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https://www.readbyqxmd.com/read/28810207/intermediate-care-to-intensive-care-triage-a-quality-improvement-project-to-reduce-mortality
#1
David N Hager, Pranav Chandrashekar, Robert W Bradsher, Ali M Abdel-Halim, Souvik Chatterjee, Melinda Sawyer, Roy G Brower, Dale M Needham
PURPOSE: Medical patients whose care needs exceed what is feasible on a general ward, but who do not clearly require critical care, may be admitted to an intermediate care unit (IMCU). Some IMCU patients deteriorate and require medical intensive care unit (MICU) admission. In 2012, staff in the Johns Hopkins IMCU expressed concern that patient acuity and the threshold for MICU admission were too high. Further, shared triage decision-making between residents and supervising physicians did not consistently occur...
August 3, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28808668/physician-preferences-for-aggressive-treatment-at-the-end-of-life-and-area-level-health-care-spending-the-johns-hopkins-precursors-study
#2
Joseph J Gallo, Martin S Andersen, Seungyoung Hwang, Lucy Meoni, Ravishankar Jayadevappa
Objective: To determine whether physician preferences for end-of-life care were associated with variation in health care spending. Method: We studied 737 physicians who completed the life-sustaining treatment questionnaire in 1999 and were linked to end-of-life care data for the years 1999 to 2009 from Medicare-eligible beneficiaries from the Dartmouth Atlas of Health Care (in hospital-related regions [HRRs]). Using latent class analysis to group physician preferences for end-of-life treatment into most, intermediate, and least aggressive categories, we examined how physician preferences were associated with health care spending over a 7-year period...
January 2017: Gerontology & Geriatric Medicine
https://www.readbyqxmd.com/read/28807314/a-candidate-gene-approach-to-study-nematode-resistance-traits-in-naturally-infected-sheep
#3
Hazel Wilkie, Valentina Riggio, Oswald Matika, Louise Nicol, Kathryn A Watt, Rona Sinclair, Alexandra M Sparks, Daniel H Nussey, Josephine M Pemberton, Ross D Houston, John Hopkins
Sheep naturally acquire a degree of resistant immunity to parasitic worm infection through repeated exposure. However, the immune response and clinical outcome vary greatly between animals. Genetic polymorphisms in genes integral to differential T helper cell polarization may contribute to variation in host response and disease outcome. A total of twelve single nucleotide polymorphisms (SNPs) were sequenced in IL23R, RORC2 and TBX21 from genomic DNA of Scottish Blackface lambs. Of the twelve SNPs, six were non-synonymous (missense), four were within the 3' UTRs and two were intronic...
August 30, 2017: Veterinary Parasitology
https://www.readbyqxmd.com/read/28800895/a-randomized-trial-of-a-web-based-platform-to-help-families-manage-dementia-related-behavioral-symptoms-the-wecareadvisor%C3%A2
#4
Laura N Gitlin, Helen J Kales, Katherine Marx, Barbara Stanislawski, Constantine Lyketsos
Dementia-related behavioral symptoms are challenging clinical features occurring across etiologies and disease progression. They are associated with increased healthcare utilization, nursing home placement, family upset and burden. Families typically manage behavioral symptoms without requisite knowledge, skills and guidance. We designed WeCareAdvisor™ as an easy-to-use, evidence-informed web-based platform. It provides families knowledge about dementia, daily tips, and a systematic approach to describe behaviors, investigate modifiable contributors, create treatment plans (WeCareAdvisor™ Prescription) consisting of management tips tailored to symptom presentation, and evaluate effectiveness...
August 8, 2017: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/28795994/potential-and-actual-health-hazards-in-the-dense-urban-operational-environment-critical-gaps-and-solutions-for-military-occupational-health
#5
Steven L Patterson, Blair C R Dancy, Danielle L Ippolito, Jonathan D Stallings
: This paper presents environmental health risks which are prevalent in dense urban environments.We review the current literature and recommendations proposed by environmental medicine experts in a 2-day symposium sponsored by the Department of Defense and supported by the Johns Hopkins University Applied Physics Laboratory.Key hazards in the dense urban operational environment include toxic industrial chemicals and materials, water pollution and sewage, and air pollution. Four critical gaps in environmental medicine were identified: prioritizing chemical and environmental concerns, developing mobile decision aids, personalized health assessments, and better real-time health biomonitoring...
