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https://www.readbyqxmd.com/read/29352682/are-allogeneic-transfusions-decreasing-in-total-knee-arthroplasty-patients-national-inpatient-sample-2009-2013
#1
Jaydev B Mistry, Chukwuweike U Gwam, Qais Naziri, Robert Pivec, Roby Abraham, Michael A Mont, Ronald E Delanois
BACKGROUND: Allogeneic transfusions are commonly used for substantial blood loss in total knee arthroplasty (TKA), but have been associated with adverse effects and increased costs. The purpose of this study is to provide a detailed description of (1) trends of allogeneic blood transfusion; (2) risk factors and adverse events; and (3) discharge disposition, length-of-stay (LOS), and cost/charge analysis for primary TKA patients who received an allogeneic blood transfusion from 2009-2013...
December 21, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29351792/successful-recruitment-to-trials-findings-from-the-scimitar-trial
#2
Emily Peckham, Catherine Arundel, Della Bailey, Tracy Callen, Christina Cusack, Suzanne Crosland, Penny Foster, Hannah Herlihy, James Hope, Suzy Ker, Tayla McCloud, Crystal-Bella Romain-Hooper, Alison Stribling, Peter Phiri, Ellen Tait, Simon Gilbody
BACKGROUND: Randomised controlled trials (RCT) can struggle to recruit to target on time. This is especially the case with hard to reach populations such as those with severe mental ill health. The SCIMITAR+ trial, a trial of a bespoke smoking cessation intervention for people with severe mental ill health achieved their recruitment ahead of time and target. This article reports strategies that helped us to achieve this with the aim of aiding others recruiting from similar populations...
January 19, 2018: Trials
https://www.readbyqxmd.com/read/29351789/prevention-of-severe-infectious-complications-after-colorectal-surgery-using-preoperative-orally-administered-antibiotic-prophylaxis-precaution-study-protocol-for-a-randomized-controlled-trial
#3
Tessa Mulder, Marjolein F Q Kluytmans-van den Bergh, Anne Marie G A de Smet, Nils E van 't Veer, Daphne Roos, Stavros Nikolakopoulos, Marc J M Bonten, Jan A J W Kluytmans
BACKGROUND: Colorectal surgery is frequently complicated by surgical site infections (SSIs). The most important consequences of SSIs are prolonged hospitalization, an increased risk of surgical reintervention and an increase in mortality. Perioperative intravenously administered antibiotic prophylaxis is the standard of care to reduce the risk of SSIs. In the last few decades, preoperative orally administered antibiotics have been suggested as additional prophylaxis to further reduce the risk of infection, but are currently not part of routine practice in most hospitals...
January 19, 2018: Trials
https://www.readbyqxmd.com/read/29351727/report-of-a-review-of-the-induction-and-refresher-scheme-placement-report-tools
#4
Martyn Hewett
GPs undertaking the Induction and Refresher (I&R) Scheme in England spend a period of between 4 weeks and 6 months in placements in a General Practice setting. During this time they have to complete a number of workplace-based assessments, and their Educational Supervisor is required to complete a report which confirms that they have demonstrated an adequate level of competence to enable them to be accepted by NHS England onto the National Medical Performers List without conditions. This report describes a process (using an online survey completed by Educational Supervisors) of reviewing and improving the end-of-placement report forms to make them clearer and easier to use...
January 19, 2018: Education for Primary Care
https://www.readbyqxmd.com/read/29351609/inequity-in-contraceptive-care-between-refugees-and-other-migrant-women-a-retrospective-study-in-dutch-general-practice
#5
Liselotte A D Raben, Maria E T C van den Muijsenbergh
Background: Female refugees are at high risk of reproductive health problems including unmet contraceptive needs. In the Netherlands, the general practitioner (GP) is the main entrance to the healthcare system and plays a vital role in the prescription of contraceptives. Little is known about contraceptive care in female refugees in primary care. Objective: To get insight into GP care related to contraception in refugees and other migrants compared with native Dutch women...
