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https://www.readbyqxmd.com/read/29151006/the-practical-update-for-family-physicians-in-the-diagnosis-and-management-of-overactive-bladder-and-lower-urinary-tract-symptoms
#1
Jack Barkin, Jeffrey Habert, Amy Wong, Livia Y T Lee
OBJECTIVE: To provide family physicians with an up-to-date, practical overview of the diagnosis and management of overactive bladder (OAB) alone or with bladder outlet obstruction. MAIN MESSAGE: OAB is urinary urgency with or without incontinence, often accompanied by frequency and nocturia, in the absence of urinary tract infection and can affect both men and women. Men often have co-existing OAB associated with bladder outlet obstruction, and benign prostatic hyperplasia...
October 2017: Canadian Journal of Urology
https://www.readbyqxmd.com/read/29150179/-therapeutic-strategies-in-patients-undergoing-surgery-for-non-small-cell-lung-cancer-results-of-the-escap-2011-cphg-study-promoted-by-the-french-college-of-general-hospital-respiratory-physicians-cphg
#2
F Pinquié, F Goupil, J-P Oster, A Dixmier, P-A Renault, A Lévy, J-P Mathieu, N Paillot, F C Goutorbe, P Masson, O Molinier, D Debieuvre, M Grivaux
BACKGROUND: The aim of ESCAP-2011-CPHG, promoted by the French College of General Hospital Respiratory Physicians, was to describe therapeutic strategies in lung cancer in the first 2 years after diagnosis, in a real-life setting. This article focuses on patients undergoing surgical management of a non-small cell lung cancer (NSCLC). METHODS: A prospective multicentre study was conducted in 53 French general hospitals. For each patient with lung cancer diagnosed in 2010, a standardised form was completed following each change in treatment strategy up to 2 years after diagnosis...
November 14, 2017: Revue des Maladies Respiratoires
https://www.readbyqxmd.com/read/29149791/the-dementia-care-coordination-program-engaging-health-systems-in-caregiver-supports
#3
Pamela Nadash, Nina M Silverstein, Frank Porell
This paper reports on a process evaluation using mixed methods to assess a Dementia Care Coordination Program, which is distinctive in using the medical system, rather than direct outreach, to identify and refer families to supports provided by an Alzheimer's Association chapter via dedicated care consultants. One care consultant received referrals from individual physicians, while the other, employed by a health plan, received referrals from health plan case managers. Through key informant interviews, focus groups, and physician and caregiver surveys, we identified key issues, finding high rates of stakeholder satisfaction, but some practical issues around information sharing and data tracking...
January 1, 2017: Dementia
https://www.readbyqxmd.com/read/29149019/incidence-and-consequences-of-near-drowning-related-pneumonia-a-descriptive-series-from-martinique-french-west-indies
#4
Laura Cerland, Bruno Mégarbane, Hatem Kallel, Yanick Brouste, Hossein Mehdaoui, Dabor Resiere
Drowning represents one major cause of accidental death. Near-drowning patients are exposed to aspiration that may result in pneumonia with life-threatening consequences. We designed this descriptive study to investigate the frequency, nature, and consequences of post-drowning pneumonia. One hundred and forty-four near-drowning patients (33 children and 111 adults) admitted during four years to the University Hospital of Martinique, French Indies, were included. Patients presented pre-hospital cardiac arrest (41%) and exhibited acute respiratory failure (54%), cardiovascular failure (27%), and lactic acidosis (75%) on admission...
November 17, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/29148329/the-implementation-of-performance-management-systems-in-u-s-physician-organizations
#5
Alexander F Pimperl, Hector P Rodriguez, Julie A Schmittdiel, Stephen M Shortell
Performance management systems (PMSYS) aid in improving the quality and efficiency of care, but little is known about factors that influence more robust PMSYS among physician organizations. Using a nationally representative survey of U.S. medical practices, we examined the extent to which organizational capabilities and external factors were associated with more developed PMSYS. Linear regression estimated the relative impact of these factors on PMSYS. On average, practices implemented a minority (32 points out of 100) of the PMSYS processes assessed...
