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https://www.readbyqxmd.com/read/28110401/evaluating-the-utility-of-a-scoring-system-for-lipomas-of-the-cerebellopontine-angle
#1
Carlito Lagman, Brittany L Voth, Lawrance K Chung, Timothy T Bui, Seung J Lee, Natalie E Barnette, Quinton Gopen, Isaac Yang
BACKGROUND: Cerebellopontine angle (CPA) lipomas are rare, benign, slow-growing masses. Resections are considered in symptomatic patients who are refractory to targeted medical therapies, but at those stages the lipomas have often reached considerable sizes and encompass critical neurovascular structures. The objective of this study is to develop and to evaluate the utility of a scoring system for CPA lipomas. The hypothesis is that CPA lipomas with lower scores are probably best managed with early surgery...
January 21, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28109841/disruption-of-aromatase-homeostasis-as-the-cause-of-a-multiplicity-of-ailments-a-comprehensive-review
#2
REVIEW
Seema Patel
Human health is beset with a legion of ailments, which is exacerbated by the lifestyle errors. Out of the numerous enzymes in human body, aromatase, a cytochromes P450 enzyme is particularly very critical. Occurring at the crossroads of multiple signalling pathways, its homeostasis is vital. Unfortunately, medications, hormone therapy, chemical additives in food, and endocrine-disrupting personal care products are oscillating the aromatase concentration beyond the permissible level. As this enzyme converts androgens (C19) into estrogens (C18), its agitation has different outcomes in different genders and age groups...
January 18, 2017: Journal of Steroid Biochemistry and Molecular Biology
https://www.readbyqxmd.com/read/28109347/how-is-physician-work-valued
#3
Jeffrey P Jacobs, Stephen J Lahey, Francis C Nichols, James M Levett, George Gilbert Johnston, Richard K Freeman, James D St Louis, Julie Painter, Courtney Yohe, Cameron D Wright, Kirk R Kanter, John E Mayer, Keith S Naunheim, Jeffrey B Rich, Joseph E Bavaria
Strategies to value physician work continue to evolve. The Society of Thoracic Surgeons and The Society of Thoracic Surgeons National Database have an increasingly important role in this evolution. An understanding of the Current Procedural Terminology (CPT) system (American Medical Association [AMA], Chicago, IL) and the Relative Value Scale Update Committee (RUC) is necessary to comprehend how physician work is valued. In 1965, with the dawn of increasingly complex medical care, immense innovation, and the rollout of Medicare, the need for a common language describing medical services and procedures was recognized as being of critical importance...
February 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28109225/effects-of-stereochemistry-and-copolymerization-on-the-lcst-of-pnipam
#4
Tiago E de Oliveira, Debashish Mukherji, Kurt Kremer, Paulo A Netz
Poly(N-isopropylacrylamide) (PNIPAm) is a smart polymer that presents a lower critical transition temperature (LCST) of 305 K. Interestingly, this transition point falls within the range of the human body temperature, making PNIPAm a highly suitable candidate for bio-medical applications. However, it is sometimes desirable to have a rather flexible tuning of the LCST of these polymers to further increase their range of applications. In this work, we use all-atom molecular dynamics simulations to study the LCST of PNIPAm-based (co-)polymers...
January 21, 2017: Journal of Chemical Physics
https://www.readbyqxmd.com/read/28109052/the-use-of-methadone-to-facilitate-opioid-weaning-in-pediatric-critical-care-patients-a-systematic-review-of-the-literature-and-meta-analysis
#5
REVIEW
Leslie A Dervan, Beryl Yaghmai, Robert Scott Watson, Fredric M Wolf
BACKGROUND: Continuous opioid infusion therapy is commonly utilized in the pediatric intensive care setting to treat pain and facilitate tolerance of invasive therapies. Transitioning to methadone is one common strategy for weaning from continuous opioid infusions, but in practice this transition can be challenging, and many children still experience iatrogenic withdrawal. AIM: We reviewed the literature to evaluate the best available evidence to guide methadone therapy in this setting, and to summarize associated adverse events...
January 20, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28108895/chronic-wound-healing-a-review-of-current-management-and-treatments
#6
REVIEW
George Han, Roger Ceilley
Wound healing is a complex, highly regulated process that is critical in maintaining the barrier function of skin. With numerous disease processes, the cascade of events involved in wound healing can be affected, resulting in chronic, non-healing wounds that subject the patient to significant discomfort and distress while draining the medical system of an enormous amount of resources. The healing of a superficial wound requires many factors to work in concert, and wound dressings and treatments have evolved considerably to address possible barriers to wound healing, ranging from infection to hypoxia...
