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https://www.readbyqxmd.com/read/28100559/what-is-involved-in-medicines-management-across-care-boundaries-a-qualitative-study-of-healthcare-practitioners-experiences-in-the-case-of-acute-kidney-injury
#1
Denham L Phipps, Rebecca L Morris, Tom Blakeman, Darren M Ashcroft
OBJECTIVES: To examine the role of individual and collective cognitive work in managing medicines for acute kidney injury (AKI), this being an example of a clinical scenario that crosses the boundaries of care organisations and specialties. DESIGN: Qualitative design, informed by a realist perspective and using semistructured interviews as the data source. The data were analysed using template analysis. SETTING: Primary, secondary and intermediate care in England...
January 18, 2017: BMJ Open
https://www.readbyqxmd.com/read/28096482/chronic-disease-management-interventions-for-people-with-chronic-kidney-disease-in-primary-care-a-systematic-review-and-meta-analysis
#2
Lauren Galbraith, Casey Jacobs, Brenda R Hemmelgarn, Maoliosa Donald, Braden Manns, Min Jun
BACKGROUND: Primary care providers manage the majority of patients with chronic kidney disease (CKD), although the most effective chronic disease management (CDM) strategies for these patients are unknown. We assessed the efficacy of CDM interventions used by primary care providers managing patients with CKD. METHODS: MEDLINE, EMBASE and CENTRAL were systematically searched (inception to November 2014) for randomized controlled trials (RCTs) assessing education-based and computer-assisted CDM interventions targeting primary care providers managing patients with CKD in the community...
January 16, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28089416/strategies-to-overcome-therapeutic-resistance-in-renal-cell-carcinoma
#3
REVIEW
Peter J Siska, Kathryn E Beckermann, W Kimryn Rathmell, Scott M Haake
BACKGROUND: Renal cell cancer (RCC) is a prevalent and lethal disease. At time of diagnosis, most patients present with localized disease. For these patients, the standard of care includes nephrectomy with close monitoring thereafter. While many patients will be cured, 5-year recurrence rates range from 30% to 60%. Furthermore, nearly one-third of patients present with metastatic disease at time of diagnosis. Metastatic disease is rarely curable and typically lethal. Cytotoxic chemotherapy and radiation alone are incapable of controlling the disease...
January 11, 2017: Urologic Oncology
https://www.readbyqxmd.com/read/28088910/sodium-glucose-cotransporter-2-inhibitors-sglt2i-their-role-in-cardiometabolic-risk-management
#4
Niki Katsiki, Dimitri P Mikhailidis, Michael J Theodorakis
BACKGROUND: Sodium-glucose cotransporter 2 inhibitors (SGLT2i) are a novel category of oral antidiabetic drugs that inhibit renal glucose reabsorption and increase renal glucose excretion, thus lowering plasma glucose levels. This unique mechanism of SGLT2i action is insulin independent, thus improving glycemic control without promoting hypoglycemia in the absence of exogenously administered insulin. METHODS: The present narrative review addresses the putative associations between SGLT2i and several cardiovascular (CV) and microvascular risk factors, as well as their effects on cardiac and renal function...
January 13, 2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/28086812/person-centred-care-in-chronic-kidney-disease-a-cross-sectional-study-of-patients-desires-for-self-management-support
#5
Kathryn Havas, Clint Douglas, Ann Bonner
BACKGROUND: People with chronic kidney disease (CKD) must self-manage their illness to assist with slowing disease-progression, but this is a complex task requiring support from healthcare professionals. Despite the established importance of person-centred care, people with CKD are rarely consulted regarding their desires for self-management support (SMS). METHODS: A cross-sectional survey was conducted face-to-face in a Queensland primary care clinic and distributed Australia-wide via an online interface promoted by Kidney Health Australia during 2015...
