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https://www.readbyqxmd.com/read/28220486/cetuximab-plus-irinotecan-versus-panitumumab-in-patients-with-refractory-metastatic-colorectal-cancer-in-ontario-canada
#1
Katarzyna J Jerzak, Scott Berry, Yoo-Joung Ko, Craig Earle, Kelvin K W Chan
The addition of irinotecan to an EGFR antibody has previously been shown to improve tumor response rate and time to progression but not overall survival (OS) for refractory metastatic colorectal cancer (mCRC). We assessed the "real world" effectiveness and toxicity of the combination versus monotherapy. In Ontario, Canada universal public funding is available for either cetuximab plus irinotecan (Cmab+I) combination therapy or panitumumab (Pmab) monotherapy, only in patients with refractory non-mutated RAS mCRC...
February 21, 2017: International Journal of Cancer. Journal International du Cancer
https://www.readbyqxmd.com/read/28220246/treatment-of-open-fractures-of-the-hand-in-the-emergency-department
#2
Nofar Ben Basat, Raviv Allon, Ahmad Nagmi, Ronit Wollstein
Current guidelines suggest early surgical treatment of open fractures. This rule in open hand fractures is not well supported and may be unpractical. Furthermore, desirable debridement and washout can be obtained in the emergency department (ED). The purpose of this study was to evaluate the relationship between the level of contamination, quality of washout in the emergency room, and the development of infection. Sixty-one patients with open fractures of the hand were retrospectively reviewed for demographic and fracture characteristics, and other complications...
February 20, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28210362/serum-lactate-predicts-adverse-outcomes-in-emergency-department-patients-with-and-without-infection
#3
Kimie Oedorf, Danielle E Day, Yotam Lior, Victor Novack, Leon D Sanchez, Richard E Wolfe, Hans Kirkegaard, Nathan I Shapiro, Daniel J Henning
INTRODUCTION: Lactate levels are increasingly used to risk stratify emergency department (ED) patients with and without infection. Whether a serum lactate provides similar prognostic value across diseases is not fully elucidated. This study assesses the prognostic value of serum lactate in ED patients with and without infection to both report and compare relative predictive value across etiologies. METHODS: We conducted a prospective, observational study of ED patients displaying abnormal vital signs (AVS) (heart rate ≥130 bpm, respiratory rate ≥24 bpm, shock index ≥1, and/or systolic blood pressure <90 mmHg)...
February 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28208229/comparing-the-performance-of-propensity-score-methods-in-healthcare-database-studies-with-rare-outcomes
#4
Jessica M Franklin, Wesley Eddings, Peter C Austin, Elizabeth A Stuart, Sebastian Schneeweiss
Nonrandomized studies of treatments from electronic healthcare databases are critical for producing the evidence necessary to making informed treatment decisions, but often rely on comparing rates of events observed in a small number of patients. In addition, studies constructed from electronic healthcare databases, for example, administrative claims data, often adjust for many, possibly hundreds, of potential confounders. Despite the importance of maximizing efficiency when there are many confounders and few observed outcome events, there has been relatively little research on the relative performance of different propensity score methods in this context...
February 16, 2017: Statistics in Medicine
https://www.readbyqxmd.com/read/28207996/the-use-of-a-contextual-modal-and-psychological-classification-of-medication-errors-in-the-emergency-department-a-retrospective-descriptive-study
#5
C J Cabilan, J A Hughes, C Shannon
BACKGROUND: The causes of medication errors are unique in every clinical setting; hence error minimisation strategies are not always effective. For this reason, it is fundamental to understand the causes specific to the emergency department so that targeted strategies can be implemented. OBJECTIVES: To describe the contextual, modal, and psychological classification of medication errors in the emergency department to know the factors associated with the reported medication errors...