January 17, 2018: Family Practice
https://www.readbyqxmd.com/read/29351295/effects-of-a-population-based-person-centred-and-integrated-care-service-on-health-wellbeing-and-self-management-of-community-living-older-adults-a-randomised-controlled-trial-on-embrace
#6
Sophie L W Spoorenberg, Klaske Wynia, Ronald J Uittenbroek, Hubertus P H Kremer, Sijmen A Reijneveld
OBJECTIVE: To evaluate the effects of the population-based, person-centred and integrated care service 'Embrace' at twelve months on three domains comprising health, wellbeing and self-management among community-living older people. METHODS: Embrace supports older adults to age in place. A multidisciplinary team provides care and support, with intensity depending on the older adults' risk profile. A randomised controlled trial was conducted in fifteen general practices in the Netherlands...
2018: PloS One
https://www.readbyqxmd.com/read/29351133/using-clinical-questions-asked-by-primary-care-providers-through-econsults-to-inform-continuing-professional-development
#7
Douglas Archibald, Clare Liddy, Heather A Lochnan, Paul J Hendry, Erin J Keely
INTRODUCTION: Continuing professional development (CPD) offerings should address the educational needs of health care providers. Innovative programs, such as electronic consultations (eConsults), provide unique educational opportunities for practice-based needs assessment. The purpose of this study is to assess whether CPD offerings match the needs of physicians by coding and comparing session content to clinical questions asked through eConsults. METHODS: This study analyzes questions asked by primary care providers between July 2011 and January 2015 using a service that allows specialists to provide consultation over a secure web-based server...
January 16, 2018: Journal of Continuing Education in the Health Professions
https://www.readbyqxmd.com/read/29351104/frequency-of-blood-pressure-and-estimated-glomerular-filtration-rate-monitoring-in-patients-affected-by-hypertension-a-retrospective-study-with-176%C3%A2-565-patients-in-germany
#8
Louis Jacob, Florian Seitz, Karel Kostev
OBJECTIVE: The aim of this study was to analyze the frequency of blood pressure (BP) and estimated glomerular filtration rate (eGFR) monitoring in hypertension patients followed in primary care practices in Germany. PATIENTS AND METHODS: This study included patients who had received at least two hypertension diagnoses (ICD-10: I10) in 2016. The primary outcome of this study was the frequency of BP and eGFR monitoring in patients with hypertension in the year 2016...
January 18, 2018: Blood Pressure Monitoring
https://www.readbyqxmd.com/read/29350592/geographic-proximity-to-specialized-pediatric-neurosurgical-care-in-the-contiguous-united-states
#9
Abdul-Kareem Ahmed, Ann-Christine Duhaime, Timothy R Smith
OBJECTIVE Absent from an analysis of supply is consideration of the geographic distribution of pediatric neurosurgeons. Several patient socioeconomic metrics are known to be associated with outcome in pediatric neurosurgical diseases, such as hydrocephalus. The purpose of this study was to determine current geographic proximity to pediatric neurosurgical care using professional society databases. This study also sought to establish how socioeconomic factors are related to distance to care, using federal government-collected data...
January 19, 2018: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29350109/tertiary-care-experience-of-sorafenib-in-the-treatment-of-progressive-radioiodine-refractory-differentiated-thyroid-carcinoma-a-korean-multicenter-study
#10
Mijin Kim, Tae Hyuk Kim, Dong Yeob Shin, Dong-Jun Lim, Eui Young Kim, Won Bae Kim, Jae Hoon Chung, YoungKee Shong, Bo Hyun Kim, Won Gu Kim
BACKGROUND: Sorafenib, a multi-kinase inhibitor, is approved for the treatment of patients with radioactive iodine (RAI)-refractory differentiated thyroid cancer (DTC). In this study, we evaluated the efficacy and safety of sorafenib in real-world clinical practice and compared the results with those of the DECISION trial. We also evaluated the clinical features associated with better clinical outcomes after sorafenib treatment. METHODS: This multicenter, retrospective cohort study evaluated 98 patients with progressive RAI-refractory DTC who were treated with sorafenib in six tertiary hospitals in Korea...
