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https://www.readbyqxmd.com/read/29236303/impact-of-antimicrobial-stewardship-program-on-hospitalized-patients-at-the-intensive-care-unit-a-prospective-audit-and-feedback-study
#1
Maher R Khdour, Hussein O Hallak, Mamoon Al-Deyab, Mowafq A Nasif, Aliaa M Khalili, Ahamad A Dallashi, Mohammad B Khofash, Michael G Scott
AIMS: Inappropriate use of antibiotics is one of the most important factors contributing to the emergence of drug resistant pathogens. The purpose of this study was to measure the clinical impact of Antimicrobial Stewardship Program (ASP) interventions on hospitalized patients at the Intensive care unit at Palestinian Medical Complex. METHODS: A prospective audit with intervention and feedback by ASP team within 48-72h of antibiotic administration began in Sep, 2015...
December 13, 2017: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29236288/disaster-preparedness-biological-threats-and-treatment-options
#2
Navaneeth Narayanan, Clifton R Lacy, Joseph E Cruz, Meghan Nahass, Jonathan Karp, Joseph A Barone, Evelyn Hermes-DeSantis
Biological disasters can be natural, accidental, or intentional. Biological threats have made a lasting impact on civilization. This review will focus on agents of clinical significance, bioterrorism, and national security; specifically Category A agents (anthrax, botulism, plague, tularemia, and smallpox), as well as briefly discuss other naturally-emerging infections of public health significance including Ebola virus (also a Category A agent) and Zika virus. The role of the pharmacist in disaster preparedness and disaster response is multifaceted and important...
December 13, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/29236273/prognosticating-hearing-outcome-in-patients-with-idiopathic-sudden-sensorineural-hearing-loss-by-means-of-otoacoustic-emissions-and-auditory-brainstem-response
#3
Masoud Motasaddi Zarandy, Mohammad Taghi Ashtiani, Shahin Bastaninejad, Sasan Dabiri Satri, Sevil Nasirmohtaram, Nourullah Agha Ebrahimi
This is an analytic-descriptive study, parallel with a randomized, controlled trial performed at Amir'Alam Hospital, a tertiary referral center, with the aim of evaluating the correlation between otoacoustic emission (OAE) and auditory brainstem response (ABR) findings with hearing outcome after treatment of idiopathic sudden sensorineural hearing loss (SSNHL). Sixty patients with idiopathic SSNHL who presented to the emergency services and otology clinics between 2012 and 2014, and whose symptoms had begun <10 days previously, enrolled in this study...
December 2017: Ear, Nose, & Throat Journal
https://www.readbyqxmd.com/read/29235739/assistance-of-medical-clowns-improves-the-physical-examinations-of-children-aged-2-6-years
#4
Noam Meiri, Amichi Ankri, Faten Ziadan, Itay Nahmias, Muriel Konopnicki, Zeev Schnapp, Omer Itzhak Sagi, Mohamad Hamad Saied, Giora Pillar
BACKGROUND: A good physical exam is necessary to help pediatricians make the correct diagnosis and can save unnecessary imaging or invasive procedures. Distraction by medical clowns may create the optimal conditions for a proper physical examination. METHODS: Children aged 2-6 years who required physical examination in the pediatric emergency department were recruited and randomly assigned to one of two groups: physical exam by a pediatrician in the presence of caregivers vs...
December 2017: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/29235734/comparison-of-the-long-term-oncological-outcomes-of-stent-as-a-bridge-to-surgery-and-surgery-alone-in-malignant-colonic-obstruction
#5
Udit Gibor, Zvi Perry, Dan Tirosh, Uri Netz, Alex Rosental, Alex Fich, Sofie Man, Samuel Ariad, Boris Kirshtein
BACKGROUND: Self-expanding metallic stents (SEMS) insertion is an alternative to emergency surgery in malignant colonic obstruction. However, the long-term oncological outcome of stents as a bridge to surgery is limited and controversial. OBJECTIVES: To determine the long-term oncological outcome of stents as a bridge to surgery. METHODS: Data of patients who underwent emergency surgery and endoscopic stent insertion as a bridge to surgery due to obstructing colon cancer at Soroka Medical Center during a 14 year period were collected retrospectively...
December 2017: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/29235658/baseline-characteristics-and-outcomes-of-older-adults-seeking-care-in-ambulatory-urgent-care-clinics
#6
Bernardo J Reyes, Javier M Lopez, Diana J Galindo, Maria Briceno, Joseph G Ouslander
OBJECTIVES: To determine the most common clinical conditions associated with older adults visiting Urgent care centers (UCCs) and the potential need for further resource use. DESIGN: Cross-sectional retrospective study. SETTING: Nonprofit academic medical center with campuses and multiple satellite offices in Ohio and Florida. PARTICIPANTS: Individuals aged 55 and older who visited UCCs between August 2014 and March 2015 (N = 9,445; average age 63...
