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https://www.readbyqxmd.com/read/28651296/early-discharge-hospital-at-home
#1
REVIEW
Daniela C Gonçalves-Bradley, Steve Iliffe, Helen A Doll, Joanna Broad, John Gladman, Peter Langhorne, Suzanne H Richards, Sasha Shepperd
BACKGROUND: Early discharge hospital at home is a service that provides active treatment by healthcare professionals in the patient's home for a condition that otherwise would require acute hospital inpatient care. This is an update of a Cochrane review. OBJECTIVES: To determine the effectiveness and cost of managing patients with early discharge hospital at home compared with inpatient hospital care. SEARCH METHODS: We searched the following databases to 9 January 2017: the Cochrane Effective Practice and Organisation of Care Group (EPOC) register, Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, CINAHL, and EconLit...
June 26, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28649705/naoh-hcl-neutralized-urine-preparation-for-direct-testing-of-uropathogens-by-bruker-ms
#2
Ji Seon Choi, Jayoung Kim, Han-Soo Kim, Chang-Wan Kwon, Min-Sung Kim, Seong-Hyeok Choi
BACKGROUND: We evaluated the analytical performance of a NaOH-HCl neutralization protocol for identifying uropathogens directly from urine samples by a Bruker MS system (Bruker Daltonics, German) and sought to establish a protocol for integrating the method with conventional screening. METHODS: Among all urine samples requested for Gram staining, UF-1000i, and urine cultures by physicians, we selected samples that were positive by both Gram staining and UF-1000i testing...
June 26, 2017: Journal of Clinical Laboratory Analysis
https://www.readbyqxmd.com/read/28649660/how-do-we-increase-uptake-of-tamoxifen-and-other-anti-estrogens-for-breast-cancer-prevention
#3
Katherine D Crew, Kathy S Albain, Dawn L Hershman, Joseph M Unger, Shelly S Lo
Several randomized controlled trials of anti-estrogens, such as tamoxifen and aromatase inhibitors, have demonstrated up to a 50-65% decrease in breast cancerincidence among high-risk women. Approximately 15% of women, age 35-79 years, in the U.S. meet criteria for breast cancer preventive therapies, but uptake of these medications remain low. Explanations for this low uptake includelack of awareness of breast cancer risk status, insufficient knowledge about breast cancer preventive therapies among patients and physicians, and toxicity concerns...
2017: NPJ Breast Cancer
https://www.readbyqxmd.com/read/28648670/the-application-of-atherogenic-dyslipidaemia-consensus-recommendations-in-the-primary-care-setting-dat-ap-study
#4
Angel Díaz Rodríguez, Adalberto Serrano Cumplido, Jesús Millán Nuñez-Cortés, Marta Rodríguez de Miguel, Mª Luisa Orera-Peña
BACKGROUND AND AIMS: The "DAT-AP" (from the Spanish, "Dislipemia ATerogénica en Atención Primaria", for Atherogenic Dyslipidaemia in Primary Care) study objective is to determine to what extent published consensus guidelines for the diagnostic and therapeutic management of AD are used in the primary care setting, and to evaluate the approach of the participating physicians towards the detection, diagnosis, and treatment of AD. METHODS: This is descriptive, cross-sectional, multicentre study performed between January and May 2015 in primary care centres throughout Spain...
June 22, 2017: Clínica e Investigación en Arteriosclerosis
https://www.readbyqxmd.com/read/28648531/attitudes-about-lung-cancer-screening-primary-care-providers-versus-specialists
#5
Sritha Rajupet, Dhvani Doshi, Juan P Wisnivesky, Jenny J Lin
BACKGROUND: On the basis of the results of the National Lung Screening Trial, the US Preventive Services Task Force now recommends yearly low-dose computed tomography (LDCT) for lung cancer screening among high-risk individuals. There is limited information regarding physician attitudes toward LDCT screening and whether these vary according to provider specialty. MATERIALS AND METHODS: Primary care providers (PCPs) and specialists were surveyed about their knowledge and attitudes toward lung cancer screening and likelihood to order an LDCT screening...
