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Administration in Emergency Medicine

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https://www.readbyqxmd.com/read/29325162/an-analysis-of-adverse-events-in-the-rehabilitation-department-using-the-veterans-affairs-root-cause-analysis-system
#1
Gregory W Hagley, Peter D Mills, Brian Shiner, Robin R Hemphill
Background: Root cause analyses (RCA) are often completed in health care settings to determine causes of adverse events (AEs). RCAs result in action plans designed to mitigate future patient harm. National reviews of RCA reports have assessed the safety of numerous health care settings and suggested opportunities for improvement. However, few studies have assessed the safety of receiving care from physical therapists, occupational therapists, or speech and language pathology pathologists...
January 9, 2018: Physical Therapy
https://www.readbyqxmd.com/read/29322848/inpatient-satisfaction-at-different-public-sector-hospitals-of-a-metropolitan-city-in-pakistan-a-comparative-cross-sectional-study
#2
Mehwish Hussain, Rehana Rehman, Zia Ikramuddin, Nava Asad, Ayesha Farooq
OBJECTIVE: To observe inpatient satisfaction at different public sector hospitals of Karachi, Pakistan. METHODS: A cross sectional study was carried out during 2010-2012 in four major public sector hospitals of Karachi. A total of 710 patients completed the study. Responses were gathered in a self-structured questionnaire that comprised of four dimensions of satisfaction with doctor, staff, administration and treatment. Average Score of each dimension was taken and compared using one way analysis of variance...
January 11, 2018: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/29321117/emergency-department-resuscitation-of-pediatric-trauma-patients-in-iraq-and-afghanistan
#3
Steven G Schauer, Guyon J Hill, Jason F Naylor, Michael D April, Matthew Borgman, Vikhyat S Bebarta
BACKGROUND: Military hospital healthcare providers treated children during the recent conflicts in Afghanistan and Iraq. Compared to adults, pediatric patients present unique challenges during trauma resuscitations and have notably been discussed in few research reports. We seek to describe ED interventions performed on pediatric trauma patients in Iraq and Afghanistan. METHODS: We queried the Department of Defense Trauma Registry (DODTR) for all pediatric patients in Iraq and Afghanistan from January 2007 to January 2016...
January 4, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29315702/strategies-to-target-the-hedgehog-signaling-pathway-for-cancer-therapy
#4
REVIEW
Minhang Xin, Xinyue Ji, Ladie Kimberly De La Cruz, Suresh Thareja, Binghe Wang
Hedgehog (Hh) signaling is an essential pathway in the human body, and plays a major role in embryo development and tissue patterning. Constitutive activation of the Hh signaling pathway through sporadic mutations or other mechanisms is explicitly associated with cancer development and progression in various solid malignancies. Therefore, targeted inhibition of the Hh signaling pathway has emerged as an attractive and validated therapeutic strategy for the treatment of a wide range of cancers. Vismodegib, a first-in-class Hh signaling pathway inhibitor was approved by the US Food and Drug Administration in 2012, and sonidegib, another potent Hh pathway inhibitor, received FDA's approval in 2015 as a new treatment of locally advanced or metastatic basal cell carcinoma...
January 5, 2018: Medicinal Research Reviews
https://www.readbyqxmd.com/read/29302193/management-of-trauma-pain-in-the-emergency-setting-low-dose-methoxyflurane-or-nitrous-oxide-a-systematic-review-and-indirect-treatment-comparison
#5
REVIEW
Keith M Porter, Mohd Kashif Siddiqui, Ikksheta Sharma, Sara Dickerson, Alice Eberhardt
Background: Low-dose methoxyflurane and nitrous oxide (N2O; 50:50 with oxygen) are both self-administered, self-titrated, rapid-acting, nonnarcotic, and noninvasive inhalational agents with similar onset times of pain relief. The aim of this review was to compare the clinical efficacy, safety, and tolerability of these analgesics in emergency care. Materials and methods: A systematic literature search and review according to Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines were performed using Embase, Medline, the Cochrane Library, several clinical trial registers, and emergency-medicine conference material...
