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https://www.readbyqxmd.com/read/29029109/early-diagnosis-of-acute-coronary-syndrome
#1
Hugo Katus, André Ziegler, Okan Ekinci, Evangelos Giannitsis, Wendy Gattis Stough, Stephan Achenbach, Stefan Blankenberg, Martina Brueckmann, Paul Collinson, Dorin Comaniciu, Filippo Crea, Wilfried Dinh, Grégory Ducrocq, Frank A Flachskampf, Keith A A Fox, Matthias G Friedrich, Kathy A Hebert, Anders Himmelmann, Mark Hlatky, Dominik Lautsch, Bertil Lindahl, Daniel Lindholm, Nicholas L Mills, Giorgio Minotti, Martin Möckel, Torbjørn Omland, Véronique Semjonow
The diagnostic evaluation of acute chest pain has been augmented in recent years by advances in the sensitivity and precision of cardiac troponin assays, new biomarkers, improvements in imaging modalities, and release of new clinical decision algorithms. This progress has enabled physicians to diagnose or rule-out acute myocardial infarction earlier after the initial patient presentation, usually in emergency department settings, which may facilitate prompt initiation of evidence-based treatments, investigation of alternative diagnoses for chest pain, or discharge, and permit better utilization of healthcare resources...
October 3, 2017: European Heart Journal
https://www.readbyqxmd.com/read/29029048/general-practitioners-perception-of-being-a-doctor-in-urban-vs-rural-regions-in-germany-a-focus-group-study
#2
Nadine J Pohontsch, Heike Hansen, Ingmar Schäfer, Martin Scherer
Background: Inadequate recruitment numbers for GPs in rural regions give cause for concern. Working in rural regions is less attractive among medical students because of strong associations concerning a higher workload, restriction of privacy and demands exceeding their competences. We aimed to explore perceptions of GPs working in urban versus rural regions to contrast these prejudices. Methods: We conducted nine focus groups with GPs [female = 21, male = 44] from urban and rural regions, using a semi-structured guideline...
September 23, 2017: Family Practice
https://www.readbyqxmd.com/read/29028792/is-a-psychotherapeutic-approach-possible-in-primary-health-care
#3
Julio Torales, Iván Barrios, Susana Calero
The development of valid psychotherapeutic approaches, adapted to the characteristics of the consultation in primary care, is a subject in constant development. In order to work effectively in a model of psychotherapy adjusted to primary care, the health practitioner (psychiatrist, psychologist, or family physician) must constantly focus on finding the most efficient way to treat the patient, in a short period of time, and with different nuances from those usually used in secondary care: That is, an eclectic and pragmatic approach to dealing with the problems that patients bring to consultation, and a practical and direct way of assisting them, in order to achieve therapeutic goals...
October 11, 2017: Medwave
https://www.readbyqxmd.com/read/29027898/surgery-versus-antibiotics-for-uncomplicated-appendicitis-which-would-a-medical-student-want
#4
Alison R Althans, Pierre Tamer, Justin T Brady, Emily Steinhagen, Vanessa P Ho
BACKGROUND: Recent data suggest that treatment of acute, uncomplicated appendicitis (AUA) with antibiotics is as effective as surgery. A 2015 study indicated that more than 50% of patients would choose antibiotic therapy. Medical students represent a unique population of potential patients with greater medical knowledge than the general public and possibly less bias than practicing physicians. Therefore, we aimed to evaluate what the MEDICAL STUDENT'S treatment choice for AUA would be and what factors influence these decisions...
October 13, 2017: Surgical Infections
https://www.readbyqxmd.com/read/29027479/understanding-barriers-to-literacy-promotion-among-new-jersey-general-pediatricians
#5
Julia Mayne, Shilpa Pai, Lesley Morrow, Daniel Lima, Manuel E Jimenez
Low literacy is associated with poor health. We sought to examine pediatricians' attitudes and practices regarding literacy promotion in early childhood. We distributed a self-administered 23-item survey to a random sample of 500 board certified or eligible New Jersey primary care pediatricians. 134 surveys were returned, 25 of which were excluded. In all, 91% of pediatricians in our sample agreed that literacy promotion was an essential aspect of practice, and two-thirds agreed that they conduct activities to promote literacy...
