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https://www.readbyqxmd.com/read/29145705/review-article-critical-care-airway-management-elearning-modules
#1
REVIEW
Deepak Doshi, Sally McCarthy, Elizabeth Mowatt, Angela Cahill, Bronwyn Peirce, Geoff Hawking, Ruth Osborne, Belinda Hibble, Katharine Ebbs
The Australasian College for Emergency Medicine (ACEM) has recently launched the Critical Care Airway Management eLearning modules to support emergency medicine trainees in developing their airway management skills in the ED. A team of emergency physicians and trainees worked collaboratively to develop the eLearning resources ensuring extensive stakeholder consultation. A comprehensive resource manual was written to provide learners with knowledge that underpins the modules. ACEM provided project coordination as well as administrative and technical team support to the production...
November 16, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29136301/ketamine-for-the-acute-management-of-excited-delirium-and-agitation-in-the-prehospital-setting
#2
Kyle A Weant, Lauren M Linder, Clint A Ross
BACKGROUND: Traditional first-line therapy in the prehospital setting for the acutely agitated patient includes an antipsychotic in combination with a benzodiazepine. Recently, interest has grown regarding the use of ketamine in the prehospital setting as an attempt to overcome the limitations of the traditional medications and provide a more safe and effective therapy. This review provides an overview of the pharmacology of ketamine, evaluates the literature regarding ketamine use for prehospital agitation, and proposes an algorithm that may be used within the prehospital setting...
November 14, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/29124374/complications-and-treatment-strategy-after-breast-augmentation-by-polyacrylamide-hydrogel-injection-summary-of-10-year-clinical-experience
#3
Rui Jin, Xusong Luo, Xiaoke Wang, Jie Ma, Fei Liu, Qun Yang, Jun Yang, Xi Wang
From 1997 to 2006, polyacrylamide hydrogel (PAAG) was approved for use in China as a permanent filler for breast augmentation, and it is estimated that 200,000 women have undergone PAAG injection since then. After injection, complications such as pain, mass, hematoma, asymmetry, migration, infection, and even cancer continue to emerge. Because of the potential toxicity and unstable nature of the material and the nonstandardized injection layers, complications after PAAG injection breast augmentation are often complex and difficult to treat...
November 9, 2017: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/29111613/management-of-shiga-toxin-producing-escherichia-coli-infected-children-a-multi-national-multi-specialty-survey
#4
Stephen B Freedman, Silviu Grisaru, Jianling Xie, Susan Samuel, Andrew Dixon, Amy C Plint, David Schnadower
AIM: Research has highlighted the potential role that hydration status may play in predicting outcomes in Shiga toxin-producing Escherichia coli (STEC)-infected children. Because little is known about the management of STEC-infected children in the pre-haemolytic uremic syndrome phase, we compared paediatric emergency medicine and nephrologist-stated management approaches to STEC-infected children. METHODS: Members of the Pediatric Emergency Research Canada (PERC; n = 228), the Pediatric Emergency Medicine Collaborative Research Committee (PEM CRC; n = 221) and the Canadian Association of Pediatric Nephrologists (CAPN; n = 66) were surveyed...
November 7, 2017: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/29107213/current-and-future-treatment-options-for-pemphigus-is-it-time-to-move-towards-more-effective-treatments
#5
REVIEW
Soheil Tavakolpour
Systemic administration of corticosteroid (CS) remains the standard gold treatment for pemphigus. However, because of several long-term adverse effects, steroid-sparing agents are usually prescribed in combination with CSs. Despite the high number of available studies, the choice of best drugs to treat pemphigus remains controversial. Therapeutic approaches for pemphigus can be divided into traditional treatment and emerging ones. Personalized medicine, which aims to increase the efficacy as well as reduce adverse effects of treatments, could be considered as the future option...
