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Theodore Gouliouris, Ben Warne, Edward J P Cartwright, Luke Bedford, Chathika K Weerasuriya, Kathy E Raven, Nick M Brown, M Estée Török, Direk Limmathurotsakul, Sharon J Peacock
Background: VRE bacteraemia has a high mortality and continues to defy control. Antibiotic risk factors for VRE bacteraemia have not been adequately defined. We aimed to determine the risk factors for VRE bacteraemia focusing on duration of antibiotic exposure. Methods: A retrospective matched nested case-control study was conducted amongst hospitalized patients at Cambridge University Hospitals NHS Foundation Trust (CUH) from 1 January 2006 to 31 December 2012...
March 13, 2018: Journal of Antimicrobial Chemotherapy
Nelson S Yee
Progress has been made in the treatment of gastrointestinal cancers through advances in systemic therapies, surgical interventions, and radiation therapy. At the Multi-Disciplinary Patient Care in Gastrointestinal Oncology conference, the faculty members of the Penn State Health Milton S. Hershey Medical Center presented a variety of topics that focused on this sub-specialty. This conference paper highlights the new development in systemic treatment of various malignant diseases in the digestive system. Results of the recent clinical trials that investigated the clinical efficacy of pegylated hyaluronidase, napabucasin, and L-asparaginase in pancreatic carcinoma are presented...
March 16, 2018: Biomedicines
Ganbold Lundeg, Amanda Baric, David C Pescod, Keith Pescod
Anesthesia in Mongolia has undergone a period of major development over the past 17 years, thanks to the work of the Mongolian Society of Anesthesiologists (MSA) and the support of the World Federation of Societies of Anaesthesiologists and the Australian Society of Anaesthetists. The specialty has made major advances in training and in its standing among medical specialties in Mongolia. The MSA has produced members who are leaders in the development of anesthesia as well as emergency medicine and critical care...
April 2018: Anesthesia and Analgesia
Emmett Harrison, Paul B A Dhillon
INTRODUCTION: Rural family physicians are often required to meet a wide variety of medical service demands that are otherwise the responsibility of specialty physicians in urban centres. However, many rural physicians enjoy the practice variety and ability to meet patients' medical needs through this wider spectrum of care. We aimed to quantify and summarize the workload and clinical disorders seen by rural family physicians in Saskatchewan relative to urban family physicians. METHODS: We used Saskatchewan Ministry of Health billing data for 2015/16 to compare rural and urban care provision...
2018: Canadian Journal of Rural Medicine
Sylvina Alvarado, Ernesto Paya, María Teresa Valenzuela, Rodolfo Villena
INTRODUCTION: Special vaccines recommendation patients are a growing population. The Ministry of Health has developed a special vaccination program for these cases, through which our hospital manages vaccine forms by an established flowchart. OBJECTIVE: To describe the special vaccines model of management results in the period between March 2015 and September 2016, and the clinical and demographics characterization of the pediatric population benefited with this program in Dr...
December 2017: Revista Chilena de Pediatría
Alison Luther, Joseph Gabriel, Richard P Watson, Nader K Francis
BACKGROUND: Despite advances in perioperative care, post-operative clinical and functional outcomes after major abdominal surgery can be suboptimal. Prehabilitation programmes attempt to optimise a patient's preoperative condition to improve outcomes. Total body prehabilitation includes structured exercise, nutritional optimisation, psychological support and cessation of negative health behaviours. This systematic review aims to report on the current literature regarding the impact of total body prehabilitation prior to major abdominal surgery...
March 15, 2018: World Journal of Surgery
Ronald L Ariagno, Henry C Lee, David K Stevenson, Daniel K Benjamin, P Brian Smith, Marilyn B Escobedo, Dilip R Bhatt
Directories of contact information have evolved over time from thick paperback times such as the "Yellow Pages" to electronic forms that are searchable and have other functionalities. In our clinical specialty, the development of a professional directory helped to promote collaboration in clinical care, education, and quality improvement. However, there are opportunities for increasing the utility of the directory by taking advantage of modern web-based tools, and expanding the use of the directory to fill a gap in the area of collaborative research...
March 15, 2018: Journal of Perinatology: Official Journal of the California Perinatal Association
Olabisi R Sanusi, Omar Arnaout, Rudy J Rahme, Craig Horbinski, James P Chandler
OBJECTIVE: Chordomas are rare tumors of notochordal origin that are known to be locally aggressive and are often treated with surgical resection followed by adjuvant radiotherapy. The accepted standard of treatment for chordomas of the mobile spine which includes en-bloc resection with wide margins cannot be easily applied to the chordomas of the skull base given their proximity to critical neurovascular structures. We describe our experience with the role of surgery and adjuvant radiation in the treatment of chordomas over 16 years...
