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https://www.readbyqxmd.com/read/29034649/implementation-a-medical-simulation-curriculum-in-emergency-medicine-residency-program
#1
Amirhossein Jahanshir, Maryam Bahreini, Mohsen Banaie, Mohammad Jallili, Shahram Hariri, Fatemeh Rasooli, Hamed Sotoodehnia, Javad Seyed Hosseini, Arash Safaie, Ehsan Karimi, Ali Labaf, Hadi Mir Fazaelian, Elnaz Vahidi
Applying simulation in medical education is becoming more and more popular. The use of simulation in medical training has led to effective learning and safer care for patients. Nowadays educators have confronted with the challenge of respecting patient safety or bedside teaching. There is widespread evidence, supported by robust research, systematic reviews and meta-analysis, on how much effective simulation is. Simulation supports the acquisition of procedural, technical and non-technical skills through repetitive practice with feedbacks...
August 2017: Acta Medica Iranica
https://www.readbyqxmd.com/read/29030677/safe-surgery-for-all-early-lessons-from-implementing-a-national-government-driven-surgical-plan-in-ethiopia
#2
Daniel Burssa, Atlibachew Teshome, Katherine Iverson, Olivia Ahearn, Tigistu Ashengo, David Barash, Erin Barringer, Isabelle Citron, Kaya Garringer, Victoria McKitrick, John Meara, Abraham Mengistu, Swagoto Mukhopadhyay, Cheri Reynolds, Mark Shrime, Asha Varghese, Samson Esseye, Abebe Bekele
Recognizing the unmet need for surgical care in Ethiopia, the Federal Ministry of Health (FMOH) has pioneered innovative methodologies for surgical system development with Saving Lives through Safe Surgery (SaLTS). SaLTS is a national flagship initiative designed to improve access to safe, essential and emergency surgical and anaesthesia care across all levels of the healthcare system. Sustained commitment from the FMOH and their recruitment of implementing partners has led to notable accomplishments across the breadth of the surgical system, including but not limited to: (1) Leadership, management and governance-a nationally scaled surgical leadership and mentorship programme, (2) Infrastructure-operating room construction and oxygen delivery plan, (3) Supplies and logistics-a national essential surgical procedure and equipment list, (4) Human resource development-a Surgical Workforce Expansion Plan and Anaesthesia National Roadmap, (5) Advocacy and partnership-strong FMOH partnership with international organizations, including GE Foundation's SafeSurgery2020 initiative, (6) Innovation-facility-driven identification of problems and solutions, (7) Quality of surgical and anaesthesia care service delivery-a national peri-operative guideline and WHO Surgical Safety Checklist implementation, and (8) Monitoring and evaluation-a comprehensive plan for short-term and long-term assessment of surgical quality and capacity...
October 13, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29016553/bleeding-and-neurologic-complications-in-58-000-interventional-pain-procedures
#3
Nafisseh S Warner, W Michael Hooten, Matthew A Warner, Tim J Lamer, Jason S Eldrige, Halena M Gazelka, Daryl J Kor, Bryan C Hoelzer, William D Mauck, Susan M Moeschler
BACKGROUND AND OBJECTIVES: Interventional pain procedures are commonly performed on patients receiving antiplatelet therapy. However, there is limited evidence to support or refute the safety of this practice. The goal of this investigation was to assess the rate of bleeding complications in a large cohort of patients undergoing intermediate- and low-risk pain procedures, with a specific focus on antiplatelet and anticoagulant medication use and baseline coagulation abnormalities. METHODS: This is a retrospective cohort study of adult patients undergoing low- and intermediate-risk pain procedures from 2005 through 2014 by the division of pain medicine at a single academic tertiary care center...
October 6, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28968283/role-of-in-situ-simulation-for-training-in-healthcare-opportunities-and-challenges
#4
Viji Kurup, Veronica Matei, Jessica Ray
PURPOSE OF REVIEW: Simulation has now been acknowledged as an important part of training in healthcare, and most academic hospitals have a dedicated simulation center. In-situ simulation occurs in patient care units with scenarios involving healthcare professionals in their actual working environment. The purpose of this review is to describe the process of putting together the components of in-situ simulation for training programs and to review outcomes studied, and challenges with this approach...
