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https://www.readbyqxmd.com/read/29440802/patients-with-end-stage-oncologic-and-nononcologic-disease-in-emergency-service-of-an-urban-tertiary-hospital
#1
Jose P Amado, Rolando Vasquez, Roberto W Huari, Andrea S Sucari, Teodoro J Oscanoa
Context: In the last decades, patients with chronic terminal diseases have had more frequent visits to emergency services. Aims: This study aims to determine the proportion of terminal illness in patients readmitted to emergency room, to evaluate the use of this service and rate of death. Settings and Design: A cross-sectional study in a tertiary hospital with 120 stretchers which annually reports 160 thousand attentions and 22 thousand admissions...
January 2018: Indian Journal of Palliative Care
https://www.readbyqxmd.com/read/29436404/from-systems-biology-to-p4-medicine-applications-in-respiratory-medicine
#2
Guillaume Noell, Rosa Faner, Alvar Agustí
Human health and disease are emergent properties of a complex, nonlinear, dynamic multilevel biological system: the human body. Systems biology is a comprehensive research strategy that has the potential to understand these emergent properties holistically. It stems from advancements in medical diagnostics, "omics" data and bioinformatic computing power. It paves the way forward towards "P4 medicine" (predictive, preventive, personalised and participatory), which seeks to better intervene preventively to preserve health or therapeutically to cure diseases...
March 31, 2018: European Respiratory Review: An Official Journal of the European Respiratory Society
https://www.readbyqxmd.com/read/29414558/illness-identity-in-young-adults-with-refractory-epilepsy
#3
Koen Luyckx, Leen Oris, Koen Raymaekers, Jessica Rassart, Philip Moons, Ludo Verdyck, Teus Mijnster, Ruth E Mark
INTRODUCTION: Refractory epilepsy is an intrusive condition with important implications for daily functioning in emerging and young adulthood. The present study examined the degree to which refractory epilepsy is integrated in one's identity, and examined how such a sense of illness identity was related to health-related quality of life (HRQOL). METHODS: A total of 121 18- to 40-year-old patients with refractory epilepsy (56.2% women) completed self-report questionnaires assessing the four illness identity states of acceptance, enrichment, engulfment, and rejection (Illness Identity Questionnaire (IIQ)); HRQOL (Quality of Life in Epilepsy Inventory - 31); and seizure frequency and severity (Liverpool Seizure Severity Scale (LSSS))...
February 1, 2018: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/29411238/hospital-level-care-at-home-for-acutely-ill-adults-a-pilot-randomized-controlled-trial
#4
David M Levine, Kei Ouchi, Bonnie Blanchfield, Keren Diamond, Adam Licurse, Charles T Pu, Jeffrey L Schnipper
BACKGROUND: Hospitals are standard of care for acute illness, but hospitals can be unsafe, uncomfortable, and expensive. Providing substitutive hospital-level care in a patient's home potentially reduces cost while maintaining or improving quality, safety, and patient experience, although evidence from randomized controlled trials in the US is lacking. OBJECTIVE: Determine if home hospital care reduces cost while maintaining quality, safety, and patient experience...
February 6, 2018: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/29401706/conceptualizing-and-managing-medical-emergencies-where-no-formal-paramedical-system-exists-perspectives-from-a-remote-indigenous-community-in-canada
#5
Jeffrey Curran, Stephen D Ritchie, Jackson Beardy, David VanderBurgh, Karen Born, John Lewko, Aaron M Orkin
(1) Background: Remote communities in Canada lack an equitable emergency medical response capacity compared to other communities. Community-based emergency care (CBEC) training for laypeople is a model that has the potential to enhance the medical emergency response capacity in isolated and resource-limited contexts. The purpose of this study was to understand the characteristics of medical emergencies and to conceptualize and present a framework for what a medical emergency is for one remote Indigenous community in northwestern Ontario, in order to inform the development of CBEC training...
February 4, 2018: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/29392748/preliminary-validation-of-a-self-efficacy-scale-for-pediatric-chronic-illness
#6
N D Emerson, H E R Morrell, N Mahtani, L Sanderson, C Neece, K C Boyd, B Distelberg
BACKGROUND: Tracking self-efficacy may be useful for identifying children at risk for medical noncompliance. We created the Pediatric Rating of Chronic Illness Self-Efficacy (PRCISE) to measure self-efficacy in youth dealing with a chronic illness. METHOD: Data were collected from 217 families where one child aged 7-20 (Mage  = 13.62, SDage  = 2.92; 62.7% Latino, 58.1% female) had a chronic illness. Parent participants provided demographic information. Youth completed a depression measure, the Patient Health Questionnaire for Adolescents and the PRCISE...
