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Permanente Journal

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https://read.qxmd.com/read/31050645/clinical-response-to-real-time-patient-reported-diabetic-peripheral-neuropathy-symptoms
#1
Somalee Banerjee, Eileen Kim, Melissa M Parker, Lisa K Gilliam, Rick Dlott, Alyce Adams
INTRODUCTION: To assess clinician response to real-time patient-reported data about diabetic peripheral neuropathy (DPN) symptoms, we analyzed DPN diagnosis and treatment patterns after administration of a 4-question symptom questionnaire in a large vertically integrated health care system. METHODS: Retrospective cohort study to analyze data from 160,852 patients screened for DPN symptoms from April 2012 to March 2014. Electronic medical record data were used to study changes in DPN diagnosis, treatment initiation, and treatment intensification...
2019: Permanente Journal
https://read.qxmd.com/read/31050644/salvage-cryoablation-for-radiorecurrent-prostate-cancer-initial-experience-at-a-regional-health-care-system
#2
Seena Safavy, Ramzi B Jabaji, Sharon M Lu, Jeff M Slezak, Harry A Cosmatos, Stephen G Williams, David S Finley
CONTEXT: Local recurrence after radiotherapy for prostate cancer remains challenging to treat effectively. Although oncologic control is highest with salvage prostatectomy, the procedure is associated with substantial morbidity. OBJECTIVE: To identify factors associated with successful salvage cryoablation for radiorecurrent prostate cancer. DESIGN: We retrospectively reviewed the medical records of patients who underwent salvage cryoablation at our institution between 2005 and 2015...
2019: Permanente Journal
https://read.qxmd.com/read/31050643/acute-convulsive-seizures-when-is-it-too-early-to-treat
#3
Omar Hussein
Acute convulsive seizures are overwhelming events that require immediate attention from clinicians and practitioners, especially when witnessed in a hospital setting. Adequate management of inpatient-witnessed seizures lies in understanding the time-related pathophysiologic stages of the seizure. The anatomical location of the seizure origin is as important as seizure stage but might not be easy to determine in the acute setting, especially if the seizure is nonfocal. Although investigating and treating the cause of a seizure has high priority, understanding the interplay between the pathophysiologic responses and the various bodily responses are crucial in treatment...
2019: Permanente Journal
https://read.qxmd.com/read/31050642/sociodemographic-determinants-of-health-and-well-being-among-adults-residing-in-the-combined-kaiser-permanente-regions
#4
Matthew C Stiefel, Nancy P Gordon, Folasade J Wilson-Anumudu, Emily L Arsen
CONTEXT: Kaiser Permanente commissioned a health and well-being (HWB) survey of adult members and nonmembers in its 8 Regions. OBJECTIVE: To estimate the prevalence of HWB indicators and evaluate differences in prevalence of excellent/very good (E/VG) health and thriving overall in life (thriving) by race/ethnicity, age group, sex, education, and financial situation. DESIGN: Cross-sectional survey conducted by email and phone during Winter 2016-2017 with a racial/ethnic group-stratified quota sample...
2019: Permanente Journal
https://read.qxmd.com/read/31050641/fractional-exhaled-nitric-oxide-assisted-management-of-uncontrolled-persistent-asthma-a-real-world-prospective-observational-study
#5
Robert Stephen Zeiger, Michael Schatz, Su-Jau Yang, Wansu Chen
CONTEXT: The utility of fractional exhaled nitric oxide (FeNO) measurement in real-world asthma management requires investigation. OBJECTIVE: To determine whether FeNO-assisted care added to standard asthma management improves asthma control in a managed care organization. DESIGN: Prospective observational study in patients aged 12 years and older with uncontrolled persistent asthma identified during a scheduled visit to an Allergy Department that routinely used FeNO (FeNO-assisted care, n = 426) vs visits to 4 Allergy Departments that did not, but followed routine guideline-based care (standard care, n = 925)...
