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Internal and emergency medicine

Shail Rawal, Janice L Kwan, Fahad Razak, Allan S Detsky, Yishan Guo, Lauren Lapointe-Shaw, Terence Tang, Adina Weinerman, Andreas Laupacis, S V Subramanian, Amol A Verma
Importance: Trauma of hospitalization refers to the depersonalizing and stressful experience of a hospital admission and is hypothesized to increase the risk of readmission after discharge. Objectives: To characterize the trauma of hospitalization by measuring patient-reported disturbances in sleep, mobility, nutrition, and mood among medical inpatients, and to examine the association between these disturbances and the risk of unplanned return to hospital after discharge...
December 3, 2018: JAMA Internal Medicine
James Tatoulis, Thomas A Schwann
Single arterial left internal thoracic artery (LITA) based coronary artery bypass surgery (LITA-SABG) has been the principal revascularization strategy for over 25 years across all patient demographics. In line with the current emphasis being placed on personalized medicine, which tailors individual, patient-specific therapy to optimize outcomes, coronary artery bypass grafting (CABG) techniques have also evolved to achieve enhanced results among specific groups of patients with coronary artery disease. Most notable has been the development of multi-arterial bypass grafting (MABG) techniques, using either the radial artery (RA) or the right internal thoracic artery (RITA) in conjunction with the LITA, as both techniques have been shown to enhance long term survival of CABG patients...
September 2018: Annals of Cardiothoracic Surgery
Lane Thaut, Wells Weymouth, Branden Hunsaker, Daniel Reschke
BACKGROUND: Central vein catheter (CVC) placement using the modified Seldinger technique is a common procedure in the emergency department, but can be time consuming due to the multiple pieces of equipment included in central line kits and the number of steps in the procedure. Preassembled devices combine a needle, guidewire, dilator, and sheath into one unit and potentially simplify the process and reduce time required for CVC placement using the accelerated Seldinger technique. OBJECTIVE: Our aim was to evaluate whether the use of combination central line devices and the accelerated Seldinger technique will reduce the time required to place a CVC and increase the ease of the procedure...
November 29, 2018: Journal of Emergency Medicine
Laura Foxcroft, Douglas Jones, Margaret Steele, Rodrick Lim
Objective: To implement a University Faculty mentorship program in the Division of Emergency Medicine. Methods: A program based on a unique Schulich faculty mentorship policy was implemented with the help of a Provider Value Officer. The process involved creating a training program which defined the roles of the mentors and mentees and established the principles of an effective mentor-mentee relationship. Faculty received training on how to participate effectively in a Schulich faculty mentorship committee...
November 2018: Canadian Medical Education Journal
(no author information available yet)
The role of chief White House physician has traditionally been held by an individual with a background in a broad medical field, such as emergency medicine, family medicine, or internal medicine. Dr. Daniel Ruge, who served as the director of the Spinal Cord Injury Service for the Veterans Administration and was appointed during President Ronald Reagan's first term, was the first neurosurgeon to become the chief White House physician. Aside from being the first neurosurgeon to serve in this capacity, Dr. Ruge also stands apart from others who have held this esteemed position because of how he handled Reagan's care after an attempt was made on the then-president's life...
October 1, 2018: Journal of Neurosurgery
Z Edwards, D N Lucas, R Gauntlett
Obstetric critical care is an emerging discipline which cuts across speciality boundaries. We have analysed the training curricula in the three major specialities (obstetrics, anaesthesia and intensive care medicine) likely to be involved in the care of the critically-ill obstetric patient, to assess whether it is adequate to ensure effective training on this subject.
September 12, 2018: International Journal of Obstetric Anesthesia
Carol Nhan, Meredith Young, Ilana Bank, Peter Nugus, Rachel Fisher, Milène Azzam, Lily H P Nguyen
Objective: Emergent medical crises, such as acute airway obstruction, are often managed by interdisciplinary teams. However, resident training in crisis resource management traditionally occurs in silos. Our objective was to compare the current state of interdisciplinary crisis resource management (IDCRM) training of otolaryngology residents with other disciplines. Methods: A survey study examining (1) the frequency with which residents are involved in interdisciplinary crises, (2) the current state of interdisciplinary training, and (3) the desired training was conducted targeting Canadian residents in the following disciplines: otolaryngology, anesthesiology, emergency medicine, general surgery, obstetrics and gynecology, internal medicine, pediatric emergency medicine, and pediatric/neonatal intensive care...
