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https://www.readbyqxmd.com/read/29352162/a-prolonged-run-in-period-of-standard-subcutaneous-microdialysis-ameliorates-quality-of-interstitial-glucose-signal-in-patients-after-major-cardiac-surgery
#1
Othmar Moser, Julia Münzker, Stefan Korsatko, Christoph Pachler, Karlheinz Smolle, Wolfgang Toller, Thomas Augustin, Johannes Plank, Thomas R Pieber, Julia K Mader, Martin Ellmerer
We evaluated a standard subcutaneous microdialysis technique for glucose monitoring in two critically ill patient populations and tested whether a prolonged run-in period improves the quality of the interstitial glucose signal. 20 surgical patients after major cardiac surgery (APACHE II score: 10.1 ± 3.2) and 10 medical patients with severe sepsis (APACHE II score: 31.1 ± 4.3) were included in this investigation. A microdialysis catheter was inserted in the subcutaneous adipose tissue of the abdominal region...
January 19, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29351496/implementation-of-a-prehospital-protocol-change-for-asthmatic-children
#2
Anriada Nassif, Daniel G Ostermayer, Kim B Hoang, Mary K Claiborne, Elizabeth A Camp, Manish I Shah
BACKGROUND: Respiratory distress due to asthma is a common reason for pediatric emergency medical services (EMS) transports. Timely initiation of asthma treatment, including glucocorticoids, improves hospital outcomes. The impact of EMS-administered glucocorticoids on hospital-based outcomes for pediatric asthma patients is unknown. OBJECTIVE: The objective of this study was to evaluate the effect of an evidence-based pediatric EMS asthma protocol update, inclusive of oral glucocorticoid administration, on time to hospital discharge...
January 19, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29351145/recent-evidence-on-early-mobilization-in-critical-ill-patients
#3
Kristina Fuest, Stefan J Schaller
PURPOSE OF REVIEW: To examine the benefits of early mobilization and summarize the results of most recent clinical studies examining early mobilization in critically ill patients followed by a presentation of recent developments in the field. RECENT FINDINGS: Early mobilization of ICU patients, defined as mobilization within 72 h of ICU admission, is still uncommon. In medical and surgical critically ill patients, mobilization is well tolerated even in intubated patients...
January 17, 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29350776/the-existential-experience-of-everyday-life-with-systemic-lupus-erythematosus
#4
Janni Lisander Larsen, Elisabeth O C Hall, Søren Jacobsen, Regner Birkelund
AIM: To explore, from the perspective of women the nature of basic existential conditions while living with systemic lupus erythematosus. BACKGROUND: Systemic lupus erythematosus has an unpredictable disease course and is documented to cause an existential rearrangement of life. The significance of changes in existential conditions and related experiences are unclear in the context of nursing and women with systemic lupus erythematosus. DESIGN: A qualitative design guided by Van Manen's hermeneutic phenomenological methodology...
January 19, 2018: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/29350672/rebounds-after-discharge-from-the-emergency-department-for-community-acquired-pneumonia-focus-on-the-usefulness-of-severity-scoring-systems
#5
Rodolfo Ferrari, Pierluigi Viale, Paolo Muratori, Fabrizio Giostra, Daniela Agostinelli, Roberto Lazzari, Riccardo Voza, Mario Cavazza
BACKGROUND: Community-acquired pneumonia (CAP) is common cause of hospital admission and leading cause of morbidity and mortality. Severity scoring systems are used to predict risk profile, outcome and mortality, and to help decisions about management strategies. Aim of the work and Methods: To critically analyze pneumonia "rebound" cases, once discharged from the emergency department (ED) and afterwards admitted. We conducted an observational clinical study in the acute setting of a university teaching hospital, prospectively analyzing, in a 1 year period, demographic, medical, clinical and laboratory data, and the outcome...
January 16, 2018: Acta Bio-medica: Atenei Parmensis
https://www.readbyqxmd.com/read/29350371/fundus-first-technique-and-partial-cholecystectomy-for-difficult-laparoscopic-cholecystectomies
#6
İsmail Cem Sormaz, Yiğit Soytaş, Ali Fuat Kaan Gök, İlker Özgür, Levent Avtan
BACKGROUND: This study aims to evaluate the impact of conversion from retrograde dissection to fundus-first technique (FF) or laparoscopic partial cholecystectomy (LPC) on complication rates, operation time, and duration of hospitalization. METHODS: The medical records of 210 consecutive patients who underwent laparoscopic cholecystectomy between January 2010 and December 2014 were retrospectively evaluated. All laparoscopic cholecystectomies were initiated with retrograde dissection (RD)...
January 2018: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/29350223/what-is-career-success-for-academic-hospitalists-a-qualitative-analysis-of-early-career-faculty-perspectives
#7
Ethan Cumbler, Essey Yirdaw, Patrick Kneeland, Read Pierce, Patrick Rendon, Carrie Herzke, Christine D Jones
BACKGROUND: Understanding the concept of career success is critical for hospital medicine groups seeking to create sustainably rewarding faculty positions. Conceptual models of career success describe both extrinsic (compensation and advancement) and intrinsic (career satisfaction and job satisfaction) domains. How hospitalists define career success for themselves is not well understood. In this study, we qualitatively explore perspectives on how early-career clinician-educators define career success...
