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Internal and emergency medicine

F F Girrbach, F Hilbig, M Michael, M Bernhard
BACKGROUND: A myriad of publications have contributed to an evidence-based approach to airway management in emergency services and admissions in recent years; however, it remains unclear which international registries on airway management in emergency medicine currently exist and how they are characterized concerning inclusion criteria, patient characteristics and definition of complications. METHODS: A systematic literature research was carried out in PubMed with respect to publications from 2007-2017...
August 13, 2018: Der Anaesthesist
Paul Bunge
CONTEXT: Finding providers to work in the hospitals and clinics in the small towns of the USA is a significant struggle. In the traditional model, the primary care doctor sees patients in the inpatient setting in addition to a clinic practice. In the usual hospitalist model, providers specialize to work only in the inpatient setting. ISSUES: Rural communities often lack the resources, facilities, and volume to safely adopt the usual hospitalist model, which has its own disadvantages...
August 2018: Rural and Remote Health
Wei-Bo Zhang, Yan-Ping Wang, Hong-Yan Li
The meridians and Zangfu -organs (viscera) are two major systems in the basic theory of traditional Chinese medicine (TCM). They were primarily emerged together in simple form possibly in the Han Dynasty shown by the unearthed silk manuscripts of Changsha Mawangdui Han Tomb, and became a systematic theory in classical book "Neijing" ( The Yellow Emperor's Internal Classic ). After classification of the meridians' disease manifestations described in book "Ling Shu-Jing Mai" ( Miraculous Pivot: Meridians ) we found that more than half of the manifestations appear along the running course of meridians...
July 25, 2018: Zhen Ci Yan Jiu, Acupuncture Research
Rajesh Kirit Daftary, Brittany Lee Murray, Teri Ann Reynolds
OBJECTIVE: Provision of timely, high-quality care for the initial management of critically ill children in African hospitals remains a challenge. Monitoring the completion of critical actions during resuscitations can inform efforts to reduce variability and improve outcomes. We sought to develop a practice-based tool based on contextually relevant actions identified via a Delphi process. Our goal was to develop a tool that could identify gaps in care, facilitate identification of training and standardised assessment to support quality improvement efforts...
August 8, 2018: BMJ Open
Kenji Sugiyama, Takao Nozaki, Tetsuya Asakawa, Tetsuro Sameshima, Schinichiro Koizumi, Hisaya Hiramatsu, Hiroki Namba
Deep brain stimulation (DBS) is used to treat symptoms by modulating the cortico-striato-thalamo-cortical (CSTC) loop in the central nervous system (CNS), and attempts to research loop circuit disorders have been globally initiated among the intractable neurological and psychiatric disorders. DBS treatment has been evaluated for all these newly found CNS loop circuit disorders. In 2011, neurosurgical treatments for psychiatric disorders were renamed from "psychosurgery" to "neurosurgery for psychiatric disorders (NPD)" by the World Society for Stereotactic and Functional Neurosurgery (WSSFN)...
August 9, 2018: Neurologia Medico-chirurgica
Melissa Barnett, M Tyson Pillow, Jennifer Carnell, Anita Rohra, Stephanie DeSandro, Aimee K Gardner
PURPOSE: We performed a needs assessment to understand how existing physician assistant (PA) program curricula and clinical training affect students' ultrasound knowledge, skills, and competence and prepare students for performing ultrasound techniques in clinical practice. METHODS: Students graduating from a PA program completed a 23-item questionnaire examining their ultrasound training experiences, their self-assessment of competency, and their demographics. Students also completed a 15-item ultrasound knowledge assessment...
August 6, 2018: Journal of Physician Assistant Education
Andrea Palermo, Ettore Capoluongo, Rossella Del Toro, Silvia Manfrini, Paolo Pozzilli, Daria Maggi, Giuseppe Defeudis, Francesco Pantano, Roberto Coppola, Francesco Maria Di Matteo, Marco Raffaelli, Paola Concolino, Alberto Falchetti
CONTEXT: Clinical phenotype variability in MEN1 syndrome exists and evidence for an established genotype-phenotype is lacking. However, a higher aggressiveness of MEN1-associated gastro-entero-pancreatic (GEP) (neuro)endocrine tumours (NETs) tumours has been reported when MEN1 gene truncating mutations are detected. We found a novel germline truncating mutation of MEN1 gene at exon 10 in a subject with an aggressive clinical behavior of GEP-NETs. Successively, other two mutant-affected familial members have been identified...
