192,874 results match your criteria Ambulatory pediatrics : the official journal of the Ambulatory Pediatric Association[Journal]


Association of Obstructive Sleep Apnea with Nighttime Blood Pressure in African Americans: the Jackson Heart Study.

Am J Hypertens 2020 Jun 3. Epub 2020 Jun 3.

Brigham and Women's Hospital, Boston, MA.

Background: Obstructive sleep apnea (OSA), nocturnal hypertension, and non-dipping systolic blood pressure (BP) are each highly prevalent among African Americans. However, few data are available on the association between OSA and nighttime BP in this population.

Methods: We examined the association of OSA with nighttime BP among African Americans who completed 24-hour ambulatory BP monitoring at Exam 1 (2000-2004) of the Jackson Heart Study (JHS) and subsequently participated in the JHS Sleep Study (2012-2016). Read More

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http://dx.doi.org/10.1093/ajh/hpaa088DOI Listing

Documenting change with the Canadian Occupational Performance Measure for children with cerebral palsy.

Dev Med Child Neurol 2020 Jun 3. Epub 2020 Jun 3.

Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada.

Aim: To assess the Canadian Occupational Performance Measure's (COPM) ability to document change over 3 years in children with cerebral palsy (CP).

Method: This was a prospective study with ambulatory children with CP, aged 2 to 6 years. Caregivers set one to three COPM goals which were rescored annually over 3 years. Read More

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http://dx.doi.org/10.1111/dmcn.14569DOI Listing

Absence of Nocturnal Fall in Blood Pressure Detected by Ambulatory Blood Pressure Monitoring in Acute Chagas Disease Patients with Oral Infection.

Arq Bras Cardiol 2020 Apr 29;114(4):711-715. Epub 2020 May 29.

Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil.

Background The involvement of the autonomic nervous system is one of the mechanisms proposed to explain the progression of myocardial lesion in Chagas disease. Evidences have shown changes in sympathetic and parasympathetic nervous system since the acute phase of the disease, and studies to clarify the pathophysiological and prognostic value of these changes are needed. Objetives To assess blood pressure profile by ambulatory blood pressure monitoring (ABPM) in normotensive patients with acute Chagas disease (ACD) without apparent cardiac damage, and the influence of the infection on nocturnal blood pressure fall. Read More

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http://dx.doi.org/10.36660/abc.20190143DOI Listing

Evaluating the Representativeness of US Centricity Electronic Medical Records With Reports From the Centers for Disease Control and Prevention: Comparative Study on Office Visits and Cardiometabolic Conditions.

JMIR Med Inform 2020 Jun 3;8(6):e17174. Epub 2020 Jun 3.

Melbourne EpiCentre, University of Melbourne, Melbourne, Australia.

Background: Electronic medical record (EMR)-based clinical and epidemiological research has dramatically increased over the last decade, although establishing the generalizability of such big databases for conducting epidemiological studies has been an ongoing challenge. To draw meaningful inferences from such studies, it is essential to fully understand the characteristics of the underlying population and potential biases in EMRs.

Objective: This study aimed to assess the generalizability and representativity of the widely used US Centricity Electronic Medical Record (CEMR), a primary and ambulatory care EMR for population health research, using data from the National Ambulatory Medical Care Surveys (NAMCS) and the National Health and Nutrition Examination Surveys (NHANES). Read More

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http://dx.doi.org/10.2196/17174DOI Listing

Pharmacist Interventions in Improving Clinical Outcomes in Patients with Type 2 Diabetes Mellitus Among the Underrepresented Population: A Collaborative Ambulatory Care Pharmacy Practice (CAPP) Approach.

Authors:
Mok Thoong Chong

J Res Pharm Pract 2020 Jan-Mar;9(1):3-9. Epub 2020 Mar 28.

Department of Clinical and Administrative Sciences, American University of Health Sciences, California, USA.

Objective: The objective of this study was to evaluate the impact of pharmacist's interventions through a collaborative ambulatory care pharmacy practice (CAPP) model in patients with type 2 diabetes mellitus (T2DM) among the underrepresented population.

Methods: Eligible patients were 18 years and older with a diagnosis of T2DM with or without comorbid cardiovascular disease risk factors. Patients were enrolled through routine primary care provider referrals. Read More

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http://dx.doi.org/10.4103/jrpp.JRPP_19_75DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7235450PMC

Prevalence and Correlates of Cardiovascular Autonomic Neuropathy Among Patients with Diabetes in Uganda: A Hospital-Based Cross-sectional Study.

Glob Heart 2020 Mar 2;15(1):21. Epub 2020 Mar 2.

Department of Internal Medicine, Mbarara University of Science and Technology, Mbarara, UG.

