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https://www.readbyqxmd.com/read/28431271/investigation-of-pathology-malpractice-claims-in-china-from-2002-2015
#1
Yuan Li, Dong Gao, Meng Tu, Ying-Zhen Luo, Zhen-Hua Deng
OBJECTIVE: To examine pathology-related medical claims in China and identify the most common errors to result in such claims. METHOD: A retrospective analysis was performed of 71 forensic evaluation reports carried out in two Chinese institutes of forensic medicine between 2002 and 2015 due to suspicion of medical malpractice. The judicial outcomes of each case were also reviewed when available. RESULTS: Of 71 cases, 54 cases had judicial outcomes...
April 15, 2017: Journal of Forensic and Legal Medicine
https://www.readbyqxmd.com/read/28431270/clinicians-conflicting-emotional-responses-to-high-suicide-risk-patients-association-with-short-term-suicide-behaviors-a-prospective-pilot-study
#2
Zimri S Yaseen, Igor I Galynker, Lisa J Cohen, Jessica Briggs
BACKGROUND: Clinician's emotional responses to patients have been recognized as potentially relating to treatment outcome, however they have received little attention in the literature on suicide risk. We examine the relationship between a novel targeted measure of clinicians' emotional responses to high-risk psychiatric inpatients and their short-term post-discharge suicide behavior. METHODS: First-year psychiatry residents' emotional responses to their patients were assessed anonymously with the novel self-report 'Therapist Response Questionnaire-Suicide Form' (TRQ-SF)...
April 6, 2017: Comprehensive Psychiatry
https://www.readbyqxmd.com/read/28431138/cardiovascular-outcome-trials-in-patients-with-chronic-kidney-disease-challenges-associated-with-selection-of-patients-and-endpoints
#3
Patrick Rossignol, Rajiv Agarwal, Bernard Canaud, Alan Charney, Gilles Chatellier, Jonathan C Craig, William C Cushman, Ronald T Gansevoort, Bengt Fellström, Dahlia Garza, Nicolas Guzman, Frank A Holtkamp, Gerard M London, Ziad A Massy, Alexandre Mebazaa, Peter G M Mol, Marc A Pfeffer, Yves Rosenberg, Luis M Ruilope, Jonathan Seltzer, Amil M Shah, Salim Shah, Bhupinder Singh, Bergur V Stefánsson, Norman Stockbridge, Wendy Gattis Stough, Kristian Thygesen, Michael Walsh, Christoph Wanner, David G Warnock, Christopher S Wilcox, Janet Wittes, Bertram Pitt, Aliza Thompson, Faiez Zannad
Although cardiovascular disease is a major health burden for patients with chronic kidney disease, most cardiovascular outcome trials have excluded patients with advanced chronic kidney disease. Moreover, the major cardiovascular outcome trials that have been conducted in patients with end-stage renal disease have not demonstrated a treatment benefit. Thus, clinicians have limited evidence to guide the management of cardiovascular disease in patients with chronic kidney disease, particularly those on dialysis...
April 18, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28431030/using-multivariate-base-rates-to-interpret-low-scores-on-an-abbreviated-battery-of-the-delis-kaplan-executive-function-system
#4
Justin E Karr, Mauricio A Garcia-Barrera, James A Holdnack, Grant L Iverson
Objective: Executive function consists of multiple cognitive processes that operate as an interactive system to produce volitional goal-oriented behavior, governed in large part by frontal microstructural and physiological networks. Identification of deficits in executive function in those with neurological or psychiatric conditions can be difficult because the normal variation in executive function test scores, in healthy adults when multiple tests are used, is largely unknown. This study addresses that gap in the literature by examining the prevalence of low scores on a brief battery of executive function tests...
