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https://www.readbyqxmd.com/read/27876328/best-clinical-practice-controversies-in-transient-ischemic-attack-evaluation-and-disposition-in-the-emergency-department
#1
Brit Long, Alex Koyfman
BACKGROUND: Transient ischemic attack (TIA) affects over 200,000 patients annually in the United States, and it precedes approximately 14% to 23% of strokes. Patients are typically admitted for evaluation and management. OBJECTIVE: This review investigates the controversies of emergency department (ED) evaluation of TIA, including imaging, clinical risk scores, rapid diagnostic protocols, and disposition. DISCUSSION: TIA is a common condition, with over 200,000 patients affected annually, and is associated with risk of stroke...
November 19, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27859987/evolution-of-the-model-of-the-clinical-practice-of-emergency-medicine-1979-to-present
#2
Francis L Counselman, Michael S Beeson, Catherine A Marco, Susan K Adsit, Anne L Harvey, Julia N Keehbauch
The Model of the Clinical Practice of Emergency Medicine (The EM Model) is a three dimensional representation of the clinical practice of Emergency Medicine. It is a product of successful collaboration involving the American Board of Emergency Medicine (ABEM), the American College of Emergency Physicians (ACEP), the Society for Academic Emergency Medicine (SAEM), the Emergency Medicine Residents' Association (EMRA), the Council of Emergency Medicine Residency Directors (CORD), the Residency Review Committee for Emergency Medicine (RRC-EM) and the American Academy of Emergency Medicine (AAEM)...
November 17, 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/27823938/are-triage-questions-sufficient-to-assign-fall-risk-precautions-in-the-ed
#3
Lauren T Southerland, Lauren Slattery, Joseph A Rosenthal, Deborah Kegelmeyer, Anne Kloos
OBJECTIVES: The American College of Emergency Physicians Geriatric Emergency Department (ED) Guidelines and the Center for Disease Control recommend that older adults be assessed for risk of falls. The standard ED assessment is a verbal query of fall risk factors, which may be inadequate. We hypothesized that the addition of a functional balance test endorsed by the Center for Disease Control Stop Elderly Accidents, Deaths, and Injuries Falls Prevention Guidelines, the 4-Stage Balance Test (4SBT), would improve the detection of patients at risk for falls...
October 17, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27792074/recognition-of-asymptomatic-hypertension-in-an-urban-emergency-department-where-are-we-now
#4
Kimberly Souffront, Christina Gestal, Gail DʼEramo Melkus, Lynne Richardson
Persistently elevated blood pressure ([BP]; hypertension [HTN]) occurs at higher rates in the emergency department ([ED]; 44%) than in the general population (27%) and disproportionately affects black patients and older adults. The American College of Emergency Physicians recommends referral to primary care for HTN confirmation and management when patients are asymptomatic and their BP is persistently elevated (). However, adherence to this clinical policy is suboptimal. The purpose of this study was to examine the prevalence of asymptomatic HTN, rates of BP reassessment and referral, and factors associated with it among adult patients who visit the ED and who were discharged a decade after this policy was disseminated...
October 2016: Advanced Emergency Nursing Journal
https://www.readbyqxmd.com/read/27726163/efficacy-and-safety-of-ixekizumab-treatment-for-japanese-patients-with-moderate-to-severe-plaque-psoriasis-erythrodermic-psoriasis-and-generalized-pustular-psoriasis-results-from-a-52-week-open-label-phase-3-study-uncover-j
#5
Hidehisa Saeki, Hidemi Nakagawa, Ko Nakajo, Taeko Ishii, Yoji Morisaki, Takehiro Aoki, Gregory S Cameron, Olawale O Osuntokun
Psoriasis, a chronic, immune-mediated skin disease characterized by red, scaly plaques, affects approximately 0.3% of the population in Japan. The aim of this open-label study was to evaluate the long-term efficacy and safety of ixekizumab, a humanized, anti-interleukin-17A monoclonal antibody, in Japanese patients with plaque psoriasis (n = 78, including 11 psoriatic arthritis), erythrodermic psoriasis (n = 8) and generalized pustular psoriasis (n = 5). Ixekizumab was administrated s.c. at baseline (week 0, 160 mg), from weeks 2 to 12 (80 mg every 2 weeks), and from weeks 16 to 52 (80 mg every 4 weeks)...
