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https://www.readbyqxmd.com/read/100001003/emergency-management-of-sepsis-the-simple-stuff-saves-lives
#1
David Sweet, Julian Marsden, Kendall Ho, Christina Krause, James A Russell
Many emergency departments have implemented sepsis protocols since the 2001 publication of results from the early goal-directed therapy trial, which showed early targeted resuscitation lowers mortality. As part of an attempt to improve clinical and operational outcomes for emergency departments across British Columbia, we reviewed sepsis management literature and considered sepsis protocol implementation in the province’s emergency departments. During the literature review we found that many observational studies confirmed an association between implementation of emergency sepsis protocols and decreased mortality...
May 2012: BC medical journal: BCMJ
https://www.readbyqxmd.com/read/27921426/-gestational-diabetes-mellitus
#2
Hana Krejčí
The present generation of women of childbearing age more frequently suffer from overweight, obesity, initial as well as fully established metabolic syndrome, which together with postponing motherhood until the third decade in life plays an important role in the increasing incidence of gestational diabetes (GDM) that currently affects about 1/5 of pregnant women. However the causal link between diabetes during pregnancy and metabolic diseases in the whole population is mutual. By way of epigenetic changes, maternal diabetes unfavourably programmes metabolism of the offspring, who tend to transfer the disorder to the next generations...
2016: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/27921421/-education-of-a-patient-with-diabetes-an-integral-part-of-complex-therapy
#3
Alena Adamíková
Determination of the diagnosis of diabetes mellitus means a radical life change for a patient. Education of a patient with diabetes means the provision of essential information and practical guidance for linkage of the disease with the life style of the patient for the purpose of providing the required control of the disease, to gain the necessary knowledge for self-care management of the disease in collaboration with the education team. Education is a permanent integral part of the complex therapy of diabetes, adaptation to the phases of the disease, targeting not only the patient but immediate family...
2016: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/27921381/cost-analysis-of-the-treatment-of-severe-acute-malnutrition-in-west-africa
#4
Sheila Isanaka, Nicolas A Menzies, Jessica Sayyad, Mudasiru Ayoola, Rebecca F Grais, Stéphane Doyon
We present an updated cost analysis to provide new estimates of the cost of providing community-based treatment for severe acute malnutrition, including expenditure shares for major cost categories. We calculated total and per child costs from a provider perspective. We categorized costs into three main activities (outpatient treatment, inpatient treatment, and management/administration) and four cost categories within each activity (personnel; therapeutic food; medical supplies; and infrastructure and logistical support)...
December 5, 2016: Maternal & Child Nutrition
https://www.readbyqxmd.com/read/27921257/impact-of-community-health-workers-on-use-of-healthcare-services-in-the-united-states-a-systematic-review
#5
Helen E Jack, Sophia D Arabadjis, Lucy Sun, Erin E Sullivan, Russell S Phillips
BACKGROUND: As the US transitions to value-based healthcare, physicians and payers are incentivized to change healthcare delivery to improve quality of care while controlling costs. By assisting with the management of common chronic conditions, community health workers (CHWs) may improve healthcare quality, but physicians and payers who are making choices about care delivery also need to understand their effects on healthcare spending. METHODS: We searched PubMed, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, PsycINFO, Embase, and Web of Science from the inception of each database to 22 June 2015...
December 5, 2016: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/27921251/skin-manifestations-of-insulin-resistance-from-a-biochemical-stance-to-a-clinical-diagnosis-and-management
#6
REVIEW
Gloria González-Saldivar, René Rodríguez-Gutiérrez, Jorge Ocampo-Candiani, José Gerardo González-González, Minerva Gómez-Flores
Worldwide, more than 1.9 billion adults are overweight, and around 600 million people suffer from obesity. Similarly, ~382 million individuals live with diabetes, and 40-50% of the global population is labeled at "high risk" (i.e., prediabetes). The impact of these two chronic conditions relies not only on the burden of illnesses per se (i.e., associated increased morbidity and mortality), but also on their increased cost, burden of treatment, and decreased health-related quality of life. For this review a comprehensive search in several databases including PubMed (MEDLINE), Ovid EMBASE, Web of Science, and Scopus was conducted...
