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Internal medicine, emergency medicine

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https://www.readbyqxmd.com/read/29905758/short-stay-unit-hospitalisation-vs-standard-care-outcomes-in-older-internal-medicine-patients-a-randomised-clinical-trial
#1
Camilla Strøm, Lars Simon Rasmussen, Anne-Sophie Löwe, Anne Kathrine Lorentzen, Nicolai Lohse, Kim Hvid Benn Madsen, Søren Wistisen Rasmussen, Thomas Andersen Schmidt
Background: the effect of hospitalisation in emergency department-based short-stay units (SSUs) has not been studied in older patients. We compared SSU hospitalisation with standard care at an Internal Medicine Department (IMD) in acutely admitted older internal medicine patients. Methods: pragmatic randomised clinical trial. We randomly assigned patients aged 75 years or older, acutely admitted for an internal medicine disease and assessed to be suitable for SSU hospitalisation to SSU hospitalisation or IMD hospitalisation...
June 13, 2018: Age and Ageing
https://www.readbyqxmd.com/read/29901556/universal-recommendations-for-the-management-of-acute-diarrhea-in-non-malnourished-children
#2
Alfredo Guarino, Andrea Lo Vecchio, Jorge Amil Dias, James A Berkley, Chris Boey, Dario Bruzzese, Mitchell B Cohen, Sylvia Cruchet, Ilaria Liguoro, Eduardo Salazar-Lindo, Bhupinder Sandhu, Philip M Sherman, Toshiaki Shimizu
OBJECTIVES: Despite a substantial consistency in recommendations for the management of children with acute gastroenteritis (AGE), a high variability in clinical practice and a high rate of inappropriate medical interventions persist in both developing and developed countries.Aim of this study was to develop a set of clinical recommendations for the management of non-severely malnourished children with AGE to be applied worldwide. METHODS: The Federation of International Societies of Pediatric Gastroenterology, Hepatology, and Nutrition (FISPGHAN) Working Group (WG) selected care protocols on the management of acute diarrhea in infants and children aged between 1 month and 18 years...
June 12, 2018: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/29895120/-analysis-on-the-trend-of-innovation-and-development-in-the-field-of-ophthalmology
#3
L H Shan, X Y An, M M Xu, S P Fan, H Zhong, P Ni, H Chi
Objective: To systematically analyze the innovation and development trend in the field of ophthalmology. Methods: The latest ophthalmology funding program from the National Eye Institute and National Natural Science Foundation of China, and funding project for 2012 to 2016 from the National Institutes of Health, National Natural Science Foundation of China and National key research and development plan of China was collected. Using the comparative analysis method, the major ophthalmology funding areas at home and abroad were analyzed...
June 11, 2018: [Zhonghua Yan Ke za Zhi] Chinese Journal of Ophthalmology
https://www.readbyqxmd.com/read/29889304/dual-antibiotics-for-bronchiectasis
#4
REVIEW
Lambert M Felix, Seamus Grundy, Stephen J Milan, Ross Armstrong, Haley Harrison, Dave Lynes, Sally Spencer
BACKGROUND: Bronchiectasis is a chronic respiratory disease characterised by abnormal and irreversible dilatation of the smaller airways and associated with a mortality rate greater than twice that of the general population. Antibiotics serve as front-line therapy for managing bacterial load, but their use is weighed against the development of antibiotic resistance. Dual antibiotic therapy has the potential to suppress infection from multiple strains of bacteria, leading to more successful treatment of exacerbations, reduced symptoms, and improved quality of life...
June 11, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29887382/halloysite-clay-nanotubes-for-life-sciences-applications-from-drug-encapsulation-to-bioscaffold
#5
REVIEW
Ana C Santos, Carolina Ferreira, Francisco Veiga, António J Ribeiro, Abhishek Panchal, Yuri Lvov, Anshul Agarwal
Natural forming clay halloysite is an emerging nanomaterial carrier for sustained drug delivery. These 50 nm diameter aluminosilicate tubes, with inner - alumina and outer - silica surface layers, can be loaded with 10-30 wt% of drug molecules, DNA and enzymes. The opposite charge of the inner and outer halloysite surface allow for selective drug adsorption inside or outside the clay nanotubes. The drug loaded halloysite enhanced the zeta potential of minus 50-60 mV allowing for stable aqueous nanocolloids...
