Practice Management Book

http://www.fpnotebook.com/

Medical Literature

Aka: Medical Literature, Patient Oriented Evidence that Matters, Disease Oriented Evidence, POEMS, DOE
  1. Approach: Patients
    1. Discuss evidence with patients regarding absolute risk (not Relative Risk) or as Number Needed to Treat
    2. Example
      1. Statin related Relative Risk of Diabetes Mellitus 9%
      2. However the absolute risk is increased only 0.4% from 4.5 to 4.9%
      3. Number needed to harm: 100/0.4 or one in 250
    3. References
      1. (2017) Presc Lett 24(10): 59
  2. General
    1. Always assess validity
    2. Focus reading on Peer Reviewed Journals (examples follow)
      1. Annals of Internal Medicine
      2. ACP Journal Review
      3. Journal Watch
      4. Pediatrics
      5. Green Journal (ACOG)
      6. Postgraduate Medicine
      7. American Family Physician
      8. New England Journal
      9. JAMA
    3. Approach literature in hierarchical pattern
      1. Scan Table of Contents
      2. Read Appropriate Abstracts (Small list)
      3. Read Appropriate articles (Smaller list)
  3. Types: Articles
    1. POEMS (Patient Oriented Evidence that Matters)
      1. Concentrate on these articles!
      2. Studies that look at illnesses
        1. Direct bearing on patient outcomes
        2. Problems common to your practice
        3. Information that will change the way you practice
    2. DOE (Disease Oriented Evidence)
      1. Understanding of pathophysiology, and pharmacology
  4. Resources: General Evidence-Based Guidelines and Databases
    1. Cochrane Collaboration
      1. http://www.cochrane.org
    2. Institute for Clinical Systems Improvement
      1. http://www.icsi.org
    3. National Guideline Clearing House
      1. http://www.guidelines.gov
  5. Resources: Literature Reviews and Summaries
    1. American College of Physicians Journal Club
      1. http://www.acpjc.org
      2. Subscription: 30 article reviews per issue published twice monthly
    2. Bandolier
      1. http://www.medicine.ox.ac.uk/bandolier
      2. Free: British Online newsletter reviews evidence-based answers to clinical questions
    3. BMJ Evidence Centre Updates
      1. http://plus.mcmaster.ca/evidenceupdates
      2. Free: Weekly email summarizing several articles
    4. Daily POEMs Alerts
      1. http://www.essentialevidenceplus.com/product/features_dailyip.cfm
      2. Subscription: One article review emailed daily
    5. Evidence-Based Practice
      1. http://www.ebponline.net
      2. Subscription
    6. Journal Watch
      1. http://www.jwatch.org
      2. Subscription: Article reviews published in two issues monthly
  6. Resources: Medication Reviews
    1. Medical Letter
      1. http://www.medicalletter.org/
      2. Subcription: Thorough individual medication and drug class reviews
    2. Prescriber's Letter
      1. http://www.prescribersletter.com/
      2. Subscription: Paragraphs summarizing new findings with links to online in-depth reports
  7. Resources: Other
    1. MLA Brandon/HIll Online Journal Links
      1. http://nnlm.gov/libinfo/ejournals/branhill.html
    2. Turning Research Into Practice
      1. http://www.tripdatabase.com
      2. Evidence-based answers to clinical questions via multi-site search
  8. Reference
    1. Shaugnessy (1997) Am Fam Physician 55(6): 2155-60 [PubMed]
    2. Shaugnessy (2009) Am Fam Physician 79(1): 25-6 [PubMed]

POEMS Syndrome (C0085404)