January 13, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28077046/rational-use-of-rasburicase-for-the-treatment-and-management-of-tumor-lysis-syndrome
#6
Suhail A Shaikh, Bernard L Marini, Shannon M Hough, Anthony J Perissinotti
Purpose There is a lack of high-level evidence identifying meaningful outcomes and the optimal place in therapy of rasburicase in patients with, or at high risk for tumor lysis syndrome. The primary objective of this study was to evaluate and characterize outcomes resulting from an institution-specific guideline emphasizing supportive care, xanthine oxidase inhibitors, and lower doses of rasburicase. Methods In this retrospective chart review, we compared conservative rasburicase dosing, in accordance with newly developed UMHS tumor lysis syndrome guidelines, with aggressive rasburicase in adult patients (≥ 18 years of age) with hematological or solid tumor malignancies, and a uric acid level between 8 and 15 mg/dL...
January 1, 2017: Journal of Oncology Pharmacy Practice
https://www.readbyqxmd.com/read/28065734/laparoscopic-roux-en-y-gastric-bypass-in-adolescents-with-severe-obesity-amos-a-prospective-5-year-swedish-nationwide-study
#7
Torsten Olbers, Andrew J Beamish, Eva Gronowitz, Carl-Erik Flodmark, Jovanna Dahlgren, Gustaf Bruze, Kerstin Ekbom, Peter Friberg, Gunnar Göthberg, Kajsa Järvholm, Jan Karlsson, Staffan Mårild, Martin Neovius, Markku Peltonen, Claude Marcus
BACKGROUND: Severe obesity in adolescence is associated with reduced life expectancy and impaired quality of life. Long-term benefits of conservative treatments in adolescents are known to be modest, whereas short-term outcomes of adolescent bariatric surgery are promising. We aimed to compare 5-year outcomes of adolescent surgical patients after Roux-en-Y gastric bypass with those of conservatively treated adolescents and of adults undergoing Roux-en-Y gastric bypass, in the Adolescent Morbid Obesity Surgery (AMOS) study...
January 5, 2017: Lancet Diabetes & Endocrinology
https://www.readbyqxmd.com/read/28060690/-peritoneal-dialysis-in-the-first-two-years-of-life-experience-of-a-nephrology-and-renal-transplantation-pediatric-unit
#8
Sofia Deuchande, Tânia Mano, Cristina Novais, Rute Machado, Rosário Stone, Margarida Almeida
INTRODUCTION: Peritoneal dialysis is the dialytic method of choice in chronic end-stage renal disease in children. This study main purpose was to characterize the long-term survival of a pediatric population who began peritoneal dialysis within the first two years of life. MATERIAL AND METHODS: A descriptive and retrospective study was performed in a portuguese nephrology and renal transplantation pediatric unit, between January 1991 and August 2014. End-stage renal disease etiology, mortality, comorbidities and complications of peritoneal dialysis and end-stage renal disease, growth and psychomotor development were evaluated...
September 2016: Acta Médica Portuguesa
https://www.readbyqxmd.com/read/28059837/complications-risk-factors-and-staffing-patterns-for-noncardiac-surgery-in-patients-with-left-ventricular-assist-devices
#9
Michael R Mathis, Subramanian Sathishkumar, Sachin Kheterpal, Matthew D Caldwell, Francis D Pagani, Elizabeth S Jewell, Milo C Engoren
BACKGROUND: Patients with left ventricular assist devices presenting for noncardiac surgery are increasingly commonplace; however, little is known about their outcomes. Accordingly, the authors sought to determine the frequency of complications, risk factors, and staffing patterns. METHODS: The authors performed a retrospective study at their academic tertiary care center, investigating all adult left ventricular assist device patients undergoing noncardiac surgery from 2006 to 2015...
January 6, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28058230/outcomes-in-randomized-controlled-trials-of-exercise-interventions-in-solid-organ-transplant
#10
Tania Janaudis-Ferreira, Sunita Mathur, Stacey Konidis, Catherine M Tansey, Cecile Beaurepaire
AIM: To identify the outcome measures that have been used in randomized controlled trials (RCTs) of exercise training in solid organ transplant (SOT) recipients and to link these outcomes to the International Classification of Functioning, Disability and Health (ICF) framework. METHODS: Electronic literature searches of MEDLINE, EMBASE, CINAHL, Cochrane, Scopus, and Web of Science were performed. We sought RCTs that investigated the effect of exercise training in SOT recipients...
