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Emergency medicine practice

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https://www.readbyqxmd.com/read/28228864/innovative-payer-engagement-strategies-will-the-convergence-lead-to-better-value-creation-in-personalized-medicine
#1
REVIEW
Ildar Akhmetov, Rostyslav V Bubnov
BACKGROUND: As reimbursement authorities are gaining greater power to influence the prescription behavior of physicians, it remains critical for life science companies focusing on personalized medicine to develop "tailor-made" payer engagement strategies to secure reimbursement and assure timely patient access to their innovative products. Depending on the types of such engagement, pharmaceutical and diagnostic companies may benefit by obtaining access to medical and pharmacy claims data, getting invaluable upfront inputs on evidence requirements and clinical trial design, and strengthening trust by payers, therefore avoiding uncertainties with regards to pricing, reimbursement, and research and development reinvestment...
December 2017: EPMA Journal
https://www.readbyqxmd.com/read/28225541/perceived-barriers-to-adherence-to-tuberculosis-infection-control-measures-among-health-care-workers-in-the-dominican-republic
#2
Helena J Chapman, Bienvenido A Veras-Estévez, Jamie L Pomeranz, Eddy N Pérez-Then, Belkys Marcelino, Michael Lauzardo
INTRODUCTION Health care workers have an increased risk of infection due to occupational Mycobacterium tuberculosis exposure, including multidrug-resistant strains. Health care workers' risk of developing tuberculosis is greater than that of the general population, whether in low-, intermediate- or high-incidence countries. Adherence to infection control measures (administrative controls, environmental controls, and personal respiratory protection) is essential to reduce risk of disease transmission between suspected tuberculosis patients and health care workers, but for different reasons, both objective and subjective, adherence is low...
January 2017: MEDICC Review
https://www.readbyqxmd.com/read/28225376/a-qualitative-analysis-of-general-emergency-medicine-providers-perceptions-on-pediatric-emergency-telemedicine
#3
Ji Won Kim, Gunjan Tiyyagura, Melissa Langhan
OBJECTIVE: Most children in the United States are evaluated in general emergency departments (ED), which are staffed by practitioners who care for both adults and children and may have limited pediatric resources. The application of telemedicine in pediatrics is growing and has been shown to be effective in outpatient as well as critical care settings. Telemedicine has the potential to address disparities in access to pediatric emergency care. The objective of this study was to explore experiences of general ED providers with telemedicine and their perception about a potential video telemedicine program with pediatric ED providers...
February 21, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28224938/overview-on-the-challenges-and-benefits-of-using-telehealth-tools-in-a-pediatric-population
#4
REVIEW
Patrick D Brophy
Telehealth in Pediatric Medicine presents many of the same benefits and challenges noted in adult-based medicine. In terms of health care delivery, the promise of improving access and reducing costs using telehealth in Pediatrics, particularly chronic care, is high. The ability to address clinician shortages and provide remote guidance for chronic care pathways from pediatric subspecialists to rural-based referring physicians is a developing model that represents a sustainable and cost-effective strategy to improve pediatric care...
January 2017: Advances in Chronic Kidney Disease
https://www.readbyqxmd.com/read/28220199/-novel-pharmaceutical-treatment-approaches-for-gastric-cancer
#5
F Lordick
This review article delineates novel approaches for the pharmaceutical treatment of gastric cancer. A newly developed molecular classification of gastric cancer based on histology, genetic, epigenetic and proteomic characteristics has evolved. It provides a road map for development of new drugs and combinations as well as for patient stratification in clinical research and it is expected to be introduced into clinical practice in the near future. Anti-HER2 targeted treatment is a validated strategy for treatment of metastatic gastric cancer and is now also being studied in the perioperative setting to increase response rates and ultimately survival in patients undergoing curative surgery; however, the resistance mechanisms of HER2-targeted treatment are poorly understood and optimal patient selection remains challenging...
