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Emergency medications

Valeria Filippou, Charalampos Tsoumpas
PURPOSE: Printing technology, capable of producing three-dimensional (3D) objects, has evolved in recent years and provides potential for developing reproducible and sophisticated physical phantoms. 3D printing technology can help rapidly develop relatively low cost phantoms with appropriate complexities, which are useful in imaging or dosimetry measurements. The need for more realistic phantoms is emerging since imaging systems are now capable of acquiring multimodal and multiparametric data...
June 22, 2018: Medical Physics
Aparna Komarraju, Twyla B Bartel, Lisa A Dickinson, Frederick D Grant, Tracy L Yarbrough
INTRODUCTION: Increasingly, emerging technologies are expanding instructional possibilities, with new methods being adopted to improve knowledge acquisition and retention. Within medical education, many new techniques have been employed in the undergraduate setting, with less utilization thus far in the continuing medical education (CME) sphere. This paper discusses the use of a new method for CME-the "flipped classroom," widely used in undergraduate medical education. This method engages learners by providing content before the live ("in class") session that aids in preparation and fosters in-class engagement...
June 21, 2018: Journal of Continuing Education in the Health Professions
Veerle Foulon, Joke Wuyts, Franciska Desplenter, Anne Spinewine, Valérie Lacour, Dominique Paulus, Jan De Lepeleire
Background and objectives Patients often experience drug-related problems at admission or after discharge from hospital. The objective of this study was to identify the main problems in medication management at transition between settings of care, as experienced by health care professionals (HCPs) and patients. Methods Focus group discussions were organised between December 2009 and February 2010; nine focus groups with primary and secondary care HCPs and patients and two with stakeholders. Focus group discussions were audiotaped and observation files were constructed...
June 22, 2018: Acta Clinica Belgica
Jessica Keim-Malpass, Kyle B Enfield, James Forrest Calland, Douglas E Lake, Matthew T Clark
Predictive analytics monitoring that informs clinicians of the risk for failed extubation would help minimize both the duration of mechanical ventilation and the risk of emergency re-intubation in ICU patients. We hypothesized that dynamic monitoring of cardiorespiratory data, vital signs, and lab test results would add information to standard clinical risk factors. To develop predictive analytic models for patients who failed extubation in critical care settings in an academic medical center using standard and novel risk factors...
June 22, 2018: Physiological Measurement
Orgest Lajthia, Jerry W Chao, Max Mandelbaum, John S Myseros, Chima Oluigbo, Suresh N Magge, Christopher S Zarella, Albert K Oh, Gary F Rogers, Robert F Keating
OBJECTIVE Intracranial empyema is a life-threatening condition associated with a high mortality rate and residual deleterious neurological effects if not diagnosed and managed promptly. The authors present their institutional experience with immediate reimplantation of the craniotomy flap and clarify the success of this method in terms of cranial integrity, risk of recurrent infection, and need for secondary procedures. METHODS A retrospective analysis of patients admitted for management of intracranial empyema during a 19-year period (1997-2016) identified 33 patients who underwent emergency drainage and decompression with a follow-up duration longer than 6 months, 23 of whom received immediate bone replacement...
June 22, 2018: Journal of Neurosurgery. Pediatrics
Matteo Danielis, Martina Chittaro, Amato De Monte, Giulio Trillò, Davide Durì
BACKGROUND: The reporting and analysing of data of out-of-hospital cardiac arrests encourages the quality improvement of the emergency medical services. For this reason, the establishment of a sufficiently large patient database is intended to allow analysis of resuscitation treatments for out-of-hospital cardiac arrests and performances of different emergency medical services. AIMS: The aim of this study was to describe the demographics, characteristics, outcomes and determinant factors of survival for patients who suffered an out-of-hospital cardiac arrest...
June 1, 2018: European Journal of Cardiovascular Nursing
Lorraine Hawick, Jennifer Cleland, Simon Kitto
CONTEXT: Buildings and learning spaces contribute in crucial ways to people's experiences of these spaces. However, this aspect of context has been under-researched in medical education. We addressed this gap in knowledge by using the conceptual notions of space and place as heuristic lenses through which to explore the impact of a new medical school building on student experiences. METHODS: We carried out an exploratory case study to explore the impact of a new medical school building on student experiences...
