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https://www.readbyqxmd.com/read/29042826/clinical-reasoning-and-knowledge-management-in-final-year-medical-students-the-role-of-student-led-grand-rounds
#1
David Arumaisingam Kandiah
OBJECTIVES: The development of clinical reasoning and decision-making skills is often limited in medical school curricula. In reality, medical graduates acquire these skills during their first few years of residency. For many, this can be stressful as they may be working under limited supervision as a part of their rotations. METHODS: Student-led Grand Rounds was developed to transfer both explicit and tacit knowledge to final year medical students. This pilot project was to apply the principles of knowledge management to allow students to be exposed to the reasoning and decision making of common clinical presentations...
2017: Advances in Medical Education and Practice
https://www.readbyqxmd.com/read/28986448/an-improved-escherichia-coli-screen-for-rubisco-identifies-a-protein-protein-interface-that-can-enhance-co2-fixation-kinetics
#2
Robert H Wilson, Elena Martin-Avila, Carly Conlan, Spencer M Whitney
An overarching goal of photosynthesis research is to identify how components of the process can be improved to benefit crop productivity, global food security and renewable energy storage. Improving carbon fixation has mostly focused on enhancing the CO2 fixing enzyme Ribulose-1,5-bisphosphate carboxylase/oxygenase (Rubisco). This grand challenge has mostly proved ineffective due to catalytic mechanism constraints and required chaperone complementarity that hinder Rubisco biogenesis in alternative hosts. Here we refashion Escherichia coli metabolism by expressing a phosphoribulokinase-neomycin phosphotransferase fusion protein to produce a high fidelity, high throughput Rubisco directed evolution (RDE2) screen that negates false positive selection...
October 6, 2017: Journal of Biological Chemistry
https://www.readbyqxmd.com/read/28975473/why-are-there-so-few-ethics-consults-in-children-s-hospitals
#3
Brian Carter, Manuel Brockman, Jeremy Garrett, Angie Knackstedt, John Lantos
In most children's hospitals, there are very few ethics consultations, even though there are many ethically complex cases. We hypothesize that the reason for this may be that hospitals develop different mechanisms to address ethical issues and that many of these mechanisms are closer in spirit to the goals of the pioneers of clinical ethics than is the mechanism of a formal ethics consultation. To show how this is true, we first review the history of collaboration between philosophers and physicians about clinical dilemmas...
October 3, 2017: HEC Forum: An Interdisciplinary Journal on Hospitals' Ethical and Legal Issues
https://www.readbyqxmd.com/read/28973212/should-we-screen-this-patient-for-carotid-artery-stenosis-grand-rounds-discussion-from-beth-israel-deaconess-medical-center
#4
Gerald W Smetana, Marc Schermerhorn, Kenneth J Mukamal
In July 2014, the U.S. Preventive Services Task Force (USPSTF) published a clinical guideline on screening for asymptomatic carotid artery stenosis. The guideline recommended against screening in asymptomatic adults, based primarily on the results of 3 large randomized trials (grade D recommendation). The principal screening test was carotid ultrasonography, and the intervention in the 3 trials was carotid endarterectomy for patients with stenosis exceeding 50% to 60%. In a meta-analysis, carotid endarterectomy reduced rates of 1) perioperative stroke, death, or subsequent ipsilateral stroke and 2) perioperative stroke, death, or any subsequent stroke...
October 3, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28948136/fetal-alcohol-spectrum-disorders-a-case-study
#5
Leila Glass, Sarah N Mattson
This grand rounds manuscript reviews important considerations in developing case conceptualizations for individuals with a history of prenatal alcohol exposure. This case study provides an introduction to fetal alcohol spectrum disorders, diagnostic issues, a detailed description of the individual's history, presenting symptoms, neuropsychological test results, and an integrated summary. We describe a 9-year old girl diagnosed with a fetal alcohol spectrum disorder (FASD): Neurobehavioral Disorder Associated with Prenatal Alcohol Exposure (ND-PAE)...
June 2017: J Pediatr Neuropsychol
https://www.readbyqxmd.com/read/28924675/malignant-triton-tumor-grand-round-presentation-of-a-rare-aggressive-case-thoracolumbar-spine-tumor
#6
Soufiane Ghailane, Sandra Fauquier, Sébastien Lepreux, Jean-Charles Le Huec
INTRODUCTION: We report a rare and aggressive case of malignant triton tumor (MTT) at the thoracolumbar junction with foraminal extension mistreated as schwannoma. MATERIALS AND METHODS: A 70-year-old man with a 2-year history of lower back pain and left L4 radiculopathy with no history of neurofibromatosis. RESULTS: Pre-operative MRI suggested a typical schwannoma. Upon complete marginal resection, histological findings revealed a MTT. The patient presented with a local and regional recurrence and died 10 months after surgery...