2018: Journal of Pain Research
https://www.readbyqxmd.com/read/29300847/an-interdisciplinary-approach-to-sports-concussion-evaluation-and-management-the-role-of-a-neuropsychologist
#6
Summer D Ott, Christopher M Bailey, Donna K Broshek
Sports neuropsychology is a rapidly emerging field that affords neuropsychologists, the opportunity to work with a diverse group of individuals in terms of age, gender, sports, ethnicity, and language and sports has a way of bringing diverse communities together. Although working with athletes can be associated with unique challenges, neuropsychological assessment with this population and being part of an interdisciplinary sports medicine team is both exciting and rewarding and can merge a passion for sports with professional interests...
December 29, 2017: Archives of Clinical Neuropsychology: the Official Journal of the National Academy of Neuropsychologists
https://www.readbyqxmd.com/read/29275030/testosterone-and-cardiovascular-health
#7
REVIEW
Andrew Elagizi, Tobias S Köhler, Carl J Lavie
There is an ongoing debate in the medical community regarding the effects of testosterone on cardiovascular (CV) health. For decades, there has been conflicting evidence regarding the association of endogenous testosterone levels and CV disease (CVD) events that has resulted in much debate and confusion among health care providers and patients alike. Testosterone therapy has become increasingly widespread, and after the emergence of studies that reported increased CVD events in patients receiving testosterone therapy, the US Food and Drug Administration (FDA) released a warning statement about testosterone and its potential risk regarding CV health...
December 20, 2017: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/29247094/oral-medicine-modification-for-older-adults-a-qualitative-study-of-nurses
#8
Aoife Mc Gillicuddy, Abina M Crean, Maria Kelly, Laura Sahm
OBJECTIVE: Oral medicines are frequently modified (eg, tablets crushed) for older adults. However, these modifications can have clinical, legal and/or ethical implications. Nurses bear responsibility for medicine administration and hence, perform these modifications. The aim of this study was to investigate the knowledge, attitudes and beliefs of nurses about oral medicine modification for older adults. DESIGN: A qualitative study was conducted using semi-structured, face-to-face interviews with nurses providing care to older adults in acute and long-term care settings...
December 14, 2017: BMJ Open
https://www.readbyqxmd.com/read/29238996/quality-management-of-a-massive-transfusion-protocol
#9
John R Hess, Patrick J Ramos, Nina E Sen, Virginia G Cruz-Cody, Erin E Tuott, Max J Louzon, Eileen M Bulger, Saman Arbabi, Monica B Pagano, Ryan A Metcalf
BACKGROUND: Massive transfusion is a response to massive uncontrolled hemorrhage. To be effective, it must be timely and address the patient's needs for blood volume, oxygen transport, and hemostasis. STUDY DESIGN AND METHODS: A review was performed on all activations of the massive transfusion protocol (MTP) in a hospital with large emergency medicine, trauma, and vascular surgery programs. Indications, transfused amounts, and outcomes were determined for each MTP event to determine appropriateness of MTP use...
December 13, 2017: Transfusion
https://www.readbyqxmd.com/read/29237706/patient-characteristics-resource-use-and-outcomes-associated-with-general-internal-medicine-hospital-care-the-general-medicine-inpatient-initiative-gemini-retrospective-cohort-study
#10
Amol A Verma, Yishan Guo, Janice L Kwan, Lauren Lapointe-Shaw, Shail Rawal, Terence Tang, Adina Weinerman, Peter Cram, Irfan A Dhalla, Stephen W Hwang, Andreas Laupacis, Muhammad M Mamdani, Steven Shadowitz, Ross Upshur, Robert J Reid, Fahad Razak
BACKGROUND: The precise scope of hospital care delivered under general internal medicine services remains poorly quantified. The purpose of this study was to describe the demographic characteristics, medical conditions, health outcomes and resource use of patients admitted to general internal medicine at 7 hospital sites in the Greater Toronto Area. METHODS: This was a retrospective cohort study involving all patients who were admitted to or discharged from general internal medicine at the study sites between Apr...
