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https://www.readbyqxmd.com/read/28651196/dancing-to-death-a-case-of-heat-stroke
#1
K Nadesan, Chandra Kumari, Mohd Afiq
Heat stroke is a medical emergency which may lead to mortality unless diagnosed early and treated effectively. Heat stroke may manifest rapidly, hence making it difficult to differentiate it from other clinical causes in a collapsed victim.(1) We are presenting a case report of twelve patients who were admitted to our emergency department from a music festival held on 13-15th of March 2014. They developed complications arising from a combination of severe adverse weather condition, prolonged outdoor physical exertion due to long hours of dancing and drug-use, resulting in heat stroke...
May 4, 2017: Journal of Forensic and Legal Medicine
https://www.readbyqxmd.com/read/28641582/a-multicentre-randomised-controlled-trial-of-levetiracetam-versus-phenytoin-for-convulsive-status-epilepticus-in-children-protocol-convulsive-status-epilepticus-paediatric-trial-consept-a-predict-study
#2
Stuart R Dalziel, Jeremy Furyk, Megan Bonisch, Ed Oakley, Meredith Borland, Jocelyn Neutze, Susan Donath, Cynthia Sharpe, Simon Harvey, Andrew Davidson, Simon Craig, Natalie Phillips, Shane George, Arjun Rao, Nicholas Cheng, Michael Zhang, Kam Sinn, Amit Kochar, Christine Brabyn, Franz E Babl
BACKGROUND: Convulsive status epilepticus (CSE) is the most common life-threatening childhood neurological emergency. Despite this, there is a lack of high quality evidence supporting medication use after first line benzodiazepines, with current treatment protocols based solely on non-experimental evidence and expert opinion. The current standard of care, phenytoin, is only 60% effective, and associated with considerable adverse effects. A newer anti-convulsant, levetiracetam, can be given faster, is potentially more efficacious, with a more tolerable side effect profile...
June 22, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28640812/challenges-in-preparing-and-implementing-a-clinical-trial-at-field-level-in-an-ebola-emergency-a-case-study-in-guinea-west-africa
#3
Sara Carazo Perez, Elin Folkesson, Xavier Anglaret, Abdoul-Habib Beavogui, Emmanuel Berbain, Alseny-Modet Camara, Evelyn Depoortere, Annabelle Lefevre, Piet Maes, Kristian Nødtvedt Malme, Jean-Marie Denis Malvy, Sien Ombelet, Geertrui Poelaert, Daouda Sissoko, Alexis Tounkara, Pierre Trbovic, Pascal Piguet, Annick Antierens
During the large Ebola outbreak that affected West Africa in 2014 and 2015, studies were launched to evaluate potential treatments for the disease. A clinical trial to evaluate the effectiveness of the antiviral drug favipiravir was conducted in Guinea. This paper describes the main challenges of the implementation of the trial in the Ebola treatment center of Guéckédou. Following the principles of the Good Clinical Research Practices, we explored the aspects of the community's communication and engagement, ethical conduct, trial protocol compliance, informed consent of participants, ongoing benefit/risk assessment, record keeping, confidentiality of patients and study data, and roles and responsibilities of the actors involved...
June 2017: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/28640036/a-constructive-reframing-of-student-roles-and-systems-learning-in-medical-education-using-a-communities-of-practice-lens
#4
Jed D Gonzalo, Britta M Thompson, Paul Haidet, Karen Mann, Daniel R Wolpaw
Health systems are in the midst of a transformation that is being driven by a variety of forces. This has important implications for medical educators because clinical practice environments play a key role in learning and professional development, and evolving health systems are beginning to demand that providers have "systems-ready" knowledge, attitudes, and skills. Such implications provide a clear mandate for medical schools to modify their goals and prepare physicians to practice flexibly within teams and effectively contribute to the improvement of health care delivery...
June 20, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28637154/shoulder-pain-after-stroke-experiences-consequences-in-daily-life-and-effects-of-interventions-a-qualitative-study
#5
Ingrid Lindgren, Gunvor Gard, Christina Brogårdh
PURPOSE: To describe experiences of shoulder pain after stroke, how pain affects daily life and perceived effects of interventions. METHOD: A qualitative interview study including 13 community-dwelling persons (six women; median age 65 years) with persistent shoulder pain after stroke. RESULTS: Three categories emerged from the content analysis. In "Multiple pain characteristics" an insidious pain onset was reported. The pain existed both day and night and could be located around the shoulder girdle but also have radiation to the arm and hand...
