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https://www.readbyqxmd.com/read/28444410/-apnea-test-for-assessment-of-brain-death-under-extracorporeal-life-support
#1
REVIEW
S Winter, H V Groesdonk, M Beiderlinden
BACKGROUND: The fourth edition of the German guideline for the assessment of brain death, published in 2015 by the German Medical Council (Bundesärztekammer), emphasizes the importance of an apnea test. It is also now required under all circumstances of extracorporeal life support. OBJECTIVES: This article is an instruction for the guideline-conforming performance of an apnea test in general and also in cases of extracorporeal life support in different configurations...
April 25, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28442271/evaluation-of-the-xpert-hcv-viral-load-point-of-care-assay-from-venepuncture-collected-and-finger-stick-capillary-whole-blood-samples-a-cohort-study
#2
Jason Grebely, Francois M J Lamoury, Behzad Hajarizadeh, Yasmin Mowat, Alison D Marshall, Sahar Bajis, Philippa Marks, Janaki Amin, Julie Smith, Michael Edwards, Carla Gorton, Nadine Ezard, David Persing, Marika Kleman, Philip Cunningham, Beth Catlett, Gregory J Dore, Tanya L Applegate
BACKGROUND: Point-of-care hepatitis C virus (HCV) RNA testing offers an advantage over antibody testing (which only indicates previous exposure), enabling diagnosis of active infection in a single visit. In this study, we evaluated the performance of the Xpert HCV Viral Load assay with venepuncture and finger-stick capillary whole-blood samples. METHODS: Plasma and finger-stick capillary whole-blood samples were collected from participants in an observational cohort enrolled at five sites in Australia (three drug and alcohol clinics, one homelessness service, and one needle and syringe programme)...
April 21, 2017: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28442189/exploring-how-residents-who-partially-participate-in-family-planning-training-determine-their-level-of-participation
#3
Jema K Turk, Felisa Preskill, Alecia Fields, Uta Landy, Jody E Steinauer
OBJECTIVES: The Accreditation Council for Graduate Medical Education (ACGME) requires that obstetrics and gynecology residency programs provide access to abortion training, though residents may elect to opt out of participating due to religious or moral objections. While clinical benefits of partial participation have previously been explored, our study aimed to explore how residents navigate partial participation in abortion training and determine their limits. STUDY DESIGN: This study was qualitative in nature...
April 22, 2017: Women's Health Issues: Official Publication of the Jacobs Institute of Women's Health
https://www.readbyqxmd.com/read/28441675/teaching-today-in-the-practice-setting-of-the-future-implementing-innovations-in-graduate-medical-education
#4
Jung G Kim, Carl G Morris, Paul Ford
PROBLEM: Implementing an innovation, such as offering new types of patient-physician encounters through the patient-centered medical home (PCMH) model while maintaining Accreditation Council for Graduate Medical Education (ACGME) accreditation standards (e.g., patient encounter minimums for trainees), is challenging. APPROACH: In 2009, the Group Health Family Medicine Residency (GHFMR) received an ACGME Program Experimentation and Innovation Project (PEIP) exception that redefined the minimum Family Medicine Resident Review Committee requirement to 1,400 face-to-face visits and 250 electronic visits (1 electronic visit defined as 3 secure message or telephone encounters)...
May 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28439356/impact-of-the-2003-acgme-resident-duty-hour-reform-on-hospital-acquired-conditions-a-national-retrospective-analysis
#5
Timothy Wen, Frank J Attenello, Steven Y Cen, Alexander A Khalessi, May Kim-Tenser, Nerses Sanossian, Steven L Giannotta, Arun P Amar, William J Mack
BACKGROUND: The Accreditation Council for Graduate Medical Education reforms in 2003 instituted an 80-hour weekly limit for resident physicians. Critics argue that these restrictions have increased handoffs among residents and the potential for a decline in patient safety. "Never events" hospital-acquired conditions (HACs) are a set of preventable events used as a quality metric in hospital safety analyses. OBJECTIVE: This analysis evaluated post-work hour reform effects on HAC incidence for US hospital inpatients, using the National Inpatient Sample...
