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https://www.readbyqxmd.com/read/29236272/medical-malpractice-and-transoral-robotic-surgery-evaluation-and-some-preemptive-thoughts
#1
Daniel D Lydiatt, Ryan Sewell
Medical malpractice is costly and disruptive, and it is important to prevent. We conducted a study with the objective to look at medical malpractice in robotic surgery overall, to evaluate reasons for litigation, and to comment on possible strategies to avoid litigation with transoral robotic surgery. We used the Westlaw computerized database to identify all state and federal verdict summaries in medical malpractice cases. We found 17 cases alleging malpractice that involved the use of robotic surgery. In all, the plaintiffs in 6 cases (35%) contended that an open rather than a robotic approach should have been used, 5 (29%) alleged negligent credentialing, 4 (24%) alleged training deficiencies, 2 (12%) alleged manufacturing problems, and 1 (6%) charged that robotic surgery should have been performed instead of open surgery (1 case involved two of these allegations)...
December 2017: Ear, Nose, & Throat Journal
https://www.readbyqxmd.com/read/29235661/association-of-higher-daptomycin-dose-%C3%A2-7-mg-kg-with-improved-survival-in-patients-with-methicillin-resistant-staphylococcus-aureus-bacteremia
#2
Tristan T Timbrook, Aisling R Caffrey, Megan K Luther, Vrishali Lopes, Kerry L LaPlante
STUDY OBJECTIVE: Current guidelines recommend higher daptomycin doses than the daptomycin label dose of 6 mg/kg for methicillin-resistant Staphylococcus aureus (MRSA) bacteremia; however, the evidence supporting this recommendation is from in vitro and cases series studies. The objective of this study was to evaluate the comparative effectiveness of the daptomycin label dose versus higher daptomycin doses in patients with MRSA bacteremia. DESIGN: Retrospective national cohort study...
December 13, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/29235301/-advantages-and-problems-of-traditional-chinese-medicine-in-treatment-of-acute-pharyngitis
#3
Xia Zhang, Yan-Ming Xie, Guang-Xi Li, Yang Gao, Yuan-Chen Zhao, Jing-Jing Tang, Xiao-Yan Yao, Meng Li
This paper systematically studies relevant literatures at home and abroad in recent years. China National Knowledge Internet (CNKI) was used to collect the literatures for acute pharyngitis treated with traditional Chinese medicine from January 1, 2006, to December 31, 2016, and the bibliometric method was employed for statistical analysis. A total of 493 papers were preliminarily selected. According to the inclusion criteria and exclusion criteria, 182 eligible articles were selected. According to the evaluation and analysis of the literatures, the Guidelines for Clinical Research of New Drugs is currently used as the common standards for the diagnosis and treatment of acute pharyngitis; Chinese patent medicines are the main traditional Chinese medicine for treating this disease; Decoctions for treatment of this disease include Lonicerae Japonicae Flos, Scutellariae Radix, Platycodonis Radix, Forsythiae Fructus, Glycyrrhizae Radix et Rhizoma, Scrophdlariae Radix, Isatidis Radix, and Ophiopogonis Radix; The bloodletting puncture is the common external therapy...
October 2017: Zhongguo Zhong Yao za Zhi, Zhongguo Zhongyao Zazhi, China Journal of Chinese Materia Medica
https://www.readbyqxmd.com/read/29235239/familial-risks-in-urolithiasis-in-the-population-of-sweden
#4
Kari Hemminki, Otto Hemminki, Asta Försti, Kristina Sundquist, Jan Sundquist, Xinjun Li
OBJECTIVES: To assess detailed familial risks for medically diagnosed urolithiasis (UL, urinary tract stone disease) based on nationwide hospital and population records. SUBJECTS/PATIENTS AND METHODS: Subjects were identified from the Swedish Multigeneration Register in which 211,718 UL patients. Standardized incidence ratios (SIRs) were calculated by comparison to individuals without a family history of UL. RESULTS: The highest familial SIRs were invariably found for the same (concordant) type of UL: 2...
