The Permanente journal最新文献

{"title":"Immunoglobulin A Nephropathy: A Review.","authors":"Sulaiman Aseem, Sijie Zheng","doi":"10.7812/TPP/24.089","DOIUrl":"10.7812/TPP/24.089","url":null,"abstract":"<p><p>Immunoglobulin A nephropathy is a primary glomerulopathy, with prevalence ranking highest in the Pacific region, followed closely by Europe, but rare in Africa. Although practice patterns likely have contributed to its prevalence, there are genetic and environmental factors that contribute as well. Management has evolved over the past decade, with recent rapid advances in diagnosis, prognosis, and therapies. This review summarizes the history, pathogenesis, and diagnosis of immunoglobulin A nephropathy and also cites relevant clinical trials, latest treatment options, and unanswered questions.</p>","PeriodicalId":23037,"journal":{"name":"The Permanente journal","volume":" ","pages":"87-94"},"PeriodicalIF":0.0,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11648327/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142583606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Introduction to Issue 28:4 by the Editor-in-Chief.","authors":"G Richard Holt","doi":"10.7812/TPP/24.188","DOIUrl":"10.7812/TPP/24.188","url":null,"abstract":"","PeriodicalId":23037,"journal":{"name":"The Permanente journal","volume":"28 4","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11648330/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relativity, Rank, and the US News Health's Cardiology, Heart, and Vascular Surgery Best Hospitals.","authors":"Alexandra Kats, Gordon H Morewood, George Moser, Eric Wilkens, Huaqing Zhao, Abul Kashem, Yoshiya Toyoda, Suyog Mokashi","doi":"10.7812/TPP/24.116","DOIUrl":"10.7812/TPP/24.116","url":null,"abstract":"<p><strong>Objective: </strong>Virtually anything can be ranked; the <i>US News and World Report</i> (USNWR or US News) ranks the top 50 hospitals specializing in cardiology, heart, and vascular surgery. Here the authors propose validating the effectiveness of rankings by comparing differences among the USNWR metrics across the top 50 hospitals.</p><p><strong>Methods: </strong>The ranking system for the top 50 hospitals specializing in cardiology, heart, and vascular surgery was derived from 16 variant scores. Each hospital's scores were collected from the USNWR. Hospitals were categorized into quintiles consisting of 10 institutions (1-10, 11-20, etc). An analysis of variance/χ² comprehensive statistical analysis was run alongside a Wilcoxon/Kruskal-Wallis test to compare statistical outcomes. A significant threshold was deemed to be <i>P</i> < 0.05.</p><p><strong>Results: </strong>Significant differences were noted between quintiles for advanced technologies (<i>P</i> = 0.05), US News specialty score (<i>P</i> < 0.001), number of patient referrals (<i>P</i> = 0.004), and expert opinion (<i>P</i> < 0.001). Non-statistically significant differences were found among patient experience, public transparency, Society of Thoracic Surgery transparency, American College of Cardiology transparency, recognition as a magnet hospital, and nursing staffing. Interestingly, a large variance was noted in the average number of referrals between the first quintile (13,371) and the last (6690).</p><p><strong>Conclusions: </strong>Expert opinion plays a critical role in the reputation of the USNWR's top 10 hospitals in cardiology, heart, and vascular surgery. Although many have argued about the merits of USNWR hospital rankings, taken together, rankings fill a strong customer demand and are sticky.</p>","PeriodicalId":23037,"journal":{"name":"The Permanente journal","volume":" ","pages":"48-56"},"PeriodicalIF":0.0,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11648326/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142475434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Squamous Cell Carcinoma of the Nail Bed.","authors":"Aisha S Chaudhry, Jane W Shiu, Nivia S Varela, George W Newton, Edward J Durant","doi":"10.7812/TPP/23.138","DOIUrl":"10.7812/TPP/23.138","url":null,"abstract":"","PeriodicalId":23037,"journal":{"name":"The Permanente journal","volume":" ","pages":"103-106"},"PeriodicalIF":0.0,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11648325/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142296127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Comparison of In-Person and Telemedicine Triage in Otolaryngology.","authors":"Jacob E Hoerter, Peter M Debbaneh, Kalena Liu, Swapnil Shah, Miranda Weintraub, Nancy Jiang","doi":"10.7812/TPP/24.077","DOIUrl":"10.7812/TPP/24.077","url":null,"abstract":"<p><strong>Introduction: </strong>The integration of virtual visits has been met with skepticism by many surgical specialties, including otolaryngology, due to the lack of a complete physical exam. Analysis of differences in the workup between patients triaged virtually or in-person is warranted.