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https://www.readbyqxmd.com/read/28415148/the-6-a-s-a-risk-manager-s-guide-to-emergency-cesarean-delivery
#1
Larry Veltman
The allegation of delay in performing an emergency cesarean delivery is common in litigation involving neurological injury to newborns. Analyzing the actual performance of an emergency cesarean involves multiple steps, individuals, and systemic processes that need coordination for appropriate action when necessary. This article gives risk managers a systematic way to evaluate a given perinatal unit's approach to the ability to perform an emergency cesarean through evaluating the 6 "A"s: Assess, Alert, Align, Assemble, Act, and Analyze...
April 2017: Journal of Healthcare Risk Management: the Journal of the American Society for Healthcare Risk Management
https://www.readbyqxmd.com/read/28414152/rituximab-for-immunologic-renal-disease-what-the-nephrologist-needs-to-know
#2
REVIEW
Andreas Kronbichler, Martin Windpessl, Herwig Pieringer, David R W Jayne
Rituximab (RTX), a chimeric, monoclonal anti-CD20 antibody, is increasingly used in immune-mediated renal diseases. While licensed in the induction treatment of ANCA-associated vasculitis, it represents one of the most commonly prescribed off-label drugs. Much of the information regarding its safety has been drawn from experience in hematology and rheumatology. Ample evidence illustrates the safety of RTX, however, rare but serious adverse events have emerged that include progressive multifocal leucoencephalopathy and hepatitis B reactivation...
April 13, 2017: Autoimmunity Reviews
https://www.readbyqxmd.com/read/28405953/angioedema-in-the-emergency-department-a-practical-guide-to-differential-diagnosis-and-management
#3
REVIEW
Jonathan A Bernstein, Paolo Cremonesi, Thomas K Hoffmann, John Hollingsworth
BACKGROUND: Angioedema is a common presentation in the emergency department (ED). Airway angioedema can be fatal; therefore, prompt diagnosis and correct treatment are vital. OBJECTIVE OF THE REVIEW: Based on the findings of two expert panels attended by international experts in angioedema and emergency medicine, this review aims to provide practical guidance on the diagnosis, differentiation, and management of histamine- and bradykinin-mediated angioedema in the ED...
December 2017: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28381249/cardiovascular-care-guideline-implementation-in-community-health-centers-in-oregon-a-mixed-methods-analysis-of-real-world-barriers-and-challenges
#4
Rachel Gold, Arwen Bunce, Stuart Cowburn, James V Davis, Celine Hollombe, Christine A Nelson, Jon Puro, John Muench, Christian Hill, Victoria Jaworski, MaryBeth Mercer, Colleen Howard, Nancy Perrin, Jennifer DeVoe
BACKGROUND: Spreading effective, guideline-based cardioprotective care quality improvement strategies between healthcare settings could yield great benefits, particularly in under-resourced contexts. Understanding the diverse factors facilitating or impeding such guideline implementation could improve cardiovascular care quality and outcomes for vulnerable patients. METHODS: We sought to identify multi-level factors affecting uptake of cardioprotective care guidelines in community health centers (CHCs), within a successful trial of cross-setting implementation of an effective intervention...
April 5, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28366353/comparing-fourier-optics-and-contrast-transfer-function-modeling-of-image-formation-in-low-energy-electron-microscopy
#5
K M Yu, A Locatelli, M S Altman
A theoretical understanding of image formation in cathode lens microscopy can facilitate image interpretation. We compare Fourier Optics (FO) and Contrast Transfer Function (CTF) approaches that were recently adapted from other realms of microscopy to model image formation in low energy electron microscopy (LEEM). Although these two approaches incorporate imaging errors from several sources similarly, they differ in the way that the image intensity is calculated. The simplification that is used in the CTF calculation advantageously leads to its computational efficiency...
