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https://www.readbyqxmd.com/read/28212647/an-interpretive-review-of-consensus-statements-on-clinical-guideline-development-and-their-application-in-the-field-of-traditional-and-complementary-medicine
#1
Jennifer Hunter, Matthew Leach, Lesley Braun, Alan Bensoussan
BACKGROUND: Despite ongoing consumer demand and an emerging scientific evidence-base for traditional and complementary medicine (T&CM), there remains a paucity of reliable information in standard clinical guidelines about their use. Often T&CM interventions are not mentioned, or the recommendations arising from these guidelines are unhelpful to end-users (i.e. patients, practitioners and policy makers). Insufficient evidence of efficacy may be a contributing factor; however, often informative recommendations could still be made by drawing on relevant information from other avenues...
February 17, 2017: BMC Complementary and Alternative Medicine
https://www.readbyqxmd.com/read/28211266/-non-febrile-syndromes-in-the-traveler-returning-from-tropical-regions-admitted-in-a-monographic-unit
#2
A Anula-Morales, B Martin-Giner, M Hernández-Cabrera, C Carranza-Rodríguez, E Pisos-Álamo, N Jaén-Sánchez, J L Pérez-Arellano
OBJECTIVE: The aim was to analyse those syndromes without fever in travellers who return from tropical regions evaluated at our Department of Infectology and Tropical Medicine. Clarifying these conditions intends to reach earlier diagnoses and, perhaps, to avoid the emergence and spread of imported diseases, as well as to establish appropriate preventive measures. METHODS: An observational descriptive transversal study was performed, selecting those patients who returned from tropical regions without fever (n = 281), amongst all travellers evaluated in our department between 1998 and 2013...
February 17, 2017: Revista Española de Quimioterapia: Publicación Oficial de la Sociedad Española de Quimioterapia
https://www.readbyqxmd.com/read/28202076/developing-quality-indicators-for-physician-staffed-emergency-medical-services-a-consensus-process
#3
Helge Haugland, Marius Rehn, Pål Klepstad, Andreas Krüger
BACKGROUND: There is increasing interest for quality measurement in health care services; pre-hospital emergency medical services (EMS) included. However, attempts of measuring the quality of physician-staffed EMS (P-EMS) are scarce. The aim of this study was to develop a set of quality indicators for international P-EMS to allow quality improvement initiatives. METHODS: A four-step modified nominal group technique process (expert panel method) was used. RESULTS: The expert panel reached consensus on 26 quality indicators for P-EMS...
February 15, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28198722/triad-viii-nationwide-multicenter-evaluation-to-determine-whether-patient-video-testimonials-can-safely-help-ensure-appropriate-critical-versus-end-of-life-care
#4
Ferdinando L Mirarchi, Timothy E Cooney, Arvind Venkat, David Wang, Thaddeus M Pope, Abra L Fant, Stanley A Terman, Kevin M Klauer, Monica Williams-Murphy, Michael A Gisondi, Brian Clemency, Ankur A Doshi, Mari Siegel, Mary S Kraemer, Kate Aberger, Stephanie Harman, Neera Ahuja, Jestin N Carlson, Melody L Milliron, Kristopher K Hart, Chelsey D Gilbertson, Jason W Wilson, Larissa Mueller, Lori Brown, Bradley D Gordon
OBJECTIVE: End-of-life interventions should be predicated on consensus understanding of patient wishes. Written documents are not always understood; adding a video testimonial/message (VM) might improve clarity. Goals of this study were to (1) determine baseline rates of consensus in assigning code status and resuscitation decisions in critically ill scenarios and (2) determine whether adding a VM increases consensus. METHODS: We randomly assigned 2 web-based survey links to 1366 faculty and resident physicians at institutions with graduate medical education programs in emergency medicine, family practice, and internal medicine...
February 14, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28191757/cartilage-regeneration-in-osteoarthritic-patients-by-a-composite-of-allogeneic-umbilical-cord-blood-derived-mesenchymal-stem-cells-and-hyaluronate-hydrogel-results-from-a-clinical-trial-for-safety-and-proof-of-concept-with-7-years-of-extended-follow-up
#5
Yong-Beom Park, Chul-Won Ha, Choong-Hee Lee, Young Cheol Yoon, Yong-Geun Park
Few methods are available to regenerate articular cartilage defects in patients with osteoarthritis. We aimed to assess the safety and efficacy of articular cartilage regeneration by a novel medicinal product composed of allogeneic human umbilical cord blood-derived mesenchymal stem cells (hUCB-MSCs). Patients with Kellgren-Lawrence grade 3 osteoarthritis and International Cartilage Repair Society (ICRS) grade 4 cartilage defects were enrolled in this clinical trial. The stem cell-based medicinal product (a composite of culture-expanded allogeneic hUCB-MSCs and hyaluronic acid hydrogel [Cartistem]) was applied to the lesion site...