January 21, 2017: Advances in Therapy
https://www.readbyqxmd.com/read/28108374/strategies-to-reduce-hospitalizations-of-children-with-medical-complexity-through-complex-care-expert-perspectives
#7
Ryan J Coller, Bergen B Nelson, Thomas S Klitzner, Adrianna A Saenz, Paul G Shekelle, Carlos F Lerner, Paul J Chung
OBJECTIVES: Interventions to reduce disproportionate hospital use among children with medical complexity (CMC) are needed. Our objective was to conduct a rigorous, structured process to develop intervention strategies aiming to reduce hospitalizations within a complex care program population. METHODS: A complex care medical home program used 1) semi-structured interviews of caregivers of CMC experiencing acute, unscheduled hospitalizations, and 2) literature review on preventing hospitalizations among CMC, to develop key drivers for lowering hospital utilization and link them with intervention strategies...
January 17, 2017: Academic Pediatrics
https://www.readbyqxmd.com/read/28108169/learning-to-manage-vasoactive-drugs-a-qualitative-interview-study-with-critical-care-nurses
#8
Marie Häggström, Ann-Christin Bergsman, Ulrika Månsson, Malin Rising Holmström
OBJECTIVE: Being a nurse in an intensive care unit entails caring for seriously ill patients. Vasoactive drugs are one of the tools that are used to restore adequate circulation. Critical care nurses often manage and administer these potent drugs after medical advice from physicians. AIM: To describe the experiences of critical care nurses learning to manage vasoactive drugs, and to highlight the competence required to manage vasoactive drugs. RESEARCH METHODOLOGY/SETTING: Twelve critical care nurses from three hospitals in Sweden were interviewed...
January 17, 2017: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/28108038/the-effect-of-endotracheal-tubes-versus-laryngeal-mask-airways-on-perioperative-respiratory-adverse-events-in-infants-a-randomised-controlled-trial
#9
Thomas F E Drake-Brockman, Anoop Ramgolam, Guicheng Zhang, Graham L Hall, Britta S von Ungern-Sternberg
BACKGROUND: Perioperative respiratory adverse events (PRAE) are the most common critical incidents in paediatric anaesthesia and occur more often in infants. Use of laryngeal mask airways (LMAs) is associated with reduced PRAE compared with endotracheal tubes in older children (>1 year). We aimed to evaluate the effect of these devices on the incidence of PRAE in infants. METHODS: We did a randomised controlled trial at the Princess Margaret Hospital for Children in Perth (WA, Australia) by recruiting infants (aged 0-12 months) undergoing general (with or without regional or local) anaesthesia with anticipated fentanyl dose 1 μg/kg or lower for minor elective surgery...
January 17, 2017: Lancet
https://www.readbyqxmd.com/read/28107348/predicting-length-of-stay-among-patients-discharged-from-the-emergency-department-using-an-accelerated-failure-time-model
#10
Chung-Hsien Chaou, Hsiu-Hsi Chen, Shu-Hui Chang, Petrus Tang, Shin-Liang Pan, Amy Ming-Fang Yen, Te-Fa Chiu
BACKGROUND: Emergency department (ED) crowding continues to be an important health care issue in modern countries. Among the many crucial quality indicators for monitoring the throughput process, a patient's length of stay (LOS) is considered the most important one since it is both the cause and the result of ED crowding. The aim of this study is to identify and quantify the influence of different patient-related or diagnostic activities-related factors on the ED LOS of discharged patients...
2017: PloS One
https://www.readbyqxmd.com/read/28107266/early-fluid-overload-prolongs-mechanical-ventilation-in-children-with-viral-lower-respiratory-tract-disease
#11
Sarah A Ingelse, Hanke M G Wiegers, Job C Calis, Job B van Woensel, Reinout A Bem
OBJECTIVES: Viral-lower respiratory tract disease is common in young children worldwide and is associated with high morbidity. Acute respiratory failure due to viral-lower respiratory tract disease necessitates PICU admission for mechanical ventilation. In critically ill patients in PICU settings, early fluid overload is common and associated with adverse outcomes such as prolonged mechanical ventilation and increased mortality. It is unclear, however, if this also applies to young children with viral-lower respiratory tract disease induced acute respiratory failure...
January 19, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28107265/long-term-function-after-pediatric-critical-illness-results-from-the-survivor-outcomes-study
#12
Neethi P Pinto, Elizabeth W Rhinesmith, Tae Yeon Kim, Peter H Ladner, Murray M Pollack
OBJECTIVE: Knowledge of the long-term outcomes of survivors of pediatric critical illness is sparse but important. The aim of this study was to evaluate morbidity and mortality 6 months and 3 years after hospital discharge. DESIGN: Prospective cohort study. SETTING: Urban, inner city, academic PICU. PATIENTS: Consecutive patients admitted to the PICU from June 2012 to August 2012. INTERVENTIONS: None...
January 19, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28107158/human-trafficking-in-areas-of-conflict-health-care-professionals-duty-to-act
#13
Christina Bloem, Rikki E Morris, Makini Chisolm-Straker
Given the significant global burden of human trafficking, the ability of clinicians to identify and provide treatment for trafficked persons is critical. Particularly in conflict settings, health care facilities often serve as the first and sometimes only point of contact for trafficked persons. As such, medical practitioners have a unique opportunity and an ethical imperative to intervene, even in nonclinical roles. With proper training, medical practitioners can assist trafficked persons by documenting human trafficking cases, thereby placing pressure on key stakeholders to enforce legal protections, and by providing adequate services to those trafficked...