Background: Cardiovascular autonomic neuropathy (CAN) is a common complication in individuals with diabetes mellitus (DM) but often overlooked in clinical practice. The burden and correlates of CAN have not been extensively studied in low-income countries, particularly in sub-Saharan Africa.

Objectives: To determine the prevalence and correlates of CAN among adults in ambulatory diabetes care in southwestern Uganda. Read More

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http://dx.doi.org/10.5334/gh.765DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7218768PMC

Impact of Diabetes on Complications, Long Term Mortality and Recurrence in 608,890 Hospitalised Patients with Stroke.

Glob Heart 2020 Feb 6;15(1). Epub 2020 Feb 6.

Ageing Clinical and Experimental Research (ACER) Team, Institute of Applied Health Sciences, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK.

Background: Patients with diabetes mellitus (DM) have been found to be at an increased risk of suffering a stroke. However, research on the impact of DM on stroke outcomes is limited.

Objectives: We aimed to examine the influence of DM on outcomes in ischaemic (IS) and haemorrhagic stroke (HS) patients. Read More

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http://dx.doi.org/10.5334/gh.364DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7218766PMC
February 2020

Pilot study on comparisons between the effectiveness of mobile video-guided and paper-based home exercise programs on improving exercise adherence, self-efficacy for exercise and functional outcomes of patients with stroke with 3-month follow-up: A single-blind randomized controlled trial.

Hong Kong Physiother J 2020 Jun 20;40(1):63-73. Epub 2020 Feb 20.

Department of Medicine and Geriatrics, Tai Po Hospital, 11 Chuen On Road, Tai Po, New Territories, Hong Kong.

Objective: To compare the effectiveness of mobile video-guided home exercise program and standard paper-based home exercise program.

Methods: Eligible participants were randomly assigned to either experimental group with mobile video-guided home exercise program or control group with home exercise program in a standard pamphlet for three months. The primary outcome was exercise adherence. Read More

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http://dx.doi.org/10.1142/S1013702520500079DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7136530PMC

Intereye Symmetry of 24-Hour Intraocular Pressure-related Patterns in Untreated Glaucoma Patients Using a Contact Lens Sensor.

J Glaucoma 2020 Jun 1. Epub 2020 Jun 1.

Glaucoma Research Center, Montchoisi Clinic, Swiss Visio Network, Lausanne, Switzerland.

Purpose: Scarce data are available on the symmetry of 24-hour intraocular pressure (IOP) variations between fellow eyes of glaucoma patients, and such evidence could have profound consequences on the interpretation of monocular therapeutic trials. The objective is to evaluate the intereye correlation of continuously measured circadian IOP-related patterns in untreated glaucoma patients.

Methods: In this single-center prospective study, a total of 29 untreated patients with open-angle glaucoma underwent bilateral ambulatory 24-hour monitoring of IOP-related patterns using a contact lens sensor (CLS; SENSIMED Triggerfish). Read More

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http://dx.doi.org/10.1097/IJG.0000000000001563DOI Listing

Improving Allergy Documentation: A Retrospective Electronic Health Record System-Wide Patient Safety Initiative.

J Patient Saf 2020 Jun 1. Epub 2020 Jun 1.

From the Division of Allergy and Clinical Immunology, Department of Medicine, Brigham and Women's Hospital.

Objectives: Documentation of allergies in a coded, non-free-text format in the electronic health record (EHR) triggers clinical decision support to prevent adverse events. Health system-wide patient safety initiatives to improve EHR allergy documentation by specifically decreasing free-text allergy entries have not been reported. The goal of this initiative was to systematically reduce free-text allergen entries in the EHR allergy module. Read More

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http://dx.doi.org/10.1097/PTS.0000000000000711DOI Listing

Attention-Deficit/Hyperactivity Disorder and Psychotropic Polypharmacy Prescribing Trends.

Pediatrics 2020 Jun 2. Epub 2020 Jun 2.

Department of Pharmacy Practice, College of Pharmacy, Ferris State University, Big Rapids, Michigan.

Background And Objectives: Attention-deficit/hyperactivity disorder (ADHD) medication use and psychotherapeutic polypharmacy is increasing. This study was designed to assess annual rates of ADHD medication prescribing and psychotherapeutic polypharmacy among patients 2 to 24 years old in the United States, identify commonly prescribed ADHD medications and concomitant psychotropic agents, and assess if specific characteristics are associated with polypharmacy.

Methods: In this cross-sectional study, we used publicly available ambulatory health care data sets to evaluate ADHD and psychotropic polypharmacy use in patients 2 to 24 years old from 2006 to 2015. Read More

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http://dx.doi.org/10.1542/peds.2019-2832DOI Listing

Metabolomics profiling of tobacco exposure in children with cystic fibrosis.