October 1, 2017: Clinical Pediatrics
https://www.readbyqxmd.com/read/29027392/summary-of-guidelines-for-the-use-of-pre-exposure-prophylaxis-for-hiv-in-korea
#6
REVIEW
(no author information available yet)
There are several guidelines for the use of pre-exposure prophylaxis (PrEP) for human immunodeficiency virus (HIV) which are used in other countries. However, the implementation of such guidelines in each country should be modified according to the country's clinical and epidemiological situation. Therefore, The Korean Society for AIDS founded a committee in 2016 to develop guidelines for the use of PrEP for HIV that are optimal for Korea's clinical and epidemiological situation. These guidelines aim to provide comprehensive information for PrEP implementation in Korea...
September 2017: Infection & Chemotherapy
https://www.readbyqxmd.com/read/29027301/challenges-of-post-authorization-safety-studies-lessons-learned-and-results-of-a-french-study-of-fentanyl-buccal-tablet
#7
REVIEW
Natalie Gavrielov-Yusim, Ilda Bidollari, Sigal Kaplan, Netta Bartov
PURPOSE: Recruiting and retaining participants in real-world studies that collect primary data are challenging. This article illustrates these challenges using a post-authorization safety study (PASS) to assess adverse events (AEs) experienced with fentanyl buccal tablet (FBT) over 3 months of treatment. METHODS: This was an observational, prospective, multicenter study in France conducted over 1 year. The study employed primary data collection in FBT-treated patients and their treating physicians via a site qualification questionnaire and patient log completed by physicians and a questionnaire and pain diary completed by patients...
October 13, 2017: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/29027127/use-of-supplementary-patient-education-material-increases-treatment-adherence-and-satisfaction-among-acne-patients-receiving-adapalene-0-1-benzoyl-peroxide-2-5-gel-in-primary-care-clinics-a-multicenter-randomized-controlled-clinical-study
#8
Timothy Myhill, Warwick Coulson, Paul Nixon, Simon Royal, Terry McCormack, Nabil Kerrouche
INTRODUCTION: Poor adherence to acne treatment may lead to unnecessary treatments, increased healthcare costs, and reduced quality of life (QoL). This multicenter study evaluated the effect of supplementary patient education material (SEM) (a short video, information card, and additional information available online) on treatment adherence and satisfaction among acne patients treated with the fixed-dose combination adapalene 0.1%/benzoyl peroxide 2.5% gel (A/BPO) in primary care clinics versus (1) standard-of-care patient education (SOCPE) (package insert and oral instruction) and (2) SOCPE plus more frequent clinic visits...
October 12, 2017: Dermatology and Therapy
https://www.readbyqxmd.com/read/29027070/assessment-of-current-genetic-counselor-practices-in-post-visit-written-communications-to-patients
#9
Emily VandenBoom, Angela M Trepanier, Erin P Carmany
Providing patients with post-visit written communication (PVWC) is a long-standing component of genetic counseling. However the depiction of this practice in today's clinical landscape is limited. To better describe this practice, we surveyed practicing clinical genetic counselors to ask if they send post-visit communications to patients and if so, what are the types, the average length, and the average time spent writing. They were also asked the perceived purpose of providing PVWC, if/how the practice has changed over time, and factors influencing the practice...
October 12, 2017: Journal of Genetic Counseling
https://www.readbyqxmd.com/read/29027005/utility-of-the-revised-edmonton-symptom-assessment-system-esas-r-and-the-patient-reported-functional-status-prfs-in-lung-cancer-patients
#10
M N Yogananda, Valliappan Muthu, Kuruswamy Thurai Prasad, Adarsh Kohli, Digambar Behera, Navneet Singh
BACKGROUND: Symptom palliation is an important objective of treatment in advanced/metastatic lung cancer (LC). Significant psychological, minor physical symptoms and several social/emotional issues often go unnoticed. This prospective study aimed to evaluate utility of patients' perspectives [self-reported symptom assessment by revised Edmonton Symptom Assessment System (ESAS-r) and self-reported functional status by Patient-Reported Functional Status (PRFS)] amongst LC patients undergoing chemotherapy...