February 2017: Stem Cells Translational Medicine
https://www.readbyqxmd.com/read/28191610/italian-intersociety-consensus-on-doac-use-in-internal-medicine
#6
Domenico Prisco, Walter Ageno, Cecilia Becattini, Armando D'Angelo, Giovanni Davì, Raimondo De Cristofaro, Francesco Dentali, Giovanni Di Minno, Anna Falanga, Gualberto Gussoni, Luca Masotti, Gualtiero Palareti, Pasquale Pignatelli, Roberto M Santi, Francesca Santilli, Mauro Silingardi, Antonella Tufano, Francesco Violi
The direct oral anticoagulants (DOACs) are drugs used in clinical practice since 2009 for the prevention of stroke or systemic embolism in non-valvular atrial fibrillation, and for the treatment and secondary prevention of venous thromboembolism. The four DOACs, including the three factor Xa inhibitors (rivaroxaban, apixaban and edoxaban) and one direct thrombin inhibitor (dabigatran) provide oral anticoagulation therapy alternatives to Vitamin K antagonists (VKAs). Despite their clear advantages, the DOACs require on the part of the internist a thorough knowledge of their pharmacokinetic and pharmacodynamic characteristics to ensure their correct use, laboratory monitoring and the appropriate management of adverse events...
February 13, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28190671/observations-of-the-role-of-science-in-the-united-states-medical-cannabis-state-policies-lessons-learnt
#7
Jelica Grbic, Perilou Goddard, David Ryder
BACKGROUND: Clinical trials have shown cannabis to be effective in the treatment of some medical conditions and there is mounting public and political pressure to enact laws enabling the use of cannabis for medicinal purposes. To date, 28 United States (U.S.) states and the District of Columbia have enacted medical cannabis laws. This study sought to identify the main issues pertaining to the development of medical cannabis laws in the U.S, including the role of scientific evidence. METHODS: Data were collected from three groups of participants: government officials, lobbyists and medical professionals involved in the medical cannabis debate in five selected states in the U...
February 9, 2017: International Journal on Drug Policy
https://www.readbyqxmd.com/read/28187802/critical-care-management-of-traumatic-brain-injury
#8
D K Menon, A Ercole
Traumatic brain injury (TBI) is a growing global problem, which is responsible for a substantial burden of disability and death, and which generates substantial healthcare costs. High-quality intensive care can save lives and improve the quality of outcome. TBI is extremely heterogeneous in terms of clinical presentation, pathophysiology, and outcome. Current approaches to the critical care management of TBI are not underpinned by high-quality evidence, and many of the current therapies in use have not shown benefit in randomized control trials...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28186708/mesenchymal-stem-cell-derived-extracellular-vesicles-as-mediators-of-anti-inflammatory-effects-endorsement-of-macrophage-polarization
#9
Claudia Lo Sicco, Daniele Reverberi, Carolina Balbi, Valentina Ulivi, Elisa Principi, Luisa Pascucci, Pamela Becherini, Maria Carla Bosco, Luigi Varesio, Chiara Franzin, Michela Pozzobon, Ranieri Cancedda, Roberta Tasso
Mesenchymal Stem Cells (MSCs) are effective therapeutic agents enhancing the repair of injured tissues mostly through their paracrine activity. Increasing evidences show that besides the secretion of soluble molecules, the release of extracellular vesicles (EVs) represents an alternative mechanism adopted by MSCs. Since macrophages are essential contributors toward the resolution of inflammation, which has emerged as a finely orchestrated process, the aim of the present study was to carry out a detailed characterization of EVs released by human adipose derived-MSCs to investigate their involvement as modulators of MSC anti-inflammatory effects inducing macrophage polarization...
January 31, 2017: Stem Cells Translational Medicine
https://www.readbyqxmd.com/read/28185142/print-me-an-organ-ethical-and-regulatory-issues-emerging-from-3d-bioprinting-in-medicine
#10
Frederic Gilbert, Cathal D O'Connell, Tajanka Mladenovska, Susan Dodds
Recent developments of three-dimensional printing of biomaterials (3D bioprinting) in medicine have been portrayed as demonstrating the potential to transform some medical treatments, including providing new responses to organ damage or organ failure. However, beyond the hype and before 3D bioprinted organs are ready to be transplanted into humans, several important ethical concerns and regulatory questions need to be addressed. This article starts by raising general ethical concerns associated with the use of bioprinting in medicine, then it focuses on more particular ethical issues related to experimental testing on humans, and the lack of current international regulatory directives to guide these experiments...