J Cyst Fibros 2020 May 30. Epub 2020 May 30.

Division of Pulmonary Medicine, Nationwide Children's Hospital, Columbus, OH, USA; Center for Microbial Pathogenesis, The Abigail Wexner Research Institute at Nationwide Children's Hospital, W510, 700 Children's Drive, Columbus, OH 43205, USA. Electronic address:

Background: Inflammation is integral to early disease progression in children with CF. The effect of modifiable environmental factors on infection and inflammation in persons with CF is poorly understood. Our prior studies determined that secondhand smoke exposure (SHSe) is highly prevalent in young children with CF. Read More

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http://dx.doi.org/10.1016/j.jcf.2020.05.003DOI Listing

Improving Psychiatric Access for Students in Crisis: An Alternative to the Emergency Department.

Psychiatr Serv 2020 Jun 3:appips201900195. Epub 2020 Jun 3.

Northwell Health, Northwell Health Solutions, Manhasset, New York (Alvarado); Department of Psychiatry, University of Vermont Medical Center, Burlington (Hegg); Department of Emergency Medicine, Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York (Rhodes). Marcela Horvitz-Lennon, M.D., and Kenneth Minkoff, M.D., are editors of this column.

School behavioral health crisis referrals have emerged as a significant driver of avoidable emergency department (ED) visits. However, few resources exist to divert students to more appropriate settings. This article examines the effectiveness of an ambulatory behavioral health urgent care pilot project in reducing ED visits and improving collaborations with schools in the local community. Read More

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http://dx.doi.org/10.1176/appi.ps.201900195DOI Listing

Service Value Activities by Nurse Practitioners in Ambulatory Specialty Care.

Policy Polit Nurs Pract 2020 Jun 2:1527154420927689. Epub 2020 Jun 2.

Department of Social and Behavioral Sciences, University of California, San Francisco.

The increase in nurse practitioners (NPs) in ambulatory medical and surgical specialty settings has prompted inquiry into their role and contribution to patient care. We explored the role and contribution of NPs in ambulatory specialty care through their activities outside of direct care and billable visits (referred to as service value activities), and how NPs perceive these activities enhance quality and efficiency of care, for both patients and the health care institution. This qualitative thematic analysis examined interviews from 16 NPs at a large academic medical center about their role and contribution to patient care quality and departmental efficiency beyond billable visits. Read More

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http://dx.doi.org/10.1177/1527154420927689DOI Listing

2019 Influenza Vaccination Campaign in an Italian Research and Teaching Hospital: Analysis of the Reasons for Its Failure.

Int J Environ Res Public Health 2020 May 30;17(11). Epub 2020 May 30.

Postgraduate School in Public Health, Department Biomedical Sciences for Health, University of Milano, 20136 Milano, Italy.

Despite recommendations, the influenza vaccination coverage rate in healthcare workers (HCWs) in Italy is far from the recommended target. The aim of the study is to analyze the influenza vaccination campaign performed in 2019 in a research and teaching hospital in Milan. The vaccination strategy included an ad hoc ambulatory, as in the previous years, and an onsite ambulatory, introduced for the first time. Read More

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http://dx.doi.org/10.3390/ijerph17113881DOI Listing

Noninvasive detection of focal seizures in ambulatory patients.

Epilepsia 2020 Jun 2. Epub 2020 Jun 2.

Department of Clinical Neurosciences, Vaud University Hospital, Lausanne, Switzerland.

Reliably detecting focal seizures without secondary generalization during daily life activities, chronically, using convenient portable or wearable devices, would offer patients with active epilepsy a number of potential benefits, such as providing more reliable seizure count to optimize treatment and seizure forecasting, and triggering alarms to promote safeguarding interventions. However, no generic solution is currently available to reach these objectives. A number of biosignals are sensitive to specific forms of focal seizures, in particular heart rate and its variability for seizures affecting the neurovegetative system, and accelerometry for those responsible for prominent motor activity. Read More

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http://dx.doi.org/10.1111/epi.16538DOI Listing

Utilization of an Online Cash-Pay Pharmacy for Topical 5-Fluorouracil Prescriptions in Older Patients.

J Drugs Dermatol 2020 May;19(5):539-542

Background: High cost of prescription medications presents a challenging issue for older patients with multimorbidities. Topical 5-fluorouracil (5-FU) is an effective treatment for actinic keratoses (AK), a highly prevalent condition among elderly populations, but it is often associated with unpredictable retail prices and high out-of-pocket costs. One online pharmacy offers branded prescription medications at fixed, low prices, but it may be less accessible to older patients for numerous reasons. Read More

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Unnecessary antibiotic prescribing in US ambulatory care settings, 2010-2015.

Clin Infect Dis 2020 Jun 2. Epub 2020 Jun 2.

