Growing demand for services is leading primary care organizations to explore new delivery models. One approach incorporates multiple primary care providers on a team. Effective incorporation of multiple clinicians into teams requires well-defined roles, including the usual provider (who provides the majority of primary care) and supplemental providers (who provide a minority of primary care visits). Using data from the Veterans Health Administration, we examined whether differences in diabetes outcomes exist among patients with different types of primary and supplemental providers (physicians, physician assistants (PAs), and NPs). No clinically meaningful differences were observed based on the profession of the usual provider or supplemental provider, or whether physicians provided supplemental care to patients with PAs or NPs as usual providers. These results suggest that physicians, PAs, and NPs can perform a variety of roles depending on the needs of the organization and patient population.
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http://dx.doi.org/10.1097/01.JAA.0000558239.06875.0b | DOI Listing |
Genet Med
January 2025
Division of Human Genetics, Children's Hospital of Philadelphia; Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Purpose: Noonan syndrome and related disorders (NS) are multisystemic conditions affecting approximately 1:1000 individuals. Previous natural history studies were conducted prior to widespread comprehensive genetic testing. This study provides updated longitudinal natural history data in participants with molecularly confirmed NS.
View Article and Find Full Text PDFEmergencias
December 2024
Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seúl, República de Corea. Department of Digital Health, SAIHST, Sungkyunkwan University, Seúl, República de Corea.
Objective: To develop a Metabolic Derangement Score (MDS) based on parameters available after initial testing and assess the score's ability to predict survival after out-of hospital cardiac arrest (OHCA) and the likely usefulness of extracorporeal life support (ECLS).
Methods: A total of 5100 cases in the Korean Cardiac Arrest Research Consortium registry were included. Patients' mean age was 67 years, and 69% were men.
Heliyon
January 2025
BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre Nedlands and Centre for Medical Research, The University of Western Australia, Perth, Australia.
Breast-conserving surgery accompanied by adjuvant radiotherapy is the standard of care for patients with early-stage breast cancer. However, re-excision is reported in 20-30 % of cases, largely because of close or involved tumor margins in the specimen. Several intraoperative tumor margin assessment techniques have been proposed to overcome this issue, however, none have been widely adopted.
View Article and Find Full Text PDFEpilepsy Behav Rep
March 2025
Department of Paediatrics, Schulich School of Medicine & Dentistry, 1151 Richmond St, London, Ontario N6A 5C1, Canada.
Epilepsy is the most common chronic neurological condition in children. Many barriers exist in early recognition which cause delay in care and impact quality of life. Some of these children require advanced treatments which are underutilized due to lack of education, awareness and referrals.
View Article and Find Full Text PDFInt J Cardiol Heart Vasc
February 2025
Department of Cardiology, Radboud University Medical Center, Nijmegen, the Netherlands.
Background: Recently it has been suggested that coronary microvascular dysfunction (CMD) may explain the high false-positive rate of exercise electrocardiographic stress testing (EST). However, patients with angina but non-obstructive coronary artery disease (ANOCA) present with a broader spectrum of coronary vasomotor dysfunction (CVDys), namely coronary artery spasm (CAS), CMD or a combination of both. We aim to investigate the diagnostic value of EST for the entire CVDys spectrum.
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