April 2018: OTO open
Christian J Wiedermann
BACKGROUND: Medical textbooks are important throughout postgraduate internship, residency and fellowship programs but authors' conflicts of interest (COI) are rarely disclosed. In anesthesiology, two high-profile cases of research fraud/unethical publishing have previously been identified. This study evaluated whether anesthesiology textbooks in German include controversial recommendations on hydroxyethyl starch (HES) and whether authors had undisclosed COI. METHODS: Forty-five anesthesiology, critical care, and emergency medicine electronic textbooks (January 2015-August 2017) were identified on the websites of German, Austrian, and Swiss publishers...
November 21, 2018: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
Akina Tamaki, Claudia I Cabrera, Clare Richardson, Nicole Maronian
PURPOSE: Deficiencies in airway management knowledge can result in harm, especially in tracheostomy patients. Our objective is to assess the degree of knowledge in different medical specialties, before and after targeted airway education. MATERIALS AND METHODS: A lecture on tracheostomy management was prepared for Otolaryngology, Anesthesia, Emergency Medicine, General Surgery, Oral and Maxillofacial Surgery (OMFS), Internal Medicine (IM), and Family Medicine (FM)...
October 21, 2018: American Journal of Otolaryngology
Seung Yun Nam, Sang-Hyug Park
To create tissue replacements with qualities similar to human tissues, and for ease of tissue loss repair, novel 3D printing fabrication methods have recently been introduced and popularized in the field of tissue engineering and regenerative medicine as an alternative to the scaffold fabrication methods. 3D printing may provide the fabricate process to better mimic the internal microstructure and external appearance. Printable bioink should be developed for stable 3D structure stratification. Advanced bioinks for 3D printing are rationally designed materials intended to improve the functionality of printed tissue scaffolds...
2018: Advances in Experimental Medicine and Biology
Nicholas Schubert, Rebecca Evans, Kristine Battye, Tarun Sen Gupta, Sarah Larkins, Lachlan McIver
BACKGROUND: Contemporary approaches to rural generalist medicine training and models of care are developing internationally as part of an integrated response to common challenges faced by rural and remote health services and policymakers (addressing health inequities, workforce shortages, service sustainability concerns). The aim of this study was to review the literature relevant to rural generalist medicine. METHODS: A scoping review was undertaken to answer the broad question 'What is documented on rural generalist medicine?' Literature from January 1988 to April 2017 was searched and, after final eligibility filtering (according to established inclusion and exclusion criteria), 102 articles in English language were included for final analysis...
November 21, 2018: Human Resources for Health
Sharon A Greenberg, Pinchas Halpern, Tomer Ziv-Baran, Ronni Gamzu
BACKGROUND AND AIM: In 2011 the Israeli Ministry of Health (MOH) instructed hospitals to limit occupancy in the internal medicine wards to 120%, which was followed by a nationwide reduction in hospitalization rates. We examined how readmission and mortality rates changed in the five years following the changes in occupancy rates and hospitalization rates. METHODS: All visits to the Tel Aviv Medical Center internal Emergency Medicine Department (ED) in 2010, 2014 and 2016 were captured, with exclusion of visits by patients below 16 of age and patients with incomplete or faulty data...
November 20, 2018: Israel Journal of Health Policy Research
M C Broccoli, J L Pigoga, M Nyirenda, L A Wallis, E J Calvello Hynes
Objectives: Essential medicines lists (EMLs) are efficient means to ensure access to safe and effective medications. The WHO has led this initiative, generating a biannual EML since 1977. Nearly all countries have implemented national EMLs based on the WHO EML. Although EMLs have given careful consideration to many public health priorities, they have yet to comprehensively address the importance of medicines for treating acute illness and injury. Methods: We undertook a multi-step consensus process to establish an EML for emergency care in Africa...