January 19, 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29349892/-can-the-patient-speak-postcolonialism-and-patient-involvement-in-undergraduate-and-postgraduate-medical-education
#8
Malika Sharma
CONTEXT: Patients are increasingly being engaged in providing feedback and consultation to health care institutions, and in the training of health care professionals. Such involvement has the potential to disrupt traditional doctor-patient power dynamics in significant ways that have not been theorised in the medical literature. Critical theories can help us understand how power flows when patients are engaged in the training of medical students. METHODS: This paper applies postcolonial theory to the involvement of patients in the development and delivery of medical education...
January 19, 2018: Medical Education
https://www.readbyqxmd.com/read/29349804/integrity-situational-judgement-test-for-medical-school-selection-judging-what-to-do-versus-what-not-to-do
#9
Wendy E de Leng, Karen M Stegers-Jager, Marise Ph Born, Axel P N Themmen
CONTEXT: Despite their widespread use in medical school selection, there remains a lack of clarity on exactly what situational judgement tests (SJTs) measure. OBJECTIVES: We aimed to develop an SJT that measures integrity by combining critical incident interviews (inductive approach) with an innovative deductive approach. The deductive approach guided the development of the SJT according to two established theoretical models, of which one was positively related to integrity (honesty-humility [HH]) and one was negatively related to integrity (cognitive distortions [CD])...
January 19, 2018: Medical Education
https://www.readbyqxmd.com/read/29349733/point-of-care-ultrasound-pocus-of-the-upper-airway
#10
REVIEW
Kong Eric You-Ten, Naveed Siddiqui, Wendy H Teoh, Michael S Kristensen
Airway management is a critical skill in the practice of several medical specialities including anesthesia, emergency medicine, and critical care. Over the years mounting evidence has showed an increasing role of ultrasound (US) in airway management. The objective of this narrative review is to provide an overview of the indications for point-of-care ultrasound (POCUS) of the upper airway. The use of US to guide and assist clinical airway management has potential benefits for both provider and patient. Ultrasound can be utilized to determine airway size and predict the appropriate diameter of single-lumen endotracheal tubes (ETTs), double-lumen ETTs, and tracheostomy tubes...
January 18, 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29349711/impact-of-an-embedded-genetic-counselor-on-breast-cancer-treatment
#11
Holly J Pederson, Najaah Hussain, Ryan Noss, Courtney Yanda, Colin O'Rourke, Charis Eng, Stephen R Grobmyer
BACKGROUND: We predicted that embedding a genetic counselor within our breast practice would improve identification of high-risk individuals, timeliness of care, and appropriateness of surgical decision making. The aim of this study is to compare cancer care between 2012 and 2014, prior to embedding a genetic counselor in the breast center and following the intervention, respectively. METHODS: A retrospective review of patients diagnosed with breast cancer in 2012 (n = 471) and 2014 (n = 440) was performed to assess patterns of medical genetics referral, compliance with referral, genetic testing findings, and impact on treatment...
January 18, 2018: Breast Cancer Research and Treatment
https://www.readbyqxmd.com/read/29349528/steps-to-getting-your-manuscript-published-in-a-high-quality-medical-journal
#12
EDITORIAL
Charles M Balch, Kelly M McMasters, V Suzanne Klimberg, Timothy M Pawlik, Mitchell C Posner, Mark Roh, Kenneth K Tanabe, Deborah Whippen, Naruhiko Ikoma
Publication of your research represents the culmination of your scientific activities. The key to getting manuscripts accepted is to make them understandable and informative so that your colleagues will read and benefit from them. We describe key criteria for acceptance of manuscripts and outline a multi-step process for writing the manuscript. The likelihood that a manuscript will be accepted by a major journal is significantly increased if the manuscript is written in polished and fluent scientific English...
January 18, 2018: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/29348284/laryngeal-tuberculosis-a-rare-cause-of-critical-airway-obstruction
#13
Abigail Elizabeth Cole, Daniel Heaton, Ahmed Chekairi
Laryngeal tuberculosis (TB) is a rare condition, occurring in less than 1% of patients infected with pulmonary TB. We present a case of a 57-year-old male patient, who presented in extremis with audible stridor, increased work of breathing and cyanosis. In addition, the patient had a complex medical history, including a recent diagnosis of congenital malformation of the epiglottis. Emergency intervention was required to secure the airway, and after initial attempts at intubation were unsuccessful, an emergency tracheostomy was performed...
January 17, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29348280/marked-cachexia-in-probable-invasive-pulmonary-aspergillosis-with-bronchopleural-fistula
#14
Christiana Page, Laura Blazy, Melanie Jenkins, Rosalba Spiritoso
A 49-year-old man with a medical history of diabetes and heavy smoking was admitted to intensive care with severe bilateral pneumonia associated with marked cachexia. He developed a complex right-sided bronchopleural fistula and was transferred to our tertiary centre for consideration of surgical intervention.Despite escalation of antibiotic therapy, he did not improve and further investigations led to a diagnosis of invasive pulmonary aspergillosis. Definitive treatment plans required a right pneumonectomy; however, given the severity of cachexia, he remained unable to undergo such a large operation...
