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https://www.readbyqxmd.com/read/27889359/elevated-liver-enzymes-emergency-department-focused-management
#1
Eric Sulava, Samuel Bergin, Brit Long, Alex Koyfman
BACKGROUND: Liver function test (LFT) abnormalities are a common problem faced by emergency physicians. This has become more common with the introduction of laboratory panels and automated routine laboratory testing. Fortunately, not all patients with irregularities in liver enzymes possess underlying pathology. This emergency medicine focused review provides a discussion of the various biochemical tests, their underlying biological basis, and an algorithmic approach to the interpretation of abnormalities...
November 23, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27873322/non-medical-prescribing-versus-medical-prescribing-for-acute-and-chronic-disease-management-in-primary-and-secondary-care
#2
REVIEW
Greg Weeks, Johnson George, Katie Maclure, Derek Stewart
BACKGROUND: A range of health workforce strategies are needed to address health service demands in low-, middle- and high-income countries. Non-medical prescribing involves nurses, pharmacists, allied health professionals, and physician assistants substituting for doctors in a prescribing role, and this is one approach to improve access to medicines. OBJECTIVES: To assess clinical, patient-reported, and resource use outcomes of non-medical prescribing for managing acute and chronic health conditions in primary and secondary care settings compared with medical prescribing (usual care)...
November 22, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27849499/trauma-resuscitation-evaluation-times-and-correlating-human-patient-simulation-training-differences-what-is-the-standard
#3
Timothy J Bonjour, Grigory Charny, Robert E Thaxton
BACKGROUND: Rapid effective trauma resuscitations (TRs) decrease patient morbidity and mortality. Few studies have evaluated TR care times. Effective time goals and superior human patient simulator (HPS) training can improve patient survivability. OBJECTIVES: The purpose of this study was to compare live TR to HPS resuscitation times to determine mean incremental resuscitation times and ascertain if simulation was educationally equivalent. The study was conducted at San Antonio Military Medical Center, Department of Defense Level I trauma center...
November 2016: Military Medicine
https://www.readbyqxmd.com/read/27812729/-under-scrutiny-by-the-state-prosecutor-legal-pitfalls-in-emergency-medicine
#4
P Schelling
Physicians who allow a suicide attempt to happen, which from an ex ante viewpoint was completely voluntary, cannot be held punishable for homicide or failing to provide medical assistance when the suicide corresponds to the putative will of the patient according to plausible information supplied by an authorized person with healthcare proxy. Guidelines for resuscitation also play a central role in the forensic practice for assessment of whether and when resuscitation can be terminated; therefore, it is urgently advised to follow and implement these guidelines: deviations are possible if they can be factually justified...
November 3, 2016: Der Anaesthesist
https://www.readbyqxmd.com/read/27660369/amssm-position-statement-on-cardiovascular-preparticipation-screening-in-athletes-current-evidence-knowledge-gaps-recommendations-and-future-directions
#5
Jonathan A Drezner, Francis G O'Connor, Kimberly G Harmon, Karl B Fields, Chad A Asplund, Irfan M Asif, David E Price, Robert J Dimeff, David T Bernhardt, William O Roberts
Cardiovascular screening in young athletes is widely recommended and routinely performed prior to participation in competitive sports. While there is general agreement that early detection of cardiac conditions at risk for sudden cardiac arrest and death (SCA/D) is an important objective, the optimal strategy for cardiovascular screening in athletes remains an issue of considerable debate. At the centre of the controversy is the addition of a resting ECG to the standard preparticipation evaluation using history and physical examination...
September 22, 2016: British Journal of Sports Medicine
https://www.readbyqxmd.com/read/27630003/nonsuicidal-self-injury-of-adolescents
#6
Shannon Lovell, Marvin Clifford
Nonsuicidal self-injury (NSSI) is more common in adolescent and young adult populations than in the past. NSSI is typically used to deal with distressing negative affective states, especially anger and depression, and mixed emotional states. Pediatricians; primary care, family medicine, and emergency room physicians; and mental health professionals are faced with the charge of responding to NSSI behaviors among patients. Physicians in family medicine, pediatrics, and primary care settings play an essential role in initiating the beginning step in the treatment process for those who self-injure...
October 2016: Clinical Pediatrics
https://www.readbyqxmd.com/read/27618246/amssm-position-statement-on-cardiovascular-preparticipation-screening-in-athletes-current-evidence-knowledge-gaps-recommendations-and-future-directions
#7
Jonathan A Drezner, Francis G O'Connor, Kimberly G Harmon, Karl B Fields, Chad A Asplund, Irfan M Asif, David E Price, Robert J Dimeff, David T Bernhardt, William O Roberts
Cardiovascular screening in young athletes is widely recommended and routinely performed prior to participation in competitive sports. While there is general agreement that early detection of cardiac conditions at risk for sudden cardiac arrest and death (SCA/D) is an important objective, the optimal strategy for cardiovascular screening in athletes remains an issue of considerable debate. At the center of the controversy is the addition of a resting electrocardiogram (ECG) to the standard preparticipation evaluation using history and physical examination...
