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https://www.readbyqxmd.com/read/28109052/the-use-of-methadone-to-facilitate-opioid-weaning-in-pediatric-critical-care-patients-a-systematic-review-of-the-literature-and-meta-analysis
#1
REVIEW
Leslie A Dervan, Beryl Yaghmai, Robert Scott Watson, Fredric M Wolf
BACKGROUND: Continuous opioid infusion therapy is commonly utilized in the pediatric intensive care setting to treat pain and facilitate tolerance of invasive therapies. Transitioning to methadone is one common strategy for weaning from continuous opioid infusions, but in practice this transition can be challenging, and many children still experience iatrogenic withdrawal. AIM: We reviewed the literature to evaluate the best available evidence to guide methadone therapy in this setting, and to summarize associated adverse events...
January 20, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28109011/individual-physician-penalties-resulting-from-violation-of-emtala-a-review-of-office-of-the-inspector-general-patient-dumping-settlements-2002-2015
#2
Sophie Terp, Brandon Wang, Brian Raffetto, Seth A Seabury, Michael Menchine
OBJECTIVE: To describe characteristics of civil monetary penalty settlements levied by the Office of the Inspector General (OIG) against individual physicians related to violation of the Emergency Medical Treatment and Labor Act (EMTALA). METHODS: Descriptions of all civil monetary penalty settlements between 2002 and 2015 were obtained from the OIG. Characteristics of settlements against individual physicians related to EMTALA violations were described including settlement date, location, amount, whether there was an associated hospital settlement, the medical specialty of the physician involved, and the nature of the allegation...
January 20, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28108941/factors-associated-with-emergency-department-useamong-veteran-psychiatric-patients
#3
Daniel M Blonigen, Kathryn S Macia, Xiaoyu Bi, Paola Suarez, Luisa Manfredi, Todd H Wagner
Frequent utilization of emergency department (ED) services contributes substantially to the cost of healthcare nationally and is often driven by psychiatric factors. Using national-level data from the Veterans Health Administration (VHA), the present study examined patient-level factors associated with ED use among veteran psychiatric patients. Veterans who had at least one ED visit with a psychiatric diagnosis in fiscal years 2011-2012 (n = 226,122) were identified in VHA administrative records. Andersen's behavioral model of healthcare utilization was used to identify need, enabling, and predisposing factors associated with frequency of ED use (primary outcome) in multivariate regression models...
January 21, 2017: Psychiatric Quarterly
https://www.readbyqxmd.com/read/28108546/automatic-health-record-review-to-help-prioritize-gravely-ill-social-security-disability-applicants
#4
Kenneth Abbott, Yen-Yi Ho, Jennifer Erickson
OBJECTIVE: Every year, thousands of patients die waiting for disability benefits from the Social Security Administration. Some qualify for expedited service under the Compassionate Allowance (CAL) initiative, but CAL software focuses exclusively on information from a single form field. This paper describes the development of a supplemental process for identifying some overlooked but gravely ill applicants, through automatic annotation of health records accompanying new claims. We explore improved prioritization instead of fully autonomous claims approval...
January 20, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28108440/autoimmune-hepatitis-and-eosinophilic-granulomatosis-with-polyangiitis-a-rare-association
#5
Saroj Lohani, Salik Nazir, Niranjan Tachamo, Pavani Pagolu
We describe a case of 40-year-old woman who presented to our hospital with symptoms of non-radiating epigastric pain for 4-5 days associated with nausea and vomiting. Her history was significant for asthma with recurrent exacerbations, polyneuropathy and recurrent sinus infections. Liver function tests revealed cholestasis. Antinuclear antibody and antismooth muscle cell antibody were positive. Liver biopsy revealed active chronic hepatitis with cholestasis. A diagnosis of autoimmune hepatitis was made. All other causes of cholestatic jaundice were ruled out...
