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Emergency medicine practice

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https://www.readbyqxmd.com/read/28319473/precision-medicine-in-asthma-the-role-of-bronchial-thermoplasty
#1
Amber J Oberle, Praveen Mathur
PURPOSE OF REVIEW: The inflammatory makeup of severe asthma is heterogeneous. Identification of the predominant cellular endotype via biomarkers can aid in the selection of more advanced therapies. This review is clinically focused on how to use these biomarkers to help select between biologic agents and/or bronchial thermoplasty. RECENT FINDINGS: Several Th2 biomarkers exist for the detection of eosinophilic disease; however, the best biomarker for clinical practice is debatable depending upon local resources...
March 17, 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28315025/practices-and-attitudes-towards-radiation-risk-disclosure-for-computed-tomography-survey-of-emergency-medicine-residency-program-directors
#2
Jennifer R Marin, Karen E Thomas, Angela M Mills, Joshua S Broder, Kathy Boutis
PURPOSE: The purposes of this study were to evaluate the frequency with which emergency physicians involved in residency leadership disclose potential malignancy risks from computed tomography (CT), assess comfort with these discussions, and evaluate factors influencing risk disclosure. METHODS: We surveyed emergency medicine residency program directors and associate/assistant directors. Primary outcome was the proportion who "almost always" or "most of the time" discussed potential risks...
March 17, 2017: Emergency Radiology
https://www.readbyqxmd.com/read/28306741/pre-hospital-midazolam-for-benzodiazepine-treated-seizures-before-and-after-the-rapid-anticonvulsant-medication-prior-to-arrival-trial-a-national-observational-cohort-study
#3
Eytan Shtull-Leber, Robert Silbergleit, William J Meurer
BACKGROUND: Implementation of evidence-based treatment for pre-hospital status epilepticus can improve outcomes. We hypothesized that publication of a pivotal pre-hospital clinical trial (RAMPART), demonstrating superiority of intramuscular midazolam over intravenous lorazepam, altered the national utilization rates of midazolam for pre-hospital benzodiazepine-treated seizures, while upholding its safety and efficacy outside the trial setting. METHODS AND FINDINGS: This is a retrospective, observational cohort study of pre-hospital patient encounters throughout the United States in the National Emergency Medicine Services Information System database, from January 2010 through December 2014...
2017: PloS One
https://www.readbyqxmd.com/read/28306185/-i-have-nine-specialists-they-need-to-swap-notes-australian-patients-perspectives-of-medication-related-problems-following-discharge-from-hospital
#4
Daniela Eassey, Andrew J McLachlan, Jo-Anne Brien, Ines Krass, Lorraine Smith
BACKGROUND: Research has shown that patients are most susceptible to medication-related problems (MRPs) when transitioning from hospital to home. Currently, the literature in this area focuses on interventions, which are mainly orientated around the perspective of the health-care professional and do not take into account patient perspectives and experiences. OBJECTIVE: To capture the experiences and perceptions of Australian patients regarding MRPs following discharge from hospital...
March 17, 2017: Health Expectations: An International Journal of Public Participation in Health Care and Health Policy
https://www.readbyqxmd.com/read/28303693/the-opinions-of-radiographers-nuclear-medicine-technologists-and-radiation-therapists-regarding-technology-in-health-care-a-qualitative-study
#5
Sil Aarts, Forra Cornelis, Yke Zevenboom, Patrick Brokken, Nicole van de Griend, Miriam Spoorenberg, Wendy Ten Bokum, Eveline Wouters
INTRODUCTION: New technology is continuously introduced in health care. The aim of this study was (1) to collect the opinions and experiences of radiographers, nuclear medicine technologists and radiation therapists regarding the technology they use in their profession and (2) to acquire their views regarding the role of technology in their future practice. METHODS: Participants were recruited from five departments in five hospitals in The Netherlands. All radiographers, nuclear medicine therapists and radiation therapists who were working in these departments were invited to participate (n = 252)...