February 16, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28196831/child-and-adolescent-mental-health-repeat-visits-to-the-emergency-department-a-systematic-review
#6
REVIEW
Stephanie L Leon, Paula Cloutier, Christine Polihronis, Roger Zemek, Amanda S Newton, Clare Gray, Mario Cappelli
OBJECTIVES: Repeat visits represent up to 45% of mental health (MH) presentations to emergency departments (EDs) and are associated with higher health care costs. We aimed to synthesize available literature on predictors of pediatric MH repeat ED visits and differences between repeat visitors and nonrepeat visitors. METHODS: A systematic review was performed using PsycINFO, PubMed, and CINAHL databases. Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement checklist...
February 14, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28186638/psychotherapy-utilization-and-retention-in-a-national-sample-of-veterans-with-ptsd
#7
Jennifer M Doran, Robert H Pietrzak, Rani Hoff, Ilan Harpaz-Rotem
OBJECTIVE: This study examines the demographic, diagnostic, and military variables associated with psychotherapy utilization and retention in a national Veteran sample. METHOD: A large administrative VA dataset (142,620 Veterans) was utilized. Logistic regression was used to determine predictors of psychotherapy utilization and retention. RESULTS: Female gender was associat ed with increased psychotherapy utilization and retention. Geriatric age was associated with less retention in individual psychotherapy...
February 10, 2017: Journal of Clinical Psychology
https://www.readbyqxmd.com/read/28178913/training-us-health-care-professionals-on-human-trafficking-where-do-we-go-from-here
#8
Clydette Powell, Kirsten Dickins, Hanni Stoklosa
: Some 21 million adults and children are labor-trafficked or sex-trafficked through force, fraud, or coercion. In recognition of the interface between trafficking victims and the healthcare setting, over the last 10 years there has been a notable increase in training of health care professionals (HCPs) on human trafficking (HT) and its health implications. Many organizations have developed curricula and offered training in various clinical settings. However, methods and content of this education on trafficking vary widely, and there is little evaluation of the impact of the training...
2017: Medical Education Online
https://www.readbyqxmd.com/read/28177940/emergency-department-pain-management-in-children-with-appendicitis-in-a-bi-ethnic-population
#9
Ron Jacob, Baruch Krauss, Gal Twito, Ronit Leiba, Itai Shavit
OBJECTIVES: Our goal was to examine factors associated with the administration of ED analgesia (any analgesia, opioid analgesia) in patients with acute appendicitis in a tertiary children's hospital in Israel, and to examine ethnic differences. METHODS: A retrospective cohort study of children evaluated in the ED, who had ICD-9 diagnosis of acute appendicitis. Regression analysis was used to test the effect of multiple variables on the provision of analgesia. Medications were administered according to a nurse-driven pain protocol...
February 7, 2017: Clinical Journal of Pain
https://www.readbyqxmd.com/read/28173749/testing-a-systematic-approach-to-identify-and-prioritise-barriers-to-successful-implementation-of-a-complex-healthcare-intervention
#10
Louise E Craig, Leonid Churilov, Liudmyla Olenko, Dominique A Cadilhac, Rohan Grimley, Simeon Dale, Cintia Martinez-Garduno, Elizabeth McInnes, Julie Considine, Jeremy M Grimshaw, Sandy Middleton
BACKGROUND: Multiple barriers may inhibit the adoption of clinical interventions and impede successful implementation. Use of standardised methods to prioritise barriers to target when selecting implementation interventions is an understudied area of implementation research. The aim of this study was to describe a method to identify and prioritise barriers to the implementation of clinical practice elements which were used to inform the development of the T(3) trial implementation intervention (Triage, Treatment [thrombolysis administration; monitoring and management of temperature, blood glucose levels, and swallowing difficulties] and Transfer of stroke patients from Emergency Departments [ED])...
