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https://www.readbyqxmd.com/read/28453820/reliability-of-clinical-impact-grading-by-healthcare-professionals-of-common-prescribing-error-and-optimisation-cases-in-critical-care-patients
#1
Richard S Bourne, Rob Shulman, Mark Tomlin, Mark Borthwick, Will Berry, Gary H Mills
Objective: To identify between and within profession-rater reliability of clinical impact grading for common critical care prescribing error and optimisation cases. To identify representative clinical impact grades for each individual case. Design: Electronic questionnaire. Setting: 5 UK NHS Trusts. Participants: 30 Critical care healthcare professionals (doctors, pharmacists and nurses). Intervention: Participants graded severity of clinical impact (5-point categorical scale) of 50 error and 55 optimisation cases...
April 1, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28453467/prognostic-significance-of-mycn-gene-amplification-and-protein-expression-in-primary-brain-tumors-astrocytoma-and-meningioma
#2
Mehrdad Asghari Estiar, Firouzeh Javan, Ali Zekri, Masoud Mehrazin, Parvin Mehdipour
BACKGROUND: Astrocytoma and meningioma are the most common primary brain tumors. MYCN as a member of MYC proto-oncogenes has recently appeared as an attractive therapeutic target. Functions of MYCN are critical for growth of nervous system and neural differentiation. OBJECTIVE: We examined MYCN amplification and protein expression in astrocytoma and meningioma cases. METHODS: In this study, we used real-time PCR, FISH assay and flowcytometry to analyze DNA amplification and protein expression of MYCN...
April 19, 2017: Cancer Biomarkers: Section A of Disease Markers
https://www.readbyqxmd.com/read/28449293/a-novel-approach-to-study-medical-decision-making-in-the-clinical-setting-the-own-point-of-view-perspective
#3
Thierry Pelaccia, Jacques Tardif, Emmanuel Triby, Bernard Charlin
BACKGROUND: Making diagnostic and therapeutic decisions is a critical activity among physicians. It relies on the ability of physicians to use cognitive processes and specific knowledge in the context of a clinical reasoning. This ability is a core competency in physicians, especially in the field of emergency medicine where the rate of diagnostic errors is high. Studies that explore medical decision-making in an authentic setting are increasing significantly. They are based on the use of qualitative methods which are applied at two separate times: 1) a video recording of the subject's actual activity in an authentic setting and 2) an interview with the subject, supported by the video recording...
April 27, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28448775/exploring-electronic-medical-record-and-self-administered-medication-risk-screening-tools-in-a-primary-care-clinic
#4
Mark J Makowsky, Ken Cor, Tat Wong
BACKGROUND: Electronic medical record (EMR) screening for indicators of medication risk could improve efficiency in identifying primary care clinic patients in need of clinical pharmacist care compared with patient self-reporting. OBJECTIVES: To (a) compare the performance of an EMR medication risk assessment questionnaire (MRAQ) with a self-administered (SA) MRAQ and (b) explore each tool's ability to predict indicators of health behavior, health status, and health care utilization...
May 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28448697/national-trends-in-antidepressant-benzodiazepine-and-other-sedative-hypnotic-treatment-of-older-adults-in-psychiatric-and-primary-care
#5
Donovan T Maust, Frederic C Blow, Ilse R Wiechers, Helen C Kales, Steven C Marcus
OBJECTIVE: To describe how use of antidepressants, benzodiazepines, and other anxiolytic/sedative-hypnotics among older adults (age ≥ 65 years) has changed over time among visits to primary care providers and psychiatrists. METHODS: Data were from the National Ambulatory Medical Care Survey (years 2003-2005 and 2010-2012), a nationally representative cross-section of outpatient physician visits. Analysis focused on visits to primary care providers (n = 14,282) and psychiatrists (n = 1,095) at which an antidepressant, benzodiazepine, or other anxiolytic/sedative-hypnotic was prescribed, which were stratified by demographic and clinical characteristic (including ICD-9-CM diagnosis) and compared across study intervals...