December 24, 2016: World Journal of Transplantation
https://www.readbyqxmd.com/read/28056960/availability-of-essential-medicines-in-selected-public-primary-and-secondary-health-care-institutions-of-a-rural-sri-lankan-district-a-spot-survey
#11
Devarajan Rathish, Indika Premarathna, Thiwanka Jayathilake, Chathurika Kandegedara, Kalani Punchihewa, Lakmali Ananda, Thejani Bandara, Channa Jayasumana, Sisira Siribaddana
BACKGROUND: Assessment of the availability of essential medicines, in rural areas of countries with free state health care system, is scarce. Dependence on essential medicines among the population in rural sector is considered to be high. Assessing the availability of essential medicines in selected state owned primary and secondary health care institutions of a rural district will help to identify areas where improvement is needed. METHODS: A descriptive cross sectional study, covering selected five primary and one secondary care institutions of a rural Sri Lankan district, was conducted...
January 5, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28055065/effect-of-fish-oil-supplementation-and-aspirin-use-on-arteriovenous-fistula-failure-in-patients-requiring-hemodialysis-a-randomized-clinical-trial
#12
Ashley B Irish, Andrea K Viecelli, Carmel M Hawley, Lai-Seong Hooi, Elaine M Pascoe, Peta-Anne Paul-Brent, Sunil V Badve, Trevor A Mori, Alan Cass, Peter G Kerr, David Voss, Loke-Meng Ong, Kevan R Polkinghorne
Importance: Vascular access dysfunction is a leading cause of morbidity and mortality in patients requiring hemodialysis. Arteriovenous fistulae are preferred over synthetic grafts and central venous catheters due to superior long-term outcomes and lower health care costs, but increasing their use is limited by early thrombosis and maturation failure. ω-3 Polyunsaturated fatty acids (fish oils) have pleiotropic effects on vascular biology and inflammation and aspirin impairs platelet aggregation, which may reduce access failure...
January 3, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28053591/potentially-inappropriate-medications-prescribed-for-elderly-patients-through-family-physicians
#13
Abdulaziz Al Odhayani, Ayla Tourkmani, Mohammed Alshehri, Hala Alqahtani, Adel Mishriky
The elderly population is increasing throughout the globe, resulting in higher healthcare costs. Potential inappropriate medication (PIM) prescriptions are a major health problem affecting the elderly persons. Due to limited studies in PIM use in primary care and home healthcare in Saudi Arabia, we aim to examine the extent of PIM prescription for and use by elderly patients. This study was carried out with 798 elderly patients, arbitrarily selected from Prince Sultan Medical Military City through the patient register...
January 2017: Saudi Journal of Biological Sciences
https://www.readbyqxmd.com/read/28052180/advances-in-psoriasis
#14
Jaclyn Smith, Abigail Cline, Steven R Feldman
Psoriasis treatments range from topical treatments and phototherapy to oral systemic medications and injections. Despite good control of the disease when applying appropriate treatments (according to disease severity, insurance parameters, patient preference, and patients' ability to adhere), continued advancements will allow even better symptomatic control, reduced adverse effects, and patient satisfaction. This review aims to assess traditional and new psoriasis treatments and how to apply them in clinical practice...
January 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28045952/predictive-factors-of-one-year-mortality-in-a-cohort-of-patients-undergoing-urgent-start-hemodialysis
#15
Luciene P Magalhães, Luciene M Dos Reis, Fabiana G Graciolli, Benedito J Pereira, Rodrigo B de Oliveira, Altay A L de Souza, Rosa M Moyses, Rosilene M Elias, Vanda Jorgetti
BACKGROUND: Chronic kidney disease (CKD) affects 10-15% of adult population worldwide. Incident patients on hemodialysis, mainly those on urgent-start dialysis at the emergency room, have a high mortality risk, which may reflect the absence of nephrology care. A lack of data exists regarding the influence of baseline factors on the mortality of these patients. The aim of this study was to evaluate the clinical and laboratory characteristics of this population and identify risk factors that contribute to their mortality...