December 13, 2017: BJU International
https://www.readbyqxmd.com/read/29234966/efficacy-and-feasibility-of-a-collaborative-multidisciplinary-program-for-antibiotic-prophylaxis-in-clean-wound-surgery
#5
Xinyu Li, Hong Chen, Shenyin Zhu, Yu Liu, Jiadan Yang, Zhe Yuan, Gaoqun Yao, Feng Qiu
Background Despite national and international guidelines and recommendations, inappropriate prophylactic antibiotic use for clean wound surgery remains a common phenomenon in many Chinese hospitals, causing higher medical costs and bacterial resistance. Objective To improve the prescribing behavior for antibiotic prophylaxis and decrease antibiotic abuse and/or misuse in clean wound surgery. Setting The teaching hospital of a medical university in Southwest China. Methods A collaborative multidisciplinary program involving educational, technical, and administrative strategies was undertaken...
December 12, 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/29234842/-patients-with-a-wearable-cardioverter-defibrillator-wcd-prescription-function-and-rehabilitation-support
#6
REVIEW
A Schlitt, M Guha, M Noutsias, H H Klein, H U Klein
Assessment of a permanent risk of life-threatening ventricular arrhythmia in patients with severely reduced left ventricular ejection fraction (LVEF <35%), e. g. after myocarditis, dilated cardiomyopathy, acute myocardial infarction, in patients with postpartum cardiomyopathy or implantable cardioverter-defibrillator (ICD) and cardiac resynchronization treatment plus defibrillator (CRT-D) infection with temporary explantation of the system is a medical challenge. This is time-consuming and unsafe because life-threatening ventricular arrhythmias may occur during the time of risk assessment...
December 12, 2017: Herz
https://www.readbyqxmd.com/read/29234379/the-instrument-for-measuring-the-implementation-situation-of-traditional-chinese-medicine-guideline-evaluation-and-application
#7
Hui Li, Yangyang Wang, Yaolong Chen, Xiaoyun Wang, Chuanjian Lu, Jingwen Deng
Clinical practice guidelines play an important role in reducing the variations in clinical practices and improving the quality of care. To assess the real effect, measuring its implementation situation is needed. The implementation situation can be reflected by testing the consistency between the actual clinical practice and the guideline. We constructed an instrument to measure the implementation situation of Traditional Chinese Medicine (TCM) guideline through consistency testing. The main objectives of our study were to validate the instrument and evaluate the implementation situation of menopause syndrome guideline of TCM, using the data from the consistency test of comparing the medical records with the guideline...
2017: Evidence-based Complementary and Alternative Medicine: ECAM
https://www.readbyqxmd.com/read/29234266/glomus-tumor-of-the-scrotum-a-case-report-and-mini-review
#8
Kareim Khalafalla, Abdulla Al-Ansari, Abdelfftah Omran, Hanan Farghaly, Abdulqadir Alobaidy
Glomus tumor in the genital area is extremely rare, with an extensive search in the medical literature revealing only 1 case arising in the scrotum. They can be easily mistaken, both clinically and radiologically, for skin neoplasms or primary testicular tumors involving the scrotum. This report presents a case of a 54-year-old man who presented with a painful right scrotal swelling. Ultrasound suggested the possibility of an epidermal inclusion cyst. The excised mass was diagnosed as a benign glomus tumor...
November 2017: Current Urology
https://www.readbyqxmd.com/read/29234146/practices-surrounding-pulmonary-hypertension-and-bronchopulmonary-dysplasia-amongst-neonatologists-caring-for-premature-infants
#9
Gabriel Altit, Henry C Lee, Susan Hintz, Theresa A Tacy, Jeffrey A Feinstein, Shazia Bhombal
OBJECTIVE: Pulmonary hypertension (PH) is associated with bronchopulmonary dysplasia (BPD). Screening strategies, a thorough investigation of co-morbidities, and multidisciplinary involvement prior to anti-PH medications have been advocated by recent guidelines. We sought to evaluate current practices of neonatologists caring for premature infants with PH. DESIGN: Electronic survey of American Academy of Pediatrics neonatology members. RESULTS: Among 306 neonatologist respondents, 38% had an institutional screening protocol for patients with BPD; 83% screened at 36 weeks for premature neonates on oxygen/mechanical ventilation...