Office of Antibiotic Stewardship, Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA.

The proportion of antibiotic prescriptions prescribed in US physician offices and emergency departments that were unnecessary decreased slightly, from 30% in 2010-2011 to 28% in 2014-15. However, a greater decrease occurred in children: 32% in 2010-11 to 19% in 2014-15. Unnecessary prescribing in adults did not change during this period. Read More

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http://dx.doi.org/10.1093/cid/ciaa667DOI Listing

Body mass index and outcomes in ischaemic versus non-ischaemic heart failure across the spectrum of ejection fraction.

Eur J Prev Cardiol 2020 Jun 2:2047487320927610. Epub 2020 Jun 2.

Fondazione Toscana G. Monasterio, Pisa, Italy.

Aims: Obesity is related to better prognosis in heart failure with either reduced (HFrEF; left ventricular ejection fraction (LVEF) <40%) or preserved LVEF (HFpEF; LVEF ≥50%). Whether the obesity paradox exists in patients with heart failure and mid-range LVEF (HFmrEF; LVEF 40-49%) and whether it is independent of heart failure aetiology is unknown. Therefore, we aimed to test the prognostic value of body mass index (BMI) in ischaemic and non-ischaemic heart failure patients across the whole spectrum of LVEF. Read More

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http://dx.doi.org/10.1177/2047487320927610DOI Listing

Interdisciplinary Patient Tracers: Routine, Systematic Safety Surveillance.

Am J Med Qual 2020 Jun 2:1062860620929306. Epub 2020 Jun 2.

Massachusetts General Hospital, Boston, MA.

Patient tracers and leadership WalkRounds proactively identify quality and safety issues. However, these programs have been inconsistent in application, results, and sustainability. The goal was to identify a more consistent and efficient approach to survey health care facilities. Read More

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http://dx.doi.org/10.1177/1062860620929306DOI Listing

Obesity and the paradox of mortality and heart failure hospitalization in heart failure with preserved ejection fraction.

Int J Obes (Lond) 2020 Jun 1. Epub 2020 Jun 1.

Department of Medicine, Baylor College of Medicine, Houston, TX, USA.

Background: Limited data exist on the association of obesity with both hospitalization and mortality in patients with heart failure with preserved ejection fraction (HFpEF), especially in the real-world ambulatory setting. We hypothesized that increasing body-mass index (BMI) in ambulatory heart failure with preserved ejection fraction would have a protective effect on these patients leading to decreased mortality and hospitalizations.

Methods: We studied the relationship between BMI and the time to all-cause mortality, time to heart failure (HF) hospitalization, and time to all-cause hospitalization over a 2-year follow-up in a national cohort of 2501 ambulatory HFpEF patients at 153 Veterans Affairs medical centers. Read More

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http://dx.doi.org/10.1038/s41366-020-0563-1DOI Listing

The Help for Hay Fever community pharmacy-based pilot randomised controlled trial for intermittent allergic rhinitis.

NPJ Prim Care Respir Med 2020 Jun 1;30(1):23. Epub 2020 Jun 1.

Faculty of Pharmacy, Building A15, The University of Sydney, Camperdown, NSW, 2006, Australia.

Management of intermittent allergic rhinitis (IAR) is suboptimal in the UK. An Australian community pharmacy-based intervention has been shown to help patients better self-manage their IAR. We conducted a pilot cluster RCT in 12 Scottish community pharmacies to assess transferability of the Australian intervention. Read More

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http://dx.doi.org/10.1038/s41533-020-0180-4DOI Listing

Clinicians Report Barriers and Facilitators to High-Quality Ambulatory Oncology Care.

Cancer Nurs 2020 May 28. Epub 2020 May 28.

Author Affiliations: University of Michigan School of Nursing (Drs. Lafferty, Manojlovich, and Friese and Mr. Wright); Michigan Oncology Quality Consortium (Dr Griggs); Ann Arbor Veterans Administration Health System, Center for Clinical Management Research (Dr Harrod); and Division of Hematology/Oncology, Internal Medicine, University of Michigan (Dr Griggs), Ann Arbor.

Background: Ambulatory oncology practices treat thousands of Americans on a daily basis with high-risk and high-cost antineoplastic agents. However, we know relatively little about these diverse practices and the organizational structures influencing care delivery.

Objective: The aim of this study was to examine clinician-reported factors within ambulatory oncology practices that affect care delivery processes and outcomes for patients and clinicians. Read More

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http://dx.doi.org/10.1097/NCC.0000000000000832DOI Listing

The effect of Mid-Day Sleep on blood pressure levels in patients with arterial hypertension.

Eur J Intern Med 2020 May 29. Epub 2020 May 29.

Asklepeion General Hospital, Voula, Athens, Greece.