April 2017: Journal of Graduate Medical Education
https://www.readbyqxmd.com/read/28439350/transgender-related-education-in-plastic-surgery-and-urology-residency-programs
#6
Shane D Morrison, Geolani W Dy, H Jonathan Chong, Sarah K Holt, Nicholas B Vedder, Mathew D Sorensen, Byron D Joyner, Jeffrey B Friedrich
BACKGROUND: With increasing public awareness of and greater coverage for gender-confirming surgery by insurers, more transgender patients are likely to seek surgical transition. The degree to which plastic surgery and urology trainees are prepared to treat transgender patients is unknown. OBJECTIVE: We assessed the number of hours dedicated to transgender-oriented education in plastic surgery and urology residencies, and the impact of program director (PD) attitudes on provision of such training...
April 2017: Journal of Graduate Medical Education
https://www.readbyqxmd.com/read/28439349/internal-medicine-program-directors-perceptions-of-the-all-in-match-rule-a-cross-sectional-survey
#7
Richard Alweis, Muhammad Sohail Khan, Sapna Kuehl, Thomas Wasser, Anthony Donato
BACKGROUND: Since 2013, the National Resident Matching Program (NRMP) has asked all programs to declare themselves to be "all in" or "all out" for the NRMP. Before this rule was enacted, program directors who were surveyed expressed concerns about what they anticipated with the change, including resources for increased applications and potential delays with residency start times. OBJECTIVE: This study investigated the positive and negative effects of the rule change on recruiting seen from the perspective of internal medicine (IM) program directors...
April 2017: Journal of Graduate Medical Education
https://www.readbyqxmd.com/read/28437749/epilepsy-awareness-and-emergency-rescue-training-ignorance-is-bliss
#8
Rohit Shankar, Caryn Jory, Brendan McLean, Phil Tittensor, Matthew Walker
Status epilepticus (SE) has a high mortality rate and is associated with complications such as neurological deficit and cognitive decline. Buccal midazolam is the recommended emergency rescue medication in the UK to reduce the duration of a seizure and SE. It should be administered by an appropriately trained person. There are agreed guidelines on training standards for its administration in the UK produced by the Joint Epilepsy Council of the United Kingdom and Ireland. Training should provide an overview of epilepsy to facilitate safe, person-centered care and appropriate administration of rescue medication to people with epilepsy (PWE)...
April 19, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28437546/root-cause-analysis-and-actions-for-the-prevention-of-medical-errors-quality-improvement-and-resident-education
#9
Ryan Charles, Brandon Hood, Joseph M DeRosier, John W Gosbee, James P Bagian, Ying Li, Michelle S Caird, J Sybil Biermann, Mark E Hake
The quality of care delivered by orthopedic surgeons continues to grow in importance. Multiple orthopedic programs, organizations, and committees have been created to measure the quality of surgical care and reduce the incidence of medical adverse events. Structured root cause analysis and actions (RCA2) has become an area of interest. If performed thoroughly, RCA2 has been shown to reduce surgical errors across many subspecialties. The Accreditation Council for Graduate Medical Education has a new mandate for programs to involve residents in quality improvement processes...
April 24, 2017: Orthopedics
https://www.readbyqxmd.com/read/28436039/nutrient-retention-values-and-cooking-yield-factors-for-three-south-african-lamb-and-mutton-cuts
#10
Salomina M van Heerden, Phillip E Strydom
BACKGROUND: Nutrient content of raw and cooked foods is important for formulation healthy diets. The retention of nutrients during cooking can be influenced by various factors including animal age, carcass characteristics and cooking method and these factors are often unique to specific countries. We studied the effects of animal age (lamb and mutton), carcass cut (shoulder, loin and leg) combined with cooking method (moist-heat and dry-heat) on yield and nutrient retention of selected nutrients of South African sheep carcasses...
