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Emergency medicine AND critical care

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https://www.readbyqxmd.com/read/29773744/worldwide-emergence-of-resistance-to-antifungal-drugs-challenges-human-health-and-food-security
#1
REVIEW
Matthew C Fisher, Nichola J Hawkins, Dominique Sanglard, Sarah J Gurr
The recent rate of emergence of pathogenic fungi that are resistant to the limited number of commonly used antifungal agents is unprecedented. The azoles, for example, are used not only for human and animal health care and crop protection but also in antifouling coatings and timber preservation. The ubiquity and multiple uses of azoles have hastened the independent evolution of resistance in many environments. One consequence is an increasing risk in human health care from naturally occurring opportunistic fungal pathogens that have acquired resistance to this broad class of chemicals...
May 18, 2018: Science
https://www.readbyqxmd.com/read/29764560/-discussion-of-the-implementation-of-mimic-database-in-emergency-medical-study
#2
Kaiyuan Li, Cong Feng, Lijing Jia, Li Chen, Fei Pan, Tanshi Li
To introduce Medical Information Mart for Intensive Care (MIMIC) database and elaborate the approach of critically emergent research with big data based on the feature of MIMIC and updated studies both domestic and overseas, we put forward the feasibility and necessity of introducing medical big data to research in emergency. Then we discuss the role of MIMIC database in emergency clinical study, as well as the principles and key notes of experimental design and implementation under the medical big data circumstance...
May 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29761755/a-deadly-wait-for-u-s-health-insurance-coverage-sitting-on-the-couch-with-malaria
#3
Jonathan S Schultz, Adam J Atherly, Andrés F Henao-Martínez
Uninsured and unprepared travelers to countries with endemic tropical diseases pose great health-care burdens and financial risks on returning to the United States. We discuss the delayed presentation of an uninsured U.S. traveler returning from West Africa with severe malaria who required intensive care measures to save his life. Despite being critically ill on his return, he sat rigoring on his couch taking antipyretics for 3 days, while he applied for insurance on the Affordable Care Act website and waited for approval because he was fearful of the costs of seeking care...
May 14, 2018: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/29760862/free-open-access-medical-education-foam-in-emergency-medicine-the-global-distribution-of-users-in-2016
#4
Taylor W Burkholder, Jennifer W Bellows, Renee A King
Introduction: Free open-access medical education (FOAM) is a collection of interactive online medical education resources-free and accessible to students, physicians and other learners. This novel approach to medical education has the potential to reach learners across the globe; however, the extent of its global uptake is unknown. Methods: This descriptive report evaluates the 2016 web analytics data from a convenience sample of FOAM blogs and websites with a focus on emergency medicine (EM) and critical care...
May 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29737962/perceived-barriers-and-facilitators-to-goals-of-care-discussions-in-the-emergency-department-a-descriptive-analysis-of-the-views-of-emergency-medicine-physicians-and-residents
#5
Niran Argintaru, Kieran L Quinn, Lucas B Chartier, Jacques Lee, Paul Hannam, Erin O'Connor, Leah Steinberg, Howard Ovens, Melissa McGowan, Samuel Vaillancourt
CLINICIAN'S CAPSULE What is known about the topic? Goals of care discussions (GOC) are critical to reflecting patients' preferences in the provision of acute care, yet these discussions can be challenging to have in the emergency department (ED) setting. What did this study ask? What are emergency physicians' perspectives on barriers and facilitators to GOC discussions? What did this study find? In this survey of emergency medicine attending and resident physicians, the majority reported feeling comfortable and adequately trained to conduct GOC discussions...
May 8, 2018: CJEM
https://www.readbyqxmd.com/read/29725559/trapped-as-a-group-escape-as-a-team-applying-gamification-to-incorporate-team-building-skills-through-an-escape-room-experience
#6
Xiao Chi Zhang, Hyunjoo Lee, Carlos Rodriguez, Joshua Rudner, Teresa M Chan, Dimitrios Papanagnou
Teamwork, a skill critical for quality patient care, is recognized as a core competency by the Accreditation Council for Graduate Medical Education (ACGME). To date, there is no consensus on how to effectively teach these skills in a forum that engages learners, immerses members in life-like activities, and builds both trust and rapport. Recreational 'Escape Rooms' have gained popularity in creating a life-like environment that rewards players for working together, solving puzzles, and completing successions of mind-bending tasks in order to effectively 'escape the room' in the time allotted...
March 2, 2018: Curēus
https://www.readbyqxmd.com/read/29716799/emergency-and-critical-care-applications-for-contrast-enhanced-ultrasound
#7
REVIEW
Tobias Kummer, Laura Oh, Mary Beth Phelan, Robert D Huang, Jason T Nomura, Srikar Adhikari
INTRODUCTION: Contrast-enhanced ultrasound (CEUS) using intravascular microbubbles has potential to revolutionize point-of-care ultrasonography by expanding the use of ultrasonography into clinical scenarios previously reserved for computed tomography (CT), magnetic resonance imaging, or angiography. METHODS: We performed a literature search and report clinical experience to provide an introduction to CEUS and describe its current applications for point-of-care indications...
