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https://www.readbyqxmd.com/read/29330245/impact-of-pharmacist-previsit-input-to-providers-on-chronic-opioid-prescribing-safety
#1
Nicholas Cox, Casey R Tak, Susan E Cochella, Eric Leishman, Karen Gunning
INTRODUCTION: Primary care providers (PCPs) account for half of opioid prescriptions, often feel chronic pain patients are challenging to manage, and there is wide variability in practice patterns. The purpose of this pilot study was to evaluate the impact of a previsit pharmacist review of high-risk patients treated with opioids for chronic pain on compliance to guideline recommendations at a family medicine residency clinic. METHODS: All adult patients with an appointment for chronic pain who were prescribed >50 morphine milligram equivalents (MMEs)/day had charts reviewed by a pharmacist before each appointment; recommendations were sent electronically to the provider before the appointment...
January 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29330235/primary-care-physician-perspectives-about-antipsychotics-and-other-medications-for-symptoms-of-dementia
#2
J William Kerns, Jonathan D Winter, Katherine M Winter, Terry Boyd, Rebecca S Etz
BACKGROUND: Guidelines, policies, and warnings have been applied to reduce the use of medications for behavioral and psychological symptoms of dementia (BPSD). Because of rare dangerous side effects, antipsychotics have been singled out in these efforts. However, antipsychotics are still prescribed "off label" to hundreds of thousands of seniors residing in nursing homes and communities. Our objective was to evaluate how and why primary-care physicians (PCPs) employ nonpharmacologic strategies and drugs for BPSD...
January 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29330018/testicular-adrenal-rest-tumor-screening-and-fertility-counseling-among-males-with-congenital-adrenal-hyperplasia
#3
Monika Chaudhari, Emilie K Johnson, Daniel DaJusta, Leena Nahata
BACKGROUND: Reduced fertility is a common potential problem among males with congenital adrenal hyperplasia (CAH), with nearly half experiencing impaired sperm production. The major cause of oligo/azoospermia in CAH is testicular adrenal rest tumors (TARTs). Studies indicate that ultrasound screening for TARTs should begin during childhood, yet it remains unclear whether boys with CAH are routinely screened for TARTs and/or counseled about infertility risk and potential interventions such as fertility testing and/or preservation...
December 21, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/29321194/polygenic-hazard-score-to-guide-screening-for-aggressive-prostate-cancer-development-and-validation-in-large-scale-cohorts
#4
Tyler M Seibert, Chun Chieh Fan, Yunpeng Wang, Verena Zuber, Roshan Karunamuni, J Kellogg Parsons, Rosalind A Eeles, Douglas F Easton, ZSofia Kote-Jarai, Ali Amin Al Olama, Sara Benlloch Garcia, Kenneth Muir, Henrik Grönberg, Fredrik Wiklund, Markus Aly, Johanna Schleutker, Csilla Sipeky, Teuvo Lj Tammela, Børge G Nordestgaard, Sune F Nielsen, Maren Weischer, Rasmus Bisbjerg, M Andreas Røder, Peter Iversen, Tim J Key, Ruth C Travis, David E Neal, Jenny L Donovan, Freddie C Hamdy, Paul Pharoah, Nora Pashayan, Kay-Tee Khaw, Christiane Maier, Walther Vogel, Manuel Luedeke, Kathleen Herkommer, Adam S Kibel, Cezary Cybulski, Dominika Wokolorczyk, Wojciech Kluzniak, Lisa Cannon-Albright, Hermann Brenner, Katarina Cuk, Kai-Uwe Saum, Jong Y Park, Thomas A Sellers, Chavdar Slavov, Radka Kaneva, Vanio Mitev, Jyotsna Batra, Judith A Clements, Amanda Spurdle, Manuel R Teixeira, Paula Paulo, Sofia Maia, Hardev Pandha, Agnieszka Michael, Andrzej Kierzek, David S Karow, Ian G Mills, Ole A Andreassen, Anders M Dale
OBJECTIVES: To develop and validate a genetic tool to predict age of onset of aggressive prostate cancer (PCa) and to guide decisions of who to screen and at what age. DESIGN: Analysis of genotype, PCa status, and age to select single nucleotide polymorphisms (SNPs) associated with diagnosis. These polymorphisms were incorporated into a survival analysis to estimate their effects on age at diagnosis of aggressive PCa (that is, not eligible for surveillance according to National Comprehensive Cancer Network guidelines; any of Gleason score ≥7, stage T3-T4, PSA (prostate specific antigen) concentration ≥10 ng/L, nodal metastasis, distant metastasis)...