August 8, 2017: Journal of Occupational and Environmental Medicine
https://www.readbyqxmd.com/read/28790487/developing-therapies-for-brain-tumors-the-impact-of-the-johns-hopkins-hunterian-neurosurgical-research-laboratory
#6
Henry Brem, Eric W Sankey, Ann Liu, Antonella Mangraviti, Betty M Tyler
The Johns Hopkins Hunterian Neurosurgical Laboratory at the Johns Hopkins University School of Medicine was created in 1904 by Harvey Cushing and William Halsted and has had a long history of fostering surgical training, encouraging basis science research, and facilitating translational application. Over the past 30 years, the laboratory has addressed the paucity of brain tumor therapies. Pre-clinical work from the laboratory led to the development of carmustine wafers with initial US Food and Drug Administration (FDA) approval in 1996...
2017: Transactions of the American Clinical and Climatological Association
https://www.readbyqxmd.com/read/28789660/development-and-validation-of-the-medical-student-scholar-ideal-mentor-scale-mss-ims
#7
Stephen M Sozio, Kitty S Chan, Mary Catherine Beach
BACKGROUND: Programs encouraging medical student research such as Scholarly Concentrations (SC) are increasing nationally. However, there are few validated measures of mentoring quality tailored to medical students. We sought to modify and validate a mentoring scale for use in medical student research experiences. METHODS: SC faculty created a scale evaluating how medical students assess mentors in the research setting. A validated graduate student scale of mentorship, the Ideal Mentor Scale, was modified by selecting 10 of the 34 original items most relevant for medical students and adding an item on project ownership...
August 8, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/28782170/short-and-long-gap-peripheral-nerve-repair-with-magnesium-metal-filaments
#8
Tracy M Hopkins, Kevin J Little, John J Vennemeyer, Jefferson L Triozzi, Michael T Turgeon, Alexander M Heilman, D Minteer, K Marra, David B Hom, Sarah K Pixley
A current clinical challenge is to replace autografts for repair of injury gaps in peripheral nerves, which can occur due to trauma or surgical interruption. Biodegradable metallic magnesium filaments, placed inside hollow nerve conduits, could support nerve repair by providing contact guidance support for axonal regeneration. This was tested by repairing sciatic nerves of adult rats with single magnesium filaments placed inside poly(caprolactone) nerve conduits. Controls were empty conduits, conduits containing titanium filaments and/or isografts from donor rats...
August 7, 2017: Journal of Biomedical Materials Research. Part A
https://www.readbyqxmd.com/read/28782048/matrix-density-engineering-of-hydrogel-nanoparticles-with-simulation-guided-synthesis-for-tuning-drug-release-and-cellular-uptake
#9
Teppei Shirakura, Christof Smith, Thomas John James Hopkins, Yong-Eun Koo Lee, Filippos Lazaridis, Panos Argyrakis, Raoul Kopelman
The use of a nanoparticle (NP)-based antitumor drug carrier has been an emerging strategy for selectively delivering the drugs to the tumor area and, thus, reducing the side effects that are associated with a high systemic dose of antitumor drugs. Precise control of drug loading and release is critical so as to maximize the therapeutic index of the NPs. Here, we propose a simple method of synthesizing NPs with tunable drug release while maintaining their loading ability, by varying the polymer matrix density of amine- or carboxyl-functionalized hydrogel NPs...
July 31, 2017: ACS Omega
https://www.readbyqxmd.com/read/28781133/smartphone-use-and-the-perception-of-professionalism-among-medical-students-and-surgical-faculty
#10
Silka Patel, Anne Lidor, Abanti Sanyal, Alice R Goepfert, Nancy Hueppchen
OBJECTIVE: To understand the perception of professionalism surrounding smartphone use (wards/educational activities) among medical students and surgical faculty. DESIGN: A prospective cohort study was conducted using an electronic survey and distributed to third- and fourth-year medical students, obstetrics/gynecology, and surgery faculty members. Five cases were randomly presented; participants were asked to review and rate the clinician's behavior on a 5-point Likert scale...