February 20, 2017: Der Pathologe
https://www.readbyqxmd.com/read/28219617/techniques-and-outcomes-of-emergency-airway-management-in-japan-an-analysis-of-two-multicentre-prospective-observational-studies-2010-2016
#6
Yukari Goto, Tadahiro Goto, Yusuke Hagiwara, Yusuke Tsugawa, Hiroko Watase, Hiroshi Okamoto, Kohei Hasegawa
OBJECTIVES: Continuous surveillance of emergency airway management practice is imperative in improving quality of care and patient safety. We aimed to investigate the changes in the practice of emergency airway management and the related outcomes in the emergency departments (EDs) in Japan. METHODS: We conducted an analysis of the data from two prospective, observational, multicentre registries of emergency airway management-the Japanese Emergency Airway Network (JEAN)-1 and -2 Registries from April 2010 through May 2016...
February 17, 2017: Resuscitation
https://www.readbyqxmd.com/read/28217529/study-of-awareness-of-adrenal-disorders-among-interns-and-postgraduate-students-of-hamidia-hospital-bhopal
#7
Sachin Chittawar, T N Dubey, Jitendra Sharma, Sagar Khandare
INTRODUCTION: Adrenal disorders could be a life-threatening emergency, hence requires immediate therapeutic management. For this awareness regarding its diagnosis, management, and treatment is prime important. AIMS AND OBJECTIVE: To study the awareness of adrenal disorders among interns and postgraduates students of Hamidia Hospital, Bhopal. MATERIALS AND METHODS: A cross-sectional questionnaire-based study was performed. Fifty-six participants, i...
January 2017: Indian Journal of Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28215397/clinical-mimics-an-emergency-medicine-focused-review-of%C3%A2-influenza-mimics
#8
Erica Simon, Brit Long, Alex Koyfman
BACKGROUND: Influenza viruses are a significant cause of morbidity and mortality in the United States. Given the wide range of symptoms, emergency physicians must maintain a broad differential diagnosis in the evaluation and treatment of patients presenting with influenza-like illnesses. OBJECTIVE: This review addresses objective and subjective symptoms commonly associated with influenza and discusses important mimics of influenza viruses, while offering a practical approach to their clinical evaluation and treatment...
February 15, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28210367/academic-primer-series-eight-key-papers-about-education-theory
#9
Michael Gottlieb, Megan Boysen-Osborn, Teresa M Chan, Sara M Krzyzaniak, Nicolas Pineda, Jordan Spector, Jonathan Sherbino
INTRODUCTION: Many teachers adopt instructional methods based on assumptions of best practices without attention to or knowledge of supporting education theory. Familiarity with a variety of theories informs education that is efficient, strategic, and evidence-based. As part of the Academic Life in Emergency Medicine Faculty Incubator Program, a list of key education theories for junior faculty was developed. METHODS: A list of key papers on theories relevant to medical education was generated using an expert panel, a virtual community of practice synthetic discussion, and a social media call for resources...
February 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28210357/a-survey-of-emergency-medicine-residents-use-of-educational-podcasts
#10
Jeff Riddell, Anand Swaminathan, Monica Lee, Abdiwahab Mohamed, Rob Rogers, Salim R Rezaie
INTRODUCTION: Emergency medicine (EM) educational podcasts have become increasingly popular. Residents spend a greater percentage of their time listening to podcasts than they do using other educational materials. Despite this popularity, research into podcasting in the EM context is sparse. We aimed to determine EM residents' consumption habits, optimal podcast preferences, and motivation for listening to EM podcasts. METHODS: We created a survey and emailed it to EM residents at all levels of training at 12 residencies across the United States from September 2015 to June 2016...
February 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28207163/prognostic-value-and-development-of-a-scoring-system-in-horses-with-systemic-inflammatory-response-syndrome
#11
M-F Roy, G P S Kwong, J Lambert, S Massie, S Lockhart
BACKGROUND: Despite its widespread use in equine medicine, the clinical value of the systemic inflammatory response syndrome (SIRS) concept in horses remains unknown. OBJECTIVES: To study the prognostic value of measures of SIRS in horses and identify the best model of severe SIRS to predict outcome. ANIMALS: A total of 479 consecutive adult horse emergency admissions to a private primary referral practice. METHODS: Prospective observational study...