December 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29235579/the-presence-of-gasping-predicts-long-term-survival-in-out-of-hospital-cardiac-arrest-patients
#7
Jiri Knor, Roman Skulec, Dominika Seblova, Malek Jiri
BACKGROUND: The presence of gasping in out-of-hospital cardiac arrest (OHCA) patients predicts short-term prognosis. We performed a retrospective study to evaluate whether the presence of gasping at the time of Emergency Medical Service (EMS) arrival in the case OHCA patients of presumed cardian origin has any impact on six-month survival and/or sustained return of spontaneous circulation (ROSC). METHODS: We collected and analyzed Utstein Style data for all patients resuscitated for OHCA of presumed cardiac origin by the EMS of the Central Bohemian Region from July 1st, 2013 to June 30th, 2014...
December 13, 2017: Biomedical Papers of the Medical Faculty of the University Palacký, Olomouc, Czechoslovakia
https://www.readbyqxmd.com/read/29235549/treatment-for-unresectable-or-metastatic-oesophageal-cancer-current-evidence-and-trends
#8
REVIEW
Peter S N van Rossum, Nadia Haj Mohammad, Frank P Vleggaar, Richard van Hillegersberg
Approximately half of the patients diagnosed with oesophageal cancer present with unresectable or metastatic disease. Treatment for these patients aims to control dysphagia and other cancer-related symptoms, improve quality of life and prolong survival. In the past 25 years, modestly improved outcomes have been achieved in the treatment of patients with inoperable non-metastatic cancer who are medically not fit for surgery or have unresectable, locally advanced disease. Concurrent chemoradiotherapy offers the best outcomes in these patients...
December 13, 2017: Nature Reviews. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29235437/impact-of-a-in-situ-laboratory-on-physician-expectancy
#9
Romain Brulé, Marianne Sarazin, Nicole Tayeb, Martine Roubille, Anton Szymanowicz
Biological examinations are essential for clinicians' medical care. The aim of this study is to assess clinicians' expectations in healthcare facilities and their perception of medical biology in different types of organization. We performed a prospective transversal study by electronic questionnaire conducted among 242 practitioners in four healthcare facilities. The aspects explored were as follows: quality, reliability, rendering time of examination results and biology platform support. Analyses were conducted after rectification of the sample by weight...
December 13, 2017: Annales de Biologie Clinique
https://www.readbyqxmd.com/read/29235417/south-south-cross-border-patient-travel-to-south-africa
#10
Abel Chikanda, Jonathan Crush
This paper explores intra-regional South-South cross-border patient travel within the context of Southern Africa. South Africa, in particular, has been widely touted as one of the emerging destinations of high-end patients from the Global North alongside other destinations such as Brazil, India, Costa Rica and Thailand. Using South Africa as a case study, the paper demonstrates that South-South cross-border patient travel is far more significant than North-South patient travel both in numerical and financial terms...
December 13, 2017: Global Public Health
https://www.readbyqxmd.com/read/29234822/-acute-vestibular-syndrome-clinical-examination-outperforms-mri-in-the-detection-of-central-lesions
#11
REVIEW
F Thömke
A significant number of patients who seek medical treatment in an emergency department because of vertigo or dizziness, suffer from acute vestibular syndrome. This is characterized by sustained vertigo, horizontal or horizontal rotatory jerk nystagmus, and unsteady stance and gait. In the acute situation it is crucial to differentiate patients with a peripheral vestibular disorder from those with a central disease. A number of recent studies have shown that a structured clinical examination enables a reliable differential diagnosis of central or peripheral disorders...
December 12, 2017: Der Nervenarzt
https://www.readbyqxmd.com/read/29234614/delayed-iatrogenic-diaphragmatic-hernia-after-left-lower-lobectomy
#12
Tae Hee Hong, Yong Soo Choi
A 66-year-old patient undergoing regular follow-up at Samsung Medical Center after left lower lobectomy visited the emergency department around 9 months postoperatively because of nausea and vomiting after routine esophagogastroduodenoscopy at a local clinic. Abdominal computed tomography showed the stomach herniating into the left thoracic cavity. We explored the pleural cavity via video-assisted thoracic surgery (VATS). Adhesiolysis around the herniated stomach and laparotomic reduction under video assistance were successfully performed...
December 2017: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29234603/a-retrospective-study-of-clinico-epidemiological-profile-of-snakebite-related-deaths-at-a-tertiary-care-hospital-in-midnapore-west-bengal-india
#13
Rituparna Ghosh, Koushik Mana, Kripasindhu Gantait, Sumana Sarkhel
Objective: Snakebite is one of the neglected tropical diseases that World Health Organization (WHO) aimed to eradicate. The objective of the study is to investigate the mortality and morbidity due to snakebite at Midnapore Medical College & Hospital in Paschim Medinipur district, West Bengal, India. Methods & materials: This is a record-based, retrospective, descriptive epidemiological study conducted from January 2012 to December 2016 at Midnapore Medical College and Hospital(MMCH), Paschim Medinipur district, West Bengal...
