Indexed in MEDLINE, PubMed, and PubMed Central PRSRT STD US POSTAGE National Library of Medicine PAID 500 NE Multnomah St, Suite 100 PORTLAND OR PERMIT NO 1452 Portland, Oregon 97232 21 No. 3 — Summer 2017 Volume Change Service Requested Summer 2017 Volume 21 No. 3 A peer-reviewed journal of medical science, social science in medicine, and medical humanities Original Research & Contributions 4 Body Mass Index and Mortality in a Very Large Cohort: Is It Really Healthier to Be Overweight? 12 Effect of Age on Outcomes of Shoulder Arthroplasty 17 Nasopharyngeal Carcinoma Diagnostic Challenge in a Nonendemic Setting: Our Experience with 101 Patients 22 Incidence of Pulmonary Arterial Hypertension in Patients with Psoriasis: A Retrospective Cohort Study THE PERMANENTE JOURNAL 28 Complementary and Alternative Medicine in an Integrated Health Care Delivery System: Users of Chiropractic, Acupuncture, and Massage Services CLINICAL MEDICINE 34 Impact of Longitudinal Electronic Health Record Training for Residents Preparing for Practice in Patient-Centered Medical Homes Case Reports Image Diagnosis 40 Mortality After Total Knee and Total Hip Arthroplasty in a Large Integrated Health Care System 67 Use of a Technetium99m-Sestamibi Scan to Detect 80 Image Diagnosis: Multivessel Percutaneous Coronary Ipsilateral Double Adenoma in a Patient with Primary Intervention in Dextrocardia: Success with Usual Special Reports Hyperparathyroidism: A Case Report Techniques in a Case of Mirror-Image Heart 46 Physician Guide to Appropriate Opioid Prescribing for Noncancer Pain 70 A Clinical Approach to Animal Bites with an Avulsion 82 Image Diagnosis: A Gastric Signet-Ring Adenocarcinoma Flap: A Case Report of Type Linitis Plastica Mimicking Splenomegaly in a 53 The Kaiser Permanente Northern California 72 Splenic Abscess in Immunocompetent Patients Managed Patient with Chronic Lymphocytic Leukemia Enhanced Recovery After Surgery Program: Design, Primarily without Splenectomy: A Series of 7 Cases 84 Image Diagnosis: Rapidly Enlarging Scrotal Hematoma: Development, and Implementation A Complication of Femoral Access? 78 Flood Syndrome: Spontaneous Umbilical Hernia Rupture Review Articles Leaking Ascitic Fluid—A Case Report 86 Image Diagnosis: Iliopsoas Abscess from Crohn Disease O Small-Bowel Intussusception in a Pregnant Woman: O Image Diagnosis: Carcinoid Tumorlets and Pulmonary 62 Supporting Muslim Patients During Advanced Illness A Case Report Sequestration in a Patient With Chronic Cough Commentary O Pembrolizumab-Induced Pancytopenia: A Case Report Without a History of Malignancy 88 Considerations in the Neuropsychological Evaluation O Image Diagnosis: Bronchial O Well-Differentiated Neuroendocrine Tumor—A Low and Treatment of Children with Limited English Anthracofibrosis— ebrat b-Grade Tumor’s Aggressive Course and Dismal Outcome: el ing C 2 Proficiency A Bronchoscopic Diagnosis 0 A Case Report y e a 90 To Err is Human: Can American Medicine Learn r s from Past Mistakes? 95 The Patient-Centered Medical Home as a Community-based Strategy 1997–2017 O = content available online at: www.thepermanentejournal.org. Editorial 100 Philanthropy and Beyond: Creating Shared Value to Promote Well-Being for Individuals in Their Communities Narrative Medicine Printed on acid-free paper. 105 Lessons Learned in War 107 Deer in the Headlights The Permanente Journal 109 Abdominal Distension—An Unexpected Gift Summer 2017 Volume 21 No. 3 ISSN 1552-5767 BOOKS PUBLISHED BY PERMANENTE AUTHORS: Summer 2017/ Volume 21 No. 3 The ORIGINAL RESEARCH arterial hypertension (PAH) developing in PermanenteJournal the severe psoriasis cohort vs their con- Gestational Diabetes During & CONTRIBUTIONS and After Pregnancy Sponsored by the National Permanente trols. The systemic inflammatory process 4 Body Mass Index and Mortality in a Very Catherine Kim; Assiamira Ferrara Medical Groups underlying psoriasis may be a cause for Large Cohort: Is It Really Healthier to an increased risk of PAH, but there are ISBN-10: 1848821190 Be Overweight? Arthur L Klatsky, MD; numerous secondary causes of PAH. Mission: The Permanente Journal advances Jasmine Zhang; Natalia Udaltsova, PhD; ISBN-13: 978-1848821194 knowledge in scientific research, clinical Yan Li, MD, PhD; H Nicole Tran, MD, PhD 28 Complementary and Alternative Medicine in an Integrated Health Care New York, NY: Springer; 2011 medicine, and innovative health care delivery. This retrospective cohort study in a multi- Hardcover: 394 pages racial population of 273,843 persons used Delivery System: Users of Chiropractic, Acupuncture, and Massage Services. $119.00 Circulation: 25,000 print readers per logistic regression with 7 covariates (sex, age, race-ethnicity, education, marital Tracy McCubbin, MD; Karin L Kempe, MD, quarter, 