April 2017: Journal of Clinical Psychiatry
https://www.readbyqxmd.com/read/28448689/trends-and-factors-associated-with-insomnia-and-sleep-apnea-in-all-united-states-military-service-members-from-2005-to-2014
#6
John A Caldwell, Joseph J Knapik, Harris R Lieberman
Sleep disorders are a critical issue for the military, as they impact operational readiness, personnel health, wellbeing and health-care costs. The incidence of insomnia and obstructive sleep apnea (OSA) are increasing in the United States civilian population, and rates in military personnel exceed those of civilians. Using a comprehensive database, rates of medical encounters for insomnia and OSA were investigated and their associations with various demographic factors examined in the total US military population [1,381,406 ± 25,123, mean ± standard deviation (SD) personnel per year] from 2005 to 2014...
April 27, 2017: Journal of Sleep Research
https://www.readbyqxmd.com/read/28448303/predictability-of-interruptions-during-medication-administration-with-related-behavioral-management-strategies
#7
Maree Johnson, Gabrielle Weidemann, Rebecca Adams, Elizabeth Manias, Tracy Levett-Jones, Vicki Aguilar, Bronwyn Everett
The aim of this qualitative study was to examine the nature of interruptions during medication administration. Focus groups were conducted with medical/surgical nurses (n = 15), critical care nurses (n = 13), and nurse managers/educators/specialists (n = 6). Most interruptions (78%) were predictable. Nurse-adopted strategies included blocking, engaging, mediating, multitasking, and preventing. Educational content was developed that relates behavioral strategies to respond to predictable and unpredictable interruptions...
April 26, 2017: Journal of Nursing Care Quality
https://www.readbyqxmd.com/read/28447933/acute-decompensated-heart-failure-new-strategies-for-improving-outcomes
#8
Emily Singer Fisher, Boyd Burns
Acute decompensated heart failure is a common emergency department presentation with significant associated morbidity and mortality. Heart failure accounts for more than 1 million hospitalizations annually, with a steadily increasing incidence as our population ages. This issue reviews recent literature regarding appropriate management of emergency department presentations of acute decompensated heart failure, with special attention to newer medication options. Emergency department management and appropriate interventions are discussed, along with critical decision-making points in resuscitation for both hypertensive and hypotensive patients...
May 2017: Emergency Medicine Practice
https://www.readbyqxmd.com/read/28447886/drug-induced-hyperlactatemia
#9
Eike Blohm, Jeffrey Lai, Mark Neavyn
BACKGROUND: Hyperlactatemia is common in critically ill patients and has a variety of etiologies. Medication toxicity remains an uncommon cause that providers often fail to recognize. In this article, we review several medications that cause hyperlactatemia in either therapeutic or supratherapeutic dosing. When known, the incidence, mortality, pathophysiology, and treatment options are discussed. METHODS: We performed a literature search using PUBMED and Google Scholar for English language articles published after 1980 regarding medication induced hyperlactatemia and its management...
April 27, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28447764/sevoflurane-anesthesia-in-pregnant-rats-negatively-affects-nerve-function-in-offspring-potentially-via-inhibition-of-the-wnt-%C3%AE-catenin-pathway
#10
Yiyao Wang, Yu Li, Qunzhi Xing, Xuechan G Han, Xu Dong, Yiping Lu, Mintao Zhou
Due to the rapid development of medical technology used to perform intrauterine procedures during pregnancy, the number of patients receiving fetal surgery under general anesthesia is increasing. The aim of the present study was to determine the effects of anesthetics on the offspring of rats, and to identify the potential mechanisms underlying these effects. On day 14 of pregnancy, Sprague‑Dawley rats were equally divided into the following 3 groups (n=9): Control group (n=3), 3% sevoflurane group (n=3) and 4% sevoflurane group (n=3)...