Study Objectives: Lifestyle changes decrease blood pressure (BP) levels by 3-5 mmHg in hypertensive patients. We assessed the effect of mid-day sleep on BP levels in hypertensive patients.

Methods: We prospectively studied two hundred and twelve hypertensive patients. Read More

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http://dx.doi.org/10.1016/j.ejim.2020.05.030DOI Listing

[New oropharyngeal double lumen cannula for sedation for transesophageal echocardiography: case series].

Rev Bras Anestesiol 2020 May 13. Epub 2020 May 13.

Instituto Dante Pazzanese de Cardiologia, São Paulo, SP, Brazil.

Introduction: Currently, transesophageal echodopplercardiography (TEE) is frequently performed under sedation on an outpatient basis. Sedation is related with increase in incidents on airways. Bearing in mind this scenario, we developed a new double lumen oropharyngeal cannula aimed at keeping airway patency, in addition to reducing risks to patients during endoscopy procedures performed under sedation. Read More

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http://dx.doi.org/10.1016/j.bjan.2020.03.005DOI Listing

Guidelines for Resident Participation in Otolaryngology Telehealth Clinics During the COVID-19 Pandemic.

Otolaryngol Head Neck Surg 2020 Jun 2:194599820932133. Epub 2020 Jun 2.

School of Medicine, Boston University, Boston, Massachusetts, USA.

The practice of otolaryngology has changed drastically since the start of the COVID-19 pandemic. To limit exposure and maintain a reserve of caregivers, residency education ceased most clinical activities and shifted to remote lecture consortiums hosted online across the country in lieu of ambulatory and operative experiences. Many practicing university otolaryngologists have transitioned their clinics to telehealth medicine to maintain access to clinical care during the pandemic. Read More

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http://dx.doi.org/10.1177/0194599820932133DOI Listing

The sensitivity of DPD scintigraphy to detect transthyretin cardiac amyloidosis in V30M mutation depends on the phenotypic expression of the disease.

Amyloid 2020 Jun 2:1-10. Epub 2020 Jun 2.

Cardiology Service, Heart and Vessels Department, Centro Hospitalar Universitário Lisboa Norte and Cardiovascular Centre at Universidade de Lisboa, Faculty of Medicine, Lisbon, Portugal.

There is a growing need for a non-invasive test to detect cardiac involvement in patients with transthyretin-related hereditary amyloidosis (ATTR) caused by V30M mutation. Tc-3,3-diphosphono-1,2-propanodicarboxylic acid (DPD) scintigraphy is a promising method, but its accuracy in this particular mutation remains unknown. A cohort of 179 patients: 92 with early-onset disease (EoD, symptoms <50-years-old), 33 with late-onset disease (LoD) and 54 asymptomatic carriers were prospectively evaluated and underwent DPD scintigraphy, which was compared with the results of echocardiogram, ambulatory blood pressure monitoring, 24 h-Holter, myocardial I-metaiodobenzylguanidine imaging and NT-proBNP. Read More

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http://dx.doi.org/10.1080/13506129.2020.1744553DOI Listing

Comparing Treatment Response Between Older and Younger Patients with Chronic Hepatitis C Virus Infection on Direct-acting Antiviral Agents.

R I Med J (2013) 2020 Jun 1;103(5):35-40. Epub 2020 Jun 1.

Assistant Professor of Health Services, Policy, and Practice and Epidemiology, School of Public Health, Brown University; Research Fellow, Center of Innovation in Long-Term Services and Supports, Providence Veterans Affairs Medical Center; Clinical Pharmacist Specialist, Department of Pharmacy, Rhode Island Hospital, Providence, RI.

Objective: To compare sustained virologic response 12 weeks post-treatment completion (SVR12) and patient characteristics for older versus younger patients with chronic hepatitis C virus infection (HCV) receiving direct-acting antiviral (DAA) agent therapy.

Methods: This retrospective cohort study included patients with chronic HCV who received DAA therapy, between 2015 and 2018, in the largest health system in Rhode Island (N=154). Patient characteristics, comorbid diagnoses, and SVR12 status were compared between older (aged ≥60 years) and younger (<60 years) adults using chi-squared tests. Read More

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Retrospective study of the analgesic effect of a 15 mg dose of ketorolac in ambulatory gynecologic surgery.

J Clin Anesth 2020 May 29;66:109904. Epub 2020 May 29.

Department of Anesthesiology, Perioperative and Pain Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA. Electronic address:

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http://dx.doi.org/10.1016/j.jclinane.2020.109904DOI Listing

Outpatient Interventions for Managing Acute Complications of Chronic Diseases: A Scoping Review and Implications for Patients With CKD.

Am J Kidney Dis 2020 May 29. Epub 2020 May 29.

