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https://www.readbyqxmd.com/read/27922981/second-opinion-expert-pathology-in-endometrial-cancer-potential-clinical-implications
#1
Friederike Grevenkamp, Felix Kommoss, Friedrich Kommoss, Sigurd Lax, Falko Fend, Diethelm Wallwiener, Birgitt Schönfisch, Bernhard Krämer, Sara Y Brucker, Florin-Andrei Taran, Annette Staebler, Stefan Kommoss
OBJECTIVE: In cancer patients, the pathology report serves as an important basis for treatment. Therefore, a correct cancer diagnosis is crucial, and diagnostic discrepancies may be of clinical relevance. It was the aim of this study to perform a specialized histopathology review and to investigate potential clinical implications of expert second opinion pathology in endometrial cancer. METHODS: Patients treated for endometrial carcinoma at the Tübingen University Women's hospital between 2003 and 2013 were identified...
December 3, 2016: International Journal of Gynecological Cancer
https://www.readbyqxmd.com/read/27922947/microbiology-and-antimicrobial-challenges-of-prosthetic-joint-infection
#2
Douglas R Osmon
Research that leads to better strategies to diagnose and treat prosthetic joint infection (PJI) is critical because PJI is a devastating complication of total knee arthroplasty. A key to the diagnosis and management of PJI is defining the microbiology of PJI and improving the medical management of PJI utilizing both systemic and local antimicrobial therapy. In this review, the author will present his opinions on future research needs as they relate to the microbiology of PJI, including antimicrobial resistance and the antimicrobial treatment of PJI...
December 5, 2016: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/27922915/lifestyle-behaviors-perceived-stress-and-inflammation-of-individuals-with-chronic-graft-versus-host-disease
#3
Debra Lynch Kelly, Debra E Lyon, Deidre Periera, Cynthia Garvan, John Wingard
BACKGROUND: Stress is a potent immunomodulator contributing to chronic conditions. Chronic graft-versus-host disease (cGVHD) is a life-threatening late effect of allogeneic hematopoietic cell transplantation associated with stress and exaggerated immune response that may be associated to lifestyle behaviors. OBJECTIVE: The aim of this study is to explore associations among lifestyle behaviors, perceived stress, and inflammation of individuals with cGVHD. METHODS: A secondary analysis from a prospective observational study of 24 adults (≥18 years) with cGVHD was conducted...
December 5, 2016: Cancer Nursing
https://www.readbyqxmd.com/read/27922625/infections-in-the-spinal-cord-injured-population-a-systematic-review
#4
L Y Garcia-Arguello, J C O'Horo, A Farrell, R Blakney, M R Sohail, C T Evans, N Safdar
STUDY DESIGN: Spinal cord injury (SCI) patients are an increasing population due to recent military conflicts. SCI patients are at an increased risk of infection, but the epidemiology management and prevention strategies for these infections are unclear. OBJECTIVE: To review the incidence, microbiology and management of pneumonia, skin and soft tissue infections (SSTI), urinary tract infections (UTI) and bloodstream infections in the SCI population via literature review...
December 6, 2016: Spinal Cord
https://www.readbyqxmd.com/read/27922624/association-of-pain-social-support-and-socioeconomic-indicators-in-patients-with-spinal-cord-injury-in-iran
#5
Z Khazaeipour, E Ahmadipour, V Rahimi-Movaghar, F Ahmadipour, A R Vaccaro, B Babakhani
STUDY DESIGN: Descriptive cross-sectional study. OBJECTIVES: Pain is a prevalent complication of individuals with spinal cord injury (SCI). Our objective was to examine the association between social support, socioeconomic factors and psychosocial factors and pain to develop more effective management strategies. SETTING: Brain and Spinal Cord Injury Research (BASIR) Center, Tehran University of Medical Sciences, Tehran, Iran. METHODS: The Persian version of the Brief Pain Inventory was used to measure the pain, and the Multidimensional Scale of Perceived Social Support was used to measure social support through structured face-to-face interviews in SCI individuals...