December 5, 2016: Dermatology and Therapy
https://www.readbyqxmd.com/read/27921218/from-problem-solving-to-problem-definition-scrutinizing-the-complex-nature-of-clinical-practice
#7
Sayra Cristancho, Lorelei Lingard, Glenn Regehr
In medical education, we have tended to present problems as being singular, stable, and solvable. Problem solving has, therefore, drawn much of medical education researchers' attention. This focus has been important but it is limited in terms of preparing clinicians to deal with the complexity of the 21st century healthcare system in which they will provide team-based care for patients with complex medical illness. In this paper, we use the Soft Systems Engineering principles to introduce the idea that in complex, team-based situations, problems usually involve divergent views and evolve with multiple solution iterations...
December 5, 2016: Perspectives on Medical Education
https://www.readbyqxmd.com/read/27921127/pre-authorization-processes-have-no-effect-on-patients-undergoing-knee-mri-in-a-pediatric-setting-when-evaluated-by-specialists
#8
Drew Pierce, J Herman Kan, Megan May, George S Bisset
OBJECTIVE: Pre-authorization processes are often used by medical insurance companies to reduce costs by managing the utilization of advanced diagnostic imaging, and their impact on patient care is unclear. The purpose of our study is to determine if a pre-authorization process increases the rate of surgically significant abnormal knee MRI and surgical referrals compared with patients referred from pediatric orthopedic specialists who do not undergo a pre-authorization process. MATERIALS AND METHODS: A retrospective study was performed; 124 patients were identified who were referred for knee MRI by a pediatric orthopedist...
December 5, 2016: Skeletal Radiology
https://www.readbyqxmd.com/read/27921080/echo-and-bnp-serial-assessment-in-ambulatory-heart-failure-care-data-on-loop-diuretic-use-and-renal-function
#9
Frank Lloyd Dini, Anca Simioniuc, Erberto Carluccio, Stefano Ghio, Andrea Rossi, Paolo Biagioli, Gianpaolo Reboldi, Gian Giacomo Galeotti, Fei Lu, Cornelia Zara, Gillian Whalley, Pier Luigi Temporelli
We compared the follow-up data on loop diuretic use and renal function, as assessed by serum creatinine levels, and the estimated glomerular filtration rate (eGFR), of two groups of consecutive ambulatory HF patients: 1) the clinically-guided group, in which management was clinically driven based on the institutional protocol of the HF Unit of the Cardiovascular and Thoracic Department of Pisa (standard of care) and 2) the echo and B-type natriuretic peptide (BNP) guided group (patients conforming to the protocol of the Network Labs Ultrasound (NEBULA) in HF Study Group: Pisa, Perugia, Pavia; Verona, Auckland, and Veruno), in which therapy was delivered according to the serial assessment of BNP and echocardiography...
December 2016: Data in Brief
https://www.readbyqxmd.com/read/27921046/weight-management-in-primary-care
#10
REVIEW
Susanne Maurer
BACKGROUND: Obesity is one of the greatest public health challenges worldwide. It is not only a medical but also a philosophical, ecological, economic, sociocultural, and psychological problem as well as a severe consequence of our modern value definition to 'receive more and more'. Therefore, physicians are not able to treat obesity broadly and should not be used as tools to achieve certain weight goals. METHODS: This article presents an outline of conservative obesity therapy...
