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Emergency Management

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https://www.readbyqxmd.com/read/29141123/improving-mental-health-training-for-primary-care-residents-a-resident-led-educational-intervention
#1
Peter J Ureste, Tammy L Duong, Andreea L Seritan, Ana-Maria Iosif, Donald M Hilty
Objective: Psychiatric training in family medicine residency programs is necessary but not always sufficient. A brief educational intervention was designed to help improve family medicine residents' knowledge, comfort, and attitudes in delivering mental health care. Methods: A 6-hour didactic curriculum was taught by 2 psychiatry residents to family medicine residents between February and April 2015. Preintervention and postintervention surveys assessed participant demographics, knowledge, comfort levels, and attitudes regarding treating patients with psychiatric illness...
November 2, 2017: Primary Care Companion to CNS Disorders
https://www.readbyqxmd.com/read/29141028/developing-methods-for-assessing-abundance-and-distribution-of-european-oysters-ostrea-edulis-using-towed-video
#2
Linnea Thorngren, Thomas Dunér Holthuis, Susanne Lindegarth, Mats Lindegarth
Due to large-scale habitat losses and increasing pressures, benthic habitats in general, and perhaps oyster beds in particular, are commonly in decline and severely threatened on regional and global scales. Appropriate and cost-efficient methods for mapping and monitoring of the distribution, abundance and quality of remaining oyster populations are fundamental for sustainable management and conservation of these habitats and their associated values. Towed video has emerged as a promising method for surveying benthic communities in a both non-destructive and cost-efficient way...
2017: PloS One
https://www.readbyqxmd.com/read/29140915/the-actual-versus-idealized-self-exploring-responses-to-feedback-about-implicit-bias-in-health-professionals
#3
Javeed Sukhera, Alexandra Milne, Pim W Teunissen, Lorelei Lingard, Chris Watling
PURPOSE: Implicit bias can adversely affect health disparities. The implicit association test (IAT) is a prompt to stimulate reflection; however, feedback about bias may trigger emotions that reduce the effectiveness of feedback interventions. Exploring how individuals process feedback about implicit bias may inform bias recognition and management curricula. The authors sought to explore how health professionals perceive the influence of the experience of taking the IAT and receiving their results...
November 14, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/29140757/new-insights-into-lymphoma-pathogenesis
#4
Kojo S J Elenitoba-Johnson, Megan S Lim
Lymphomas represent clonal proliferations of lymphocytes that are broadly classified based upon their maturity (peripheral or mature versus precursor) and lineage (B cell, T cell, and natural killer cell). Insights into the pathogenetic mechanisms involved in lymphoma impact the classification of lymphoma and have significant implications for the diagnosis and clinical management of patients. Serial scientific and technologic advances over the last 30 years in immunology, cytogenetics, molecular biology, gene expression profiling, mass spectrometry-based proteomics, and, more recently, next-generation sequencing have contributed to greatly enhance our understanding of the pathogenetic mechanisms in lymphoma...
November 15, 2017: Annual Review of Pathology
https://www.readbyqxmd.com/read/29140737/older-americans-were-sicker-and-faced-more-financial-barriers-to-health-care-than-counterparts-in-other-countries
#5
Robin Osborn, Michelle M Doty, Donald Moulds, Dana O Sarnak, Arnav Shah
High-income countries are grappling with the challenge of caring for aging populations, many of whose members have chronic illnesses and declining capacity to manage activities of daily living. The 2017 Commonwealth Fund International Health Policy Survey of Older Adults in eleven countries showed that US seniors were sicker than their counterparts in other countries and, despite universal coverage under Medicare, faced more financial barriers to health care. The survey's findings also highlight economic hardship and mental health problems that may affect older adults' health, use of care, and outcomes...
November 15, 2017: Health Affairs
https://www.readbyqxmd.com/read/29139364/advanced-management-of-severe-keloids
#6
REVIEW
Thomas Hagele, Hoka Nyanda, Nishit Patel, Nicole Russell, George Cohen, Christopher Nelson
Keloids negatively impact the health and quality of life of many affected dermatologic patients. Treating keloids is often difficult, and suboptimal responses are frequent. Fortunately, there are many treatment options available to the clinician that may lead to improved clinical outcomes. We present a review of currently available therapeutic options. Intralesional steroid injection remains the first-line treatment for keloids. Imiquimod, direct interferon therapy, or intralesional 5-flurouracil may alleviate the need for excessive corticosteroid therapy...