October 11, 2016: Journal of Dermatology
https://www.readbyqxmd.com/read/27720540/best-clinical-practice-current-controversies-in-pulmonary-embolism-imaging-and-treatment-of-subsegmental-thromboembolic-disease
#6
Brit Long, Alex Koyfman
BACKGROUND: Pulmonary embolism (PE) affects >600,000 patients per year in the United States. Evaluation includes clinical decision rules, laboratory tests, and several imaging modalities. The diagnosis of PE has risen in recent years, particularly subsegmental PE (SSPE). Controversy exists concerning the diagnosis and treatment of these lesions. OBJECTIVE: We sought to provide emergency physicians with a review of the controversies surrounding PE testing and the diagnosis and treatment of SSPE...
October 6, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27704323/comparison-of-emergency-department-crowding-scores-a-discrete-event-simulation-approach
#7
Virginia Ahalt, Nilay Tanık Argon, Serhan Ziya, Jeff Strickler, Abhi Mehrotra
According to American College of Emergency Physicians, emergency department (ED) crowding occurs when the identified need for emergency services exceeds available resources for patient care in the ED, hospital, or both. ED crowding is a widely reported problem and several crowding scores are proposed to quantify crowding using hospital and patient data as inputs for assisting healthcare professionals in anticipating imminent crowding problems. Using data from a large academic hospital in North Carolina, we evaluate three crowding scores, namely, EDWIN, NEDOCS, and READI by assessing strengths and weaknesses of each score, particularly their predictive power...
October 4, 2016: Health Care Management Science
https://www.readbyqxmd.com/read/27698636/a-cross-sectional-study-of-musculoskeletal-health-literacy-in-patients-with-carpal-tunnel-syndrome
#8
Andrew J Rosenbaum, Andrew Dunkman, Daniel Goldberg, Richard L Uhl, Michael Mulligan
Background: Approximately 33% of Americans have inadequate health literacy, which is associated with infrequent use of preventative services, increased hospitalization and use of emergency care, and worse control of chronic diseases. In this study, the Literacy in Musculoskeletal Problems (LiMP) questionnaire was used to evaluate the prevalence of limited musculoskeletal literacy in patients undergoing carpal tunnel release (CTR), as these individuals may be at increased risk of inferior outcomes. Methods: This cross-sectional study included individuals older than or equal to 18 years of age who were scheduled for elective CTR...
September 2016: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/27677856/survey-of-emergency-physician-approaches-to-management-of-asymptomatic-hypertension
#9
Aaron Brody, Michael Twiner, Arun Kumar, Elizabeth Goldberg, Candace McNaughton, Kimberly Souffront, Scott Millis, Phillip D Levy
Uncontrolled hypertension (HTN) is commonly encountered in emergency medicine practice, but the optimal approach to management has not been delineated. The objective of this study was to define emergency physician (EP) approaches to management of asymptomatic HTN in various clinical scenarios and assess adherence to the American College of Emergency Physician clinical policies, utilizing an online survey of EPs. A total of 1200 surveys were distributed by e-mail with completion by 199 participants. The variables associated with a decision to prescribe oral antihypertensive medications were a history of HTN and referral from primary care...
September 28, 2016: Journal of Clinical Hypertension
https://www.readbyqxmd.com/read/27664899/multidisciplinary-approach-to-decrease-pediatric-trauma-undertriage
#10
Benjamin Eithun, Ankush Gosain
BACKGROUND: Trauma activation and/or leveling criteria are designed to balance the potential harm to individual patients from undertriage (UT) of severe injuries versus overutilization of resources from overtriage (OT) of lesser injuries. The American College of Surgeons (ACS) recommends an acceptable UT rate ≤5% and OT 25%-50%. To improve UT or OT, an intervention was performed to (1) improve accuracy in following established leveling criteria and (2) modify activation criteria in an evidence-based manner to better identify severely injured children...
October 2016: Journal of Surgical Research
https://www.readbyqxmd.com/read/27625718/leadership-and-teamwork-in-trauma-and-resuscitation
#11
REVIEW
Kelsey Ford, Michael Menchine, Elizabeth Burner, Sanjay Arora, Kenji Inaba, Demetrios Demetriades, Bertrand Yersin
INTRODUCTION: Leadership skills are described by the American College of Surgeons' Advanced Trauma Life Support (ATLS) course as necessary to provide care for patients during resuscitations. However, leadership is a complex concept, and the tools used to assess the quality of leadership are poorly described, inadequately validated, and infrequently used. Despite its importance, dedicated leadership education is rarely part of physician training programs. The goals of this investigation were the following: 1...