</p><p><strong>Methods: </strong>A chart review was performed for a cohort of adults undergoing septoplasty (January 2021-May 2022). Groups (telemedicine, in-person) were compared by 2-sample <i>t</i>-test and chi-square test to determine the difference in the number of preoperative visits and to assess the variation in patients with preoperative laboratory testing, imaging, or referrals.</p><p><strong>Results: </strong>Of 338 patients, initial evaluation was in-person for 225 (66.5%) and via telemedicine for 113 (33.5%). The groups were similar in demographics (mean age 39.1 years for telemedicine vs 38.8 years for in-person, female 28.9% vs male 37.7%, <i>P</i> = 0.088). The telemedicine group had a significantly higher number of preoperative visits (3.03) compared to the in-person group (2.38, <i>P</i> = 0.001). There was no significant difference in patients who underwent preoperative laboratory testing, imaging, or referrals. Patients triaged via telemedicine experienced a shorter time to surgery compared to those triaged in person (434 vs 208, <i>P</i> = 0.003).</p><p><strong>Discussion: </strong>In this cohort, triage by telemedicine allowed otolaryngology patients to have an expedited path to surgery despite having more visits. There is no evidence to suggest that otolaryngologists had an overreliance on diagnostic modalities when triaging by telemedicine.</p><p><strong>Conclusion: </strong>Among patients undergoing septoplasty, those initially evaluated by telemedicine were more likely to have more preoperative visits and shorter time to surgery than those evaluated in person. Telemedicine can serve as an effective method for triaging surgical patients without excess diagnostics.</p>","PeriodicalId":23037,"journal":{"name":"The Permanente journal","volume":" ","pages":"31-37"},"PeriodicalIF":0.0,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11648324/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142296123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of the Graphic Memoir <i>My Degeneration: A Journey Through Parkinson's</i> on Patients With Parkinson's Disease: A Mixed Methods Study.","authors":"Michael J Green, Sol De Jesus, Daniel R George, Margaret Hopkins, Erik Lehman, Lauren Van Scoy, Bethany Snyder, Kimberly R Myers","doi":"10.7812/TPP/23.184","DOIUrl":"10.7812/TPP/23.184","url":null,"abstract":"<p><strong>Introduction: </strong>Understanding the lived experience of illness is important for empowering patients and informing health care practitioners. This study investigated the impact of a book-length comic memoir, <i>My Degeneration: A Journey Through Parkinson's</i>, by Peter Dunlap-Shohl, on patients' mental health, knowledge, and attitudes about living with Parkinson's disease (PD). The authors further explored which patients found the book to be beneficial and why.</p><p><strong>Methods: </strong>In this convergent mixed methods study, patients with PD were recruited from a multidisciplinary movement disorders clinic in 2019-2020 and were eligible if cognitively intact; English-speaking; had stage I, II, or III PD; and < 12 months had elapsed since diagnosis. Participants received <i>My Degeneration</i> to read at home, measures were obtained pre- and postintervention, and participants were interviewed within approximately 1 month.</p><p><strong>Results: </strong>Thirty participants completed the study (13 males and 17 female; mean age = 59 years). Four qualitative themes emerged: Reading <i>My Degeneration</i> 1) validated the experience of living with PD, 2) reinforced practical behaviors that support well-being, 3) provided insight about the illness experience, and 4) was emotionally and physically taxing. There were no statistically significant pre-/postintervention changes in knowledge, self-efficacy, hope, or emotional distress. Book \"endorsers\" appreciated Dunlap-Shohl's dark humor and resonated with his experience; \"detractors\" found the book to be blunt and sometimes frightening.</p><p><strong>Discussion/conclusion: </strong>Participants who liked the book-the \"endorsers\"-revealed that it deeply resonated with them and helped them realize they were not alone with the disease. Many commented that Dunlap-Shohl's story was in some ways their story-and that this was both practically and emotionally reassuring. <i>My Degeneration</i> has the potential to benefit patients who appreciate comics, enjoy dark humor, and are not overly pessimistic.