The Role of Ultrasound-Guided Therapeutic Thoracentesis in an Outpatient Transitional Care Program: A Case Series.

Background: Symptomatic pleural effusions create discomfort and are a frequent cause of hospitalization. Ultrasound-guided thoracentesis is a key palliative intervention to assist in the management of this vulnerable population. Our institution has created a multidisciplinary transitional care program to address the needs of those discharged from the hospital with chronic complex conditions, including symptomatic pleural effusions.

Adjuvant Therapy for Resected Biliary Tract Cancer: ASCO Clinical Practice Guideline.

Purpose: To develop an evidence-based clinical practice guideline to assist in clinical decision making for patients with resected biliary tract cancer.

Methods: ASCO convened an Expert Panel to conduct a systematic review of the literature on adjuvant therapy for resected biliary tract cancer and provide recommended care options for this patient population.

Results: Three phase III randomized controlled trials, one phase II trial, and 16 retrospective studies met the inclusion criteria.

Understanding Social and Cultural Contexts of Alcohol Misuse in Mexican-Origin Hispanic Men.

Evidence suggests that Hispanic and non-Hispanic White men (NHW) have comparable prevalence rates of alcohol use. However, Hispanic men consistently have higher prevalence rates of alcohol misuse compared with NHW men. Consequently, Hispanic men experience disproportionate levels of adverse health consequences of alcohol misuse when compared with NHW men.

Attempts to Limit Opioid Prescribing in Critically Ill Patients: Not So Easy, Not So Fast.

Objective: To discuss why opioids have been considered the long-standing first-line therapy for treating acute, severe nociceptive pain in critically ill patients and discuss considerations for limiting opioid overuse in the intensive care unit setting.

Data Sources: Articles were identified through searches of PubMed and EMBASE from database inception until December 2018. Additional references were located through a review of the bibliographies of articles and clinical practice guidelines.

Percutaneous Embolization of an Inferior Mesenteric Artery Aneurysm in a Patient With Type IV Ehlers-Danlos Syndrome.

Ehlers-Danlos syndrome (EDS) refers to a group of genetic disorders involving the connective tissues. Type IV EDS impairs type III collagen that is responsible for vessel integrity. Patients with type IV EDS are susceptible to vascular and visceral complications, including aortic aneurysms, pseudoaneurysms, dissections, and spontaneous rupture of internal organs.

What Patients Know About Services to Help Manage Chronic Diseases and Medications: Findings from Focus Groups on Medication Therapy Management.

Background: Managing and treating patients with multiple chronic conditions presents challenges on many levels. Pharmacist-delivered medication therapy management (MTM) services, mandated as part of the Medicare Part D drug benefit, are designed to help patients manage their chronic conditions and medications.

Objective: To identify factors that influence patient understanding and use of MTM services and potential strategies to educate individuals about MTM.

Integrating Innovative Telehealth Solutions into an Interprofessional Team-Delivered Chronic Care Management Pilot Program.

Background: Pharmacist-delivered medication therapy management (MTM) services can improve patient outcomes, yet little is known about outpatient, interprofessional telepharmacy programs.

Objective: To evaluate an outpatient, interprofessional telehealth chronic care management (CCM) pilot program.

Methods: This 6-month program integrated family medicine providers, a university-based medication management telepharmacist, and an interprofessional care coordinator using telehealth solutions for CCM and pharmacy education services.

Endovascular Retrieval of an Embolized Atrial Septal Occluder Device From the Abdominal Aorta.

Patent foramen ovale (PFO) is a common heart condition in adults. Closure with a septal occluder device is a safe, well-established treatment option with excellent clinical outcomes. One rare complication of percutaneous PFO closure is embolization of the device to the heart chambers or distal vasculature.

Implementation of Health Information Exchange at the Pima County Adult Detention Complex: Lessons Learned.

Successful transition of patients between health care entities is difficult. Historically, the process of transitioning individuals through the corrections system with regard to health care was made even more challenging by the limitation of paper records. Recently, the advent of electronic medical records has improved health care nationwide.

Community-Clinical Linkages With Community Health Workers in the United States: A Scoping Review.

