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https://www.readbyqxmd.com/read/100001003/emergency-management-of-sepsis-the-simple-stuff-saves-lives
#1
David Sweet, Julian Marsden, Kendall Ho, Christina Krause, James A Russell
Many emergency departments have implemented sepsis protocols since the 2001 publication of results from the early goal-directed therapy trial, which showed early targeted resuscitation lowers mortality. As part of an attempt to improve clinical and operational outcomes for emergency departments across British Columbia, we reviewed sepsis management literature and considered sepsis protocol implementation in the province’s emergency departments. During the literature review we found that many observational studies confirmed an association between implementation of emergency sepsis protocols and decreased mortality...
May 2012: BC medical journal: BCMJ
https://www.readbyqxmd.com/read/27926927/male-circumcision-and-the-epidemic-emergence-of-hiv-2-in-west-africa
#2
João Dinis Sousa, Marina Padrão Temudo, Barry Stephen Hewlett, Ricardo Jorge Camacho, Viktor Müller, Anne-Mieke Vandamme
BACKGROUND: Epidemic HIV-2 (groups A and B) emerged in humans circa 1930-40. Its closest ancestors are SIVsmm infecting sooty mangabeys from southwestern Côte d'Ivoire. The earliest large-scale serological surveys of HIV-2 in West Africa (1985-91) show a patchy spread. Côte d'Ivoire and Guinea-Bissau had the highest prevalence rates by then, and phylogeographical analysis suggests they were the earliest epicenters. Wars and parenteral transmission have been hypothesized to have promoted HIV-2 spread...
2016: PloS One
https://www.readbyqxmd.com/read/27926887/the-application-of-genomics-in-diabetes-barriers-to-discovery-and-implementation
#3
James S Floyd, Bruce M Psaty
The emerging availability of genomic and electronic health data in large populations is a powerful tool for research that has drawn interest in bringing precision medicine to diabetes. In this article, we discuss the potential application of genomics to the prediction, prevention, and treatment of diabetes, and we use examples from other areas of medicine to illustrate some of the challenges involved in conducting genomics research in human populations and implementing findings in practice. At this time, a major barrier to the application of genomics in diabetes care is the lack of actionable genomic findings...
November 2016: Diabetes Care
https://www.readbyqxmd.com/read/27926854/structural-characterization-and-statistical-mechanical-model-of-epidermal-patterns
#4
Duyu Chen, Wen Yih Aw, Danelle Devenport, Salvatore Torquato
In proliferating epithelia of mammalian skin, cells of irregular polygon-like shapes pack into complex, nearly flat two-dimensional structures that are pliable to deformations. In this work, we employ various sensitive correlation functions to quantitatively characterize structural features of evolving packings of epithelial cells across length scales in mouse skin. We find that the pair statistics in direct space (correlation function) and Fourier space (structure factor) of the cell centroids in the early stages of embryonic development show structural directional dependence (statistical anisotropy), which is a reflection of the fact that cells are stretched, which promotes uniaxial growth along the epithelial plane...
December 6, 2016: Biophysical Journal
https://www.readbyqxmd.com/read/27926799/2015-academic-emergency-medicine-consensus-conference-attendees
#5
(no author information available yet)
No abstract text is available yet for this article.
December 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/27926759/mortality-and-prehospital-blood-pressure-in-patients-with-major-traumatic-brain-injury-implications-for-the-hypotension-threshold
#6
Daniel W Spaite, Chengcheng Hu, Bentley J Bobrow, Vatsal Chikani, Duane Sherrill, Bruce Barnhart, Joshua B Gaither, Kurt R Denninghoff, Chad Viscusi, Terry Mullins, P David Adelson
Importance: Current prehospital traumatic brain injury guidelines use a systolic blood pressure threshold of less than 90 mm Hg for treating hypotension for individuals 10 years and older based on studies showing higher mortality when blood pressure drops below this level. However, the guidelines also acknowledge the weakness of the supporting evidence. Objective: To evaluate whether any statistically supportable threshold between systolic pressure and mortality emerges from the data a priori, without assuming that a cut point exists...
December 7, 2016: JAMA Surgery
https://www.readbyqxmd.com/read/27926672/mechanisms-predisposing-factors-and-prognosis-of-intra-operative-vertebral-subluxation-during-pedicle-subtraction-osteotomy-in-surgical-correction-of-thoracolumbar-kyphosis-secondary-to-ankylosing-spondylitis
#7
Bang-Ping Qian, Sai-Hu Mao, Jun Jiang, Bin Wang, Yong Qiu
STUDY DESIGN: A retrospective study. OBJECTIVE: To analyze the mechanisms, predisposing factors and prognosis of the intraoperative vertebral subluxation (VS) during pedicle subtraction osteotomy (PSO) for thoracolumbar kyphosis secondary to ankylosing spondylitis (AS). SUMMARY OF BACKGROUND DATA: VS is one of the most daunting challenges that surgeons encounter during PSO closure, especially in AS patients with ankylosed and mostly osteoporotic spine...