March 2017: Journal of Medical Radiation Sciences
https://www.readbyqxmd.com/read/28303465/pharmacotherapy-in-generalized-anxiety-disorder-novel-experimental-medicine-models-and-emerging-drug-targets
#6
REVIEW
David S Baldwin, Ruihua Hou, Robert Gordon, Nathan T M Huneke, Matthew Garner
Many pharmacological and psychological approaches have been found efficacious in patients with generalized anxiety disorder (GAD), but many treatment-seeking patients will not respond and others will relapse despite continuing with interventions that initially had beneficial effects. Other patients will respond but then stop treatment early because of untoward effects such as sexual dysfunction, drowsiness, and weight gain. There is much scope for the development of novel approaches that could have greater overall effectiveness or acceptability than currently available interventions or that have particular effectiveness in specific clinical subgroups...
March 16, 2017: CNS Drugs
https://www.readbyqxmd.com/read/28295894/cost-effectiveness-analysis-appraisal-and-application-an-emergency-medicine-perspective
#7
Michael D April, Brian P Murray
Cost-effectiveness is an important goal for emergency care delivery. The many diagnostic, treatment, and disposition decisions made in the emergency department (ED) have a significant impact upon healthcare resource utilization. Cost-effectiveness analysis (CEA) is an analytic tool to optimize these resource allocation decisions through the systematic comparison of costs and effects of alternative healthcare decisions. Yet few emergency medicine leaders and policy-makers have any formal training in CEA methodology...
March 10, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28293677/the-reliability-and-predictive-validity-of-a-sixth-semester-ospe-in-conservative-dentistry-regarding-performance-on-the-state-examination
#8
Petkov Petko, Katja Knuth-Herzig, Sebastian Hoefer, Sebastian Stehle, Sonja Scherer, Björn Steffen, Stephan Scherzer, Falk Ochsendorf, Holger Horz, Robert Sader, Susanne Gerhardt-Szép
Introduction: The aim of this study was to ascertain whether the testing format of an OSPE (Objective Structured Practical Examination) in conservative dentistry (sixth semester) predicts the scores on the practical section of the state examination (11(th) semester) in the same subject. Taking general student profiles into consideration (score on the school-leaving exam [Abitur], score on the preliminary exam in dental medicine [Physikum], length of university study, cohorts, and sex), we also investigated if any correlations or differences exist in regard to the total and partial scores on the OSPE and the corresponding state examination...
2017: GMS Journal for Medical Education
https://www.readbyqxmd.com/read/28291033/assessing-suicide-risk-what-is-commonly-missed-in-the-emergency-room
#9
Nazanin Alavi, Taras Reshetukha, Eric Prost, Kristen Antoniak, Dianne Groll
OBJECTIVE: Although risk assessment for suicide has been extensively studied, it is still an inexact process. The current study determined how busy emergency clinicians actually assessed and documented suicide risk, while also examining the differences between psychiatric and emergency medicine opinions on the importance of various suicide predictors. METHOD: Phase 1 of the study involved the administration of a survey on the relative importance of various suicide predictors for the specialties of psychiatry and emergency medicine...