December 6, 2016: Spinal Cord
https://www.readbyqxmd.com/read/27922579/srs-22r-scores-in-non-operated-adolescent-idiopathic-scoliosis-patients-with-curves-greater-than-forty-degrees
#6
W Timothy Ward, Nicole A Friel, Tanya S Kenkre, Maria M Brooks, Joanne A Londino, James W Roach
STUDY DESIGN: Case control comparative series OBJECTIVE.: Describe surgical range adolescent idiopathic scoliosis (AIS) patients electing to forgo surgery and compare health related quality of life outcomes to a similar cohort of operated AIS patients by the same single surgeon. SUMMARY OF BACKGROUND DATA: No data have been published either documenting SRS-22r scores of non-operated patients with curves ≥ 40° or comparing these scores to a demographically similar operated cohort...
December 2, 2016: Spine
https://www.readbyqxmd.com/read/27922570/developing-a-simulation-based-training-program-for-the-prehospital-professionals-and-students-on-the-management-of-middle-east-respiratory-syndrome
#7
Melih Elcin, Arif Onan, Orhan Odabasi, Melahat Saylam, Handan Ilhan, Pinar Daylan Kockaya, Ilker Gurcuoglu, Yavuz Uckuyu, Duygu Cengiz, Osman Arikan Nacar
INTRODUCTION: Middle East Respiratory Syndrome (MERS) is a major global health threat. Prehospital professionals face the risk of infection as they work to save lives. They should be made aware of the disease and be prepared to handle such cases. The aims of our study are to develop a training program about the prehospital management of a MERS case using standardized patient (SP) scenarios, to evaluate the awareness and preparedness of the participants about MERS, and to evaluate the effectiveness of this training...
December 2016: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
https://www.readbyqxmd.com/read/27922561/a-pharmacologic-review-of-anaphylaxis
#8
Nancy S Yunker, Bradley J Wagner
Anaphylaxis occurs in the surgical population and may have devastating consequences. Anaphylaxis and anaphylactoid reactions are immediate hypersensitivity reactions that are most commonly precipitated by medications, insect stings, and foods. In the surgical population, 47.4% of immediate hypersensitivity reactions were precipitated by neuromuscular blocking agents, followed by latex and antibiotics in 20% and 18.1% of cases, respectively. Initial treatment consists of removing the precipitating trigger, administering epinephrine, and correct patient positioning...
October 2016: Plastic Surgical Nursing
https://www.readbyqxmd.com/read/27922506/coding-in-muscle-disease
#9
Lyell K Jones, John P Ney
Accurate coding is critically important for clinical practice and research. Ongoing changes to diagnostic and billing codes require the clinician to stay abreast of coding updates. Payment for health care services, data sets for health services research, and reporting for medical quality improvement all require accurate administrative coding. This article provides an overview of administrative coding for patients with muscle disease and includes a case-based review of diagnostic and Evaluation and Management (E/M) coding principles in patients with myopathy...
December 2016: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/27922495/toxic-and-endocrine-myopathies
#10
Hans D Katzberg, Charles D Kassardjian
PURPOSE OF REVIEW: This article discusses the clinical features, pathophysiology, and management of toxic and endocrine myopathies. RECENT FINDINGS: Early detection and expeditious correction of metabolic disturbances in endocrinopathies such as Cushing syndrome, thyroid and parathyroid diseases, and acromegaly can minimize and prevent neurologic complications including myopathy. Recently proposed mechanisms of injury in patients with critical illness myopathy include inhibition of protein synthesis, mitochondrial dysfunction, disruption of the ubiquitin-proteasome system, oxidative stress, and disruption of intramuscular calcium homeostasis, which can cause a myosin-loss myopathy...