September 2018: African Journal of Emergency Medicine Revue Africaine de la Médecine D'urgence
Nicholas Dufourq, Lara Nicole Goldstein, Martin Botha
Introduction: Despite the differences in exposure and experience in dealing with medical emergencies, all doctors should nevertheless be competent to assist a patient in need of resuscitation. The objective of this study was to describe the level of self-assessed emergency skill competence that specialist trainees in various disciplines possessed as well as to identify factors that may have contributed to their level of self-perceived competence. Methods: A prospective, cross-sectional, questionnaire study of various specialist trainees' self-perceived levels of competence in emergency skills was conducted across three academic hospitals in Johannesburg, South Africa...
December 2017: African Journal of Emergency Medicine Revue Africaine de la Médecine D'urgence
C Cunningham, P Brysiewicz, A Sepeku, L White, B Murray, N Lobue, H Sawe
Nurses are the largest group of healthcare workers in Africa. By adequately equipping nurses to identify, intervene and care for emergency conditions, emergency healthcare systems can be strengthened. To address this need, a nursing working group was formed within the African Federation for Emergency Medicine (AFEM). The aim of this international emergency nursing group was to develop a guiding document to help improve emergency nursing skills within Africa. Using this guiding document, a group of Tanzanian clinical nurse trainers was selected to develop a context specific short course...
December 2017: African Journal of Emergency Medicine Revue Africaine de la Médecine D'urgence
Kathryn Lemery-Chalfant, Sierra Clifford, Thomas J Dishion, Daniel S Shaw, Melvin N Wilson
Development involves synergistic interplay among genotypes and the physical and cultural environments, and integrating genetics into experimental designs that manipulate the environment can improve understanding of developmental psychopathology and intervention efficacy. Consistent with differential susceptibility theory, individuals can vary in their sensitivity to environmental conditions including intervention for reasons including their genotype. As a consequence, understanding genetic influences on intervention response is critical...
December 2018: Development and Psychopathology
János Fazakas, Anikó Smudla
One of the most prominent results of our age is organ transplantation, the single treatment option for patients with end-stage organ failure. The success of transplants depends on the donor care, the patient preoperative preassessment, the perioperative care of organ transplantation and aftercare. Successful transplantation therefore requires a prominent level of continuous collaboration between the surgeon, anaesthesiologist, radiologist, internal medicine and hepatologist, laboratory physician and almost all their associates...
November 2018: Orvosi Hetilap
Mario Plebani, Michael Laposata, Giuseppe Lippi
Laboratory medicine plays an increasingly essential role in modern healthcare systems, since it is integral to most care pathways and plays an essential role for optimizing patient flow, harmonizing procedures before and after analysis, improving harmonization and containing unnecessary testing. Nevertheless, recent changes in the nature of laboratory services, promoted by innovation and introduction of more complex tests in emerging diagnostic fields, more advanced diagnostics along with other "internal" and "external" drivers, will promote a paradigmatic transformation of current scenarios...
November 13, 2018: Clinica Chimica Acta; International Journal of Clinical Chemistry
Lanair Amaad Lett, Whitney U Orji, Ronnie Sebro
OBJECTIVE: To evaluate trends in racial, ethnic, and sex representation at US medical schools across 16 specialties: internal medicine, pediatrics, surgery, psychiatry, radiology, anesthesiology, obstetrics and gynecology, neurology, family practice, pathology, emergency medicine, orthopedic surgery, ophthalmology, otolaryngology, physical medicine and rehabilitation, and dermatology. Using a novel, Census-derived statistical measure of diversity, the S-score, we quantified the degree of underrepresentation for racial minority groups and female faculty by rank for assistant, associate, and full professors from 1990-2016...
2018: PloS One
Megan Cox
In the past 5 years Botswana graduated its first home-grown doctors and emergency medicine specialists for the country. The postgraduate emergency medicine specialist training arrangement between Botswana and South Africa was challenging in development, implementation and maintenance. Numerous varied supports from ACEM and its International Emergency Medicine Network were integral to these successes. This article encourages further investment of ACEM grants and scholarships in Africa by describing how ACEM supported significant advances in Botswana emergency medicine...
November 14, 2018: Emergency Medicine Australasia: EMA
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