June 22, 2018: Medical Education
Suzanne G Pitama, Suetonia C Palmer, Tania Huria, Cameron Lacey, Tim Wilkinson
CONTEXT: The effectiveness of cultural competency education in improving health practitioner proficiency and addressing health inequities for minoritised patient groups is uncertain. Identification of institutional factors that shape or constrain development of indigenous health curricula may provide insights into the impact of these factors on the broader cultural competency curricula. METHODS: We undertook a systematic review using actor-network theory to inform our interpretive synthesis of studies that reported indigenous health curricula evaluated within medical, nursing and allied health education...
June 22, 2018: Medical Education
Stefano Manfredini, Carlo Contini
Louse infestation is one of the oldest contagious pestilential diseases of humankind, which has recently re-emerged in several developing countries as well as in homeless individuals and migrants. The present work provides the first phase of an historical excursus of louse remedies based on the classics of pharmaceutical literature, codes, pharmacopoeia and treatises. The second phase involves a literature search, based on the principal medical databases (SciFinder, Pubmed, Google Scholar, ISI-Web of Science and Scopus), to match ancient raw materials and active principles for the treatment of pediculosis and their possible applications, with other current infectious pathologies transmitted by different carriers...
June 1, 2018: Le Infezioni in Medicina
Jessica E Galarraga, William J Frohna, Jesse M Pines
BACKGROUND: In 2014, the state of Maryland moved away from fee-for-service payments and into a global budget revenue (GBR) structure where hospitals have a fixed revenue target, independent of patient volume or services provided. We assess the effects of GBR adoption on emergency department (ED) admission decisions among adult encounters. METHODS: We used hospital medical record and billing data from adult ED encounters from January 1, 2011 through December 31, 2015, with four Maryland (MD) hospitals and two District of Columbia (DC) hospitals within the same health system...
June 22, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Richard Silbert, Alejandro Salcido-Montenegro, Rene Rodriguez-Gutierrez, Abdulrahman Katabi, Rozalina G McCoy
PURPOSE OF REVIEW: Hypoglycemia is the most common and often treatment-limiting serious adverse effect of diabetes therapy. Despite being potentially preventable, hypoglycemia in type 2 diabetes incurs substantial personal and societal burden. We review the epidemiology of hypoglycemia in type 2 diabetes, discuss key risk factors, and introduce potential prevention strategies. RECENT FINDINGS: Reported rates of hypoglycemia in type 2 diabetes vary widely as there is marked heterogeneity in how hypoglycemia is defined, measured, and reported...
June 21, 2018: Current Diabetes Reports
Julie Rotival, Youri Yordanov, Pierre-Clément Thiebaud, Nathalie Pelletier-Fleury, Elsa Jacquet, Erwan Debuc, Dominique Pateron, Diane Naouri
Background: Some studies have demonstrated an association between poor continuity of care, high likelihood of 'inappropriate' use of emergency departments (EDs) and avoidable hospitalization. However, we lack data concerning primary care use after an ED visit. Objective: Identify the determinants of a visit to the general practitioner (GP) after an ED visit. Design: Observational study (single-centre cohort). Setting: One emergency department in Paris, France...
June 21, 2018: Family Practice
Nicole T Lopez, Sean K McCoy, Christine Carroll, Ellen Jones, Joel A Miller
Background: Two studies by Bledsoe et al and Anand et al reported limited efficacy of the Supraglottic Airway Laryngeal Tube (SALT), which is a supraglottic airway (SGA) specifically designed for blind endotracheal intubation. Miller et al reported a 50% success rate using an Eschmann introducer as an adjunct for blind airway exchange via the laryngeal mask airway (LMA) classic. Another study by Ueki et al found that endotracheal tube (ETT) intubation was faster and less damaging to the airway when the Aintree intubating catheter was used in conjunction with a fiberoptic bronchoscope...
June 19, 2018: Military Medicine
Saeed Majidi, Abdolrahman Parna, Majid Zamani, Kourosh Akhbari
Background: Painful diagnostic and therapeutic procedures performed for children are routine actions. Opioids and nonsteroidal anti-inflammatory drugs such as acetaminophens are among medications that can be used for this purpose. This study aimed to compare the onset and duration of action of intrabuccal (IB, submucosal) space and intramuscular (IM) injection of ketamine in pediatrics. Materials and Methods: This clinical trial study was carried out on 126 children of 1-15 years old referred to the emergency room of Al-Zahra and Kashani Hospitals in Isfahan and divided into two 63 populated groups of IM and IB...