March 3, 2017: Disability and Rehabilitation
https://www.readbyqxmd.com/read/28636455/the-role-of-the-healthcare-chaplain-a-literature-review
#6
Fiona Timmins, Sílvia Caldeira, Maryanne Murphy, Nicolas Pujol, Greg Sheaf, Elizabeth Weathers, Jacqueline Whelan, Bernadette Flanagan
Healthcare chaplains operate in many healthcare sites internationally and yet their contribution is not always clearly understood by medical and healthcare staff. This review aims to explore the chaplains' role in healthcare, with a view to informing best practice in future healthcare chaplaincy. Overall the extent of the provision and staffing of chaplaincy service internationally is unclear. From this review, several key spiritual and pastoral roles in healthcare emerge including a potential contribution to ethical decision making at the end of life...
June 21, 2017: Journal of Health Care Chaplaincy
https://www.readbyqxmd.com/read/28636421/analysis-of-origins-of-admission-for-solid-tumor-oncology-inpatients-disease-severity-and-outcomes
#7
Christopher E Wee, Lindsey M Goodman, Leticia Varella, Lisa A Rybicki, Alberto J Montero, Bassam N Estfan, Carolyn H Best, James P Stevenson
PURPOSE: Hospital transfers may affect clinical outcomes. Evaluation of admission by source of transfer, time of admission, and provider type may identify opportunities to improve inpatient outcomes. METHODS: We reviewed charts of patients admitted to the solid tumor oncology service between July and December 2014 from the Cleveland Clinic Foundation (CCF) Main Campus emergency department (ED), CCF Regional EDs, outside hospital (OSH) ED, OSH inpatient services, and CCF outpatient clinics...
June 21, 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28630743/comparison-of-five-video-assisted-intubation-devices-by-novice-and-expert-laryngoscopists-for-use-in-the-aeromedical-evacuation-environment
#8
Matthew C Wallace, SSgt Tyler Britton, Robbie Meek, Sharon Walsh-Hart, Col Todd E Carter, Steven J Lisco
BACKGROUND: The critically ill or injured patient undergoing military medical evacuation may require emergent intubation. Intubation may be life-saving, but it carries risks. The novice or infrequent laryngoscopist has a distinct disadvantage because experience is critical for the rapid and safe establishment of a secured airway. This challenge is compounded by the austere environment of the back of an aircraft under blackout conditions. This study determined which of five different video-assisted intubation devices (VAIDs) was best suited for in-flight use by U...
2017: Military Medical Research
https://www.readbyqxmd.com/read/28628463/operational-research-during-the-ebola-emergency
#9
Gabriel Fitzpatrick, Tom Decroo, Bertrand Draguez, Rosa Crestani, Axelle Ronsse, Rafael Van den Bergh, Michel Van Herp
Operational research aims to identify interventions, strategies, or tools that can enhance the quality, effectiveness, or coverage of programs where the research is taking place. Médecins Sans Frontières admitted ≈5,200 patients with confirmed Ebola virus disease during the Ebola outbreak in West Africa and from the beginning nested operational research within its emergency response. This research covered critical areas, such as understanding how the virus spreads, clinical trials, community perceptions, challenges within Ebola treatment centers, and negative effects on non-Ebola healthcare...
July 2017: Emerging Infectious Diseases
https://www.readbyqxmd.com/read/28625669/role-of-language-discordance-in-complication-and-readmission-rate-after-infrainguinal-bypass
#10
Elica Inagaki, Alik Farber, Jeffrey Kalish, Jeffrey J Siracuse, Clara Zhu, Denis V Rybin, Gheorghe Doros, Mohammad H Eslami
OBJECTIVE: Studies have shown that language discordance between treatment teams and patients leads to worse patient outcomes, including longer hospital stays, higher rates of readmission, impaired comprehension of discharge instructions, and lower treatment adherence. Yet, there is a paucity of data evaluating the effects of language discordance on postoperative outcomes among vascular surgery patients. This study compared 30-day postoperative complications and readmissions after nonemergent infrainguinal bypass between non-English-speaking (NES) and English-speaking (ES) patients...