2019: Permanente Journal
https://read.qxmd.com/read/31050640/ensuring-mentorship-of-new-physicians-in-their-first-year-constructs-for-new-mentoring-processes
#6
Wynnyee Tom, Wynnmian Tom, Daisy Albarran, Nina Salman, Aneema Van Groenou
INTRODUCTION: The importance of mentoring new physicians is well established. OBJECTIVES: To evaluate and improve use of a competencies-based mentoring checklist to help new physicians understand the basic work environment and resources in their daily jobs as well as achieve needed competencies. METHODS: Literature searches, process improvements, and a review of curricula and mentoring from both inside and outside our large Medical Group were conducted to understand the workflow for new physician orientation, onboarding, and mentoring processes...
2019: Permanente Journal
https://read.qxmd.com/read/31050639/temporal-trends-in-mortality-rates-among-kaiser-permanente-southern-california-health-plan-enrollees-2001-2016
#7
Wansu Chen, Janis Yao, Zhi Liang, Fagen Xie, Don McCarthy, Lee Mingsum, Kristi Reynolds, Corinne Koebnick, Steven Jacobsen
BACKGROUND: Temporal analyses of death rates in the US have found a decreasing trend in all-cause and major cause-specific mortality rates. OBJECTIVES: To determine mortality trends in Kaiser Permanente Southern California (KPSC), a large insured population, and whether they differ from those of California and the US. METHODS: Trends in age-adjusted all-cause and cause-specific mortality rates from 2001 to 2016 were determined using data collected in KPSC and those derived through linkage with California State death files and were compared with trends in the US and California...
2019: Permanente Journal
https://read.qxmd.com/read/31050638/relapse-prevention-by-plant-based-diet-incorporated-into-induction-therapy-for-ulcerative-colitis-a-single-group-trial
#8
Mitsuro Chiba, Kunio Nakane, Tsuyotoshi Tsuji, Satoko Tsuda, Hajime Ishii, Hideo Ohno, Kenta Watanabe, Yu Obara, Masafumi Komatsu, Takeshi Sugawara
CONTEXT: No known previous study has focused on plant-based diet (PBD) to prevent relapse of ulcerative colitis (UC) except our previous educational hospitalization study. OBJECTIVE: To describe the relapse rate in a large case series of UC after incorporation of PBD into induction therapy. DESIGN: All patients with UC between 2003 and 2017 were admitted for induction therapy. Patients receiving educational hospitalization or treated with infliximab were excluded...
2019: Permanente Journal
https://read.qxmd.com/read/31039107/stories-for-my-daughter
#9
Lindsay Mazotti
No abstract text is available yet for this article.
2019: Permanente Journal
https://read.qxmd.com/read/31039106/the-elderly-couple
#10
William Lynes
No abstract text is available yet for this article.
2019: Permanente Journal
https://read.qxmd.com/read/31039105/hiding-it
#11
Tina Olkowski
No abstract text is available yet for this article.
2019: Permanente Journal
https://read.qxmd.com/read/30939291/enlightened-aging-building-resilience-for-a-long-active-life
#12
REVIEW
Arthur Hayward
No abstract text is available yet for this article.
2019: Permanente Journal
https://read.qxmd.com/read/30939290/knowing-how-to-ask-good-questions-comparing-latinos-and-non-latino-whites-enrolled-in-a-cardiovascular-disease-prevention-study
#13
Diego X Torres, Wendy Y Lu, Connie S Uratsu, Stacy A Sterling, Richard W Grant
INTRODUCTION: Latinos face unique challenges engaging with their health care providers for risk management of cardiovascular disease (CVD). OBJECTIVE: To better understand differences in how Latinos and non-Latino whites (NLWs) experience CVD care. METHODS: We examined self-reported activation, engagement, confidence, and communication comparing Latinos (n = 194) and NLWs (n = 208). Data were taken from baseline survey assessments of participants in the CREATE Wellness Study (NCT02302612), designed to help patients with poorly controlled CVD risk factors more actively engage in their care...
