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https://www.readbyqxmd.com/read/29471574/-type-2-diabetes-diabetes-in-older-adults-example-for-patient-centered-drug-therapy
#1
Dirk Müller-Wieland
Diabetes in older adults has a high prevalence and is frequently associated with comorbidities of the cardiovascular system, dysfunction of cognition as well as depression and impaired mobility or increased frailty. Furthermore, impaired renal function, heart failure, risk for hypoglycemia and polypharmacy has to be considered in the decision about the diabetes treatment strategy. The goal of blood glucose management is driven by patient relevant issues and patient self-esteem, quality of life defined by the patient, preservation of physical and social mobility rather than potential long-term effects on reduction of cardio- and microvascular events in the future, which is limited by patient-inherent reduced life expectancy of the aged individual...
February 2018: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/29470455/urban-rural-county-and-state-differences-in-chronic-obstructive-pulmonary-disease-united-states-2015
#2
Janet B Croft, Anne G Wheaton, Yong Liu, Fang Xu, Hua Lu, Kevin A Matthews, Timothy J Cunningham, Yan Wang, James B Holt
Chronic obstructive pulmonary disease (COPD) accounts for the majority of deaths from chronic lower respiratory diseases, the third leading cause of death in the United States in 2015 and the fourth leading cause in 2016.* Major risk factors include tobacco exposure, occupational and environmental exposures, respiratory infections, and genetics.† State variations in COPD outcomes (1) suggest that it might be more common in states with large rural areas. To assess urban-rural variations in COPD prevalence, hospitalizations, and mortality; obtain county-level estimates; and update state-level variations in COPD measures, CDC analyzed 2015 data from the Behavioral Risk Factor Surveillance System (BRFSS), Medicare hospital records, and death certificate data from the National Vital Statistics System (NVSS)...
February 23, 2018: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/29469794/inflamed-actinic-keratoses-associated-with-pemetrexed-and-carboplatin-therapy
#3
Jimmy Lam, Samantha R Ellis, Raja K Sivamani
Eruptive actinic keratosis (AK) consequent to systemic chemotherapy can be confused with drug allergies. We present the first case of inflamed AKs in one patient after receiving combination therapy with pemetrexed and carboplatin.A 68-year-old woman with non-small cell lung adenocarcinoma (NSCLC) presented with numerous pruritic ill-defined, gritty, erythematous papules consistent with AKs on her upper chest, upper back, and arms two weeks after completing the first cycle of combination therapy with carboplatin and pemetrexed...
October 15, 2017: Dermatology Online Journal
https://www.readbyqxmd.com/read/29468901/osteochondritis-dissecans-of-the-knee-conservative-treatment-strategies-a-systematic-review
#4
Luca Andriolo, Christian Candrian, Tiziana Papio, Alessia Cavicchioli, Francesco Perdisa, Giuseppe Filardo
Objective Osteochondritis dissecans (OCD) lesions are a relevant problem that affects the long-term prognosis of young patients. The purpose of this study was to analyze the evidence on potential and indications of nonsurgical treatment strategies for knee OCD. Design The search was conducted on 3 medical electronic databases according to PRISMA guidelines, including reports of any level of evidence dealing with the conservative management of knee OCD. Of 1688 identified records, 55 full-text articles were screened: 27 studies met the inclusion criteria, for a total of 908 knees, and were used for the analysis...
February 1, 2018: Cartilage
https://www.readbyqxmd.com/read/29468678/image-guidance-doses-delivered-during-radiotherapy-quantification-management-and-reduction-report-of-the-aapm-therapy-physics-committee-task-group-180
#5
George X Ding, Parham Alaei, Bruce Curran, Ryan Flynn, Michael Gossman, T Rock Mackie, Moyed Miften, Richard Morin, X George Xu, Timothy C Zhu
With radiotherapy having entered the era of image guidance, or image-guided radiation therapy (IGRT), imaging procedures are routinely performed for patient positioning and target localization. The imaging dose delivered may result in excessive dose to sensitive organs and potentially increase the chance of secondary cancers and, therefore, needs to be managed. This task group was charged with: a) providing an overview on imaging dose, including megavoltage electronic portal imaging (MV EPI), kilovoltage digital radiography (kV DR), Tomotherapy MV-CT, megavoltage cone-beam CT (MV-CBCT) and kilovoltage cone-beam CT (kV-CBCT), and b) providing general guidelines for commissioning dose calculation methods and managing imaging dose to patients...