May 31, 2018: Advances in Colloid and Interface Science
https://www.readbyqxmd.com/read/29884665/dangerous-mistake-an-accidental-caffeine-overdose
#6
Ana Andrade, Catarina Sousa, Mónica Pedro, Martinho Fernandes
Caffeine (1,3,7-trimethylxanthine) is a natural product commonly presented in food's composition, beverages and medicinal products. Generally, it is thought to be safe under normal dosage, yet it can be fatal in case of severe intoxication. We report a case of a healthy 32-year-old woman who went to the local emergency department (ED) 30 min after ingesting, accidentally, 5000 mg of anhydrous caffeine for a preworkout supplement. At the ED, she presented an episode of presyncope followed by agitation. ECG showed polymorphic broad complex QRS tachycardia and arterial blood gas revealed metabolic acidaemia with severe hypokalemia...
June 8, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29883198/bridging-the-expertise-gap-developing-and-utilizing-a-radiological-advisory-committee-for-new-york-city
#7
Mark L Maiello, Jessica Cole, Elaine Vernetti
From the Field is a semi-regular column that explores what it means to be a local health professional on the front lines of an emergency. Typically, National Association of County and City Health Officials (NACCHO) members share their stories of preparing for and responding to disasters, epidemics, and other major health issues. This month's column features a submission from the New York City health department that describes their experience in setting up a radiological advisory committee. Through exploring the analysis of the challenges faced and the solutions developed, readers can learn how these public health champions keep their communities safe even in extreme situations...
June 8, 2018: Health Security
https://www.readbyqxmd.com/read/29882065/emergency-medicine-clerkship-curriculum-in-a-high-income-developing-country-methods-for-development-and-application
#8
Arif Alper Cevik, Elif Dilek Cakal, Fikri M Abu-Zidan
BACKGROUND: The published recommendations for international emergency medicine curricula cover the content, but exclude teaching and learning methods, assessment, and evaluation. We aim to provide an overview on available emergency medicine clerkship curricula and report the development and application experience of our own curriculum. METHODS: Our curriculum is an outcome-based education, enriched by e-learning and various up-to-date pedagogic principles. RESULTS: Teaching and learning methods, assessment, and evaluation are described...
June 7, 2018: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29877914/the-aliem-faculty-incubator-a-novel-online-approach-to-faculty-development-in-education-scholarship
#9
Teresa M Chan, Michael Gottlieb, Jonathan Sherbino, Robert Cooney, Megan Boysen-Osborn, Anand Swaminathan, Felix Ankel, Lalena M Yarris
PROBLEM: Early- and mid-career clinician educators often lack a local discipline-specific community of practice (CoP) that encourages scholarly activity. As a result, these faculty members may feel disconnected from other scholars. APPROACH: Academic Life in Emergency Medicine (ALiEM) piloted the Faculty Incubator. This longitudinal, asynchronous, online curriculum focused on developing a virtual CoP among 30 early-to-mid-career medical educators (the "incubatees"), 8 core faculty mentors, and 10 guest mentors...
June 5, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/29874192/procalcitonin-guided-antibiotic-therapy-an-expert-consensus
#10
Michele Bartoletti, Massimo Antonelli, Francesco Arturo Bruno Blasi, Ivo Casagranda, Arturo Chieregato, Roberto Fumagalli, Massimo Girardis, Filippo Pieralli, Mario Plebani, Gian Maria Rossolini, Massimo Sartelli, Bruno Viaggi, Pierluigi Viale, Claudio Viscoli, Federico Pea
BACKGROUND: Procalcitonin (PCT) is a useful biomarker of bacterial infection and its use is associated to reduced duration of antibiotic therapy in the setting of intensive care medicine. To address the need of practical guidance for the use of PCT in various clinical settings, a group of experts was invited to participate at a consensus process with the aims of defining the rationale for appropriate use of PCT and for improving the management of critically ill patients with sepsis. METHODS: A group of 14 experts from anesthesiology and critical care, infectious diseases, internal medicine, pulmonology, clinical microbiology, laboratory medicine, clinical pharmacology and methodology provided expert opinion through a modified Delphi process, after a comprehensive literature review...