January 20, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28108416/symptoms-and-the-body-taking-the-inferential-leap
#6
REVIEW
Omer Van den Bergh, Michael Witthöft, Sibylle Petersen, Richard J Brown
The relationship between the conscious experience of physical symptoms and indicators of objective physiological dysfunction is highly variable and depends on characteristics of the person, the context and their interaction. This relationship often breaks down entirely in the case of "medically unexplained" or functional somatic symptoms, violating the basic assumption in medicine that physical symptoms have physiological causes. In this paper, we describe the prevailing theoretical approach to this problem and review the evidence pertaining to it...
January 17, 2017: Neuroscience and Biobehavioral Reviews
https://www.readbyqxmd.com/read/28108355/an-unusual-case-of-a-pheochromocytoma-mimicking-both-acute-coronary-syndrome-and-central-nervous-system-infection-case-report-and-literature-review
#7
Andreas Mitsis, Christina Hadjilouka, Maria Skarpari, Michael Myrianthefs
Pheochromocytoma has been called 'the great mimic', capable of presenting itself as many other medical conditions. We present a 58-year-old woman admitted with recurrent episodes of nausea and vomiting and high blood pressure. Elevated cardiac biomarkers and diffuse ST-T abnormalities on electrocardiography suggested myocardial injury. However the biochemical and electrocardiography abnormalities normalized in a few hours. The next day the combination of fever, mental disorientation and confusion associated with elevated levels of C-reactive protein and leukocytosis suggested infection of central neural system...
January 17, 2017: Hellenic Journal of Cardiology: HJC, Hellēnikē Kardiologikē Epitheōrēsē
https://www.readbyqxmd.com/read/28108324/the-circle-nephrostomy-tube-an-attractive-nephrostomy-drainage-system-following-complex-percutaneous-nephrolithotomy
#8
Marawan M El Tayeb, Michael S Borofsky, James E Lingeman
OBJECTIVE: To describe our experience with the circle NT (Cook® Medical), a drainage system uniquely designed for use after multiple access PNL. MATERIALS AND METHODS: A retrospective review of 1317 consecutive patients undergoing 1599 PNLs at IU Health Methodist Hospital was performed. All multiple access cases utilizing circle NTs were reviewed and analyzed. The method of insertion of circle NT is demonstrated. RESULTS: A total of 1843 accesses were obtained in 1599 renal units RUs: 380 upper, 129 mid, and 1334 lower...
January 17, 2017: Urology
https://www.readbyqxmd.com/read/28108319/how-the-changes-in-the-system-affect-trauma-care-provision-the-assessment-of-and-implications-for-lithuanian-trauma-service-performance-in-2007-2012
#9
Žilvinas Dambrauskas, Vytautas Aukštakalnis, Aurika Karbonskienė, Dmitrijus Kačiurinas, Jolanta Vokietienė, Robertas Lapka, Algimantas Pamerneckas, Narūnas Porvaneckas, Kęstutis Stašaitis, Nedas Jasinskas, Paulius Dobožinskas, Dinas Vaitkaitis, Raimundas Lunevičius
OBJECTIVE: The aim of this study was to identify and assess the effects of changes in the Lithuanian trauma service from 2007 to 2012. We postulate that the implications derived from this study will be of importance to trauma policy planners and makers in Lithuania and throughout other countries of Eastern and Central Europe. MATERIALS AND METHODS: Out of 10,390 trauma admissions to four trauma centers in 2007, 294 patients (2.8%) were randomly selected for the first arm of a representative study sample...
January 6, 2017: Medicina
https://www.readbyqxmd.com/read/28108142/identifying-mronj-affected-bone-with-digital-fusion-of-functional-imaging-fi-and-cone-beam-computed-tomography-cbct-case-reports-and-hypothesis
#10
Gayathri Subramanian, Evelyne Kalyoussef, Meredith Blitz-Goldstein, Jessenia Guerrero, Nasrin Ghesani, Samuel Y P Quek
Surgical debridement of medication-related osteonecrosis of the jaw (MRONJ) lesions is far less predictable than lesion resection. Margins for surgical debridement are guided by surrogate markers of bone viability, such as bleeding and bone fluorescence, which limit debridement to visibly necrotic bone. In contrast, surgical resection is extensive, including a substantial portion of surrounding bone. The concept that the MRONJ lesion is a composite of affected but viable ("compromised") and necrotic bone is supported by histopathological data...