September 2016: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27593494/aligning-critical-care-interventions-with-patient-goals-a-modified-delphi-study
#12
Alison E Turnbull, Sarina K Sahetya, Dale M Needham
OBJECTIVE: To develop a list of non-emergent, potentially harmful interventions commonly performed in ICUs that require a clear understanding of patients' treatment goals. BACKGROUND: A 2016 policy statement from the American Thoracic Society and American College of Critical Care Medicine calls on intensivists to engage in shared decision-making when "making major treatment decisions that may be affected by personal values, goals, and preferences." METHODS: A three-round modified Delphi consensus process was conducted via a panel of 6 critical care physicians, 6 ICU nurses, 6 former ICU patients, and 6 family members from 6 academic and community-based medical institutions in the U...
November 2016: Heart & Lung: the Journal of Critical Care
https://www.readbyqxmd.com/read/27568419/clinical-policy-critical-issues-in-the-evaluation-of-adult-patients-with-suspected-transient-ischemic-attack-in-the-emergency-department
#13
REVIEW
Bruce M Lo, Christopher R Carpenter, Benjamin W Hatten, Brian J Wright, Michael D Brown
No abstract text is available yet for this article.
September 2016: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/27550983/executive-summary-evaluation-and-management-of-children-with-acute-mental-health-or-behavioral-problems-part-ii-recognition-of-clinically-challenging-mental-health-related-conditions-presenting-with-medical-or-uncertain-symptoms
#14
https://www.readbyqxmd.com/read/27550980/executive-summary-evaluation-and-management-of-children-and-adolescents-with-acute-mental-health-or-behavioral-problems-part-i-common-clinical-challenges-of-patients-with-mental-health-and-or-behavioral-emergencies
#15
https://www.readbyqxmd.com/read/27550977/evaluation-and-management-of-children-and-adolescents-with-acute-mental-health-or-behavioral-problems-part-i-common-clinical-challenges-of-patients-with-mental-health-and-or-behavioral-emergencies
#16
https://www.readbyqxmd.com/read/27550976/evaluation-and-management-of-children-with-acute-mental-health-or-behavioral-problems-part-ii-recognition-of-clinically-challenging-mental-health-related-conditions-presenting-with-medical-or-uncertain-symptoms
#17
https://www.readbyqxmd.com/read/27520068/goal-directed-focused-ultrasound-milestones-revised-a-multiorganizational-consensus
#18
Mathew Nelson, Amin Abdi, Srikar Adhikari, Michael Boniface, Robert M Bramante, Daniel J Egan, J Matthew Fields, Megan M Leo, Andrew S Liteplo, Rachel Liu, Jason T Nomura, David C Pigott, Christopher C Raio, Jennifer Ruskis, Robert Strony, Chris Thom, Resa E Lewiss
In 2012 the Accreditation Council for Graduate Medical Education and the American Board of Emergency Medicine released the emergency medicine milestones. The Patient Care 12 (PC12) subcompetency delineates staged and progressive accomplishment in emergency ultrasound. While valuable as an initial framework for ultrasound resident education, there are limitations to PC12. This consensus paper provides a revised description of criteria to define the subcompetency. A multiorganizational task force was formed between the American College of Emergency Physicians Ultrasound Section, the Council of Emergency Medicine Residency Directors, and the Academy of Emergency Ultrasound of the Society for Academic Emergency Medicine...
November 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/27382661/american-college-of-emergency-physicians-takes-issue-with-report-from-new-healthfacts-ri-database
#19
(no author information available yet)
No abstract text is available yet for this article.
March 2016: Rhode Island Medical Journal
https://www.readbyqxmd.com/read/27358210/long-term-clinical-safety-and-efficacy-of-brodalumab-in-the-treatment-of-japanese-patients-with-moderate-to-severe-plaque-psoriasis
#20
Y Umezawa, H Nakagawa, H Niiro, K Ootaki
BACKGROUND: Brodalumab (KHK4827) is a human anti-interleukin-17-receptor A monoclonal antibody. In Japanese patients with moderate-to-severe plaque psoriasis, brodalumab showed rapid and robust efficacy and a favourable safety profile in a 12-week, phase 2, double-blind, randomized controlled trial. OBJECTIVES: To evaluate the long-term safety and efficacy of brodalumab, an extension of a phase 2 trial of Japanese patients with moderate-to-severe psoriasis was performed...
June 29, 2016: Journal of the European Academy of Dermatology and Venereology: JEADV
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