2017: Skinmed
https://www.readbyqxmd.com/read/29139209/protocol-for-a-new-concept-of-no-prep-ultrathin-ceramic-veneers
#7
Camillo D'Arcangelo, Mirco Vadini, Maurizio D'Amario, Zaccheo Chiavaroli, Francesco De Angelis
OBJECTIVES: No-prep veneers, although ideally considered the best option because of tooth structure maximum preservation, have been frequently criticized for some potential limitations including esthetic outcomes and periodontal complications. CLINICAL CONSIDERATIONS: A new protocol to optimize no-prep veneers restorations is presented. A key point of the proposed technique is to identify optimal margins' positions: margin is positioned in the point of maximum convexity of teeth, avoiding the over contouring of traditional no-prep veneers...
November 15, 2017: Journal of Esthetic and Restorative Dentistry
https://www.readbyqxmd.com/read/29139019/pharmacists-confidence-when-providing-pharmaceutical-care-on-anticoagulants-a-multinational-survey
#8
John Papastergiou, Nadir Kheir, Katerina Ladova, Silas Rydant, Fabio De Rango, Sotiris Antoniou, Reka Viola, Maria Dolores Murillo, Stephane Steurbaut, Filipa Alves da Costa
Background Guidelines on the management of orally anticoagulated patients are continuously evolving, leading to an increased need for pharmacists to be fully integrated in care provision. Objective To identify self-reported gaps in confidence among practicing pharmacists in the area of anticoagulation. Setting Pharmacists in different work settings in different countries. Method Cross-sectional international survey from October 2015 till November 2016 among pharmacists working in different settings to assess their level of confidence when delivering anticoagulants as well as to identify possible educational needs regarding this medication class...
November 14, 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/29138603/fatal-collapse-due-to-autonomic-dysreflexia-during-manual-self-evacuation-of-bowel-in-a-tetraplegic-patient-living-alone-lessons-to-learn
#9
Subramanian Vaidyanathan, Bakul M Soni, Paul Mansour, Tun Oo
Background: To identify areas for improvement, the National Health Service in England mandates the review of case reports of patients who have died, which should be translated into improved care for other patients. Case report: A 49-year-old Caucasian man sustained C-7 tetraplegia in a motorcycle accident in 1992. In 2009, he developed seizures and collapsed in the lavatory on a number of occasions during manual self-evacuation of his bowel. A 24-hour electrocardiogram recording at that time showed sinus rhythm with a maximum heart rate of 97 and a minimum of 39 beats per minute; there were no significant arrhythmias that could have contributed to his episodes of collapse...
2017: International Medical Case Reports Journal
https://www.readbyqxmd.com/read/29138540/a-qualitative-study-exploring-issues-related-to-medication-management-in-residential-aged-care-facilities
#10
Mariani Ahmad Nizaruddin, Marhanis-Salihah Omar, Adliah Mhd-Ali, Mohd Makmor-Bakry
Background: Globally, the population of older people is on the rise. As families are burdened with the high cost of care for aging members, demand is increasing for medical care and nursing homes. Thus, medication management is crucial to ensure that residents in a care center benefit and assist the management of the care center in reducing the burden of health care. This study is aimed to qualitatively explore issues related to medication management in residential aged care facilities (RACFs)...
