The journal article “Improved Coordination of Care for Patients with Abnormal Chest Imaging: the Rapid Access Chest and Lung Assessment Program” was published in the October 2014 Journal of Clinical Outcomes Management by Stephen Cattaneo, MD; Maria Geronimo, RN; Teresa Putscher, RN; Catherine Brady-Copertino, BSN; and Barry Meisenberg, MD. Read the full article here.
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“This system misses all of the intangible factors that help gauge the quality and efficiency of the care being delivered. It focuses physicians on the wrong goals for promoting health, such as how well they code chart to capture higher-value “units”. The Advisory Board Company, a health-care consulting firm, estimates that when hospitals last went on a physician-acquisition binge in the late 1990s, productivity fell as much as 35%.” (WSJ Mar 2013) Click here to read full text.
Article concludes: The high rate of E-cigarette use observed is consistent with recent articles highlighting increased E-cigarette us in the general population. The current longitudinal findings raise doubts concerning the usefulness of E-cigarettes for facilitating smoking cessation among patients with cancer. Cancer, Sept, 2014 online early pub) Click here to read full-text.
This Medscape article deals with many of the problems that physicians have in regard to getting organized. An oft-heard comments is, “We let them do this to us, we gave away our power. If we want to change medicine in a different way, we have to work together to take it back.” But can – or will – that ever happen? This article reviews the options. Click here to read full-text.
The American Geriatrics Society Position Statement statement: 1. Feeding tubes are not recommended for older adults with advanced dementia. Careful hand feeding should be offered; for persons with advanced dementia, hand feeding is at least as good as tube feeding for the outcomes of death, aspiration penumonia, functional status, and comfort. Tube feeding is associated with agitation, greater use of physical and chemical restraints, greater healthcare use due to tube-related complications, the development of new pressure ulcers. 2. Efforts to enhance oral feeding by altering the environment and creating individual-centered approaches to feeding should be part of usual care for older adults with advanced dementia. 3. Tube feeding is meedical therapy that an individual’s surrogat3e decision-maker can decline or accept in accordance with advance directives, previously stated wishes, or what it is thought the individual would want. 4. It is the responsibility of all members of the healthcare team caring for residents in long-term care settings to understand any previously expressed wishes of the individual (through review of advance directives and with surrogate caregivers) regarding tube feeding and incoproarte these wishes into the care plan. (JAGS, Aug) Click here to read full text.
This updated review (Lancet, March) summarizes the epidemiology, causes, pathophysiology, diagnosis, assessment and workup, non-pharmacological prevention and treatment, pharmacological prevention and treatment, controversies and future directions with recommendations. “Delirium is an acute disorder of attention and cognition in elderly peiople that is common, serious, costly, under-recognised, and often fatal. A formal cognitive assessment and history of acute onset of symptoms are necessary for diagnosis. In view of the complex multifactorial causes of delirium, multicomponent pharacological approaches are recommended.” Click here to read full-text.
“Use of mortality after bilateral mastectomy compared with other surgical treatments for breast Cancer” and accompanying editorial, “Contralateral prophylactic mastectomy: Is it a reasonable option?”by jmiller on September 11, 2014
This article concludes that the “use of bilateral mastectomy increased significantly through California from 1998 to 2011 and was not associated with lower mortaligy than that achieved with breast-conserving surgery plus radiation. Unilateral mastectomy was associated with higher mortality than the other 2 surgical options.” (JAMA, Sept) Click here to read full-text.
This review article (NEJM, Aug 28) updates the pathogenesis, diagnosis, screening and surveillance, management, endoscopic eradication of dysplasia, management of low-grade dysplasia, and radiofrequency ablation of nondysplastic metaplasia. Click here to read full-text