May 10, 2017: Clinical Lung Cancer
https://www.readbyqxmd.com/read/28648330/experience-with-patient-referrals-for-upper-extremity-transplantation-at-a-u-s-academic-medical-center
#6
Harriet Kiwanuka, Mario A Aycart, Ericka M Bueno, Bohdan Pomahac, Simon G Talbot
PURPOSE: To date, there have been over 100 upper extremity transplantations (UET) performed worldwide. However, little data are available regarding institutional screening practices or description of the population of patients that seek transplantation as a treatment modality for their upper extremity disabilities. We performed a review of our institutional experience in an attempt to better understand our referral patterns and identify factors that may be associated with successful screening...
June 22, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28648264/position-of-the-academy-of-nutrition-and-dietetics-interprofessional-education-in-nutrition-as-an-essential-component-of-medical-education
#7
Lisa A Hark, Darwin Deen
It is the position of the Academy of Nutrition and Dietetics that registered dietitian nutritionists (RDNs) should play a significant role in educating medical students, residents, fellows, and physicians in practice. The more physicians learn about the effectiveness of nutrition for the prevention and treatment of noncommunicable diseases, the more likely they are to consult with RDNs and refer patients for medical nutrition therapy. The more interprofessional education that occurs between medical students, other health professional students, and RDNs, the more likely all health care professionals will understand and value the role of the RDN in improving the quality of care provided to patients...
July 2017: Journal of the Academy of Nutrition and Dietetics
https://www.readbyqxmd.com/read/28648253/statistical-validation-of-1-h-nmr-protocol-vs-standard-biochemical-assay-in-quality-control-of-rbc-packed-units
#8
Thelma A Pertinhez, Emanuela Casali, Laura Zambianchi, Alberto Spisni, Roberto Baricchi
BACKGROUND: Time dependent quantification of endogenous metabolites in biological samples (blood, urine, biological tissues extracts) in normal and pathological conditions as well as following therapeutic protocols is well established. In the clinical practice, such a dynamic flux of information allows the physician to identify and appreciate alterations associated to biochemical pathways of specific organs. In the years, many biochemical assays have been developed to detect, selectively, this vast array of molecules...
June 15, 2017: Journal of Pharmaceutical and Biomedical Analysis
https://www.readbyqxmd.com/read/28647933/a-new-system-of-documentation-to-improve-dietitian-physician-crosstalk
#9
Shelly Rachman-Elbaum, Aliza H Stark, Josefa Kachal, Teresa W Johnson, Bat Sheva Porat-Katz
BACKGROUND: Standardization of the dietetic care process allows for early identification of malnutrition and metabolic disorders, interdisciplinary collaboration among the medical team, and improved quality of patient care. Globally, dietitians are adopting a nutrition care model that integrates national regulations with professional scope of practice. Currently, Israel lacks a standardized dietetic care process and documentation terminology. OBJECTIVES: To assess the utilization of a novel sectoral documentation system for nutrition care in Israel...
June 2017: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/28647851/a-questionnaire-survey-of-radiological-diagnosis-and-management-of-renal-dysplasia-in-children
#10
Giovanni Montini, Marco Busutti, Fatos Yalcinkaya, Adrian S Woolf, Stefanie Weber
BACKGROUND: The condition called renal dysplasia is considered to be a frequent cause of chronic kidney disease in children. Formally, it is defined by histological parameters. In current nephrology practice, however, the appearance of the kidneys on ultrasound scanning is often used as a basis for the diagnosis. METHODS: The European Society for Pediatric Nephrology Working Group on Congenital Anomalies of the Kidney and Urinary Tract hypothesized that the current diagnostic approach with regard to renal dysplasia was not homogeneous...
