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https://www.readbyqxmd.com/read/29454509/group-c-strep-mediastinitis-a-case-report
#1
Joseph G Kotora, Eric J Schmieler, Christian S McEvoy, Stephen L Noble
This case is significant to the practice of emergency medicine because it represents the development of an uncommon and potentially fatal mediastinal infection from a commonly encountered and appropriately treated community respiratory pathogen. Most published reports on mediastinitis are those that are status-post cardiothoracic surgery. In our report, we discuss a case of a healthy, young individual who developed this morbid entity from extension of a simple respiratory infection where Group C Streptococcus has been isolated as the causative organism, which to our knowledge has not been previously reported...
February 3, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29453548/-big-data-from-clinical-routine
#2
REVIEW
U Mansmann
BACKGROUND: Over the past 100 years, evidence-based medicine has undergone several fundamental changes. Through the field of physiology, medical doctors were introduced to the natural sciences. Since the late 1940s, randomized and epidemiological studies have come to provide the evidence for medical practice, which led to the emergence of clinical epidemiology as a new field in the medical sciences. Within the past few years, big data has become the driving force behind the vision for having a comprehensive set of health-related data which tracks individual healthcare histories and consequently that of large populations...
February 16, 2018: Zeitschrift Für Rheumatologie
https://www.readbyqxmd.com/read/29442540/management-of-immune-related-adverse-events-in-patients-treated-with-immune-checkpoint-inhibitor-therapy-american-society-of-clinical-oncology-clinical-practice-guideline
#3
Julie R Brahmer, Christina Lacchetti, Bryan J Schneider, Michael B Atkins, Kelly J Brassil, Jeffrey M Caterino, Ian Chau, Marc S Ernstoff, Jennifer M Gardner, Pamela Ginex, Sigrun Hallmeyer, Jennifer Holter Chakrabarty, Natasha B Leighl, Jennifer S Mammen, David F McDermott, Aung Naing, Loretta J Nastoupil, Tanyanika Phillips, Laura D Porter, Igor Puzanov, Cristina A Reichner, Bianca D Santomasso, Carole Seigel, Alexander Spira, Maria E Suarez-Almazor, Yinghong Wang, Jeffrey S Weber, Jedd D Wolchok, John A Thompson
Purpose To increase awareness, outline strategies, and offer guidance on the recommended management of immune-related adverse events in patients treated with immune checkpoint inhibitor (ICPi) therapy. Methods A multidisciplinary, multi-organizational panel of experts in medical oncology, dermatology, gastroenterology, rheumatology, pulmonology, endocrinology, urology, neurology, hematology, emergency medicine, nursing, trialist, and advocacy was convened to develop the clinical practice guideline. Guideline development involved a systematic review of the literature and an informal consensus process...
February 14, 2018: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/29440586/national-practice-patterns-of-obtaining-informed-consent-for-stroke-thrombolysis
#4
Scott J Mendelson, D Mark Courtney, Elisa J Gordon, Leena F Thomas, Jane L Holl, Shyam Prabhakaran
BACKGROUND AND PURPOSE: No standard approach to obtaining informed consent for stroke thrombolysis with tPA (tissue-type plasminogen activator) currently exists. We aimed to assess current nationwide practice patterns of obtaining informed consent for tPA. METHODS: An online survey was developed and distributed by e-mail to clinicians involved in acute stroke care. Multivariable logistic regression analyses were performed to determine independent factors contributing to always obtaining informed consent for tPA...
February 12, 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29438133/accuracy-of-ultrasound-exam-performed-by-emergency-medicine-versus-radiology-residents-in-the-diagnosis-of-acute-appendicitis
#5
Marzieh Shahbazipar, Javad Seyedhosseini, Elnaz Vahidi, Hojat Sheikh Motahar Vahedi, Amirhossein Jahanshir
BACKGROUND: Although the traditional approach to the diagnosis of acute appendicitis (AA) is using clinical methods, experience has shown that strict reliance on clinical data can lead to mismanagement or unnecessary surgery. OBJECTIVE: The objective of this study was to determine the total agreement of ultrasound (US) results in AA performed by emergency medicine (EM) versus radiology residents in emergency department. PATIENTS AND METHODS: In this cross-sectional study, 121 patients with AA suspicion underwent an US exam by both trained EM and radiology residents in emergency department...