March 2017: Journal of Psychiatric Practice
https://www.readbyqxmd.com/read/28290958/comparative-assessment-of-three-approaches-of-teaching-nonmedically-trained-persons-in-the-handling-of-supraglottic-airways-a-randomized-controlled-trial
#10
Mario Hensel, Willi Schmidbauer, Michael Benker, Paula Schmieder, Thoralf Kerner
BACKGROUND: The use of supraglottic airways has been recommended in combat trauma airway management. To ensure an adequate airway management on the battlefield, suitable training concepts are sought to efficiently teach as many soldiers as possible. Our aim was to compare three approaches of teaching laypersons in the handling of supraglottic airways in a mannequin model. METHODS: In this prospective randomized blinded study, 285 military service men without any medical background were divided into three groups and trained in the use of the Laryngeal Mask Airway Supreme (LMA) and the Laryngeal Tube Disposable (LT-D)...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28290956/multidisciplinary-in-situ-simulation-based-training-as-a-postpartum-hemorrhage-quality-improvement-project
#11
Monica A Lutgendorf, Carmen Spalding, Elizabeth Drake, Dennis Spence, Jason O Heaton, Kristina V Morocco
BACKGROUND: Postpartum hemorrhage is a common obstetric emergency affecting 3 to 5% of deliveries, with significant maternal morbidity and mortality. Effective management of postpartum hemorrhage requires strong teamwork and collaboration. We completed a multidisciplinary in situ postpartum hemorrhage simulation training exercise with structured team debriefing to evaluate hospital protocols, team performance, operational readiness, and real-time identification of system improvements...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28290925/two-decades-of-saving-lives-on-the-battlefield-tactical-combat-casualty-care-turns-20
#12
Frank K Butler
BACKGROUND: Twenty years ago, the original Tactical Combat Casualty Care (TCCC) article was published in this journal. Since TCCC is essentially a set of best-practice prehospital trauma care guidelines customized for use on the battlefield, the presence of a journal with a specific focus on military medicine was a profound benefit to the initial presentation of TCCC to the U.S. Military. METHODS: In the two ensuing decades, which included the longest continuous period of armed conflict in our nation's history, TCCC steadily evolved as the prehospital trauma care evidence base was augmented and as feedback from user medics, corpsmen, and pararescuemen was obtained...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28286821/smartphones-and-medical-applications-in-the-emergency-department-daily-practice
#13
Amirhosein Jahanshir, Ehsan Karimialavijeh, Hojjat Sheikh, Motahar Vahedi, Mehdi Momeni
INTRODUCTION: Medical applications help physicians to make more rapid and evidence based decisions that may provide better patient care. This study aimed to determine the extent to which smart phones and medical applications are integrated in the emergency department daily practice. METHOD: In a cross sectional study, a modified standard questionnaire (Payne et al.) consisting of demographic data and information regarding quality and quantity of smartphone and medical app utilization was sent to emergency-medicine residents and interns twice (two weeks apart), in January 2015...
2017: Emergency (Tehran, Iran)
https://www.readbyqxmd.com/read/28284769/sustainable-resuscitation-ultrasound-education-in-a-low-resource-environment-the-kumasi-experience
#14
Chelsea A Tafoya, Matthew J Tafoya, Maxwell Osei-Ampofo, Rockefeller A Oteng, Torben K Becker
BACKGROUND: Point-of-care-ultrasound (POCUS) is an increasingly important tool for emergency physicians and has become a standard component of emergency medicine residency training in high-income countries. Cardiopulmonary ultrasound (CPUS) is emerging as an effective way to quickly and accurately assess patients who present to the emergency department with shock and dyspnea. Use of POCUS, including CPUS, is also becoming more prevalent in low- and middle-income countries (LMICs); however, formal ultrasound training for emergency medicine resident physicians in these settings is not widely available...
March 8, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28283684/pharmacogenetics-in-type-2-diabetes-precision-medicine-or-discovery-tool
#15
REVIEW
Jose C Florez
In recent years, technological and analytical advances have led to an explosion in the discovery of genetic loci associated with type 2 diabetes. However, their ability to improve prediction of disease outcomes beyond standard clinical risk factors has been limited. On the other hand, genetic effects on drug response may be stronger than those commonly seen for disease incidence. Pharmacogenetic findings may aid in identifying new drug targets, elucidate pathophysiology, unravel disease heterogeneity, help prioritise specific genes in regions of genetic association, and contribute to personalised or precision treatment...