2019: Permanente Journal
https://read.qxmd.com/read/30939289/-prevention-produce-integrating-medical-student-mentorship-into-a-fruit-and-vegetable-prescription-program-for-at-risk-patients
#14
Jane Marie Forbes, Cameron Russell Forbes, Erik Lehman, Daniel R George
INTRODUCTION: Fruit and vegetable prescription (FVRx) programs provide increased access to produce to food-insecure, at-risk populations, yet many lack the educational and social components to support long-term disease prevention. OBJECTIVES: To address these barriers, students at Penn State College of Medicine designed "Prevention Produce"-a modified FVRx program that integrated a community-based, month-long educational curriculum-and undertook preliminary evaluation...
2019: Permanente Journal
https://read.qxmd.com/read/30939288/image-diagnosis-scapholunate-dissociation
#15
Matthew Stevenson, Joel T Levis
No abstract text is available yet for this article.
2019: Permanente Journal
https://read.qxmd.com/read/30939287/disrupting-physician-clinical-practice-peer-review
#16
Rajesh Swaroop
The goal of physician peer review has been to assess and improve the quality of care by individual physicians. Unfortunately, this enshrined piece of medical practice suffers from deep flaws that hamper the achievement of assessment and improvement. This institution is in serious need of disruption, both for the safety of patients and for the wellness of practicing physicians. This commentary describes the inherent flaws of physician practice review and how physicians and health care organizations can address them...
2019: Permanente Journal
https://read.qxmd.com/read/30939286/effect-of-helicobacter-pylori-treatment-on-unexplained-iron-deficiency-anemia
#17
Daniel S Tseng, Dan Li, Sri M Cholleti, Julia C Wei, Yves Jodesty, Hung-Viet Pham
BACKGROUND: A large number of patients with iron deficiency anemia have no known cause of their anemia despite a full evaluation. Optimal management and follow-up for this issue is unclear. Results of previous studies have implicated Helicobacter pylori infection as a potential cause of iron deficiency anemia. OBJECTIVES: To investigate whether H pylori infection could be a cause of unexplained iron deficiency anemia. METHODS: All adult patients with both unexplained iron deficiency anemia and H pylori infection diagnosed between January 1, 2008 and April 30, 2015 were identified from Kaiser Permanente Northern California's electronic medical records database and were followed-up for up to 2 years...
2019: Permanente Journal
https://read.qxmd.com/read/30939285/before-and-after
#18
Cecilia Runkle
No abstract text is available yet for this article.
2019: Permanente Journal
https://read.qxmd.com/read/30939284/a-rare-case-of-an-abdominal-aneurysm-in-a-patient-with-lymphangioleiomyomatosis-a-case-report
#19
Iván Chérrez-Ojeda, José Espinoza-Plaza, Vincent Cottin, Sofía Chérrez
INTRODUCTION: Lymphangioleiomyomatosis (LAM) is a multisystemic disorder characterized by the proliferation, metastasis, and infiltration of smooth muscle cells in the lung and other tissues. Although LAM is rarely seen in men, it is usually detected in women during the third decade of life. Renal microaneurysms have been reported in patients with LAM, but abdominal aneurysms have not. We describe a patient with a diagnosis of LAM who had an unusual aneurysm in the inferior pancreaticoduodenal artery...
2019: Permanente Journal
https://read.qxmd.com/read/30939283/pain-management-associated-with-total-joint-arthroplasty-a-primer
#20
REVIEW
Michelle J Lespasio, A J Guarino, Nipun Sodhi, Michael A Mont
This primer presents a synopsis of pain management strategies associated with total joint arthroplasty. Patients considering total joint arthroplasty often experience moderate to severe pain, which places them at risk of opioid abuse or addiction. Currently, the best practice strategies involve the development of individualized multimodal perioperative approaches to pain management. These practices include prescribing opioids at their lowest dose and for the shortest duration necessary to control symptoms, with close monitoring of common adverse effects...
2019: Permanente Journal
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