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Internal and emergency medicine

Benjamin Marent, Flis Henwood, Mary Darking
BACKGROUND: Despite advances in testing and treatment, HIV incidence rates within European countries are at best stable or else increasing. mHealth technology has been advocated to increase quality and cost-effectiveness of health services while dealing with growing patient numbers. However, studies suggested that mHealth apps are rarely adopted and often considered to be of low quality by users. Only a few studies (conducted in the United States) have involved people living with HIV (PLWH) in the design of mHealth...
October 19, 2018: JMIR MHealth and UHealth
Muhammad Bilal, Abdul Haseeb, Anum Mari, Mohammad Hussham Arshad, M Raafe Ali Khan, Ayesha Ahmed, Ramsha Jeoffrey, Zainab Saleem, Muhammad Abrar Irfan, Arsalan Aamir Khan, Sana Husain, Simrah Najeeb, Amal Fuad Garib, Fatema Mustafa Attarwala, Muhammad Hasnain Mankani
Background Few studies have explored factors affecting preference of medical students towards general practice as a career choice. We conducted a survey in Karachi across various public and private sector medical colleges to examine factors associated with students' general practice career aspirations in Karachi, Pakistan. Methods From January to March 2018, we distributed a 21-item questionnaire to final year medical students in eight medical schools. The survey asked students about their top three career preferences from 19 specialty fields, their demographics and their career priorities...
August 6, 2018: Curēus
M Ortiz, J Masjuan, M I Egocheaga, A Martín, C Suarez, I Roldán, R Salgado, J J Mira, P Llamas
OBJECTIVE: To describe the milestones in the anticoagulant care process of atrial fibrillation patients (AF), as well as quality and safety indicators, in order to establish an integrated care process of these patients in the Community of Madrid. METHODS: A consensus conference technique was applied, with the participation of 21 professionals (seven in the Steering Group and 14 known experts), from the specialties of Emergency, Internal Medicine, Cardiology, Neurology, Haematology, Family Medicine, Nursing, and Quality...
May 2018: Journal of healthcare quality research
M H F Sakeena, Alexandra A Bennett, Andrew J McLachlan
BACKGROUND: Antimicrobial resistance (AMR) is a global challenge. Developing countries are more vulnerable to the consequences of AMR than developed nations because of complex issues pertaining to the nature their health care systems. Inappropriate antimicrobial drug use and the unrestricted availability of antimicrobial agents in community pharmacies in developing countries can contribute to emergence of resistant microbes. The aim of this systematic review is to explore the availability of antimicrobial agents without a doctor's prescription in developing countries and to investigate factors that contribute to inappropriate antimicrobial supply in developing countries...
October 9, 2018: International Journal of Antimicrobial Agents
Thomas J Papadimos, Evadne G Marcolini, Mehrnaz Hadian, George E Hardart, Nicholas Ward, Mitchell M Levy, Stanislaw P Stawicki, Judy E Davidson
OBJECTIVES: Continue the dialogue presented in Ethics of Outbreaks Position Statement. Part 1, with a focus on strategies for provision of family-centered care in critical illness during Pubic Health Emergency of International Concern. DESIGN: Development of a Society of Critical Care Medicine position statement using literature review, expert consensus from the Society of Critical Care Medicine Ethics Committee. A family member of a patient who was critically ill during a natural disaster served on the writing panel and provided validation from a family perspective to the recommendations...
November 2018: Critical Care Medicine
Thomas J Papadimos, Evadne G Marcolini, Mehrnaz Hadian, George E Hardart, Nicholas Ward, Mitchell M Levy, Stanislaw P Stawicki, Judy E Davidson
OBJECTIVES: Outbreaks of disease, especially those that are declared a Public Health Emergency of International Concern, present substantial ethical challenges. Here we start a discourse (with a continuation of the dialogue in Ethics of Outbreaks Position Statement. Part 2: Family-Centered Care) concerning the ethics of the provision of medical care, research challenges and behaviors during a Public Health Emergency of International Concern with a focus on the proper conduct of clinical or epidemiologic research, clinical trial designs, unregistered medical interventions (including vaccine introduction, devices, pharmaceuticals, who gets treated, vulnerable populations, and methods of data collection), economic losses, and whether there is a duty of health care providers to provide care in such emergencies, and highlighting the need to understand cultural diversity and local communities in these efforts...
November 2018: Critical Care Medicine
Wen Pan, Miaolue Wu, Zhiqiang Ye, Xiaoyu Qiao, Kouxing Zhang
OBJECTIVE: To evaluate whether patients aged over 70 years old is an independent predictor for prolonging the waiting time, and to know whether the population can be prioritized in the emergency grading system. METHODS: A retrospective analysis was conducted. All the clinical data of adult visitors to the emergency department of the Third Affiliated Hospital of Sun Yat-sen University from January 1st in 2016 to December 31st in 2017 were collected. All the patients received four emergency first aid triages and treated according to the emergency classification results...