February 22, 2018: Medical Physics
https://www.readbyqxmd.com/read/29468518/cultural-factors-influencing-osteoarthritis-care-in-asian-communities-a-review-of-the-evidence
#6
REVIEW
Thrmiga Sathiyamoorthy, Shabana Amanda Ali, Marita Kloseck
With the prevalence of osteoarthritis (OA) increasing internationally, there is a need to study the impact of this disease on culturally diverse populations. Individuals of Asian descent make up more than 60% of the world population, yet comprehensive information on the cultural factors that impact OA care is not available. Scoping review methodology using directed content analysis was employed to identify and analyze existing research on OA care for Asians. A categorization matrix was developed using the six care areas from the OA clinical practice guidelines along with an additional three non-clinical areas (cross-cultural adaptation of clinical tools; psychological well-being; family systems and informal care) identified in an initial scan resulting in a total of nine OA care areas to guide initial coding...
February 21, 2018: Journal of Community Health
https://www.readbyqxmd.com/read/29468104/cerebellar-stroke-occupational-therapy-and-physical-therapy-management-from-intensive-care-unit-to-outpatient-a-case-report
#7
Christopher M Wilson, Christina L Mitchell, Katherine M Hebert
Cerebellar stroke increases the risk of extensive physical disability and long-term institutionalization. The purpose of this case report is to describe the 14-month longitudinal rehabilitation management and outcomes from the intensive care unit, inpatient rehabilitation unit and outpatient care of a patient after cerebellar stroke. A goal of this case report is to provide rehabilitation clinicians with a long-term perspective and understanding of the course of recovery for a patient after cerebellar cerebrovascular accident or related injury...
December 14, 2017: Curēus
https://www.readbyqxmd.com/read/29462728/treatment-of-lumbar-discitis-using-silicon-nitride-spinal-spacers-a-case-series-and-literature-review
#8
William M Rambo
INTRODUCTION: Septic infection of a lumbar intervertebral disc is a serious disorder which is often difficult to diagnose and appropriately treat because of the rarity of the disease, the varied presentation of symptoms, and the frequency of low-back pain within the overall population. Its etiology can be pyogenic, granulomatous, fungal, or parasitic; its incidence is rising due to increased patient susceptibility and improved diagnostic tools. Conservative treatments involve antibiotics, physical therapy, and/or immobilization...
February 10, 2018: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29462631/rapidly-dissolving-microneedle-patches-for-transdermal-iron-replenishment-therapy
#9
A Maurya, H N Shivakumar, S Honnavar, M Salwa, S N Murthy
The prevalence of Iron Deficiency Anemia (IDA) is predominant in women and children especially in developing countries. The disorder affects cognitive functions and physical activity. While oral iron supplementation and parenteral therapy remains the preferred choice of treatment, gastric side effects and risk of iron overload decreases adherence to therapy. Transdermal route is an established approach which circumvents the side-effects associated with conventional therapy. In this project, an attempt was made to investigate the use of rapidly dissolving microneedles loaded with Ferric pyrophosphate (FPP) as a potential therapeutic approach for management of IDA...
February 17, 2018: Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/29461340/attitudes-about-cognitive-screening-a-survey-of-home-care-physical-therapists
#10
Jean D Miles, William H Staples, Daniel J Lee
BACKGROUND AND PURPOSE: Home care physical therapists (PTs) are inconsistent regarding cognitive screening, possibly because screening tools were traditionally considered the domain of other home care disciplines, or because therapists perceive their dementia training to be inadequate. A cross sectional study was designed to survey home care therapists' attitudes and beliefs about the management of persons with dementia and to find out whether any specific cognitive tools or measures are currently used...