October 2016: Visceral Medicine
https://www.readbyqxmd.com/read/27921037/acute-kidney-injury-in-western-countries
#11
REVIEW
Josée Bouchard, Ravindra L Mehta
BACKGROUND: Acute kidney injury (AKI) is frequent and is associated with poor outcomes, including increased mortality, higher risk of chronic kidney disease, and prolonged hospital lengths of stay. The epidemiology of AKI mainly derives from studies performed in Western high-income countries. More limited data are available from Western low-income and middle-income countries (LMICs) located in Central and South America. SUMMARY: In this review, we summarize the most recent data on the epidemiology of AKI in Western countries, aiming to contrast results from industrialized high-income countries with LMICs...
October 2016: Kidney Diseases
https://www.readbyqxmd.com/read/27921036/acute-kidney-injury-in-asia
#12
REVIEW
Li Yang
BACKGROUND: Acute kidney injury (AKI) is a common disorder and is associated with a high morbidity and mortality worldwide. The diversity of the climate and of the socioeconomic and developmental status in Asia has a great influence on the etiology and presentation of AKI in different regions. In view of the International Society of Nephrology's 0by25 initiative, more and more attention has been paid to AKI in Asian countries. SUMMARY: In this review, we summarize the recent achievements with regard to the prevalence and clinical patterns of AKI in Asian countries...
October 2016: Kidney Diseases
https://www.readbyqxmd.com/read/27921017/factors-impacting-mortality-in-the-pre-hospital-period-after-road-traffic-accidents-in-urban-india
#13
Ananthnarayan Chandrasekharan, Aditya J Nanavati, Sandhya Prabhakar, Subramaniam Prabhakar
BACKGROUND: India currently has the dubious distinction of experiencing the highest number of road traffic accidents in the world. OBJECTIVES: We believe that this study on road traffic accidents may help to identify factors in the pre-hospital setting that may influence mortality rates. PATIENTS AND METHODS: A prospective observational study was carried out in a metro area in India over a period of one year. The study included consecutive patients admitted to the trauma service after road traffic accidents...
July 2016: Trauma Monthly
https://www.readbyqxmd.com/read/27921004/a-rare-case-of-gestational-gigantomastia-with-hypercalcemia-the-challenges-of-management-and-follow-up
#14
Bahram Moazzami, Shahla Chaichian, Mohammad Reza Farahvash, Saeedeh Taheri, Seyed Ali Ahmadi, Majid Mokhtari, Kourosh Sheibani
BACKGROUND: Gigantomastia is a breast disorder marked by exaggerated rapid growth of the breasts, generally bilaterally. Since this disorder is very rare and has been reported only in sparse case reports its etiology has yet to be fully established. Treatment is aimed at improving the clinical and psychological symptoms and reducing the treatment side effects; however, the best therapeutic option varies from case to case. CASE PRESENTATION: The present report described a case of gestational gigantomastia in a 30-year-old woman, gravida 2, parity 1, 17 week pregnant admitted to Pars Hospital, Tehran, Iran, on May 2014...
October 2016: Journal of Reproduction & Infertility
https://www.readbyqxmd.com/read/27920974/a-case-report-of-malignant-obesity-hypoventilation-syndrome-a-weighty-problem-in-our-icus
#15
Michael Tatusov, Joshua J Joseph, Brian M Cuneo
INTRODUCTION: The obesity epidemic is reflected by increasing numbers of morbidly obese patients being admitted to intensive care units (ICUs). These are complicated patients whose care involves many diagnostic and treatment challenges. We are presenting a fatal case of super obesity, hypoventilation, and multi-organ failure known as malignant obesity hypoventilation syndrome (MOHS). CASE PRESENTATION: 35 year old African American gentleman with a body mass index (BMI) of 115 kg/m(2) presented to the hospital with respiratory distress...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/27920936/steroid-resistant-tolosa-hunt-syndrome-with-a-de-novo-intracavernous-aneurysm-a-case-report
#16
Hiroshi Takasuna, Rie Sasaki, Makoto Shiraishi, Masatomo Doi, Daisuke Wakui, Hidemichi Ito, Kotaro Oshio, Yuichiro Tanaka
BACKGROUND: We report a case of steroid-resistant Tolosa-Hunt syndrome (THS) with recurrent bilateral painful ophthalmoplegia, accompanied with sphenoid sinusitis, pituitary abscess, and an aneurysm arising from the cavernous portion of the internal carotid artery. CASE DESCRIPTION: A 53-year-old woman suffered severe left painful ophthalmoplegia. A magnetic resonance image (MRI) revealed thickness of the left cavernous sinus (CS). Steroid was administrated under the diagnosis of THS, and the symptom transiently diminished...