September 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
Chih-Hsu Lin, Daniel M Konecki, Meng Liu, Stephen J Wilson, Huda Nassar, Angela D Wilkins, David F Gleich, Olivier Lichtarge
Motivation: Precision medicine is an emerging field with hopes to improve patient treatment and reduce morbidity and mortality. To these ends, computational approaches have predicted associations among genes, chemicals and diseases. Such efforts, however, were often limited to using just some available association types. This lowers prediction coverage and, since prior evidence shows that integrating heterogeneous data is likely beneficial, it may limit accuracy. Therefore, we systematically tested whether using more association types improves prediction...
October 9, 2018: Bioinformatics
Fabrizio Consorti, Shiphra Ginsburg, Ming J Ho, Laura Potasso, Emanuele Toscano
Phenomenon: Medical professionalism is a complex construct, based in social and cultural influences, yet little research has been done to show how culture influences the behaviors and attitudes of medical students. We presented Italian students with the same professional dilemmas used in a previous Canadian and Taiwanese cross-cultural study to look for similarities and differences and detect elements of Italian culture that influenced how students responded to dilemmas. The aim was to provide medical educators with some insights into students' behavioral strategies and feelings when faced with a professional dilemma...
October 10, 2018: Teaching and Learning in Medicine
Sara Gasparini, Ettore Beghi, Edoardo Ferlazzo, Massimiliano Beghi, Vincenzo Belcastro, Klaus P Biermann, Gabriella Bottini, Giuseppe Capovilla, Rosa A Cervellione, Vittoria Cianci, Giangennaro Coppola, Cesare M Cornaggia, Pasquale De Fazio, Salvatore De Masi, Giovambattista De Sarro, Maurizio Elia, Giuseppe Erba, Lucia Fusco, Antonio Gambardella, Valentina Gentile, Anna T Giallonardo, Renzo Guerrini, Francesca Ingravallo, Alfonso Iudice, Angelo Labate, Ersilia Lucenteforte, Adriana Magaudda, Laura Mumoli, Costanza Papagno, Giovanni B Pesce, Eugenio Pucci, Pietrantonio Ricci, Antonino Romeo, Rui Quintas, Chiara Sueri, Giovanna Vitaliti, Riccardo Zoia, Umberto Aguglia
BACKGROUND: The International League Against Epilepsy (ILAE) proposed a diagnostic scheme for psychogenic nonepileptic seizures (PNES). The debate on ethical aspects of the diagnostic procedures is ongoing, the treatment is not standardized, and management might differ according to the age groups. OBJECTIVE: To reach an expert and stakeholder consensus on PNES management. METHODS: A board comprising adult and child neurologists, neuropsychologists, psychiatrists, pharmacologists, experts in forensic medicine and bioethics as well as patients' representatives was formed...
October 9, 2018: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
Akshat C Pujara, Eric Kim, Deborah Axelrod, Amy N Melsaether
Positron emission tomography / magnetic resonance imaging (PET/MRI) is an emerging imaging technology that allows for the acquisition of multiple MRI parameters simultaneously with PET data. In this review, we address the technical requirements of PET/MRI including protocols and tracers, the potential of integrated localized breast PET/MRI exams, and possible applications of whole-body PET/MRI in breast cancer patients. Currently, PET/MRI can be performed on sequential and integrated PET/MRI scanners but, as not all practices can access these dedicated machines, several studies look at PET and MRI exams that are performed separately on separate scanners within a short time frame...
October 6, 2018: Journal of Magnetic Resonance Imaging: JMRI
Nazmiye Koyuncu, Özgür Karcioglu
The objective of this study is to investigate musculoskeletal complaints (MSCs) in healthcare workers (HCWs) in 3 community hospital-based departments [internal medicine (IM), general surgery (GS), and emergency department (ED)] and its effects on the quality of work life (QWL) of hospital HCW.This prospective cross-sectional study was performed in the 700-bed community training hospital. All HCW staffed in 3 departments (IM, GS, ED) of the hospital were asked to respond to items in the study data sheet. Enrolled personnel were inquired about their demographic data, work history and schedule, and medical history...
October 2018: Medicine (Baltimore)
D Baines, I Bates, L Bader, C Hale, P Schneider
CONTEXT AND BACKGROUND: People and health systems worldwide face serious challenges due to shifting disease demographics, rising population demands and weaknesses in healthcare provision, including capacity shortages and lack of impact of healthcare services. These multiple challenges, linked with the global push to achieve universal health coverage, have made apparent the importance of investing in workforce development to improve population health and economic well-being. In relation to medicines, health systems face challenges in terms of access to needed medicines, optimising medicines use and reducing risk...
