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https://www.readbyqxmd.com/read/27853688/prime-incision-and-modified-moving-window-a-minimally-invasive-access-for-breast-cancer-surgical-treatment
#1
Silvio E Bromberg, Roberto Giordano
BACKGROUND: Conservative surgical treatment has been the treatment of choice for early breast cancer. It allows feasible oncological treatment with a satisfactory cosmetic approach and fast recovery. However, in some cases mastectomy is necessary. This study proposes a surgical approach with only one surgical access through the same incision, which is in line with precepts mentioned above. It is called the prime incision and modified moving window techniques. METHODS: Thirty one patients with a breast cancer diagnosis who would have to undergo surgery were enrolled...
September 2016: World Journal of Plastic Surgery
https://www.readbyqxmd.com/read/27756923/an-analysis-of-community-pharmacy-shared-faculty-members-contributions-to-teaching-service-and-scholarship
#2
Jennifer L Bacci, Tolu P Akinwale, Alex J Adams, Melissa Somma McGivney
Objective. To identify community pharmacy shared faculty members across the United States and to describe their roles and responsibilities in terms of teaching, service, and scholarship. Methods. This study was a mixed-methods analysis using surveys and key informant interviews. Results. Twenty-two faculty members completed the survey; nine were interviewed. Their major roles and responsibilities included teaching in community-based and experiential learning courses, precepting students and/or residents, being actively involved in professional organizations, providing patient care while leading innovation, and disseminating findings through scholarship...
September 25, 2016: American Journal of Pharmaceutical Education
https://www.readbyqxmd.com/read/27745945/is-failure-to-awaken-and-wean-malpractice
#3
Constantine A Manthous
BACKGROUND: Respiratory failure is among the most common primary causes of or complications of critical illness, and although mechanical ventilation can be lifesaving, it also engenders substantial risk of morbidity and mortality to patients. Three decades of research suggests that the duration of invasive mechanical ventilation can be reduced substantially, reducing morbidity and mortality. Mean duration of ventilation reported in recent international studies suggests a quality chasm in management of this common critical illness...
May 4, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27710811/interprofessional-education-in-the-clinical-setting-a-qualitative-look-at-the-preceptor-s-perspective-in-training-advanced-practice-nursing-students
#4
Angel K Chen, Josette Rivera, Nicole Rotter, Emily Green, Susan Kools
With the shift towards interprofessional education to promote collaborative practice, clinical preceptors are increasingly working with trainees from various professions to provide patient care. It is unclear whether and how preceptors modify their existing precepting approach when working with trainees from other professions. There is little information on strategies for this type of precepting, and how preceptors may foster or impede interprofessional collaboration. The purpose of this qualitative description pilot study was to identify current methods preceptors use to teach trainees from other professions in the clinical setting, particularly advanced practice nursing and medical trainees, and to identify factors that support or impede this type of precepting...
November 2016: Nurse Education in Practice
https://www.readbyqxmd.com/read/27689202/gastrointestinal-side-effects-of-post-transplant-therapy
#5
REVIEW
Valerian Ciprian Lucan, Luisa Berardinelli
Modern immunosuppressive therapy has produced a real revolution in renal and organ transplantation but it comes with the price of multiple side effects. There are many gastrointestinal (GI) complications that are the consequence of transplant immunosuppressant medication. In fact, for any immunosuppressant therapy, certain standardized precepts and attitudes that aim to reduce the incidence and the impact of the medication side effects must be applied. Many patients undergo renal transplantation and the physicians have to be aware of the advantages and the risks associated...
September 2016: Journal of Gastrointestinal and Liver Diseases: JGLD
https://www.readbyqxmd.com/read/27638986/an-advisory-committee-for-the-regulation-of-innovation-in-gynaecologic-practice-development-and-implementation
#6
Scott A Farrell, Nancy Van Eyk
The fundamental precepts that underpin the delivery of all medical care are safety and efficacy. Although these precepts, in theory, are accepted without challenge, in many settings where clinical care is delivered, there is a lack of formal oversight necessary to ensure their implementation in practice. Even though most medical specialties have national bodies that provide guidelines for good medical practice, and hospital accreditation makes reference to dissemination of such guidelines, there is usually not a mechanism to monitor medical uptake and adherence to good practice in the day-to-day delivery of care...