September 28, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28962509/trans-right-axillary-aortic-valve-replacement-propensity-matched-comparison-with-standard-sternotomy-approach
#5
Masayoshi Tokoro, Toshiaki Ito, Atsuo Maekawa, Sadanari Sawaki, Junji Yanagisawa, Takahiro Ozeki, Mamoru Orii
OBJECTIVES: We developed trans-right axillary aortic valve replacement (TAX-AVR) as a more cosmetically superior approach to minimally invasive AVR. We herein retrospectively compared the safety and invasiveness between TAX-AVR and conventional AVR (C-AVR). METHODS: TAX-AVR was performed under femorofemoral cardiopulmonary bypass. Creation of a small right axillary vertical skin incision was followed by anterolateral intercostal thoracotomy. AVR was performed using long-shafted minimally invasive instruments, a knot pusher and endoscopic assistance...
October 1, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28945987/sedation-and-analgesia-for-procedures-in-the-pediatric-emergency-room
#6
REVIEW
Carlos Eduardo Ramalho, Pedro Messeder Caldeira Bretas, Claudio Schvartsman, Amélia Gorete Reis
OBJECTIVE: Children and adolescents often require sedation and analgesia in emergency situations. With the emergence of new therapeutic options, the obsolescence of others, and recent discoveries regarding already known drugs, it became necessary to review the literature in this area. DATA SOURCES: Non-systematic review in the PubMed database of studies published up to December 2016, including original articles, review articles, systematic reviews, and meta-analyses...
September 23, 2017: Jornal de Pediatria
https://www.readbyqxmd.com/read/28916367/rucaparib-maintenance-treatment-for-recurrent-ovarian-carcinoma-after-response-to-platinum-therapy-ariel3-a-randomised-double-blind-placebo-controlled-phase-3-trial
#7
Robert L Coleman, Amit M Oza, Domenica Lorusso, Carol Aghajanian, Ana Oaknin, Andrew Dean, Nicoletta Colombo, Johanne I Weberpals, Andrew Clamp, Giovanni Scambia, Alexandra Leary, Robert W Holloway, Margarita Amenedo Gancedo, Peter C Fong, Jeffrey C Goh, David M O'Malley, Deborah K Armstrong, Jesus Garcia-Donas, Elizabeth M Swisher, Anne Floquet, Gottfried E Konecny, Iain A McNeish, Clare L Scott, Terri Cameron, Lara Maloney, Jeff Isaacson, Sandra Goble, Caroline Grace, Thomas C Harding, Mitch Raponi, James Sun, Kevin K Lin, Heidi Giordano, Jonathan A Ledermann
BACKGROUND: Rucaparib, a poly(ADP-ribose) polymerase inhibitor, has anticancer activity in recurrent ovarian carcinoma harbouring a BRCA mutation or high percentage of genome-wide loss of heterozygosity. In this trial we assessed rucaparib versus placebo after response to second-line or later platinum-based chemotherapy in patients with high-grade, recurrent, platinum-sensitive ovarian carcinoma. METHODS: In this randomised, double-blind, placebo-controlled, phase 3 trial, we recruited patients from 87 hospitals and cancer centres across 11 countries...
September 12, 2017: Lancet
https://www.readbyqxmd.com/read/28910472/a-descriptive-analysis-of-occupational-fatalities-due-to-felonious-assault-among-u-s-law-enforcement-officers-during-tactical-incidents-1996-2014
#8
Moriah S Thompson, Tyler M Hartman, Matthew D Sztajnkrycer
INTRODUCTION: Little is known about occupational fatalities among tactical officers. A greater understanding of such injuries is needed to improve officer safety. The purpose of this study was to provide a descriptive analysis of line-of-duty deaths secondary to felonious assault during tactical incidents. METHODS: Retrospective analysis was performed of open-source de-identified Federal Bureau of Investigation Uniform Crime Reporting Law Enforcement Officers Killed and Assaulted (LEOKA) data inclusive of the years 1996-2014...
2017: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/28881007/delayed-antibiotic-prescriptions-for-respiratory-infections
#9
REVIEW
Geoffrey Kp Spurling, Chris B Del Mar, Liz Dooley, Ruth Foxlee, Rebecca Farley
BACKGROUND: Concerns exist regarding antibiotic prescribing for respiratory tract infections (RTIs) owing to adverse reactions, cost, and antibacterial resistance. One proposed strategy to reduce antibiotic prescribing is to provide prescriptions, but to advise delay in antibiotic use with the expectation that symptoms will resolve first. This is an update of a Cochrane Review originally published in 2007, and updated in 2010 and 2013. OBJECTIVES: To evaluate the effects on clinical outcomes, antibiotic use, antibiotic resistance, and patient satisfaction of advising a delayed prescription of antibiotics in respiratory tract infections...
