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https://www.readbyqxmd.com/read/28108265/palliative-care-and-parkinson-s-disease-meeting-summary-and-recommendations-for-clinical-research
#1
REVIEW
Benzi M Kluger, Siobhán Fox, Suzanne Timmons, Maya Katz, Nicholas B Galifianakis, Indu Subramanian, Julie H Carter, Miriam J Johnson, Edward W Richfield, David Bekelman, Jean S Kutner, Janis Miyasaki
INTRODUCTION: Palliative care is an approach to caring for patients and families affected by serious illnesses that focuses on the relief of suffering through the management of medical symptoms, psychosocial issues, advance care planning and spiritual wellbeing. Over the past decade there has been an emerging clinical and research interest in the application of palliative care approaches to Parkinson's disease (PD) and outpatient palliative care services are now offered by several movement disorders centers...
January 11, 2017: Parkinsonism & related Disorders
https://www.readbyqxmd.com/read/28097328/diabetes-outpatient-care-and-acute-complications-before-and-after-high-deductible-insurance-enrollment-a-natural-experiment-for-translation-in-diabetes-next-d-study
#2
J Frank Wharam, Fang Zhang, Emma M Eggleston, Christine Y Lu, Stephen Soumerai, Dennis Ross-Degnan
Importance: High-deductible health plans (HDHPs) have expanded under the Affordable Care Act and are expected to play a major role in the future of US health policy. The effects of modern HDHPs on chronically ill patients and adverse outcomes are unknown. Objective: To determine the association of HDHP with high-priority diabetes outpatient care and preventable acute complications. Design, Setting, and Participants: Controlled interrupted-time-series study using a large national health insurer database from January 1, 2003, to December 31, 2012...
January 9, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28040411/emergency-department-critical-care-unit-for-critically-ill-cardiovascular-patients-an-observation-study
#3
Ken-Hui Fu, Yin-Ru Chen, Ju-Shin Fan, Yen-Chia Chen, Hsien-Hao Huang, Chorng-Kuang How, David Hung-Tsang Yen, Si-An Chen, Mu-Shun Huang
BACKGROUND: We investigated an intensive care model for acute critically cardiovascular emergency patients in the emergency department (ED) as compared with those in the coronary care unit (CCU) after ED visits. METHODS: We performed a retrospective cohort analysis of patients with acute cardiovascular emergency admitted to the intensive care unit in the ED (EICU) or CCU from January 1, 2010 to March 31, 2011 in an university-affiliated medical center. All clinical characteristics or predictors possibly related to in-hospital mortality were documented, completed, and measured via electronic medical records review...
December 28, 2016: Journal of the Chinese Medical Association: JCMA
https://www.readbyqxmd.com/read/28034584/percutaneous-endovascular-aneurysm-repair-in-morbidly-obese-patients
#4
Jason A Chin, Laura Skrip, Bauer E Sumpio, Jonathan A Cardella, Jeffrey E Indes, Timur P Sarac, Alan Dardik, Cassius I Ochoa Chaar
OBJECTIVE: Endovascular aneurysm repair (EVAR) with percutaneous femoral access (PEVAR) has several potential advantages. Morbidly obese (MO) patients present unique anatomical challenges and have not been specifically studied. This study examines the trends in the use of PEVAR and its surgical outcomes compared with open femoral cutdown (CEVAR) in MO patients. METHODS: The American College of Surgeons National Surgical Quality Improvement Program files for the years 2005 to 2013 were reviewed...
December 26, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28028673/outcomes-of-elderly-critically-ill-medical-and-surgical-patients-a-multicentre-cohort-study
#5
Ian M Ball, Sean M Bagshaw, Karen E A Burns, Deborah J Cook, Andrew G Day, Peter M Dodek, Demetrios J Kutsogiannis, Sangeeta Mehta, John G Muscedere, Alexis F Turgeon, Henry T Stelfox, George A Wells, Ian G Stiell
PURPOSE: Very elderly (over 80 yr of age) critically ill patients admitted to medical-surgical intensive care units (ICUs) have a high incidence of mortality, prolonged hospital length of stay, and dependent living conditions should they survive. The primary purpose of this study is to describe the outcomes and differences in outcomes between very elderly medical patients and their surgical counterparts admitted to Canadian ICUs, thereby informing decision-making for clinicians and substitute decision-makers...
