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Operational medicine

Karthik Balakrishnan, Shelagh Cofer, Jane M Matsumoto, Joseph A Dearani, R Paul Boesch
Three-dimensional printed models are increasingly used in medicine and surgery, but applications of these models in the planning of operative procedures is not well described. In particular, their benefits have not been documented in complex, multiservice, high-risk operations. We describe five cases of complex pediatric tracheal reconstruction for which three-dimensional models had specific benefits in planning as well as in education of trainees, operating room staff, and patient families. We also describe our method for producing models so that others can adopt the technology if desired...
October 18, 2016: Laryngoscope
Xiangtong Liu, Jason Peter Fine, Zhenghong Chen, Long Liu, Xia Li, Anxin Wang, Jin Guo, Lixin Tao, Gehendra Mahara, Zhe Tang, Xiuhua Guo
The competing risk method has become more acceptable for time-to-event data analysis because of its advantage over the standard Cox model in accounting for competing events in the risk set. This study aimed to construct a prediction model for diabetes using a subdistribution hazards model.We prospectively followed 1857 community residents who were aged ≥ 55 years, free of diabetes at baseline examination from August 1992 to December 2012. Diabetes was defined as a self-reported history of diabetes diagnosis, taking antidiabetic medicine, or having fasting plasma glucose (FPG) ≥ 7...
October 2016: Medicine (Baltimore)
Zulfi Haneef, Sharon Chiang, Holly Rutherford, Arun Antony
INTRODUCTION: Fellowship training in Clinical Neurophysiology (CNP) is often sought following Neurology residency. However, data documenting the reasons for choosing CNP fellowship, and experiences therein, are sparse. METHODS: Current Neurophysiology fellows across the United States participated in a 17-item, internet-based survey. Data regarding demographics, reasons for choosing fellowship, adequacy of training, and future plans were collected. RESULTS: Among respondents (n=49), 84% graduated from a US medical school...
October 5, 2016: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
E Chapman, A Eastman, A Gilmore-Bykovskyi, B Vogelman, A J Kind
Older adults often face poor outcomes when transitioning from hospital to home. Although physicians play a key role in overseeing transitions, there is a lack of practice-based educational programs that prepare resident physicians to manage care transitions of older adults. An educational intervention to provide residents with real-life transitional care practice was therefore developed-Resident-coordinated Transitional Care (RC-TraC). RC-TraC adapted the evidence-based Coordinated-Transitional Care (C-TraC) nurse role for residents, providing opportunities to follow patients during the peri-hospital period without additional costs to the residency program...
October 17, 2016: Gerontology & Geriatrics Education
Christoph F Dietrich, Rudolf Horn, Susanne Morf, Liliana Chiorean, Yi Dong, Xin-Wu Cui, Nathan S S Atkinson, Christian Jenssen
Central venous access has traditionally been performed on the basis of designated anatomical landmarks. However, due to patients' individual anatomy and vessel pathology and depending on individual operators' skill, this landmark approach is associated with a significant failure rate and complication risk. There is substantial evidence demonstrating significant improvement in effectiveness and safety of vascular access by realtime ultrasound (US)-guidance, as compared to the anatomical landmark-guided approach...
September 2016: Journal of Thoracic Disease
Yun-Ho Hwang, Kyung-Yun Kang, Jong-Jin Kim, Sung-Ju Lee, Young-Jin Son, Soo-Heui Paik, Sung-Tae Yee
Polygonum multiflorum (PM), a traditional Chinese medicine, is used to treat various diseases including nonalcoholic fatty liver disease and hyperlipidemia. However, the influence of PM on osteoporosis in animals is unclear. The present study investigated the antiosteoporotic effect of PM on bone mass in ovariectomized (OVX) mice and its possible mechanism of action. Twenty-five female C3H/HeN mice were divided into five groups of five mice as follows. Sham-operated control mice received daily oral gavage of an equal volume of water, and OVX mice received daily oral gavage of water or an injection of β-estradiol or PM for 6 weeks...
2016: Evidence-based Complementary and Alternative Medicine: ECAM
Felix Neumaier, Mario Paterno, Serdar Alpdogan, Etienne E Tevoufouet, Toni Schneider, Jürgen Hescheler, Walid Albanna
Brain surgery to promote behavioural or affective changes in men remains one of the most controversial topics at the interface of medicine, psychiatry, neuroscience and bioethics. Rapid expansion of neuropsychiatric deep brain stimulation has recently revived the field and warrants a careful appraisal of its two sides, namely the promise to help severely devastated patients on the one hand and the dangers of premature application without appropriate justification on the other. Here, we reconstruct the vivid history of the field and examine its present status to delineate the progression from crude free-hand operations into a multi-disciplinary treatment of last resort...