August 3, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28772298/measurement-of-gamma-irradiated-corneal-patch-graft-thickness-after-aqueous-drainage-device-surgery
#11
Regina A de Luna, Ameera Moledina, Jiangxia Wang, Henry D Jampel
Importance: Exposure of the tube of an aqueous drainage device (ADD) through the conjunctiva is a serious complication of ADD surgery. Although placement of gamma-irradiated sterile cornea (GISC) as a patch graft over the tube is commonly performed, exposures still occur. Objectives: To measure GISC patch graft thickness as a function of time after surgery, estimate the rate of graft thinning, and determine risk factors for graft thinning. Design, Setting, and Participants: Cross-sectional study of graft thickness using anterior segment optic coherence tomography (AS-OCT) was conducted at the Wilmer Eye Institute at Johns Hopkins Hospital...
August 3, 2017: JAMA Ophthalmology
https://www.readbyqxmd.com/read/28767491/medical-student-perceptions-of-global-surgery-at-an-academic-institution-identifying-gaps-in-global-health-education
#12
Ambar Mehta, Tim Xu, Matthew Murray, Kathleen M Casey
PURPOSE: Robust global health demands access to safe, affordable, timely surgical care for all. The long-term success of global surgery requires medical students to understand and engage with this emerging field. The authors characterized medical students' perceptions of surgical care relative to other fields within global health. METHOD: An optional, anonymous survey was given to all Johns Hopkins medical students from February to March 2016 to assess perceptions of surgical care and its role in global health...
August 1, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28767289/deleterious-germline-mutations-in-patients-with-apparently-sporadic-pancreatic-adenocarcinoma
#13
Koji Shindo, Jun Yu, Masaya Suenaga, Shahriar Fesharakizadeh, Christy Cho, Anne Macgregor-Das, Abdulrehman Siddiqui, P Dane Witmer, Koji Tamura, Tae Jun Song, Jose Alejandro Navarro Almario, Aaron Brant, Michael Borges, Madeline Ford, Thomas Barkley, Jin He, Matthew J Weiss, Christopher L Wolfgang, Nicholas J Roberts, Ralph H Hruban, Alison P Klein, Michael Goggins
Purpose Deleterious germline mutations contribute to pancreatic cancer susceptibility and are well documented in families in which multiple members have had pancreatic cancer. Methods To define the prevalence of these germline mutations in patients with apparently sporadic pancreatic cancer, we sequenced 32 genes, including known pancreatic cancer susceptibility genes, in DNA prepared from normal tissue obtained from 854 patients with pancreatic ductal adenocarcinoma, 288 patients with other pancreatic and periampullary neoplasms, and 51 patients with non-neoplastic diseases who underwent pancreatic resection at Johns Hopkins Hospital between 2000 and 2015...
August 2, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28762529/the-impact-of-statin-use-on-the-efficacy-of-abiraterone-acetate-in-patients-with-castration-resistant-prostate-cancer
#14
Lauren C Harshman, Lillian Werner, Abhishek Tripathi, Xiaodong Wang, Benjamin L Maughan, Emmanuel S Antonarakis, Mari Nakabayashi, Rana McKay, Mark Pomerantz, Lorelei A Mucci, Mary-Ellen Taplin, Christopher J Sweeney, Gwo-Shu Mary Lee, Philip W Kantoff
BACKGROUND: Statins compete with DHEAS for influx through the SLCO2B1 transporter, which may prolong time to progression (TTP) on androgen deprivation therapy. Abiraterone acetate (AA) may also undergo SLCO-mediated transport. Based on preclinical findings showing antagonism, we hypothesized that statins may compete with AA for influx via SLCO2B1 and could negatively impact drug efficacy. METHODS: We queried two institutional clinical databases (Dana-Farber Cancer Institute [DFCI], Johns Hopkins University [JHU]) for CRPC patients treated with AA...
August 1, 2017: Prostate
https://www.readbyqxmd.com/read/28759969/physical-activity-in-midlife-is-not-associated-with-cognitive-health-in-later-life-among-cognitively-normal-older-adults
#15
Alden L Gross, Haidong Lu, Lucy Meoni, Joseph J Gallo, Jennifer A Schrack, A Richey Sharrett
BACKGROUND: Links between physical activity and dementia are based primarily on cross-sectional data or studies with unsatisfactory follow-up. OBJECTIVE: We leveraged three decades of follow-up from an established cohort to determine whether physical activity in midlife is associated with late-life cognition and dementia. METHODS: The Johns Hopkins Precursors study (n = 646) enrolled participants from 1948-1964 and administered questions about physical activity, from which we calculated metabolic equivalents (MET h/day), and exercise from 1978-present...