March 1, 2017: Medical Care Research and Review: MCRR
https://www.readbyqxmd.com/read/29148002/targeting-zero-catheter-related-bloodstream-infections-in-pediatric-intensive-care-unit-a-retrospective-matched-case-control-study
#6
Daniele G Biasucci, Mauro Pittiruti, Alessandra Taddei, Enzo Picconi, Alessandro Pizza, Davide Celentano, Marco Piastra, Giancarlo Scoppettuolo, Giorgio Conti
INTRODUCTION: The aim of this study was to evaluate the effectiveness and safety of a new three-component 'bundle' for insertion and management of centrally inserted central catheters (CICCs), designed to minimize catheter-related bloodstream infections (CRBSIs) in critically ill children. METHODS: Our 'bundle' has three components: insertion, management, and education. Insertion and management recommendations include: skin antisepsis with 2% chlorhexidine; maximal barrier precautions; ultrasound-guided venipuncture; tunneling of the catheter when a long indwelling time is expected; glue on the exit site; sutureless securement; use of transparent dressing; chlorhexidine sponge dressing on the 7th day; neutral displacement needle-free connectors...
November 8, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/29145728/understanding-how-emergency-medicine-physicians-survive-and-thrive-in-rural-practice-a-theoretical-model
#7
Ashra Kolhatkar, Andrea Keesey, Bob Bluman, Brenna Lynn, Tandi Wilkinson
INTRODUCTION: The challenges facing emergency medicine (EM) services in Canada reflect the limitations of the entire healthcare system. The emergency department (ED) is uniquely situated in the healthcare system such that shortcomings in hospital- and community-based services are often first revealed there. This is especially true in rural settings, where there are additional site-specific barriers to the provision of EM care. Existing studies look at the factors that influence rural EM physicians in isolation...
November 2017: Rural and Remote Health
https://www.readbyqxmd.com/read/29145708/managing-non-serious-low-back-pain-in-the-emergency-department-time-for-a-change
#8
Gustavo C Machado, Eileen Rogan, Chris G Maher
Low back pain is a common condition seen in the ED. However, its management in this setting has received relatively little attention and there have been few efforts to develop strategies to improve emergency care of low back pain. In order to ensure that care is appropriately delivered for low back pain patients in the ED, emergency physicians must understand issues of providing low-value care and consider potential solutions to the problem. In this paper, we describe the usual emergency care provided for non-serious low back pain and present possible strategies for restructuring ED practice and approaches for changing physician and patient behaviour...
November 16, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29144559/treatment-of-helicobacter-pylori-infection-a-clinical-practice-update
#9
REVIEW
Rocco Maurizio Zagari, Stefano Rabitti, Leonardo Henry Eusebi, Franco Bazzoli
BACKGROUND: Helicobacter pylori infection is still frequent in the community and all infected subjects should be offered an eradication therapy. Nowdays physicians have to face the challenge of antibiotic resistance in treating Helicobacter pylori infected individuals. AIM: This review provides an overview of current international guidelines and reports recent evidence from systematic reviews and clinical trials on the treatment of Helicobacter pylori infection, and should help physicians to better treat their patients...
November 16, 2017: European Journal of Clinical Investigation
https://www.readbyqxmd.com/read/29144156/upmc-prescription-for-wellness-a-quality-improvement-case-study-for-supporting-patient-engagement-and-health-behavior-change
#10
Rebecca J Maners, Eric Bakow, Michael D Parkinson, Gary S Fischer, Geoffrey R Camp
Addressing patient health and care behaviors that underlie much of chronic disease continues to challenge providers, medical practices, health systems, and insurers. Improving health and care as described by the Quadruple Aim requires innovation at the front lines of clinical care: the doctor-patient interaction and office practice. This article describes the use of Lean Six Sigma in a quality improvement (QI) effort to design an effective and scalable method for physicians to prescribe health coaching for healthy behaviors in a primary care medical home within a large integrated delivery and financing system...