2018: Toxicology Reports
https://www.readbyqxmd.com/read/29234547/testicular-cancer-presenting-as-gastric-variceal-hemorrhage
#14
Carlos Eduardo Salazar-Mejía, David Hernández-Barajas, Edio Llerena-Hernández, José Luis González-Vela, María Inés Contreras-Salcido, Adriana González-Gutiérrez, Omar David Borjas-Almaguer, Luis Alberto Pérez-Arredondo, Blanca Otilia Wimer-Castillo
Testicular cancer is the most common solid malignancy affecting males between the ages of 15 and 35. The symptomatology caused by this tumor varies according to the site of metastasis. We present the case of a 26-year-old male who arrived to the emergency department with hematemesis. He had no previous medical history. On arrival, we noted enlargement of the left scrotal sac. There was also a mass in the left scrotum which provoked displacement of the penis and right testis. The serum alpha-fetoprotein level was 17,090 ng/mL, lactate dehydrogenase was 1480 U/L, and human chorionic gonadotropin was 287...
2017: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/29234482/roads-to-health-in-developing-countries-understanding-the-intersection-of-culture-and-healing
#15
REVIEW
S Ibeneme, G Eni, A Ezuma, G Fortwengel
Background: The most important attribute to which all human beings aspire is good health because it enables us to undertake different forms of activities of daily living. The emergence of scientific knowledge in Western societies has enabled scientists to explore and define several parameters of health by drawing boundaries around factors that are known to influence the attainment of good health. For example, the World Health Organization defined health by taking physical and psychological factors into consideration...
2017: Current Therapeutic Research, Clinical and Experimental
https://www.readbyqxmd.com/read/29234481/in-defense-of-pharmaceutically-enhancing-human-morality
#16
Evangelos D Protopapadakis
Purpose: I will discuss the prospect of pharmaceutically enhancing human morality and decision making in such a way as to eliminate morally unjustifiable choices and promote desirable ones. Background: Our species in the relatively short period since it has emerged has enormously advanced in knowledge, science, and technical progress. When it comes to moral development, the distance it has covered is almost negligible. What if we could medically accelerate our moral development? What if we could once and for all render our species totally immune to certain vices? Methodology: I will examine whether pharmaceutically intervening in human morality would compromise the autonomy of moral agents...
2017: Current Therapeutic Research, Clinical and Experimental
https://www.readbyqxmd.com/read/29233853/variation-in-pediatric-procedural-sedations-across-children-s-hospital-emergency-departments
#17
Andrew F Miller, Michael C Monuteaux, Florence T Bourgeois, Eric W Fleegler
OBJECTIVES: Describe the trends in pediatric sedation use over time and determine variation in use of procedural sedation across children's hospital emergency departments (EDs). METHODS: We analyzed ED data from 35 hospitals within the Pediatric Health Information System for patients <19 years old who received sedation medications and were discharged from 2009 to 2014. Patients with chronic comorbidities or undergoing intubation were excluded. We determined frequency and trends in use of sedation and compared these between EDs...
December 12, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/29233583/diagnostic-approach-to-the-acute-abdomen
#18
REVIEW
Gilles Fecteau, André Desrochers, David Francoz, Sylvain Nichols
The acute abdomen is a term used to characterize an animal presented as an emergency, in a more or less severe critical state, and for which medical and possibly surgical treatment will be necessary. To succeed, the clinician should use a systematic approach, have an excellent knowledge of the bovine abdominal anatomy, and have a good understanding of the pathophysiology of abdominal pain. Good clinical judgment, critical analysis, and good client communication skills are also essential. This article presents and discusses those necessary skills in the context of field practice...
December 9, 2017: Veterinary Clinics of North America. Food Animal Practice
https://www.readbyqxmd.com/read/29233397/assessment-of-student-pharmacists-ethical-decision-making
#19
Jaclyn R Myers, Mary E Kiersma, Kimberly S Plake
INTRODUCTION: In previous research, investigators have expressed concern about the ethical ambivalence of pharmacists in decision-making. The objectives of this study were to examine student pharmacists': 1) attitudes and responses regarding specific common ethical situations and 2) perceived level of difficulty in making ethical decisions. METHODS: A self-administered 38-item survey was given to second and third year student pharmacists at Purdue University. The survey comprised five sections, including: 1) attitudes towards common ethical situations, 2) responses to specific ethical scenarios, 3) emergency lending, 4) perceived level of difficulty in resolving ethical dilemmas, and 5) demographics...
November 2017: Currents in Pharmacy Teaching & Learning
https://www.readbyqxmd.com/read/29233228/disease-and-non-battle-traumatic-injuries-evaluated-by-emergency-physicians-in-a-us-tertiary-combat-hospital
#20
Col S Vikhyat S Bebarta, Alejandra G Mora, Capt Patrick C Ng, Phillip E Mason, Andrew Muck, Maj Joseph K Maddry
Introduction Analysis of injuries during military operations has focused on those related to combat. Non-combat complaints have received less attention, despite the need for many troops to be evacuated for non-battle illnesses in Iraq. This study aims to further characterize the disease and non-battle injuries (DNBIs) seen at a tertiary combat hospital and to describe the types of procedures and medications used in the management of these cases. METHODS: In this observational study, patients were enrolled from a convenience sample with non-combat-related diseases and injuries who were evaluated in the emergency department (ED) of a US military tertiary hospital in Iraq from 2007-2008...
December 13, 2017: Prehospital and Disaster Medicine
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