January 10, 2018: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/29306523/palliative-and-end-of-life-care-for-lesbian-gay-bisexual-and-transgender-lgbt-cancer-patients-and-their-caregivers
#5
REVIEW
Kristin G Cloyes, William Hull, Andra Davis
OBJECTIVE: To identify the unique needs of lesbian, gay, bisexual, and transgender (LGBT) cancer patients and caregivers, and review recommendations supporting more effective and inclusive palliative and end-of-life care. DATA SOURCES: Published research and clinical guidelines. CONCLUSION: Transitions in care raise particular challenges for LGBT patients, including provider communication, perceptions of safety and acceptance, and assessing and respecting patients' definitions of family and spirituality...
January 3, 2018: Seminars in Oncology Nursing
https://www.readbyqxmd.com/read/29302534/exercise-in-patients-with-type-2-diabetes-facilitators-and-barriers-a-qualitative-study
#6
T S Advika, Jyothi Idiculla, S Jaya Kumari
Introduction: Diabetes is a major noncommunicable disease affecting more than 65 million Indians. Although treatment algorithms suggest lifestyle measures (diet and exercise) along with medications data regarding adherence to exercise as well as facilitators and barriers to the practice of physical activity in such patients are limited. Hence, this qualitative study was conducted. Objectives: The objective of this study is to describe the factors which (1) Facilitated and (2) hindered the practice of regular exercise in patients with Type 2 diabetes...
April 2017: Journal of Family Medicine and Primary Care
https://www.readbyqxmd.com/read/29298363/dietary-and-nutrition-recommendations-in-pediatric-primary-care-a-call-to-action
#7
Sayward E Harrison, Deborah Greenhouse
Rapid increases in childhood obesity reflect widespread changes in diet and physical activity, which are of significant concern because obesity increases a child's risk for negative health outcomes and frequently creates a pathway to adult obesity. Diet and nutrition play a key role in maintaining energy balance and preventing weight gain; therefore, they are obvious targets for obesity prevention efforts. Primary care providers are in an optimal position to convey messages about healthy eating to children and families, and specific guidelines exist for how to incorporate diet and nutrition prevention into primary care...
January 2018: Southern Medical Journal
https://www.readbyqxmd.com/read/29295487/infant-feeding-beliefs-attitudes-knowledge-and-practices-of-chinese-immigrant-mothers-an-integrative-review-of-the-literature
#8
REVIEW
Ana Cristina Lindsay, Qun Le, Mary L Greaney
Chinese are a fast-growing immigrant population group in several parts of the world (e.g., Australia, Canada, Europe, Southeast Asia, United States). Research evidence suggests that compared to non-Hispanic whites, individuals of Asian-origin including Chinese are at higher risk of developing cardiovascular disease and type 2 diabetes at a lower body mass index (BMI). These risks may be possibly due to genetic differences in body composition and metabolic responses. Despite the increasing numbers of Chinese children growing up in immigrant families and the increasing prevalence of obesity among Chinese, little research has been focused on children of Chinese immigrant families...
December 23, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/29287289/-current-german-and-american-guidelines-for-autologous-fat-grafting-a-transatlantic-comparison
#9
G Felix Broelsch, Sören Könneker, Ramin Ipaktchi, Peter M Vogt
CLINICAL PROBLEM: The renewed clinical interest in fat grafting for both reconstructive and aesthetic purposes prompted the American Society of Plastic Surgeons to establish a Fat Graft Task Force (AFGT) in 2009. Moreover, in 2015, the German Society of Plastic, Reconstructive and Aesthetic Surgeons (DGPRÄC), in cooperation with three relevant medical societies (DDG, DGMKG, DGGG), formulated statements on the provision of strategies for patient management and to guide physicians in clinical decision making, on the basis of the scientific literature, clinical experience and current laws...
