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https://www.readbyqxmd.com/read/28925860/pharmacologic-and-perioperative-considerations-for-antihypertensive-medications
#1
Sher-Lu Pai, Ryan M Chadha, Joan M Irizarry Alvarado, Johnathan Ross Renew, Stephen Aniskevich
BACKGROUND: As the prevalence of hypertension continues to increase, physicians routinely encounter patients preoperatively receiving one or more cardiovascular medications to manage hypertension. Thus, the physician's knowledge of perioperative antihypertensive medication management is crucial to ensure patient safety. OBJECTIVE: We discuss the decisions to continue or stop antihypertensive medications to reduce the risk of perioperative complications. METHOD: We conducted a review of the original research studies, review articles, and editorials present on PubMed within the past 60 years...
September 18, 2017: Current Clinical Pharmacology
https://www.readbyqxmd.com/read/28925635/diabetes-self-management-facilitating-lifestyle-change
#2
Marlon Russell Koenigsberg, Jennifer Corliss
Healthy eating and increased physical activity can prevent or delay the onset of diabetes mellitus and facilitate diabetes management. Current guidelines recommend long-term weight loss of 5% to 7% of body weight and 150 minutes of at least moderate-intensity physical activity per week for most patients with prediabetes and diabetes. Techniques to assess and facilitate adherence to these lifestyle changes can be practical in primary care. During office visits, physicians should assess and gradually encourage patients' readiness to work toward change...
September 15, 2017: American Family Physician
https://www.readbyqxmd.com/read/28922270/decision-making-in-pediatric-transport-team-dispatch-using-script-concordance-testing
#3
Prakadeshwari Rajapreyar, Karen Marcdante, Liyun Zhang, Pippa Simpson, Michael T Meyer
OBJECTIVES: Our objective was to compare decision-making in dispatching pediatric transport teams by Medical Directors of pediatric transport teams (serving as experts) to that of Pediatric Intensivists and Critical Care fellows who often serve as Medical Control physicians. Understanding decision-making around team composition and dispatch could impact clinical management, cost effectiveness, and educational needs. DESIGN: Survey was developed using Script Concordance Testing guidelines...
September 15, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28922228/anesthesia-capacity-in-ghana-a-teaching-hospital-s-resources-and-the-national-workforce-and-education
#4
Mark A Brouillette, Alfred J Aidoo, Maria A Hondras, Nana A Boateng, Akwasi Antwi-Kusi, William Addison, Alec R Hermanson
BACKGROUND: Quality anesthetic care is lacking in low- and middle-income countries (LMICs). Global health leaders call for perioperative capacity reports in limited-resource settings to guide improved health care initiatives. We describe a teaching hospital's resources and the national workforce and education in this LMIC capacity report. METHODS: A prospective observational study was conducted at Komfo Anokye Teaching Hospital (KATH) in Kumasi, Ghana, during 4 weeks in August 2016...
September 14, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28921886/clinical-practices-and-attitudes-regarding-the-diagnosis-and-management-of-heart-failure-findings-from-the-core-needs-assessment-survey
#5
Jonathan Howlett, Josep Comin-Colet, Kenneth Dickstein, Ahmet Fuat, Gerhard Pölzl, Sean Delaney
AIMS: CORE is a continuing medical education initiative designed to support the evidence-based management of heart failure (HF) in the primary and secondary care settings. The goal of the CORE Needs Assessment Survey is to describe current clinical practice patterns and attitudes among global stakeholders in HF care. METHODS AND RESULTS: The CORE Steering Committee guided the development of survey questions to assess clinical practice, confidence, and attitudes/perceptions among cardiologists, primary care physicians, and nurses involved in HF management...