Department of Community Health Sciences, University of Calgary, Calgary, AB.

Rationale & Objective: Patients with chronic kidney disease (CKD) have high rates of emergency department (ED) use and hospitalization. Outpatient care may provide an alternative to ED and inpatient care in this population. We aimed to explore the scope of outpatient interventions used to manage acute complications of chronic diseases and highlight opportunities to adapt and test interventions in the CKD population. Read More

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http://dx.doi.org/10.1053/j.ajkd.2020.04.006DOI Listing

Trends in prevalence of depression in Germany between 2009 and 2017 based on nationwide ambulatory claims data.

J Affect Disord 2020 Jun 18;271:239-247. Epub 2020 Apr 18.

Department of Regional Health Care Analysis and Health Care Atlas, Central Research Institute of Ambulatory Health Care in Germany (Zi).

Background: Studies based on health insurance funds unanimously indicate a rise in administrative prevalence of depression, while population surveys with standardized diagnostic procedures do not. We describe recent trends in the prevalence of depressive disorders as diagnosed in routine care from 2009-2017 in Germany.

Methods: We used nationwide ambulatory claims data from all residents with statutory health insurance, covering 87% of the total population. Read More

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http://dx.doi.org/10.1016/j.jad.2020.03.082DOI Listing

Avoidable Hospitalizations And Observation Stays: Shifts In Racial Disparities.

Health Aff (Millwood) 2020 Jun;39(6):1065-1071

Ashish K. Jha is the director of the Harvard Global Health Institute and is dean of global strategy and the K. T. Li Professor of Global Health, Harvard T. H. Chan School of Public Health.

Racial disparities in hospitalization rates for ambulatory care-sensitive conditions are concerning and may signal differential access to high-quality ambulatory care. Whether racial disparities are improving as a result of better ambulatory care versus artificially narrowing because of increased use of observation status is unclear. Using Medicare data for 2011-15, we sought to determine whether black-white disparities in avoidable hospitalizations were improving and evaluated the degree to which changes in observations for ambulatory care-sensitive conditions may be contributing to changes in these gaps. Read More

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http://dx.doi.org/10.1377/hlthaff.2019.01019DOI Listing

Ambulatory visits, active component, U.S. Armed Forces, 2019.

Authors:

MSMR 2020 May;27(5):18-24

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Assessment of Fall-Related Self-Efficacy: Characteristics that Influence the Perception of Patients with Chemotherapy-Induced Peripheral Neuropathy.

Asia Pac J Oncol Nurs 2020 Apr-Jun;7(2):190-195. Epub 2020 Jan 14.

Division of Health Sciences, Osaka University Graduate School of Medicine, Osaka, Japan.

Objective: The present study aims to describe fall-related self-efficacy as perceived by patients with chemotherapy-induced peripheral neuropathy (CIPN). The characteristics of patients associated with low perceived self-efficacy of preventing falls were investigated.

Methods: A cross-sectional study of four hospitals in Japan. Read More

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http://dx.doi.org/10.4103/apjon.apjon_54_19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7233563PMC
January 2020

Association between Arrhythmia and Pulmonary Artery Pressure in Heart Failure Patients Implanted with a Cardiac Defibrillator and Ambulatory Pulmonary Artery Pressure Sensor.

J Innov Card Rhythm Manag 2019 Sep 15;10(9):3815-3821. Epub 2019 Sep 15.

Abbott Laboratories, Sylmar, CA, USA.

The association between ventricular arrhythmia (VA) burden or defibrillator therapy and pulmonary artery pressure (PAP) has not been characterized in an ambulatory setting; thus, we sought in the present research to determine the relationship between ambulatory PAP and VA burden. A retrospective cohort study involving patients with an implantable cardiac defibrillator and CardioMEMS™ PAP sensor (Abbott Laboratories, Chicago, IL, USA) both transmitting remotely into the Merlin.net™ patient care network (Abbott Laboratories, Chicago, IL, USA) was conducted. Read More

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http://dx.doi.org/10.19102/icrm.2019.100903DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7252698PMC
September 2019

Feasibility and Usability of Patch-based Continuous Cardiac Rhythm Monitoring in Comparison with Traditional Telemetry in Noncritically Ill Hospitalized Patients.

J Innov Card Rhythm Manag 2019 Sep 15;10(9):3803-3808. Epub 2019 Sep 15.

Electrophysiology Section, Department of Cardiovascular Medicine, Cleveland Clinic Foundation, Cleveland, OH, USA.