December 2017: Handchirurgie, Mikrochirurgie, Plastische Chirurgie
https://www.readbyqxmd.com/read/29284905/application-of-ethics-for-providing-telemedicine-services-and-information-technology
#10
REVIEW
Mostafa Langarizadeh, Fatemeh Moghbeli, Ali Aliabadi
Introduction: Advanced technology has increased the use of telemedicine and Information Technology (IT) in treating or rehabilitating diseases. An increased use of technology increases the importance of the ethical issues involved. The need for keeping patients' information confidential and secure, controlling a number of therapists' inefficiency as well as raising the quality of healthcare services necessitates adequate heed to ethical issues in telemedicine provision. Aim: The goal of this review is gathering all articles that are published through 5 years until now (2012-2017) for detecting ethical issues for providing telemedicine services and Information technology...
October 2017: Medical Archives
https://www.readbyqxmd.com/read/29283088/compliance-of-the-recurrent-renal-stone-former-with-current-best-practice-guidelines
#11
Derek Bos, Kevin Kim, Jen Hoogenes, Shahid Lambe, Bobby Shayegan, Edward D Matsumoto
INTRODUCTION: Patient compliance to best practice guidelines is a significant factor in preventing renal stone recurrence. While patient compliance has been historically poor, there remains a paucity of data in the renal stone setting. We evaluated compliance of the recurrent renal stone former with current Canadian Urological Association (CUA) best practice guidelines. METHODS: A prospective, cross-sectional study design was used to evaluate patient compliance...
December 22, 2017: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
https://www.readbyqxmd.com/read/29282327/practice-guideline-update-summary-mild-cognitive-impairment-report-of-the-guideline-development-dissemination-and-implementation-subcommittee-of-the-american-academy-of-neurology
#12
Ronald C Petersen, Oscar Lopez, Melissa J Armstrong, Thomas S D Getchius, Mary Ganguli, David Gloss, Gary S Gronseth, Daniel Marson, Tamara Pringsheim, Gregory S Day, Mark Sager, James Stevens, Alexander Rae-Grant
OBJECTIVE: To update the 2001 American Academy of Neurology (AAN) guideline on mild cognitive impairment (MCI). METHODS: The guideline panel systematically reviewed MCI prevalence, prognosis, and treatment articles according to AAN evidence classification criteria, and based recommendations on evidence and modified Delphi consensus. RESULTS: MCI prevalence was 6.7% for ages 60-64, 8.4% for 65-69, 10.1% for 70-74, 14.8% for 75-79, and 25.2% for 80-84...
December 27, 2017: Neurology
https://www.readbyqxmd.com/read/29277629/patterns-and-correlates-of-cervical-cancer-screening-initiation-in-a-large-integrated-healthcare-system
#13
Tracy A Becerra-Culqui, Neal M Lonky, Qiaoling Chen, Chun R Chao
BACKGROUND: The latest 2012 United States Preventive Services Task Force cervical cancer screening guidelines recommended screening initiation at age 21 years. Little is known about the cervical cancer screening initiation practices in the community, and whether there are critical gaps with respect to adherence to current clinical guidelines. Despite an overall decline in cervical cancer incidence across women of all ages, the incidence rate has not declined among 24-25 year-olds between 2000 (2...
December 22, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29277495/clinical-pharmacist-understanding-of-the-2013-american-college-of-cardiology-american-heart-association-cholesterol-guideline
#14
John D Bucheit, Haleigh Helsing, Pramit Nadpara, Salim S Virani, Dave L Dixon
BACKGROUND: Clinical pharmacists are frequently involved in the management of dyslipidemia, yet clinical pharmacists' knowledge, awareness, and the level of agreement with the 2013 American College of Cardiology (ACC)/American Heart Association (AHA) cholesterol guideline are unknown. OBJECTIVE: The objective of the study was to examine clinical pharmacists' knowledge, awareness, and the level of agreement with the 2013 ACC/AHA cholesterol guideline. METHODS: We administered a validated questionnaire via an online survey that was electronically mailed to clinical pharmacists...
December 6, 2017: Journal of Clinical Lipidology
https://www.readbyqxmd.com/read/29276766/challenges-to-ethically-managing-parkinson-disease-an-interview-study-of-patient-perspectives
#15
Shelagh T Shaw, Pirashanthie Vivekananda-Schmidt
This study investigated the current ethical issues in relation to recognizing and managing Parkinson disease (PD) from the patient's perspective. Methods: Twelve patients living with PD who were from the medical school's Patients as Educators program were recruited. Semistructured interviews were conducted to record patient experiences in order to identify potential ethical issues in relation to recognizing and managing PD. Thematic analysis was applied to the interview transcripts. Results: Four key themes emerged from the interviews...