September 7, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28859210/oral-desensitization-to-penicillin-for-the-treatment-of-pregnant-women-with-syphilis-a-successful-program
#10
Jéssica Dallé, Mauro Cunha Ramos, Mirela Foresti Jimenez, Fernanda Garcia Escobar, Vicente Sperb Antonello
Gestational syphilis is a prevalent disease in Brazil and other low and medium income countries. Desensitization to penicillin is recommended for pregnant women with syphilis who are allergic to β-lactams. This is a descriptive study utilizing outpatient medical records from 2011 to 2015 from a mother and child hospital that is part of the national healthcare system in the South of Brazil, which performs an average of 3,600 birth assistances per year. All cases of pregnant women with syphilis and presumptive diagnosis of β-lactam allergy during the study period were included...
August 31, 2017: Revista Brasileira de Ginecologia e Obstetrícia
https://www.readbyqxmd.com/read/28839865/transnasal-endoscopy-no-gagging-no-panic
#11
Clare Parker, Estratios Alexandridis, John Plevris, James O'Hara, Simon Panter
BACKGROUND: Transnasal endoscopy (TNE) is performed with an ultrathin scope via the nasal passages and is increasingly used. This review covers the technical characteristics, tolerability, safety and acceptability of TNE and also diagnostic accuracy, use as a screening tool and therapeutic applications. It includes practical advice from an ear, nose, throat (ENT) specialist to optimise TNE practice, identify ENT pathology and manage complications. METHODS: A Medline search was performed using the terms "transnasal", "ultrathin", "small calibre", "endoscopy", "EGD" to identify relevant literature...
October 2016: Frontline Gastroenterology
https://www.readbyqxmd.com/read/28837980/-chances-and-risks-of-telemedicine-in-orthopaedics-and-trauma-surgery
#12
Martin Holderried, Madeleine Schlipf, Ansgar Höper, Reinhard Meier, Ulrich Stöckle, Tobias Maximilian Kraus
Background The use of information technology (IT) in health care has continuously increased. This includes software solutions for digitalisation, data storage and innovative approaches in diagnostics. The facilitation of the access to specific information, even by the patient, has changed daily clinical work. Patients inform themselves about symptoms, diagnostic methods and treatment options. This urge for information and the wish for the best treatment is summarised in the expression "patient empowerment"...
August 24, 2017: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/28835751/radiofrequency-ablation-for-treatment-of-refractory-gastric-antral-vascular-ectasia-a-systematic-review-of-the-literature
#13
REVIEW
M Maida, S Camilleri, M Manganaro, S Garufi, G Scarpulla
BACKGROUND AND STUDY AIMS: GAVE is an uncommon cause of upper nonvariceal bleeding and often manifests itself as occult bleeding with chronic anemia. To date, the standard of care for GAVE is endoscopic treatment with thermoablative techniques. Despite good technical results, approximately two thirds of patients remain dependent on transfusions after the therapy. One of the emerging and more promising endoscopic treatments for GAVE is radiofrequency ablation (RFA). The aim of this study is to perform a systematic review of literature in order to assess current evidence supporting the effectiveness of this technique for treatment of refractory GAVE...
2017: Gastroenterology Research and Practice
https://www.readbyqxmd.com/read/28808901/the-utility-of-routine-intensive-care-admission-for-patients-undergoing-intracranial-neurosurgical-procedures-a-systematic-review
#14
Cesar Cimonari de Almeida, M Dustin Boone, Yosef Laviv, Burkhard S Kasper, Clark C Chen, Ekkehard M Kasper
BACKGROUND: Patients who have undergone intracranial neurosurgical procedures have traditionally been admitted to an intensive care unit (ICU) for close postoperative neurological observation. The purpose of this study was to systematically review the evidence for routine ICU admission in patients undergoing intracranial neurosurgical procedures and to evaluate the safety of alternative postoperative pathways. METHODS: We were interested in identifying studies that examined selected patients who presented for elective, non-emergent intracranial surgery whose postoperative outcomes were compared as a function of ICU versus non-ICU admission...