December 2016: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/27922462/fostering-evidence-based-quality-improvement-for-patient-centered-medical-homes-initiating-local-quality-councils-to-transform-primary-care
#11
Susan E Stockdale, Jessica Zuchowski, Lisa V Rubenstein, Negar Sapir, Elizabeth M Yano, Lisa Altman, Jacqueline J Fickel, Skye McDougall, Timothy Dresselhaus, Alison B Hamilton
BACKGROUND: Although the patient-centered medical home endorses quality improvement principles, methods for supporting ongoing, systematic primary care quality improvement have not been evaluated. We introduced primary care quality councils at six Veterans Health Administration sites as an organizational intervention with three key design elements: (a) fostering interdisciplinary quality improvement leadership, (b) establishing a structured quality improvement process, and (c) facilitating organizationally aligned frontline quality improvement innovation...
December 3, 2016: Health Care Management Review
https://www.readbyqxmd.com/read/27922454/a-clinician-s-guide-to-privacy-and-communication-in-the-icu
#12
Leslie Francis, Micah A Vorwaller, Hanan Aboumatar, Dominick L Frosch, John Halamka, Ronen Rozenblum, Eileen Rubin, Barbara Sarnoff Lee, Jeremy Sugarman, Kathleen Turner, Samuel M Brown
OBJECTIVE: To review the legal issues concerning family members' access to information when patients are in the ICU. DATA SOURCES: U.S. Code, U.S. Code of Federal Regulations, and state legislative codes. DATA EXTRACTION: Relevant legal statutes and regulations were identified and reviewed by the two attorney authors (L. F., M. A. V.). STUDY SELECTION: Not applicable. DATA SYNTHESIS: Review by all coauthors...
December 2, 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27922281/the-effect-of-recurrent-pulsed-dye-laser-treatments-in-rosacea-patients
#13
Mark Strand Do, Gunnar Bergqvist, Shane Griffith, Emma Bergqvist
BACKGROUND: Rosacea is common chronic skin condition and is known to have a negative impact on patient's quality of life. The use of pulsed dye laser treatment to improve quality of life is well documented in the literature. Prior work has emphasized a single series of laser treatments but we investigated the effect of recurrent pulsed dye laser treatment on patient's symptomalology and quality of life. METHODS: We designed an 8 question survey about patient's rosacea symptoms, prior treatments, effectiveness of prior treatments, benefit of the laser treatments, and number of laser treatments...
December 6, 2016: Journal of Cosmetic and Laser Therapy: Official Publication of the European Society for Laser Dermatology
https://www.readbyqxmd.com/read/27922227/increasing-knowledge-and-confidence-in-behavioral-change-a-pilot-study
#14
Elizabeth P Frates, Ryan C Xiao, Kate Simeon, Tracie McCargo, Michelle Guo, Theodore A Stern
Objective: To assess whether and how effectively an interactive presentation about lifestyle medicine could impact the knowledge and attitudes of medical students to prepare them for managing chronic conditions in their patients. Chronic diseases are increasingly prevalent and problematic. Although chronic disease management involves lifestyle modification, few physicians are adequately trained in effective motivational interventions. Methods: We surveyed first- and second-year Harvard Medical School students in October 2015 before and after a presentation on lifestyle medicine and quantified changes in their knowledge, attitudes/confidence, and skills...
November 24, 2016: Primary Care Companion to CNS Disorders
https://www.readbyqxmd.com/read/27922024/improvements-in-the-long-term-outcome-of-crohn-s-disease-over-the-past-two-decades-and-the-relation-to-changes-in-medical-management-results-from-the-population-based-ibdsl-cohort
#15
Steven F G Jeuring, Tim R A van den Heuvel, Limmie Y L Liu, Maurice P Zeegers, Wim H Hameeteman, Mariëlle J L Romberg-Camps, Liekele E Oostenbrug, Ad A M Masclee, Daisy M A E Jonkers, Marieke J Pierik
OBJECTIVES: Medical treatment options and strategies for Crohn's disease (CD) have changed over the past decades. To assess its impact, we studied the evolution of the long-term disease outcome in the Dutch Inflammatory Bowel Disease South Limburg (IBDSL) cohort. METHODS: In total, 1,162 CD patients were included. Three eras were distinguished: 1991-1998 (n=316), 1999-2005 (n=387), and 2006-2011 (n=459), and patients were followed until 2014. Medication exposure and the rates of hospitalization, surgery, and phenotype progression were estimated using Kaplan-Meier survival analyses and compared between eras by multivariable Cox regression models...