</p>","PeriodicalId":23037,"journal":{"name":"The Permanente journal","volume":" ","pages":"65-76"},"PeriodicalIF":0.0,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11648332/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142141185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cervical Cancer Screening: Patient Perspectives on Transitioning to Primary High-Risk Human Papillomavirus Testing Alone.","authors":"Larissa L White, Shauna R Goldberg, Alison G Escobar, Brian Hixon, Chun R Chao, Erin E Hahn, Devansu Tewari, Brian S Mittman, Heather Spencer Feigelson","doi":"10.7812/TPP/24.076","DOIUrl":"10.7812/TPP/24.076","url":null,"abstract":"<p><strong>Introduction: </strong>In 2018, the US Preventive Services Task Force updated cervical cancer screening recommendations to allow for screening every 5 years with primary human papillomavirus (HPV) testing in combination with cytology (cotesting) or every 5 years with primary HPV screening alone. Despite these changes, the uptake of primary HPV screening has been lower than expected. The purpose of this study was to evaluate the patient perspective of an integrated health system transition from cotesting to primary HPV testing among a 30- to 65-year-old cohort.</p><p><strong>Methods: </strong>Semistructured phone interviews were conducted from July to December 2023 at Kaiser Permanente Colorado with 16 members aged 30-65 years. Interviews asked about reactions to the forthcoming change in cervical cancer screening, personal concern about cervical cancer risk, feedback on patient-facing education materials, and preference on communication timing and modality.</p><p><strong>Results: </strong>Participants reported concerns about cervical cancer screening intervals, primarily the reduction in frequency leading to underdiagnosis of sexually transmitted infections (STIs). Participants recommended defining the rationale for the change to primary HPV testing in the patient education materials. Participants preferred communication about the change in-clinic between practitioner and patient.</p><p><strong>Discussion: </strong>The interviews identified key themes, including the differentiation between cervical cancer and STI screening methodologies, potential underdiagnosis of STI and cervical cancer, and the rationale supporting primary HPV testing and associated screening intervals.</p><p><strong>Conclusion: </strong>These qualitative findings can inform health systems of potential patient concerns to address when considering the transition from cotesting every 3 years to primary HPV testing every 5 years for cervical cancer screening.</p>","PeriodicalId":23037,"journal":{"name":"The Permanente journal","volume":" ","pages":"57-64"},"PeriodicalIF":0.0,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11648333/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142508516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of Obesity Medications in the Era of GLP-1 Agonists: An Expert Panel Discussion.","authors":"Jamy Ard, Lydia Alexander, Daniel Bessesen, Karlijn Burridge, Sean Hasan Hashmi","doi":"10.7812/TPP/24.176","DOIUrl":"10.7812/TPP/24.176","url":null,"abstract":"","PeriodicalId":23037,"journal":{"name":"The Permanente journal","volume":" ","pages":"7-19"},"PeriodicalIF":0.0,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11648321/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142802231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Delusional Parasitosis in a Patient With a History of COVID-19 and Substance Use Disorder.","authors":"Jami Wang, Brian Kato, Samantha Li, Davin A Agustines","doi":"10.7812/TPP/24.006","DOIUrl":"10.7812/TPP/24.006","url":null,"abstract":"<p><p>Delusional parasitosis is a psychotic disorder that manifests as a belief that the skin is infested with parasites. This case report documents the association between COVID-19 infection and new-onset delusional parasitosis superimposed on preexisting psychosis, which has not been previously documented in the current literature. A 28-year-old male presented with new-onset delusional parasitosis superimposed on existing psychosis following COVID-19 infection. Computed tomography scan of the head was unremarkable. He was treated with olanzapine, which appeared to lessen the intensity of the delusions. This case report should encourage increased monitoring of COVID-positive patients with psychosis.</p>","PeriodicalId":23037,"journal":{"name":"The Permanente journal","volume":" ","pages":"100-102"},"PeriodicalIF":0.0,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11648334/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142296124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Kaiser Permanente Los Angeles Annual Research Week 2023: Research as a Pillar for Well-Being in Graduate Medical Education and Beyond.","authors":"Joon S Park, Davida Becker, John J Sim","doi":"10.7812/TPP/23.144","DOIUrl":"10.7812/TPP/23.144","url":null,"abstract":"","PeriodicalId":23037,"journal":{"name":"The Permanente journal","volume":" ","pages":"3-6"},"PeriodicalIF":0.0,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11648319/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142354312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}