December 2017: International Immunopharmacology
https://www.readbyqxmd.com/read/29098050/training-the-trainers-a-survey-of-simulation-fellowship-graduates
#6
Patrick G Hughes, Jose Cepeda Brito, Rami A Ahmed
Background: Coupled with the expansion of simulation has been the development and growth of medical simulation fellowships. These non-accredited fellowships do not have a standardized curriculum and there are currently no studies investigating the simulation fellowship experience. The purpose of this study was to explore the simulation fellowship experience of graduates throughout North America and how it prepared them for their post-fellowship career. Methods: A web-based survey was developed by Emergency Medicine attending physicians both of whom completed one-year fellowships in medical simulation...
June 2017: Canadian Medical Education Journal
https://www.readbyqxmd.com/read/29095057/high-inpatient-utilization-among-veterans-health-administration-patients-with-substance-use-disorders-and-co-occurring-mental-health-conditions
#7
Janelle M Painter, Carol A Malte, Anna D Rubinsky, Timothy R Campellone, Amanda K Gilmore, John S Baer, Eric J Hawkins
BACKGROUND: Substance-use disorders (SUDs) are common and costly conditions. Understanding high inpatient utilization (HIU) among patients with SUD can inform the development of treatment approaches designed to reduce healthcare expenditures and improve service quality. OBJECTIVES: To examine the prevalence, type, and predictors of HIU among patients with SUD and co-occurring mental health conditions. METHODS: Service utilization and demographic and clinical variables were extracted from a national sample of Veterans Health Administration (VA) patients with SUD-only [n = 148,960 (98...
November 2, 2017: American Journal of Drug and Alcohol Abuse
https://www.readbyqxmd.com/read/29079370/impact-of-an-emergency-medicine-pharmacist-on-initial-antibiotic-prophylaxis-for-open-fractures-in-trauma-patients
#8
Somer Harvey, A Brad Hall, Kayla Wilson
BACKGROUND: Targeted antibiotic treatment reduces the infection risk of open fractures when soft tissue and bone are exposed to the environment. The risk of infection increases with higher degrees of injury. The Gustilo-Anderson system was developed to identify the degree of injury of open fractures and can be utilized to guide initial antibiotic therapy. Few studies have been published evaluating the potential impact of emergency medicine pharmacists in trauma, and currently no study has evaluated a pharmacist's influence on antibiotic selection and timing for open fractures...
October 17, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29071804/contributions-of-academic-emergency-medicine-programs-to-us-healthcare-summary-of-the-aaaem-aacem-benchmarking-data
#9
Martin A Reznek, James J Scheulen, Cathi A Harbertson, Kevin A Kotkowski, Gabor D Kelen, Gregory A Volturo
OBJECTIVES: The societal contribution of emergency care in the United States has been described. The role and impact of academic emergency departments (EDs) has been less clear. Our report summarizes the results of a benchmarking effort specifically focused on academic emergency medicine (EM) practices. METHODS: From October through December of 2016, the Academy of Academic Administrators of Emergency Medicine (AAAEM) and the Association of Academic Chairs of Emergency Medicine (AACEM) jointly administered a benchmarking survey to allopathic, academic departments and divisions of emergency medicine...
October 26, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29071767/communicating-value-in-simulation-cost-benefit-analysis-and-return-on-investment
#10
Carl V Asche, Minchul Kim, Alisha Brown, Antoinette Golden, Torrey A Laack, Javier Rosario, Christopher Strother, Vicken Y Totten, Yasuharu Okuda
Value-based health care requires a balancing of medical outcomes with economic value. Administrators need to understand both the clinical and economic effects of potentially expensive simulation programs to rationalize the costs. Given the often-disparate priorities of clinical educators relative to health care administrators, justifying the value of simulation requires the use of economic analyses few physicians have been trained to conduct. Clinical educators need to be able to present thorough economic analyses demonstrating returns on investment and cost effectiveness to effectively communicate with administrators...