October 13, 2016: World Neurosurgery
Kamol Wattanakrai, Nattawut Chiemchaisri, Penpun Wattanakrai
BACKGROUND: Blepharoplasty is a common aesthetic surgery performed worldwide. In Asians, too high eyelid folds after blepharoplasty cause an unsatisfactory aesthetic outcome that is difficult to correct. In this article, the authors propose surgical techniques to correct the high eyelid fold after blepharoplasty. METHODS: During a 4-year period, 213 secondary blepharoplasties were performed to correct high folds. Postoperative results were reviewed, graded, and analyzed...
October 14, 2016: Aesthetic Plastic Surgery
Sufian S Ahmad, Johannes C Meyer, Anna M Krismer, Suhaib S Ahmad, Dimitrios S Evangelopoulos, Sven Hoppe, Sandro Kohl
PURPOSE: Clinical research in the area of anterior cruciate ligament (ACL) injury has shown substantial growth during the last decade. This was accompanied by the establishment of a wide range of outcome measures used to address the demands of clinical studies. The aim of this study was to evaluate outcome measures reported by highly cited level I trials in ACL research and identify factors influencing citation metrics. METHODS: The database of the Institute for Scientific Information (ISI) was utilized to screen journals under the subject categories "Orthopaedics", "Sports Sciences", "Radiology" and "General medicine" for the 50 most cited level I ACL trials based on predefined inclusion criteria...
October 14, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Chulin Chen, Ting Kan, Shuang Li, Chen Qiu, Li Gui
OBJECTIVES: This review aimed to analyze published literature to introduce the use and implementation of standard operating procedures (SOPs) and checklists in prehospital emergency medicine and their impact on guideline adherence and patient outcome. METHODS: An English literature search was carried out using the Cochrane Library, MEDLINE, EMBASE, Springer, Elsevier, and ProQuest databases. Original articles describing the use and implementation of SOPs or checklists in prehospital emergency medicine were included...
September 28, 2016: American Journal of Emergency Medicine
Lynn M Yee, Grecio Sandoval, Jennifer Bailit, Uma M Reddy, Ronald J Wapner, Michael W Varner, Steve N Caritis, Mona Prasad, Alan T N Tita, George Saade, Yoram Sorokin, Dwight J Rouse, Sean C Blackwell, Jorge E Tolosa
OBJECTIVE: To describe factors associated with delayed pushing and evaluate the relationship between delayed pushing and perinatal outcomes in nulliparous women with singleton term gestations. METHODS: This was a secondary analysis of the Eunice Kennedy Shriver National Institute of Child Health and Human Development Assessment of Perinatal Excellence cohort of 115,502 women and their neonates born in 25 U.S. hospitals from 2008 to 2011. Nulliparous women with singleton, cephalic, nonanomalous term births who achieved 10-cm cervical dilation were included...
October 6, 2016: Obstetrics and Gynecology
Chaeyoun Oh, Joong Kee Youn, Ji-Won Han, Gi Beom Kim, Hyun-Young Kim, Sung-Eun Jung
INTRODUCTION: The Fontan procedure (FP) has become the standard operation for patients with single ventricle physiology. However, a long period of elevated systemic venous pressure and low cardiac output after the procedure result in chronic inflammation and liver cirrhosis, which may eventually lead to the occurrence of hepatocellular carcinoma (HCC). CLINICAL FINDINGS: We described the case of a 16-year-old female who developed HCC after the FP. At 21 months, the patient received a lateral tunnel FP, and 14 years later, she began complaining of abdominal distension, telangiectasia, and fatigue...
October 2016: Medicine (Baltimore)
J Trnka, M Špaček, V Šírová, P Mitáš, G Hodková, J Kubinyi, R Špunda, J Lindner
BACKGROUND: Hyperthermic isolated limb perfusion is used to treat irresectable extremity malignancies. It is based on the following principle - the perfusion of the extremity is isolated from systemic circulation and connected to an extra-corporal circuit via which a very high concentration of a chemotherapeutic agent is administered into the blood compartment of the extremity. In some cases, treatment efficiency can be improved using tasonermin (a TNF-α agent). By itself, tasonermin can cause severe health complications in patients if leakage into systemic circulation results in a level that exceeds the maximally tolerated dose...