December 6, 2016: Spine
https://www.readbyqxmd.com/read/27926663/the-impact-of-value-based-healthcare-for-inflammatory-bowel-diseases-on-healthcare-utilization-a-pilot-study
#8
Welmoed K van Deen, Arlen Spiro, A Burak Ozbay, Martha Skup, Adriana Centeno, Natalie E Duran, Precious N Lacey, Darius Jatulis, Eric Esrailian, Martijn G H van Oijen, Daniel W Hommes
BACKGROUND AND OBJECTIVES: Value-based healthcare (VBHC) is considered to be the solution that will improve quality and decrease costs in healthcare. Many hospitals are implementing programs on the basis of this strategy, but rigorous scientific reports are still lacking. In this pilot study, we present the first-year outcomes of a VBHC program for inflammatory bowel disease (IBD) management that focuses on highly coordinated care, task differentiation of providers, and continuous home monitoring...
December 6, 2016: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/27926623/clinician-perceptions-of-teamwork-in-the-emergency-department-does-nurse-and-medical-provider-workspace-placement-make-a-difference
#9
Amy L Weaver, Susan Hernandez, Daiwai M Olson
OBJECTIVE: This study was intended to determine whether positioning emergency department (ED) physicians, physician assistants, and nurse practitioners at the same workstations as registered nurses (RNs) improved communication and teamwork. BACKGROUND: Historically in this organization, providers and staff had separate physical locations (workstations). Construction of a new ED provided the opportunity to redesign the physical layout and to study whether a new design improved the perception of communication and teamwork among medical providers...
January 2017: Journal of Nursing Administration
https://www.readbyqxmd.com/read/27926621/accountable-care-organization-implementation-experiences-and-rural-participation-considerations-for-nurses
#10
Matt Thomas Bagwell, Angeline Bushy, Judith Ortiz
BACKGROUND: Little is known about how accountable care organizations (ACOs) participate with rural health providers. This pilot study examines ACO participation with rural health clinics (RHCs). METHODS: Telephone interviews with 8 ACO administrators were conducted to determine the early implementation experiences of these organizations, and their participation with rural health providers, such as RHCs, using qualitative content analysis, ACO characteristics, and emerging themes from the ACO executive responses was identified...
January 2017: Journal of Nursing Administration
https://www.readbyqxmd.com/read/27926614/clinical-coordination-in-accountable-care-organizations-a-qualitative-study
#11
Valerie A Lewis, Karen Schoenherr, Taressa Fraze, Aleen Cunningham
BACKGROUND: Accountable care organizations (ACOs) are becoming a common payment and delivery model. Despite widespread interest, little empirical research has examined what efforts or strategies ACOs are using to change care and reduce costs. Knowledge of ACOs' clinical efforts can provide important context for understanding ACO performance, particularly to distinguish arenas where ACOs have and have not attempted care transformation. PURPOSE: The aim of the study was to understand ACOs' efforts to change clinical care during the first 18 months of ACO contracts...
December 6, 2016: Health Care Management Review
https://www.readbyqxmd.com/read/27926592/development-of-a-tobacco-cessation-clinical-decision-support-system-for-pediatric-emergency-nurses
#12
(no author information available yet)
No abstract text is available yet for this article.
December 2016: Computers, Informatics, Nursing: CIN
https://www.readbyqxmd.com/read/27926573/further-delineation-between-typical-and-atypical-dopamine-uptake-inhibitors-effects-on-food-maintained-behavior-and-food-consumption
#13
Jonathan M Slezak, Rajeev I Desai, Jonathan L Katz
The present studies compared the acute effects of benztropine analogs (4-Cl-BZT, JHW 007, AHN 1-055), which are atypical dopamine uptake inhibitors, with those of the standard dopamine uptake inhibitors GBR 12909 and cocaine, on the reinforcing efficacy of food and food intake in male Sprague-Dawley rats. Repeated drug effects of JHW 007 on food intake were also determined. The number of ratios completed under a progressive-ratio schedule of food delivery was used as an index of reinforcing efficacy. Food intake was determined by measuring powdered laboratory-chow consumption during daily 40 min food-availability time periods...
December 6, 2016: Behavioural Pharmacology
https://www.readbyqxmd.com/read/27926555/avoiding-radical-surgery-in-elderly-patients-with-rectal-cancer-is-cost-effective
#14
Christopher Rao, Arthur Sun Myint, Thanos Athanasiou, Omar Faiz, Antony Paul Martin, Brendan Collins, Fraser McLean Smith
BACKGROUND: Radical surgery is associated with significant perioperative mortality in elderly and comorbid populations. Emerging data suggest for patients with a clinical complete response after neoadjuvant chemoradiotherapy that a watch-and-wait approach may provide equivalent survival and oncological outcomes. OBJECTIVE: The purpose of this study was to compare the cost-effectiveness of watch and wait and radical surgery for patients with rectal cancer after a clinical complete response following chemoradiotherapy...