February 12, 2018: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/29435856/modern-theories-of-pelvic-floor-support-a-topical-review-of-modern-studies-on-structural-and-functional-pelvic-floor-support-from-medical-imaging-computational-modeling-and-electromyographic-perspectives
#6
REVIEW
Yun Peng, Brandi D Miller, Timothy B Boone, Yingchun Zhang
PURPOSE OF REVIEW: Weakened pelvic floor support is believed to be the main cause of various pelvic floor disorders. Modern theories of pelvic floor support stress on the structural and functional integrity of multiple structures and their interplay to maintain normal pelvic floor functions. Connective tissues provide passive pelvic floor support while pelvic floor muscles provide active support through voluntary contraction. Advanced modern medical technologies allow us to comprehensively and thoroughly evaluate the interaction of supporting structures and assess both active and passive support functions...
February 12, 2018: Current Urology Reports
https://www.readbyqxmd.com/read/29431584/horizon-scanning-how-will-metabolomics-applications-transform-food-science-bioengineering-and-medical-innovation-in-the-current-era-of-foodomics
#7
Mustafa Bayram, Çağlar Gökırmaklı
Food and engineering sciences have tended to neglect the importance of human nutrition sciences and clinical study of new molecules discovered by food engineering community, and vice versa. Yet, the value of systems thinking and use of omics technologies in food engineering are rapidly emerging. Foodomics is a new concept and practice to bring about "precision nutrition" and integrative bioengineering studies of food composition, quality, and safety, and applications to improve health of humans, animals, and other living organisms on the planet...
February 12, 2018: Omics: a Journal of Integrative Biology
https://www.readbyqxmd.com/read/29429430/review-of-implementation-strategies-to-change-healthcare-provider-behaviour-in-the-emergency-department
#8
Kerstin de Wit, Janet Curran, Brent Thoma, Shawn Dowling, Eddy Lang, Nebojsa Kuljic, Jeffrey J Perry, Laurie Morrison
OBJECTIVES: Advances in emergency medicine research can be slow to make their way into clinical care, and implementing a new evidence-based intervention can be challenging in the emergency department. The Canadian Association of Emergency Physicians (CAEP) Knowledge Translation Symposium working group set out to produce recommendations for best practice in the implementation of a new science in Canadian emergency departments. METHODS: A systematic review of implementation strategies to change health care provider behaviour in the emergency department was conducted simultaneously with a national survey of emergency physician experience...
February 12, 2018: CJEM
https://www.readbyqxmd.com/read/29429062/towards-precision-medicine-a-new-biomedical-cosmology
#9
M W Vegter
Precision Medicine has become a common label for data-intensive and patient-driven biomedical research. Its intended future is reflected in endeavours such as the Precision Medicine Initiative in the USA. This article addresses the question whether it is possible to discern a new 'medical cosmology' in Precision Medicine, a concept that was developed by Nicholas Jewson to describe comprehensive transformations involving various dimensions of biomedical knowledge and practice, such as vocabularies, the roles of patients and physicians and the conceptualisation of disease...
February 10, 2018: Medicine, Health Care, and Philosophy
https://www.readbyqxmd.com/read/29428868/mapping-the-cancer-patient-information-landscape-a-comparative-analysis-of-patient-groups-across-europe-and-north-america
#10
Mark Lawler, Gillian Prue, Ian Banks, Kate Law, Peter Selby, Gordon McVie, Richard Sullivan
AIM: Little is known about how patient groups provide information for patients. We invited 838 patient groups from Europe and North America to participate in an online survey. METHODS: The survey covered: (i) availability, accessibility and quality of information provided; (ii) methods by which patient groups communicate; (iii) ways in which patient groups acquire information and confirm its veracity/accuracy; (iv) how people access information online. RESULTS: European patient groups were significantly less effective in providing medical-related information than their North American counterparts in: clinical trials, potential causes of cancer, medical research, diagnosis/screening, symptoms, treatments (all p < 0...