September 18, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28919493/heat-stress-incident-prevalence-and-tennis-matchplay-performance-at-the-australian-open
#7
Matthew T Smith, Machar Reid, Stephanie Kovalchik, Tim O Woods, Rob Duffield
OBJECTIVES: To examine the association of wet bulb globe temperature (WBGT) with the occurrence of heat-related incidents and changes in behavioural and matchplay characteristics in men's Grand Slam tennis. DESIGN: On-court calls for trainers, doctors, cooling devices and water, post-match medical consults and matchplay characteristic data were collected from 360 Australian Open matches (first 4 rounds 2014-2016). METHODS: Data were referenced against estimated WBGT and categorised into standard zones...
September 6, 2017: Journal of Science and Medicine in Sport
https://www.readbyqxmd.com/read/28885473/ins-2017-infusion-nursing-grand-rounds
#8
(no author information available yet)
No abstract text is available yet for this article.
September 2017: Journal of Infusion Nursing: the Official Publication of the Infusion Nurses Society
https://www.readbyqxmd.com/read/28880614/professional-and-political-reflections-on-the-grand-round-a-critical-case-study
#9
Dan Cooper, Dave Mercer
This case study presents a critical reflective account of a change to working practices in one NHS Trust. To promote quality care and effective clinical decision making, a 'grand round' was introduced in the orthopaedic department. Implementation presented frustrations and challenges for members of the multidisciplinary team. These are explored using transformative learning and critical reflection, enabling connections to be made between micro-level interactions of clinical care and macro-level structures that frame healthcare services...
September 7, 2017: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/28837548/cdc-grand-rounds-newborn-screening-for-hearing-loss-and-critical-congenital-heart-disease
#10
Scott D Grosse, Tiffany Riehle-Colarusso, Marcus Gaffney, Craig A Mason, Stuart K Shapira, Marci K Sontag, Kim Van Naarden Braun, John Iskander
Newborn screening is a public health program that benefits 4 million U.S. infants every year by enabling early detection of serious conditions, thus affording the opportunity for timely intervention to optimize outcomes (1). States and other U.S. jurisdictions decide whether and how to regulate newborn screening practices. Most newborn screening is done through laboratory analyses of dried bloodspot specimens collected from newborns. Point-of-care newborn screening is typically performed before discharge from the birthing facility...
August 25, 2017: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/28807628/vertebral-alveolar-echinococcosis-a-case-report-systematic-analysis-and-review-of-the-literature
#11
REVIEW
Thomas Raphael Meinel, Bruno Gottstein, Vanessa Geib, Marius Johann Keel, Ruggero Biral, Markus Mohaupt, Jan Brügger
Alveolar echinococcosis caused by Echinococcus multilocularis is an infrequent zoonosis with a high degree of disability, morbidity, and mortality, especially in disease clusters of the northern hemisphere. The diagnosis is complicated by extended incubation time, diverse clinical manifestations, and mimicking of differential diagnoses. The primary organ affected is the liver, but extrahepatic disease is possible, with vertebral involvement in only a few dozen cases described worldwide. Although vertebral alveolar echinococcosis seems to be rare, it might be under diagnosed, and it might be seen more often as the number of people with immunocompromised conditions increases...
August 11, 2017: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/28793354/-central-auditory-processing-disorder-grand-rounds-multiple-cases-multiple-causes-multiple-outcomes
#12
Cynthia McCormick Richburg, Samuel R Atcherson, Ursula M Findlen, Sarah Wakefield, Natalie J Benafield
Purpose: The purpose of this article was to provide multiple examples of how (central) auditory processing disorder ([C]APD) is being evaluated and treated at various audiology clinics throughout the United States. Method: The authors present 5 cases highlighting the diagnosis and treatment of (C)APD in children and adults. Similarities and differences between these cases have been showcased through detailed histories, evaluation protocol, and treatment options...
September 18, 2017: American Journal of Audiology
https://www.readbyqxmd.com/read/28776131/pure-distraction-injury-of-t1-2-with-quad-fever
#13
Jun-Yeong Seo, Chae-Moon Lim, Young-Hoon Kim, Kee-Yong Ha
INTRODUCTION: We report a pure distraction injury of the upper thoracic spine and uncontrolled hyperthermia without an infectious cause. Quad fever appears in the first several weeks to months after a cervical or upper thoracic SCI and is characterized by an extreme elevation in body core temperature beyond 40 °C without an infectious cause. Discriminating between infectious and noninfectious causes is important, and a thorough clinical assessment is required. MATERIALS AND METHODS: A 52-year-old male visited the emergency room complaining of back pain with complete paralysis [American Spinal Injury Association (ASIA) A] of both lower extremities after a pedestrian-motor vehicle accident...