January 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/28106853/significant-change-spotting-for-periodic-human-motion-segmentation-of-cleaning-tasks-using-wearable-sensors
#14
Kai-Chun Liu, Chia-Tai Chan
The proportion of the aging population is rapidly increasing around the world, which will cause stress on society and healthcare systems. In recent years, advances in technology have created new opportunities for automatic activities of daily living (ADL) monitoring to improve the quality of life and provide adequate medical service for the elderly. Such automatic ADL monitoring requires reliable ADL information on a fine-grained level, especially for the status of interaction between body gestures and the environment in the real-world...
January 19, 2017: Sensors
https://www.readbyqxmd.com/read/28106717/air-embolism-diagnosis-clinical-management-and-outcomes
#15
Colin J McCarthy, Sasan Behravesh, Sailendra G Naidu, Rahmi Oklu
Air embolism is a rare but potentially fatal complication of surgical procedures. Rapid recognition and intervention is critical for reducing morbidity and mortality. We retrospectively characterized our experience with air embolism during medical procedures at a tertiary medical center. Electronic medical records were searched for all cases of air embolism over a 25-year period; relevant medical and imaging records were reviewed. Sixty-seven air embolism cases were identified; the mean age was 59 years (range, 3-89 years)...
January 17, 2017: Diagnostics
https://www.readbyqxmd.com/read/28105784/what-prevents-critically-ill-patients-with-respiratory-failure-from-using-non-invasive-positive-pressure-ventilation-a-mixed-methods-study
#16
Hiroaki Murata, Tomoko Inoue, Osamu Takahashi
AIM: To identify the factors that prevent patients in respiratory failure from using noninvasive positive pressure ventilation (NPPV). The following were evaluated: (i) the patients who converted from NPPV to endotracheal intubation; and (ii) the patients who abandoned NPPV. METHODS: Patients were interviewed regarding their experience with NPPV. Next, the factors that prevented the continuation of NPPV were identified and those data were collected retrospectively from medical records...
January 20, 2017: Japan Journal of Nursing Science: JJNS
https://www.readbyqxmd.com/read/28104826/screening-for-medication-errors-using-an-outlier-detection-system
#17
Gordon D Schiff, Lynn A Volk, Mayya Volodarskaya, Deborah H Williams, Lake Walsh, Sara G Myers, David W Bates, Ronen Rozenblum
OBJECTIVE: The study objective was to evaluate the accuracy, validity, and clinical usefulness of medication error alerts generated by an alerting system using outlier detection screening. MATERIALS AND METHODS: Five years of clinical data were extracted from an electronic health record system for 747 985 patients who had at least one visit during 2012-2013 at practices affiliated with 2 academic medical centers. Data were screened using the system to detect outliers suggestive of potential medication errors...
January 19, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28103854/making-theory-explicit-an-analysis-of-how-medical-education-research-ers-describe-how-they-connect-to-theory
#18
Klara Bolander Laksov, Tim Dornan, Pim W Teunissen
BACKGROUND: As medical education develops into a varied and well-developed field of research, the issue of quality research anchored in or generating theory has gained increasing importance. Medical education researchers have been criticized of not connecting their work to relevant theory. This paper set out to analyse how researchers can connect to theory in medical education. The goal of this paper is to provide an accessible framework for those entering medical education research, regarding how theory may become an integral part of one's work...
January 19, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/28103147/effectiveness-of-a-video-based-aging-services-technology-education-program-for-health-care-professionals
#19
Alyssa Weakley, Joyce W Tam, Catherine Van Son, Maureen Schmitter-Edgecombe
Health care professionals (HCPs) are a critical source of recommendations for older adults. Aging services technologies (ASTs), which include devices to support the health-care needs of older adults, are underutilized despite evidence for improving functional outcomes and safety and reducing caregiver burden and health costs. This study evaluated a video-based educational program aimed at improving HCP awareness of ASTs. Sixty-five HCPs viewed AST videos related to medication management, daily living, and memory...
January 19, 2017: Gerontology & Geriatrics Education
https://www.readbyqxmd.com/read/28102573/posttraumatic-stress-disorder-and-alcohol-use-disorder-a%C3%A2-critical-review-of-pharmacologic-treatments
#20
REVIEW
Ismene L Petrakis, Tracy L Simpson
Treatment of alcohol use disorder (AUD) is complicated by the presence of psychiatric comorbidity including posttraumatic stress disorder (PTSD). This is a critical review of the literature to date on pharmacotherapy treatments of AUD and PTSD. A systematic literature search using PubMed MESH terms for alcohol and substance use disorders, PTSD, and treatment was undertaken to identify relevant randomized controlled trials (RCTs). The studies were independently evaluated (ILP and TLS) and those that evaluated the efficacy of a pharmacotherapy for individuals diagnosed with AUD and PTSD and were RCTs were selected...
January 19, 2017: Alcoholism, Clinical and Experimental Research
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