December 11, 2017: CMAJ Open
https://www.readbyqxmd.com/read/29232052/the-us-food-and-drug-administration-s-tentative-approval-process-and-the-global-fight-against-hiv
#11
Harinder Singh Chahal, Jeffrey S Murray, Martin Shimer, Peter Capella, Ryan Presto, Mary Lou Valdez, Peter G Lurie
INTRODUCTION: In 2004, the US government began to utilize the Food and Drug Administration's (USFDA) tentative approval process (tFDA) as a basis to determine which HIV drugs are appropriate to be purchased and used in resource-constrained settings. This process permits products that are not approved for marketing in the US, including medicines with active patents or marketing restrictions in the US, to be purchased and distributed in resource-constrained settings. Although the tFDA was originally intended to support the United States' President's Emergency Plan for AIDS Relief (PEPFAR), the USFDA list has become a cornerstone of international HIV programmes that support procurement of ARVs, such as the World Health Organization and the Global Fund to Fight AIDS, Tuberculosis, and Malaria...
December 2017: Journal of the International AIDS Society
https://www.readbyqxmd.com/read/29225112/fisetin-a-bioactive-phytochemical-with-potential-for-cancer-prevention-and-pharmacotherapy
#12
REVIEW
Dharambir Kashyap, Ajay Sharma, Katrin Sak, Hardeep Singh Tuli, Harpal Singh Buttar, Anupam Bishayee
A wide variety of chronic diseases, such as neurodegenerative and cardiovascular disorders, diabetes mellitus, osteoarthtitis, obesity and various cancers, are now being treated with cost effective phytomedicines. Since synthetic medicines are very expensive, concerted efforts are being made in developing and poor countries to discover cost effective medicines for the treatment of non-communicable diseases (NCDs). Understanding the underlying mechanisms of bioactive medicines from natural sources would not only open incipient avenues for the scientific community and pharmaceutical industry to discover new drug molecules for the therapy of NCDs, but also help to garner knowledge for alternative therapeutic approaches for the management of chronic diseases...
December 7, 2017: Life Sciences
https://www.readbyqxmd.com/read/29223983/ensuring-patient-safety-and-access-in-cancer-care
#13
Katy Winckworth-Prejsnar, Elizabeth A Nardi, James McCanney, F Marc Stewart, Terry Langbaum, Bruce J Gould, C Lyn Fitzgerald, Robert W Carlson
The inability to obtain the right high-quality cancer care in a timely and safe manner can have devastating results for patients. As cancer care becomes inundated with cutting edge and novel treatments, such as personalized medicine, oral chemotherapy, biosimilars, and immunotherapy, new safety challenges are emerging at increasing speed and complexity. Moreover, shifting federal healthcare policies could have significant implications for the safety and access to high-quality and effective cancer care for millions of patients with cancer...
December 2017: Journal of the National Comprehensive Cancer Network: JNCCN
https://www.readbyqxmd.com/read/29223536/polymeric-gels-for-intravaginal-drug-delivery
#14
REVIEW
Michael T Cook, Marc B Brown
Intravaginal drug delivery can elicit a local effect, or deliver drugs systemically without hepatic first pass metabolism. There are a number of emerging areas in intravaginal drug delivery, but the vagina is a challenging route of administration, due to the clearance mechanisms present which result in poor retention of dosage forms, and the potential for irritation and other adverse reactions. Gel formulations are desirable due to the ease of application, spreading and that they cause little to no discomfort to the patient...
December 6, 2017: Journal of Controlled Release: Official Journal of the Controlled Release Society
https://www.readbyqxmd.com/read/29218280/the-effect-of-lithospermum-officinale-silver-sulfadiazine-and-alpha-ointments-in-healing-of-burn-wound-injuries-in-rat
#15
Zahra Mohtasham Amiri, Nader Tanideh, Anahita Seddighi, Maral Mokhtari, Masood Amini, Alborz Shakouri Partovi, Amir Manafi, Seyedeh Sara Hashemi, Davood Mehrabani
BACKGROUND: Burn is the most devastating condition in emergency medicine leading to chronic disabilities. This study aimed to compare the effect of Lithospermum officinale, silver sulfadiazine and alpha ointments on healing of burn wounds in rat. METHODS: Ninety-five rats were divided into 5 groups. Group 1 just underwent burn injury, and groups 2-5 received alpha ointment, silver sulfadiazine (SSD), gel base and L. officinale extract, respectively. A hot plate was used for induction of a standard 3rd degree burn wound...
