The Value in Verifying Medical Folklore

Citing a related article published within this issue of the Journal of Patient-Centered Research and Reviews, the author opines on why traditional ideas regarding human health can persist over decades, and even centuries, despite a lack of scientifically accumulated evidence. It is important to keep in mind that some commonly accepted truths are supported by little to no factual data, and that occasionally patients may benefit from clarification on what is (or, often, is not) actually known about longstanding “rules of thumb” (eg, certain home remedies, disease-prevention measures or behavioral concerns). On the flip side, traditions that are shown to be not harmful, like drinking chicken soup to relieve cold symptoms, may be safely indulged regardless of effectiveness

Freshwater Fungal Infections

Fungal infections as a result of freshwater exposure or trauma are fortunately rare. Etiologic agents are varied, but commonly include filamentous fungi and Candida. This narrative review describes various sources of potential freshwater fungal exposure and the diseases that may result, including fungal keratitis, acute otitis externa and tinea pedis, as well as rare deep soft tissue or bone infections and pulmonary or central nervous system infections following traumatic freshwater exposure during natural disasters or near-drowning episodes. Fungal etiology should be suspected in appropriate scenarios when bacterial cultures or molecular tests are normal or when the infection worsens or fails to resolve with appropriate antibacterial therapy

Fungal Infections From Human and Animal Contact

Fungal infections in humans resulting from human or animal contact are relatively uncommon, but they include a significant proportion of dermatophyte infections. Some of the most commonly encountered diseases of the integument are dermatomycoses. Human or animal contact may be the source of all types of tinea infections, occasional candidal infections, and some other types of superficial or deep fungal infections. This narrative review focuses on the epidemiology, clinical features, diagnosis and treatment of anthropophilic dermatophyte infections primarily found in North America. Other human-acquired and zoonotic fungal infections also are discussed in brief

Limiting Antibiotic Use in Acute Sinusitis: Partly a Matter of Vocabulary?

In his issue introduction, the editor-in-chief of Journal of Patient-Centered Research and Reviews comments on an included article that describes the successful use of an electronic medical record best practice alert to reduce the rate of antibiotic prescription for acute sinusitis. Various methods previously tried to improve antibiotic stewardship in this illness are briefly reviewed. Borrowing on the model of acute bronchitis, it is suggested that a change in conveyed diagnostic vocabulary to “sinus cold” when describing acute sinusitis may help limit antibiotics for this predominantly viral infection

Defining Patient-Oriented Research for the Average Person (and Potential Research Partner)

In this introduction to the first issue of 2019, the editor-in-chief of Journal of Patient-Centered Research and Reviews offers additional context to the findings of Kaur and Pluye (p. 7), who methodically formalized an operational definition of patient-oriented research for the purposes of searching bibliographic databases. A possible succinct, lay definition of patient-oriented research for the average “person on the street” is proposed

Did You Hear What I Meant to Say?

The author introduces Volume 4, Issue 1 of Journal of Patient-Centered Research and Reviews by acknowledging the importance of communication between patient and caregiver in the clinical setting. Failure to communicate effectively can have a negative impact on a patient's well-being, therefore efforts to improve communication skills among clinicians, researchers and health practice administrators should be undertaken with regularity

Asking Questions, Seeking Improvements

The author connects the rapid growth of scientific journals to the inquisitiveness of committed health professionals and their persistent efforts to improve patient care

Cutline: 1981-82 scholarship winner - Ronan

Background: Self-management support has been shown to improve clinical outcomes. Health coaching, one form of self-management support, empowers patients within the health care system by providing information and through collaboratively developed care plans. Purpose: Assess the impact of The Lifestyle Initiative, a coaching-based health program utilized by Aurora Health Care caregivers or family members. Methods: The Lifestyle Initiative is a coaching-based approach for Aurora caregivers or family members enrolled in Aurora’s health insurance network. Individuals were recruited from the care management database, and all participants had an Aurora primary care provider. Participation was limited to those ≥ 18 years of age who had a diagnosis of type 2 diabetes or hypertension (or both), had glycated hemoglobin (A1c) ≤ 8.0, and were not on insulin. The Lifestyle Initiative was rolled out in three phases. Phase I: health coaching sessions through a standard web- and app-based platform (Noom Health), and access to a stress-management program (HeartMath). Phase II: health coaching sessions through a standard web- and app-based platform co-created by Aurora’s Department of Integrative Medicine and Noom Health, and access to HeartMath; Phase III: health coaching sessions through a standard web- and app-based platform (Noom Health), and a customized web- and app-based platform. Those enrolled in each phase acted as their own controls. Paired t-tests were used to compare pre- and postintervention results of each phase. Results: The majority of Phase I participants (n = 23; mean age 54.4 years) were female (91.3%) and white (52.2%). Preintervention A1c and blood pressure were not statistically different postintervention. However, pre- vs postintervention weights were statistically different (228.2 vs 218.5 lb; P \u3c 0.01), as well as pre- vs postintervention body mass index (37.3 vs 35.7 kg/m2; P \u3c 0.01). The majority of Phase II participants (n = 63; mean age 54.8 years) also were female (81.0%) and white (88.9%). Pre- and postintervention blood pressures were not statistically different. However, pre- vs postintervention A1c (7.2 vs 6.6; P \u3c 0.02), weights (229.6 vs 225.7 lb; P \u3c 0.05), and body mass index (37.1 vs 36.5 kg/m2; P \u3c 0.05) were statistically improved. Phase III data collection is underway. Conclusion: The Lifestyle Initiative health coaching program significantly improves certain health metrics when applied to health system employees and family members with diabetes or hypertension. Further study is needed to explore sustainability and the effects of more robust programs

Primary Care for Melanoma: Should We Be Screaming for Screening?

The incidence of cutaneous malignant melanoma continues to rise in the United States. This deadly disease is potentially curable if caught at an early stage, however screening programs remain controversial. The United States Preventive Services Task Force cites insufficient evidence to recommend screening, by total-body skin examination (TBSE), for early detection of cutaneous melanoma. While definitive studies may be cost-prohibitive in the United States, more recent evidence suggests that organized programs to increase TBSE reduce mortality from melanoma. The positive impact of TBSE, and education regarding risk reduction and skin self-examination, is most likely to be cost-effective in high-risk patients such as middle-aged and older men. This population also includes those with changing moles or those who always or usually sunburn; those with melanoma in a first-degree relative, or dysplastic nevi or extensive moles; and those with high-risk ultraviolet (UV) exposure or other risk factors. The role of new technology, such as in-office and in-home dermoscopy, continues to evolve. Primary care clinicians are challenged in everyday practice to appropriately prioritize TBSE and empower their patients for “skin awareness” and self-detection of melanoma