June 16, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28625305/decision-to-delivery-interval-is-30%C3%A2-min-the-magic-time-what-is-the-evidence-does-it-work
#11
REVIEW
J H Tomlinson, D N Lucas
Emergency caesarean section is required when delivery can reduce the risk to the life of the mother or foetus. When a caesarean section is indicated for foetal compromise, a decision-to-delivery interval of 30 min (or less) has been suggested as the ideal time frame within which an obstetric team should achieve delivery. In theory, a short decision-to-delivery interval may minimise intra-uterine hypoxia and improve neonatal outcome. Current medical evidence does not support this time frame. There are certain indications for caesarean section that necessitate a much shorter decision-to-delivery interval, but evidence suggests that the majority of neonates may be safely delivered within a longer interval of time...
March 2017: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/28620921/consistency-of-total-body-surface-area-assessment-in-severe-burns-implications-for-practice
#12
Stephen Face, Sarah Dalton
BACKGROUND: Paediatric burn injury is common and often serious. Injuries occur across New South Wales (NSW), with specialised treatment provided in a centralised burns unit. Early management prior to transfer is essential but variation is seen. OBJECTIVES: To determine if differences exist between referring hospital estimates of the total body surface area (TBSA) of burns, and estimates for the same burns by the Burns Unit. To consider if differences in estimations influence initial and ongoing management, and decisions regarding transfer/retrieval...
June 15, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28620725/understanding-adaptations-to-patient-centered-medical-home-activities-the-pcmh-adaptations-model
#13
Tristen L Hall, Jodi Summers Holtrop, L Miriam Dickinson, Russell E Glasgow
Primary care practices have increasingly adopted the patient-centered medical home (PCMH) model and often adapted quality improvement efforts to fit local context. This paper implemented a modified framework for understanding adaptations in the context of primary care PCMH transformation efforts. We combined an adaptations model by Stirman et al. that categorized adaptations to evidence-based interventions in research studies with dimensions from the RE-AIM framework, as well as items specific to PCMH. The resulting constructs were translated into a "plain English" adaptations interview...
June 15, 2017: Translational Behavioral Medicine
https://www.readbyqxmd.com/read/28616422/evaluation-of-educational-program-in-the-master-of-medical-education-by-eisner-s-educational-connoisseurship-and-criticism-model
#14
Fariba Khanipoor, Mitra Amini, Laila Bazrafcan
INTRODUCTION: To be more successful in medical education and identify the strengths and weaknesses of the curriculum in this field, assessment of the students' views, graduates, professors, and experts is essential. The aim of this qualitative assessment was to identify the strengths and weaknesses of the medical education curriculum. SUBJECTS AND METHODS: This research is a qualitative study using the Eisner's educational connoisseurship and criticism model that was conducted in Shiraz Medical Sciences University in 2014...
2017: Journal of Education and Health Promotion
https://www.readbyqxmd.com/read/28611875/patient-perspectives-on-accessing-acute-illness-care
#15
Mary K Finta, Amy Borkenhagen, Nicole E Werner, Joyce Duckles, Craig R Sellers, Sandhya Seshadri, Denise Lampo, Manish N Shah
INTRODUCTION: Older adults use the emergency department (ED) at high rates, including for illnesses that could be managed by their primary care providers (PCP). Policymakers have implemented barriers and incentives, often financial, to try to modify use patterns but with limited success. This study aims to understand the factors that influence older adults' decision to obtain acute illness care from the ED rather than from their PCPs. METHODS: We performed a qualitative study using a directed content analysis approach from February to October 2013...
June 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28611008/the-female-athlete-body-fab-study-rationale-design-and-baseline-characteristics
#16
Tiffany M Stewart, Tarryn Pollard, Tom Hildebrandt, Robbie Beyl, Nicole Wesley, Lisa Smith Kilpela, Carolyn Black Becker
BACKGROUND: Eating Disorders (EDs) are serious psychiatric illnesses marked by psychiatric comorbidity, medical complications, and functional impairment. Research indicates that female athletes are often at greater risk for developing ED pathology versus non-athlete females. The Female Athlete Body (FAB) study is a three-site, randomized controlled trial (RCT) designed to assess the efficacy of a behavioral ED prevention program for female collegiate athletes when implemented by community providers...