7620 eTOC readers, and in 2016, status, smoking, alcohol intake). With av- MPH; Arne Beck, PhD 1.4 million page views on TPJ articles erage follow-up exceeding 30 years, there From 2007-2014, 27,225 patients sought in PubMed from a broad international were 103,218 deaths: 41,215 attributed to Center for Complementary Medicine readership. cardiovascular causes and 62,003 to non- (CCM) services (62% female, 73% white). cardiovascular causes. Compared with Modalities included chiropractic (67%), Calamity Jane: persons with body mass index defined as acupuncture (18%), and massage (15%). How the West Began normal, persons who were underweight, Spine/truncal pain was most commonly Bryan Ney overweight, and obese were at increased reported (71%). Of patients, 59% saw risk of death during a 30-year period. their physician for their condition; 59% ISBN-10: 0997747803 had not used CCM services previously; ISBN-13: 978-0997747805 12 Effect of Age on Outcomes of Shoulder and 60% received medications for their Arthroplasty. Oke A Anakwenze, MD; condition. Mean ratings included pain Pampano Beach, FL: Tameem Yehyawi, MD; Mark T Dillon, MD; relief with prior treatment (30%), current Dragon Tree Books; 2016 Elizabeth Paxton, MA; Ronald Navarro, pain (4.33), and functional impairment Paperback: 186 pages MD; Anshuman Singh, MD ranging from 3.03 for relationships to 5.42 $10.99 In a retrospective cohort study of prospec- for enjoyment of life. tively collected data, using an integrated health care system’s shoulder arthroplasty 34 Impact of Longitudinal Electronic Health (SA) registry (1/2007-6/2012), patients Record Training for Residents Preparing were grouped into older (> 75 years) and for Practice in Patient-Centered Medical If you are a Permanente author and would like your book cited here, younger groups (≤ 75 years). The total Homes. Jung G Kim, MPH, CPH; Hector P send an e-mail to [email protected]. SA cohort had 2007 patients, 538 (27% Rodriguez, PhD, MPH; Katherine AT Estlin, MD; Carl G Morris, MD, MPH ON THE COVER: > age 75 years), and the reverse total Reed Flute Cave SA cohort had 568 patients, 295 (52%) The patient-centered medical home photograph age > 75 years. In the total SA cohort, (PCMH) electronic health record (EHR) By David D Clarke, MD older patients had higher risk of readmis- training consisted of case-based routine sion and mortality. In the reverse total clinic visits delivered to 3 resident cohorts The elaborate natural limestone formations in Reed SA cohort, older patients had lower risk (N = 18). Participants (127) completed Flute Cave, in Guilin, Guangxi, China, attract many of revision. an EHR competency self-assessment visitors to the area with their diversity and beauty. (2011-2016). Comprehensive training de- 17 Nasopharyngeal Carcinoma Diagnostic signed to improve EHR competencies for The cover of the first issue of The Permanente Challenge in a Nonendemic Setting: practicing in a PCMH resulted in improved Journal, Summer 1997, featured Dr Clarke’s Our Experience with 101 Patients. assessment scores. Findings indicate photograph of body pigments for sale in a Kevin H Wang, MD; Stephanie A Austin, EHR training as part of resident exposure Kathmandu, Nepal market. Twenty years later, MD; Sonia H Chen, MD; David C Sonne, to the PCMH measurably improves self- we are proud to be publishing high-quality articles MD; Deepak Gurushanthaiah, MD assessed competencies, even among graced by high-quality art. A retrospective chart review (2007-2010) residents less engaged in EHR training. included 101 patients; 70 were of Chinese IHI AD TO or Southeast Asian descent. Median time GO HERE from symptom onset to treatment was 6 months. One-third of cancers were missed with nasal endoscopy and imag- ing. An understanding of the risk factors, 111 BOOK REVIEW presenting symptoms, and limitations 112 CME EVALUATION FORM associated with these diagnostic tests is necessary to support earlier detection of SOUL OF THE HEALER this insidious cancer. 16 Lisbon 22 Incidence of Pulmonary Arterial Samuel H Glassner, MD Hypertension in Patients with Psoriasis: 33 The Mercantile Truck A Retrospective Cohort Study. April M Day, MD Young M Choi, MD; Shannon Famenini, MD; 45 Sherbrooke Cemetery, Jashin J Wu, MD North Dakota The Permanente Journal In a retrospective cohort study (1/2004- Stephen C Henry, MD 11/2012), there were 10,115 patients 500 NE Multnomah St, Suite 100 69 Plitvice Falls with mild psoriasis, 3821 with severe Portland, Oregon 97232 Boardwalk Panorama psoriasis, and 69,360 matched controls. David D Clarke, MD www.thepermanentejournal.org On multivariable analysis, there was a ISSN 1552-5767 significantly increased risk of pulmonary 77 Bobcat, Los Gatos, California J Richard Gaskill, MD For information