April 22, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29707380/look-around-the-world-focus-on-asia-the-establishment-of-the-asia-society-of-emergency-and-critical-care-medicine
#8
Zhongheng Zhang
No abstract text is available yet for this article.
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29706056/changes-in-medical-care-due-to-the-absence-of-internal-medicine-physicians-in-emergency-departments
#9
Kyoung Ho Kim, Jang Young Lee, Won Suk Lee, Won Young Sung, Sang Won Seo
Objective: Especially in emergency departments (EDs), a lack of internal medicine (IM) residents in charge causes difficulties in medical care and ED overcrowding. Thus, protocols without IM residents in EDs is needed. This study aimed to investigate changes in medical care when emergency medicine residents replaced the roles of IM residents. Methods: This study was conducted at a single-site ED of a university medical center. The study group contained patients admitted to the IM department between September and December 2015, during which IM residents were absent in the ED...
April 30, 2018: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/29704018/consensus-statement-for-cancer-patients-requiring-intensive-care-support
#10
M G Kiehl, G Beutel, B Böll, D Buchheidt, R Forkert, V Fuhrmann, P Knöbl, M Kochanek, F Kroschinsky, P La Rosée, T Liebregts, C Lück, U Olgemoeller, E Schalk, A Shimabukuro-Vornhagen, W R Sperr, T Staudinger, M von Bergwelt Baildon, P Wohlfarth, V Zeremski, P Schellongowski
This consensus statement is directed to intensivists, hematologists, and oncologists caring for critically ill cancer patients and focuses on the management of these patients.
April 27, 2018: Annals of Hematology
https://www.readbyqxmd.com/read/29695178/sepsis-induced-coagulopathy-and-japanese-association-for-acute-medicine-dic-in-coagulopathic-patients-with-decreased-antithrombin-and-treated-by-antithrombin
#11
Toshiaki Iba, Makoto Arakawa, Jerrold H Levy, Kazuma Yamakawa, Hiroyuki Koami, Toru Hifumi, Koichi Sato
Disseminated intravascular coagulation (DIC) in patients with sepsis represents a critical condition. Thus, a simple and rapid diagnosis is required. The purpose of this study was to compare the performances of a recently developed Sepsis-Induced Coagulopathy (SIC) with the Japanese Association for Acute Medicine (JAAM) DIC. Four hundred nine patients with sepsis having coagulopathy and antithrombin activity of less than 70% and treated with antithrombin were retrospectively analyzed, and the SIC and JAAM-DIC criteria on days 1 (before treatment), 2, 4, and 7 were compared...
January 1, 2018: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/29671037/-geriatric-intensive-care-patients-perspectives-and-limits-of-geriatric-intensive-care-medicine
#12
REVIEW
U Müller-Werdan, H-J Heppner, G Michels
Critically ill geriatric patients are vitally endangered due to the aging processes of organs, the frequently existing multimorbidity with subsequent polypharmacy and the typical geriatric syndrome of functional impairments. Aging processes in organs lower the clinical threshold for organ dysfunction and organ failure. Physiological organ aging processes with practical consequences for intensive care medicine are atypical manifestion of sepsis in immunosenescence, altered pharmacokinetics, reduced tolerance to hypovolemia due to proportionally reduced water compartment of the body in old age, the frequently only apparently normal function of the kidneys and the continuous reduction in pulmonary function in old age...
April 18, 2018: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/29666946/pharmaceutical-products-as-emerging-contaminant-in-water-relevance-for-developing-nations-and-identification-of-critical-compounds-for-indian-environment
#13
Prakash Chinnaiyan, Santosh G Thampi, Mathava Kumar, K M Mini
Pharmaceuticals and personal care products (PPCPs) are contaminants of emerging concern and have been detected worldwide in water bodies in trace concentrations. Most of these emerging contaminants are not regulated in water quality standards except a few in the developed countries. In the case of developing countries, research in this direction is at a nascent stage. For the effective management of Pharmaceutical contaminants (PC) in developing countries, the relevance of PCs as an emerging contaminant has to be analyzed followed by regular monitoring of the environment...
April 17, 2018: Environmental Monitoring and Assessment
https://www.readbyqxmd.com/read/29658536/-education-motivations-and-working-conditions-of-a-cohort-of-nurses-attending-to-an-open-competition
#14
Roberto Accardi, Silvia Pazzaglia, Antonella Demarchi, Barbara Sappa, Dario Laquintana
. Education, motivations and working conditions of a cohort of nurses attending to an open-competition. INTRODUCTION: In the last decade, the progressive reduction of staff turnover decreased together with the number of open competitions, now attended by thousands of candidates, portraying an image of massive unemployment in the nursing profession. AIM: To describe the socio-demographic profile, the studies, previous work experiences and motivations of a cohort of nurses participats a maxi-competition in Lombardy region...