Research on traditional cardiac telemetry demonstrates that excessive alarms are related to lead failures and noise-related interruptions. Patch-based continuous cardiac rhythm monitoring (CCRM) has emerged in outpatient ambulatory monitoring situations as a means to improve recording fidelity. In this study, patients hospitalized but not in the intensive care unit were simultaneously monitored via telemetry in parallel with the use of the Vital Signs Patch™ (VSP) CCRM system (LifeWatch Services, Rosemont, IL, USA), applying standardized monitoring and notifications provided by an off-site central monitoring unit (CMU). Read More

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http://dx.doi.org/10.19102/icrm.2019.100901DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7252747PMC
September 2019

Primary health care policy and vision for community pharmacy and pharmacists in Australia.

Pharm Pract (Granada) 2020 Apr-Jun;18(2):1967. Epub 2020 May 15.

PhD, MPharm, BPharm. University of Technology Sydney. Sydney, NSW (Australia).

There is evidence that the Australian Government is embracing a more integrated approach to health, with implementation of initiatives like primary health networks (PHNs) and the Government's Health Care Homes program. However, integration of community pharmacy into primary health care faces challenges, including the lack of realistic integration in PHNs, and in service and remuneration models from government. Ideally, coordinated multidisciplinary teams working collaboratively in the community setting are needed, where expanding skills are embraced rather than resisted. Read More

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http://dx.doi.org/10.18549/PharmPract.2020.2.1967DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7243858PMC

Community pharmacy and primary health care in Sweden - at a crossroads.

Pharm Pract (Granada) 2020 Apr-Jun;18(2):1927. Epub 2020 May 2.

MD, PhD. Associate Professor. Institute of Medicine, Sahlgrenska Academy, University of Gothenburg. Gothenburg (Sweden).

The overall goal of Swedish health care is good health and equitable care for the whole population. The responsibility for health is shared by the central government, the regions, and the municipalities. Primary care accounts for approximately 20 percent of all expenditures on health care. Read More

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http://dx.doi.org/10.18549/PharmPract.2020.2.1927DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7243747PMC

Task-Specific Versus Impairment-Based Training on Locomotor Performance in Individuals With Chronic Spinal Cord Injury: A Randomized Crossover Study.

Neurorehabil Neural Repair 2020 Jun 1:1545968320927384. Epub 2020 Jun 1.

Rehabilitation Hospital of Indiana, Indianapolis, IN, USA.

. Many research studies attempting to improve locomotor function following motor incomplete spinal cord injury (iSCI) focus on providing stepping practice. However, observational studies of physical therapy strategies suggest the amount of stepping practice during clinical rehabilitation is limited; rather, many interventions focus on mitigating impairments underlying walking dysfunction. Read More

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http://dx.doi.org/10.1177/1545968320927384DOI Listing

C-reactive protein point of care testing: the answer to antibiotic prescribing in ambulatory patients with exacerbations of chronic obstructive pulmonary disease?

Expert Rev Respir Med 2020 Jun 1. Epub 2020 Jun 1.

Pneumology Department, Hospital Universitari Vall d'Hebron/Vall d'Hebron Research Institute (VHIR). CIBER de Enfermedades Respiratorias (CIBERS) , Barcelona, Spain.

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http://dx.doi.org/10.1080/17476348.2020.1776611DOI Listing

Increased masked hypertension prevalence in patients with polycystic ovary syndrome (PCOS).

Clin Exp Hypertens 2020 May 30:1-4. Epub 2020 May 30.

Department of Cardiology, Medical Park Ankara Hospital, Yuksek Ihtisas University , Ankara, Turkey.

Objective: Polycystic ovary syndrome (PCOS) is a common disorder with important clinical consequences. Many studies have proven that hypertension is one of the most important comorbid disorders in PCOS. Masked hypertension is defined as a presence of normal office blood pressure together with abnormal results in 24-h ambulatory blood pressure monitoring (ABPM). Read More

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http://dx.doi.org/10.1080/10641963.2020.1772815DOI Listing

Telemedicine for head and neck ambulatory visits during COVID-19: Evaluating usability and patient satisfaction.

Head Neck 2020 Jun 1. Epub 2020 Jun 1.

Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

Background: In light of the COVID-19 pandemic, there has been a rapid increase in telemedicine visits. Otolaryngology patient satisfaction with these visits has not yet been extensively studied using a validated survey.

Methods: All patients who had telemedicine visits with three head and neck surgeons, by phone or video-based platform, between March 25, 2020 and April 24, 2020. Read More

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http://dx.doi.org/10.1002/hed.26285DOI Listing

Clinical and economic strategies in outpatient medical care during the COVID-19 pandemic.

Reg Anesth Pain Med 2020 May 31. Epub 2020 May 31.

Hand & UpperEx Center, Wexford, Pennsylvania, USA.