January 17, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29348163/ifcc-working-group-recommendations-for-assessing-commutability-part-1-general-experimental-design
#15
W Greg Miller, Heinz Schimmel, Robert Rej, Neil Greenberg, Ferruccio Ceriotti, Chris Burns, Jeffrey R Budd, Cas Weykamp, Vincent Delatour, Göran Nilsson, Finlay MacKenzie, Mauro Panteghini, Thomas Keller, Johanna E Camara, Ingrid Zegers, Hubert W Vesper
Commutability is a property of a reference material (RM) that relates to the closeness of agreement between results for an RM and results for clinical samples (CSs) when measured by ≥2 measurement procedures (MPs). Commutability of RMs used in a calibration traceability scheme is an essential property for them to be fit for purpose. Similarly, commutability of trueness controls or external quality assessment samples is essential when those materials are used to assess trueness of results for CSs. This report is part 1 of a 3-part series describing how to assess commutability of RMs...
January 18, 2018: Clinical Chemistry
https://www.readbyqxmd.com/read/29347853/sar-thresholds-for-electromagnetic-exposure-using-functional-thermal-dose-limits
#16
Fatemeh Adibzadeh, Margarethus M Paulides, Gerard C van Rhoon
BACKGROUND AND PURPOSE: To protect against any potential adverse effects to human health from localised exposure to radio frequency (100 kHz-3 GHz) electromagnetic fields (RF EMF), international health organisations have defined basic restrictions on specific absorption rate (SAR) in tissues. These exposure restrictions incorporate safety factors which are generally conservative so that exposures that exceed the basic restrictions are not necessarily harmful. The magnitude of safety margin for various exposure scenarios is unknown...
January 18, 2018: International Journal of Hyperthermia
https://www.readbyqxmd.com/read/29346395/evaluation-of-participatory-teaching-methods-in-undergraduate-medical-students-learning-along-the-first-academic-courses
#17
Beatriz Gal, Margarita Rubio, Eva Iglesias, Purificación González
The European Higher Education Area (EHEA) is an opportunity to redesign medical education. Academic training is now focused on acquiring not only knowledge, but also those competencies critical to face complex professional scenarios. Together with re-evaluating traditional teaching methods, EHEA has forced a technological shift in the way we teach. By critically assessing the impact of novel teaching methodologies, we can better define biomedical education demands. Here, we address this question on a sample of medical students instructed in basic subjects along the first two academic courses...
2018: PloS One
https://www.readbyqxmd.com/read/29346342/attention-deficit-hyperactivity-disorder-medication-prescription-claims-among-privately-insured-women-aged-15-44-years-united-states-2003-2015
#18
Kayla N Anderson, Elizabeth C Ailes, Melissa Danielson, Jennifer N Lind, Sherry L Farr, Cheryl S Broussard, Sarah C Tinker
Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder that affects individuals across the lifespan. ADHD medication use among pregnant women is increasing (1), but consensus about the safety of ADHD medication use during pregnancy is lacking. Given that nearly half of U.S. pregnancies are unintended (2), and early pregnancy is a critical period for fetal development, examining trends in ADHD medication prescriptions among reproductive-aged women is important to quantify the population at risk for potential exposure...
January 19, 2018: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/29346222/-to-err-is-human-but-disclosure-must-be-taught-a-simulation-based-assessment-study
#19
Ashley C Crimmins, Ambrose H Wong, James W Bonz, Alina Tsyrulnik, Karen Jubanyik, James D Dziura, Kelly L Dodge, Leigh V Evans
INTRODUCTION: Although error disclosure is critical in promoting safety and patient-centered care, physicians are inconsistently trained in its practice, and few objective methods to assess competence exist. We used an immersive simulation scenario to determine whether providers with varying levels of clinical experience adhere to the disclosure safe practice guidelines when exposed to a serious adverse event simulation scenario. METHODS: This was a prospective cohort study with medical students, junior emergency medicine (EM) residents (PGY 1-2), senior EM residents (PGY 3-4), and attending EM physicians participating in a simulated case in which a scripted medication overdose resulted in an adverse event...
January 17, 2018: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
https://www.readbyqxmd.com/read/29346142/neonatal-abstinence-syndrome-an-update
#20
Lauren A Sanlorenzo, Ann R Stark, Stephen W Patrick
PURPOSE OF REVIEW: The current review provides an update focused on the evolving epidemiology of neonatal abstinence syndrome (NAS), factors influencing disease expression, advances in clinical assessment of withdrawal, novel approaches to NAS treatment, and the emerging role of quality improvement in assessment and management of NAS. RECENT FINDINGS: The rise in the incidence of NAS disproportionately occurred in rural and suburban areas. Polysubstance exposure and genetic polymorphisms have been shown to modify NAS expression and severity...
January 17, 2018: Current Opinion in Pediatrics
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