March 24, 2017: Ultramicroscopy
https://www.readbyqxmd.com/read/28359011/diagnostic-triage-for-low-back-pain-a-practical-approach-for-primary-care
#6
REVIEW
Lynn D Bardin, Peter King, Chris G Maher
Diagnostic triage is an essential guideline recommendation for low back pain (LBP), which is the most frequent musculoskeletal condition that general practitioners encounter in Australia. Clinical diagnosis of LBP - informed by a focused history and clinical examination - is the key initial step for GPs, and determines subsequent diagnostic workup and allied health and medical specialist referral. The goal of diagnostic triage of LBP is to exclude non-spinal causes and to allocate patients to one of three broad categories: specific spinal pathology (< 1% of cases), radicular syndrome (∼ 5-10% of cases) or non-specific LBP (NSLBP), which represents 90-95% of cases and is diagnosed by exclusion of the first two categories...
April 3, 2017: Medical Journal of Australia
https://www.readbyqxmd.com/read/28334561/determining-current-insulin-pen-use-practices-and-errors-in-the-inpatient-setting
#7
Katelyn E Brown, John B Hertig
BACKGROUND: The use of insulin pens in the inpatient setting has continued to be a controversial decision. Insulin pens provide several advantages, but given significant reports of medication errors, several organizations have issued alerts to caution users about safety concerns. A survey was conducted to assess the prevalence of insulin pen use and current utilization trends in the inpatient setting. METHODS: The 31-question guided-logic survey was developed based on review of primary literature regarding insulin pen utilization and evaluated by a panel of medication safety experts from a variety of health care settings...
December 2016: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28257919/progressing-moodswings-the-upgrade-and-evaluation-of-moodswings-2-0-an-online-intervention-for-bipolar-disorder
#8
S Lauder, V E Cosgrove, E Gliddon, D Grimm, S Dodd, L Berk, D Castle, T S Suppes, M Berk
MoodSwings 2.0 is a self-guided online intervention for bipolar disorder. The intervention incorporates technological improvements on an earlier validated version of the intervention (MoodSwings 1.0). The previous MoodSwings trial provides this study with a unique opportunity to progress previous work, whilst being able to take into consideration lesson learnt, and technological enhancements. The structure and technology of MoodSwings 2.0 are described and the relevance to other online health interventions is highlighted...
February 28, 2017: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/28256829/computational-approach-to-structural-alerts-furans-phenols-nitroaromatics-and-thiophenes
#9
Na Le Dang, Tyler B Hughes, Grover P Miller, S Joshua Swamidass
Structural alerts are commonly used in drug discovery to identify molecules likely to form reactive metabolites and thereby become toxic. Unfortunately, as useful as structural alerts are, they do not effectively model if, when, and why metabolism renders safe molecules toxic. Toxicity due to a specific structural alert is highly conditional, depending on the metabolism of the alert, the reactivity of its metabolites, dosage, and competing detoxification pathways. A systems approach, which explicitly models these pathways, could more effectively assess the toxicity risk of drug candidates...
April 17, 2017: Chemical Research in Toxicology
https://www.readbyqxmd.com/read/28254350/the-current-status-of-artisanal-cannabis-for-the-treatment-of-epilepsy-in-the-united-states
#10
Dustin Sulak, Russell Saneto, Bonni Goldstein
The widespread patient use of artisanal cannabis preparations has preceded quality validation of cannabis use for epilepsy. Neurologists and cannabinoid specialists are increasingly in a position to monitor and guide the use of herbal cannabis in epilepsy patients. We report the retrospective data on efficacy and adverse effects of artisanal cannabis in Patients with medically refractory epilepsy with mixed etiologies in Washington State, California, and Maine. Clinical considerations, including potential risks and benefits, challenges related to artisanal preparations, and cannabinoid dosing, are discussed...