October 26, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29069119/do-combined-pharmacist-and-prescriber-efforts-on-medication-reconciliation-reduce-postdischarge-patient-emergency-department-visits-and-hospital-readmissions
#11
Michelle Baker, Chaim M Bell, Wei Xiong, Edward Etchells, Peter G Rossos, Kaveh G Shojania, Kelly Lane, Tim Tripp, Mary Lam, Kimindra Tiwana, Derek Leong, Gary Wong, Jin-Hyeun Huh Huh, Emily Musing, Olavo Fernandes
BACKGROUND: Although medication reconciliation (Med Rec) has demonstrated a reduction in potential adverse drug events, its effect on hospital readmissions remains inconclusive. OBJECTIVE: To evaluate the impact of an interprofessional Med Rec bundle from admission to discharge on patient emergency department visits and hospital readmissions (hospital visits). METHODS: The design was a retrospective, cohort study. Patients discharged from general internal medicine over a 57-month interval were identified through administrative databases...
October 4, 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29068247/australian-elapid-snake-envenomation-in-cats-clinical-priorities-and-approach
#12
Trudi J Mcalees, Linda A Abraham
Practical relevance: No fewer than 140 species of terrestrial snakes reside in Australia, 92 of which possess venom glands. With the exception of the brown tree snake, the venom-producing snakes belong to the family Elapidae. The venom of a number of elapid species is more toxic than that of the Indian cobra and eastern diamondback rattle snake, which has earned Australia its reputation for being home to the world's most venomous snakes. Clinical challenges: The diagnosis of elapid snake envenomation is not always easy...
November 2017: Journal of Feline Medicine and Surgery
https://www.readbyqxmd.com/read/29067138/does-ear-acupuncture-have-a-role-for-pain-relief-in-the-emergency-setting-a-systematic-review-and-meta-analysis
#13
REVIEW
Andrew L Jan, Emogene S Aldridge, Ian R Rogers, Eric J Visser, Max K Bulsara, Richard C Niemtzow
Objective: Ear acupuncture might be the form of acupuncture best suited to improving acute pain management in the emergency department (ED). The primary aim of this review was to assess the analgesic efficacy of ear acupuncture in the ED. Secondary outcomes included measures of patient satisfaction, adverse effects, cost, administration techniques, and reduction of medication usage. Methods: Seven databases and Google Scholar were searched up to April 27, 2017, using MeSH descriptors for three overarching themes (ear acupuncture, pain management, and emergency medicine)...
October 1, 2017: Medical Acupuncture
https://www.readbyqxmd.com/read/29065277/regulatory-issues-with-multiplicity-in-drug-approval-principles-and-controversies-in-a-changing-landscape
#14
Norbert Benda, Andreas Brandt
Recently, new draft guidelines on multiplicity issues in clinical trials have been issued by European Medicine Agency (EMA) and Food and Drug Administration (FDA), respectively. Multiplicity is an issue in clinical trials, if the probability of a false-positive decision is increased by insufficiently accounting for testing multiple hypotheses. We outline the regulatory principles related to multiplicity issues in confirmatory clinical trials intended to support a marketing authorization application in the EU, describe the reasons for an increasing complexity regarding multiple hypotheses testing and discuss the specific multiplicity issues emerging within the regulatory context and being relevant for drug approval...
October 24, 2017: Journal of Biopharmaceutical Statistics
https://www.readbyqxmd.com/read/29064937/a-history-of-us-army-pas
#15
Robyn L Chalupa, W Sanders Marble
The US military has a long tradition of using physician assistants (PAs). The Army began using PAs in 1971 in an effort to supplement the physicians and surgeons in the medical corps. As their numbers grew, PAs gradually replaced general medical officers assigned to battalions. Later, specialty positions developed in aviation medicine, orthopedics, and emergency medicine. The need for a PA serving as an adviser in the major commands slowly developed at all levels of leadership. In 2015, the Army removed limitations on female PAs assigned to combat units...