June 6, 2018: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/29862670/computational-anatomy-and-diffeomorphometry-a-dynamical-systems-model-of-neuroanatomy-in-the-soft-condensed-matter-continuum
#11
REVIEW
Michael I Miller, Sylvain Arguillère, Daniel J Tward, Laurent Younes
The nonlinear systems models of computational anatomy that have emerged over the past several decades are a synthesis of three significant areas of computational science and biological modeling. First is the algebraic model of biological shape as a Riemannian orbit, a set of objects under diffeomorphic action. Second is the embedding of anatomical shapes into the soft condensed matter physics continuum via the extension of the Euler equations to geodesic, smooth flows with inverses, encoding divergence for the compressibility of atrophy and expansion of growth...
June 4, 2018: Wiley Interdisciplinary Reviews. Systems Biology and Medicine
https://www.readbyqxmd.com/read/29860585/a-review-of-the-burden-of-trauma-pain-in-emergency-settings-in-europe
#12
REVIEW
Patrick D Dißmann, Maxime Maignan, Paul D Cloves, Blanca Gutierrez Parres, Sara Dickerson, Alice Eberhardt
Trauma pain represents a large proportion of admissions to emergency departments across Europe. There is currently an unmet need in the treatment of trauma pain extending throughout the patient journey in emergency settings. This review aims to explore these unmet needs and describe barriers to the delivery of effective analgesia for trauma pain in emergency settings. A comprehensive, qualitative review of the literature was conducted using a structured search strategy (Medline, Embase and Evidence Based Medicine Reviews) along with additional Internet-based sources to identify relevant human studies published in the prior 11 years (January 2006-December 2017)...
June 2, 2018: Pain and Therapy
https://www.readbyqxmd.com/read/29813034/midwife-assisted-planned-home-birth-an-essential-component-of-improving-the-safety-of-childbirth-in-sub-saharan-africa
#13
Aliyu Labaran Dayyabu, Yusuf Murtala, Amos Grünebaum, Laurence B McCullough, Birgit Arabin, Malcolm I Levene, Robert L Brent, Giovanni Monni, Cihat Sen, Alexander Makatsariya, Frank A Chervenak
Hospital births, when compared to out-of-hospital births, have generally led to not only a significantly reduced maternal and perinatal mortality and morbidity but also an increase in certain interventions. A trend seems to be emerging, especially in the US where some women are requesting home births, which creates ethical challenges for obstetricians and the health care organizations and policy makers. In the developing world, a completely different reality exists. Home births constitute the majority of deliveries in the developing world...
May 29, 2018: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/29809258/use-of-a-clinical-pathologic-conference-to-demonstrate-residents-acgme-emergency-medicine-milestones-aid-in-faculty-development-and-increase-academic-output
#14
Kathleen Kane, Kevin Weaver, Gavin Barr, Shawn Quinn, Terrence Goyke, Amy Smith, Dawn Yenser, Bryan Kane
The Emergency Medicine Milestones Project, developed by the Accreditation Council for Graduate Medical Education (ACGME) and the American Board of Emergency Medicine, includes competence targets for residents to attain and, ultimately, to exceed American Osteopathic Association and ACGME expectations for residents. The authors sought to use the clinical pathologic conference (CPC) format in their institutions' Emergency Medicine Milestones Project to provide measurable residency academic and faculty development outcomes...
June 1, 2018: Journal of the American Osteopathic Association
https://www.readbyqxmd.com/read/29808384/an-innovative-approach-to-improve-communication-and-reduce-physician-stress-and-burnout-in-a-university-affiliated-residency-program
#15
Ryan Lapointe, Siddharth Bhesania, Tristan Tanner, Adithya Peruri, Parag Mehta
Ineffective communication between nursing staff and residents leads to numerous educational and patient-care interruptions, increasing resident stress and overall workload. We developed an innovative and simple, secure electronic health record (EHR) base text paging system to communicate with internal medicine residents. The goal is to avoid unnecessary interruption during patient care or educational activities and reduce stress. Traditional paging system can send a phone number to call back. We developed and implemented a HIPPA-compliant, EHR-integrated text paging at a busy 591-bed urban hospital...