2017: PloS One
https://www.readbyqxmd.com/read/28043204/safety-of-gelatin-solutions-for-the-priming-of-cardiopulmonary-bypass-in-cardiac-surgery-a-systematic-review-and-meta-analysis
#16
Idris Ghijselings, Dirk Himpe, Steffen Rex
This systematic review and meta-analysis was conducted to evaluate the safety of gelatin versus hydroxyethyl starches (HES) and crystalloids when used for cardiopulmonary bypass (CPB)-priming in cardiac surgery. MEDLINE (Pubmed), Embase and CENTRAL were searched. We included only randomized, controlled trials comparing CPB-priming with gelatin with either crystalloids or HES-solutions of the newest generation. The primary endpoint was the blood loss during the first 24 hours. Secondary outcomes included perioperative transfusion requirements, postoperative kidney function, postoperative ventilation times and length of stay on the intensive care unit...
December 1, 2016: Perfusion
https://www.readbyqxmd.com/read/28041996/utilization-of-perioperative-systemic-chemotherapy-in-upper-tract-urothelial-carcinoma
#17
Greg E Gin, Nora H Ruel, Steven V Kardos, John P Sfakianos, Edward Uchio, Clayton S Lau, Bertram E Yuh
INTRODUCTION: Evidence for the use of perioperative chemotherapy (PC) in upper tract urothelial carcinoma (UTUC) is largely derived from level I evidence for invasive urothelial carcinoma of the bladder (UCB). There has been an increase in PC for urothelial carcinoma of the bladder, as it has disseminated into clinical practice. Therefore, we sought to not only analyze trends in the utilization of PC in UTUC, but also assess factors associated with its use in a large cancer registry database...
December 29, 2016: Urologic Oncology
https://www.readbyqxmd.com/read/28040503/are-interferential-electrical-stimulation-and-diaphragmatic-breathing-exercises-beneficial-in-children-with-bladder-and-bowel-dysfunction
#18
Vesna D Zivkovic, Ivona Stankovic, Lidija Dimitrijevic, Mirjana Kocic, Hristina Colovic, Marina Vlajkovic, Andjelka Slavkovic, Milica Lazovic
OBJECTIVE: To evaluate the effects of interferential current (IC) stimulation and diaphragmatic breathing exercises (DBE) in children with bladder and bowel dysfunction. PATIENTS AND METHODS: Seventy-nine children with dysfunctional voiding and chronic constipation who were failures of primary care interventions were included in the prospective clinical study. All the children were checked for their medical history regarding LUTS and bowel habits. Physical examination including abdominal and anorectal digital examination were performed...
December 28, 2016: Urology
https://www.readbyqxmd.com/read/28033742/assessment-of-achieved-systolic-blood-pressure-in-newly-treated-hypertensive-patients-aged-60-79-years-before-and-after-eighth-joint-national-committee-recommendations
#19
Michael S Kelly, Joseph J Saseen, Joel C Marrs
OBJECTIVE: To determine whether patients who were newly prescribed antihypertensive therapy after the Eighth Joint National Committee (JNC 8) update were treated to a relaxed systolic blood pressure (SBP) goal compared with patients treated before the update. METHODS: A retrospective cohort study approved by the Colorado Multiple Institutional Review Board. Patients aged 60-79 years, without diabetes or chronic kidney disease (CKD), newly treated for hypertension at a University of Colorado primary care clinics were included...
February 2017: Therapeutic Advances in Cardiovascular Disease
https://www.readbyqxmd.com/read/28030868/implementation-of-an-automated-primary-care-acute-kidney-injury-warning-system-a-quantitative-and-qualitative-review-of-2-years-of-experience
#20
Omid Sadeghi Alavijeh, Jas Bansal, Katie Hadfield, Christopher Laing, Anne Dawnay
BACKGROUND: Acute kidney injury (AKI) is often detected late, leading to worse clinical outcomes. In 2012, we pioneered an AKI-alerting system for primary care clinicians (PCCs). We retrospectively analysed the alerts and evaluated PCC satisfaction to assess the feasibility of the system. METHODS: The study used a 2-pronged approach. AKI alerts, generated by an algorithm designed by University College London Hospital biochemistry department between June 2012 and June 2014, were analysed to reveal the demographics and outcomes of each patient generating an alert...
December 29, 2016: Nephron
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