January 19, 2018: Thyroid: Official Journal of the American Thyroid Association
https://www.readbyqxmd.com/read/29349682/managing-obesity-in-primary-care-breaking-down-the-barriers
#11
REVIEW
Nicholas Forgione, Gary Deed, Gary Kilov, Georgia Rigas
Several Australian obesity management guidelines have been developed for general practice but, to date, implementation of these guidelines has been shown to be inadequate. In this review, we explore the barriers to obesity treatment and propose a four-stage plan to manage individuals with obesity in general practice using a framework of a multidisciplinary team. FUNDING: Novo Nordisk.
January 18, 2018: Advances in Therapy
https://www.readbyqxmd.com/read/29348370/-diagnosis-and-treatment-of-myalgic-encephalomyelitis-chronic-fatigue-syndrome
#12
Hirohiko Kuratsune
We present here the Japanese clinical diagnostic criteria for myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) that were proposed in 2016 by the Japanese Ministry of Health, Labour and Welfare study group. The clinical diagnosis criteria of ME/CFS were created to be used by healthcare agencies in charge of primary care practice. We also explain the current prognosis in ME/CFS and medical treatments used in major medical institutions in Japan.
January 2018: Brain and Nerve, Shinkei Kenkyū No Shinpo
https://www.readbyqxmd.com/read/29348052/thirty-day-complication-rate-of-percutaneous-gastrojejunostomy-and-gastrostomy-tube-insertion-using-a-single-puncture-dual-anchor-technique
#13
Rebecca Zener, Alexandra C Istl, Kerollos N Wanis, David Hocking, Jacob Kachura, Shaker Alshehri, Amol Mujoomdar, Steven Latosinsky, Daniele Wiseman
PURPOSE: Our objective was to assess 30-day mortality and complication rates associated with percutaneous enteral feeding tube insertion using a single-puncture, dual-suture anchor gastropexy and peel-away sheath technique. We explored differences in complications based on indication and gastrostomy versus gastrojejunostomy tube. METHODS: A retrospective review was conducted of adult patients undergoing fluoroscopically guided gastrojejunostomy (GJ) and gastrostomy (G) tube insertions between July 2011 and 2014 by five interventional radiologists at a single tertiary care centre...
January 10, 2018: Clinical Imaging
https://www.readbyqxmd.com/read/29346701/identifying-prevalence-and-characteristics-of-behavioral-health-education-in-family-medicine-clerkships-a-cera-study
#14
Mario P DeMarco, Renée M Betancourt, Kelly M Everard, Kent D W Bream
BACKGROUND AND OBJECTIVES: Many patients with behavioral health disorders do not seek or receive adequate care for their conditions. Among those that do, most will receive care in a primary care setting. To best meet this need, clinicians will need to demonstrate proficiency of behavioral health skills and evidence-based practices. We sought to explore the degree to which these skills are being taught in family medicine clerkships. METHODS: The Council of Academic Family Medicine's (CAFM) Educational Research Alliance (CERA) 2016 survey of clerkship directors (CDs) was sent to 141 CDs at US and Canadian medical schools with a required family medicine run course...
January 2018: Family Medicine
https://www.readbyqxmd.com/read/29345427/review-article-best-practice-management-of-common-shoulder-injuries-and-conditions-in-the-emergency-department-part-4-of-the-musculoskeletal-injuries-rapid-review-series
#15
REVIEW
Kirsten Strudwick, Megan McPhee, Anthony Bell, Melinda Martin-Khan, Trevor Russell
Shoulder injuries are a commonly presenting complaint to the ED. In the absence of an obvious deformity, they can be difficult to assess and definitively diagnose because of the multiple structures that cause shoulder pain, the acuity and severity of pain and the lack of range of motion in the ED setting. The quality of ED care provided to patients with musculoskeletal shoulder pain is crucial to ensure the best possible outcomes for the patient. This rapid review investigated best practice for the assessment and management of common shoulder injuries and conditions in the ED...
