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Emergency Medicin

Tarsh Pandit, Sabe Sabesan, Robin A Ray
OBJECTIVE: This study aimed to explore doctors' perceptions of the training needs of rural doctors in the context of managing emergencies in rural North Queensland. DESIGN: Using a qualitative approach, 20 semistructured interviews were conducted via telephone, video conference and in-person. Using an interview guide, areas such as preparedness of junior doctors for rural practice, areas for further training and confidence with managing emergencies were discussed...
November 16, 2018: Australian Journal of Rural Health
Arsenio Paez
The role of expertise in evidence-based medicine (EBM) and practice (EBP) has long been debated. In the early years of the EBP movement, the role of expertise and experience were diminished in clinical decision-making. However, the concepts of EBP are evolving. A more nuanced view of the value of clinician expertise, based on experience and clinical judgement, has emerged. This article proposes that clinical expertise does not belong within the evidence hierarchy's decision-making pyramid as the lowest form of evidence, but rather alongside it, representing a complementary source of knowledge that supports the processes of EBP...
November 16, 2018: Journal of Evidence-based Medicine
Rahul Mittal, Frank W Woo, Carlo S Castro, Madeline A Cohen, Joana Karanxha, Jeenu Mittal, Tanya Chhibber, Vasanti M Jhaveri
Before a lead compound goes through a clinical trial, preclinical studies utilize two-dimensional (2D) in vitro models and animal models to study the pharmacodynamics and pharmacokinetics of that lead compound. However, these current preclinical studies may not accurately represent the efficacy and safety of a lead compound in humans, as there has been a high failure rate of drugs that enter clinical trials. All of these failures and the associated costs demonstrate a need for more representative models of human organ systems for screening in the preclinical phase of drug development...
November 15, 2018: Journal of Cellular Physiology
Daniel St Louis, Kenneth V Iserson, Nicolas Forget
Introduction: Although the fascia iliaca compartment block (FICB) seems to be an ideal technique for femoral neck and shaft fractures occurring in resource-poor settings, it has been unclear how effective it is when used by emergency physicians (EP) with little training in the technique, using equipment, medications and methods that differ from those commonly available in developed countries. This series was designed to demonstrate that EPs in a resource-poor setting can provide effective analgesia for femur fractures with anatomic landmark-guided FICBs, clinician-compounded lidocaine-epinephrine (1:100,000), and a standard injection needle...
November 2018: Clinical practice and cases in emergency medicine
Chiara La Rosa, Luca Bonfanti
Comparative medicine deals with similarities and differences between veterinary and human medicine. All mammals share most basic cellular and molecular mechanisms, thus justifying murine animal models in a translational perspective; yet "mice are not men," thus some biases can emerge when complex biological processes are concerned. Brain plasticity is a cutting-edge, expanding topic in the field of Neurosciences with important translational implications, yet, with remarkable differences among mammals, as emerging from comparative studies...
2018: Frontiers in Veterinary Science
Zilin Li, Shen Kiat Lim, Xu Liang, Yoon Pin Lim
The transcriptional coactivator WW domain-binding protein 2 (WBP2) is an emerging oncogene and serves as a node between the signaling protein Wnt and other signaling molecules and pathways, including epidermal growth factor receptor, estrogen receptor/progesterone receptor, and the Hippo pathway. The upstream regulation of WBP2 is well-studied, but its downstream activity remains unclear. Here, we elucidated WBP2's role in triple-negative breast cancer (TNBC), in which Wnt signaling is predominantly activated...
November 15, 2018: Journal of Biological Chemistry
William C Puddy, Lisa A Blankinship, Joshua Bernstein, Basil H Aboul-Enein
Conscientious objectors are typically defined only by their unwillingness to serve in the armed forces. Desmond Doss participated in World War II as a combat medic and a conscientious objector by providing emergency medicine on active battlefields while refusing to handle a weapon or harm another human being. Born and raised with humility, Doss developed spiritually as a Seventh Day Adventist. Although fixated on the Ten Commandments and "Thou shall not kill," Doss felt a call to serve and voluntarily enlisted in the U...