Definition (NCI) A syndrome characterized by polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes. It is often associated with osteosclerotic myeloma.
Definition (MSH) A multisystemic disorder characterized by a sensorimotor polyneuropathy (POLYNEUROPATHIES), organomegaly, endocrinopathy, monoclonal gammopathy, and pigmentary skin changes. Other clinical features which may be present include EDEMA; CACHEXIA; microangiopathic glomerulopathy; pulmonary hypertension (HYPERTENSION, PULMONARY); cutaneous necrosis; THROMBOCYTOSIS; and POLYCYTHEMIA. This disorder is frequently associated with osteosclerotic myeloma. (From Adams et al., Principles of Neurology, 6th ed, p1335; Rev Med Interne 1997;18(7):553-62)
Concepts Disease or Syndrome (T047)
MSH D016878
SnomedCT 79268002
English Crow Fukase Syndrome, Crow-Fukase Syndrome, POEMS Syndrome, Syndrome, Crow-Fukase, Syndrome, POEMS, Syndrome, Takatsuki's, Takatsuki Syndrome, Takatsuki's Syndrome, POEMS - Poly org endo mono syn, POEMS - Polyneurpath organomegal endocrinop moncl+skin chan, Polyn orgomeg endoc monoclon s, Polyneuropathy organomegaly endocrinop monoc gam+skin chang, POEMS syndrome (disorder), Polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes (POEMS) syndrome, POEMS, POEMS syndrome (diagnosis), POEMS Syndrome [Disease/Finding], Polyneuropathy, Organomegaly, Endocrinopathy, M Protein, and Skin Changes Syndrome, Polyneuropathy Organomegalies, Organomegaly, Polyneuropathy, Polyneuropathy Organomegaly, Organomegalies, Polyneuropathy, crow-fukase syndrome, poem syndrome, poems syndrome, Polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes (POEMS) syndrome (disorder), Polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes syndrome (disorder), Polyneuropathy, organomegaly, endocrinopathy, M-protein, and skin changes, Crow-Fukase syndrome, POEMS syndrome, POEMS - Polyneuropathy organomegaly endocrinopathy monoclonal and skin changes, Polyneuropathy organomegaly endocrinopathy monoclonal gammopathy and skin changes, Polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes syndrome, Polyneuropathy organomegaly endocrinopathy monoclonal gammopathy and skin changes (disorder)
Japanese POEMS症候群, クロウ・深瀬症候群, クロウフカセショウコウグン, POEMSショウコウグン, Crow-深瀬症候群, Crow-Fukase症候群, POEMS症候群, 多発ニューロパチー・臓器肥大・内分泌障害・M蛋白および皮膚病変, タハツニューロパチーゾウキヒダイナイブンピツショウガイMタンパクオヨビヒフビョウヘン, タハツニューロパチーゾウキヒダイナイブンピショウガイMタンパクオヨビヒフビョウヘン, クロウ-深瀬症候群, 高月病, 高月症候群
Swedish POEMS-syndrom
Spanish síndrome de polineuropatía, organomegalia, endocrinopatía, gammapatía monoclonal y cambios cutáneos (POEMS), síndrome POEMS (trastorno), síndrome de polineuropatía, organomegalia, endocrinopatía, gammapatía monoclonal y cambios cutáneos (POEMS) (trastorno), síndrome de polineuropatía, organomegalia, endocrinopatía, gammapatía monoclonal y cambios cutáneos (trastorno), Polineuropatía, organomegalia, endocrinopatía, proteína M y cambios cutáneos, síndrome POEMS, síndrome de polineuropatía, organomegalia, endocrinopatía, gammapatía monoclonal y cambios cutáneos, síndrome de polineuropatía, organomegalia, endocrinopatía, gammapatía monoclonal y modificaciones de la piel, Síndrome de Crow-Fukase, Síndrome de Takatsuki, Síndrome POEMS
Czech Crow-Fukase syndrom, syndrom POEMS, Takatsuki syndrom, Crow-Fukasův syndrom, POEMS syndrom, Myelom s nervovými poruchami, organomegalií, endokrinopatií, kožními změnami
Finnish POEMS-oireyhtymä
Russian TAKATZUKI SINDROM, POEMS SINDROM, POEMS СИНДРОМ, ТАКАТЗУКИ СИНДРОМ
Italian Sindrome di Takatsuki, Sindrome di Crow-Fukase, Polineuropatia, organomegalia, endocrinopatia, proteina M e variazioni cutanee, Sindrome POEMS
Polish Zespół Crow-Fukase, Zespół Takatsuki, Zespół POEMS
Hungarian Crow-Fukase syndroma, POEMS-syndroma, Polyneuropathia, organomegalia, endocrinopathia, M-protein és bőrelváltozások
Norwegian Syndrom med polynevropati, organomegali, endokrinopati, monoklonal gammopati og hudforandringer, POEMS-syndrom
Dutch polyneuropathie, organomegalie, endocrinopathie, M-proteïne en huidafwijkingen, Crow-Fukase-syndroom, POEMS-syndroom, Syndroom, POEMS-, Takatsuki-syndroom
French Polyneuropathie, organomégalie, endocrinopathie, Protéine M et signes cutanés, Syndrome POEMS, Syndrome de Crow-Fukase, Syndrome de Takatsuki
German Polyneuropathie, Organomegalie, Endokrinopathie, M-Protein- und Hautveraenderungen, POEMS Syndrom, Crow-Fukase-Syndrom, POEMS-Syndrom, Takatsuki-Syndrom
Portuguese Polineuropatia, organomegalia, endocrinopatia, proteína M e alterações da pele, Síndrome de POEMS, Síndrome de Crow-Fukase, Síndrome de Takatsuki, Síndrome POEMS
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Does - Ability interpretation value (C1272751)

Concepts Finding (T033)
SnomedCT 371155004, 385640009
English Able to and does, Does - Ability interpretation value, Demonstrates ability, Able to and does (qualifier value), Does (qualifier value), Does
Spanish es capaz y lo realiza (calificador), lo realiza (calificador), es capaz y lo realiza, lo realiza, lo hace (calificador), lo hace
Sources
Derived from the NIH UMLS (Unified Medical Language System)


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