February 16, 2017: Journal of Veterinary Internal Medicine
https://www.readbyqxmd.com/read/28207079/the-growing-threat-of-antimicrobial-resistance
#12
Jose M Munita, Samuel Shelburne, David E Greenberg, Cesar A Arias
The emergence and widespread dissemination of multidrug-resistant organisms is considered one of the three most important public health threats for humankind in the 21st century and jeopardizes the practice of modern medicine. Failure to tackle this problem in a comprehensive fashion could result in a dire post-antibiotic era, impairing the future development of treatments against important diseases, such as cancer, and transplant medicine, among others. Here, we provide a global perspective of the problem and describe some of the most important antibiotic-resistant organisms affecting the health of our patients...
February 1, 2017: Texas Medicine
https://www.readbyqxmd.com/read/28206829/validity-of-low-contrast-letter-acuity-as-a-visual-performance-outcome-measure-for-multiple-sclerosis
#13
Laura J Balcer, Jenelle Raynowska, Rachel Nolan, Steven L Galetta, Raju Kapoor, Ralph Benedict, Glenn Phillips, Nicholas LaRocca, Lynn Hudson, Richard Rudick
Low-contrast letter acuity (LCLA) has emerged as the leading outcome measure to assess visual disability in multiple sclerosis (MS) research. As visual dysfunction is one of the most common manifestations of MS, sensitive visual outcome measures are important in examining the effect of treatment. Low-contrast acuity captures visual loss not seen in high-contrast visual acuity (HCVA) measurements. These issues are addressed by the MS Outcome Assessments Consortium (MSOAC), including representatives from advocacy organizations, Food and Drug Administration (FDA), European Medicines Agency (EMA), National Institute of Neurological Disorders and Stroke (NINDS), academic institutions, and industry partners along with persons living with MS...
February 1, 2017: Multiple Sclerosis: Clinical and Laboratory Research
https://www.readbyqxmd.com/read/28201852/the-probability-of-probability-and-research-truths
#14
Daniel M Fatovich, Michael Phillips
The foundation of much medical research rests on the statistical significance of the P-value, but we have fallen prey to the seductive certainty of significance. Other scientific disciplines work to a different standard. This may partly explain why medical reversal is an increasing phenomenon, whereby new studies (based on the 0.05 standard) overturn previous significant findings. This has generated a crisis in the rigour of evidence-based medicine, as many people erroneously believe that a P < 0.05 means the treatment effect is clinically important...
February 15, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28198722/triad-viii-nationwide-multicenter-evaluation-to-determine-whether-patient-video-testimonials-can-safely-help-ensure-appropriate-critical-versus-end-of-life-care
#15
Ferdinando L Mirarchi, Timothy E Cooney, Arvind Venkat, David Wang, Thaddeus M Pope, Abra L Fant, Stanley A Terman, Kevin M Klauer, Monica Williams-Murphy, Michael A Gisondi, Brian Clemency, Ankur A Doshi, Mari Siegel, Mary S Kraemer, Kate Aberger, Stephanie Harman, Neera Ahuja, Jestin N Carlson, Melody L Milliron, Kristopher K Hart, Chelsey D Gilbertson, Jason W Wilson, Larissa Mueller, Lori Brown, Bradley D Gordon
OBJECTIVE: End-of-life interventions should be predicated on consensus understanding of patient wishes. Written documents are not always understood; adding a video testimonial/message (VM) might improve clarity. Goals of this study were to (1) determine baseline rates of consensus in assigning code status and resuscitation decisions in critically ill scenarios and (2) determine whether adding a VM increases consensus. METHODS: We randomly assigned 2 web-based survey links to 1366 faculty and resident physicians at institutions with graduate medical education programs in emergency medicine, family practice, and internal medicine...
February 14, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28196622/non-cardiac-chest-pain-a-review-for-the-consultation-liaison-psychiatrist
#16
Kirsti A Campbell, Elizabeth N Madva, Ana C Villegas, Eleanor E Beale, Scott R Beach, Jason H Wasfy, Ariana M Albanese, Jeff C Huffman
BACKGROUND: Patients presenting with chest pain to general practice or emergency providers represent a unique challenge, as the differential is broad and varies widely in acuity. Importantly, most cases of chest pain in both acute and general practice settings are ultimately found to be non-cardiac in origin, and a substantial proportion of patients experiencing non-cardiac chest pain (NCCP) suffer significant disability. In light of emerging evidence that mental health providers can serve a key role in the care of patients with NCCP, knowledge of the differential diagnosis, psychiatric co-morbidities, and therapeutic techniques for NCCP would be of great use to both consultation-liaison (C-L) psychiatrists and other mental health providers...
