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Qing Han, Xue Zhao, Chenyu Wang, Bingpeng Chen, Xiaonan Wang, Ziyan Zhang, Kesong Zhang, Yuhao Zheng, Jincheng Wang
INTRODUCTION: Periprosthetic femoral fractures (PFF) around tumor prosthesis of knee are stubborn problems for surgeons, huge bone defect and inappropriate biomechanics of the revision implant design can be disaster for reconstruction. With the development of three-dimensional (3D) printing technology, surgeons participate more in precise preoperative design and simulation for treatment of such fractures. In this study we explored an accurate and feasible way to restore normal anatomy and function of the knee joint with 3D printing technology...
October 2018: Medicine (Baltimore)
Mihai Dimitriu, Cringu Antoniu Ionescu, Alexandra Matei, Roxana Viezuina, George Rosu, Corina Ilinca, Mihai Banacu, Liana Ples
RATIONALE: The extent of pregnancy in adolescents and young adults, especially in low and middle-income countries, is a source of increasing concern given its social and economic impact. AIMS AND OBJECTIVE: We hypothesized that there would be correlations between female patients becoming pregnant at a young age and practices such as harmful alcohol misuse, cigarette smoking, and drug use, the use of toxic substances, low educational attainment, and an essential absence of health care seeking about the outcome of adolescent pregnancies...
October 17, 2018: Journal of Evaluation in Clinical Practice
Guilherme Gozzoli Podolsky-Gondim, Luciano Lopes Furlanetti, Dinark Conceição Viana, Matheus Fernando Manzolli Ballestero, Ricardo Santos de Oliveira
INTRODUCTION: Head injury is a significant economic, social, and medical problem in developing countries and remains one of the leading causes of pediatric morbidity and mortality. The association of traumatic brain injury and coagulopathy in children is linked with an increase in mortality and poor functional outcomes. However, its impact on long-term outcome has not been discussed in the literature so far. OBJECTIVES: The aim of this paper was to investigate the effect of coagulopathy diagnosed by routine laboratory tests on neurological outcome following traumatic brain injury in children...
October 18, 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Gabriella Caleres, Åsa Bondesson, Patrik Midlöv, Sara Modig
BACKGROUND: Discharge summary with medication report effectively counteracts drug-related problems among elderly patients due to insufficient information transfer in care transitions. However, this requires optimal transfer and use of the discharge summaries. This study aimed to examine information transfer with discharge summaries from hospital to primary care. METHODS: A descriptive study with data consisting of discharge summaries of 115 patients, 75 years or older, using five or more drugs, collected during one week from 28 different hospital wards in Skåne county, Sweden...
October 11, 2018: BMC Health Services Research
Jan M Stratil, Monika A Rieger, Susanne Voelter-Mahlknecht
BACKGROUND: In the German rehabilitation system, primary care physicians (PCPs), occupational health physicians (OPs), and rehabilitation physicians (RPs) fulfill different distinct functions and roles. While effective cooperation can improve outcomes of rehabilitation, the cooperation between these groups of stakeholders has been criticized as lacking or insufficient. This article proposes an approach to understand the low levels of cooperation by examining the role of group perception and group identity in intra-professional cooperation as a barrier to cooperation between physicians in different roles...
October 11, 2018: BMC Health Services Research
Hossam Hamdy
The complexity of medical education and healthcare systems is a 'wicked problem'. Change will be a continuous iteration between evaluation and revaluation. Medicine is a social science. It is about people, societies and human interaction and communication. Medical College of the future should be developed in the light of social constructivism theories. Students from year one, day one, should be embedded in the work environment. Academic Healthcare Systems will be the norm not the exceptional. The training of students will be in all healthcare related facilities in the community...
October 9, 2018: Medical Teacher
Thomas Bodley, Janice L Kwan, John Matelski, Patrick J Darragh, Peter Cram
BACKGROUND: Missed test results are a cause of medical error. Few studies have explored test result management in the inpatient setting. OBJECTIVE: To examine test result management practices of general internal medicine providers in the inpatient setting, examine satisfaction with practices, and quantify self-reported delays in result follow-up. DESIGN: Cross-sectional survey. PARTICIPANTS: General internal medicine attending physicians and trainees (residents and medical students) at three Canadian teaching hospitals...