November 1, 2017: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/29142906/hierarchical-modeling-of-patient-and-physician-determinants-of-blood-pressure-outcomes-in-hypertensive-patients-with-and-without-diabetes-pooled-analysis-of-six-observational-valsartan-studies-with-15-282-evaluable-patients
#11
Noha Ashy, Thanh-Nga Nguyen, Kris Denhaerynck, Mahdi Gharaibeh, Abdulaziz Alhossan, Stefaan Vancayzeele, Heidi Brié, Ann Aerts, Karen MacDonald, Ivo Abraham
We pooled data from 6 valsartan-related studies including 3,658 diabetic and 11,624 nondiabetic patients to evaluate blood pressure (BP) outcomes after approximately 90 days of second- or later-line valsartan treatment. Hierarchical linear and logistic regressions were applied to identify determinants of BP outcomes. Similar reductions in BP values and similar BP control rates were achieved in both groups after approximately 90 days of therapy. The modeling analyses identified several common and different patient- and physician-related determinants of BP outcomes for both groups, many of which are modifiable or clinically manageable...
2017: International Journal of Chronic Diseases
https://www.readbyqxmd.com/read/29141797/diagnosis-and-management-of-neuromyelitis-optica-spectrum-disorder-nmosd-in-iran-a-consensus-guideline-and-recommendations
#12
REVIEW
Mohammad Ali Sahraian, Abdorreza Naser Moghadasi, Amir Reza Azimi, Nasrin Asgari, Fahimeh H Akhoundi, Roya Abolfazli, Shekoofeh Alaie, Fereshteh Ashtari, Hormoz Ayromlou, Seyed Mohammad Baghbanian, Nahid Beladi Moghadam, Farzad Fatehi, Mohsen Foroughipour, Hamidreza Ghalyanchi Langroodi, Nastaran Majdinasab, Alireza Nickseresht, Abbas Nourian, Vahid Shaygannejad, Hamid Reza Torabi
Neuromyelitis Optica Spectrum Disorder (NMOSD) is a relapsing neuro inflammatory disease of the central nervous system that typically presents with optic neuritis or myelitis and may cause severe disability. The diagnostic criteria have been updated and several immunosuppressive agents have been demonstrated to prevent acute exacerbations. As the disease rarely develops in a progressive course, management of acute attacks and proper prevention of exacerbations may change the long term out-come and prevent future disability...
November 2017: Multiple Sclerosis and related Disorders
https://www.readbyqxmd.com/read/29141062/management-of-severe-acne-vulgaris-with-topical-therapy
#13
Linda Stein Gold, Hilary E Baldwin, Tina Lin
<p>Acne vulgaris (acne) is the most common skin disease we see in dermatology practice. Although rare in childhood, severe acne can affect up to 12% of the adolescent population. A chronic disease, it requires both aggressive management and effective maintenance strategies. Oral antibiotics, in combination with topical agents are recommended for treatment, with topical agents being continued as maintenance therapy to minimize resistance and recurrence. However, concerns with systemic side effects have recently resulted in a greater focus on the potential of fixed combination topical therapies to treat severe acne...
November 1, 2017: Journal of Drugs in Dermatology: JDD
https://www.readbyqxmd.com/read/29140974/physician-patient-communication-about-overactive-bladder-results-of-an-observational-sociolinguistic-study
#14
Steven R Hahn, Pamela Bradt, Kathleen A Hewett, Daniel B Ng
INTRODUCTION: Overactive bladder (OAB) and urinary incontinence are common problems that have significant impact on quality of life (QOL). Less than half of sufferers seek help from their physicians; many who do are dissatisfied with treatment and their physicians' understanding of their problems. Little is known about the sociolinguistic characteristics of physician-patient communication about OAB in community practice. METHODS: An IRB-approved observational sociolinguistic study of dialogues between patients with OAB and treating physicians was conducted...
2017: PloS One
https://www.readbyqxmd.com/read/29140917/medical-trainees-experiences-of-treating-people-with-chronic-pain-a-lost-opportunity-for-medical-education
#15
Kathleen Rice, Jae Eun Ryu, Cynthia Whitehead, Joel Katz, Fiona Webster
PURPOSE: Evidence suggests that physicians' opinions about chronic pain patients become progressively negative over the course of medical training, leading to a decline in empathy for these patients. Few qualitative studies have focused on this issue and thus the experiences shaping this process remain unexplored. This study addressed how medical trainees learn about chronic pain management through informal and formal curricula. METHOD: This study adopted a descriptive qualitative interview-based approach informed by the theoretical lens of the hidden curriculum...