November 28, 2016: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
https://www.readbyqxmd.com/read/28108051/epstein-barr-virus-related-mucocutaneous-ulceration-that-mimics-oral-squamous-cell-carcinoma-the-importance-of-recognising-this-new-condition
#11
T Aldridge, Paraneetharan, P Brennan, V Ilankovan
We report a case and present a literature search of the relatively newly reported condition of Epstein Barr Virus (EBV)-related mucocutaneous ulceration. EBV-related mucocutaneous ulcers clinically present as oral squamous cell carcinoma (OSCC) in immunocompromised elderly patients but usually resolve by stopping or modifying the medication. As the two conditions can present in a similar way, and the management of each is totally different, this case highlights the importance of recognising this condition at an early stage...
January 17, 2017: British Journal of Oral & Maxillofacial Surgery
https://www.readbyqxmd.com/read/28107475/review-and-analysis-of-publication-trends-over-three-decades-in-three-high-impact-medicine-journals
#12
Alexander Ivanov, Beata A Kaczkowska, Saadat A Khan, Jean Ho, Morteza Tavakol, Ashok Prasad, Geetha Bhumireddy, Allan F Beall, Igor Klem, Parag Mehta, William M Briggs, Terrence J Sacchi, John F Heitner
CONTEXT: Over the past three decades, industry sponsored research expanded in the United States. Financial incentives can lead to potential conflicts of interest (COI) resulting in underreporting of negative study results. OBJECTIVE: We hypothesized that over the three decades, there would be an increase in: a) reporting of conflict of interest and source of funding; b) percentage of randomized control trials c) number of patients per study and d) industry funding...
2017: PloS One
https://www.readbyqxmd.com/read/28107430/discontinuation-from-antiretroviral-therapy-a-continuing-challenge-among-adults-in-hiv-care-in-ethiopia-a-systematic-review-and-meta-analysis
#13
Hailay Abrha Gesesew, Paul Ward, Kifle Woldemichael Hajito, Garumma Tolu Feyissa, Leila Mohammadi, Lillian Mwanri
BACKGROUND: Discontinuation of antiretroviral therapy (ART) reduces the immunological benefit of treatment and increases complications related to human immune-deficiency virus (HIV). However, the risk factors for ART discontinuation are poorly understood in developing countries particularly in Ethiopia. This review aimed to assess the best available evidence regarding risk factors for ART discontinuation in Ethiopia. METHODS: Quantitative studies conducted in Ethiopia between 2002 and 2015 that evaluated factors associated with ART discontinuation were sought across six major databases...
2017: PloS One
https://www.readbyqxmd.com/read/28107301/implementation-of-a-pediatric-orthopaedic-bundle-to-reduce-surgical-site-infections
#14
Jan Schriefer, James Sanders, Julie Michels, Kori Wolcott, Connor Ruddy, Jenna Hanson
Surgical site infections (SSIs) cost an estimated $27,288 per case. An analysis of the National Surgical Quality Improvement Program data at the University of Rochester Medical Center suggested that rates of SSIs could be lowered in comparison with both peers and baseline. The aim of this study was to reduce the number of SSIs to zero through the implementation of a "bundle" or a combination of practices. Meetings were held with the multidisciplinary care team that includes surgeons and staff from pediatric pharmacy, pediatric infectious diseases, anesthesia, and nursing to create a care bundle for all pediatric orthopaedic surgery patients...
January 2017: Orthopaedic Nursing
https://www.readbyqxmd.com/read/28107158/human-trafficking-in-areas-of-conflict-health-care-professionals-duty-to-act
#15
Christina Bloem, Rikki E Morris, Makini Chisolm-Straker
Given the significant global burden of human trafficking, the ability of clinicians to identify and provide treatment for trafficked persons is critical. Particularly in conflict settings, health care facilities often serve as the first and sometimes only point of contact for trafficked persons. As such, medical practitioners have a unique opportunity and an ethical imperative to intervene, even in nonclinical roles. With proper training, medical practitioners can assist trafficked persons by documenting human trafficking cases, thereby placing pressure on key stakeholders to enforce legal protections, and by providing adequate services to those trafficked...
