Diseases, Ninth Revision, Clinical Modification code 708...
December 2016: Value in Health Regional Issues
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