October 8, 2018: Journal of General Internal Medicine
J Nas, J Thannhauser, J J Herrmann, K van der Wulp, P M van Grunsven, N van Royen, M J de Boer, J L Bonnes, M A Brouwer
PURPOSE: Out-of-hospital cardiac arrests (OHCAs) are a major healthcare problem. Over the years, several initiatives have contributed to more lay volunteers providing cardiopulmonary resuscitation (CPR) and increased use of automated external defibrillators (AEDs) in the Netherlands. As part of a quality and outcomes program, we registered bystander CPR, AED use and outcome in the Nijmegen area. METHODS: Prospective resuscitation registry with a study cohort of non-traumatic OHCA cases from 2013-2016 and historical controls from 2008-2011...
October 2, 2018: Netherlands Heart Journal
Roberto Amore, Domenico Amuso, Vincenza Leonardi, Francesco Leva, Andrea Carnovale Sibaud, Antonio Guida, Ezio Costa, Ferdinando Terranova, Vincenzo Amodeo, Konstantinos Gkritzalas
Background: The use of deoxycholic acid to reduce localized fat deposits is a procedure that has been in use for about 30 years. Its effectiveness as treatment is due to emulsification of phospholipids and therefore, solubilization of the biological membranes with resulting fat necrosis. The purpose of the study was to assess the effectiveness and the safety of an injectable solution containing sodium deoxycholtate 1.25% (DB125), used as intralipotherapy. Methods: The effectiveness and safety of DB125 solution have been assessed with a multicentre observational prospective study carried out between February and October 2017...
June 2018: Plastic and Reconstructive Surgery. Global Open
Birgitta Häggman-Henrikson, EwaCarin Ekberg, Dominik A Ettlin, Ambra Michelotti, Justin Durham, Jean-Paul Goulet, Corine M Visscher, Karen G Raphael
The biopsychosocial model is advocated as part of a more comprehensive approach in both medicine and dentistry. However, dentists have not traditionally been taught psychosocial screening as part of their predoctoral education. The aim of this systematic review was to provide an overview of published studies on the implementation of screening for psychological comorbidity in dental and dental hygiene education. The term "psychological comorbidity" refers to the degree of coexisting anxiety, depression, or other mental health problems in a patient presenting with a physical condition...
October 2018: Journal of Dental Education
Johannes Hauswaldt, Valérie Kempter, Wolfgang Himmel, Eva Hummers
BACKGROUND: Routinely recorded data from everyday ambulatory medical care are urgently needed for health services and systems research, but this faces major limitations in Germany. In 2018, European General Data Protection Regulation (GDPR) and new German Federal Data Protection Act (FDPA) become effective. Via simulated real-life scenarios it may be possible to find out if access to and utilization of routine data for research becomes easier or faces additional obstacles. METHODS: General practitioners, information scientists, data trustees and privacy protection experts create concepts, processes and standards for lawful handling of routinely recorded data for secondary research and study their feasibility in 2 scenarios (anonymous and pseudonymous data utilization)...
October 1, 2018: Das Gesundheitswesen
Annelies Colliers, Samuel Coenen, Roy Remmen, Hilde Philips, Sibyl Anthierens
RATIONALE: Antibiotics (ABs) are one of the most prescribed medications in out-of-hours (OOH) care in Belgium. Developing a better understanding of why ABs are prescribed in this setting is essential to improve prescribing habits. OBJECTIVES: To assess AB prescribing and dispensing challenges for general practitioners (GPs) and pharmacists in OOH primary care, and to identify context-specific elements that can help the implementation of behaviour change interventions to improve AB prescribing in this setting...
September 28, 2018: BMJ Open
Bashir Alaour, Felicity Liew, Thomas E Kaier
The definition of a high-sensitivity cardiac Troponin (cTn) assay describes the ability to quantify a cardiac biomarker level in at least 50% of healthy individuals. This advance in analytic sensitivity has come with a perceived loss of specificity in the most classic application - chest pain triage and the diagnosis of acute myocardial infarction (AMI). As cardiac Troponin can no longer be used as a dichotomous test, the medical field is increasingly moving towards a more granular interpretation. However, rapid rule-out/rule-in algorithms for AMI still rely on concrete thresholds for efficient triage, irrespective of the patient's comorbidities...