December 27, 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28006091/cardiometabolic-assessment-diagnosis-and-treatment-of-chronic-medical-illnesses-during-an-inpatient-psychiatric-hospitalization-colocated-medical-care-versus-treatment-as-usual
#6
Jason R Tatreau, Suzanne Harris, Brian Sheitman, Beat D Steiner
Background: Reverse colocation care models reduce lifestyle risk factors, emergency department visits, and readmissions. Persons with serious mental illness have higher than average rates of cardiovascular disease-related morbidity and mortality, with second-generation antipsychotics (SGAs) conferring added related risks. Little is written about reverse colocated medical care (RCL) in inpatient psychiatric settings. The objective of this study was to identify associations between screening, diagnosis, and treatment of chronic medical comorbidities and mode of medical care for patients discharged from 2 inpatient psychiatric units on SGAs...
December 22, 2016: Primary Care Companion to CNS Disorders
https://www.readbyqxmd.com/read/27999490/predictors-for-post-stroke-delirium-outcome
#7
Zikrija Dostovic, Ernestina Dostovic, Dzevdet Smajlovic, Omer C Ibrahimagic, Leila Avdic, Elvir Becirovic
BACKGROUND: There have been only a small number of studies that have evaluated the outcome of post-stroke delirium. OBJECTIVES: To evaluate the effects of gender, age, stroke localization, delirium severity, previous illnesses, associated medical complications on delirium outcome as well as, to determine effects of delirium on cognitive functioning one year after stroke. PATIENTS AND METHODS: Comprehensive neuropsychological assessments were performed within the first week of stroke onset, at hospital discharge, and followed-up for 3, 6 and 12 months after stroke...
October 2016: Materia Socio-medica
https://www.readbyqxmd.com/read/27965236/outcomes-of-emergency-medical-patients-admitted-to-an-intermediate-care-unit-with-detailed-admission-guidelines
#8
Catherine E Simpson, Sarina K Sahetya, Robert W Bradsher, Eric L Scholten, William Bain, Shazia M Siddique, David N Hager
BACKGROUND: An important, but not well characterized, population receiving intermediate care is that of medical patients admitted directly from the emergency department. OBJECTIVE: To characterize emergency medical patients and their outcomes when admitted to an intermediate care unit with clearly defined admission guidelines. METHODS: Demographic data, admitting diagnoses, illness severity, comorbid conditions, lengths of stay, and hospital mortality were characterized for all emergency medical patients admitted directly to an intermediate care unit from July through December 2012...
December 2016: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
https://www.readbyqxmd.com/read/27957661/-it-s-been-an-experience-a-life-learning-experience-a-qualitative-study-of-hospitalized-patients-with-substance-use-disorders
#9
Christine M Velez, Christina Nicolaidis, P Todd Korthuis, Honora Englander
BACKGROUND: Individuals with substance use disorders (SUD) have high rates of chronic illness and readmission, yet few are engaged in addiction treatment. Hospitalization may be a reachable moment for initiating and coordinating addiction care, but little is known about motivation for change in the inpatient setting. OBJECTIVE: To explore the experiences of hospitalized adults with SUD and to better understand patient and system level factors impacting readiness for change...
December 12, 2016: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/27917433/deaths-among-elderly-patients-in-the-emergency-department-a-needs-assessment-for-end-of-life-care
#10
Rakhee Yash Pal, Win Sen Kuan, Yiwen Koh, Kuhan Venugopal, Irwani Ibrahim
INTRODUCTION: Elderly patients with serious chronic diseases often present to the emergency department (ED) in the last moments of their life, many with identifiable trajectories of dying: organ failure; advanced cancer; and chronic frailty. These patients and their families may benefit more from good end-of-life (EOL) care provision than the standard resuscitative approach. This study aimed to determine the incidence and nature of death among patients aged 65 years and above in an ED, and characterise their trajectories of dying...