May 1, 2017: Archives of Clinical Neuropsychology: the Official Journal of the National Academy of Neuropsychologists
https://www.readbyqxmd.com/read/28431019/identifying-cytomegalovirus-cmv-complications-using-the-quantiferon-cmv-assay-after-allogeneic-hematopoietic-stem-cell-transplantation
#5
Michelle K Yong, Paul U Cameron, Monica Slavin, C Orla Morrissey, Krystal Bergin, Andrew Spencer, David Ritchie, Allen C Cheng, Assia Samri, Guislaine Carcelain, Brigitte Autran, Sharon R Lewin
Background: Cytomegalovirus (CMV) reactivation and disease remain a major cause of morbidity and mortality in hematopoietic stem cell transplant (HSCT) recipients. A simple test to identify recovery of CMV-specific T-cell immunity could assist clinicians in managing CMV-related complications. Methods: In an observational multi-centre prospective study of 94 allogeneic HSCT recipients we evaluated CMV-specific T-cell immunity at baseline, 3, 6, 9 and 12 months post-transplant using the Quantiferon-CMV®, an ELISpot assay and in a subset, we also evaluated intracellular cytokine staining (ICS)...
April 18, 2017: Journal of Infectious Diseases
https://www.readbyqxmd.com/read/28430889/accuracy-of-diagnostic-tests-for-schistosoma-mansoni-infection-in-asymptomatic-eritrean-refugees-serology-and-poc-cca-against-stool-microscopy
#6
Afona Chernet, Kerstin Kling, Véronique Sydow, Esther Kuenzli, Christoph Hatz, Jürg Utzinger, Lisette van Lieshout, Hanspeter Marti, Niklaus D Labhardt, Andreas Neumayr
Background: The unprecedented increase in number of African refugees arriving in Europe is confronting clinicians and general practitioners with the question of whether or not and how to screen migrants from endemic regions for Schistosoma mansoni infection. Methods: We assessed the accuracy of three different diagnostic tests for S.mansoni infection (stool microscopy [samples prepared by sedimentation technique], serology, and point-of-care circulating cathodic antigen [POC-CCA] urine cassette test) in 107 newly arrived asymptomatic Eritrean refugees in Switzerland...
April 19, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28430862/how-health-related-quality-of-life-assessment-should-be-used-in-advanced-colorectal-cancer-clinical-trials
#7
F Bonnetain, C Borg, R R Adams, J A Ajani, A Benson, H Bleiberg, B Chibaudel, E Diaz-Rubio, J Y Douillard, C S Fuchs, B J Giantonio, R Goldberg, V Heinemann, M Koopman, R Labianca, A K Larsen, T Maughan, E Mitchell, M Peeters, C J A Punt, H J Schmoll, C Tournigand, A de Gramont
Traditionally, the efficacy of cancer treatment in patients with advance or metastatic disease in clinical studies has been studied using overall survival (OS) and more recently tumor-based endpoints such as progression-free survival, measurements of response to treatment. However, these seem not to be the relevant clinical endpoints in current situation if such endpoints were no validated as surrogate of OS to demonstrate the clinical efficacy. Appropriate, meaningful, primary patient-oriented and patient-reported endpoints that adequately measure the effects of new therapeutic interventions are then crucial for the advancement of clinical research in metastatic colorectal cancer to complement the results of tumor-based endpoints...
April 18, 2017: Annals of Oncology: Official Journal of the European Society for Medical Oncology
https://www.readbyqxmd.com/read/28430829/effect-of-a-price-transparency-intervention-in-the-electronic-health-record-on-clinician-ordering-of-inpatient-laboratory-tests-the-price-randomized-clinical-trial
#8
Mina S Sedrak, Jennifer S Myers, Dylan S Small, Irving Nachamkin, Justin B Ziemba, Dana Murray, Gregory W Kurtzman, Jingsan Zhu, Wenli Wang, Deborah Mincarelli, Daniel Danoski, Brian P Wells, Jeffrey S Berns, Patrick J Brennan, C William Hanson, C Jessica Dine, Mitesh S Patel
Importance: Many health systems are considering increasing price transparency at the time of order entry. However, evidence of its impact on clinician ordering behavior is inconsistent and limited to single-site evaluations of shorter duration. Objective: To test the effect of displaying Medicare allowable fees for inpatient laboratory tests on clinician ordering behavior over 1 year. Design, Setting, and Participants: The Pragmatic Randomized Introduction of Cost data through the electronic health record (PRICE) trial was a randomized clinical trial comparing a 1-year intervention to a 1-year preintervention period, and adjusting for time trends and patient characteristics...