January 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/27926537/lactate-arterial-and-venous-agreement-in-sepsis-a-prospective-observational-study
#15
Deepankar Datta, Julia Grahamslaw, Alasdair J Gray, Catriona Graham, Craig A Walker
BACKGROUND: Sepsis is a common condition in the emergency department (ED). Lactate measurement is an important part of management: arterial lactate (A-LACT) measurement is the gold standard. There is increasing use of peripheral venous lactate (PV-LACT); however, there is little research supporting the interchangeability of the two measures.If PV-LACT has good agreement with A-LACT, it would significantly reduce patient discomfort and the risks of arterial sampling for a large group of acutely unwell patients, while allowing faster and wider screening, with potential reduced costs to the healthcare system...
December 6, 2016: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/27926444/common-and-distinctive-approaches-to-motivation-in-different-disciplines
#16
T Strombach, S Strang, S Q Park, P Kenning
Over the last couple of decades, a body of theories has emerged that explains when and why people are motivated to act. Multiple disciplines have investigated the origins and consequences of motivated behavior, and have done so largely in parallel. Only recently have different disciplines, like psychology and economics, begun to consolidate their knowledge, attempting to integrate findings. The following chapter presents and discusses the most prominent approaches to motivation in the disciplines of biology, psychology, and economics...
2016: Progress in Brain Research
https://www.readbyqxmd.com/read/27926430/insights-in-waste-management-bioprocesses-using-genomic-tools
#17
H J Purohit, A Kapley, A Khardenavis, A Qureshi, N A Dafale
Microbial capacities drive waste stabilization and resource recovery in environmental friendly processes. Depending on the composition of waste, a stress-mediated selection process ensures a scenario that generates a specific enrichment of microbial community. These communities dynamically change over a period of time while keeping the performance through the required utilization capacities. Depending on the environmental conditions, these communities select the appropriate partners so as to maintain the desired functional capacities...
2016: Advances in Applied Microbiology
https://www.readbyqxmd.com/read/27926381/a-review-on-brain-structures-segmentation-in-magnetic-resonance-imaging
#18
REVIEW
Sandra González-Villà, Arnau Oliver, Sergi Valverde, Liping Wang, Reyer Zwiggelaar, Xavier Lladó
BACKGROUND AND OBJECTIVES: Automatic brain structures segmentation in magnetic resonance images has been widely investigated in recent years with the goal of helping diagnosis and patient follow-up in different brain diseases. Here, we present a review of the state-of-the-art of automatic methods available in the literature ranging from structure specific segmentation methods to whole brain parcellation approaches. METHODS: We divide first the algorithms according to their target structures and then we propose a general classification based on their segmentation strategy, which includes atlas-based, learning-based, deformable, region-based and hybrid methods...
October 2016: Artificial Intelligence in Medicine
https://www.readbyqxmd.com/read/27925849/development-and-prospective-federal-state-wide-evaluation-of-a-device-for-height-based-dose-recommendations-in-prehospital-pediatric-emergencies-a-simple-tool-to-prevent-most-severe-drug-errors
#19
Jost Kaufmann, Bernhard Roth, Thomas Engelhardt, Alex Lechleuthner, Michael Laschat, Christoph Hadamitzky, Frank Wappler, Martin Hellmich
OBJECTIVE: Drug dosing errors pose a particular threat to children in prehospital emergency care. With the Pediatric emergency ruler (PaedER), we developed a simple height-based dose recommendation system and evaluated its effectiveness in a pre-post interventional trial as the Ethics Committee disapproved randomization due to the expected positive effect of the PaedER on outcome. METHODS: Pre-interventional data were retrospectively retrieved from the electronic records and medical protocols of the Cologne Emergency Medical Service over a two-year period prior to the introduction of the PaedER...
December 7, 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27925844/a-two-dose-heterologous-prime-boost-vaccine-regimen-eliciting-sustained-immune-responses-to-ebola-zaire-could-support-a-preventive-strategy-for-future-outbreaks
#20
Georgi Shukarev, Benoit Callendret, Kerstin Luhn, Macaya Douoguih, The Ebovac Consortium
The consequences of the 2013-16 Ebola Zaire virus disease epidemic in West Africa were grave. The economies, healthcare systems and communities of Guinea, Sierra Leone and Liberia were devastated by over 18 months of active Ebola virus transmission, followed by sporadic resurgences potentially related to sexual transmission by survivors with viral persistence in body fluids following recovery. The need to develop and implement strategies to prevent and mitigate future outbreaks is now beyond dispute. The potential for unpredictable outbreaks of indeterminate duration, and control challenges posed by the possibility of sporadic re-emergence, mean that implementation of an effective vaccination programme for outbreak containment necessitates a vaccine providing durable immunity...
December 7, 2016: Human Vaccines & Immunotherapeutics
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