December 12, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/29233498/proton-pump-inhibitors-and-cardiovascular-events-a-systematic-review
#10
REVIEW
Timothy P Shiraev, Andrew Bullen
BACKGROUND: Proton pump inhibitors (PPIs) are a commonly prescribed medication that recent data has linked to an increased risk of cardiovascular morbidity and all cause morbidity. The current study sought to perform a systematic review to investigate the link between PPIs and morbidity and mortality METHODS: A systematic review was carried out as per the PRISMA guidelines, with information databases including Pubmed, Medline, and the Cochrane Review Database. English-language studies of all types published from January 1990 to October 2016 were considered...
November 20, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29233279/pharmacy-student-engagement-in-the-evaluation-of-medication-documentation-within-an-ambulatory-care-electronic-medical-record
#11
Tatum Mead, Stephanie Schauner
BACKGROUND AND PURPOSE: An abundance of literature supports the benefits of electronic medical records (EMR) for improving overall healthcare quality. Identifying preventative care opportunities, reducing medical and medication related errors and incorporating clinical practice guidelines are just a few attributes of EMR implementation. The goals of this study were to engage experiential pharmacy students in the assessment of medication related documentation discrepancies in a newly implemented EMR system and to provide exposure to various aspects of conducting research...
May 2017: Currents in Pharmacy Teaching & Learning
https://www.readbyqxmd.com/read/29233074/-you-have-to-take-action-changing-knowledge-and-attitudes-towards-newborn-care-practices-during-crisis-in-south-sudan
#12
Samira Sami, Kate Kerber, Barbara Tomczyk, Ribka Amsalu, Debra Jackson, Elaine Scudder, Alexander Dimiti, Janet Meyers, Kemish Kenneth, Solomon Kenyi, Caitlin E Kennedy, Kweku Ackom, Luke C Mullany
Highest rates of neonatal mortality occur in countries that have recently experienced conflict. International Medical Corps implemented a package of newborn interventions in June 2016, based on the Newborn health in humanitarian settings: field guide, targeting community- and facility-based health workers in displaced person camps in South Sudan. We describe health workers' knowledge and attitudes toward newborn health interventions, before and after receiving clinical training and supplies, and recommend dissemination strategies for improved uptake of newborn guidelines during crises...
December 13, 2017: Reproductive Health Matters
https://www.readbyqxmd.com/read/29232377/association-between-infrastructure-and-observed-quality-of-care-in-4-healthcare-services-a-cross-sectional-study-of-4-300-facilities-in-8-countries
#13
Hannah H Leslie, Zeye Sun, Margaret E Kruk
BACKGROUND: It is increasingly apparent that access to healthcare without adequate quality of care is insufficient to improve population health outcomes. We assess whether the most commonly measured attribute of health facilities in low- and middle-income countries (LMICs)-the structural inputs to care-predicts the clinical quality of care provided to patients. METHODS AND FINDINGS: Service Provision Assessments are nationally representative health facility surveys conducted by the Demographic and Health Survey Program with support from the US Agency for International Development...
December 2017: PLoS Medicine
https://www.readbyqxmd.com/read/29232273/practice-bulletin-no-191-tubal-ectopic-pregnancy
#14
(no author information available yet)
Ectopic pregnancy is defined as a pregnancy that occurs outside of the uterine cavity. The most common extrauterine site of ectopic pregnancy is the fallopian tube. Most cases of tubal ectopic pregnancy that are detected early can be treated successfully either with minimally invasive surgery or with medical management using methotrexate. However, tubal ectopic pregnancy in an unstable patient is a medical emergency that requires prompt surgical intervention. The purpose of this document is to review information on the current understanding of tubal ectopic pregnancy and to provide guidelines for timely diagnosis and management that are consistent with the best available scientific evidence...