September 2016: Current Sports Medicine Reports
https://www.readbyqxmd.com/read/27598018/amssm-position-statement-on-cardiovascular-preparticipation-screening-in-athletes-current-evidence-knowledge-gaps-recommendations-and-future-directions
#8
Jonathan A Drezner, Francis G OʼConnor, Kimberly G Harmon, Karl B Fields, Chad A Asplund, Irfan M Asif, David E Price, Robert J Dimeff, David T Bernhardt, William O Roberts
Cardiovascular (CV) screening in young athletes is widely recommended and routinely performed before participation in competitive sports. While there is general agreement that early detection of cardiac conditions at risk for sudden cardiac arrest and death (SCA/D) is an important objective, the optimal strategy for CV screening in athletes remains an issue of considerable debate. At the center of the controversy is the addition of a resting electrocardiogram (ECG) to the standard preparticipation evaluation using history and physical examination...
September 2016: Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine
https://www.readbyqxmd.com/read/27553919/emergency-medicine-management-of-sickle-cell-disease-complications-an-evidence-based-update
#9
Erica Simon, Brit Long, Alex Koyfman
BACKGROUND: Sickle cell disease (SCD) affects approximately 100,000 individuals in the United States. Due to alterations in the structural conformation of hemoglobin molecules under deoxygenated conditions, patients with SCD are predisposed to numerous sequelae, many of which require acute intervention. OBJECTIVE: Our aim was to provide emergency physicians with an evidence-based update regarding the diagnosis and management of SCD complications. DISCUSSION: SCD patients experience significant morbidity and mortality secondary to cerebrovascular accident, acute chest syndrome, acute vaso-occlusive pain crises, SCD-related multi-organ failure, cholecystitis, acute intrahepatic cholestasis, acute sickle hepatic crisis, acute hepatic sequestration, priapism, and renal disease...
October 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27543134/networks-and-games-for-precision-medicine
#10
Célia Biane, Franck Delaplace, Hanna Klaudel
Recent advances in omics technologies provide the leverage for the emergence of precision medicine that aims at personalizing therapy to patient. In this undertaking, computational methods play a central role for assisting physicians in their clinical decision-making by combining data analysis and systems biology modelling. Complex diseases such as cancer or diabetes arise from the intricate interplay of various biological molecules. Therefore, assessing drug efficiency requires to study the effects of elementary perturbations caused by diseases on relevant biological networks...
August 16, 2016: Bio Systems
https://www.readbyqxmd.com/read/27537503/the-value-of-3d-printing-models-of-left-atrial-appendage-using-real-time-3d-transesophageal-echocardiographic-data-in-left-atrial-appendage-occlusion-applications-toward-an-era-of-truly-personalized-medicine
#11
Peng Liu, Rijing Liu, Yan Zhang, Yingfeng Liu, Xiaoming Tang, Yanzhen Cheng
AIMS AND OBJECTIVES: The objective of this study was to assess the clinical feasibility of generating 3D printing models of left atrial appendage (LAA) using real-time 3D transesophageal echocardiogram (TEE) data for preoperative reference of LAA occlusion. BACKGROUND: Percutaneous LAA occlusion can effectively prevent patients with atrial fibrillation from stroke. However, the anatomical structure of LAA is so complicated that adequate information of its structure is essential for successful LAA occlusion...
August 19, 2016: Cardiology
https://www.readbyqxmd.com/read/27510612/pediatrics-in-21-st-century-and-beyond
#12
Meharban Singh
Pediatrics is a dynamic discipline and there is awareness and hope for actualizing outstanding achievements in the field of child health in 21(st) century and beyond. Improved lifestyle and quality of children's health is likely to reduce the burden of adult diseases and enhance longevity because seeds of most adult diseases are sown in childhood. Identification and decoding of human genome is expected to revolutionize the practice of pediatrics. The day is not far off when a patient will walk into doctor's chamber with an electronic or digital health history on a CD or palmtop and a decoded genomic constitution...
November 2016: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/27484467/inflammatory-bowel-disease-mimicking-granulomatosis-with-polyangiitis-a-case-report
#13
Samantha C Shapiro, Armen Khararjian, Rebecca L Manno
BACKGROUND: We report a case in which the extraintestinal manifestations of inflammatory bowel disease preceded development of gastrointestinal symptoms by nearly 9 months in the context of an unusual autoantibody panel, mimicking granulomatosis with polyangiitis. This case highlights the intricacies and overlap of autoimmune diseases, and illustrates an interesting clinical phenotype: cytoplasmic anti-neutrophil cytoplasmic antibody positive inflammatory bowel disease with predominantly extraintestinal manifestations...