2016: Klinická Onkologie: Casopis Ceské a Slovenské Onkologické Spolecnosti
P S Sidhu
In these days of political vagueness, to use a kinder term, although many would describe the situation as turmoil, in Europe, there are success stories to be lauded. Notwithstanding the direction individual countries choose in relation to closer or not so close co-operation in Europe and the direction the political agenda will travel over the next few years, I believe science and in particular medicine has benefited enormously form close co-operation across the European Union and with colleagues outside this political and trading block of nations...
October 2016: Ultraschall in der Medizin
Myles R McKenzie, Ernest W Parrish, Ethan A Miles, James C Spradling, Lanny F Littlejohn, Mark D Quinlan, George A Barbee, David R King
During an assault on an extremely remote target, a US Special Operations Soldier sustained multiple gunshot and fragmentation wounds to the thorax, resulting in a traumatic arrest and subsequent survival. His care, including care under fire, tactical field care, tactical evacuation care, and Role III, IV, and V care, is presented. The case is used to illustrate the complex dynamics of Special Operations care on the modern battlefield and the exceptional outcomes possible when evidence-based medicine is taken to the warfighter with effective, farforward, expeditionary medical-force projection...
2016: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
Bvudzai Priscilla Magadzire, Bruno Marchal, Kim Ward
BACKGROUND: The rising demand for chronic disease treatment and the barriers to accessing these medicines have led to the development of novel models for distributing medicines in South Africa's public sector, including distribution away from health centres, known as community-based distribution (CBD). In this article, we provide a typology of CBD models and outline perceived facilitators and barriers to their implementation using an adapted health systems framework with a view to analysing how future policy decisions on CBD could impact existing models and the health system as a whole...
2016: Journal of Pharmaceutical Policy and Practice
Abu Nasar, Aminoor Rahman, Nazmul Hoque, Anup Kumar Talukder, Ziban Chandra Das
AIM: To investigate the status, problems and prospects of Japanese quail (Coturnix coturnix japonica) farming in selected areas of Bangladesh. MATERIALS AND METHODS: The study was conducted in 14 districts of Bangladesh, viz., Dhaka, Narayanganj, Munshiganj, Mymensingh, Netrakona, Faridpur, Jessore, Khulna, Satkhira, Kushtia, Bogra, Naogaon, Comilla, and Sylhet during the period from July 2011 to June 2012. A total of 52 quail farmers were interviewed for data collection using a structured questionnaire...
September 2016: Veterinary World
Tennille K Marx, Róbert Glávits, John R Endres, Philip A Palmer, Amy E Clewell, Timothy S Murbach, Gábor Hirka, Ilona Pasics
Morus alba L. (white mulberry) leaves are one of the oldest recognized traditional Chinese medicines. More recently, M alba leaves and their constituents, particularly iminosugars (or azasugars), have garnered attention for their ability to maintain normal blood glucose concentrations, an effect identified in both animal studies and human clinical trials. Reducose (Phynova Group Limited) is a commercial water-soluble extract of M alba leaves standardized to 5% 1-deoxynojirimycin (DNJ), an iminosugar with α-glucosidase inhibition properties...
October 12, 2016: International Journal of Toxicology
Amy Tanti, Benjamin Micallef, Anthony Serracino-Inglott, John-Joseph Borg
Regulatory authorities have a legal mandate to implement and maintain a Pharmacovigilance System designed to monitor the safety of authorised medicinal products and detect any change to their risk-benefit balance. Areas covered: This review maps the implementation of pharmacovigilance activities in Malta since accession in the EU in mid 2004 and discusses the challenges the Maltese Regulator encountered while setting up adequate and effective systems to fulfil its legal mandate. Areas reviewed are those around ADR reporting, promotion and safety communications including rapid alerts and recalls, direct healthcare professional communications, risk minimisation measures and safety circulars and quality systems...
October 12, 2016: Expert Opinion on Drug Safety
Christian Blake Cameron, Vinay Nair, Manu Varma, Martha Adams, Kenar D Jhaveri, Matthew A Sparks
BACKGROUND: Electronic educational (e-learning) technology usage continues to grow. Many medical journals operate companion blogs (an application of e-learning technology) that enable rapid dissemination of scientific knowledge and discourse. Faculty members participating in promotion and tenure academic tracks spend valuable time and effort contributing, editing, and directing these medical journal blogs. OBJECTIVE: We sought to understand whether chairs of medicine and pediatric departments acknowledge blog authorship as academic achievement...
June 23, 2016: JMIR Med Educ
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