June 10, 2017: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/28610435/access-and-engagement-in-hiv-care-among-a-national-cohort-of-women-living-with-hiv-in-canada
#17
Nadine Kronfli, Ashley Lacombe-Duncan, Ying Wang, Alexandra de Pokomandy, Angela Kaida, Carmen Logie, Tracey Conway, V Logan Kennedy, Ann Burchell, Wangari Tharao, Neora Pick, Mary Kestler, Paul Sereda, Mona Loutfy, On Behalf Of The Chiwos Research Team
Attrition along the cascade of HIV care poses significant barriers to attaining the UNAIDS targets of 90-90-90 and achieving optimal treatment outcomes for people living with HIV. Understanding the correlates of attrition is critical and particularly for women living with HIV (WLWH) as gender disparities along the cascade have been found. We measured the proportion of the 1425 WLWH enrolled in the Canadian HIV Women's Sexual and Reproductive Health Cohort Study (CHIWOS) who had never accessed HIV medical care, who reported delayed linkage into HIV care (>3 months between diagnosis and initial care linkage), and who were not engaged in HIV care at interview (<1 visit in prior year)...
June 13, 2017: AIDS Care
https://www.readbyqxmd.com/read/28606620/efficacy-and-safety-of-lumacaftor-and-ivacaftor-in-patients-aged-6-11-years-with-cystic-fibrosis-homozygous-for-f508del-cftr-a-randomised-placebo-controlled-phase-3-trial
#18
Felix Ratjen, Christopher Hug, Gautham Marigowda, Simon Tian, Xiaohong Huang, Sanja Stanojevic, Carlos E Milla, Paul D Robinson, David Waltz, Jane C Davies
BACKGROUND: Lumacaftor and ivacaftor combination treatment showed efficacy in patients aged 12 years or older with cystic fibrosis homozygous for F508del-cystic fibrosis transmembrane conductance regulator (CFTR) in placebo-controlled studies and patients aged 6-11 years with cystic fibrosis homozygous for F508del-CFTR in an open-label study. We report efficacy and safety of lumacaftor and ivacaftor in patients with cystic fibrosis aged 6-11 years homozygous for F508del-CFTR. METHODS: In this phase 3, randomised, double-blind, placebo-controlled, multicentre study, patients were enrolled at 54 hospitals and medical centres in nine countries (the USA, Australia, Belgium, Canada, Denmark, France, Germany, Sweden, and the UK)...
June 8, 2017: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/28603881/early-palliative-care-for-adults-with-advanced-cancer
#19
REVIEW
Markus W Haun, Stephanie Estel, Gerta Rücker, Hans-Christoph Friederich, Matthias Villalobos, Michael Thomas, Mechthild Hartmann
BACKGROUND: Incurable cancer, which often constitutes an enormous challenge for patients, their families, and medical professionals, profoundly affects the patient's physical and psychosocial well-being. In standard cancer care, palliative measures generally are initiated when it is evident that disease-modifying treatments have been unsuccessful, no treatments can be offered, or death is anticipated. In contrast, early palliative care is initiated much earlier in the disease trajectory and closer to the diagnosis of incurable cancer...
June 12, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28601206/prolonged-field-care-beyond-the-golden-hour
#20
REVIEW
Sean Keenan, Jamie C Riesberg
Prolonged field care (PFC) has emerged as a recent area of focus for US military Special Operations Forces (SOF) medical experts. Focused on the current reality of providing medical care to military forces often deployed in remote and austere locations far from medical support or a robust casualty evacuation chain, PFC encompasses evolving operational situations not unlike many wilderness medicine practice environments. SOF currently operates in all areas of the world and on a variety of different missions, which finds these small teams far from the accustomed practice environment of robust deployed medical infrastructure commonly seen during the last 15 years of military conflicts...
June 2017: Wilderness & Environmental Medicine
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