April 23, 2017: Journal of the Science of Food and Agriculture
https://www.readbyqxmd.com/read/28433523/association-of-preresidency-peer-reviewed-publications-with-radiation-oncology-resident-choice-of-academic-versus-private-practice-career
#11
Shearwood McClelland, Charles R Thomas, Lynn D Wilson, Emma B Holliday, Jerry J Jaboin
INTRODUCTION: The decision of radiation oncology residents to pursue academic versus private practice careers plays a central role in shaping the present and future of the field, but factors that are potentially predictive of this decision are lacking. This study was performed to examine the role of several factors publicly available before residency on postresidency career choice, including preresidency peer-reviewed publications (PRPs), which have been associated with resident career choice in comparably competitive subspecialties such as neurosurgery...
April 5, 2017: Practical Radiation Oncology
https://www.readbyqxmd.com/read/28432089/preparing-future-doctors-for-palliative-care-views-of-course-organisers
#12
Steven Walker, Jane Gibbins, Paul Paes, Stephen Barclay, Astrid Adams, Madawa Chandratilake, Faye Gishen, Philip Lodge, Bee Wee
BACKGROUND: Effective training at medical school is essential to prepare new doctors to safely manage patients with palliative care (PC) and end of life care (EOLC) needs. The contribution of undergraduate PC course organisers is central but their collective views regarding role are unknown. OBJECTIVE: To survey attitudes of PC course organisers regarding their course, organisation, the adequacy of training provided and level of personal satisfaction. METHODS: An anonymised, multifactorial, web-based questionnaire was devised, tested, modified and then sent to lead PC course organisers at all UK medical schools...
April 21, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28431025/1h-magnetic-resonance-spectroscopy-of-live-human-sperm
#13
S Reynolds, S J Calvert, M N Paley, A A Pacey
STUDY QUESTION: Can 1H Magnetic Resonance Spectroscopy (MRS) be used to obtain information about the molecules and metabolites in live human spermatozoa? SUMMARY ANSWER: Percoll-based density gradient centrifugation (DGC) followed by a further two washing steps, yielded enough sperm with minimal contamination (<0.01%) from seminal fluid to permit effective MRS which detected significant differences (p < 0.05) in the choline/glycerophosphocholine, lipid and lactate regions of the 1H MRS spectrum between sperm in the pellet and those from the 40/80% interface...
April 18, 2017: Molecular Human Reproduction
https://www.readbyqxmd.com/read/28428332/education-in-nephrology-fellowship-a-survey-based-needs-assessment
#14
Robert W Rope, Kurtis A Pivert, Mark G Parker, Stephen M Sozio, Sylvia Bereknyei Merell
Educational needs assessments for nephrology fellowship training are limited. This study assessed fellows' perceptions of current educational needs and interest in novel modalities that may improve their educational experience and quantified educational resources used by programs and fellows. We distributed a seven-question electronic survey to all United States-based fellows receiving complimentary American Society of Nephrology (ASN) membership at the end of the 2015-2016 academic year in conjunction with the ASN Nephrology Fellows Survey...
April 20, 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/28428185/investments-in-cancer-research-awarded-to-uk-institutions-and-the-global-burden-of-cancer-2000-2013-a-systematic-analysis
#15
Mahiben Maruthappu, Michael G Head, Charlie D Zhou, Barnabas J Gilbert, Majd A El-Harasis, Rosalind Raine, Joseph R Fitchett, Rifat Atun
OBJECTIVES: To systematically categorise cancer research investment awarded to United Kingdom (UK) institutions in the period 2000-2013 and to estimate research investment relative to disease burden as measured by mortality, disability-adjusted life years (DALYs) and years lived with disability (YLDs). DESIGN: Systematic analysis of all open-access data. SETTING AND PARTICIPANTS: Public and philanthropic funding to all UK cancer research institutions, 2000-2013...
April 20, 2017: BMJ Open
https://www.readbyqxmd.com/read/28424503/sexuality-education-in-japanese-medical-schools
#16
M Shirai, A Tsujimura, A Abdelhamed, S Horie
The present study aimed to investigate current sexuality education in Japanese medical schools and the impact of position title in the Japanese Society for Sexual Medicine (JSSM). Questionnaires were mailed to urology departments in all Japanese medical schools. The responses were evaluated according to four factors: the number of lecture components, curriculum hours, degree of satisfaction with the components and degree of satisfaction with the curriculum hours. We also investigated differences in these four factors among three groups: Directors, Council members and non-members of the JSSM...