September 18, 2017: ESC Heart Failure
https://www.readbyqxmd.com/read/28915897/development-of-a-complex-intervention-to-promote-appropriate-prescribing-and-medication-intensification-in-poorly-controlled-type-2-diabetes-mellitus-in-irish-general-practice
#6
Mark E Murphy, Molly Byrne, Atieh Zarabzadeh, Derek Corrigan, Tom Fahey, Susan M Smith
BACKGROUND: Poorly controlled type 2 diabetes mellitus (T2DM) can be seen as failure to meet recommended targets for management of key risk factors including glycaemic control, blood pressure and lipids. Poor control of risk factors is associated with significant morbidity, mortality and healthcare costs. Failure to intensify medications for patients with poor control of T2DM when indicated is called clinical inertia and is one contributory factor to poor control of T2DM. We aimed to develop a theory and evidence-based complex intervention to improve appropriate prescribing and medication intensification in poorly controlled T2DM in Irish general practice...
September 16, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28910335/medical-leaders-or-masters-a-systematic-review-of-medical-leadership-in-hospital-settings
#7
Mathilde A Berghout, Isabelle N Fabbricotti, Martina Buljac-Samardžić, Carina G J M Hilders
Medical leadership is increasingly considered as crucial for improving the quality of care and the sustainability of healthcare. However, conceptual clarity is lacking in the literature and in practice. Therefore, a systematic review of the scientific literature was conducted to reveal the different conceptualizations of medical leadership in terms of definitions, roles and activities, and personal-and context-specific features. Eight databases were systematically searched for eligible studies, including empirical studies published in peer-reviewed journals that included physicians carrying out a manager or leadership role in a hospital setting...
2017: PloS One
https://www.readbyqxmd.com/read/28906541/roadmap-to-achieve-25-hypertension-control-in-africa-by-2025
#8
Anastase Dzudie, Brian Rayner, Dike Ojji, Aletta E Schutte, Marc Twagirumukiza, Albertino Damasceno, Seringe Abdou Ba, Abdoul Kane, Euloge Kramoh, Jean Baptiste Kacou, Basden Onwubere, Ruth Cornick, Karen Sliwa, Benedict Anisiuba, Ana Olga Mocumbi, Elijah Ogola, Mohamed Awad, George Nel, Harun Otieno, Ali Ibrahim Toure, Samuel Kingue, Andre Pascal Kengne, Pablo Perel, Alma Adler, Neil Poulter, Bongani Mayosi
BACKGROUND AND AIM: The Pan-African Society of Cardiology (PASCAR) has identified hypertension as the highest area of priority for action to reduce heart disease and stroke on the continent. The aim of this PASCAR roadmap on hypertension was to develop practical guidance on how to implement strategies that translate existing knowledge into effective action and improve detection, treatment and control of hypertension and cardiovascular health in sub-Saharan Africa (SSA) by the year 2025...
July 2017: Cardiovascular Journal of Africa
https://www.readbyqxmd.com/read/28906171/association-of-state-level-restrictions-in-nurse-practitioner-scope-of-practice-with-the-quality-of-primary-care-provided-to-medicare-beneficiaries
#9
Jennifer Perloff, Sean Clarke, Catherine M DesRoches, Monica O'Reilly-Jacob, Peter Buerhaus
CONTEXT: State scope of practice (SoP) laws impose significant restrictions on the services that a nurse practitioner (NP) may provide in some states, yet evidence about SoP limitations on the quality of primary care is very limited. METHOD: This study uses six different classifications of state regulations and bivariate and multivariate analyses to compare beneficiaries attributed to primary care nurse practitioners and primary care physicians in 2013 testing two hypotheses: (1) chronic disease management, cancer screening, preventable hospitalizations, and adverse outcomes of care provided by primary care nurse practitioners are better in reduced and restricted practice states compared to states without restrictions and (2) by decreasing access to care, SoP restrictions negatively affect the quality of primary care...
September 1, 2017: Medical Care Research and Review: MCRR
https://www.readbyqxmd.com/read/28905454/management-considerations-in-the-failing-renal-allograft
#10
REVIEW
Tom Lea-Henry, Bobby Chacko
Patients with a failed or failing renal transplant are increasing in number. Graft failure resulting in dialysis re-initiation is not uncommon, yet there are limited data to guide management of these patients. Physician practices vary regarding timing of dialysis initiation and the timing and extent of immunosuppression withdrawal. The risks of immunosuppression withdrawal need to be carefully balanced against the benefits of continuing low-dose therapy. The latter helps minimise the risk of sensitisation and has been proposed to possibly slow the loss of residual renal function; however, the use of common immunosuppressive agents may contribute to cardiovascular disease, malignancy, and infection, the major causes of death following the loss of a renal transplant...