September 2017: World Journal of Plastic Surgery
https://www.readbyqxmd.com/read/29196046/prehospital-antibiotics-in-the-ambulance-for-sepsis-a-multicentre-open-label-randomised-trial
#16
Nadia Alam, Erick Oskam, Patricia M Stassen, Pieternel van Exter, Peter M van de Ven, Harm R Haak, Frits Holleman, Arthur van Zanten, Hien van Leeuwen-Nguyen, Victor Bon, Bart A M Duineveld, Rishi S Nannan Panday, Mark H H Kramer, Prabath W B Nanayakkara
BACKGROUND: Emergency medical services (EMS) personnel have already made substantial contributions to improving care for patients with time-dependent illnesses, such as trauma and myocardial infarction. Patients with sepsis could also benefit from timely prehospital care. METHODS: After training EMS personnel in recognising sepsis, we did a randomised controlled open-label trial in ten large regional ambulance services serving 34 secondary and tertiary care hospitals in the Netherlands...
November 28, 2017: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/29190192/suspected-zonisamide-related-anticonvulsant-hypersensitivity-syndrome-in-a-cat
#17
Audrey Collinet, Veronique Sammut
CASE DESCRIPTION A 2-year-old neutered male domestic shorthair cat was evaluated for sudden onset of cluster seizures. CLINICAL FINDINGS At an emergency clinic, the cat had hyperimmunoglobulinemia and thrombocytopenia. On referral, treatment with levetiracetam, zonisamide, and phenobarbital initially provided good control of cluster seizure activity (attributable to epilepsy of unknow origin). Two weeks later, assessments revealed that serum phenobarbital concentration was within the ideal range but serum zonisamide concentration exceeded the recommended therapeutic range...
December 15, 2017: Journal of the American Veterinary Medical Association
https://www.readbyqxmd.com/read/29184671/urine-test-for-egfr-analysis-in-patients-with-non-small-cell-lung-cancer
#18
REVIEW
Aleksandra Franovic, Victoria M Raymond, Mark G Erlander, Karen L Reckamp
Precision medicine approaches in oncology are reliant on the accurate genomic characterization of tumors. While tissue remains the mainstay specimen for molecular testing, tumor biopsies are riddled with challenges and limitations due to their invasive and site-specific nature. Tumor inaccessibility and intratumoral heterogeneity, in particular, represent significant obstacles to the identification of actionable genetic alterations and hence effective mono- and combination therapy strategies. Proof-of-concept studies indicate that circulating tumor DNA (ctDNA) released from multiple tumor regions and anatomical locations is more reflective of intra- and intertumoral heterogeneity...
October 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29184448/older-adults-and-high-risk-medication-administration-in-the-emergency-department
#19
Mitchell Kim, Steven H Mitchell, Medley Gatewood, Katherine A Bennett, Paul R Sutton, Carol A Crawford, Itay Bentov, Mamatha Damodarasamy, Stephen J Kaplan, May J Reed
Background: Older adults are susceptible to adverse effects from opioids, nonsteroidal anti-inflammatory drugs (NSAIDs), and benzodiazepines (BZDs). We investigated factors associated with the administration of elevated doses of these medications of interest to older adults (≥65 years old) in the emergency department (ED). Patients and methods: ED records were queried for the administration of medications of interest to older adults at two academic medical center EDs over a 6-month period...
2017: Drug, Healthcare and Patient Safety
https://www.readbyqxmd.com/read/29178487/therapeutic-benefit-of-smoked-cannabis-in-randomized-placebo-controlled-studies
#20
REVIEW
Lynneice L Bowen, Aimee L McRae-Clark
The medicinal use of marijuana has been legalized in 28 states, with a wide range of specificity for approved medical conditions. Even with the emergence of non-combustion-based delivery systems, 90% of marijuana users in 2014 used smoked marijuana. This review summarizes the data available on the use of smoked marijuana for medical purposes. A literature search was performed to retrieve randomized controlled trials exploring the efficacy of smoked cannabis for treatment of a medical condition. Studies with the primary end point listed as the effect of smoked cannabis on a disease-specific characteristic were included...
January 2018: Pharmacotherapy
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