February 14, 2018: Journal of Geriatric Physical Therapy
https://www.readbyqxmd.com/read/29459102/older-age-early-symptoms-and-physical-function-are-associated-with-the-severity-of-late-symptom-clusters-for-men-undergoing-radiotherapy-for-prostate-cancer
#11
A Lemanska, D P Dearnaley, R Jena, M R Sydes, S Faithfull
AIMS: To identify symptom clusters and predisposing factors associated with long-term symptoms and health-related quality of life after radiotherapy in men with prostate cancer. MATERIALS AND METHODS: Patient-reported outcomes (PROs) data from the Medical Research Council RT01 radiotherapy with neoadjuvant androgen deprivation therapy trial of 843 patients were used. PROs were collected over 5 years with the University of California, Los Angeles Prostate Cancer Index (UCLA-PCI) and the 36 item Short-Form Health Survey (SF-36)...
February 16, 2018: Clinical Oncology: a Journal of the Royal College of Radiologists
https://www.readbyqxmd.com/read/29456447/a-preliminary-analysis-of-outcomes-and-end-range-procedures-used-to-achieve-centralization-in-people-with-low-back-pain
#12
Thomas Stowell, Ronald Schenk, Madeleine Hellman, Carlos Ladeira
Objectives: To investigate the relationship between clinical outcome and the types of end range procedures used to achieve centralization in a sample of patients with low back pain (LBP) and/or peripheral symptoms. Methods: Small sample retrospective analysis of an observational cohort. Patients with LBP who centralized during initial visit at two physical therapy clinics were recruited to participate. The types of end range procedures used to achieve centralization were documented during each office visit and a chart review was performed after 4 weeks...
February 2018: Journal of Manual & Manipulative Therapy
https://www.readbyqxmd.com/read/29454383/multidimensional-needs-of-patients-living-and-dying-with-heart-failure-in-kenya-a-serial-interview-study
#13
Kellen N Kimani, Scott A Murray, Liz Grant
BACKGROUND: Heart failure is an emerging challenge for Sub Saharan Africa. However, research on patients' needs and experiences of care is scarce with little evidence available to support and develop services. We aimed to explore the experiences of patients living and dying with heart failure in Kenya. METHODS: We purposively recruited 18 patients admitted with advanced heart failure at a rural district hospital in Kenya. We conducted serial in depth interviews with patients at 0, 3 and 6 months after recruitment, and conducted bereavement interviews with carers...
February 17, 2018: BMC Palliative Care
https://www.readbyqxmd.com/read/29453745/investigating-the-effectiveness-acceptability-and-impact-on-healthcare-usage-of-providing-a-cognitive-behavioural-based-psychological-therapy-service-for-patients-with-primary-antibody-deficiency
#14
Mari Campbell, Alex Clarke, Andrew Symes, Sarita Workman, Hans Stauss, A David Webster
PURPOSE: Patients with primary antibody deficiency report poorer quality of life and higher rates of anxiety and depression than the general population. Cognitive-behavioral therapy has been shown to be a valuable treatment for patients with other long-term physical health conditions, improving well-being and enabling them to manage their symptoms more effectively. The aim of this project was to establish the feasibility and effectiveness of providing cognitive-behavioral based therapy to patients with primary antibody deficiency...
February 17, 2018: Journal of Clinical Immunology
https://www.readbyqxmd.com/read/29453669/physical-training-and-cardiac-rehabilitation-in-heart-failure-patients
#15
Cesare de Gregorio
Regardless of advances in medical and interventional treatment of cardiovascular disease (CVD), a limited number of patients attend a cardiac rehabilitation (CR) programme on a regular basis. Due to modern therapies more individuals will be surviving an acute cardiovascular event, but the expected burden of chronic heart failure will be increasing worldwide.However, both in high- and low-income countries, secondary prevention after an acute myocardial infarction or stroke has been implemented in less than a half of eligible patients...