May 28, 2018: Journal of Medical Systems
https://www.readbyqxmd.com/read/29807546/surgical-plate-fixation-of-multiple-rib-fractures-a-case-report
#16
Konstantin Mitev, Dashurie Neziri, Emil Stoicovski, Zan Mitrev
BACKGROUND: The healthcare system in developing countries is limited; particularly, medical specialties such as emergency and trauma medicine are underdeveloped. Consequently, trauma injuries sustained in traffic accidents result in chronic morbidity more often than similar cases in developed countries. Multiple rib fractures induce significant patient morbidity. Current international guidelines recommend a multidisciplinary, surgery-based treatment approach to achieve optimal clinical benefit...
May 29, 2018: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/29796143/assessment-of-toxicology-knowledge-in-the-fourth-year-medical-students-three-years-of-data
#17
Jennie Buchanan, Daniel Windels, Jeffrey Druck, Kennon Heard
BACKGROUND: Pharmacology and toxicology are core content knowledge for physicians. Medical students should demonstrate understanding of general pharmacology and basic treatment of poisoning. The objective of this study was to measure the knowledge of the 4th-year medical students (MS4) on these topics over 3 years. METHODS: A multiple-choice exam (15 questions) was administered to MS4 students in spring of 2010, 2011, and 2012. Questions were developed by medical toxicologists to evaluate basic knowledge in three areas: pharmacologic effects (PE), treatment of poisoning (TOP), and pharmacokinetics (PK)...
2018: World Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29793471/surgical-informed-consent-in-obstetric-and-gynecologic-surgeries-experience-from-a-comprehensive-teaching-hospital-in-southern-ethiopia
#18
Million Teshome, Zenebe Wolde, Abel Gedefaw, Mequanent Tariku, Anteneh Asefa
BACKGROUND: Surgical Informed Consent (SIC) has long been recognized as an important component of modern medicine. The ultimate goals of SIC are to improve clients' understanding of the intended procedure, increase client satisfaction, maintain trust between clients and health providers, and ultimately minimize litigation issues related to surgical procedures. The purpose of the current study is to assess the comprehensiveness of the SIC process for women undergoing obstetric and gynecologic surgeries...
May 24, 2018: BMC Medical Ethics
https://www.readbyqxmd.com/read/29792142/collaboration-of-the-joint-research-centre-and-the-european-customs-laboratories-for-identification-of-new-psychoactive-substances
#19
Claude Guillou, Fabiano Reniero, Joana Lobo Pereira Vicente, Margaret Holland, Kamil Kolar, Hubert Chassaigne, Salvatore Tirendi, Herve Schepers
The emergence of designer drugs as substances of abuse has seen a dramatic increase over the last few years. Customs officials are responsible for the control of products entering the European Union (EU) market. This control applies to chemicals in general, pharmaceutical products and medicines. Numerous products imported from non-EU countries, often -declared as 'bath salts' or 'fertilizers', may in fact contain new psychoactive substance (NPS). These are not necessarily controlled under international law, but are subject to monitoring in agreement with EU legislation...
May 23, 2018: Current Pharmaceutical Biotechnology
https://www.readbyqxmd.com/read/29790923/missed-opportunities-to-prescribe-preexposure-prophylaxis-in-south-carolina-2013-2016
#20
Dawn K Smith, Man-Huei Chang, Wayne A Duffus, Stella Okoye, Sharon Weissman
Introduction: Expanding use of preexposure prophylaxis (PrEP) in ways that address current racial/ethnic disparities is an important HIV prevention goal. We investigated missed opportunities to provide PrEP during healthcare visits occurring prior to HIV infection. Methods: This retrospective cohort study linked South Carolina HIV case surveillance data to 3 statewide healthcare databases. Characteristics of patients, health care visits and providers, sexually transmitted diseases (STD), and other diagnoses, were assessed for medical encounters occurring before an initial HIV diagnosis...
May 22, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
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