January 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/28107093/adult-clonidine-overdose-prolonged-bradycardia-and-central-nervous-system-depression-but-not-severe-toxicity
#16
Geoffrey K Isbister, Simon P Heppell, Colin B Page, Nicole M Ryan
CONTEXT: There are limited reports of adult clonidine overdose. We aimed to describe the clinical effects and treatment of clonidine overdose in adults. METHODS: This was a retrospective review of a prospective cohort of poisoned patients who took clonidine overdoses (>200 μg). Demographic information, clinical effects, treatment, complications (central nervous system and cardiovascular effects) and length of stay (LOS) were extracted from a clinical database or medical records...
January 20, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28106744/oligonucleotide-therapy-for-obstructive-and-restrictive-respiratory-diseases
#17
REVIEW
Wupeng Liao, Jinrui Dong, Hong Yong Peh, Lay Hong Tan, Kah Suan Lim, Li Li, Wai-Shiu Fred Wong
Inhaled oligonucleotide is an emerging therapeutic modality for various common respiratory diseases, including obstructive airway diseases like asthma and chronic obstructive pulmonary disease (COPD) and restrictive airway diseases like idiopathic pulmonary fibrosis (IPF). The advantage of direct accessibility for oligonucleotide molecules to the lung target sites, bypassing systemic administration, makes this therapeutic approach promising with minimized potential systemic side effects. Asthma, COPD, and IPF are common chronic respiratory diseases, characterized by persistent airway inflammation and dysregulated tissue repair and remodeling, although each individual disease has its unique etiology...
January 17, 2017: Molecules: a Journal of Synthetic Chemistry and Natural Product Chemistry
https://www.readbyqxmd.com/read/28106717/air-embolism-diagnosis-clinical-management-and-outcomes
#18
Colin J McCarthy, Sasan Behravesh, Sailendra G Naidu, Rahmi Oklu
Air embolism is a rare but potentially fatal complication of surgical procedures. Rapid recognition and intervention is critical for reducing morbidity and mortality. We retrospectively characterized our experience with air embolism during medical procedures at a tertiary medical center. Electronic medical records were searched for all cases of air embolism over a 25-year period; relevant medical and imaging records were reviewed. Sixty-seven air embolism cases were identified; the mean age was 59 years (range, 3-89 years)...
January 17, 2017: Diagnostics
https://www.readbyqxmd.com/read/28106675/treatment-of-slipped-capital-femoral-epiphysis-with-the-modified-dunn-procedure-a-multicenter-study
#19
Masquijo J Javier, Allende Victoria, D'Elia Martín, Miranda Gabriela, Fernández Claudio A
INTRODUCTION: Treatment of moderate to severe slipped capital femoral epiphysis (SCFE) is controversial. Over the last years, 3 institutions in Argentina adopted the modified Dunn procedure for capital realignment in selected cases of SCFE. Our aim in this study was to evaluate the clinical outcome and the rate of complications of patients who had undergone surgical hip dislocation and capital realignment. METHODS: A multicenter retrospective cohort study of patients who received the modified Dunn procedure from January 2009 to 2013 was performed...
January 18, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28106657/impact-of-case-order-on-laparoscopic-sacrocolpopexy-do-surgeons-need-a-warm-up
#20
Erin Seifert Lavelle, Lindsay C Turner, Jonathan P Shepherd
OBJECTIVES: Warm-up is defined as a preparatory activity or procedure. Using case order as a surrogate for surgeon warm-up, first cases were compared with second or later cases for intraoperative complications, operative time, and length of stay (LOS) among women undergoing laparoscopic sacrocolpopexy. METHODS: This is a retrospective study of laparoscopic sacrocolpopexies performed from 2009 through 2014 at a large academic center. Any surgery preceding laparoscopic sacrocolpopexy was considered a surrogate for surgeon warm-up...
January 18, 2017: Female Pelvic Medicine & Reconstructive Surgery
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