September 14, 2017: Nephrology
https://www.readbyqxmd.com/read/28903733/increasing-confidence-and-changing-behaviors-in-primary-care-providers-engaged-in-genetic-counselling
#11
Michael S Wilkes, Frank C Day, Tonya L Fancher, Haley McDermott, Erik Lehman, Robert A Bell, Michael J Green
BACKGROUND: Screening and counseling for genetic conditions is an increasingly important part of primary care practice, particularly given the paucity of genetic counselors in the United States. However, primary care physicians (PCPs) often have an inadequate understanding of evidence-based screening; communication approaches that encourage shared decision-making; ethical, legal, and social implication (ELSI) issues related to screening for genetic mutations; and the basics of clinical genetics...
September 13, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/28903542/reviewing-the-evidence-for-biosimilars-key-insights-lessons-learned-and-future-horizons
#12
Till Uhlig, Guro L Goll
Biologic therapies have become central to the long-term management of many chronic diseases, including inflammatory rheumatic diseases. Over recent years, the development and licensing pathways for biosimilars have become more standardized, and several biosimilars have been made available for patients with inflammatory rheumatic diseases, such as RA. Pre-licensing requirements for biosimilars mandate the demonstration of comparability with reference products in terms of clinical activity, safety and immunogenicity, whereas post-marketing surveillance and risk minimization requirements are set in place to ensure that long-term, real-world safety data are collected to assess biosimilars in clinical practice...
August 1, 2017: Rheumatology
https://www.readbyqxmd.com/read/28901283/a-systematic-review-of-religious-beliefs-about-major-end-of-life-issues-in-the-five-major-world-religions
#13
Rajshekhar Chakraborty, Areej R El-Jawahri, Mark R Litzow, Karen L Syrjala, Aric D Parnes, Shahrukh K Hashmi
OBJECTIVE: The objective of this study was to examine the religious/spiritual beliefs of followers of the five major world religions about frequently encountered medical situations at the end of life (EoL). METHOD: This was a systematic review of observational studies on the religious aspects of commonly encountered EoL situations. The databases used for retrieving studies were: Ovid MEDLINE In-Process & Other Non-Indexed Citations, Ovid MEDLINE, Ovid EMBASE, Ovid PsycINFO, Ovid Cochrane Central Register of Controlled Trials, Ovid Cochrane Database of Systematic Reviews, and Scopus...
October 2017: Palliative & Supportive Care
https://www.readbyqxmd.com/read/28900839/behavioral-health-integration-into-primary-care-a-microsimulation-of-financial-implications-for-practices
#14
Sanjay Basu, Bruce E Landon, John W Williams, Asaf Bitton, Zirui Song, Russell S Phillips
BACKGROUND: New payments from Medicare encourage behavioral health services to be integrated into primary care practice activities. OBJECTIVE: To evaluate the financial impact for primary care practices of integrating behavioral health services. DESIGN: Microsimulation model. PARTICIPANTS: We simulated patients and providers at federally qualified health centers (FQHCs), non-FQHCs in urban and rural high-poverty areas, and practices outside of high-poverty areas surveyed by the National Association of Community Health Centers, National Ambulatory Medical Care Survey, National Health and Nutrition Examination Survey, and National Health Interview Survey...
September 12, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28898296/characterizing-the-interaction-between-physicians-pharmacists-and-pharmaceutical-representatives-in-a-middle-income-country-a-qualitative-study
#15
Rima Hajjar, Aya Bassatne, Mohamad Ali Cheaito, Rabie Naser El Dine, Sarah Traboulsy, Fadi Haddadin, Gladys Honein-AbouHaidar, Elie A Akl
BACKGROUND: Studies around the world have shown that interactions between pharmaceutical companies, pharmacists and physicians have a great influence on prescribing and drug dispensing practices. In middle-income countries, the nature and extent of these interactions have not been well researched. Our objectives were to qualitatively explore the nature of the interactions between pharmaceutical companies, physicians and pharmacists, their impact on drug prescription and dispensing practices in Lebanon...