The COVID-19 pandemic has resulted in significant clinical and economic consequences for medical practices of all specialties across the nation. Although the clinical implications are of the utmost importance, the economic consequences have also been serious and resulted in substantial damage to the US healthcare system, including pain practices. Outpatient pain practices have had to significantly change their clinical care pathways, including the incorporation of telemedicine. Read More

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http://dx.doi.org/10.1136/rapm-2020-101640DOI Listing

[Mental health care in French correctional facilities during the Covid-19 pandemic].

Encephale 2020 May 8. Epub 2020 May 8.

CHU de Lille, Pôle de psychiatrie, 59000 Lille, France; Université Lille, Inserm, U1172 - Lille Neuroscience & Cognition - Équipe Plasticity & Subjectivity, 59000 Lille, France.

Objective: The impact of the Covid-19 pandemic on the 11 million people currently incarcerated worldwide is the subject of many concerns. Prisons and jails are filled with people suffering from many preexisting medical conditions increasing the risk of complications. Detainees' access to medical services is already limited and overcrowding poses a threat of massive contagion. Read More

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http://dx.doi.org/10.1016/j.encep.2020.05.002DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7205690PMC

Randomized Pragmatic Trial of Stroke Transitional Care: The COMPASS Study.

Circ Cardiovasc Qual Outcomes 2020 Jun 1:CIRCOUTCOMES119006285. Epub 2020 Jun 1.

Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill. (S.B.J., A.M.J., A.M.K.-N., L.H.M., W.D.R.).

Background The objectives of this study were to develop and test in real-world clinical practice the effectiveness of a comprehensive postacute stroke transitional care (TC) management program. Methods and Results The COMPASS study (Comprehensive Post-Acute Stroke Services) was a pragmatic cluster-randomized trial where the hospital was the unit of randomization. The intervention (COMPASS-TC) was initiated at 20 hospitals, and 20 hospitals provided their usual care. Read More

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http://dx.doi.org/10.1161/CIRCOUTCOMES.119.006285DOI Listing

Silicone Sheets and new gels to Treat Hypertrophic Scars and Keloids: a short review.

Dermatol Ther 2020 May 30:e13705. Epub 2020 May 30.

Gold Skin Care Center, Tennessee Clinical Research Center, Nashville, Tennessee, USA.

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http://dx.doi.org/10.1111/dth.13705DOI Listing

The Impact of Syndromic Genetic Disorders on Medical Management and Mortality in Pediatric Hypertrophic Cardiomyopathy Patients.

Pediatr Cardiol 2020 May 30. Epub 2020 May 30.

Division of Cardiology, Cardiac Center, The Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, 3400 Civic Center Boulevard, Suite 8NW90, Philadelphia, PA, 19104, USA.

Hypertrophic cardiomyopathy (HCM) is a prevalent cardiomyopathy in children, with variable etiologies, phenotypes, and associated syndromic genetic disorders (GD). The spectrum of evaluation in this heterogeneous population has not been well described. We aimed to describe mortality and medical management in the pediatric HCM population, and compare HCM pediatric patients with GD to those without GD. Read More

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http://dx.doi.org/10.1007/s00246-020-02373-4DOI Listing

Forgoing health care under universal health insurance: the case of France.

Int J Public Health 2020 May 30. Epub 2020 May 30.

Assistance Publique Hôpitaux de Paris, Nutrition Department, Georges Pompidou European Hospital, Centre Spécialisé Obésité, Paris, France.

Objectives: We investigate the reliability of a survey question on forgone healthcare services for financial reasons, based on analysis of actual healthcare use over the 3-year period preceding response to the question. We compare the actual use of different health services by patients who report having forgone health care to those who do not.

Methods: Based on a prospective cohort study (CONSTANCES), we link survey data from enrolled participants to the Universal Health Insurance (UHI) claims database and compare use of health services of those who report having forgone health care to controls. Read More

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http://dx.doi.org/10.1007/s00038-020-01395-2DOI Listing
May 2020
1.966 Impact Factor

The MSReactor computerized cognitive battery correlates with the processing speed test in relapsing-remitting multiple sclerosis.

Mult Scler Relat Disord 2020 May 25;43:102212. Epub 2020 May 25.

Department of Neurology, MSNI Service, Alfred Health, Melbourne, Australia; Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Australia; Department of Neurology, Royal Prince Alfred Hospital, Sydney, Australia. Electronic address:

Background: Monitoring and screening of cognitive function in the ambulatory setting requires simple, brief cognitive tests that are reproducible. MSReactor (MSR) is a web-based platform that screens psychomotor (processing) speed, attention and working memory using a game-like interface. The Processing Speed Test (PST) is a validated computerized version of the Symbol Digit Modalities test (SDMT) and component of the Multiple Sclerosis Performance Test (MSPT). Read More

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http://dx.doi.org/10.1016/j.msard.2020.102212DOI Listing