March 12, 2018: World Neurosurgery
C M S Hassing, T F Tvedskov, N Kroman, T L Klausen, J B Drejøe, J F Tvedskov, T-L Lambine, H Kledal, G Lelkaitis, L Langhans
BACKGROUND: Radioactive seed localisation (RSL) is a preoperative localisation method using a small titanium seed containing iodine-125. The method is increasingly applied for localising non-palpable lesions in the treatment of breast cancer. We believe that RSL has the potential to be used in various surgical specialties. The aim of this feasibility study was to test RSL as a preoperative localisation of non-palpable lymph nodes. METHODS: Between November 24, 2015 and October 26, 2016, 15 patients with suspicious lymph nodes on imaging were included in the study...
March 6, 2018: European Journal of Surgical Oncology
George Richard Holt, Kevin Christopher McMains, Randal A Otto
Evaluating and providing global health assistance, humanitarian aid, and medical missions to Middle Eastern countries can be rewarding and challenging. A broad spectrum of financial capabilities supports effective health care delivery and infrastructure. Middle East tension can make obtaining a visa difficult. Personal safety considerations may hinder efforts to develop and carry out clinical and educational programs. Several Middle East countries have sophisticated and modern health care systems. Medical education and specialty training compares with that of Western medicine...
March 12, 2018: Otolaryngologic Clinics of North America
Christopher J L Stone, Haris M Vaid, Rajajee Selvam, Allison Ashworth, Andrew Robinson, Geneviève C Digby
Multidisciplinary cancer clinics (MDCCs) are recognized in cancer care as an alternate model of care for lung cancer patients. However, the precise MDCC characteristics that could potentially improve the quality of care in lung cancer care have not been clearly defined. We performed a systematic review of the data regarding MDCCs in the treatment of patients with lung cancer to summarize and evaluate the available evidence and to determine valuable clinic characteristics and projected outcomes. We searched Embase, Cochrane, Medline, PubMed, and Web of Science through April 2017 for studies that included ≥ 2 physician specialties in a MDCC for lung cancer...
February 21, 2018: Clinical Lung Cancer
Andrew B Rosenkrantz, Kristina Hoque, Jennifer Hemingway, Danny R Hughes, Richard Duszak
PURPOSE: The aims of this study were to compare the number of unique Medicare fee-for-service beneficiaries served by radiologists and other physicians and to identify characteristics of radiologists serving the most number of unique patients. METHODS: Medicare Physician and Other Supplier Public Use Files were used to identify all physicians who provided services to Medicare fee-for-service beneficiaries for the entirety of 2013. The average number of unique beneficiaries served was computed per specialty...
March 13, 2018: Journal of the American College of Radiology: JACR
Christoph Ihle, Christoph Weiß, Gunnar Blumenstock, Ulrich Stöckle, Björn Gunnar Ochs, Christian Bahrs, Andreas Nüssler, Anna Janine Schreiner
BACKGROUND: Being at risk for malnutrition can be observed among hospitalized patients of all medical specialties. There are only few studies in arthroplasty dealing with defining and assessing malnutrition as such a potentially risk. This study aims to identify the risk for malnutrition following primary (pAP) and revision arthroplasty (rAP) (1) using non-invasive interview based assessment tools and to analyze effects on clinical outcome (2) and quality of life (3). METHODS: A consecutive series of hospitalized patients of a Department of Arthroplasty at a Level 1 Trauma Center in Western Europe was observed between June 2014 and June 2016...
March 15, 2018: BMC Musculoskeletal Disorders
Hiroki Maruyama, Kaori Miyata, Mariko Mikame, Atsumi Taguchi, Chu Guili, Masaru Shimura, Kei Murayama, Takeshi Inoue, Saori Yamamoto, Koichiro Sugimura, Koichi Tamita, Toshihiro Kawasaki, Jun Kajihara, Akifumi Onishi, Hitoshi Sugiyama, Teiko Sakai, Ichijiro Murata, Takamasa Oda, Shigeru Toyoda, Kenichiro Hanawa, Takeo Fujimura, Shigehisa Ura, Mimiko Matsumura, Hideki Takano, Satoshi Yamashita, Gaku Matsukura, Ryushi Tazawa, Tsuyoshi Shiga, Mio Ebato, Hiroshi Satoh, Satoshi Ishii
PurposePlasma globotriaosylsphingosine (lyso-Gb3) is a promising secondary screening biomarker for Fabry disease. Here, we examined its applicability as a primary screening biomarker for classic and late-onset Fabry disease in males and females.MethodsBetween 1 July 2014 and 31 December 2015, we screened 2,360 patients (1,324 males) referred from 169 Japanese specialty clinics (cardiology, nephrology, neurology, and pediatrics), based on clinical symptoms suggestive of Fabry disease. We used the plasma lyso-Gb3 concentration, α-galactosidase A (α-Gal A) activity, and analysis of the α-Gal A gene (GLA) for primary and secondary screens, respectively...