November 12, 2018: Journal of Emergency Medicine
C M Oliver, M G Bassett, T E Poulton, I D Anderson, D M Murray, M P Grocott, S R Moonesinghe
BACKGROUND: Studies across healthcare systems have demonstrated between-hospital variation in survival after an emergency laparotomy. We postulate that this variation can be explained by differences in perioperative process delivery, underpinning organisational structures, and associated hospital characteristics. METHODS: We performed this nationwide, registry-based, prospective cohort study using data from the National Emergency Laparotomy Audit organisational and patient audit data sets...
December 2018: British Journal of Anaesthesia
Philippe J Domeyer, Vasiliki Katsari, Pavlos Sarafis, Vassilis Aletras, Dimitris Niakas
BACKGROUND: The penetration of generic medicines in the pharmaceutical market is influenced, among others, by the consumer's attitude upon them. The attitude of students in health management and recent alumni is particularly important, as they constitute tomorrow's policymakers. The aim of our study was to assess their attitude, perception and knowledge towards generic medicines. METHODS: A cross-sectional study was undertaken, involving students in Health Management and recent alumni...
November 15, 2018: BMC Medical Education
Radek Vančata, Jan Lhotský, Václav Beránek, Josef Krištof, Richard Rokyta
Severe carbon monoxide intoxication may cause tissue injury by hypoxemia and histotoxicity. The affection of the heart muscle often leads to transient global or regional systolic dysfunction of left ventricle or both ventricles and increased occurences of malignant arrhytmias. On the contrary, stress-induced cardiomyopathy is described as temporary segmental loss of contractility, mostly in apical segments of the left ventricle with mid- and basal sparing and less common hypokinesias in mid- or basal parts, or affection of both ventricles...
2018: Vnitr̆ní Lékar̆ství
Vladimír Bencko, Petr Šíma
Genetic information is transmitted among organisms through two pathways - vertically from generation to generation (from parents to progeny) and horizontally (laterally) by direct exchange of genetic material across species barriers. These are primarily prokaryotes, in which the exchange of genes or whole gene segments by horizontal transmission is quite common. They can dynamically and in a relatively short time generate highly diverse genomes, which does not allow the vertical transmission. As a result, prokaryotes can rapidly acquire new properties such as virulence and pathogenicity as well as resistance to toxins, including antibiotics, by which they increase their adaptability...
2018: Casopís Lékar̆ů C̆eských
Karl Olofsson, Björn Hammarström, Martin Wiklund
Systems and devices for in vitro tissue modelling and engineering are valuable tools, which combine the strength between the controlled laboratory environment and the complex tissue organization and environment in vivo. Device-based tissue engineering is also a possible avenue for future explant culture in regenerative medicine. The most fundamental requirements on platforms intended for tissue modelling and engineering are their ability to shape and maintain cell aggregates over long-term culture. An emerging technology for tissue shaping and culture is ultrasonic standing wave (USW) particle manipulation, which offers label-free and gentle positioning and aggregation of cells...
November 14, 2018: Micromachines
Donald R Hopkins, Ernesto Ruiz-Tiben, Adam J Weiss, Sharon L Roy, James Zingeser, Sarah Anne J Guagliardo
Dracunculiasis (Guinea worm disease), caused by the parasite Dracunculus medinensis, is acquired by drinking water containing copepods (water fleas) infected with its larvae. The worm typically emerges through the skin on a lower limb approximately 1 year after infection, causing pain and disability (1). The worldwide eradication campaign began at CDC in 1980. In 1986, the World Health Assembly called for dracunculiasis elimination, and the global Guinea Worm Eradication Program (GWEP), led by the Carter Center in partnership with the World Health Organization (WHO), United Nations Children's Fund (UNICEF), CDC, and others, began assisting ministries of health in countries with dracunculiasis...