November 2017: JAAPA: Official Journal of the American Academy of Physician Assistants
https://www.readbyqxmd.com/read/29050491/some-antidiabetic-medicinal-plants-used-by-traditional-healers-in-ado-ekiti-nigeria
#16
F C Akharaiyi, A J Akinyemi, C C Isitua, O T Ogunmefun, S O Opakunle, J K Fasae
OBJECTIVES: The work described plants collection, preparation and administration for diabetes cure in Ado Ekiti in Nigeria. METHODS: Twenty three plant samples were identified for the use in the treatment of diabetes by the herbalists. The plants that are common among the healers are Anthocleista djalonensis, Vernonia amygdalina, Ocimum gratissimum, Momordica charantia. RESULTS: The most preferred method of preparation by the healers is concoction and decoction of fresh leaves, stem bark and roots...
2017: Bratislavské Lekárske Listy
https://www.readbyqxmd.com/read/29025019/differing-molecular-response-of-young-and-advanced-maternal-age-human-oocytes-to-ivm
#17
J M Reyes, E Silva, J L Chitwood, W B Schoolcraft, R L Krisher, P J Ross
STUDY QUESTION: What effect does maternal age have on the human oocyte's molecular response to in vitro oocyte maturation? SUMMARY ANSWER: Although polyadenylated transcript abundance is similar between young and advanced maternal age (AMA) germinal vesicle (GV) oocytes, metaphase II (MII) oocytes exhibit a divergent transcriptome resulting from a differential response to in vitro oocyte maturation. WHAT IS KNOWN ALREADY: Microarray studies considering maternal age or maturation stage have shown that either of these factors will affect oocyte polyadenylated transcript abundance in human oocytes...
November 1, 2017: Human Reproduction
https://www.readbyqxmd.com/read/29016795/leonurine-exerts-antidepressant-like-effects-in-the-chronic-mild-stress-induced-depression-model-in-mice-by-inhibiting-neuroinflammation
#18
Miaomiao Jia, Chenxin Li, Ying Zheng, Xiaojing Ding, Meng Chen, Jianhua Ding, Renhong Du, Ming Lu, Gang Hu
Background: Leonurine is an active alkaloid that is extracted from Traditional Chinese Medicine Herba leonuri. Emerging evidence indicates that leonurine produces neuroprotective effects in ischemic stroke, Parkinson's disease, and Alzheimer's disease. However, the effect of leonurine in neuropsychiatric disorders, especially in major depression, remains unknown. Methods: We used the chronic mild stress mouse model to explore the antidepressant effects of leonurine and the potential mechanisms...
November 1, 2017: International Journal of Neuropsychopharmacology
https://www.readbyqxmd.com/read/28987435/acute-limb-ischemia-an-emergency-medicine-approach
#19
REVIEW
Jamie R Santistevan
Acute limb ischemia is a medical emergency with significant morbidity and mortality. Rapid diagnosis is required because it is a time-sensitive condition. Timely treatment is necessary to restore blood flow to the extremity and prevent complications. The differential diagnosis of acute limb ischemia is broad. Classification of severity of acute limb ischemia is based on clinical variables. A suspicion of acute ischemia based on history and physical examination warrants heparin administration and vascular surgery consultation...
November 2017: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/28967529/intranasal-fentanyl-and-quality-of-pediatric-acute-care
#20
Kathleen M Adelgais, Alison Brent, Joseph Wathen, Suhong Tong, Derrek Massanari, Sara Deakyne, Marion R Sills
BACKGROUND: Changes in the manner in which medications can be delivered can have significant effects on the quality of care in the acute care setting. OBJECTIVE: The objective of this study was to evaluate the change in three Institute of Medicine quality indicators (timeliness, safety, and effectiveness) in the pediatric emergency department (ED) after the introduction of the Mucosal Atomizer Device Nasal™ (MADn) for opioid analgesia. METHODS: This was a retrospective review of patients receiving opioid analgesia for certain conditions over a 5-year period...
November 2017: Journal of Emergency Medicine
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