February 9, 2017: Science and Engineering Ethics
https://www.readbyqxmd.com/read/28183374/experiences-of-codeine-use-misuse-and-dependence-application-of-liese-and-franz-s-cognitive-developmental-model-of-substance-abuse
#11
Marie Claire Van Hout, Ian Norman, Eileen Rich, Michael Bergin
BACKGROUND: Misuse of codeine-containing medicines is an emerging public health issue. AIMS: We present the application of Liese and Franz's (1996) cognitive developmental model of substance abuse to the trajectory from legitimate codeine use for pain, towards that of therapeutic and other forms of misuse, and physical and psychological dependence. It illustrates a cognitive behavioural analysis of the experiences of codeine misusers - which 'surfaces' the specific beliefs, thoughts, emotions and behaviours of this group of hidden codeine dependent individuals, who are distinct and unique from other opioid-dependent cohorts...
February 10, 2017: Behavioural and Cognitive Psychotherapy
https://www.readbyqxmd.com/read/28181847/international-service-learning-and-interprofessional-education-in-ecuador-findings-from-a-phenomenology-study-with-students-from-four-professions
#12
Audrey M Johnson, Dana M Howell
Combined international service learning (ISL) and interprofessional education (IPE) experiences can move health professional student learning beyond the traditional confines of the classroom and outside uniprofessional ethos. The purpose of this transcendental phenomenological study was to describe the shared experience of health professional students participating in an ISL trip to a small community in Ecuador. The study focused on the learning and collaboration that occurred among students from multiple health professions during the trip and the cross-cultural exchange between the students and the patients in Ecuador...
March 2017: Journal of Interprofessional Care
https://www.readbyqxmd.com/read/28178918/global-health-training-among-u-s-residency-specialties-a-systematic-literature-review
#13
Duncan K Hau, Luke R Smart, Jennifer I DiPace, Robert N Peck
BACKGROUND: Interest in global health training during residency is increasing. Global health knowledge is also becoming essential for health-care delivery today. Many U.S. residency programs have been incorporating global health training opportunities for their residents. We performed a systematic literature review to evaluate global health training opportunities and challenges among U.S. residency specialties. METHODS: We searched PubMed from its earliest dates until October 2015...
2017: Medical Education Online
https://www.readbyqxmd.com/read/28178729/re-examining-physical-findings-with-point-of-care-ultrasound-a-narrative-review
#14
William Diprose, Francois Verster, Cameron Schauer
The art of physical examination has continued to be practised by physicians largely unchanged for over 200 years. Ultrasound, once the domain of the radiologist, is now being increasingly used by emergency physicians and intensivists to make rapid, accurate diagnoses at the point-of-care. We review the growing body of evidence supporting point-of-care ultrasound (PoCUS) as the preferred alternative to many aspects of the cardiovascular, respiratory, abdominal and neurological examinations in internal medicine...
January 27, 2017: New Zealand Medical Journal
https://www.readbyqxmd.com/read/28173801/cryptococcus-gattii-molecular-type-vgii-infection-associated-with-lung-disease-in-a-goat
#15
Evelin Catarine da Silva, Juliana Mariotti Guerra, Luciana Neves Torres, Alessandra Maria Dias Lacerda, Raquel Gonçalves Gomes, Danilo Marin Rodrigues, Rodrigo Albergaria Réssio, Priscilla Anne Melville, Camila Cecilia Martin, Fernando José Benesi, Lílian Rose Marques de Sá, Bruno Cogliati
BACKGROUND: Cryptococcus gattii-induced cryptococcosis is an emerging infectious disease of humans and animals with worldwide distribution and public health importance due to its significant morbidity and mortality rate. The present study aimed to report a case of pulmonary infection by C. gattii molecular type VGII in State of São Paulo, Brazil. CASE PRESENTATION: A 5-year-old goat showing intermittent dry cough, ruminal tympany, anorexia, fever, tachycardia and tachypnea was presented for necropsy at the Veterinary Hospital of the School of Veterinary Medicine and Animal Sciences, São Paulo University, São Paulo, Brazil...