February 18, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28240694/improving-clinical-outcomes-for-patients-with-class-iii-heart-failure
#11
Melissa Shapiro, Angela Macci Bires, Kristen Waterstram-Rich, Thomas W Cline
Heart failure (HF) is a serious medical problem in the United States and is placing a financial strain on the health care system. It is the leading cause of mortality and as the overall incidence continues to increase, so does the economic impact on the health care system. Innovative treatment options, in the form of disease management programs and implantable cardiac devices, such as the CorVue capable implantable cardioverter defibrillator (ICD) pacemaker, offer the promise of an enhanced quality of life and reduced mortality...
April 2017: Critical Care Nursing Quarterly
https://www.readbyqxmd.com/read/28152907/developing-and-implementing-emr-functionality-to-improve-oral-chemotherapy-outcomes
#12
Bruce Brockstein, George W Carro, Ashton Marie Hullett, Brad Hughes, Wayne Spath, Sharon Huginnie
159 Background: Approval of new oral anticancer agents (OAA) continues to rise, accounting for 75% of new oncology drugs approved so far in 2015. OAA prescriptions generated at our institution demonstrate similar growth, as the prescription volume for OAA is approximately 200% greater than it was 8 years ago. Challenges of OAA, including safe prescribing, monitoring toxicities, and assessing adherence, continue to be an obstacle to providing quality care. In recognition of these challenges, our institution employed the electronic medical record (EMR) to develop tools to enhance safe prescribing, monitoring, and follow up for patients receiving OAA...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28148471/a-self-regulation-theory-based-asthma-management-mobile-app-for-adolescents-a-usability-assessment
#13
Adam Sage, Courtney Roberts, Lorie Geryk, Betsy Sleath, Deborah Tate, Delesha Carpenter
BACKGROUND: Self-regulation theory suggests people learn to influence their own behavior through self-monitoring, goal-setting, feedback, self-reward, and self-instruction, all of which smartphones are now capable of facilitating. Several mobile apps exist to manage asthma; however, little evidence exists about whether these apps employ user-centered design processes that adhere to government usability guidelines for mobile apps. OBJECTIVE: Building upon a previous study that documented adolescent preferences for an asthma self-management app, we employed a user-centered approach to assess the usability of a high-fidelity wireframe for an asthma self-management app intended for use by adolescents with persistent asthma...
February 1, 2017: JMIR Human Factors
https://www.readbyqxmd.com/read/28089663/phase-dependent-activity-of-neurons-in-the-rostral-part-of-the-thalamic-reticular-nucleus-with-saccharin-intake-in-a-cue-guided-lever-manipulation-task
#14
Ryuhei Aoki, Risako Kato, Satoshi Fujita, Jun Shimada, Noriaki Koshikawa, Masayuki Kobayashi
Neurons in the rostral part of the thalamic reticular nucleus (rTRN) receive somatosensory and motor information and regulate neural activities of the thalamic nuclei. Previous studies showed that when activity in visual TRN neurons is suppressed prior to the visual stimuli in a visual detection task, the performance of the task improves. However, little is known about such changes in the rTRN preceding certain events. In the present study, we performed unit recordings in the rTRN in alert rats during a cue-guided lever-manipulation task in which saccharin was provided as a reward...
January 12, 2017: Brain Research
https://www.readbyqxmd.com/read/28077345/tips-and-traps-lessons-from-codesigning-a-clinician-e-monitoring-tool-for-computerized-cognitive-behavioral-therapy
#15
Frederick Sundram, Susan J Hawken, Karolina Stasiak, Mathijs Fg Lucassen, Theresa Fleming, Matthew Shepherd, Andrea Greenwood, Raechel Osborne, Sally N Merry
BACKGROUND: Computerized cognitive behavioral therapy (cCBT) is an acceptable and promising treatment modality for adolescents with mild-to-moderate depression. Many cCBT programs are standalone packages with no way for clinicians to monitor progress or outcomes. We sought to develop an electronic monitoring (e-monitoring) tool in consultation with clinicians and adolescents to allow clinicians to monitor mood, risk, and treatment adherence of adolescents completing a cCBT program called SPARX (Smart, Positive, Active, Realistic, X-factor thoughts)...