April 21, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28430626/expression-of-pd-l1-and-prognosis-in-breast-cancer-a-meta-analysis
#9
Minghui Zhang, Houbin Sun, Shu Zhao, Yan Wang, Haihong Pu, Yan Wang, Qingyuan Zhang
The associations between programmed cell death ligand 1 (PD-L1) and the prognosis of various cancers have always been a research topic of considerable interest. However, the prognostic value of PD-L1 in breast cancer patients remains a controversial subject. We aimed to assess the association between PD-L1 protein expression and clinicopathological features and the impact of this relationship on breast cancer survival. We performed a systematic search of the PubMed, EMBASE, and Cochrane Library databases to determine the correlations among PD-L1 expression, clinicopathological features and overall survival (OS)...
February 20, 2017: Oncotarget
https://www.readbyqxmd.com/read/28430572/lessons-about-so-called-difficult-patients-from-the-uk-controversy-over-patient-access-to-electronic-health-records
#10
Federica Lucivero
Increasing numbers of patients have direct access to their electronic health records (EHRs). Proponents of direct access argue that it empowers patients by making them more informed and offering them more control over their health and care. According to some proponents of patients' access to EHRs, clinicians' concerns about potential negative implications are grounded in a form of paternalism that protects clinicians' authority. This paper draws upon narratives from patients in the United Kingdom (UK) who have access to their EHRs and suggests strategies for moving beyond these controversies between proponents and critics of the system...
April 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/28430571/forty-years-since-taking-care-of-the-hateful-patient
#11
Richard B Gunderman, Peter R Gunderman
Using the word "hateful" is not the only option in describing patients who induce in clinicians feelings of dread. We suggest an alternative approach to the language of hate, one that seeks dignity and perhaps even a divine spark in every patient.
April 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/28430570/repairing-difficult-patient-clinician-relationships
#12
Denise M Dudzinski, Carrol Alvarez
Using a case example, we offer guidance for improving "difficult" clinician-patient relationships. These relationships may be repaired by acknowledging a clinician's part in conflict, empathizing with patients, identifying a patient's skill deficits, and employing communication and engagement techniques used by mental health professionals. Clinicians will inevitably take on more of the work of repairing damaged relationships, but doing so improves the odds of these patients receiving the help they need.
April 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/28430568/reflection-based-learning-for-professional-ethical-formation
#13
William T Branch, Maura George
One way practitioners learn ethics is by reflecting on experience. They may reflect in the moment (reflection-in-action) or afterwards (reflection-on-action). We illustrate how a teaching clinician may transform relationships with patients and teach person-centered care through reflective learning. We discuss reflective learning pedagogies and present two case examples of our preferred method, guided group reflection using narratives. This method fosters moral development alongside professional identity formation in students and advanced learners...
April 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/28430567/how-should-clinicians-respond-to-medical-requests-from-clinician-family-members-of-patients
#14
Andrew Thurston
In the medical profession, receiving a request for medical management from a colleague is a routine experience. However, when the colleague is a family member of a patient and the desired or requested medical intervention is not medically indicated in the attending physician's view, the situation becomes more complicated. Ethical issues include respect for patient autonomy and social justice as well as nonmaleficence. Furthermore, interpersonal and professional relationships may be tested in this situation...
April 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/28430565/do-physicians-have-an-ethical-duty-to-repair-relationships-with-so-called-difficult-patients
#15
Micah Johnson
This essay argues that physicians hold primary ethical responsibility for repairing damaged patient-physician relationships. The first section establishes that the patient-physician relationship has an important influence on patient health and argues that physicians' duty to treat should be understood as including a responsibility to repair broken relationships, regardless of which party was "responsible" for the initial tension. The second section argues that the person with more power to repair the relationship also has more responsibility to do so and considers the moral psychology of pain as foundational to conceiving the patient in this case as especially vulnerable and disempowered...
April 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/28430557/utilization-management-of-high-cost-imaging-in-an-outpatient-setting-in-a-large-stable-patient-and-provider-cohort-over-7-years
#16
Jeffrey B Weilburg, Christopher L Sistrom, Daniel I Rosenthal, Markus B Stout, Keith J Dreyer, Helaine R Rockett, Jason M Baron, Timothy G Ferris, James H Thrall
Purpose To quantify the effect of a comprehensive, long-term, provider-led utilization management (UM) program on high-cost imaging (computed tomography, magnetic resonance imaging, nuclear imaging, and positron emission tomography) performed on an outpatient basis. Materials and Methods This retrospective, 7-year cohort study included all patients regularly seen by primary care physicians (PCPs) at an urban academic medical center. The main outcome was the number of outpatient high-cost imaging examinations per patient per year ordered by the patient's PCP or by any specialist...