February 1, 2018: Child: Care, Health and Development
https://www.readbyqxmd.com/read/29388467/emerging-therapeutics-in-pulmonary-hypertension
#7
Matthew K Hensley, Andrea Levine, Mark T Gladwin, Yen-Chun Lai
Pulmonary hypertension (PH) is a progressive and often fatal illness presenting with nonspecific symptoms of dyspnea, lower extremity edema, and exercise intolerance. Pathologically, endothelial dysfunction leads to abnormal intimal and smooth muscle proliferation along with reduced apoptosis, resulting in increased pulmonary vascular resistance (PVR) and elevated pulmonary pressures. PH is subdivided into five WHO groups based on the disease pathology and specific cause. While there are FDA-approved medications for the treatment of pulmonary arterial hypertension (PAH, Group 1 PH), as well as for chronic thromboembolic pulmonary hypertension (CTEPH, Group 4 PH), the morbidity and mortality remain high...
February 1, 2018: American Journal of Physiology. Lung Cellular and Molecular Physiology
https://www.readbyqxmd.com/read/29377711/the-period-prevalence-of-mind-and-body-practice-use-by-adult-emergency-department-patients
#8
Ashleigh J Sellar, David McD Taylor, Nicholas D Ross, Hayley H Chen, Luke D Plant, Daniel McLean, Paul Berlingeri, Rex Gavan, Tracey J Weiland, Jonathan C Knott
OBJECTIVES: Mind and Body Practice (MBP) use (e.g., chiropractic, acupuncture, meditation) among Emergency Department (ED) patients is largely unknown. We aimed to determine the period prevalence, nature of MBP use, and perceptions of MBP among adult ED patients. DESIGN AND SETTING: We undertook a cross-sectional survey of a convenience sample of patients presenting to three EDs between February and June 2016. SUBJECTS: Patients were eligible for inclusion if they were aged 18 years or more and had presented for medical treatment...
January 29, 2018: Journal of Alternative and Complementary Medicine: Research on Paradigm, Practice, and Policy
https://www.readbyqxmd.com/read/29361704/usefulness-of-a-telemedicine-program-in-refractory-older-congestive-heart-failure-patients
#9
Emanuela Burdese, Marzia Testa, Pasquale Raucci, Cinzia Ferreri, Gabriele Giovannini, Enrico Lombardo, Enrico Avogadri, Mauro Feola
BACKGROUND: Home telemonitoring is a modern and effective disease management model that is able to improve medical care, quality of life, and prognosis of chronically ill patients, and to reduce expenditure. The objective of this study was to evaluate the efficacy, costs, and patients' and caregivers' acceptance of our model of telemedicine in a high-risk chronic heart failure (CHF) older population. METHODS: Patients with high risk/refractory CHF were included...
January 20, 2018: Diseases (Basel)
https://www.readbyqxmd.com/read/29352532/the-impact-of-severe-mental-disorders-and-psychotropic-medications-on-sexual-health-and-its-implications-for-clinical-management
#10
Angel L Montejo, Laura Montejo, David S Baldwin
Sexual dysfunction often accompanies severe psychiatric illness and can be due to both the mental disorder itself and the use of psychotropic treatments. Many sexual symptoms resolve as the mental state improves, but treatment-related sexual adverse events tend to persist over time, and are unfortunately under-recognized by clinicians and scarcely investigated in clinical trials. Treatment-emergent sexual dysfunction adversely affects quality of life and may contribute to reduce treatment adherence. There are important differences between the various compounds in the incidence of adverse sexual effects, associated with differences in mechanisms of action...
February 2018: World Psychiatry: Official Journal of the World Psychiatric Association (WPA)
https://www.readbyqxmd.com/read/29347834/acute-care-use-for-ambulatory-care-sensitive-conditions-in-high-cost-users-of-medical-care-with-mental-illness-and-addictions
#11
Jennifer M Hensel, Valerie H Taylor, Kinwah Fung, Rebecca Yang, Simone N Vigod
OBJECTIVE: The role of mental illness and addiction in acute care use for chronic medical conditions that are sensitive to ambulatory care management requires focussed attention. This study examines how mental illness or addiction affects risk for repeat hospitalization and/or emergency department use for ambulatory care-sensitive conditions (ACSCs) among high-cost users of medical care. METHOD: A retrospective, population-based cohort study using data from Ontario, Canada...
January 1, 2018: Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie
https://www.readbyqxmd.com/read/29329727/parent-activation-in-the-pediatric-emergency-department-theory-vs-reality
#12
Danica B Liberman, Phung K Pham
OBJECTIVE: To measure parent activation and test for its associations with sociodemographics, clinical factors, and short-term outcomes. METHODS: By convenience sampling, 246 parents of children treated in an emergency department (ED) of a children's hospital completed the Parent-Patient Activation Measure (P-PAM) and answered sociodemographic questions. Clinical information was abstracted from medical records. Phone calls to parents and primary care physician offices were conducted within one-month post-ED visit for information about short-term outcomes...
January 8, 2018: Patient Education and Counseling
https://www.readbyqxmd.com/read/29305389/before-narrative-episodic-reading-and-representations-of-chronic-pain
#13
Sara Wasson
This article suggests that some illness experience may require a reading practice less concerned with narrative coherence or self-authorship, and more interested in the value of textual fragments, episodes and moments considered outside a narrative framework. Chronic pain can pose multiple challenges to the narrative orientations celebrated in both 'survivorship' discourse and classic medical humanities scholarship. In its recalcitrance to cure, its often mysterious aetiology and its complex blend of somatic, interpersonal and affective elements, representations of chronic pain can require a richer vocabulary of temporality...