2017: Patient Preference and Adherence
https://www.readbyqxmd.com/read/29138274/five-year-effectiveness-of-the-multidisciplinary-risk-assessment-and-management-program-for-primary-care-patients-with-type-2-diabetes-mellitus%C3%A2-ramp-dm-on-dm-related-complications-and-health-service-uses-a-population-based-and-propensity-matched-cohort-study
#11
Eric Yuk Fai Wan, Colman Siu Cheung Fung, Fang Fang Jiao, Esther Yee Tak Yu, Weng Yee Chin, Daniel Yee Tak Fong, Carlos King Ho Wong, Anca Ka Chun Chan, Karina Hiu Yen Chan, Ruby Lai Ping Kwok, Cindy Lo Kuen Lam
OBJECTIVE: To evaluate the 5-year effectiveness of a multidisciplinary Risk Assessment and Management Program for primary care patients with type 2 Diabetes Mellitus (RAMP-DM)‎. RESEARCH DESIGN AND METHODS: A 5-year prospective cohort study was conducted with 121,584 Chinese primary care patients with type 2 DM who were recruited between August 2009 and June 2011. Missing data were dealt with multiple imputations. After excluding patients with prior DM-related complications and one-to-one propensity score matching on all patient characteristics, 26,718 RAMP-DM participants and 26,718 matched usual-care patients were followed up for a median time of 4...
November 14, 2017: Diabetes Care
https://www.readbyqxmd.com/read/29138272/the-role-of-peers-for-diabetes-management-in-adolescents-and-emerging-adults-with-type-1-diabetes-a-longitudinal-study
#12
Koen Raymaekers, Leen Oris, Sofie Prikken, Philip Moons, Eva Goossens, Ilse Weets, Koen Luyckx
OBJECTIVE: The increasing importance of peers in adolescence and emerging adulthood has been widely acknowledged. However, longitudinal research linking the peer context to diabetes management and outcomes is scarce. The present longitudinal study in a large sample of youths with type 1 diabetes related both positive and negative peer variables to diabetes outcomes over a time interval of 1 year. RESEARCH DESIGN AND METHODS: Our sample consisted of 467 adolescents (14-17 years of age) and emerging adults (18-25 years of age) with type 1 diabetes who participated in a two-wave longitudinal study...
November 14, 2017: Diabetes Care
https://www.readbyqxmd.com/read/29138043/non-traumatic-limping-in-paediatric-emergencies-epidemiology-evaluation-and-results
#13
M I Lázaro Carreño, R Fraile Currius, A García Clemente
INTRODUCTION: Non-traumatic limping is a common reason for consultation in paediatric emergencies. Although transient synovitis of the hip (TS) is the most frequent diagnosis, there are cases of limping secondary to serious pathologies. The aim of this review is to describe the variables related to non-traumatic limp that come to the paediatric emergency department to establish the best management protocol, making the most of resources and speeding up emergency care. MATERIAL AND METHOD: A prospective study was conducted, selecting all children less than 15 years old who consulted aspaediatric emergencies for non-traumatic limping during the 2014...
November 11, 2017: Revista Española de Cirugía Ortopédica y Traumatología
https://www.readbyqxmd.com/read/29137905/emergency-department-chest-radiography-for-children-with-asthma-exacerbation-is-infrequently-associated-with-change-of-management
#14
Evan H Allie, Henry E Dingle, William N Johnson, Jeffrey R Birnbaum, Melissa A Hilmes, Sudha P Singh, Donald H Arnold
BACKGROUND: Acute asthma exacerbations (AAE) account for many Pediatric Emergency Department (PED) visits. Chest radiography (CXR) is often performed in these patients to identify practice-changing findings such as pneumonia (PNA). Limited knowledge exists to balance the cost and radiation dose of CXR with expected yield of clinically meaningful information. OBJECTIVE: To determine in children with AAE with CXR, whether patient characteristics are associated with radiographic PNA; and significant practice change by initiation of antibiotic...
October 6, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29137904/implications-of-iodinated-contrast-media-extravasation-in-the-emergency-department
#15
Jonathan D Sonis, Ravi V Gottumukkala, McKinley Glover, Brian J Yun, Benjamin A White, Mannudeep K Kalra, Alexi Otrakji, Ali S Raja, Anand M Prabhakar
PURPOSE: To characterize the management, outcomes, and emergency department (ED) length of stay (LOS) following iodinated contrast media extravasation events in the ED. METHODS: All ED patients who developed iodinated contrast media extravasation following contrast-enhanced CT (CECT) from October 2007-December 2016 were retrospectively identified. Medical records were reviewed and management, complications, frequency of surgical consultation, and ED LOS were quantified using descriptive statistics...
