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Daniel K Ting, Eddy S Lang
Clinical question Should I use apneic oxygenation when intubating patients in the emergency department to increase peri-intubation oxygen saturation and first-pass success? Article chosen Oliveira JE, Silva L, Cabrera D, Barrionuevo P, et al. Effectiveness of apneic oxygenation during intubation: a systematic review and meta-analysis. Ann Emerg Med 2017;70(4):483-94. OBJECTIVE: The purpose of this study was to synthesize and appraise the apneic oxygenation literature for its effect on peri-intubation outcomes...
March 20, 2018: CJEM
Silje B Jørgensen, Nina Handal, Kaja Linn Fjeldsæter, Lars Kåre Kleppe, Torni Myrbakk, Dorthea Hagen Oma, Yngvar Tveten, Mette Walberg, Grethe Ørnevik
BAKGRUNN: I norsk helsevesen gjennomføres omfattende tiltak for å hindre spredning av meticillinresistente Staphylococcus aureus (MRSA). Vi ønsket å undersøke hvor mange smitteoppsporinger som gjøres rundt nyoppdagede MRSA-tilfeller hos pasienter og ansatte i sykehus, og hvor ofte smitteoppsporingene fører til ytterligere funn hos helsepersonell. MATERIALE OG METODE: I denne retrospektive observasjonsstudien bidro smittevernenhetene ved åtte helseforetak i landets fire helseregioner med opplysninger om MRSA-funn hos helsepersonell etter gjennomførte MRSA-smitteoppsporinger...
March 19, 2018: Tidsskrift for Den Norske Lægeforening: Tidsskrift for Praktisk Medicin, Ny Række
Jan Hammer, Didrik Heggdal, Arne Lillelien, Peggy Lilleby, Roar Fosse
BAKGRUNN: Vestre Viken tilbyr basal eksponeringsterapi til døgnpasienter med alvorlige sammensatte psykiske lidelser og lavt funksjonsnivå. I behandlingen kan de som ønsker det få hjelp til å bli medisinfrie. Det sentrale behandlingselementet er eksponering for uønskede indre opplevelser, betegnet som eksistensiell katastrofeangst. Vi undersøkte pasientenes psykososiale fungering etter minst to år etter avsluttet døgnbehandling. MATERIALE OG METODE: Det var tilgjengelige data for 33 av 36 utskrevne pasienter...
March 19, 2018: Tidsskrift for Den Norske Lægeforening: Tidsskrift for Praktisk Medicin, Ny Række
F Willeboordse, F G Schellevis, M C Meulendijk, J G Hugtenburg, P J M Elders
Background Implementation of clinical medication reviews in daily practice is scarcely evaluated. The Opti-Med intervention applied a structured approach with external expert teams (pharmacist and physician) to conduct medication reviews. The intervention was effective with respect to resolving drug related problems, but did not improve quality of life. Objective The objective of this process evaluation was to gain more insight into the implementation fidelity of the intervention. Setting Process evaluation alongside a cluster randomized trial in 22 general practices and 518 patients of 65 years and over...
March 20, 2018: International Journal of Clinical Pharmacy
Bram Verstockt, Marc Ferrante, Séverine Vermeire, Gert Van Assche
The advent of anti-TNF agents has dramatically changed the treatment algorithms for IBD in the last 15 years, but primarily and more importantly secondary loss of response is often observed. Fortunately , new treatment options have been actively explored and some have already entered our clinical practice. In the class of anti-cytokine agents, the anti-IL12/IL23 monoclonal antibodies (mAbs) have entered clinical practice with the anti-p40 mAb ustekinumab in Crohn's disease (CD). Also, more selective anti-IL23 agents (anti-p19) have shown efficacy and are being further developed, in contrast to agents inhibiting IL-17 downstream which have failed in clinical trials despite their clear efficacy in psoriasis (Verstockt et al...
March 19, 2018: Journal of Gastroenterology
A Newman-Tancredi, L Bardin, A Auclair, F Colpaert, R Depoortère, M A Varney
NLX-112 (a.k.a. F13640 or befiradol) possesses marked activity in a variety of animal models of pain and of neuropsychiatric disorders; it exhibits nanomolar affinity, exceptional selectivity and high agonist efficacy at 5-hydroxytryptamine 1A (5-HT1A ) receptors. Although NLX-112 has been shown to activate 5-HT1A postsynaptic heteroreceptors in the prefrontal cortex (PFC), a brain region involved in the control of depressive states, the influence of NLX-112 on spinal cord 5-HT1A receptors (implicated in the control of pain) has not been described...