August 2016: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/27400180/exploring-the-reality-of-using-patient-experience-data-to-provide-resident-feedback-a-qualitative-study-of-attending-physician-perspectives
#7
Steffanie Campbell, Heather Honoré Goltz, Sarah Njue, Bich Ngoc Dang
INTRODUCTION: Little is known about the attitudes of faculty and residents toward the use of patient experience data as a tool for providing resident feedback. The purpose of this study was to explore the attitudes of teaching faculty surrounding patient experience data and how those attitudes may influence the feedback given to trainees. METHODS: From July 2013 to August 2013, we conducted in-depth, face-to-face, semistructured interviews with 9 attending physicians who precept residents in internal medicine at 2 continuity clinics (75% of eligible attendings)...
2016: Permanente Journal
https://www.readbyqxmd.com/read/27146222/preceptor-teaching-tips-in-longitudinal-clerkships
#8
Robyn Latessa, Anthony Schmitt, Norma Beaty, Stephen Buie, Lisa Ray
BACKGROUND: In longitudinal integrated clerkships (LICs), the continuous preceptor and student relationship over time creates opportunities for more in-depth teaching approaches than shorter preceptorships allow. We identify student perceptions of the most effective teaching practices and develop tips for LIC preceptors. METHODS: The first four third-year medical student classes completing the Asheville LIC of the University of North Carolina School of Medicine (UNC SOM) formed the subject group...
June 2016: Clinical Teacher
https://www.readbyqxmd.com/read/27136387/the-experiences-of-chronically-ill-patients-and-registered-nurses-when-they-negotiate-patient-care-in-hospital-settings-a-feminist-poststructural-approach-a-qualitative-study-that-explores-negotiation-of-patient-care-between-patients-and-chronically-ill-patients
#9
Odette Griscti, Megan Aston, Ruth Martin-Misener, Deborah Mcleod, Grace Warner
AIMS AND OBJECTIVES: The aim of this study was to understand the experiences of chronically ill patients and registered nurse in negotiating patient care in hospital. Specifically, we explored how social and institutional discourses shaped power relations and negotiation of patient care. BACKGROUND: Current literature indicates that although nurses embrace this notion, such partnerships are not easily implemented. Most existing studies focus on the role of the nurse as the leader of the partnership with little attention paid to how social and institutional values, beliefs and practices shape nurse/patient power relations; or how these relationships are negotiated between nurses and patients...
July 2016: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/27102579/integrating-correctional-and-community-health-care-an-innovative-approach-for-clinical-learning-in-a-baccalaureate-nursing-program
#10
Mary T Bouchaud, Beth Ann Swan
PROBLEM: With an evolving focus on primary, community-based, and patient-centered care rather than acute, hospital-centric, disease-focused care, and recognition of the importance of coordinating care and managing transitions across providers and settings of care, registered nurses need to be prepared from a different and broader knowledge base and skills set. A culture change among nurse educators and administrators and in nursing education is needed to prepare competent registered nurses capable of practicing from a health promotion, disease prevention, community- and population-focused construct in caring for a population of patients who are presenting health problems and conditions that persist across decades and/or lifetimes...