April 21, 2017: Radiology
https://www.readbyqxmd.com/read/28430550/round-table-on-malignant-hyperthermia-in-physically-active-populations-meeting-proceedings
#17
Yuri Hosokawa, Douglas J Casa, Henry Rosenberg, John F Capacchione, Emmanuel Sagui, Sheila Riazi, Luke N Belval, Patricia A Deuster, John F Jardine, Stavros A Kavouras, Elaine C Lee, Kevin C Miller, Sheila M Muldoon, Francis G O'Connor, Scott R Sailor, Nyamkhishig Sambuughin, Rebecca L Stearns, William M Adams, Robert A Huggins, Lesley W Vandermark
CONTEXT:   Recent case reports on malignant hyperthermia (MH)-like syndrome in physically active populations indicate potential associations among MH, exertional heat stroke (EHS), and exertional rhabdomyolysis (ER). However, an expert consensus for clinicians working with these populations is lacking. OBJECTIVE:   To provide current expert consensus on the (1) definition of MH; (2) history, etiology, and pathophysiology of MH; (3) epidemiology of MH; (4) association of MH with EHS and ER; (5) identification of an MH-like syndrome; (6) recommendations for acute management of an MH-like syndrome; (7) special considerations for physically active populations; and (8) future directions for research...
April 2017: Journal of Athletic Training
https://www.readbyqxmd.com/read/28430396/patient-and-caregiver-perspectives-on-decision-support-for-symptom-and-quality-of-life-management-during-cancer-treatment-implications-for-ehealth
#18
Mary E Cooley, Manan M Nayak, Janet L Abrahm, Ilana M Braun, Michael S Rabin, Jane Brzozowski, Christopher Lathan, Donna L Berry
OBJECTIVES: Adequate symptom and quality-of-life (SQL) management is a priority during cancer treatment. eHealth is a timely way to enhance patient-engagement, facilitate communication and improve health outcomes. The objectives of this study were to describe patient and caregivers' perspectives for providing, processing and managing SQL data to enhance communication and identify desired components for decision support. METHODS: Data were collected from 64 participants through questionnaires and focus groups...
April 21, 2017: Psycho-oncology
https://www.readbyqxmd.com/read/28430309/variation-in-use-of-technology-among-vascular-access-specialists-an-analysis-of-the-picc1-survey
#19
Vineet Chopra, Latoya Kuhn, David Ratz, Suzanne Winter, Peter J Carr, David Paje, Sarah L Krein
BACKGROUND: While the use of technologies such as ultrasound and electrocardiographic (ECG) guidance systems to place peripherally inserted central catheters (PICCs) has grown, little is known about the clinicians who use these tools or their work settings. METHODS: Using data from a national survey of vascular access specialists, we identified technology users as PICC inserters that: (a) use ultrasound to find a suitable vein for catheter placement; (b) measure catheter-to-vein ratio; and (c) use ECG for PICC placement...
April 20, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28430299/effect-of-retreatment-instruments-on-microcrack-formation-a-microcomputed-tomography-study
#20
Mustafa M Koçak, Neslihan Y Çırakoğlu, Sibel Koçak, Baran C Sağlam, Ersan Çiçek, Sevinç A Türker, Emre Bodrumlu
INTRODUCTION: The purpose of this study was to compare the occurrence of microcracks in teeth prepared with different retreatment systems using microcomputed tomography (micro-CT). METHODS: Forty-two freshly extracted mandibular premolar teeth were used. The root canals were instrumented with stainless steel K-files to an apical size of 35/.02 using the balanced-force technique and were obturated using the passive compaction technique. The specimens were divided into 3 experimental groups according to retreatment system used (n = 14): ProTaper Universal retreatment (PTUR), Mtwo retreatment (MTR), or D-RaCe retreatment (D-RC) systems...
April 4, 2017: International Journal of Artificial Organs
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