2016: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/27455340/clonidine-overdose-in-a-toddler-due-to-accidental-ingestion-of-a-compounding-cream
#14
Alexis L Cates, Scott M Wheatley, Kenneth D Katz
A 22-month-old girl without any significant medical history accidentally consumed a small amount of a therapeutic compounding cream that contained camphor, gabapentin, clonidine, ketoprofen, and lidocaine. Upon presentation to the emergency department, the child exhibited immediate onset of altered mental status with wide fluctuation in her vital signs, which included intermittent apnea requiring bag-valve mask assistance and endotracheal intubation. Serum laboratory analysis measured a clonidine level of 2...
July 23, 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27316915/french-intensive-care-society-international-congress-r%C3%A3-animation-2016
#15
(no author information available yet)
No abstract text is available yet for this article.
June 2016: Annals of Intensive Care
https://www.readbyqxmd.com/read/27215891/surgical-and-resuscitation-capabilities-for-the-next-war-based-on-lessons-learned-from-this-war
#16
David Freel, Bradley J Warr
The Army gleaned many lessons regarding the provision of medical care to casualties during the past 14 years of combat. Using these lessons learned in the Joint Capabilities and Integration Development process and through the analysis of an integrated process action team, the Army recently approved 3 changes to medical organizations that are intended to provide trauma management farther forward on the battlefield. These changes include the substitution of an emergency medicine trained physician and emergency medicine physician assistant (PA) in lieu of a general medical officer and primary care PA within the brigade combat team; reorganization of the forward surgical team into a forward surgical and resuscitative team; and the modularization of the traditional 248 bed combat support hospital...
April 2016: U.S. Army Medical Department Journal
https://www.readbyqxmd.com/read/27193986/views-of-emergency-physicians-working-in-university-and-state-hospitals-in-turkey-regarding-the-use-of-analgesics-in-patients-with-acute-abdominal-pain
#17
Özgür Özen, Selahattin Kıyan
BACKGROUND: Use of narcotic analgesics in patients with acute abdominal pain does not cause delayed misdiagnosis, increases patient comfort and does not suppresses physical examination. The purpose of this study was to determine attitudes anddaily practices of emergency medicine (EM) specialists, residents and faculty members in Turkey on the use of analgesics in patients with acute abdominal pain and factors affecting their decisions on the use of analgesics. METHODS: A cross-sectional study was performed between November 15, 2013 and January 25, 2014 by conducting a questionnaire to EM physicians working in University Hospitals, Education and Research Hospitals of the Ministry of Health, State Hospitals, and Private Hospitals in Turkey...
March 2016: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/27186151/development-of-a-novel-sports-medicine-rotation-for-emergency-medicine-residents
#18
Anna L Waterbrook, T Gail Pritchard, Allison D Lane, Lisa R Stoneking, Bryna Koch, Robert McAtee, Kristi H Grall, Alice A Min, Jessica Prior, Isaac Farrell, Holly G McNulty, Uwe Stolz
Musculoskeletal complaints are the most common reason for patients to visit a physician, yet competency in musculoskeletal medicine is invariably reported as a deficiency in medical education in the USA. Sports medicine clinical rotations improve both medical students' and residents' musculoskeletal knowledge. Despite the importance of this knowledge, a standardized sports medicine curriculum in emergency medicine (EM) does not exist. Hence, we developed a novel sports medicine rotation for EM residents to improve their musculoskeletal educational experience and to improve their knowledge in musculoskeletal medicine by teaching the evaluation and management of many common musculoskeletal disorders and injuries that are encountered in the emergency department...
2016: Advances in Medical Education and Practice
https://www.readbyqxmd.com/read/27162040/ionizing-radiation-knowledge-among-emergency-department-providers
#19
Noah Ditkofsky, Haris N Shekhani, Megan Cloutier, Zhengjia Nelson Chen, Chao Zhang, Tarek N Hanna
PURPOSE: The aim of this study was to assess knowledge of ionizing radiation exposure from diagnostic imaging examinations among emergency department (ED) providers. METHODS: An electronic questionnaire was distributed to ED providers in a five-hospital university-affiliated health care system. Providers included attending emergency medicine (EM) physicians, EM residents, and midlevel providers (MLPs) (nurse practitioners and physicians assistants). Data were collected and analyzed...
September 2016: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/27084068/technology-assisted-virtual-consultation-for-medical-imaging
#20
Andrew B Rosenkrantz, Jason Sherwin, Chandan P Prithiani, Dana Ostrow, Michael P Recht
PURPOSE: The aim of this study was to report the investigators' preliminary experience in the implementation of a "virtual consult" (VC) system enabling consultations between radiologists and referring physicians in physically remote locations throughout their enterprise. METHODS: Referrers and radiologists directly access the VC through the electronic medical record and PACS, respectively. Referrers may click a VC link associated with any examination report to instant message the appropriate subspecialist radiologist, who receives an alert allowing automatic loading of the examination...
August 2016: Journal of the American College of Radiology: JACR
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