April 22, 2016: Nursing Forum
https://www.readbyqxmd.com/read/27098045/inhaler-technique-facts-and-fantasies-a-view-from-the-aerosol-drug-management-improvement-team-admit
#11
REVIEW
Mark L Levy, P N R Dekhuijzen, P J Barnes, M Broeders, C J Corrigan, B L Chawes, L Corbetta, J C Dubus, Th Hausen, F Lavorini, N Roche, J Sanchis, Omar S Usmani, J Viejo, W Vincken, Th Voshaar, G K Crompton, Soren Pedersen
Health professionals tasked with advising patients with asthma and chronic obstructive pulmonary disease (COPD) how to use inhaler devices properly and what to do about unwanted effects will be aware of a variety of commonly held precepts. The evidence for many of these is, however, lacking or old and therefore in need of re-examination. Few would disagree that facilitating and encouraging regular and proper use of inhaler devices for the treatment of asthma and COPD is critical for successful outcomes. It seems logical that the abandonment of unnecessary or ill-founded practices forms an integral part of this process: the use of inhalers is bewildering enough, particularly with regular introduction of new drugs, devices and ancillary equipment, without unnecessary and pointless adages...
2016: NPJ Primary Care Respiratory Medicine
https://www.readbyqxmd.com/read/27073354/practical-application-of-the-neuroregenerative-properties-of-ketamine-real-world-treatment-experience
#12
REVIEW
Theodore A Henderson
While controversial, ketamine has emerged as an effective treatment for refractory depression. Serial infusions have been performed 3 times per week, but our practical experience has challenged this precept concerning infusion frequency. Depression is associated with neuron loss, reduced synapse numbers, and dearborization of dendrites. Ketamine appears to potently induce mechanisms which reverse these neurodegenerative processes. Ketamine not only blocks the glutamate receptor, it activates eukaroyotic elongation factor 2 (eEF2)...
February 2016: Neural Regeneration Research
https://www.readbyqxmd.com/read/26990847/exploring-medical-student-learning-needs-in-the-pediatric-emergency-department-what-do-you-want-to-learn-right-now
#13
Martin V Pusic, Robert Best, John B Black, Andrew Mutnick
BACKGROUND: When precepting medical students in the emergency department, faculty physicians often have only minutes per patient encounter to devote to direct teaching. Instructional strategies that promote independent student learning after each case may have merit. It is not known, however, to what degree patient-triggered learning needs are amenable to independent study. OBJECTIVE: The aims of this study were to determine self- and faculty-reported learner needs at the time of patient encounters and to assess the degree to which these perceived needs may be satisfied by independent study...
April 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/26868311/an-experiential-learning-model-facilitates-learning-of-bedside-ultrasound-by-preclinical-medical-students
#14
Hamid Shokoohi, Keith Boniface, Parisa Kaviany, Paige Armstrong, Kathleen Calabrese, Ali Pourmand
OBJECTIVE: To examine the effects of an experiential learning model of ultrasound training on preclinical medical students' knowledge and practice of Focused Assessment with Sonography for Trauma (FAST) examination. METHODS: The study was conducted in 2 phases. In phase 1, first- and second-year medical students participated in a 45-minute didactic presentation and subsequent 1-hour hands-on practice followed by 3-5 precepted FAST examinations in the emergency department...
March 2016: Journal of Surgical Education
https://www.readbyqxmd.com/read/26814434/medical-machiavellianism-the-tradeoff-between-benefit-and-harm-with-targeted-chemotherapy
#15
Bryan Oronsky, Corey Carter, Anna Scicinska, Arnold Oronsky, Neil Oronsky, Michelle Lybeck, Jan Scicinski
Machiavellianism is a word synonymous with the phrase "the end justifies the means", and in this article we have coined the term Medical Machiavellianism to describe the 'cruel-to-be-kind' administration of toxic chemotherapeutic agents in apparent violation of the precept first do no harm, while acknowledging the 'dirty hands' dilemma of having to decide between and choose the lesser of two evils in the setting of advanced cancer--i.e. to treat or not to treat. The perception that 'targeted' therapies are relatively non-toxic and therefore respect the Hippocratic First Commandment by virtue of their narrow selectivity is belied by their often inherent promiscuity, addressing multiple targets either inadvertently or deliberately, which may result in multiple side effects...