June 24, 2017: Journal of Nephrology
https://www.readbyqxmd.com/read/28647705/revolution-in-acute-ischaemic-stroke-care-a-practical-guide-to-mechanical-thrombectomy
#11
REVIEW
Matthew Evans, Phil White, Peter Cowley, David Werring
Rapid, safe and effective arterial recanalisation to restore blood flow and improve functional outcome remains the primary goal of hyperacute ischaemic stroke management. The benefit of intravenous thrombolysis with recombinant tissue-type plasminogen activator for patients with severe stroke due to large artery occlusion is limited; early recanalisation is generally less than 30% for carotid, proximal middle cerebral artery or basilar artery occlusion. Since November 2014, nine positive randomised controlled trials of mechanical thrombectomy for large vessel occlusion in the anterior circulation have led to a revolution in the care of patients with acute ischaemic stroke...
June 24, 2017: Practical Neurology
https://www.readbyqxmd.com/read/28647446/social-and-geographic-determinants-of-hysterectomy-in-ontario-a-population-based-retrospective-cross-sectional-analysis
#12
Innie Chen, Michelle R Wise, Sheila Dunn, Geoffrey Anderson, Naushaba Degani, Guylaine Lefebvre, Arlene S Bierman
OBJECTIVES: This study sought to determine whether social factors (neighbourhood education and income) and geographic factors (urban or rural dwelling and local service area) are associated with hysterectomy rates, proportion of hysterectomies performed minimally invasively, and hysterectomy complication and readmission rates in Ontario. METHODS: The Canadian Institute for Health Information Discharge Abstract Database was used to perform a population-based retrospective cross-sectional study on women who had an abdominal, vaginal, and laparoscopic hysterectomy in 2007 for benign gynaecologic conditions in hospitals in Ontario, Canada...
June 21, 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28646809/efficacy-of-fascial-distortion-model-treatment-for-acute-nonspecific-low-back-pain-in-primary-care-a-prospective-controlled-trial
#13
Detlef Richter, Matthias Karst, Hartmut Buhck, Matthias G Fink
Context • Low-back pain (LBP) is a prevalent and potentially crippling condition for which treatment is often unsatisfactory from the perspectives of physicians, patients, and payers. The application of the fascial distortion model (FDM), an integrated concept for the diagnosis and manipulative treatment of musculoskeletal disorders, is conceptually promising for LBP but has not been investigated systematically. Objective • The study intended to provide proof of concept to establish the noninferiority of the FDM treatment as opposed to the therapy recommended by the German National Disease Management Guideline (NDMG) for acute LBP...
June 23, 2017: Alternative Therapies in Health and Medicine
https://www.readbyqxmd.com/read/28646580/biosimilars-for-psoriasis-worldwide-overview-of-regulatory-guidelines-uptake-and-implications-for-dermatology-clinical-practice
#14
REVIEW
A D Cohen, J J Wu, L Puig, S Chimenti, R Vender, M Rajagopalan, R Romiti, C de la Cruz, L Skov, C Zachariae, H S Young, P Foley, J M van der Walt, L Naldi, A Blauvelt
The introduction of biologic drugs for the treatment of patients with psoriasis has revolutionized treatment paradigms and enabled numerous patients to achieve disease control with an acceptable safety profile. However, the high cost of biologics limits access to these medications for the majority of patients worldwide. In recent years, the introduction of biosimilars for inflammatory diseases has become a fast evolving field. The future use of biosimilars offers the potential for decreased cost and increased access to biologic drugs for patients with psoriasis...
June 24, 2017: British Journal of Dermatology
https://www.readbyqxmd.com/read/28645968/development-of-a-meta-algorithm-for-guiding-primary-care-encounters-for-patients-with-multimorbidity-using-evidence-based-and-case-based-guideline-development-methodology
#15
Cathleen Muche-Borowski, Dagmar Lühmann, Ingmar Schäfer, Rebekka Mundt, Hans-Otto Wagner, Martin Scherer
OBJECTIVE: The study aimed to develop a comprehensive algorithm (meta-algorithm) for primary care encounters of patients with multimorbidity. We used a novel, case-based and evidence-based procedure to overcome methodological difficulties in guideline development for patients with complex care needs. STUDY DESIGN: Systematic guideline development methodology including systematic evidence retrieval (guideline synopses), expert opinions and informal and formal consensus procedures...