March 10, 2017: Diabetologia
https://www.readbyqxmd.com/read/28282257/human-microbiome-and-learning-healthcare-systems-integrating-research-and-precision-medicine-for-inflammatory-bowel-disease
#16
Kim H Chuong, David R Mack, Alain Stintzi, Kieran C O'Doherty
Healthcare institutions face widespread challenges of delivering high-quality and cost-effective care, while keeping up with rapid advances in biomedical knowledge and technologies. Moreover, there is increased emphasis on developing personalized or precision medicine targeted to individuals or groups of patients who share a certain biomarker signature. Learning healthcare systems (LHS) have been proposed for integration of research and clinical practice to fill major knowledge gaps, improve care, reduce healthcare costs, and provide precision care...
March 10, 2017: Omics: a Journal of Integrative Biology
https://www.readbyqxmd.com/read/28279201/magnetic-targeting-as-a-strategy-to-enhance-therapeutic-effects-of-mesenchymal-stromal-cells
#17
REVIEW
Luisa H A Silva, Fernanda F Cruz, Marcelo M Morales, Daniel J Weiss, Patricia R M Rocco
Mesenchymal stromal cells (MSCs) have been extensively investigated in the field of regenerative medicine. It is known that the success of MSC-based therapies depends primarily on effective cell delivery to the target site where they will secrete vesicles and soluble factors with immunomodulatory and potentially reparative properties. However, some lesions are located in sites that are difficult to access, such as the heart, spinal cord, and joints. Additionally, low MSC retention at target sites makes cell therapy short-lasting and, therefore, less effective...
March 9, 2017: Stem Cell Research & Therapy
https://www.readbyqxmd.com/read/28277413/community-primary-care-provider-preferences-for-emergency-department-follow-up-recommendations-a-regional-study
#18
Marissa A Hendrickson, Eta Obeya, Andrew R Wey, Philippe R Gaillard
BACKGROUND: Children who present to emergency departments (EDs) for care are frequently advised to follow up with their primary care providers (PCPs) after discharge; little is known about whether PCPs agree that follow-up advised by EDs is appropriate for their patients. OBJECTIVES: The aims of this study were to determine PCP preferences for follow-up recommendations given to their pediatric patients at the time of ED visits and to compare these preferences to reported emergency medicine provider (EMP) practice...
March 9, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28276841/effectiveness-of-an-interprofessional-education-model-based-on-the-transtheoretical-model-of-behaviour-change-to-improve-interprofessional-collaboration
#19
Fatemeh Keshmiri, Mahdi Rezai, Reza Mosaddegh, Kamran Moradi, Peyman Hafezimoghadam, Mohammad Amin Zare, Nader Tavakoli, Mohammad Ali Cheraghi, Mandana Shirazi
This study aimed to assess the effectiveness of an interprofessional education model (IPE) based on the transtheoretical model to improve the participants' interprofessional collaborative practice. The study was conducted in Iran using a controlled before-and-after study design. The participants (n = 91) were the residents of emergency medicine and nurses of the emergency units from two teaching hospitals affiliated to Iran University of Medical Sciences. The participants in the intervention group (n = 40) were 22 residents and 18 nurses...
February 28, 2017: Journal of Interprofessional Care
https://www.readbyqxmd.com/read/28274125/training-generalist-doctors-for-rural-practice-in-new-zealand
#20
Garry Nixon, Katharina Blattner, Martyn Williamson, Patrick McHugh, James Reid
Targeted postgraduate training increases the likelihood young doctors will take up careers in rural generalist medicine. This article describes the postgraduate pathways that have evolved for these doctors in New Zealand. The Cairns consensus statement 2014 defined rural medical generalism as a scope of practice that encompasses primary care, hospital or secondary care, emergency care, advanced skill sets and a population-based approach to the health needs of rural communities. Even as work goes on to define this role different jurisdictions have developed their own training pathways for these important members of the rural healthcare workforce...
January 2017: Rural and Remote Health
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