March 13, 2017: Molecular Medicine Reports
https://www.readbyqxmd.com/read/28447145/-recommendations-for-education-in-ultrasound-in-medical-intensive-care-and-emergency-medicine-position-paper-of-dgiin-degum-and-dgk
#11
G Michels, H Zinke, M Möckel, D Hempel, C Busche, U Janssens, S Kluge, R Riessen, M Buerke, M Kelm, R S von Bardeleben, F Knebel, H-J Busch
Point-of-care ultrasound in acute care medicine is a prerequisite for diagnosis and therapy monitoring of critically ill patients. There is currently no uniform education strategy for medical intensive care and emergency medicine. As part of the basic level, the trainee takes theoretical and clinical training covering abdominal and thoracic ultrasonography and focused cardiovascular ultrasound. In a second step, special knowledge and skills can be acquired at an expert level. This two-stage concept is intended to guarantee quality assurance in ultrasound education in medical intensive care and emergency medicine...
April 26, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28447144/-standardized-collection-of-presenting-complaints-in-the-emergency-room-integration-of-coded-presenting-complaints-into-the-electronic-medical-record-system-of-an-emergency-department-and-their-value-for-health-care-research
#12
F Greiner, D Brammen, M Kulla, F Walcher, B Erdmann
BACKGROUND: The point of entry of a patient in emergency care is a symptom or a complaint. To evaluate subsequent processes in an emergency department until a diagnosis is made, this information has to be taken into account. OBJECTIVES: We report the introduction of coded presenting complaints into the electronic medical record system of an emergency department and describe the patients based on these data. METHODS: The CEDIS presenting complaint list was integrated into the emergency department information system of an emergency department (38,000 patients/year)...
April 26, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28445774/voxresnet-deep-voxelwise-residual-networks-for-brain-segmentation-from-3d-mr-images
#13
REVIEW
Hao Chen, Qi Dou, Lequan Yu, Jing Qin, Pheng-Ann Heng
Segmentation of key brain tissues from 3D medical images is of great significance for brain disease diagnosis, progression assessment and monitoring of neurologic conditions. While manual segmentation is time-consuming, laborious, and subjective, automated segmentation is quite challenging due to the complicated anatomical environment of brain and the large variations of brain tissues. We propose a novel voxelwise residual network (VoxResNet) with a set of effective training schemes to cope with this challenging problem...
April 23, 2017: NeuroImage
https://www.readbyqxmd.com/read/28445653/describing-the-mental-health-profile-of-first-respondersa-systematic-review-formula-see-text
#14
Sara Jones
BACKGROUND: First responders (FRs) are responsible for providing multiple services during various critical events. Considering the frequency, nature, and intensity of duty-related traumatic exposures, the cumulative impact on FRs' mental health is of paramount importance. OBJECTIVES: The purpose of this systematic review was to describe how duty-related trauma exposure can affect the comprehensive mental health profile of FRs, including firefighters, emergency medical technicians, and paramedics...
February 1, 2017: Journal of the American Psychiatric Nurses Association
https://www.readbyqxmd.com/read/28445220/catalyzing-interdisciplinary-research-and-training-initial-outcomes-and-evolution-of-the-affinity-research-collaboratives-model
#15
Katya Ravid, Francesca Seta, David Center, Gloria Waters, David Coleman
Team science has been recognized as critical to solving increasingly complex biomedical problems and advancing discoveries in the prevention, diagnosis, and treatment of human disease. In 2009, the Evans Center for Interdisciplinary Biomedical Research (ECIBR) was established in the Department of Medicine at Boston University School of Medicine as a new organizational paradigm to promote interdisciplinary team science. The ECIBR is made up of affinity research collaboratives (ARCs), consisting of investigators from different departments and disciplines who come together to study biomedical problems that are relevant to human disease and not under interdisciplinary investigation at the university...