November 16, 2018: MMWR. Morbidity and Mortality Weekly Report
Maria Grazia Spurio
An increasing number of human behavior scholars are redirecting their professional curiosity towards studies carried out with innovative research and intervention methods, far from the obsolete and reductive systems of analysis of the past. As part of these studies, aimed at the individual's bio-psycho-social betterment, the fascinating perspective of using the opportunities offered by a trip as a catalyst for important changes, has an important place. A sort of 'Journey' in the Journey, in which the suspended space-time of a travel can be the frame for innovative and interesting situations of parallel discovery of one's inner world...
November 2018: Psychiatria Danubina
Gianfranco Del Buono
The Precision Psychiatry is a new emergent topic in Psychiatry, and is "an approach for treatment and prevention that takes into account each person's variability in genes, environment, and lifestyle". It promises to be even more transformative than in other fields of medicine, because the psychiatry has not yet benefited from the advanced diagnostic and therapeutic technologies that now form an integral part of other clinical specialties. It may be an epistemological change in the field of psychiatry...
November 2018: Psychiatria Danubina
Holly E Depinet, Michelle Eckerle, Olga Semenova, Jareen Meinzen-Derr, Lynn Babcock
OBJECTIVE: To inform the future development of a pediatric prehospital sepsis tool, we sought to 1) describe the characteristics, emergent care, and outcomes for children with septic shock who are transported by emergency medicine services (EMS) and compare them to those self-transported; and 2) determine the EMS capture rate of common sepsis screening parameters and the concordance between the parameters documented in the EMS record and in the emergency department (ED) record. METHODS: This is a retrospective cohort study of children ages 0 through 21 years who presented to a pediatric ED with septic shock between 11/2013 and 06/2016...
November 15, 2018: Prehospital Emergency Care
Teck Yew Low, M Aiman Mohtar, Mia Yang Ang, Rahman Jamal
Understanding the relationship between genotypes and phenotypes is essential to disentangle biological mechanisms and to unravel the molecular basis of diseases. Genes and proteins are closely linked in biological systems. However, genomics and proteomics have developed separately into two distinct disciplines whereby crosstalk among scientists from the two domains has been limited and this constrains the integration of both fields into a single data modality of useful information. The emerging field of proteogenomics attempts to address this by building bridges between the two disciplines...
November 15, 2018: Proteomics
Atam P Dhawan
Point-of-Care Technologies (POCT) in Healthcare have emerged as a potential pathway in global and resource-limited environments towards improving access to healthcare with emphasis on preventive, personalized and precision medicine. The potential uses for POC technologies by patients or clinicians are many-from home-based monitoring to semi-managed and clinical inpatient healthcare. However, it is yet to be proven precisely what technologies are necessary or how they should be used to make an impact in improving access to quality healthcare...
2018: IEEE Journal of Translational Engineering in Health and Medicine
Katherine M Joyce, Ryan C Burke, Thomas J Veldman, Michelle M Beeson, Erin L Simon
Introduction: Time to facility is a crucial element in emergency medicine (EM). Fine-scale geospatial units such as census block groups (CBG) and publicly available population datasets offer a low-cost and accurate approach to modeling geographic access to and utilization of emergency departments (ED). These methods are relevant to the emergency physician in evaluating patient utilization patterns, emergency medical services protocols, and opportunities for improved patient outcomes and cost utilization...
November 2018: Western Journal of Emergency Medicine
Samreen Vora, Matt Lineberry, Valerie Ann Dobiesz
It has been a challenge to assess communication and professional values Milestones in emergency medicine (EM) residents using standardized methods, as mandated by the Accreditation Council for Graduate Medical Education (ACGME). This paper outlines an innovative method of assessing these Milestones using an established instructional method. EM faculty mapped the communication and professional values Milestones to an existing communication and interpersonal skills scale. We identified six communication-focused scenarios: death notification; informed consent; medical non-compliance; medical error; treatment refusal; and advanced directives...
November 2018: Western Journal of Emergency Medicine
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