October 3, 2018: Human Resources for Health
Stacey L Rowe, Irani Thevarajan, Jack Richards, Katherine Gibney, Cameron P Simmons
Dengue notifications have increased dramatically over the past seven years in Victoria, Australia-a trend which has been seen nationally and reflects increased cases internationally. We reviewed the epidemiology of dengue among Victorian travellers, changes in diagnostic methods and describe the burden placed on local health systems resulting from this disease of public health importance. Cases of dengue notified to the Department of Health and Human Services in Victoria, Australia, between 1 January 2010 and 31 December 2016 were included in this review...
January 21, 2018: Tropical Medicine and Infectious Disease
Lindsey A Query, Krisjon R Olson, Michael T Meyer, Amy L Drendel
BACKGROUND: Pediatric emergency care provision in the United States is uneven. Institutional barriers to readiness in the general emergency department (GED) are known, but little is understood about the frontline providers. Our objective was to explore the lived experiences of emergency medicine (EM) providers caring for acutely ill children in the GED and identify opportunities to optimize their pediatric practice. METHODS: This grounded theory study used theoretical sampling with snowball recruitment to enroll EM physicians and advanced practice providers from 25 Wisconsin GEDs...
September 29, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Inés María Fernández-Guerrero, Abraham Hidalgo-Rodríguez, María de Las Mercedes Leal-Lobato, Celia Rivilla-Doce, F Javier Martín-Sánchez, Òscar Miró
OBJECTIVES: To gain greater understanding of the development of emergency medicine in Spain by analyzing the presentations at conferences of the Spanish Society of Emergency Medicine (SEMES) over the past 30 years (1988-2017). MATERIAL AND METHODS: We examined the programs of all SEMES conferences and described the characteristics of both presentations and presenters. We also analyzed changes occurring between 1988 and 2017 of some of the characteristics observed...
October 2018: Emergencias: Revista de la Sociedad Española de Medicina de Emergencias
Terrell Caffery, Tonya Jagneaux, Glenn N Jones, Erik Stopa, Nathan Freeman, Cara Cantelli Quin, Ann C Long, Lauren Zatarain, Mandi W Musso
Background: Obtaining central venous cannulation of the internal jugular vein is an important skill for physicians to master. To our knowledge, no studies to date have examined residents' preferences or the safety of the oblique approach compared to other approaches. This study compared medical residents' preferences for and performance of ultrasound-guided central venous access using the transverse, longitudinal, and oblique approaches. Methods: Emergency medicine and internal medicine residents (n = 72) at an urban community hospital participated in a central venous access course...
2018: Ochsner Journal
Yan Qiu, Ying Liu, Wen Ren, Yunqing Qiu, Jingjing Ren
BACKGROUND: Globally, mHealth is increasing as a promising technology for promoting the quality of health care. Thus, a growing number of internet hospitals have been established in China to avail all its advantages. However, no study has investigated the service scope and patient satisfaction of the internet hospital to date. OBJECTIVE: The objective of our study was to explore the features of outpatients in general practice, the disease information, and the satisfaction through an internet rating site...
September 25, 2018: Journal of Medical Internet Research
V Scholtz, F Meyer, H-U Schulz, R Albrecht, Z Halloul
AIM: To investigate the perioperative management and outcome of patients undergoing abdominal surgery with additional vascular (comorbid) alterations for internal quality assurance of the clinical results. METHODS: Over a defined study period all consecutive cases of the aforementioned profile were documented and retrospectively analyzed as part of an ongoing prospective monocentric observational study to reflect the daily surgical practice. RESULTS: Over 10 years (from January 1999 to December 2008), a total of 113 cases were registered...
September 25, 2018: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
Lucio Brugioni, Marco Barchetti, Giovanni Tazzioli, Roberta Gelmini, Massimo Girardis, Marcello Bianchini, Filippo Schepis, Matteo Nicolini, Giovanni Pinelli, Pietro Martella, Marco Barozzi, Francesca Mori, Serena Scarabottini, Andrea Righetti, Mirco Ravazzini, Elisabetta Bertellini
BACKGROUND: In patients with difficult peripheral venous access, alternative techniques require expertise and are invasive, expensive, and prone to serious adverse events. This brought us to designing a new venous catheter (JLB® Deltamed, Inc.) for the cannulation of medium and large bore veins; it is echogenic, and available in different lengths (60 / 70 / 80 mm) and Gauges (14 / 16 / 17 / 18). METHODS: We led a multi-center observational convenience sampling study to evaluate safety and effectiveness of JLB...
September 25, 2018: Journal of Vascular Access
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