October 12, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/29026889/study-design-of-real-world-evidence-for-treatment-of-hyperkalemia-in-the-emergency-department-reveal-ed-a-multicenter-prospective-observational-study
#11
Zubaid Rafique, Mikhail Kosiborod, Carol L Clark, Adam J Singer, Stewart Turner, Joseph Miller, Douglas Char, W Frank Peacock
OBJECTIVE: Hyperkalemia affects up to 10% of hospitalized patients and, if left untreated, can lead to serious cardiac arrhythmias or death. Although hyperkalemia is frequently encountered in the emergency department (ED), and is potentially life-threatening, standard of care for the treatment is poorly defined, with little supporting evidence. The main objectives of this observational study are to define the overall burden of hyperkalemia in the ED setting, describe its causes, the variability in treatment patterns and characterize the effectiveness and safety of ED standard of care therapies used in the United States...
September 2017: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/29026820/a-qualitative-assessment-of-the-journey-to-delayed-breast-reconstruction
#12
Ho Man Cheng, Catherine McMillan, Joan E Lipa, Laura Snell
BACKGROUND: Canada has low immediate breast reconstruction (IBR) rates compared to the United States and Europe. Breast cancer survivors live with mastectomy defects sometimes for years, and this represents an area for improvement in cancer care. PURPOSE: This study qualitatively assessed (1) information provided about breast reconstruction at the time of cancer diagnosis among women seeking delayed breast reconstruction (DBR) and (2) referral practices for plastic surgery consultation for DBR...
August 2017: Plastic Surgery
https://www.readbyqxmd.com/read/29026808/low-frequency-ultrasound-debridement-in-chronic-wound-healing-a-systematic-review-of-current-evidence
#13
Ying-Ju Ruby Chang, Julie Perry, Karen Cross
Chronic wounds are painful and debilitating to patients, pose a clinical challenge to physicians, and impose financial burden on the health-care system. New treatment options are therefore highly sought after. Ultrasound debridement is a promising technology that functions to disperse bacterial biofilms and stimulate wound healing. In this review, we focus on low-frequency ultrasound (20-60 kHz) and summarize the findings of 25 recent studies examining ultrasound efficacy. Ultrasound debridement appears to be most effective when used 3 times a week and has the potential to decrease exudate and slough, decrease patient pain, disperse biofilms, and increase healing in wounds of various etiology...
February 2017: Plastic Surgery
https://www.readbyqxmd.com/read/29026730/important-role-of-medical-training-curriculum-to-promote-the-rate-of-human-milk-feeding
#14
REVIEW
Yong Joo Kim
The rate of human milk feeding has been decreasing despite the diverse efforts of many physicians and nurses, as well as numerous professional organizations and various international health institutions. The number of physicians and nurses who can provide proper guidance for human milk feeding and offer appropriate knowledge and techniques to allow the most beneficial and convenient manner of breastfeeding is quite deficient. It is suggested that physicians and nurses be trained to teach and educate about the medical importance of human milk feeding to lactating mothers...
September 2017: Pediatric Gastroenterology, Hepatology & Nutrition
https://www.readbyqxmd.com/read/29026602/re-phrasing-the-question-a-simple-tool-for-evaluation-of-adherence-to-therapy-in-patients-with-inflammatory-bowel-disease
#15
T Engel, B Ungar, G Ben-Haim, N Levhar, R Eliakim, S Ben-Horin
BACKGROUND: Non-adherence to medication in patients with inflammatory bowel disease (IBD) is a challenging problem which is often overlooked or under-estimated by the physician or denied by the patient. We aimed to examine if re-phrasing the wording of the question used by the physician could help in revealing more patients who are non-adherent, and for whom appropriate counseling may be instituted. METHODS: A cross-sectional questionnaire-based study of IBD patients treated in a tertiary center was conducted...