December 5, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29231870/improving-the-care-and-treatment-of-monkeypox-patients-in-low-resource-settings-applying-evidence-from-contemporary-biomedical-and-smallpox-biodefense-research
#15
REVIEW
Mary G Reynolds, Andrea M McCollum, Beatrice Nguete, Robert Shongo Lushima, Brett W Petersen
Monkeypox is a smallpox-like illness that can be accompanied by a range of significant medical complications. To date there are no standard or optimized guidelines for the clinical management of monkeypox (MPX) patients, particularly in low-resource settings. Consequently, patients can experience protracted illness and poor outcomes. Improving care necessitates developing a better understanding of the range of clinical manifestations-including complications and sequelae-as well as of features of illness that may be predictive of illness severity and poor outcomes...
December 12, 2017: Viruses
https://www.readbyqxmd.com/read/29231770/pharmacological-and-non-pharmacological-treatment-of-obstructive-hypertrophic-cardiomyopathy
#16
Luis F Hidalgo, Srihari S Naidu, Wilbert S Aronow
Hypertrophic obstructive cardiomyopathy has been rising in prevalence, due to increased awareness and advanced imaging. For the symptomatic patient, pharmacological management remains an effective approach to the majority of patients with obstructive hypertrophic cardiomyopathy. However, a significant subset fails to improve sufficiently with medical therapy initially, or progressively becomes more symptomatic despite augmented medications over time. Most of the advances in the treatment of obstructive hypertrophic cardiomyopathy have therefore been made in the area of non-pharmacologic management, particularly septal reduction therapy...
December 12, 2017: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/29231314/-differences-and-international-standardization-between-acupuncture-as-therapy-and-as-specialty
#17
Szetuen Ng
The purpose of this study is to explore the differences of definition and clinical roles as well as international standardization between acupuncture as therapy and as specialty, which can provide reference evidence for specialization and internationalization of acupuncture. Owing to the clinical efficacy and safety, the credibility and controversy both exist in acupuncture; moreover, there is a lack of fair definition and international precedent regarding acupuncture specialty. Therefore, it is particularly essential to objectively compare the differences of definitions and clinical roles as well as criteria of international standardization for acupuncture as therapy and as specialty...
January 12, 2017: Zhongguo Zhen Jiu, Chinese Acupuncture & Moxibustion
https://www.readbyqxmd.com/read/29230699/predictive-psychiatric-genetic-testing-in-minors-an-exploration-of-the-non-medical-benefits
#18
Arianna Manzini, Danya F Vears
Predictive genetic testing for susceptibility to psychiatric conditions is likely to become part of standard practice. Because the onset of most psychiatric diseases is in late adolescence or early adulthood, testing minors could lead to early identification that may prevent or delay the development of these disorders. However, due to their complex aetiology, psychiatric genetic testing does not provide the immediate medical benefits that current guidelines require for testing minors. While several authors have argued non-medical benefits may play a crucial role in favour of predictive testing for other conditions, little research has explored such a role in psychiatric disorders...
December 11, 2017: Journal of Bioethical Inquiry
https://www.readbyqxmd.com/read/29230472/individualized-glycemic-control-for-u-s-adults-with-type-2-diabetes-a-cost-effectiveness-analysis
#19
Neda Laiteerapong, Jennifer M Cooper, M Reza Skandari, Philip M Clarke, Aaron N Winn, Rochelle N Naylor, Elbert S Huang
Background: Intensive glycemic control in type 2 diabetes (glycated hemoglobin [HbA1c] level <7%) is an established, cost-effective standard of care. However, guidelines recommend individualizing goals on the basis of age, comorbidity, diabetes duration, and complications. Objective: To estimate the cost-effectiveness of individualized control versus uniform intensive control (HbA1c level <7%) for the U.S. population with type 2 diabetes. Design: Patient-level Monte Carlo-based Markov model...
December 12, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/29230124/oncology-and-palliative-medicine-providing-comprehensive-care-for-patients-with-cancer
#20
REVIEW
Laura Finn, Alva Roche Green, Sonia Malhotra
Background: Despite the evidence for the fundamental need for palliative medicine services in the practice of oncology, integration of these medical specialties remains a clinical challenge. Methods: We reviewed the current literature regarding the practice of palliative medicine in the field of oncology, examining randomized clinical trials of palliative medicine services in advanced cancer, models of palliative medicine delivery, studies of cost effectiveness, and national palliative medicine practice and referral guidelines...
2017: Ochsner Journal
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