December 5, 2016: Singapore Medical Journal
https://www.readbyqxmd.com/read/27908330/sepsis-in-special-populations
#11
REVIEW
Matthew P Borloz, Khalief E Hamden
Sepsis is recognized by the presence of physiologic and laboratory changes that reflect the inflammatory response to infection on cellular and systemic levels. Comorbid conditions, such as cirrhosis, end-stage renal disease, and obesity, alter patients' susceptibility to infection and their response to it once present. Baseline changes in vital signs and chronic medications often mask clues to the severity of illness. The physiologic, hematologic, and biochemical adjustments that accompany pregnancy and the puerperium introduce similar challenges...
February 2017: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/27903142/systematic-literature-review-of-general-health-care-interventions-within-programs-of-assertive-community-treatment
#12
Erik R Vanderlip, Benjamin F Henwood, Debra R Hrouda, Piper S Meyer, Maria Monroe-DeVita, Lynette M Studer, April J Schweikhard, Lorna L Moser
OBJECTIVE: Assertive community treatment (ACT) is one of the few evidence-based practices for adults with severe mental illness. Interest has slowly waned for ACT implementation. Yet ACT remains an appealing services platform to achieve the triple aim of health care reform (improved health outcomes, reduced cost, and improved satisfaction) through integration of primary care and behavioral health services. This review highlights the evidence for ACT to improve general medical outcomes, reduce treatment costs, and increase access to treatment...
December 1, 2016: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/27884006/current-psychosomatic-practice
#13
Giovanni A Fava, Fiammetta Cosci, Nicoletta Sonino
Psychosomatic research has advanced over the past decades in dealing with complex biopsychosocial phenomena and may provide new effective modalities of patient care. Among psychosocial variables affecting individual vulnerability, course, and outcome of any medical disease, the role of chronic stress (allostatic load/overload) has emerged as a crucial factor. Assessment strategies include the Diagnostic Criteria for Psychosomatic Research. They are presented here in an updated version based on insights derived from studies carried out so far and encompass allostatic overload, type A behavior, alexithymia, the spectrum of maladaptive illness behavior, demoralization, irritable mood, and somatic symptoms secondary to a psychiatric disorder...
2017: Psychotherapy and Psychosomatics
https://www.readbyqxmd.com/read/27865292/katrina-s-legacy-processes-for-patient-disaster-preparation-have-improved-but-important-gaps-remain
#14
Marjorie Icenogle, Sasha Eastburn, Martha Arrieta
BACKGROUND: Ensuring continuity of care for patients with chronic illness, who are elderly or indigent presents unique challenges after disasters; this population has fewer financial resources, is less likely to evacuate, has limited access to recovery resources and is significantly dependent on charitable and government-funded institutions for care. This study expands a previous investigation of the extent to which healthcare providers in coastal Mississippi and Alabama have made changes to facilitate continued care to these populations after disasters...
November 2016: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/27855438/how-to-prevent-depression-current-directions-and-future-challenges-in-children-with-chronic-medical-conditions
#15
Anna Felnhofer, Oswald D Kothgassner, Claudia Klier
With its high rates of chronicity and concomitant economic costs to society, depression ranges among the most prevalent mental disorders. Several trials have succeeded in demonstrating the beneficial effects of early depression prevention programs for otherwise healthy children and adolescents. However, comparable programs for children and adolescents with a medical condition are still scarce. This paper discusses the situation of chronically ill children and adolescents who are at risk of developing comorbid depressive symptoms using the example of three conditions frequently encountered in pediatric psychosomatic medicine: diabetes, epilepsy and inflammatory bowel disease (IBD)...