February 7, 2017: BMC Medical Research Methodology
https://www.readbyqxmd.com/read/28166990/use-of-fsh-in-two-different-regimens-for-ovarian-superstimulation-prior-to-ovum-pick-up-and-in%C3%A2-vitro-embryo-production-in-holstein-cows
#11
Júlio César Barboza da Silva, Roberta Machado Ferreira, Milton Maturana Filho, Julianne de Rezende Naves, Thiago Santin, Guilherme Pugliesi, Ed Hoffmann Madureira
We aimed with the present study to evaluate the effects of FSH treatment (200 mg) split in four or six administrations on ovarian follicle stimulation and in vitro oocyte competence for embryo production in dairy cows with synchronized follicular wave emergence. On random days of the estrous cycle (Day 0), non-lactating Holstein cows received a progesterone (P4)-releasing intravaginal device and 2 mg estradiol benzoate IM. On Day 3, they received 0.530 mg sodium cloprostenol (PGF2α) IM. Control cows (n = 35) received no further treatments, whereas FSH-treated cows received 200 mg FSH split in four (FSH4 group; n = 33) or six (FSH6 group; n = 33) administration regimens...
March 1, 2017: Theriogenology
https://www.readbyqxmd.com/read/28166446/use-of-intranasal-naloxone-by-basic-life-support-providers
#12
Scott G Weiner, Patricia M Mitchell, Elizabeth S Temin, Breanne K Langlois, K Sophia Dyer
STUDY OBJECTIVES: Intranasal delivery of naloxone to reverse the effects of opioid overdose by Advanced Life Support (ALS) providers has been studied in several prehospital settings. In 2006, in response to the increase in opioid-related overdoses, a special waiver from the state allowed administration of intranasal naloxone by Basic Life Support (BLS) providers in our city. This study aimed to determine: 1) if patients who received a 2-mg dose of nasal naloxone administered by BLS required repeat dosing while in the emergency department (ED), and 2) the disposition of these patients...
February 6, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28163066/development-of-a-simple-rapid-and-robust-intrathecal-catheterization-method-in-the-rat
#13
Curt Mazur, Bethany Fitzsimmons, Fredrik Kamme, Brandon Nichols, Berit Powers, Ed Wancewicz
BACKGROUND: The blood brain barrier (BBB) is an impediment to the development of large and highly charged molecules as therapeutics for diseases and injuries of the central nervous system (CNS). Antisense oligonucleotides (ASOs) are large (6000-8000MW) and highly charged and therefore do not cross the BBB. A method of circumventing the blood brain barrier to test ASOs, and other non-BBB penetrant molecules, as CNS therapeutics is the direct administration of these molecules to the CNS tissue or cerebral spinal fluid...
February 2, 2017: Journal of Neuroscience Methods
https://www.readbyqxmd.com/read/28153061/trajectories-of-stroke-care-in-ontario-which-path-to-best-care
#14
Ruth E Hall, Diana Sondergaard, Walter P Wodchis, Jiming Fang, Prosanta Mondal, Mark T Bayley
BACKGROUND: Few studies have tracked stroke survivors through transitions across the health system and identified the most common trajectories and quality of care received. The objectives of our study were to examine the trajectories that incident stroke patients experience and to quantify the extent to which their care adhered to the best practices for stroke care. METHODS: A population-based cohort of first-ever stroke/transient ischemic attack (TIA) patients from the 2012/13 Ontario Stroke Audit was linked to administrative databases using an encrypted health card number to identify dominant trajectories (N=12,362)...
February 3, 2017: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
https://www.readbyqxmd.com/read/28152815/development-of-an-integrated-practice-unit-utilizing-a-lean-approach-to-impact-value-of-care-for-brain-tumor-patients
#15
Christine Ahn, Preston White, Linda M Liau, Timothy Francis Cloughesy, Phioanh Leia Nghiemphu
: 99 Background: Lack of care coordination across subspecialty departments involved in the treatment of brain tumor patients at our institution has negatively impacted patient outcomes, patient experience, and costs. Meanwhile, value-based health care has become increasingly relevant as a means to respond to changing payment structures and improve quality. With the aim to increase value, we restructured medical practice across the continuum of care for brain tumor patients by developing a virtual (non co-located) Integrated Practice Unit (IPU)...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28139291/phosphodiesterase-type-5-inhibitors-for-the-treatment-of-erectile-dysfunction-pharmacology-and-clinical-impact-of-the-sildenafil-citrate-orodispersible-tablet-formulation
#16
REVIEW
Francesco Scaglione, Shaantanu Donde, Tarek A Hassan, Emmanuele A Jannini
PURPOSE: The purpose of this review is to provide an overview of the pharmacology, tolerability, and efficacy of the different phosphodiesterase type 5 (PDE5) inhibitors available for the treatment of erectile dysfunction (ED), with a special focus on the sildenafil orodispersible tablet (ODT) formulation. METHODS: A literature search was performed in PubMed, EMBASE, and Cochrane Reviews using the terms erectile dysfunction, patient preference, sildenafil, and PDE5 inhibitors to identify articles published in English between May 1, 2006, and November 18, 2016...