December 6, 2016: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/27921426/-gestational-diabetes-mellitus
#16
Hana Krejčí
The present generation of women of childbearing age more frequently suffer from overweight, obesity, initial as well as fully established metabolic syndrome, which together with postponing motherhood until the third decade in life plays an important role in the increasing incidence of gestational diabetes (GDM) that currently affects about 1/5 of pregnant women. However the causal link between diabetes during pregnancy and metabolic diseases in the whole population is mutual. By way of epigenetic changes, maternal diabetes unfavourably programmes metabolism of the offspring, who tend to transfer the disorder to the next generations...
2016: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/27921413/short-time-efficiency-of-rhinophototherapy-in-management-of-patients-with-allergic-rhinitis-resistant-to-medical-therapy
#17
Soheila Alyasin, Seyed Hesamedin Nabavizadeh, Hamidreza Houshmand, Hossein Esmaeilzadeh, Sina Jelodar, Reza Amin
Allergic rhinitis is one of the most common health problems with a major effect on the quality of life. We intended to treat Allergic Rhinitis (AR) in patients who are either unresponsive to antihistamines or their job requires optimal alertness that may be disturbed by antihistamine's side effects and those who do not comply with the regular use. We tried short term phototherapy and evaluated its effect on AR. As phototherapy is effective in the treatment of atopic dermatitis (AD) and the same allergens can produce both AD and AR, phototherapy is proposed as a new tool in the AR treatment...
August 2016: Iranian Journal of Allergy, Asthma, and Immunology
https://www.readbyqxmd.com/read/27921381/cost-analysis-of-the-treatment-of-severe-acute-malnutrition-in-west-africa
#18
Sheila Isanaka, Nicolas A Menzies, Jessica Sayyad, Mudasiru Ayoola, Rebecca F Grais, Stéphane Doyon
We present an updated cost analysis to provide new estimates of the cost of providing community-based treatment for severe acute malnutrition, including expenditure shares for major cost categories. We calculated total and per child costs from a provider perspective. We categorized costs into three main activities (outpatient treatment, inpatient treatment, and management/administration) and four cost categories within each activity (personnel; therapeutic food; medical supplies; and infrastructure and logistical support)...
December 5, 2016: Maternal & Child Nutrition
https://www.readbyqxmd.com/read/27921321/from-paperwork-to-parenting-experiences-of-professional-staff-in-student-support
#19
Wendy C Y Hu, Eleanor Flynn, Rebecca Mann, Robyn Woodward-Kron
CONTEXT: For academic staff, responding to student concerns is an important responsibility. Professional staff, or non-academic staff who do administrative work in medical schools, are often the first to be approached by students, yet there is little research on how they manage student issues. Informed by the conceptual framework of emotional labour, we examined the experiences of professional staff, aiming to identify theoretical and practical insights for improving the provision of student support...
December 5, 2016: Medical Education
https://www.readbyqxmd.com/read/27921218/from-problem-solving-to-problem-definition-scrutinizing-the-complex-nature-of-clinical-practice
#20
Sayra Cristancho, Lorelei Lingard, Glenn Regehr
In medical education, we have tended to present problems as being singular, stable, and solvable. Problem solving has, therefore, drawn much of medical education researchers' attention. This focus has been important but it is limited in terms of preparing clinicians to deal with the complexity of the 21st century healthcare system in which they will provide team-based care for patients with complex medical illness. In this paper, we use the Soft Systems Engineering principles to introduce the idea that in complex, team-based situations, problems usually involve divergent views and evolve with multiple solution iterations...
December 5, 2016: Perspectives on Medical Education
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