August 6, 2018: Hormones: International Journal of Endocrinology and Metabolism
Barbara Glover, Olalekan Akinbo, Moussa Savadogo, Samuel Timpo, Godwin Lemgo, Woldeyesus Sinebo, Sunday Akile, Silas Obukosia, Jeremy Ouedraogo, Margareth Ndomondo-Sigonda, Muffy Koch, Diran Makinde, Aggrey Ambali
The New Partnership for Africa's Development (NEPAD) Agency recognizes that Africa is in a period of transition and that this demands exploring and harnessing safe advances made in science-based innovations including modern biotechnology. To advance the science of biotechnology in Africa effectively, while at the same time safeguarding human health and the environment, the African Union (AU) adopted a High-Level Panel report on modern biotechnology entitled, Freedom to Innovate , which advocated for a coevolutionary approach where technology development goes hand in hand with regulation...
2018: BMC Proceedings
A Michon, S Jammal, A Passeron, G De Luna, C Bomahou, V Jullien, J Pouchot, J-B Arlet, B Ranque
INTRODUCTION: Point of care ultrasound (POCUS) is routinely used by intensivists and emergency physicians for many years. Its interest is not arguable any more for these specialists, despite the large variety of diseases they care. Hospitalists and internists also should find some interest in POCUS, which convenience and wide range of indications responds well to the variety of their practice. However, it is still not widely used in internal medicine departments. METHODS: We here report our experience of using a pocket-sized ultrasound device in a French internal medicine department...
August 2, 2018: La Revue de Médecine Interne
Isabelle Gagnon, Debbie Friedman, Miriam H Beauchamp, Brian Christie, Carol DeMatteo, Gail Macartney, Bradford J McFadyen, Katia Sirois, Chand Taneja, Karl Zabjek, Roger Zemek, Martin Mrazik
A critical component for accelerating the clinical uptake of research data in the area of pediatric concussion or mild traumatic brain injury (MTBI) pertains to the establishment and utilization of common databases. The objective of the first phase of our CanPedCDE initiative was to agree upon pediatric common data elements (CDEs) that could best characterize children with MTBI over their recovery period. The selection of CDEs for our framework aimed to balance factors such as the comprehensiveness of outcomes collected, their applicability to diverse settings, as well as the costs associated with their use...
August 15, 2018: Journal of Neurotrauma
Laura G Militello, Nicholas A Rattray, Mindy E Flanagan, Zamal Franks, Shakaib Rehman, Howard S Gordon, Paul Barach, Richard M Frankel
BACKGROUND: Poor-quality handoffs have been associated with serious patient consequences. Researchers and educators have answered the call with efforts to increase system safety and resilience by supporting handoffs using increased communication standardization. The focus on strategies for formalizing the content and delivery of patient handoffs has considerable intuitive appeal; however, broader conceptual framing is required to both improve the process and develop and implement effective measures of handoff quality...
August 2018: Joint Commission Journal on Quality and Patient Safety
K S Chan
There is a great need for palliative care in the modern era of medicine. Despite medical advances, patients with life-limiting illnesses still suffer significantly. Palliative care emerged a half century ago as an ethos based on compassion and care for patients and their families to relieve their suffering. It entails a paradigm shift from the biomedical model to the biopsychospiritual model. Palliative care is recognised by the World Health Organization as an essential part of the continuum of universal health coverage...
July 30, 2018: Hong Kong Medical Journal, Xianggang Yi Xue za Zhi
Jessica Pace, Narcyz Ghinea, Ian Kerridge, Wendy Lipworth
There are increasing demands on regulators and insurers internationally to provide access to medicines more quickly, and often on the basis of less robust evidence of safety, efficacy or cost-effectiveness than have traditionally been required. These demands arise from a number of sources, including those advocating for access to medicines for patients with life-threatening diseases, rare diseases, or subsets of common diseases and where entire populations are threatened in the context of public health emergencies...