January 5, 2018: Medical Humanities
https://www.readbyqxmd.com/read/29305381/thirty-day-hospital-readmissions-among-mechanically-ventilated-emergency-department-patients
#14
David B Page, Anne M Drewry, Enyo Ablordeppey, Nicholas M Mohr, Marin H Kollef, Brian M Fuller
BACKGROUND: Unplanned 30-day readmissions have a negative impact on patients and healthcare systems. Mechanically ventilated ED patients are at high risk for complications, but factors associated with readmission are unknown. OBJECTIVE: (1) Determine the rate of 30-day hospital readmission for ED patients receiving mechanical ventilation. (2) Identify associations between ED-based risk factors and readmission. DESIGN: Retrospective cohort study...
January 5, 2018: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29298247/the-effect-of-early-knowledge-of-respiratory-syncytial-virus-positivity-on-medical-decision-making-and-throughput-time-within-the-pediatric-emergency-department
#15
Jessica Schnell, Lisa Schroeder, Kelly Sinclair, Lina Patel, Denise Dowd
OBJECTIVE: The aim of this study was to evaluate whether early knowledge of respiratory syncytial virus (RSV) positivity by rapid triage-based testing protocol improved emergency department (ED) throughput time and decreased ED ancillary testing and antibiotic administration. METHODS: A retrospective cohort study was performed of ED patients aged 2 to 12 months, presenting November 1 to March 31 for the years 2008-2013. Included patients presented with fever and upper respiratory tract symptoms...
January 2, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29295829/medication-therapy-management-after-hospitalization-in-ckd-a-randomized-clinical-trial
#16
Katherine R Tuttle, Radica Z Alicic, Robert A Short, Joshua J Neumiller, Brian J Gates, Kenn B Daratha, Celestina Barbosa-Leiker, Sterling M McPherson, Naomi S Chaytor, Brad P Dieter, Stephen M Setter, Cynthia F Corbett
BACKGROUND AND OBJECTIVES: CKD is characterized by remarkably high hospitalization and readmission rates. Our study aim was to test a medication therapy management intervention to reduce subsequent acute care utilization. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: The CKD Medication Intervention Trial was a single-blind (investigators), randomized clinical trial conducted at Providence Health Care in Spokane, Washington. Patients with CKD stages 3-5 not treated by dialysis who were hospitalized for acute illness were recruited...
January 2, 2018: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/29231878/greek-medicine-practice-at-ancient-rome-the-physician-molecularist-asclepiades
#17
Luigi Santacroce, Lucrezia Bottalico, Ioannis Alexandros Charitos
Background: In the pre-Hellenistic period, the concept of medicine was not well-defined. Usually, a disease was considered as a divine punishment and its treatment was devolved to the priests who asked for healing from the divinities. The only job that could be compared to medical practice was a kind of itinerant medicine, derived from the Egyptian therapeutic tradition based only on practical experience and performed by people that knew a number of remedies, mostly vegetable, but without any theoretical bases about the possible mechanisms of action...
December 12, 2017: Medicines (Basel, Switzerland)
https://www.readbyqxmd.com/read/29217389/competencies-for-engaging-high-needs-patients-in-primary-care
#18
Michael J Yedidia
BACKGROUND: Patients who heavily utilize hospitals and emergency departments frequently have complex needs requiring services spanning medical, behavioral, and social service sectors. This study identifies essential competencies for caring for high-needs patients and highlights their importance to primary care delivery. METHODS: Transcripts of in-depth interviews with 30 clinical and administrative staff at 23 complex care programs across the United States were analyzed using standard qualitative techniques...
December 4, 2017: Healthcare
https://www.readbyqxmd.com/read/29200315/psychosocial-working-conditions-as-determinants-of-asthma-self-management-at-work-a-systematic-review
#19
Katherina Heinrichs, Peter Angerer, Adrian Loerbroks
OBJECTIVE: Asthma exerts a considerable impact on patients and their employers. While adequate self-management is able to improve patients' prognosis, its actual implementation in everyday life may depend on contextual factors. We aimed to review the literature on the potential determinants of asthma self-management at the workplace. DATA SOURCES: We systematically searched Medline and PsycINFO using terms related to the key concepts of interest (i.e., adult asthma, working conditions, and self-management)...
December 4, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/29195773/cognitive-deficits-in-bipolar-disorders-implications-for-emotion
#20
REVIEW
Isabela M M Lima, Andrew D Peckham, Sheri L Johnson
Prominent cognitive deficits have been documented in bipolar disorder, and multiple studies suggest that these deficits can be observed among non-affected first-degree relatives of those with bipolar disorder. Although there is variability in the degree of cognitive deficits, these deficits are robustly relevant for functional outcomes. A separate literature documents clear difficulties in emotionality, emotion regulation, and emotion-relevant impulsivity within bipolar disorder, and demonstrates that these emotion-relevant variables are also central to outcome...
November 21, 2017: Clinical Psychology Review
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