January 2018: Assistenza Infermieristica e Ricerca: AIR
https://www.readbyqxmd.com/read/29657720/promising-novel-therapy-with-hydrogen-gas-for-emergency-and-critical-care-medicine
#15
REVIEW
Motoaki Sano, Masaru Suzuki, Koichiro Homma, Kei Hayashida, Tomoyoshi Tamura, Tadashi Matsuoka, Yoshinori Katsumata, Shuko Onuki, Junichi Sasaki
It has been reported that hydrogen gas exerts a therapeutic effect in a wide range of disease conditions, from acute illness such as ischemia-reperfusion injury, shock, and damage healing to chronic illness such as metabolic syndrome, rheumatoid arthritis, and neurodegenerative diseases. Antioxidant and anti-inflammatory properties of hydrogen gas have been proposed, but the molecular target of hydrogen gas has not been identified. We established the Center for Molecular Hydrogen Medicine to promote non-clinical and clinical research on the medical use of hydrogen gas through industry-university collaboration and to obtain regulatory approval of hydrogen gas and hydrogen medical devices (http://www...
April 2018: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29628333/multidisciplinary-difficult-airway-course-an-essential-educational-component-of-a-hospital-wide-difficult-airway-response-program
#16
W Robert Leeper, Elliott R Haut, Vinciya Pandian, Sajan Nakka, Jeffrey Dodd-O, Nasir Bhatti, Elizabeth A Hunt, Mustapha Saheed, Nicholas Dalesio, Adam Schiavi, Christina Miller, Thomas D Kirsch, Lauren Berkow
OBJECTIVE: A hospital-wide difficult airway response team was developed in 2008 at The Johns Hopkins Hospital with three central pillars: operations, safety monitoring, and education. The objective of this study was to assess the outcomes of the educational pillar of the difficult airway response team program, known as the multidisciplinary difficult airway course (MDAC). DESIGN: The comprehensive, full-day MDAC involves trainees and staff from all provider groups who participate in airway management...
April 5, 2018: Journal of Surgical Education
https://www.readbyqxmd.com/read/29623383/-mechanical-circulatory-support-in-terminal-heart-failure
#17
REVIEW
M Derwall, A Moza, A Brücken
BACKGROUND: After exhaustion of all conservative measures in the treatment of acute and chronic heart insufficiency, there is the possibility to temporarily or permanently support or replace the pump performance of the heart by mechanical circulatory support (MCS) systems. OBJECTIVE: Presentation of the most important cardiac support systems for intensive care medicine, their indications and important risk factors. MATERIAL AND METHODS: Critical review of device manufacturer's specifications, current research and expert opinions...
April 5, 2018: Der Anaesthesist
https://www.readbyqxmd.com/read/29619627/new-advances-in-acute-postoperative-pain-management
#18
REVIEW
Sukanya Mitra, Daniel Carlyle, Gopal Kodumudi, Vijay Kodumudi, Nalini Vadivelu
PURPOSE OF REVIEW: Postoperative pain remains one of the most common challenges following inpatient and outpatient surgeries. With our advances in modern medicine, pain following surgical procedures still remains a challenge, though significant accomplishments have been made over the past few decades. This article highlights some of the promising new advances and approaches in postoperative pain management. RECENT FINDINGS: Over the last decade, Enhanced Recovery after Surgery (ERAS) pathways and protocols are becoming the benchmark standards for enhancing postoperative recovery...
April 4, 2018: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/29602433/improving-resident-s-skills-in-the-management-of-circulatory-shock-with-a-knowledge-based-e-learning-tool
#19
David Riaño, Francis Real, Jose Ramon Alonso
BACKGROUND: Correct clinical management of circulatory shock in emergency departments (ER) and intensive care units (ICU) is critical. In this context, the transmission of professional skills by means of the practical supervision of real cases at the point of care entails important issues that can be widely overcome with the use of computer knowledge-based e-learning tools. OBJECTIVE: Shock-Instructor is a web-based e-learning tool implementing the already tested training program model (TPM) that uses a knowledge base about the evidence found in the clinical practice guidelines about seven types of shock...
May 2018: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/29598889/severe-malaria-presenting-to-the-emergency-department-a-collaborative-approach-utilizing-exchange-transfusion-and-artesunate
#20
David Zodda, Gabrielle Procopio, Kevin Hewitt, Andrew Parrish, Bindu Balani, Joseph Feldman
We describe the case of a previously healthy 33year-old male pilot recently arrived to the United States from Africa. The patient presented to our ED febrile and disoriented, with projectile coffee-ground emesis. He was later found to have severe malaria and cerebral parasitemia. Due to the severity of his illness, the patient received the anti-malarial medication Artesunate as well as several exchange transfusions. Within 48h his parasitic load was reduced from 42% to 0.4%. The following is an account of a collaborative effort that spans the specialties of emergency medicine, infectious disease, and critical care medicine...
March 14, 2018: American Journal of Emergency Medicine
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