January 11, 2017: JMIR Mental Health
https://www.readbyqxmd.com/read/27922904/utilization-of-quantitative-eeg-trends-for-critical-care-continuous-eeg-monitoring-a-survey-of-neurophysiologists
#16
Christa B Swisher, Saurabh R Sinha
PURPOSE: Quantitative EEG (QEEG) can be used to assist with review of large amounts of data generated by critical care continuous EEG monitoring. This study aimed to identify current practices regarding the use of QEEG in critical care continuous EEG monitoring of critical care patients. METHODS: An online survey was sent to 796 members of the American Clinical Neurophysiology Society (ACNS), instructing only neurophysiologists to participate. RESULTS: The survey was completed by 75 neurophysiologists that use QEEG in their practice...
December 2016: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
https://www.readbyqxmd.com/read/27920491/interactive-navigation-guided-ophthalmic-plastic-surgery-navigation-enabling-of-telescopes-and-their-use-in-endoscopic-lacrimal-surgeries
#17
Mohammad Javed Ali, Swati Singh, Milind N Naik, Swathi Kaliki, Tarjani Vivek Dave
PURPOSE: The aims of this study were to report the preliminary experience of using telescopes, which were enabled for navigation guidance, and their utility in complex endoscopic lacrimal surgeries. METHODS: Navigation enabling of the telescope was achieved by using the AxiEM™ malleable neuronavigation shunt stylet. Image-guided dacryolocalization was performed in five patients using the intraoperative image-guided StealthStation™ system in the electromagnetic mode...
2016: Clinical Ophthalmology
https://www.readbyqxmd.com/read/27910294/medication-management-in-the-older-adult-a-narrative-exploration
#18
Johnanna Hernandez
BACKGROUND AND PURPOSE: The purpose of this study was to characterize the meaning nurse practitioners (NPs) ascribed to personal experiences providing care to older adults who take multiple medications to manage complex conditions. The study illuminated the NP experience in caring for the older adult while addressing the complexities of medication management through narrative stories in practice. METHODS: NPs self-identifying as caring for older adults were interviewed (N=15)...
April 2017: Journal of the American Association of Nurse Practitioners
https://www.readbyqxmd.com/read/27864204/integrating-pharmacogenomics-into-electronic-health-records-with-clinical-decision-support
#19
J Kevin Hicks, Henry M Dunnenberger, Karl F Gumpper, Cyrine E Haidar, James M Hoffman
PURPOSE: Existing pharmacogenomic informatics models, key implementation steps, and emerging resources to facilitate the development of pharmacogenomic clinical decision support (CDS) are described. SUMMARY: Pharmacogenomics is an important component of precision medicine. Informatics, especially CDS in the electronic health record (EHR), is a critical tool for the integration of pharmacogenomics into routine patient care. Effective integration of pharmacogenomic CDS into the EHR can address implementation challenges, including the increasing volume of pharmacogenomic clinical knowledge, the enduring nature of pharmacogenomic test results, and the complexity of interpreting results...
December 1, 2016: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/27793961/acute-kidney-injury-in-the-era-of-the-aki-e-alert
#20
Jennifer Holmes, Timothy Rainer, John Geen, Gethin Roberts, Kate May, Nick Wilson, John D Williams, Aled O Phillips
BACKGROUND AND OBJECTIVES: Our aim was to use a national electronic AKI alert to define the incidence and outcome of all episodes of community- and hospital-acquired adult AKI. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: A prospective national cohort study was undertaken in a population of 3.06 million. Data were collected between March of 2015 and August of 2015. All patients with adult (≥18 years of age) AKI were identified to define the incidence and outcome of all episodes of community- and hospital-acquired AKI in adults...
December 7, 2016: Clinical Journal of the American Society of Nephrology: CJASN
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