August 3, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28761956/should-this-patient-receive-an-antidepressant-grand-rounds-discussion-from-beth-israel-deaconess-medical-center
#14
Risa B Burns, Gerald W Smetana, Roscoe Brady
Depression is a major public health problem and a common cause of disability. To help physicians choose among available treatment options, the American College of Physicians recently issued a guideline titled "Nonpharmacologic Versus Pharmacologic Treatment of Adult Patients with Major Depressive Disorder." The evidence review done for the guideline found no statistically significant difference in the efficacy of second-generation antidepressants (SGAs) versus most other treatments for this disorder. However, rates of adverse events and discontinuation were generally higher in patients treated with SGAs...
August 1, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28759692/a-nurse-led-innovation-in-education-implementing-a-collaborative-multidisciplinary-grand-rounds
#15
Lisa Matamoros, Michelle Cook
Multidisciplinary grand rounds provides an opportunity to promote excellence in patient care through scholarly presentations and interdisciplinary collaboration with an innovative approach. In addition, multidisciplinary grand rounds serves to recognize expertise of staff, mentor and support professional development, and provide a collaborative environment across all clinical disciplines and support services. This article describes a process model developed by nurse educators for implementing a multidisciplinary grand rounds program...
August 1, 2017: Journal of Continuing Education in Nursing
https://www.readbyqxmd.com/read/28755075/rheumatoid-arthritis-associated-spinal-neuroarthropathy-with-double-level-isthmic-spondylolisthesis
#16
Sang-Il Kim, Young-Hoon Kim, Jae-Won Lee, Won-Woo Kang, Kee-Yong Ha
INTRODUCTION: To the best of our knowledge, there has been no report regarding rheumatoid arthritis associated with spinal neuroarthropathy and combined double-level isthmic spondylolisthesis. Here, we report a rare case of spinal neuroarthropathy with double-level isthmic spondylolisthesis in a rheumatoid arthritis (RA) patient. A 56-year-old female patient under medical treatment for RA during the last 13 years presented aggravating radiating pain to her right lower extremity and a limping gait developed 4 months ago...
July 28, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28749927/cdc-grand-rounds-addressing-health-disparities-in-early-childhood
#17
Lara R Robinson, Rebecca H Bitsko, Ross A Thompson, Paul H Dworkin, Mary Ann McCabe, Georgina Peacock, Phoebe G Thorpe
Research suggests that many disparities in overall health and well-being are rooted in early childhood (1,2). Stressors in early childhood can disrupt neurologic, metabolic, and immunologic systems, leading to poorer developmental outcomes (1). However, consistent, responsive caregiving relationships and supportive community and health care environments promote an optimal trajectory (3,4). The first 8 years of a child's life build a foundation for future health and life success (5-7). Thus, the cumulative and lifelong impact of early experiences, both positive and negative, on a child's development can be profound...
July 28, 2017: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/28742774/improving-adherence-to-intraoperative-lung-protective-ventilation-strategies-at-a-university-medical-center
#18
Sean A Josephs, Gretchen A Lemmink, Judith A Strong, Cassandra L Barry, William E Hurford
BACKGROUND: Intraoperative lung-protective ventilation (ILPV) is defined as tidal volumes <8 mL/kg ideal bodyweight and is increasingly a standard of care for major abdominal surgical procedures performed under general anesthesia. In this study, we report the result of a quality improvement initiative targeted at improving adherence to ILPV guidelines in a large academic teaching hospital. METHODS: We performed a time-series study to determine whether anesthesia provider adherence to ILPV was affected by certain improvement interventions and patient ideal body weight (IBW)...
July 24, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28728205/-predictability-of-postoperative-pain-and-satisfaction-how-precise-are-we-and-what-is-the-role-of-professional-experience
#19
Ulf Krister Hofmann, Cosima Dobler, Marco Gesicki, Torsten Kluba, Sebastian Scheidt
Background The indication for surgery is justified by an expected improvement for the patient. To evaluate the probability and extent of individual postoperative patient benefit, the surgeon needs to elaborate numerous parameters of potential relevance for the outcome beyond his key competence, that is the technical dimension of the operation. Despite the highest medical standards, individual postoperative satisfaction with surgery is highly variable, even in cases with a technically good result. The aim of the present study was to investigate the individual predictability of postoperative pain and satisfaction in patients with elective musculoskeletal surgery...
October 2017: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/28670889/heuristic-classifier-for-observe-accuracy-of-cancer-polyp-using-video-capsule-endoscopy
#20
Geetha K, Rajan C
Methods: Colonoscopy is a technique for examine colon cancer, polyps. In endoscopy, video capsule is universally used mechanism for finding gastrointestinal stages. But both the mechanisms are used to find the colon cancer or colorectal polyp. The Automatic Polyp Detection sub-challenge conducted as part of the Endoscopic Vision Challenge (http://endovis.grand-challenge.org). Method: Colonoscopy may be primary way of improve the ability of colon cancer detection especially flat lesions. Which otherwise may be difficult to detect...
June 25, 2017: Asian Pacific Journal of Cancer Prevention: APJCP
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