Malignant transformation of testicular teratoma to primitive neuroectodermal tumor.

Teratoma is a common germ cell tumor that affects young adult males. A small number of testicular teratomas have the potential for malignant transformation along endodermal, ectodermal, or mesodermal lines. The metastatic mixed germ cell tumor we reported consists of the primitive neuroectodermal tumor (PNET) with mature teratoma.

Impact of a Pharmacist-Led Chronic Disease State Management Clinic on Patient Assessment of Chronic Illness Care.

The Patient Assessment of Chronic Illness Care (PACIC) tool measures patient satisfaction with chronic disease care. A modified PACIC tool (PACIC-RxFM) was used to assess patient satisfaction in a pharmacist-led chronic disease state management clinic. The secondary outcome compared satisfaction with pharmacist-led and physician-led visits.

Impact of a Pharmacist-Driven Protocol to Improve Guideline-Concordant Prescribing of Diabetes Medications in Patients With Atherosclerotic Cardiovascular Disease: A Pilot Study.

Purpose: To determine whether a pharmacist-driven protocol improves guideline-concordant prescribing of diabetes medications in patients with atherosclerotic cardiovascular disease (ASCVD).

Methods: A retrospective pre- and post-intervention study was conducted at a university-based family medicine clinic. A pharmacist-driven protocol was implemented which involved the creation of an algorithm recommending specific diabetes medications in patients with ASCVD.

Blood pressure targets: How low should you go (and for whom)?

The ACC/AHA's lower BP goals are supported by previously unavailable evidence, the strongest of which is for patients with CVD. But others can benefit, too.

Utilization and prescribing patterns of direct oral anticoagulants.

Background: Scant literature exists evaluating utilization patterns for direct oral anticoagulants (DOACs).

Objectives: The primary objective was to assess DOAC prescribing in patients with venous thromboembolism (VTE) and nonvalvular atrial fibrillation (NVAF) in outpatient clinics. Secondary objectives were to compare utilization between family medicine (FM) and internal medicine (IM) clinics, characterize potentially inappropriate use, and identify factors associated with adverse events (AEs).

Impact of an Interprofessional Teaching Clinic on Preventive Care Services.

Background And Objectives: Recent legislative and regulatory initiatives have emphasized preventive medicine and team-based health care delivery and education. Influenced by these initiatives, the investigators created an interprofessional teaching clinic to provide preventive care services (PCS) structured around Medicare's Annual Wellness Visit (AWV). The primary objective of this pilot study was to determine if PCS status improved for participating patients.

Physician-pharmacist collaborative management of asthma in primary care.

Objective: To determine if asthma control improves in patients who receive physician-pharmacist collaborative management (PPCM) during visits to primary care medical offices.

Design: Prospective pre-post study of patients who received the intervention in primary care offices for 9 months. The primary outcome was the sum of asthma-related emergency department (ED) visits and hospitalizations at 9 months before, 9 months during, and 9 months after the intervention.

Measuring changes in perception using the Student Perceptions of Physician-Pharmacist Interprofessional Clinical Education (SPICE) instrument.

Background: The Student Perceptions of Physician-Pharmacist Interprofessional Clinical Education (SPICE) instrument contains 10 items, 3 factors (interprofessional teamwork and team-based practice, roles/responsibilities for collaborative practice, and patient outcomes from collaborative practice), and utilizes a five-point response scale (1 = strongly disagree, 5 = strongly agree). Given the SPICE instrument's demonstrated validity and reliability, the objective of this study was to evaluate whether it was capable of measuring changes in medical (MS) and pharmacy students' (PS) perceptions following an interprofessional education (IPE) experience.

Methods: In this prospective cohort study, MS and PS completed the SPICE instrument before and after participation in a predefined IPE experience.

Development and validation of the student perceptions of physician-pharmacist interprofessional clinical education (SPICE) instrument.

Objectives: To describe the development and validation of an instrument designed to assess student perceptions of physician-pharmacist interprofessional clinical education (SPICE).

Methods: Faculty members from pharmacy and medical schools developed items for the instrument, and 179 medical and pharmacy students completed the scale. Psychometric properties, including reliability and construct validity, were assessed using confirmatory factor analysis.

Institutional review board barriers and solutions encountered in the Collaboration Among Pharmacists and Physicians to Improve Outcomes Now Study: a national multicenter practice-based implementation trial.

Study Objective: To categorize institutional review board (IRB) challenges and solutions encountered in a multicenter practice-based research network (PBRN) study and to assess the impact of IRB requirements on the willingness of individual principal investigators (PIs) to participate in future PBRN studies.

Design: Descriptive analysis of IRB challenges and solutions encountered in the Collaboration Among Pharmacists and Physicians to Improve Outcomes Now (CAPTION) trial, a multicenter prospective cluster-randomized study conducted by the National Interdisciplinary Primary Care PBRN, and a correlational analysis from a survey of individual site PIs.

Measurements And Main Results: IRB barriers encountered and solutions were categorized for study sites.

Use of the internet for health information among primary care patients in rural West Texas.

Background: Little is known about how primary care patients in rural, remote or border areas use the internet for their health information. This study examined the factors related to internet use for medical information among primary care clinic patients in such areas of West Texas.

Methods: A convenience sample was drawn from nine clinics that serve low-income rural area populations.

Complementary and alternative medicine use among primary care patients in west Texas.

Background: This study explored factors related to practitioner-based complementary and alternative medicine (CAM) usage among primary care clinic patients in rural West Texas areas, including physicians' awareness of their patients' CAM use.

Methods: A convenience sample was drawn from nine clinics that served low-income populations. Surveys were distributed to patients during a 6-week period in the winter of 2006.

Overall self-rated health as an outcome indicator in primary care.

Rationale, Aims And Objectives: The ultimate goal of health care systems is to improve overall health from the patient's point of view. However, overall self-rated health is not routinely monitored as a performance indicator. The purpose of this study was to investigate the feasibility of using a measure normally employed in community health surveys as a quality indicator in primary care clinics.

The detection of antibacterial actions of whole herb tinctures using luminescent Escherichia coli.

Two whole cell Escherichia coli luminescent biosensors were used to determine the antibacterial actions of 16 herbal tinctures. These bioassays can detect genotoxic (strain DPD2794) and general oxidative stress (DE135) events when challenged with antibacterial substances. Many of the herbal tinctures were active against these Gram-negative bacteria, affecting their metabolism without, in some cases, arresting cell growth or causing cell death.

Overall self-rated health: a new quality indicator for primary care.

Rationale, Aims And Objectives: Patient 'empowerment' gives patients choices about their own care and about the outcomes they would most prefer. Many patients can be presumed to regard overall self-rated health as an important outcome. Therefore, overall self-rated health can be considered a relevant and important outcome measure for a patient-centred medical clinic.

How do family physicians provide anticipatory guidance during well-child visits?

Introduction: Anticipatory guidance is an important part of well-child care, yet little is known about the way family physicians provide this guidance. This study describes the methods that family physicians use to provide anticipatory guidance during well-child visits.

Methods: A questionnaire was mailed to 1000 family physicians.

Self-esteem, stress and self-rated health in family planning clinic patients.

Background: The independent effects of stress on the health of primary care patients might be different for different types of clinic populations. This study examines these relationships in a low-income female population of patients attending a family planning clinic.

Methods: This study investigated the relevance of different sources of personal stress and social support to self-rated health, adjusting for mental health, health behavior and demographic characteristics of subjects.