December 2016: Psychiatria Danubina
https://www.readbyqxmd.com/read/27818420/what-is-the-potential-of-community-paramedicine-to-fill-rural-health-care-gaps
#16
Davis G Patterson, Cynthia Coulthard, Lisa A Garberson, Gary Wingrove, Eric H Larson
Community paramedicine (CP) uses emergency medical services (EMS) providers to help rural communities increase access to primary care and public health services. This study examined goals, activities, and outcomes of 31 rural-serving CP programs through structured interviews of program leaders and document review. Common goals included managing chronic disease (90.3%); and reducing emergency department visits (83.9%), hospital admissions/readmissions (83.9%), and costs (83.9%). Target populations included the chronically ill (90...
2016: Journal of Health Care for the Poor and Underserved
https://www.readbyqxmd.com/read/27806533/epidemiologic-correlates-of-chronic-respiratory-infections-in-adults-an-urban-slum-of-bhubaneswar-odisha-india
#17
Sonali Kar, Ipsa Mohapatra, Amrita Konar
INTRODUCTION: Urbanization is marked by emergence of slum areas, wherein migrants from the nearby villages stay in temporary establishments for seeking avenues of employment. These dwellings lack most of the essential living conditions like safe water, healthy living conditions and access to health services. This population is also vulnerable to social evils like alcohol and tobacco addiction. KIMS, a medical college in Bhubaneswar, Odisha, India has an Urban Health Training Centre (UHTC) that caters to a slum population of nearly 12,000 population for their primary health needs...
August 4, 2016: Global Journal of Health Science
https://www.readbyqxmd.com/read/27799823/dental-management-in-patients-with-hypertension-challenges-and-solutions
#18
REVIEW
Janet H Southerland, Danielle G Gill, Pandu R Gangula, Leslie R Halpern, Cesar Y Cardona, Charles P Mouton
Hypertension is a chronic illness affecting more than a billion people worldwide. The high prevalence of the disease among the American population is concerning and must be considered when treating dental patients. Its lack of symptoms until more serious problems occur makes the disease deadly. Dental practitioners can often be on the frontlines of prevention of hypertension by evaluating preoperative blood pressure readings, performing risk assessments, and knowing when to consider medical consultation of a hypertensive patient in a dental setting...
2016: Clinical, Cosmetic and Investigational Dentistry
https://www.readbyqxmd.com/read/27793514/integrating-behavioral-healthcare-for-individuals-with-serious-mental-illness-a-randomized-controlled-trial-of-a-peer-health-navigator-intervention
#19
Erin Kelly, Lei Duan, Heather Cohen, Holly Kiger, Laura Pancake, John Brekke
OBJECTIVE: Individuals with serious mental illness also have high rates of comorbid physical health issues. To address those issues, this population needs interventions that improve self-management of health and healthcare. METHODS: In order to improve the health and healthcare of individuals with serious mental illnesses, 151 consumers with serious mental illness were randomized to receive either usual mental healthcare plus the Bridge intervention (n=76) or usual mental healthcare while on a 6month waitlist (n=75)...
October 25, 2016: Schizophrenia Research
https://www.readbyqxmd.com/read/27756373/dieulafoy-lesion-in-a-two-year-old-boy-a-case-report
#20
Takaki Emura, Kenji Hosoda, Shota Harai, Noboru Oyachi, Takeyuki Suzuki, Ken Takada, Koji Kobayashi, Hisatake Ikeda
BACKGROUND: Massive gastrointestinal bleeding in children, mostly caused by esophageal varices secondary to chronic liver disease, is uncommon. Dieulafoy lesion in the gastrointestinal tract is a rare but important cause of gastrointestinal bleeding; massive bleeding from this lesion can be fatal unless adequate treatment is promptly initiated. We report a case of gastric Dieulafoy lesion in a 2-year old successfully treated with endoscopic hemoclipping. CASE PRESENTATION: A 2-year-old Japanese boy was admitted to our department with sudden massive hematemesis...
October 19, 2016: Journal of Medical Case Reports
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