February 17, 2018: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/29449772/differential-examination-diagnosis-and-management-for-tingling-in-toes-fellow-s-case-problem
#16
Cody J Mansfield, Jake Bleacher, Paul Tadak, Matthew S Briggs
Background: The diagnosis of chronic exertional compartment syndrome can be challenging as other pathologies involving bone, muscle, nerve and vascular structures can mimic the syndrome. The purpose of this Fellow's Case Problem is to describe the clinical decision-making and physical therapy differential diagnosis regarding a 25-year-old patient with un-resolved neurovascular complaints following chronic exertional compartment syndrome surgical release. Diagnosis: After surgery, the patient's previous complaint of numbness and tingling in the plantar surfaces of her first and second toes of right foot was still present...
December 2017: Journal of Manual & Manipulative Therapy
https://www.readbyqxmd.com/read/29449296/gp-and-parent-dissonance-about-the-assessment-and-treatment-of-childhood-eczema-in-primary-care-a-qualitative-study
#17
Kingsley Powell, Emma Le Roux, Jonathan Banks, Matthew J Ridd
OBJECTIVES: To compare parents' and clinicians' perspectives on the assessment and treatment of children with eczema in primary care. DESIGN: Qualitative interview study with purposive and snowball sampling and thematic analysis. SETTING: 14 general practices in the UK. PARTICIPANTS: 11 parents of children with eczema and 15 general practitioners (GPs) took part in semistructured individual interviews. RESULTS: We identified several areas of dissonance between parents and GPs...
February 15, 2018: BMJ Open
https://www.readbyqxmd.com/read/29446796/posttraumatic-headache
#18
Raquel Langdon, Sharief Taraman
After sustaining a concussion or mild traumatic brain injury, headaches are one of the most common complaints. The pathophysiologic changes that occur in the setting of injury likely contribute to or cause posttraumatic headaches. Posttraumatic headaches often present as migraine or tension-type headaches. Unlike pain from other types of injuries, headaches following mild traumatic brain injury are more likely to persist. Preexisting conditions such as migraine and mood disorders may influence posttraumatic headache and complicate management...
February 1, 2018: Pediatric Annals
https://www.readbyqxmd.com/read/29445533/insomnia-and-cognitive-behavioural-therapy-how-to-assess-your-patient-and-why-it-should-be-a-standard-part-of-care
#19
REVIEW
Kirstie N Anderson
Hippocrates recognized the importance of asking about sleep as long ago as 400 BC when he wrote " sleep and watchfulness, both of them when immoderate, constitute disease ". Disrupted sleep for any reason has immediate and long term consequences on physical and mental health. Insomnia disorder ("immoderate watchfulness") remains the commonest sleep disorder in primary and secondary care with an estimated 5-10% of the adult population affected. While it is commonly comorbid with other physical and mental health problems, the new diagnostic classification has been helpfully simplified such that it is considered a disorder in itself...
January 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29445354/effects-of-acupuncture-on-the-recovery-outcomes-of-stroke-survivors-with-shoulder-pain-a-systematic-review
#20
Janita Pak Chun Chau, Suzanne Hoi Shan Lo, Xingfeng Yu, Kai Chow Choi, Alexander Yuk Lun Lau, Justin Che Yuen Wu, Vivian Wing Yan Lee, William Hoi Ngai Cheung, Jessica Yuet Ling Ching, David R Thompson
Background: Poststroke shoulder pain limits stroke survivors' physical functioning, impairs their ability to perform daily activities, and compromises their quality of life. The use of acupuncture to manage shoulder pain after a stroke is believed to free the blockage of energy flow and produce analgesic effects, but the evidence is unclear. We therefore conducted a systematic review to summarize the current evidence on the effects of acupuncture on the recovery outcomes of stroke survivors with shoulder pain...
2018: Frontiers in Neurology
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