November 7, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29137663/patent-landscape-of-neglected-tropical-diseases-an-analysis-of-worldwide-patent-families
#16
Folahanmi Tomiwa Akinsolu, Vitor Nobre de Paiva, Samuel Santos Souza, Orsolya Varga
BACKGROUND: "Neglected Tropical Diseases" (NTDs) affect millions of people in Africa, Asia and South America. The two primary ways of strategic interventions are "preventive chemotherapy and transmission control" (PCT), and "innovative and intensified disease management" (IDM). In the last 5 years, phenomenal progress has been achieved. However, it is crucial to intensify research effort into NTDs, because of the emerging drug resistance. According to the World Health Organization (WHO), the term NTDs covers 17 diseases, namely buruli ulcer, Chagas disease, dengue, dracunculiasis, echinococcosis, trematodiasis, human African trypanosomiasis, leishmaniasis, leprosy, lymphatic filariasis, onchocerciasis, rabies, schistosomiasis, soil-transmitted helminthes, taeniasis, trachoma, and yaws...
November 14, 2017: Globalization and Health
https://www.readbyqxmd.com/read/29137550/reengineering-electronic-fetal-monitoring-interpretation-using-the-fetal-reserve-index-to-anticipate-the-need-for-emergent-operative-delivery
#17
Robert D Eden, Mark I Evans, Shara M Evans, Barry S Schifrin
OBJECTIVE: The near-ubiquitous use of electronic fetal monitoring has failed to lower the rates of both cerebral palsy and emergency operative deliveries (EODs). Its performance metrics have low sensitivity, specificity, and predictive values for both. There are many EODs, but the vast majority have normal outcomes. The EODs, however, cause serious disruption in the delivery suite routine with increased complications, anxiety, and concern for all. METHODS: We developed the fetal reserve index (FRI) as multicomponent algorithm including 4 FHR components (analyzed individually), uterine activity, and maternal, obstetrical, and fetal risk factors to assess risk of cerebral palsy and EOD...
January 1, 2017: Reproductive Sciences
https://www.readbyqxmd.com/read/29137025/tapentadol-versus-tramadol-in-the-management-of-low-back-pain-in-the-emergency-department-impact-of-use-on-the-need-for-reassessments
#18
Carlos A Guillén-Astete, César Cardona-Carballo, Cristina de la Casa-Resino
Nontraumatic musculoskeletal disorders are the main reason for presentation to the emergency department (ED), with rachialgia (back pain) being the most common reason to request medical assessment among them. This also generates the highest demand for reassessments due to poor pain control or onset of adverse reactions to the treatment prescribed in the initial assessment.A retrospective observational study based on usual clinical practice was conducted in patients attending the ED due to low back pain during a period of 24 months...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29137023/a-case-report-of-schatzker-type-vi-tibial-plateau-fracture-treated-with-double-reverse-traction-closed-reduction-combined-with-minimally-invasive-percutaneous-plate-osteosynthesis-technique-a-case-report
#19
Dian-Qing Li, De-Ye Song, Jiang-Dong Ni, Mu-Liang Ding, Jun Huang
RATIONALE: The knee joint is an important weight-bearing joint, tibial plateau fractures affect knee function and stability. High-energy intra-articular fractures involving the tibial plateau can cause management-related problems such as wound dehiscence; severe comminution leading to malalignment; and delayed complications such as varus collapse, implant failure, and arthritis of the knee joint. The treatment of severe or complex tibial plateau fractures can be quite difficult. Traditional methods of open reduction and plating require extensive exposures, which may further compromise soft tissue and devascularize bone fragments, leading to infection...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29136556/industry-interests-in-gambling-research-lessons-learned-from-other-forms-of-hazardous-consumption
#20
S Cowlishaw, S L Thomas
Research indicates that the evidential bases for many harm reduction policies targeting hazardous consumptions (including tobacco, alcohol and gambling) have been distorted by commercial industries that derive revenue from such commodities. These distortions are best illustrated by research on tobacco and alcohol, which indicates similar tactics used by industries to determine favourable policy environments through engineering of evidence, among other approaches. Although there is concern that gambling research is similarly vulnerable to commercial interests, the relevant literature lags far behind other fields and the aim of this paper is to increase familiarity with tactics used by industries for influencing research...
November 6, 2017: Addictive Behaviors
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