July 20, 2018: Health Policy
Sunny Bang, Amit Bahl
Objectives: Coding of a medical visit is based on provider documentation in the medical record; the documentation should reflect the level of care that was provided. To maximize coding and subsequent billing, providers must complete various components of the record to best convey the complexity of the case. Little education is provided to resident physicians regarding appropriate documentation practices, and studies suggest a need for improved education in this area. The primary goal of this study is to determine if implementing an early educational intervention will improve billing and coding...
July 2018: AEM education and training
Eric Shappell, James Ahn, Nadia Ahmed, Ilene Harris, Yoon Soo Park, Ara Tekian
Introduction: Personal finance has been linked to wellness and resiliency; however, the level of financial literacy among residents is low. Development of a personal finance curriculum could improve the financial well-being of trainees. The first step in this process is understanding residents' educational needs. Objective: The objective was to describe the financial knowledge, attitudes, and experiences of residents to inform the design of a personal finance curriculum...
July 2018: AEM education and training
Julie Rice, Rodney Omron, Hugh Calkins
Background: Deliberate practice (DP) is a method of mastery learning widely used in healthcare education. Investigations into improved mastery learning environments are important as we move to competency-based educational models. The objective of this pilot project is to create and test the feasibility of a simulation-based learning methodology based on close adherence to the tenants of DP for the acquisition of mastery knowledge. Methods: We created a new methodology for simulation-based mastery learning modules after review of the tenants of DP...
April 2018: AEM education and training
Andrew W Phillips, David Diller, Sarah Williams, Yoon Soo Park, Jonathan Fisher, Kevin Biese, Jacob Ufberg
Objectives: No summative speaker evaluation form with validity and reliability evidence currently exists in the English medical education literature specifically to help conference planners make future decisions on speakers. We seek to perform a proof-of-concept evaluation of a concise, effective evaluation form to be filled out by audience members to aid conference planners. Methods: We created the Council of Emergency Medicine Residency Directors (CORD-EM) form, a novel, three-question speaker evaluation form for the CORD-EM national conference and evaluated it for proof of concept...
October 2017: AEM education and training
Shawn Mondoux, Teresa M Chan, Felix Ankel, David P Sklar
International graduate medical accreditation bodies are placing increasing emphasis on resident education and competency in the principles of quality improvement and patient safety (QIPS). Current QIPS educational curricula are heterogeneous and variably attain stated objectives. We have conducted a review of QIPS curricular best practices and barriers to implementation of successful QIPS curricula and provide clear solutions aimed at overcoming these barriers. Emergency medicine programs provide fertile ground for QIPS initiatives and can become world leaders in QIPS curricular development and education...
October 2017: AEM education and training
Tomasz Ucinski, Grzegorz Dolata, Robert Hełminiak, Lutz Fischer, Steffen Fleßa, Bernhard Brehmer, Armin Viert, Volker Grundmann, Sebastian Rehberg, Kathrin Krügel, Maud Partecke, Peter Brinkrolf, Klaus Hahnenkamp, Konrad Meissner
The European Union intends to enable its citizens to interact across borders in relevant areas of society and culture to further integrate neighboring regions. Medicine has not been at the core of recent EU-funded efforts in central Europe, partially due to significant differences in health care administration, delivery, reimbursement, and culture. However, impeding changes in social structure and centralization of specialized care warrant changes in preclinical administration of medical care, which are already transforming practices across developed countries in central Europe...
March 2018: Best Practice & Research. Clinical Anaesthesiology
Thomas M Kollars
Background: Dengue, chikungunya, and Zika viruses are emerging infectious disease threats wherever suitable vectors, hosts, and habitat are present. The aim of the present study was to use the bioagent transport and environmental modeling system (BioTEMS) to identify the potential for arbovirus-infected Aedes species to invade the Chabahar area in southeastern Iran. Methods: ArcGIS geospatial analysis software, Statistica software, and BioTEMS were used to analyze geographic information and conduct data analysis...
July 2018: Iranian Journal of Medical Sciences
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