February 8, 2018: European Journal of Cancer
https://www.readbyqxmd.com/read/29428560/enabling-personalized-implant-and-controllable-biosystem-development-through-3d-printing
#11
REVIEW
Neerajha Nagarajan, Agnes Dupret-Bories, Erdem Karabulut, Pinar Zorlutuna, Nihal Engin Vrana
The impact of additive manufacturing in our lives has been increasing constantly. One of the frontiers in this change is the medical devices. 3D printing technologies not only enable the personalization of implantable devices with respect to patient-specific anatomy, pathology and biomechanical properties but they also provide new opportunities in related areas such as surgical education, minimally invasive diagnosis, medical research and disease models. In this review, we cover the recent clinical applications of 3D printing with a particular focus on implantable devices...
February 8, 2018: Biotechnology Advances
https://www.readbyqxmd.com/read/29428368/leaders-growing-leaders-designing-a-tier-based-leadership-program-for-surgeons
#12
Laura Torbeck, Grace Rozycki, Gary Dunnington
BACKGROUND: Leadership has emerged as a crucial component of professional development for physicians in academic medicine. Most leadership skills can be learned and therefore best practices of delivering leadership development are in high demand. For practicing surgeons, specific strategies to teach leadership have been lacking. OBJECTIVE: The purpose of this paper is to describe the structure of a tier-based leadership development program called Leaders Growing Leaders, to identify the major curricular components to each tier including measures and outcomes, and to share lessons learned for those who may want to begin a similar leadership development program...
February 7, 2018: Journal of Surgical Education
https://www.readbyqxmd.com/read/29427988/emerging-concepts-in-evidence-based-asthma-management
#13
Helen K Reddel
Asthma management is in an intriguing phase, with acceptance of asthma as a heterogeneous condition with different phenotypes and underlying mechanisms and the potential for personalized asthma care, in parallel with increasing evidence about the population-level impact of basic strategies to increase access to medicines and improve inhaler technique and adherence. These changes have been facilitated by a more comprehensive view of evidence, including both randomized controlled trials with high internal validity and pragmatic and observational studies with high generalizability to patients in clinical practice...
February 2018: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29427374/economic-analysis-of-diagnostic-imaging-in-pediatric-patients-with-suspected-appendicitis
#14
Anupam B Kharbanda, Eric W Christensen, Nanette C Dudley, Lalit Bajaj, Michelle D Stevenson, Charles G Macias, Manoj K Mittal, Richard G Bachur, Jonathan E Bennett, Kelly Sinclair, Brianna McMichael, Peter S Dayan
OBJECTIVE: The use of computed tomography (CT) and ultrasound (US) in patients with acute abdominal pain has substantial variation across pediatric emergency departments (ED). This study compares the cost of diagnosing and treating suspected appendicitis across a multi-center network of children's hospitals. METHODS: This study is a secondary analysis using de-identified data of a prospective, observational study of patients with suspected appendicitis at nine pediatric EDs...
February 10, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29422373/international-commission-for-mountain-emergency-medicine-consensus-guidelines-for-on-site-management-and-transport-of-patients-in-canyoning-incidents
#15
REVIEW
Giacomo Strapazzon, Oliver Reisten, Fabien Argenone, Ken Zafren, Greg Zen-Ruffinen, Gordon L Larsen, Inigo Soteras
Canyoning is a recreational activity that has increased in popularity in the last decade in Europe and North America, resulting in up to 40% of the total search and rescue costs in some geographic locations. The International Commission for Mountain Emergency Medicine convened an expert panel to develop recommendations for on-site management and transport of patients in canyoning incidents. The goal of the current review is to provide guidance to healthcare providers and canyoning rescue professionals about best practices for rescue and medical treatment through the evaluation of the existing best evidence, focusing on the unique combination of remoteness, water exposure, limited on-site patient management options, and technically challenging terrain...