April 20, 2017: International Journal of Impotence Research
https://www.readbyqxmd.com/read/28423852/using-the-mrc-framework-for-complex-interventions-to-develop-clinical-decision-support-a-case-study
#17
Dawn Dowding, Valentina Lichtner, S José Closs
The Medical Research Council (MRC) framework for complex interventions provides useful guidance to assist with the development and evaluation of health technology interventions such as decision support. In this paper we briefly summarise a project that focused on designing a decision support intervention to assist with the recognition, assessment and management of pain in patients with dementia in an acute hospital setting. We reflect on our experience of using the MRC framework to guide our study design, and highlight the importance of considering decision support interventions as complex interventions...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28422753/steroid-metabolome-analysis-reveals-prevalent-glucocorticoid-excess-in-primary-aldosteronism
#18
Wiebke Arlt, Katharina Lang, Alice J Sitch, Anna S Dietz, Yara Rhayem, Irina Bancos, Annette Feuchtinger, Vasileios Chortis, Lorna C Gilligan, Philippe Ludwig, Anna Riester, Evelyn Asbach, Beverly A Hughes, Donna M O'Neil, Martin Bidlingmaier, Jeremy W Tomlinson, Zaki K Hassan-Smith, D Aled Rees, Christian Adolf, Stefanie Hahner, Marcus Quinkler, Tanja Dekkers, Jaap Deinum, Michael Biehl, Brian G Keevil, Cedric H L Shackleton, Jonathan J Deeks, Axel K Walch, Felix Beuschlein, Martin Reincke
BACKGROUND: Adrenal aldosterone excess is the most common cause of secondary hypertension and is associated with increased cardiovascular morbidity. However, adverse metabolic risk in primary aldosteronism extends beyond hypertension, with increased rates of insulin resistance, type 2 diabetes, and osteoporosis, which cannot be easily explained by aldosterone excess. METHODS: We performed mass spectrometry-based analysis of a 24-hour urine steroid metabolome in 174 newly diagnosed patients with primary aldosteronism (103 unilateral adenomas, 71 bilateral adrenal hyperplasias) in comparison to 162 healthy controls, 56 patients with endocrine inactive adrenal adenoma, 104 patients with mild subclinical, and 47 with clinically overt adrenal cortisol excess...
April 20, 2017: JCI Insight
https://www.readbyqxmd.com/read/28421889/overall-assessment-of-human-research-and-ethics-committees-in-the-united-arab-emirates
#19
Mahera Abdulrahman, Satish Chandrasekhar Nair
Growing demand for human health research in the United Arab Emirates (UAE) has prompted the need to develop a robust research ethics oversight. Examination of the structure, function, and practices of the human research ethics committees (HRECs), followed by evaluation of standards for measuring research output, was conducted. Results indicate that among the HRECs, 90% followed International Council for Harmonization-Good Clinical Practice guidelines, 66.6% have been in operation for more than 5 years, 95% reviewed proposals within 8 weeks, and 56% reviewed for scientific merit apart from ethics...
April 2017: Journal of Empirical Research on Human Research Ethics: JERHRE
https://www.readbyqxmd.com/read/28420034/a-fluorescence-in-situ-hybridization-based-screen-allows-rapid-detection-of-adverse-cytogenetic-alterations-in-patients-with-acute-myeloid-leukemia
#20
Nadine Sandhöfer, Klaus H Metzeler, Purvi M Kakadia, Zlatana Pasalic, Wolfgang Hiddemann, Michaela Neusser, Ortrud Steinlein, Michael Fiegl, Marion Subklewe, Karsten Spiekermann, Stefan K Bohlander, Stephanie Schneider, Jan Braess
In adult acute myeloid leukemia (AML), the karyotype of the leukemic cell is among the strongest prognostic factors. The Medical Research Council (MRC) and the European LeukemiaNet (ELN) classifications distinguish between favorable, intermediate and adverse cytogenetic risk patients who differ in their treatment response and overall survival. Conventional cytogenetic analyses are a mandatory component of AML diagnostics but they are time-consuming; therefore, therapeutic decisions in elderly patients are often delayed...
April 18, 2017: Genes, Chromosomes & Cancer
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