September 28, 2018: Annals of Medicine
Andrea Heras, Victoria Vallejo, Marcela I Pineda, Allan J Jacobs, Lourdes Cohen
OBJECTIVES: To determine the incidence of immediate complications of elective newborn circumcision in 2 community teaching hospitals. METHODS: We performed a retrospective chart review of all term neonates who had circumcision performed between August 2011 and December 2014 at 2 community hospitals in New York. Neonatal hospital records and subsequent inpatient and outpatient records were reviewed. We classified complications as minor, intermediate, and major. RESULTS: Out of a total of 1115 circumcisions, 1064 met inclusion criteria...
October 2018: Hospital Pediatrics
Brigette Lee, Ramya Vangipuram, Erik Petersen, Stephen K Tyring
Intimate body piercings involving the nipple and genitalia have increased in prevalence in both men and women. Despite this increase, there is a deficiency in the literature regarding the short and long-term complications of body piercings, including an increased risk of infection, malignancy, and structural damage to the associated tissue. Breast abscesses associated with nipple piercing can be mistaken as inflammatory carcinoma. Male genital piercings have been associated with urethral rupture, paraphimosis, urethral obstruction, scar formation, and squamous cell carcinoma, whereas female genital piercings may lead to a higher risk of pregnancy and sexually transmitted infections...
July 15, 2018: Dermatology Online Journal
A N L M De Silva, Andrew H Dawson, Indika B Gawarammana, Sampath Tennakoon, Thilini Rajapakse
Background: Deliberate self-harm in the form of non-fatal self-poisoning is a major public health problem in Sri Lanka. Previous work suggests that many nurses in Sri Lanka-particularly those who work in primary care in the medical treatment of persons who attempt self-poisoning-already approach their role in a holistic fashion and consider "advising" or "counseling" patients after self-poisoning to be a part of their nursing role. But there is no formal training given to such nurses at present nor has the efficacy or feasibility of such an intervention been assessed in Sri Lanka...
2018: Pilot and Feasibility Studies
Alejandro De Los Angeles, Nam Pho, D Eugene Redmond
The shortage of human organs for transplantation is a devastating medical problem. One way to expand organ supply is to derive functional organs from patient-specific stem cells. Due to their capacity to grow indefinitely in the laboratory and differentiate into any cell type of the human body, patient-specific pluripotent stem (PS) cells harbor the potential to provide an inexhaustible supply of donor cells for transplantation. However, current efforts to generate functional organs from PS cells have so far been unsuccessful...
September 2018: Yale Journal of Biology and Medicine
Hadas Matas, Jenny Bronstein
BACKGROUND: This paper examines the health literacy of seniors and the strategies they use to deal with health uncertainty in the context of changes in the health system in Israel that have created a need to examine health literacy in this sector of the population who use the health system the most. The oldest were born and grew up in an era when a physician's knowledge was unchallenged; now, they find it difficult to cope with the expectation of patients taking a role in decision making...
September 24, 2018: Health Information and Libraries Journal
Salman AlSabah, Eliana Al Haddad, Haris Khwaja
OBJECTIVE: To investigate the prevalence of musculoskeletal (MSK) injuries in bariatric surgeons around the world. BACKGROUND: As the popularity of bariatric surgery increases, efforts into improving its patient safety and decreasing its invasiveness have also been on the rise. However, with this shift towards minimal invasiveness, surgeon ergonomic constraints have been imposed, with a recent report showing a 73-88% prevalence of physical complaints in surgeons performing laparoscopic surgeries...
September 24, 2018: Surgical Endoscopy
Gary W Jay, Robert L Barkin
Patients experiencing a terminal drug related event reflect a sentinel event. If this pharmacotherapy is a widely used agent, it may be viewed as a catastrophic problem. If patients are dying from illegal drug use when the medical establishment fails them by withdrawing or minimizing their medically prescribed medication, then the burden rests with their health care providers, legislation, and insurance carriers to actively participate in a collegial fashion to achieve parity. Causing a decay in functionality in previously functional patients, may occur with appropriately prescribed opioid medications addressing non-cancer pain when withdrawing or diminishing either with or without patient consent...
October 2018: Disease-a-month: DM
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