Despite the proliferation of community-clinical linkage (CCL) interventions with community health workers (CHWs), little is known about the components of these programs or how linkages are realized. In this scoping review, we synthesize evidence concerning the role of CHWs in creating and sustaining CCLs aimed at improving individual health outcomes. Our inclusion criteria included peer-reviewed articles that described a CHW intervention in the United States that used a CCL model.

A Comparison of Plate Versus Screw Fixation for Segmental Scaphoid Fractures: A Biomechanical Study.

Background: Volar locking plate fixation may offer several advantages over headless screw fixation for scaphoid nonunion, or segmental or comminuted fractures: (1) increased surface area for bony healing; (2) preserved vascularity; and (3) maintenance of a gap for graft insertion. The purpose of this study is to compare headless screw and locking plate fixation of segmental scaphoid fractures and to determine whether either fixation provides a greater mechanical advantage in osteoporotic versus nonosteoporotic bone.

Methods: Sixteen matched-pair cadaver scaphoids were dissected from a range of osteoporotic and nonosteoporotic specimens.

The Role of Conscious Attention in How Weight Serves as an Embodiment of Importance.

Inconsistency among findings in the embodied cognition literature suggests a need for theoretical boundary conditions. The current research proposes that conscious attention of a bodily state can moderate its influence on social judgment. Three studies tested this possibility in the case of the demonstrated effect of weight sensations on judgments of an abstract idea's importance.

The Evil Animal: A Terror Management Theory Perspective on the Human Tendency to Kill Animals.

This research tested whether support for the killing of animals serves a terror management function. In five studies, death primes caused participants to support the killing of animals more than control primes, unless the participants' self-esteem had been elevated (Study 4). This effect was not moderated by gender, preexisting attitudes toward killing animals or animal rights, perceived human-animal similarity, religiosity, political orientation, or by the degree to which the killing was justified.

Philosophical Clarity and Justifying the Scope of Advanced Practice Nursing.

The United States (US) Department of Veterans Affairs proposed a policy change for nursing practice that would grant full practice authority to advanced practice registered nurses (APRNs) nationwide. In this article, the author briefly explains this proposed policy and explores the relevance and implications of bringing philosophy into policy debates and discussions about the nature and scope of practice.

Dietary Supplements Commonly Used by Cancer Survivors: Are There Any Benefits?

Following a cancer diagnosis, dietary supplements are reportedly used by 20%-80% of individuals. Supplements are most commonly used by breast cancer survivors, followed by patients with prostate, colorectal, and lung cancers, which is not surprising since these are the most common types of cancer diagnosed in adults. Reasons cited for such use include improving quality of life, reducing symptoms related to treatment and/or the disease process, and recommendation from medical practitioners; family and friends may also be an influence.

Ulnar Nerve Injury as a Result of Galeazzi Fracture: A Case Report and Literature Review.

Background: Sparse documentation of Galeazzi fracture with associated nerve injury exists in the medical literature. The purpose of this report is to review the available literature in regard to incidence, nerve injury type, treatment strategies, and expected outcomes.

Methods: We present a classic Galeazzi fracture dislocation with associated complete ulnar nerve transection injury at the level of the wrist.

Does Everything That's Counted Count? Value of Inflammatory Markers for Following Therapy and Predicting Outcome in Diabetic Foot Infection.

To assess the severity of inflammation associated with diabetic foot infection (DFI), values of inflammatory markers such as white blood count (WBC), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and neutrophil to lymphocyte ratio (NLR) are often measured and tracked over time. It remains unclear if these markers can aid the clinician in the diagnosis and management of DFI, and ensure more rational use of antibiotics. Hospitalized adult patients (n = 379) with DFI were retrospectively assessed for abnormal inflammatory markers, correlation between values of inflammatory markers, and clinical diagnosis on initial admission and on last follow-up.

Improved metabolism and redox state with a novel preservation solution: implications for donor lungs after cardiac death (DCD).

Lungs donated after cardiac death (DCD) are an underutilized resource for a dwindling donor lung transplant pool. Our study investigates the potential of a novel preservation solution, Somah, to better preserve statically stored DCD lungs, for an extended time period, when compared to low-potassium dextran solution (LPD). We hypothesize that Somah is a metabolically superior organ preservation solution for hypothermic statically stored porcine DCD lungs, possibly improving lung transplant outcomes.