March 16, 2018: Brain Research
Luis Lassaletta, Isabel Sánchez-Cuadrado, Juan Manuel Espinosa, Ángel Batuecas, Carlos Cenjor, María José Lavilla, Laura Cavallé, Alicia Huarte, Faustino Nuñez, Manuel Manrique, Ángel Ramos, Carlos de Paula, Elisa Gil-Carcedo
Active middle ear implants are surgically implanted prosthesis, which intend to stimulate the ossicular chain or the inner ear fluids through the oval or round windows. These implants may be useful for the treatment of certain patients with sensorineural hearing loss as well as for conductive or mixed hearing loss. This clinical guide attempts to summarize the current knowledge concerning the basic characteristics and indications of the most commonly used middle ear implants, including Vibrant Soundbrige (Med-el, Innsbruck), Carina (Cochlear, Australia), and CodacsTM ...
March 16, 2018: Acta Otorrinolaringológica Española
Dina Hafez, Laurence F McMahon, Linda Balogh, Floyd John Brinley, John Crump, Mark Ealovega, Audrey Fan, Yeong Kwok, Kristen Krieger, Thomas O'Connor, Elisa Ostafin, Heidi Reichert, Jennifer Meddings
OBJECTIVES: To characterize patterns of emergency department (ED) utilization for ambulatory care-sensitive conditions (ACSCs) among patients with established care within a patient-centered medical home. STUDY DESIGN: Retrospective chart review using Michigan Medicine's (formerly University of Michigan Health System) electronic health record. METHODS: Ten general medicine (GM) physicians reviewed 256 ambulatory care-sensitive ED encounters that occurred between January 1, 2014, and December 31, 2014, among patients of a GM medical home...
March 1, 2018: American Journal of Managed Care
Mersedeh TariVerdi, Elise Miller-Hooks, Thomas Kirsch
Mass casualty incidents are a concern in many urban areas. A community's ability to cope with such events depends on the capacities and capabilities of its hospitals for handling a sudden surge in demand of patients with resource-intensive and specialized medical needs. This paper uses a whole-hospital simulation model to replicate medical staff, resources, and space for the purpose of investigating hospital responsiveness to mass casualty incidents. It provides details of probable demand patterns of different mass casualty incident types in terms of patient categories and arrival patterns, and accounts for related transient system behavior over the response period...
March 19, 2018: Disaster Medicine and Public Health Preparedness
Scott A Goldberg, Jeremy Maggin, Michael S Molloy, Olesya Baker, Ritu Sarin, Michael Kelleher, Kevin Mont, Adedeji Fajana, Eric Goralnick
OBJECTIVE: Mass gathering events can substantially impact public safety. Analyzing patient presentation and transport rates at various mass gathering events can help inform staffing models and improve preparedness. METHODS: A retrospective review of all patients seeking medical attention across a variety of event types at a single venue with a capacity of 68,756 from January 2010 through September 2015. RESULTS: We examined 232 events with a total of 8,260,349 attendees generating 8157 medical contacts...
March 19, 2018: Disaster Medicine and Public Health Preparedness
Joan M King, Chetan Tiwari, Armin R Mikler, Martin O'Neill
Ebola is a high consequence infectious disease-a disease with the potential to cause outbreaks, epidemics, or pandemics with deadly possibilities, highly infectious, pathogenic, and virulent. Ebola's first reported cases in the United States in September 2014 led to the development of preparedness capabilities for the mitigation of possible rapid outbreaks, with the Centers for Disease Control and Prevention (CDC) providing guidelines to assist public health officials in infectious disease response planning...
March 19, 2018: Disaster Medicine and Public Health Preparedness
Emmanuel Weyne, Johanna L Hannan, Thomas Gevaert, Yodi Soebadi, Hotaka Matsui, Fabio Castiglione, Koenraad van Renterghem, Dirk De Ridder, Frank Van der Aa, Trinity J Bivalacqua, Maarten Albersen
BACKGROUND: Previously, we found that the neuropeptide galanin was strongly upregulated soon after bilateral cavernous nerve injury (BCNI) and that galanin and its receptors were expressed in nitrergic erectile innervation. Galanin has been observed to exert neuroregenerative effects in dorsal root ganglion neurons, but evidence for these effects in the major pelvic ganglion (MPG) after BCNI is lacking. AIM: To evaluate the neurotropic effects of galanin receptor agonists and antagonists in vitro in nitrergic neurons and MPG and in vivo in rats after BCNI...
March 14, 2018: Journal of Sexual Medicine
Elia Wyverkens, Marieke Dewitte, Ellen Deschepper, Joke Corneillie, Lien Van der Bracht, Dina Van Regenmortel, Kim Van Cleempoel, Noortje De Boose, Petra Prinssen, Guy T'Sjoen
INTRODUCTION: 10 years ago, Meston and Buss (Arch Sex Behav 2007;36:477-507) identified 237 reasons for having sex. Since then, only a few studies have built on the analyses of differences in sexual motivation. AIM: To replicate the YSEX? in a broader sample of women and men of different ages. METHODS: Women and men younger than 18 (n = 141), 18 to 22 (n = 1,039), 22 to 55 (n = 2,804), and at least 55 (n = 667) years old completed an online survey about their reasons for engaging in sex during the past year...