February 23, 2016: Oncotarget
https://www.readbyqxmd.com/read/26786462/hallucinations-insights-and-supportive-first-care
#16
Bob Price
Nurses working in a range of clinical settings may encounter patients who report experiencing hallucinations, whether auditory, visual or any other form. This article, which has been written for nurses working in general practice rather than mental health practice, clarifies the differences between hallucinations and delusions and explains that both symptoms are often experienced together in mental illness. The possible causes of hallucinations are summarised and the advice that should be given to patients is discussed...
January 20, 2016: Nursing Standard
https://www.readbyqxmd.com/read/26786246/trends-and-tenets-in-relapsing-and-progressive-opsoclonus-myoclonus-syndrome
#17
REVIEW
Michael R Pranzatelli, Elizabeth D Tate
Despite advances in inducing remission in pediatric opsoclonus-myoclonus syndrome (OMS), relapse remains a challenge. By definition, relapse is not a characteristic of monophasic OMS, but occurs at any time in the course of multiphasic OMS. Due to variability and heterogeneity, patients are best approached and treated on a case-by-case basis, using precepts derived from clinical and scientific studies. Treatment of provocations, such as infection or immunotherapy tapering, is the short-term goal, but discovering unresolved neuroinflammation and re-configuring disease-modifying agents is crucial in the long-term...
May 2016: Brain & Development
https://www.readbyqxmd.com/read/26767154/systematic-review-of-thigh-symptoms-after-lateral-transpsoas-interbody-fusion-for-adult-patients-with-degenerative-lumbar-spine-disease
#18
Isaac D Gammal, Jeffrey M Spivak, John A Bendo
BACKGROUND: Lateral transpsoas interbody fusion (LTIF) is a minimally invasive technique for achieving lumbar spinal fusion. While it has many advantages over open techniques it carries with it a distinct set of risks, most commonly post-operative ipsilateral thigh pain, weakness and sensory disturbances. It is vital for both the surgeon and patient to understand the risks for and outcomes of injury associated with this procedure. We conducted a systematic review of the literature to evaluate the incidence, risks, and long-term clinical outcomes of post-operative thigh symptoms in patients treated with LTIF...
2015: International Journal of Spine Surgery
https://www.readbyqxmd.com/read/26766936/an-academic-multihealth-system-pgy2-pediatric-pharmacy-residency-program
#19
Theresa Klosterman, Rachel Meyers, Anita Siu, Pooja Shah, Katelin Kimler, Marc Sturgill, Christine Robinson
We describe a novel multihealth system pediatric pharmacy residency program through the Ernest Mario School of Pharmacy at Rutgers University. Pediatric clinical pharmacy is a growing field that has seen an increase in demand for practitioners. Practice sites include freestanding children's hospitals, children's hospitals within adult hospitals, and pediatric units within adult hospitals. To accommodate a residency program in a region with no freestanding children's hospital, the pediatric faculty members at the Ernest Mario School of Pharmacy at Rutgers University developed a multihealth system postgraduate year 2 (PGY2) pediatric pharmacy residency program with 6 pediatric faculty members functioning as preceptors at their 5 respective practice sites...
November 2015: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/26682098/the-outcome-of-using-closed-suction-wound-drains-in-patients-undergoing-lumbar-spine-surgery-a-systematic-review
#20
REVIEW
Feras Waly, Mohammad M Alzahrani, Fahad H Abduljabbar, Tara Landry, Jean Ouellet, Kathryn Moran, Joseph R Dettori
Study Design Systematic review. Objective Determine whether closed suction wound drains decrease the incidence of postoperative complications compared with no drain use in patients undergoing spine surgery for lumbar degenerative conditions. Methods Electronic databases and reference lists of key articles were searched up through January 22, 2015, to identify studies comparing the use of closed suction wound drains with no drains in spine surgery for lumbar degenerative conditions. Outcomes assessed included the cumulative incidence of epidural hematoma, superficial and deep wound infection, and postoperative blood transfusion...
December 2015: Global Spine Journal
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