February 7, 2017: BMC Veterinary Research
https://www.readbyqxmd.com/read/28170280/super-users-at-an-acupuncture-and-oriental-medicine-teaching-clinic-demographics-and-unique-clinical-characteristics
#16
Forrest Cooper, Benjamin L Marx, Tamsin L Lee, Deborah Espesete
OBJECTIVE: The use of acupuncture in the United States has consistently grown over the last two decades, and the National Center for Complementary and Integrative Health has recently called for greater understanding of "real life outcomes and use" by complementary and alternative medicine users. This study assesses the demographics and utilization patterns of "super-users" treated at the Oregon College of Oriental Medicine intern clinic. METHODS: This was a retrospective chart review at the Oregon College of Oriental Medicine (OCOM) intern clinic, a large acupuncture and oriental medicine (AOM) school in Portland, Oregon...
February 7, 2017: Journal of Alternative and Complementary Medicine: Research on Paradigm, Practice, and Policy
https://www.readbyqxmd.com/read/28164320/perception-of-point-of-care-ultrasound-performed-by-emergency-medicine-physicians
#17
Whitney Hansen, Carl E Mitchell, Bikash Bhattarai, Napatkamon Ayutyanont, Jeffrey R Stowell
PURPOSE: Point-of-care ultrasound (POCUS) is integral to the practice of emergency medicine (EM). Furthermore, EM-performed POCUS (EM-POCUS) offers consultants the opportunity to avoid delays in care due to wait times for confirmatory imaging studies. This study is the first to describe the perception of POCUS to consulting services at a single institution where EM-POCUS is routinely performed. METHODS: This study was conducted as a survey distributed to residents from consultant specialties (internal medicine [IM], general surgery [GS], and obstetrics and gynecology [OB-GYN])...
February 6, 2017: Journal of Clinical Ultrasound: JCU
https://www.readbyqxmd.com/read/28160444/imaging-mass-cytometry
#18
REVIEW
Qing Chang, Olga I Ornatsky, Iram Siddiqui, Alexander Loboda, Vladimir I Baranov, David W Hedley
Imaging Mass Cytometry (IMC) is an expansion of mass cytometry, but rather than analyzing single cells in suspension, it uses laser ablation to generate plumes of particles that are carried to the mass cytometer by a stream of inert gas. Images reconstructed from tissue sections scanned by IMC have a resolution comparable to light microscopy, with the high content of mass cytometry enabled through the use of isotopically labeled probes and ICP-MS detection. Importantly, IMC can be performed on paraffin-embedded tissue sections, so can be applied to the retrospective analysis of patient cohorts whose outcome is known, and eventually to personalized medicine...
February 3, 2017: Cytometry. Part A: the Journal of the International Society for Analytical Cytology
https://www.readbyqxmd.com/read/28159128/high-weight-gain-during-pregnancy-increases-the-risk-for-emergency-caesarean-section-population-based-data-from-the-swedish-maternal-health-care-register-2011-2012
#19
Carin Nilses, Margareta Persson, Marie Lindkvist, Kerstin Petersson, Ingrid Mogren
OBJECTIVE: The aim was to investigate maternal background factors' significance in relation to risk of elective and emergency caesarean sections (CS) in Sweden. STUDY DESIGN: Population-based, retrospective, cross-sectional study. The Swedish Maternal Health Care Register (MHCR) is a national quality register that collects data on pregnancy, delivery and postpartum period. All women registered in MHCR 2011 to 2012 were included in the study sample (N = 178,716)...
March 2017: Sexual & Reproductive Healthcare: Official Journal of the Swedish Association of Midwives
https://www.readbyqxmd.com/read/28155017/implementing-standardized-inter-unit-communication-in-an-international-setting-handoff-of-patients-from-emergency-medicine-to-internal-medicine
#20
Kamna S Balhara, Susan M Peterson, Mohamed Moheb Elabd, Linda Regan, Xavier Anton, Basil Ali Al-Natour, Yu-Hsiang Hsieh, James Scheulen, Sarah A Stewart de Ramirez
Standardized handoffs may reduce communication errors, but research on handoff in community and international settings is lacking. Our study at a community hospital in the United Arab Emirates characterizes existing handoff practices for admitted patients from emergency medicine (EM) to internal medicine (IM), develops a standardized handoff tool, and assesses its impact on communication and physician perceptions. EM physicians completed a survey regarding handoff practices and expectations. Trained observers utilized a checklist based on the Systems Engineering Initiative for Patient Safety model to observe 40 handoffs...
February 3, 2017: Internal and Emergency Medicine
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