November 14, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/29138593/intrathecal-pain-management-a-team-based-approach
#16
REVIEW
Jeremy A Adler, Neona M Lotz
Objective: Physician assistants (PAs), nurse practitioners (NPs), and registered nurses (RNs) provide professional services on pain management teams. This review provides an overview of the practical management of chronic pain with intrathecal (IT) therapy using an interprofessional approach (eg, physicians and other health care professionals), with a focus on the contributions of PAs, NPs, and RNs. Methods: Narrative review based on literature searches of the Medline database and treatment guidelines on the use of IT therapy in the management of patients with chronic pain...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/29138154/pharmacologic-management-of-chronic-neuropathic-pain-review-of-the-canadian-pain-society-consensus-statement
#17
REVIEW
Alex Mu, Erica Weinberg, Dwight E Moulin, Hance Clarke
OBJECTIVE: To provide family physicians with a practical clinical summary of the Canadian Pain Society (CPS) revised consensus statement on the pharmacologic management of neuropathic pain. QUALITY OF EVIDENCE: A multidisciplinary interest group within the CPS conducted a systematic review of the literature on the current treatments of neuropathic pain in drafting the revised consensus statement. MAIN MESSAGE: Gabapentinoids, tricyclic antidepressants, and serotonin-norepinephrine reuptake inhibitors are the first-line agents for treating neuropathic pain...
November 2017: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/29137507/nationwide-mortality-studies-to-quantify-causes-of-death-relevant-lessons-from-india-s-million-death-study
#18
Mireille Gomes, Rehana Begum, Prabha Sati, Rajesh Dikshit, Prakash C Gupta, Rajesh Kumar, Jay Sheth, Asad Habib, Prabhat Jha
Progress toward the United Nations 2030 Sustainable Development Goals requires improved information on mortality and causes of death. However, causes of many of the fifty million annual deaths in low- and middle-income countries remain unknown, as most of the deaths occur at home without medical attention. In 2001 India began the Million Death Study in 1.3 million nationally representative households. Nonmedical staff conduct verbal autopsies, which are structured interviews including a half-page narrative in local language of the family's story of the symptoms and events leading to death...
November 2017: Health Affairs
https://www.readbyqxmd.com/read/29135763/health-system-creation-and-integration-at-a-health-sciences-university-a-five-year-follow-up
#19
Catherine P Slade, Ricardo Azziz, Steven Levin, Gretchen B Caughman, David S Hefner, Kimberly V Halbur, Martha S Tingen, Susan James
Shifting healthcare market forces and regulation have exerted near-constant pressure on U.S. academic health centers (AHCs) attempting to successfully execute their traditional tripartite mission. A governance structure and organizational alignment that works well under one set of conditions is rarely optimal when conditions change. Thus, the degree and type of alignment of an AHC's clinical, educational, and faculty practice organizations have changed regularly within the sector, typically landing near one end or the other on a continuum from fully aligned with centralized governance to largely independent with separate governance...
November 2017: Journal of Healthcare Management / American College of Healthcare Executives
https://www.readbyqxmd.com/read/29135667/nationwide-analysis-of-femoral-neck-fractures-in-elderly-patients-a-receding-tide
#20
Derek G Ju, Sean S Rajaee, James Mirocha, Carol A Lin, Charles N Moon
BACKGROUND: Geriatric femoral neck fractures are associated with substantial morbidity and medical cost. We evaluated the incidence and management trends of femoral neck fractures in recent years in the U.S. METHODS: Patient data from 2003 through 2013 were obtained from the Nationwide Inpatient Sample database. Femoral neck fractures in patients ≥65 years old were identified and grouped using the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) procedure codes for internal fixation, hemiarthroplasty, or total hip arthroplasty (THA)...
November 15, 2017: Journal of Bone and Joint Surgery. American Volume
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