January 27, 2017: Clinical Therapeutics
https://www.readbyqxmd.com/read/28135183/proposed-icd-10-cm-surveillance-case-definitions-for-injury-hospitalizations-and-emergency-department-visits
#17
Holly B Hedegaard, Renee L Johnson, Michael F Ballesteros
This report describes a collaboration between the National Center for Health Statistics and the National Center for Injury Prevention and Control to develop proposed surveillance case definitions for injury hospitalizations and emergency department (ED) visits for use with administrative data sets coded using the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM). The proposed ICD-10-CM surveillance case definitions were developed by applying General Equivalence Mappings to the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) definitions...
January 2017: National Health Statistics Reports
https://www.readbyqxmd.com/read/28133708/tadalafil-improves-lean-mass-and-endothelial-function-in-nonobese-men-with-mild-ed-luts-in-vivo-and-in-vitro-characterization
#18
Antonio Aversa, Simona Fittipaldi, Davide Francomano, Viviana M Bimonte, Emanuela A Greco, Clara Crescioli, Luigi Di Luigi, Andrea Lenzi, Silvia Migliaccio
PURPOSE: Phosphodiesterase type-5 inhibitor administration in diabetic men with erectile dysfunction (ED) is associated with reduced waist circumference. We evaluated potential effects of daily tadalafil administration on body composition and investigated its possible mechanism(s) of action in C2C12 skeletal muscle cells in vitro. METHODS: Forty-three men on stable caloric intake (mean age 48.5 ± 7; BMI 25.5 ± 0.9 kg/m(2)) complaining mild ED and/or low urinary tract symptoms (LUTS) were randomly assigned to receive tadalafil (TAD) 5 mg/daily (once-a-day=OAD-TAD; n = 23) or 20 mg on-demand (on-demand=OD-TAD; n = 20) for 2 months...
January 30, 2017: Endocrine
https://www.readbyqxmd.com/read/28131489/risk-of-acute-kidney-injury-after-intravenous-contrast-media-administration
#19
Jeremiah S Hinson, Michael R Ehmann, Derek M Fine, Elliot K Fishman, Matthew F Toerper, Richard E Rothman, Eili Y Klein
STUDY OBJECTIVE: The study objective was to determine whether intravenous contrast administration for computed tomography (CT) is independently associated with increased risk for acute kidney injury and adverse clinical outcomes. METHODS: This single-center retrospective cohort analysis was performed in a large, urban, academic emergency department with an average census of 62,179 visits per year; 17,934 ED visits for patients who underwent contrast-enhanced, unenhanced, or no CT during a 5-year period (2009 to 2014) were included...
January 19, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28123620/patterns-of-ketorolac-dosing-by-emergency-physicians
#20
Emil Soleyman-Zomalan, Sergey Motov, Antonios Likourezos, Victor Cohen, Illya Pushkar, Christian Fromm
BACKGROUND: Ketorolac tromethamine is a non-steroidal anti-inflammatory drug (NSAIDs) that is widely used in the emergency department (ED) for the treatment of moderate-to-severe pain. Ketorolac, like other NSAIDs, exhibits an analgesic ceiling effect and previous research suggests that 10 mg is possibly the ceiling dose. Do the patterns of ketorolac dosing by emergency physicians follow its analgesic ceiling dose? METHODS: This was a single center retrospective, descriptive study to characterize patterns of ketorolac administration in ED patients...
2017: World Journal of Emergency Medicine
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