March 14, 2018: Journal of Sexual Medicine
Joceline S Fuchs, Nabeel Shakir, Maxim J McKibben, Shawn Mathur, Sloan Teeple, Jeremy M Scott, Allen F Morey
BACKGROUND: For prolonged ischemic priapism, outcomes after distal shunt are poor, with only 30% success for priapic episodes lasting longer than 48 hours. AIM: To present a novel, glans-sparing approach of corporal decompression through a penoscrotal approach for cases of refractory ischemic priapism (RIP) after failed distal shunt procedures. METHODS: We describe the technique and present our initial experience with penoscrotal decompression (PSD) for treatment of RIP after failed distal shunt...
March 14, 2018: Journal of Sexual Medicine
Eric Chung, Run Wang, David Ralph, Laurence Levine, Gerald Brock
BACKGROUND: Despite published guidelines on Peyronie's disease (PD), there are limited data on actual surgical practice among surgeons. AIM: To evaluate the surgical practice patterns in PD among surgeons from different continents and members of various sexual medicine societies. METHODS: An anonymous survey on various pre-, intra-, and postoperative aspects of PD surgical care was distributed in printed format during International Society of Sexual Medicine meetings and as an online survey to International Society of Sexual Medicine members...
March 14, 2018: Journal of Sexual Medicine
Geoff Hackett, Mike Kirby, Kevan Wylie, Adrian Heald, Nick Ossei-Gerning, David Edwards, Asif Muneer
BACKGROUND: This is an update of the 2008 British Society for Sexual Medicine (BSSM) guidelines. AIM: To provide up-to-date guidance for U.K. (and international) health care professionals managing male sexual dysfunction. METHODS: Source information was obtained from peer-reviewed articles, meetings, and presentations. A search of Embase, MEDLINE, and Cochrane Reviews was performed, covering the search terms "hypogonadism," "eugonadal or hypogonadism or hypogonadal or gonadal," and "low or lower testosterone," starting from 2009 with a cut-off date of September 2017...
March 14, 2018: Journal of Sexual Medicine
Pia Bornefeld-Ettmann, Regina Steil, Klara A Lieberz, Martin Bohus, Sophie Rausch, Julia Herzog, Kathlen Priebe, Thomas Fydrich, Meike Müller-Engelmann
BACKGROUND: Impairments in sexual functioning and sexual satisfaction are very common in women who have experienced childhood sexual abuse (CSA). A growing body of literature suggests a high prevalence of sexual distress in patients with post-traumatic stress disorder (PTSD). However, the influence of sexual trauma exposure per se and the influence of PTSD symptoms on impairments in sexual functioning remain unclear. AIM: The aim of this study was to investigate the influence of sexual trauma exposure and PTSD on sexual functioning and sexual satisfaction by comparing 3 groups of women...
March 14, 2018: Journal of Sexual Medicine
Tae Beom Kim, Young Sup Shim, Sang Min Lee, Eun Suk Son, Jung Woo Shim, Sang Pyo Lee
Post-orgasmic illness syndrome (POIS) is a very rare disease characterized by local allergic symptoms and transient flu-like illness that nearly always occur after masturbation, coitus, or spontaneous ejaculation and last for 2 to 7 days. In a previous case report, 2 patients with POIS received hyposensitization therapy composed of multiple subcutaneous injections of autologous semen that resulted in a gradual decrease of symptoms. However, this procedure requires patients to endure pain and discomfort during frequent subcutaneous injections and preceding masturbations to obtain the autologous semen used for therapy...
March 14, 2018: Sexual Medicine
Thomas W Gaither, Mohannad A Awad, Gregory P Murphy, Ian Metzler, Thomas Sanford, Michael L Eisenberg, Siobhan Sutcliffe, E Charles Osterberg, Benjamin N Breyer
BACKGROUND: Bicycle riding has become an increasingly popular mode of transportation and exercise, especially among women, and previous studies have demonstrated a relationship between cycling and sexual dysfunction, albeit using non-validated questionnaires. AIM: We aimed to explore the relationship between cycling and sexual and urinary dysfunction. METHODS: Cyclists were recruited to complete a survey through Facebook advertisements and outreach to sporting clubs across 5 English-speaking countries...
March 6, 2018: Journal of Sexual Medicine
Emily C Earl-Royal, Elinore J Kaufman, Alexandra L Hanlon, Daniel N Holena, Kristin L Rising, M Kit Delgado
No abstract text is available yet for this article.
March 13, 2018: American Journal of Emergency Medicine
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