2018: Advanced Biomedical Research
Kyawzaw Lin, Aung Naing Lin, Won Jun Park, Pwint Phyu Hlaing, Cesar Ayala-Rodriguez
Splenic infarction is an unusual cause for a patient to present with left upper abdomen pain. A 47-year-old woman presented to the emergency department with left upper abdomen pain. She reported that she stopped taking warfarin two days prior to presentation. A physical examination revealed fine crackles within the left lower lobe and significant tenderness within the left upper abdomen. Computed tomography of the abdomen showed mild cardiomegaly with a 2.3 cm calcified thrombus in the left ventricular apex...
April 19, 2018: Curēus
S E Baldeweg, S Ball, A Brooke, H K Gleeson, M J Levy, M Prentice, J Wass
Cranial diabetes insipidus (CDI) is a treatable chronic condition that can potentially develop into a life-threatening medical emergency. CDI is due to the relative or absolute lack of the posterior pituitary hormone vasopressin (AVP), also known as anti-diuretic hormone. AVP deficiency results in uncontrolled diuresis. Complete deficiency can lead to polyuria exceeding 10 L/24 h. Given a functioning thirst mechanism and free access to water, patients with CDI can normally maintain adequate fluid balance through increased drinking...
July 2018: Endocrine Connections
Filippo Sanfilippo, Alberto Noto, Gaetano J Palumbo, Mariachiara Ippolito, Mariapia Gagliardone, Maria Scarlata, Elena Bignami, Fabio Sangalli, Sergio Cattaneo, Ilaria Blangetti, Sabino Scolletta, Alessandro Locatelli, Luigi Tritapepe, Ferdinando L Lorini, Antonio Arcadipane
OBJECTIVE: There is increasing burnout incidence among medical disciplines, and physicians working in emergency settings seem at higher risk. Cardiac anesthesiology is a stressful anesthesiology subspecialty dealing with high-risk patients. The authors hypothesized a high risk of burnout in cardiac anesthesiologists. DESIGN: National survey conducted on burnout SETTING: Italian cardiac centers. PARTICIPANTS: Cardiac anesthesiologists. INTERVENTIONS: The authors administered via email an anonymous questionnaire divided into 3 parts...
May 16, 2018: Journal of Cardiothoracic and Vascular Anesthesia
Sumathi Sivapalasingam, Mohamed Kamal, Rabih Slim, Romana Hosain, Weiping Shao, Randall Stoltz, Joseph Yen, Laura G Pologe, Yuan Cao, Michael Partridge, Giane Sumner, Leah Lipsich
BACKGROUND: REGN3470-3471-3479 is a co-formulated cocktail of three human monoclonal antibodies targeting three non-overlapping epitopes on Ebola virus. We investigated safety, tolerability, pharmacokinetics, and anti-drug antibodies in healthy adults. METHODS: This randomised, double-blind, placebo-controlled, dose-escalation study was done at a phase 1 unit in the USA. Healthy adults, aged 18-60 years, with a body-mass index of 18·0-30·0 kg/m2 were randomly assigned (3:1) to receive a single intravenous dose of REGN3470-3471-3479 or placebo on day 1 (baseline) in one of the four sequential ascending intravenous dose cohorts (3 mg/kg, 15 mg/kg, 60 mg/kg, and 150 mg/kg)...
June 18, 2018: Lancet Infectious Diseases
Mahnaz Yadollahi, Ali Kashkooe, Monireh Feyzi, Saman Bornapour
PURPOSE: Trauma-related injuries are the leading cause of death worldwide. Some risk factors make traumatic patients susceptible to infection. Furthermore, some mortality risk factors, including length of hospitalization and increasing age, were detected in non-traumatic infected patients. This study aimed to assess mortality risk factors among nosocomial infected traumatic patients in Rajaee trauma center, Shiraz, Iran. METHODS: This prospective cohort study was conducted during a period of 2 years since April 2015 to March 2017 in Rajaee hospital, which is the center of emergency medical services for traumatic injuries in Shiraz, Iran...
May 19, 2018: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
Stephen Erickson, Zachary Nahmias, Ilana S Rosman, Brian S Kim
Chronic pruritus, or itch lasting greater than 6 weeks, is an increasingly common and debilitating medical problem. Recent studies have unveiled previously unrecognized neuroimmune axes whereby inflammatory cytokines act directly on the nervous system to promote itch. Thus, the emergence of newer targeted biologic therapies has generated the possibility of novel treatment strategies for chronic itch disorders. This article reviews the pathophysiology of multiple chronic itch disorders, including atopic dermatitis, chronic idiopathic pruritus, chronic urticaria, and prurigo nodularis...
July 2018: Dermatologic Clinics
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