December 2017: Journal of Patient Experience
https://www.readbyqxmd.com/read/29274203/establishing-a-comprehensive-genetic-diagnosis-strategy-for-hemophilia-b-and-its-application-in-chinese-population
#16
X Y Lin, J Wang, X Xiao, Y W Xu, Q J Yan, W Y Jiang
INTRODUCTION: To reduce the incidence of hemophilia B (HB) which with no complete cure currently, prenatal diagnosis and preimplantation genetic diagnosis (PGD) are effective and feasible means. However, previous studies about genetic diagnosis in HB mostly just focused on the detection of patients and carriers. Here, we established a comprehensive genetic diagnosis strategy for HB and worked it out in Chinese population. The strategy includes the detection of patients and carriers, prenatal diagnosis, and PGD...
December 23, 2017: International Journal of Laboratory Hematology
https://www.readbyqxmd.com/read/29273473/radiology-architecture-project-primer
#17
Raymond W Sze, Laurie Hogan, Satoshi Teshima, Scott Davidson
The rapid pace of technologic advancement and increasing expectations for patient- and family-friendly environments make it common for radiology leaders to be involved in imaging remodel and construction projects. Most radiologists and business directors lack formal training in architectural and construction processes but are expected to play significant and often leading roles in all phases of an imaging construction project. Avoidable mistakes can result in significant increased costs and scheduling delays; knowledgeable participation and communication can result in a final product that enhances staff workflow and morale and improves patient care and experience...
December 19, 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/29260485/managing-variant-interpretation-discrepancies-in-hereditary-cancer-clinical-practice-concerns-and-desired-resources
#18
Ellen Zirkelbach, Syed Hashmi, Aarti Ramdaney, Leslie Dunnington, Myla Ashfaq, Elizabeth K Nugent, Kate Wilson
Variant interpretation is a complex process, and classification may vary between sources. This study aimed to determine the practice of cancer genetic counselors regarding discrepancies in variant interpretation and to identify concerns when counseling these discrepancies. An electronic survey was sent to genetic counselors in the NSGC Cancer Special Interest Group. The vast majority of counselors (93%) had seen a variant interpretation discrepancy in practice. A large majority (96%) of respondents indicated that they conducted their own research on reported variants...
December 20, 2017: Journal of Genetic Counseling
https://www.readbyqxmd.com/read/29246151/suboptimal-control-of-lipid-levels-results-from-the-non-interventional-centralized-pan-russian-survey-of-the-undertreatment-of-hypercholesterolemia-ii-cepheus-ii
#19
Sergey Boytsov, Natalia Logunova, Yunona Khomitskaya
BACKGROUND: Elevated levels of low-density lipoprotein cholesterol (LDL-C) and glycosylated hemoglobin (HbA1c) are risk factors for cardiovascular complications. This study evaluated LDL-C goal attainment in Russian clinical practice among patients with moderate to very high cardiovascular risk. The study also assessed LDL-C goal attainment in patients prescribed lipid-lowering therapy for primary compared with secondary cardiovascular disease (CVD) prevention, predictors of LDL-C goal attainment, and the proportion of individuals with diabetes mellitus who achieved HbA1c < 7%...
December 16, 2017: Cardiovascular Diabetology
https://www.readbyqxmd.com/read/29243544/communication-is-key-the-utility-of-a-revised-neuropsychological-report-format
#20
Katherine T Baum, Christian von Thomsen, Megan Elam, Christel Murphy, Melissa Gerstle, Cynthia A Austin, Dean W Beebe
OBJECTIVE: The neuropsychological report is a critical tool for communicating evaluation results to multiple audiences who have varying knowledge about neuropsychology and often have limited ability to review long, complex reports. Considerable time is spent writing these reports and challenges persist related to readability, length/complexity, and billable clinical time (which may be capped by third-party payors or families' ability to pay). METHODS: This quality improvement effort systematically evaluated the redesign of pediatric neuropsychological reports in an outpatient clinic serving primarily medical populations...
December 15, 2017: Clinical Neuropsychologist
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