August 14, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28802869/use-of-a-standardized-procedure-to-improve-behavioral-health-patients-care-a-quality-improvement-initiative
#15
Elizabeth J Winokur, Jeannine Loucks, Glenn H Raup
PROBLEM: Meeting the complex needs of behavioral health (BH) patients in the emergency department is an ongoing challenge. Delays in care can have adverse consequences for patient and staff safety and delay transfer to specialized care. METHODS: A quality improvement, nurse-driven initiative using a standardized procedure (STP) was developed and implemented in our busy Southern California Emergency Department, which focused on improving time to first medication and reduction of restraints...
August 9, 2017: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
https://www.readbyqxmd.com/read/28791782/predicting-short-term-risk-of-arrhythmia-among-patients-with-syncope-the-canadian-syncope-arrhythmia-risk-score
#16
Venkatesh Thiruganasambandamoorthy, Ian G Stiell, Marco L A Sivilotti, Brian H Rowe, Muhammad Mukarram, Kirtana Arcot, Kenneth Kwong, Andrew D McRae, George A Wells, Monica Taljaard
BACKGROUND: Syncope can be caused by serious occult arrhythmias not evident during initial emergency department (ED) evaluation. We sought to develop a risk tool for predicting 30-day arrhythmia or death after ED disposition. METHODS: We conducted a multicenter prospective cohort study at six tertiary care EDs and included adults (≥16 years) with syncope. We collected standardized variables from clinical evaluation and investigations including electrocardiogram and troponin at index presentation...
August 9, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28765654/-analysis-of-clinical-safety-in-the-units-of-allergy-of-the-valencian-community
#17
M D De Las Marinas Alvarez, B E Garcia Figueroa, R Alamar, C Pérez Francés, C Martorell Calatayud, M D Hernandez Fernandez de Ro
The introduction of new diagnostic and therapeutic procedures involving allergen exposure may increase the risk of allergic reactions. We designed and distributed an anonymous questionnaire among the allergy units of the Valencian Community in order to collect information on measures to ensure clinical safety. Twelve hospital outpatient clinics and 8 ambulatory care centres reported similar patterns of activities, including the use of critical care units, emergency rooms or day hospitals for higher risk techniques...
July 28, 2017: Anales del Sistema Sanitario de Navarra
https://www.readbyqxmd.com/read/28764269/analysis-of-clinical-indicators-of-quality-in-patients-with-endotracheal-intubation
#18
Sulochana Dash, Sreelatha Balasubramanian
INTRODUCTION: Quality and safety in anaesthesia is usually monitored by analysis of perioperative mortality-morbidity and are influenced by anaesthetic and non-anaesthetic factors. AIM: This study was conducted to analyse the incidence of clinical indicators of quality in endotracheally intubated patients undergoing general abdominal surgeries and obstetric and gynaecological procedures under general anaesthesia and to determine contributing factors for the same...
June 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28744243/the-odyssey-of-dental-anxiety-from-prehistory-to-the-present-a-narrative-review
#19
REVIEW
Enrico Facco, Gastone Zanette
Dental anxiety (DA) can be considered as a universal phenomenon with a high prevalence worldwide; DA and pain are also the main causes for medical emergencies in the dental office, so their prevention is an essential part of patient safety and overall quality of care. Being DA and its consequences closely related to the fight-or-flight reaction, it seems reasonable to argue that the odyssey of DA began way back in the distant past, and has since probably evolved in parallel with the development of fight-or-flight reactions, implicit memory and knowledge, and ultimately consciousness...
2017: Frontiers in Psychology
https://www.readbyqxmd.com/read/28735437/prospective-and-retrospective-study-of-videoconference-telemedicine-follow-up-after-elective-neurosurgery-results-of-a-pilot-program
#20
Melissa Reider-Demer, Pushpa Raja, Neil Martin, Mariel Schwinger, Diana Babayan
Existing literature suggests that use of telemedicine during postoperative appointments can increase access to care and is valued by patients and providers alike. While research examining the clinical equivalency of telemedicine visits for postoperative care has been growing, few studies have reported on telemedicine follow-up after neurosurgery. This study examined if a videoconferencing visit could substitute for an in-person clinic visit for elective neurosurgical cases in the USA. This was a single-center prospective study of patients who underwent elective neurosurgical procedures (aneurysm clipping, resection of cavernous angiomas, resection of arterial venous malformation, microvascular decompression for trigeminal neuralgia and hemifacial spasm, and certain benign brain tumors) and were offered telemedicine follow-up care by an allied health professional during the first 90 days after neurosurgery...
July 22, 2017: Neurosurgical Review
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