January 18, 2018: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29345404/individual-variability-in-response-to-renin-angiotensin-aldosterone-system-inhibition-predicts-cardiovascular-outcome-in-patients-with-type-2-diabetes-a-primary-care-cohort-study
#16
Ellen M Apperloo, Michelle J Pena, Dick de Zeeuw, Petra Denig, Hiddo Jl Heerspink
AIMS: Variability in response to Renin-Angiotensin-Aldosterone System (RAAS) inhibition has been shown in clinical trials but its occurrence and impact in clinical practice are unknown. We assessed variability in systolic blood pressure (SBP) and albuminuria (UACR) responses in patients with type 2 diabetes mellitus initiating RAAS inhibition, and assessed the association of response variability with cardiovascular outcomes. METHODS: We performed an observational cohort study in patients with type 2 diabetes who started RAAS inhibition between 2007 and 2013 (n=1600) were identified from general practices in the Netherlands...
January 18, 2018: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/29345234/current-approaches-to-epistaxis-treatment-in-primary-and-secondary-care
#17
Rafael Beck, Martin Sorge, Antonius Schneider, Andreas Dietz
BACKGROUND: The lifetime prevalence of epistaxis is approximately 60%, and 6-10% of the affected persons need medical care. In rare cases, severe bleeding calls for the rapid initiation of effective treatment. METHODS: This review is based on pertinent articles that were retrieved by a selective search PubMed, and on the authors' clinical experience. RESULTS: There are no German guidelines for the management of epistaxis. The available evidence consists mainly of retro spective analyses and expert opinions...
January 8, 2018: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/29345003/investigation-of-attributes-which-guide-choice-in-cataract-surgery-services-in-urban-sydney-australia
#18
Celeste Gilbert, Lisa Keay, Anna Palagyi, Vu Quang Do, Peter McCluskey, Andrew White, Nicole Carnt, Fiona Stapleton, Tracey-Lea Laba
BACKGROUND: It is critical to consult patients to develop patient-centred cataract surgery care. We aimed to identify attributes patients consider when making decisions about cataract surgery in an Australian context, where both publicly and privately funded surgery are available. This is the first step in investigating how decisions are made about cataract surgery services. METHODS: This observational qualitative study was undertaken in two public hospitals and one private practice in Sydney, Australia...
January 17, 2018: Clinical & Experimental Optometry: Journal of the Australian Optometrical Association
https://www.readbyqxmd.com/read/29344338/current-best-practice-in-the-management-of-turner-syndrome
#19
REVIEW
Roopa Kanakatti Shankar, Philippe F Backeljauw
Turner syndrome (TS) is characterized by partial or complete loss of the second X-chromosome in phenotypic females resulting in a constellation of clinical findings that may include lymphedema, cardiac anomalies, short stature, primary ovarian failure and neurocognitive difficulties. Optimizing health care delivery is important to enable these individuals achieve their full potential. We review the current best practice management recommendations for individuals with TS focusing on the latest consensus opinion in regard to genetic diagnosis, treatment of short stature, estrogen supplementation, addressing psychosocial issues, as well screening for other comorbidities...
January 2018: Therapeutic Advances in Endocrinology and Metabolism
https://www.readbyqxmd.com/read/29344092/engaging-the-primary-care-community-to-encourage-appropriate-prostate-cancer-screening
#20
Malhar P Patel, Ariel Schulman, Kevin P Shah, John B Anderson, Thomas J Polascik
Prostate-specific antigen (PSA) screening for prostate cancer remains a controversial topic, particularly in the primary care community. Our multidisciplinary prostate screening panel at Duke University Health System, USA created a nuanced PSA screening algorithm, implemented it into the Electronic Health Record of Duke Primary Care, and conducted outreach meetings with primary care practices to support its rollout. Through this project, we identified areas of concern among primary care clinicians regarding PSA screening that we structured into two major categories: ideological opposition and logistical opposition...
January 2018: Therapeutic Advances in Urology
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