February 5, 2018: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/29420543/does-the-chronic-care-model-meet-the-emerging-needs-of-people-living-with-multimorbidity-a-systematic-review-and-thematic-synthesis
#16
Kasey R Boehmer, Abd Moain Abu Dabrh, Michael R Gionfriddo, Patricia Erwin, Victor M Montori
BACKGROUND: The Chronic Care Model (CCM) emerged in the 1990s as an approach to re-organize primary care and implement critical elements that enable it to proactively attend to patients with chronic conditions. The chronic care landscape has evolved further, as most patients now present with multiple chronic conditions and increasing psychosocial complexity. These patients face accumulating and overwhelming complexity resulting from the sum of uncoordinated responses to each of their problems...
2018: PloS One
https://www.readbyqxmd.com/read/29417914/primary-care-practitioner-perceptions-and-attitudes-of-complementary-medicine-a-content-analysis-of-free-text-responses-from-a-survey-of-non-metropolitan-australian-general-practitioners
#17
Jon L Wardle, David W Sibbritt, Jon Adams
Aim This study examines GP perceptions, attitudes and knowledge of complementary medicine (CM), and to understand contextual factors that influence these perceptions, attitudes and knowledge. BACKGROUND: CM use is increasing, and its influence on primary care becoming increasingly significant. Although general practitioners (GPs) often have central primary care gate-keeper roles within health systems, few studies have looked specifically at GPs' perceptions, attitudes and knowledge of CM...
February 8, 2018: Primary Health Care Research & Development
https://www.readbyqxmd.com/read/29417357/emergency-medicine-summary-code-for-reporting-ct-scan-results-implementation-and-survey-results
#18
Joanne Lam, Ryan Coughlin, Luce Buhl, Meghan Herbst, Timothy Herbst, Jared Martillotti, Bret Coughlin
PURPOSE: The purpose of the study was to assess the emergency department (ED) providers' interest and satisfaction with ED CT result reporting before and after the implementation of a standardized summary code for all CT scan reporting. MATERIALS AND METHODS: A summary code was provided at the end of all CTs ordered through the ED from August to October of 2016. A retrospective review was completed on all studies performed during this period. A pre- and post-survey was given to both ED and radiology providers...
February 7, 2018: Emergency Radiology
https://www.readbyqxmd.com/read/29416865/a-week-of-pain-in-the-emergency-department
#19
Hilary Sarah Thornton, Joseph Reynolds, Timothy J Coats
Background: Pain is a common complaint in patients attending the emergency department (ED), and historically, it is under-assessed and undertreated. Previous research is heterogeneous and does not well describe pain in EDs over time. Our aim was to describe pain in a UK ED using a sample that included every adult attendance over the course of 1 week. Methods: We retrospectively reviewed every adult attendance (N = 1872) over 1 week to the ED of a large English NHS District General Hospital...
February 2018: British Journal of Pain
https://www.readbyqxmd.com/read/29411300/the-sound-of-air-point-of-care-lung-ultrasound-in-perioperative-medicine
#20
REVIEW
Alberto Goffi, Richelle Kruisselbrink, Giovanni Volpicelli
PURPOSE: Lung ultrasound (LUS) has emerged as an effective and accurate goal-directed diagnostic tool that can be applied in real time for the bedside assessment of patients with respiratory symptoms and signs. Lung ultrasound has definite and easily recognized findings and has been shown to outperform physical examination and chest radiography for the diagnosis and monitoring of many pulmonary and pleural conditions. In this article, we review the principles of LUS image acquisition and interpretation, summarizing key terms and sonographic findings...
February 6, 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
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