July 25, 2017: Journal of Alzheimer's Disease: JAD
https://www.readbyqxmd.com/read/28755878/hyperprolactinaemia-in-first-episode-psychosis-a-longitudinal-assessment
#16
John Lally, Olesya Ajnakina, Brendon Stubbs, Hugh R Williams, Marco Colizzi, Elena Carra, Sara Fraietta, Poonam Gardner-Sood, Kathryn E Greenwood, Zerrin Atakan, Valeria Mondelli, Khalida Ismail, Oliver Howes, David M Taylor, Shubalade Smith, David Hopkins, Robin M Murray, Fiona Gaughran
Little is known about hyperprolactinaemia (HPL) in first episode psychosis (FEP) patients. We investigated longitudinal changes in serum prolactin in FEP, and the relationship between HPL, and antipsychotic medication and stress. Serum prolactin was recorded in FEP patients at recruitment and again, 3 and 12months later. HPL was defined as a serum prolactin level >410mIU/L (~19.3ng/ml) for males, and a serum prolactin level >510mIU/L (~24.1ng/ml) for females. From a total of 174 people with serum prolactin measurements at study recruitment, 43% (n=74) had HPL, whilst 27% (n=21/78) and 27% (n=26/95) had HPL at 3 and 12months respectively...
July 27, 2017: Schizophrenia Research
https://www.readbyqxmd.com/read/28754545/major-histocompatibility-mismatch-and-donor-choice-for-second-allogeneic-bone-marrow-transplant
#17
Philip H Imus, Amanda L Blackford, Maria Bettinotti, Brian Iglehart, August Dietrich, Noah Tucker, Heather Symons, Kenneth R Cooke, Leo Luznik, Ephraim J Fuchs, Robert A Brodsky, William H Matsui, Carol Ann Huff, Douglas Gladstone, Richard F Ambinder, Ivan M Borrello, Lode J Swinnen, Richard J Jones, Javier Bolaños-Meade
Large alternative donor pools provide the potential for selecting a different donor for a second allogeneic transplant (alloBMT). As HLA disparity may contribute to the graft versus tumor effect, potentially utilizing new mismatched haplotype donors could improve the antitumor activity for relapsed hematologic malignancies despite a previous alloBMT. Data from patients who received a second alloBMT for relapsed hematologic malignancies at Johns Hopkins were analyzed. Outcomes were compared between patients who received a second allograft with the same MHC composition and those who received an allograft with a new mismatched haplotype...
July 25, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28753135/personalizing-environmental-health-at-the-intersection-of-precision-medicine-and-occupational-health-in-the-military
#18
Christopher Bradburne, John A Lewis
: Recent efforts in precision medicine present unique opportunities for military environmental and occupational health. Risk assessments can be refined by individualized risk factors such as genomics, and health status can be monitored and informed using mobile health (mHealth) devices. The military currently monitors exposures with service-wide databases and has one of the world's largest biobanks of serum samples available for health surveillance. New approaches are being developed for risk assessment, novel exposure-based biomarkers, and mobile applications to combine the facile collection of exposure data with tracking and planning utility...
July 27, 2017: Journal of Occupational and Environmental Medicine
https://www.readbyqxmd.com/read/28753084/development-and-implementation-of-a-school-wide-institute-for-excellence-in-education-to-enable-educational-scholarship-by-medical-school-faculty
#19
Joseph Cofrancesco, Michael A Barone, Janet R Serwint, Mitchell Goldstein, Michael Westman, Pamela A Lipsett
PROBLEM: Educational scholarship is an important component for faculty at Academic Medical Centers, especially those with single-track promotion systems. Yet, faculty may lack the skills and mentorship needed to successfully complete projects. In addition, many educators feel undervalued. INTERVENTION: To reinvigorate our school's educational mission, the Institute for Excellence in Education (IEE) was created. Here we focus on one of the IEE's strategic goals, that of inspiring and supporting educational research, scholarship, and innovation...
July 28, 2017: Teaching and Learning in Medicine
https://www.readbyqxmd.com/read/28747365/the-antibiotic-course-has-had-its-day
#20
Martin J Llewelyn, Jennifer M Fitzpatrick, Elizabeth Darwin, SarahTonkin-Crine, Cliff Gorton, John Paul, Tim E A Peto, Lucy Yardley, Susan Hopkins, Ann Sarah Walker
No abstract text is available yet for this article.
July 26, 2017: BMJ: British Medical Journal
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