December 9, 2016: Psychosomatics
https://www.readbyqxmd.com/read/28193377/another-time-another-space-the-evolution-of-the-virtual-journal-club
#17
REVIEW
Alison L Chetlen, Carol M Dell, Agnieszka O Solberg, Hansel J Otero, Kirsteen R Burton, Matthew T Heller, Nikita Lakomkin, Stephane L Desouches, Stacy E Smith
Virtual journal clubs (VJCs) provide a standardized, easily accessible forum for evidence-based discussion. The new virtual reality setting in which journal clubs and other online education events now take place offers great advantages and new opportunities for radiologists in academic medicine and private practice. VJCs continue to evolve, largely due to many emerging technologies and platforms. VJCs will continue to play an increasingly important role in medical education, interdisciplinary interaction, and multi-institutional collaboration...
March 2017: Academic Radiology
https://www.readbyqxmd.com/read/28192087/endothelial-cell-markers-from-clinician-s-perspective
#18
REVIEW
Jelena Rakocevic, Dejan Orlic, Olivera Mitrovic-Ajtic, Miloje Tomasevic, Milan Dobric, Natasa Zlatic, Dejan Milasinovic, Goran Stankovic, Miodrag Ostojić, Milica Labudovic-Borovic
Endothelial cell markers are membrane-bound or cytoplasmic molecules expressed by endothelial cells, which help their easier identification and discrimination from other cell types. During vasculogenesis, endothelial cells differentiate from hemangioblasts to form new blood vessels. With the discovery of endothelial progenitor cells (EPC) and their ability to form new blood vessels, the term vasculogenesis is not only reserved for the embryonic development. Possibility of de novo blood vessel formation from EPC is now widely explored in different ischemic conditions, especially in cardiovascular medicine...
February 9, 2017: Experimental and Molecular Pathology
https://www.readbyqxmd.com/read/28191610/italian-intersociety-consensus-on-doac-use-in-internal-medicine
#19
Domenico Prisco, Walter Ageno, Cecilia Becattini, Armando D'Angelo, Giovanni Davì, Raimondo De Cristofaro, Francesco Dentali, Giovanni Di Minno, Anna Falanga, Gualberto Gussoni, Luca Masotti, Gualtiero Palareti, Pasquale Pignatelli, Roberto M Santi, Francesca Santilli, Mauro Silingardi, Antonella Tufano, Francesco Violi
The direct oral anticoagulants (DOACs) are drugs used in clinical practice since 2009 for the prevention of stroke or systemic embolism in non-valvular atrial fibrillation, and for the treatment and secondary prevention of venous thromboembolism. The four DOACs, including the three factor Xa inhibitors (rivaroxaban, apixaban and edoxaban) and one direct thrombin inhibitor (dabigatran) provide oral anticoagulation therapy alternatives to Vitamin K antagonists (VKAs). Despite their clear advantages, the DOACs require on the part of the internist a thorough knowledge of their pharmacokinetic and pharmacodynamic characteristics to ensure their correct use, laboratory monitoring and the appropriate management of adverse events...
February 13, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28191605/integrating-palliative-care-into-routine-care-of-patients-with-heart-failure-models-for-clinical-collaboration
#20
REVIEW
Warren H Lewin, Kristen G Schaefer
Heart failure (HF) affects nearly 5.7 million Americans and is described as a chronic incurable illness carrying a poor prognosis. Patients living with HF experience significant symptoms including dyspnea, pain, anxiety, fatigue, and depression. As the illness advances into later stages, symptoms become more intense and refractory to standard treatments, leading to recurrent acute-care utilization and contributing to poor quality of life. Advanced HF symptoms have been described to be as burdensome, if not more than, those in cancer populations...
February 13, 2017: Heart Failure Reviews
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