June 22, 2017: BMJ Open
https://www.readbyqxmd.com/read/28645938/practice-patterns-for-acute-ischemic-stroke-workup-a-longitudinal-population-based-study
#16
Matthew C Loftspring, Brett M Kissela, Matthew L Flaherty, Jane C Khoury, Kathleen Alwell, Charles J Moomaw, Dawn O Kleindorfer, Daniel Woo, Opeolu Adeoye, Simona Ferioli, Joseph P Broderick, Pooja Khatri
BACKGROUND: We examined practice patterns of inpatient testing to identify stroke etiologies and treatable risk factors for acute ischemic stroke recurrence. METHODS AND RESULTS: We identified stroke cases and related diagnostic testing from four 1-year study periods (July 1993 to June 1994, 1999, 2005, and 2010) of the Greater Cincinnati/Northern Kentucky Stroke Study. Patients aged ≥18 years were included. We focused on evaluation of extracranial arteries for carotid stenosis and assessment of atrial fibrillation because randomized controlled trials supported treatment of these conditions for stroke prevention across all 4 study periods...
June 23, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28645640/communicating-to-promote-informed-decisions-in-the-context-of-early-pregnancy-loss
#17
Maria Brann, Jennifer J Bute
OBJECTIVE: To evaluate residents' ability to engage standardized patients in informed decision making during a pregnancy loss scenario. METHODS: Forty patient encounters between interns and standardized patients were coded to assess informed decision-making practices, exploration of unexpressed concerns, and support provision. RESULTS: Interns engaged in minimum informed decision making but did not address all of the communicative elements necessary for informed decisions, and most elements were only partially addressed...
June 17, 2017: Patient Education and Counseling
https://www.readbyqxmd.com/read/28644788/initiatives-for-responding-to-medical-trainees-moral-distress-about-end-of-life-cases
#18
M Sara Rosenthal, Maria Clay
Moral distress frequently arises for medical trainees exposed to end-of-life cases. We review the small literature on best practices for reducing moral distress in such cases and propose two areas to target for moral distress reduction: medical education and organizational ethics programs. Students require training in end-of-life dialogues and truthful prognostication, which are not generally available without skilled mentors. But physician-mentors and teachers can suffer from lingering moral residue themselves, which can affect the teaching culture and student expectations...
June 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/28644784/how-should-physicians-respond-when-the-best-treatment-for-an-individual-patient-conflicts-with-practice-guidelines-about-the-use-of-a-limited-resource
#19
Edmund G Howe
The case presents a physician's ethical conflict, due to limited resources, between his obligations to meet the needs of a community and those of his patient. Elements of the decision-making process (and who should make the decision) are discussed, including the limitations of what ethical reasoning can offer and risks of arbitrary outcomes. Additionally, potential benefits to physicians and their patients of discussing these conflicts, including reducing the physician's moral distress, are noted. I argue that physicians' abilities to make "right" decisions in such situations are limited, and I suggest ways in which physicians can try to preserve their relationships with patients...
June 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/28644782/how-should-resident-physicians-respond-to-patients-discomfort-and-students-moral-distress-when-learning-procedures-in-academic-medical-settings
#20
Bonnie M Miller
In this scenario, a medical student, Lauren, experiences moral distress because she feels that learning to perform a procedure on a patient who requested not to be used for "practice" puts her own interests above the patient's. Lauren might also worry that the resident physician is misrepresenting her abilities. The resident physician could help alleviate Lauren's distress and align her interests with the patient's by more clearly explaining the training situation to the patient and seeking the patient's approval...
June 1, 2017: AMA Journal of Ethics
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