April 25, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28445217/why-health-insurance-matters-and-why-research-evidence-should-too
#16
Benjamin D Sommers
In the current debate over the future of the Affordable Care Act (ACA), research evidence on the impact of the law and the effects of health insurance coverage in general is critical. Studies of health insurance expansion over the past decade have demonstrated that coverage expansions can produce significant reductions in mortality-particularly among minorities, those living in poorer areas, and those with chronic conditions potentially treatable with timely medical care. More recent studies of the ACA in particular demonstrate that the law has produced historically large reductions in the uninsured rate, with resulting improvements in access to care, perceived quality of care, and self-reported health...
April 25, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28445214/teaching-the-social-determinants-of-health-a-path-to-equity-or-a-road-to-nowhere
#17
Malika Sharma, Andrew D Pinto, Arno K Kumagai
Medical schools are increasingly called to include social responsibility in their mandates. As such, they are focusing their attention on the social determinants of health (SDOH) as key drivers in the health of the patients and communities they serve. However, underlying this emphasis on SDOH is the assumption that teaching medical students about SDOH will lead future physicians to take action to help achieve health equity. There is little evidence to support this belief. In many ways, the current approach to SDOH within medical education positions the SDOH as "facts to be known" rather than as "conditions to be challenged and changed...
April 25, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28445001/inhibition-properties-of-some-flavonoids-on-carbonic-anhydrase-i-and-ii-isoenzymes-purified-from-human-erythrocytes
#18
Zübeyir Huyut, Şükrü Beydemir, İlhami Gülçin
Carbonic anhydrases (CAs, E.C.4.2.1.1) play a critical role in many important physiological events and treatment of some diseases. Flavonoids or phenolic compounds have been discovered as novel CAs inhibitors instead of the traditional sulfonamides, with different binding to CAs, pro-drug activities, and new inhibition mechanisms. Here, we investigated the inhibition effects of some flavonoids including malvin, callistephin, oenin, pelargonin, silychristin, and 1-(4-methoxyphenyl)-2-methyl-3-nitro-1-H-indol-6-ol (ID-8) against hCA I and II, which purified from human erythrocytes by affinity column chromatography...
April 26, 2017: Journal of Biochemical and Molecular Toxicology
https://www.readbyqxmd.com/read/28444836/ephedra-alkaloid-contents-of-chinese-herbal-formulae-sold-in-taiwan
#19
Chih-Wei Chang, Szu-Yun Hu, Guan-Qian Huang, Mei-Chich Hsu
Consumption of Ephedra alkaloids has been prohibited in-competition by the World Anti-Doping Agency (WADA). In Taiwan, colds are often treated with Chinese herbal formulae containing Herba Ephedrae. We screened the products sold in Taiwan and preliminarily assessed their relationships with WADA threshold violations. Fifty-six concentrated powder products, including 19 Chinese herbal formulae that contained Herba Ephedrae, were collected. The content of Ephedra alkaloids, namely ephedrine (E), methylephedrine (ME), norpseudoephedrine (NPE; cathine), pseudoephedrine (PE), and norephedrine (NE; phenylpropanolamine), was determined using a validated high-performance liquid chromatography method...
April 25, 2017: Drug Testing and Analysis
https://www.readbyqxmd.com/read/28444760/vancomycin-levels-are-frequently-subtherapeutic-in-critically-ill-patients-a-prospective-observational-study
#20
V Bakke, H Sporsem, E Von der Lippe, I Nordøy, Y Lao, H C Nyrerød, L Sandvik, K R Hårvig, J F Bugge, E Helset
BACKGROUND: Appropriate utilization of vancomycin is important to attain therapeutic targets while avoiding clinical failure and the development of antimicrobial resistance. Our aim was to observe the use of vancomycin in an intensive care population, with the main focus on achievement of therapeutic serum concentrations (15-20 mg/l) and to evaluate how this was influenced by dose regimens, use of guidelines and therapeutic drug monitoring. METHODS: A prospective observational study was carried out in the intensive care units at two tertiary hospitals in Norway...
April 25, 2017: Acta Anaesthesiologica Scandinavica
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