October 2017: United European Gastroenterology Journal
https://www.readbyqxmd.com/read/29026591/irritable-bowel-syndrome-diagnosis-and-management-a-simplified-algorithm-for-clinical-practice
#16
REVIEW
Paul Moayyedi, Fermín Mearin, Fernando Azpiroz, Viola Andresen, Giovanni Barbara, Maura Corsetti, Anton Emmanuel, A Pali S Hungin, Peter Layer, Vincenzo Stanghellini, Peter Whorwell, Frank Zerbib, Jan Tack
BACKGROUND: Effective management of irritable bowel syndrome (IBS), a common functional gastrointestinal disorder, can be challenging for physicians because of the lack of simple diagnostic tests and the wide variety of treatment approaches available. OBJECTIVE: The objective of this article is to outline a simple algorithm for day-to-day clinical practice to help physicians navigate key stages to reaching a positive IBS diagnosis and guidance on how to prioritise the use of specific management strategies...
October 2017: United European Gastroenterology Journal
https://www.readbyqxmd.com/read/29026590/eosinophilic-esophagitis-what-can-we-learn-from-crohn-s-disease
#17
REVIEW
Javier Molina-Infante, Alain M Schoepfer, Alfredo J Lucendo, Evan S Dellon
Eosinophilic esophagitis (EoE) is an emerging esophageal inflammatory disorder affecting children and young adults. As a relatively new disease, EoE is still burdened by frequent diagnostic and therapeutic pitfalls in clinical practice. This manuscript posits a number of similarities with Crohn's disease, which may help optimize EoE patient management. Commonalities include epidemiologic trends (Westernized diseases, rising incidence, early-life risk factors), diagnostic considerations (symptoms are poor predictors of disease activity, difficulties in disease activity assessment) and therapeutic issues (similar natural history and therapeutic goals, induction and maintenance phases, combination of drug and endoscopic treatment, potential drug interchangeability, long-term unsolved issues)...
October 2017: United European Gastroenterology Journal
https://www.readbyqxmd.com/read/29026523/medical-support-during-an-ironman-70-3-triathlon-race
#18
Hae-Rang Yang, Jinwoo Jeong, Injoo Kim, Ji Eun Kim
BACKGROUND: The Ironman 70.3 race is also called a half Ironman, and consists of 1.9 km of swimming, 90.1 km of cycling, and 21.1 km of running. The authors provide practical insights that may be useful for medical support in future events by summarizing the process and results of on-scene medical care. METHODS: The medical post was established at the transition area between the cycling and running courses, which was close to the finish line, and staffed with the headquarters team comprised of an emergency physician, an EMT, two nurses, and an ambulance with a driver...
2017: F1000Research
https://www.readbyqxmd.com/read/29025820/well-being-of-family-medicine-graduates
#19
Olga Szafran, Wayne Woloschuk, Jacqueline M I Torti, Douglas Myhre
OBJECTIVE: To determine family medicine graduates' professional and personal well-being, general health status, stress levels, coping strategies, and the degree to which they felt supported or isolated in professional life; and to compare findings by sex, practice location, and location of medical school (Canadian medical graduates [CMGs] vs international medical graduates [IMGs]). DESIGN: Retrospective, cross-sectional survey. SETTING: University of Alberta in Edmonton and the University of Calgary in Alberta...
October 2017: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/29025786/disparity-between-nephrologists-opinions-and-contemporary-practices-for-community-follow-up-after-aki-hospitalization
#20
Divya J Karsanji, Neesh Pannu, Braden J Manns, Brenda R Hemmelgarn, Zhi Tan, Kailash Jindal, Nairne Scott-Douglas, Matthew T James
BACKGROUND AND OBJECTIVES: Recent guidelines suggest that patients should be evaluated after AKI for resolution versus progression of CKD. There is uncertainty as to the role of nephrologists in this process. The objective of this study was to compare the follow-up recommendations from nephrologists with contemporary processes of care for varying scenarios of patients hospitalized with AKI. DESIGN, SETTING PARTICIPANTS, & MEASUREMENTS: We surveyed Canadian nephrologists using a series of clinical vignettes of patients hospitalized with severe AKI and asked them to rank their likelihood of recommending follow-up for each patient after hospital discharge...
October 12, 2017: Clinical Journal of the American Society of Nephrology: CJASN
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