Provider Perspectives of Patient Experiences in Primary Care Imaging

This study aimed to explore the perceived impacts imaging tests have on patients from the perspective of the primary care providers (PCPs) and determine PCPs' understanding of patient-centered outcomes (PCOs) from imaging tests. Methods: Recruitment of PCPs occurred at 4 family medicine clinics in Washington and Idaho. Primary care physicians, nurse practitioners, or physician assistants who order imaging tests were eligible to participate. Semistructured interviews explored providers' perceptions of patient experiences during the process of ordering, performing and following up on imaging tests. Classic content analysis generated themes and subthemes. Results: Sixteen PCPs, including 11 physicians, 3 physician assistants, and 2 nurse practitioners, completed interviews. Two themes were identified: 1) perceived PCOs, and 2) factors influencing the incorporation of PCOs into clinical management. Perceived outcomes included emotions related to the answer a test provides and costs to the patient such as monetary, physical, and added risk. Patient expectations, provider-patient communication, and inadequate knowledge all contributed as barriers to incorporating PCOs into clinical management. Discussion: PCPs recognize different outcomes of imaging tests that they consider important for patients. While providers are perceptive to patient outcomes there remains a challenge to how patient outcomes are used to improve care. Communication with patients and improving provider knowle...
Source: Journal of the American Board of Family Medicine - Category: Primary Care Authors: Tags: Original Research Source Type: research

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This study aims to report a literature review considering epidemiological and molecular mechanisms that correlate PCOS and breast cancer, as well as the influence of PCOS treatment on the incidence of breast cancer.Epidemiological studies failed to adjust potential variables that affect the risk and have thus provided inconclusive results. Molecular effects of androgenic pathways in breast cancer have been studied and androgens seem to have an inhibitory effect on mammary epithelial proliferation. However, increased bioavailable androgens were associated with recurrence of breast cancer due to conversion to oestrogens. Sex...
Source: European Journal of Obstetrics and Gynecology and Reproductive Biology - Category: OBGYN Source Type: research
Conclusion: Taken together, substantially elevated serum mannose levels are significantly associated with PCOS, highlighting the importance of further research into the role of mannose in the pathogenesis of PCOS.
Source: Frontiers in Endocrinology - Category: Endocrinology Source Type: research
CONCLUSIONS: A new multicellular, scaffold-free endometrial organoid system was established that resembled physiology of the native endometrium. Excess androgens in PCOS promoted cell proliferation in endometrial organoids, revealing new mechanisms of PCOS-associated with risk of endometrial neoplasia. PMID: 31614364 [PubMed - as supplied by publisher]
Source: The Journal of Clinical Endocrinology and Metabolism - Category: Endocrinology Authors: Tags: J Clin Endocrinol Metab Source Type: research
ConclusionEndometrial cancer, specifically type I endometrioid adenocarcinoma and its precursor lesions are strongly associated with unopposed estrogen states such as polycystic ovarian syndrome (PCOS), obesity as well as nulliparity. Patients seeking assisted reproductive technologies make up a subset of these patients and strongly desire to maintain their fertility. Progesterone therapy for select patients may be a safe and effective temporary treatment for endometrial carcinoma and atypical precursor lesions prior to starting IVF-ET. IVF-ET is very effective in treating such patients.
Source: Journal of Minimally Invasive Gynecology - Category: OBGYN Source Type: research
This study aims to report a literature review considering epidemiological and molecular mechanisms that correlate PCOS and breast cancer, as well as the influence of PCOS treatment on the incidence of breast cancer.Epidemiological studies failed to adjust potential variables that affect the risk and have thus provided inconclusive results. Molecular effects of androgenic pathways in breast cancer have been studied and androgens seem to have an inhibitory effect on mammary epithelial proliferation.
Source: European Journal of Obstetrics, Gynecology, and Reproductive Biology - Category: OBGYN Authors: Tags: Review article Source Type: research
nky E Abstract CONTEXT: Increased prevalence of asthma is reported from epidemiological studies in women with PCOS. OBJECTIVE: To investigate respiratory function in women with PCOS compared to controls in a clinical setting. DESIGN: 8-year clinical follow-up including self-reported asthma diagnoses and spirometry of women with PCOS randomized to metformin or placebo during pregnancy in the original studies (the Pilot and the PregMet-study), compared to matched controls from a population-based cohort study (The HUNT Study). SETTING: Secondary and tertiary care centers. PARTICIPANTS: 145 women w...
Source: The Journal of Clinical Endocrinology and Metabolism - Category: Endocrinology Authors: Tags: J Clin Endocrinol Metab Source Type: research
ConclusionThese results suggest that MHT ameliorates the symptoms of PCOS by improving the dysregulation of ovarian steroids and steroidogenic enzymes in PCOS rats.Graphical abstract
Source: Journal of Ethnopharmacology - Category: Drugs & Pharmacology Source Type: research
Authors: McGowan L, Quinlivan J PMID: 31595811 [PubMed - as supplied by publisher]
Source: Journal of Psychosomatic Obstetrics and Gynaecology - Category: OBGYN Tags: J Psychosom Obstet Gynaecol Source Type: research
New biomarker, anti-Müllerian hormone (AMH), could help in the diagnosis of polcystic ovarian syndrome (PCOS), according to a study published inFrontiers in Endocrinology.Endocrinology Advisor
Source: Society for Endocrinology - Category: Endocrinology Source Type: news
CONCLUSION The therapeutic effect of combined treatment is better than clomifene citrate alone in the treatment of PCOS.RESUMO OBJETIVO Tendo em vista a alta incid ência de síndrome dos ovários policísticos (SOP) e os efeitos terapêuticos insatisfatórios da dimetildiguanida ou do citrato de clomifeno isoladamente, nosso estudo teve como objetivo investigar os efeitos terapêuticos da dimetildiguanida associada ao citrato de clomifeno no tratamento da SOP . MÉTODOS Um total de 79 pacientes com POCS e 35 mulheres saudáveis foram incluídos, e biópsias en...
Source: Revista da Associacao Medica Brasileira - Category: General Medicine Source Type: research
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