2016: Surgical Neurology International
https://www.readbyqxmd.com/read/27920872/anterior-and-posterior-suprasellar-extensions-of-a-symmetrical-trilobed-nonfunctional-giant-pituitary-adenoma-in-the-sagittal-plane-a-case-report-and-review-of-literature
#17
Rushabh M Vakharia, Roman Kremen, Ajit Vakharia, Obed Adarkwah, Gordon Anderson
INTRODUCTION: To the best of our knowledge, the presence of a trilobed nonfunctional giant pituitary adenoma has never been described before in the literature. These tumors present unique diagnostic and therapeutic challenges. Tumors of this etiology can be managed with pharmacologic treatment or aggressive surgical intervention. The following case illustrates an unique visual presentation of a giant pituitary adenoma. CASE PRESENTATION: We report the case of a 40-year-old Hispanic man who presented with new onset seizures...
December 2016: Radiology case reports
https://www.readbyqxmd.com/read/27920753/neuroproteomics-and-systems-biology-approach-to-identify-temporal-biomarker-changes-post-experimental-traumatic-brain-injury-in-rats
#18
Firas H Kobeissy, Joy D Guingab-Cagmat, Zhiqun Zhang, Ahmed Moghieb, Olena Y Glushakova, Stefania Mondello, Angela M Boutté, John Anagli, Richard Rubenstein, Hisham Bahmad, Amy K Wagner, Ronald L Hayes, Kevin K W Wang
Traumatic brain injury (TBI) represents a critical health problem of which diagnosis, management, and treatment remain challenging. TBI is a contributing factor in approximately one-third of all injury-related deaths in the United States. The Centers for Disease Control and Prevention estimate that 1.7 million people suffer a TBI in the United States annually. Efforts continue to focus on elucidating the complex molecular mechanisms underlying TBI pathophysiology and defining sensitive and specific biomarkers that can aid in improving patient management and care...
2016: Frontiers in Neurology
https://www.readbyqxmd.com/read/27920661/endoscopic-removal-of-a-duodenal-perforating-leg-of-glasses-with-dormia-basket
#19
Li Wang, Wei Wen, Jiamiao Huang, Weijie Hu, Renrong Zhou, Xin Li, Xiaojiang Wang
Ingestion of foreign bodies is common in clinical practice. Most ingested foreign bodies will pass through the gastrointestinal (GI) tract without any problems. While GI tract injury due to the ingested foreign body such as a toothpick, a fishbone, a date pit, or a chicken bone, is common, duodenal perforation is rare. In this report, our experience with this rare entity is shared. We present a 38-year-old male patient with GI tract perforation in the bulbus of the duodenum due to a leg of glasses. The patient was admitted to our hospital with severe abdominal pain...
September 2016: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/27920617/chiropractic-identity-a-neurological-professional-and-political-assessment
#20
REVIEW
Anthony L Rosner
OBJECTIVE: The purpose of this article is to propose a focused assessment of the identity of chiropractic and its profession, triangulating multiple viewpoints converging upon various aspects and definitions of neurology, manual medicine, and alternative or mainstream medicine. DISCUSSION: Over 120 years since its inception, chiropractic has struggled to achieve an identity for which its foundations could provide optimal health care. Despite recognition of the benefits of spinal manipulation in various government guidelines, advances in US military and Veterans Administration, and persistently high levels of patient satisfaction, the chiropractic profession remains underrepresented in most discussions of health care delivery...
December 2016: Journal of Chiropractic Humanities
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