March 15, 2018: Genetics in Medicine: Official Journal of the American College of Medical Genetics
Jeffrey Olivet, Morgan Haselden, Sarah Piscitelli, Rachael Kenney, Alexander Shulman, Deborah Medoff, Lisa Dixon
AIM: Recent research on first episode psychosis (FEP) has demonstrated the effectiveness of coordinated specialty care (CSC) models to support young adults and their families, yet few tools exist to promote engagement in care. This study aimed to develop a prototype computer-based role-playing game (RPG) designed for young people who have experienced FEP, and conduct a pilot study to determine feasibility and test whether the game improves consumers' attitudes toward treatment and recovery...
March 15, 2018: Early Intervention in Psychiatry
Michael A Mazzeffi, John M See, Brittney Williams, Justin Richards, Darin Zimmerman, Samuel Galvagno, Magali Fontaine, Kenichi Tanaka
BACKGROUND: Red blood cell (RBC) transfusion can be life-saving; however, the risks of RBC transfusion have been increasingly recognized, and current guidelines recommend restrictive transfusion in most patients. We hypothesized that RBC transfusions are decreasing in surgical patients. STUDY DESIGN AND METHODS: A retrospective review of the National Surgical Quality Improvement Program database was performed from 2011 to 2015. Index cases in five surgical specialties were studied: neurosurgery, thoracic surgery, gynecologic surgery, orthopedic surgery, and vascular surgery...
March 14, 2018: Transfusion
Andrea Moglia, Luca Morelli, Vincenzo Ferrari, Mauro Ferrari, Franco Mosca, Alfred Cuschieri
BACKGROUND: There is an increasing interest for a test assessing objectively the innate aptitude for surgery as a craft specialty to complement the current selection process of surgical residents. The aim of this study was to quantify the size of individuals with high, average, and low level of innate psychomotor skills among medical students. METHODS: A volunteer sample of 155 medical students, without prior experience with surgical simulator, executed five tasks at a virtual simulator for robot-assisted surgery...
March 14, 2018: Surgical Endoscopy
Jeffrey A Allen, Kenneth C Gorson, Deborah Gelinas
Introduction: We explored adherence to the European Federation of Neurological Societies/Peripheral Nerve Society (EFNS/PNS) guidelines for the diagnosis and treatment of chronic inflammatory demyelinating polyneuropathy (CIDP) by reviewing data from a specialty pharmacy database. Materials and Methods: Clinical and electrophysiologic data were reviewed for 65 consecutive patients treated with intravenous immunoglobulin (IVIG) for CIDP. Three neuromuscular neurologists independently classified cases according to EFNS/PNS criteria as (1) fulfilling CIDP criteria; (2) non-CIDP (neither clinical nor electrophysiologic criteria met); or (3) unknown (insufficient information)...
March 2018: Brain and Behavior
Marc-Etienne Parent, François Vézina, Nathalie Carrier, Ariel Masetto
OBJECTIVE: To analyze the indications for and clinical procedures resulting from knee magnetic resonance imaging (MRI) in older patients. DESIGN: We retrospectively analyzed 215 medical records of patients 50 years of age and older who had undergone a unilateral knee MRI in 2009. SETTING: Centre hospitalier universitaire de Sherbrooke in Quebec. PARTICIPANTS: Patients 50 years of age and older who underwent a knee MRI in 2009...
March 2018: Canadian Family Physician Médecin de Famille Canadien
Amber Hoffman, Ingrid A Larson
It can be difficult to assist children with medical complexities (CMC) in maintaining wellness outside of hospital and emergency department settings. This growing population, with high use of medical technology and specialty care, has created a challenge for community providers who may infrequently care for children with these rare disorders and needs. CMCs have increased hospitalization rates and emergency care use. It is not realistic to believe that emergency health providers will know how to manage every type of CMC when they present for emergency care...
March 1, 2018: Pediatric Annals
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