2017: PloS One
https://www.readbyqxmd.com/read/28894695/which-obstacles-prevent-us-from-recruiting-into-clinical-trials-a-survey-about-the-environment-for-clinical-studies-at-a-german-university-hospital-in-a-comprehensive-cancer-center
#16
Christoph Straube, Peter Herschbach, Stephanie E Combs
BACKGROUND: Prospective clinical studies are the most important tool in modern medicine. The standard in good clinical practice in clinical trials has constantly improved leading to more sophisticated protocols. Moreover, translational questions are increasingly addressed in clinical trials. Such trials must follow elaborate rules and regulations. This is accompanied by a significant increase in documentation issues which require substantial manpower. Furthermore, university-based clinical centers are interested in increasing the amount of patients treated within clinical trials, and this number has evolved to be a key quality criterion...
2017: Frontiers in Oncology
https://www.readbyqxmd.com/read/28893815/risk-stratification-methods-and-provision-of-care-management-services-in-comprehensive-primary-care-initiative-practices
#17
Ashok Reddy, Laura Sessums, Reshma Gupta, Janel Jin, Tim Day, Bruce Finke, Asaf Bitton
PURPOSE: Risk-stratified care management is essential to improving population health in primary care settings, but evidence is limited on the type of risk stratification method and its association with care management services. METHODS: We describe risk stratification patterns and association with care management services for primary care practices in the Comprehensive Primary Care (CPC) initiative. We undertook a qualitative approach to categorize risk stratification methods being used by CPC practices and tested whether these stratification methods were associated with delivery of care management services...
September 2017: Annals of Family Medicine
https://www.readbyqxmd.com/read/28893689/management-of-kpc-producing-klebsiella-pneumoniae-infections
#18
REVIEW
M Bassetti, D R Giacobbe, H Giamarellou, C Viscoli, G L Daikos, G Dimopoulos, F G De Rosa, E J Giamarellos-Bourboulis, G M Rossolini, E Righi, I Karaiskos, M Tumbarello, D P Nicolau, P L Viale, G Poulakou
BACKGROUND: Klebsiella pneumoniae carbapenemase (KPC)-producing K. pneumoniae (KPC-KP) has become one of the most important contemporary pathogens, especially in endemic areas. AIMS: our aim was to provide practical suggestion for physicians dealing with the management of KPC-KP infections in critically ill patients, based on expert opinions. SOURCES: PubMed search for relevant publications related to the management of KPC-KP infections. CONTENTS: a panel of experts developed a list of 12 questions to be addressed...
September 9, 2017: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/28893514/nurse-practitioners-physician-assistants-and-physicians-are-comparable-in-managing-the-first-five-years-of-diabetes
#19
Yihan Yang, Qi Long, Sandra L Jackson, Mary K Rhee, Anne Tomolo, Darin Olson, Lawrence S Phillips
BACKGROUND: Increasing use of nurse practitioners (NPs) and physician assistants (PAs) is a possible solution to the shortage of primary care providers (PCPs) in the US, but the quality of care they provide is not well understood. METHODS: Since the scope of practice of the three provider types is similar in the Veterans Health Administration (VA), we determined whether patients managed by primary care NPs, PAs or physicians had similar HbA1c levels at comparable times in the natural history of diabetes...
September 8, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28891842/the-american-society-of-colon-and-rectal-surgeons-clinical-practice-guidelines-for-the-treatment-of-colon-cancer
#20
Jon D Vogel, Cagla Eskicioglu, Martin R Weiser, Daniel L Feingold, Scott R Steele
The American Society of Colon and Rectal Surgeons is dedicated to ensuring high-quality patient care by advancing the science, prevention, and management of disorders and diseases of the colon, rectum, and anus. The Clinical Practice Guidelines Committee is composed of society members who are chosen because they have demonstrated expertise in the specialty of colon and rectal surgery. This committee was created to lead international efforts in defining quality care for conditions related to the colon, rectum, and anus...
October 2017: Diseases of the Colon and Rectum
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