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https://www.readbyqxmd.com/read/28662832/vascular-causes-of-syncope-an-emergency-medicine-review
#1
Brit Long, Alex Koyfman
BACKGROUND: Syncope is a common emergency department (ED) complaint, accounting for 2% of visits annually. A wide variety of etiologies can result in syncope, and vascular causes may be deadly. OBJECTIVE: This review evaluates vascular causes of syncope and their evaluation and management in the ED. DISCUSSION: Syncope is defined by a brief loss of consciousness with loss of postural tone and complete, spontaneous recovery without medical intervention...
June 26, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28651747/the-rise-of-artificial-intelligence-and-the-uncertain-future-for-physicians
#2
EDITORIAL
C Krittanawong
Physicians in everyday clinical practice are under pressure to innovate faster than ever because of the rapid, exponential growth in healthcare data. "Big data" refers to extremely large data sets that cannot be analyzed or interpreted using traditional data processing methods. In fact, big data itself is meaningless, but processing it offers the promise of unlocking novel insights and accelerating breakthroughs in medicine-which in turn has the potential to transform current clinical practice [1]. Physicians can analyze big data, but at present it requires a large amount of time and sophisticated analytic tools such as supercomputers...
June 23, 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/28556857/emergency-health-care-professionals-understanding-of-the-costs-of-care-in-the-emergency-department
#3
Kevin A Hoffman, Michelino Mancini
Background: Efficiency and fiscal responsibility are important to the equal, safe, and effective delivery of care in the emergency department, where all presenting patients must be evaluated for emergent conditions. Health care professionals' understanding of the costs of care is a first step to developing rational approaches for the efficient distribution of the finite resources hospitals and emergency departments have at their disposal to reduce costs to patients and health care systems...
June 1, 2017: Journal of the American Osteopathic Association
https://www.readbyqxmd.com/read/28530771/macrophage-migration-inhibitory-factor-levels-correlate-with-an-infection-in-trauma-patients
#4
Young Duck Cho, Sung Hyuk Choi, Jung Youn Kim, Sung Jun Park, Young Hoon Yoon, Han Jin Cho, Ji Won Yeom
BACKGROUND: The role of migration inhibitory factor (MIF) is best understood in septic shock and septic disease; however, the role of MIF in a secondary infection after trauma has not yet been completely studied. This study aimed to evaluate the role of MIF in trauma patients. METHODS: The patients in the study population were divided into two groups according to the results of their MIF levels. The initial MIF levels, trauma mechanism, revised trauma score, survival rate, length of stay (LOS) in the intensive care unit (ICU), level of leukocytes, and level of C-reactive protein (CRP) were compared between the groups...
May 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/28469903/transitional-care-management-in-the-outpatient-setting
#5
Analiza Baldonado, Ofelia Hawk, Thomas Ormiston, Danielle Nelson
Patients who are high risk high cost (HRHC), those with severe or multiple medical issues, and the chronically ill elderly are major drivers of rising health care costs.1 The HRHC patients with complex health conditions and functional limitations may likely go to emergency rooms and hospitals, need more supportive services, and use long-term care facilities.2 As a result, these patient populations are vulnerable to fragmented care and "falling through the cracks".2 A large county health and hospital system in California, USA introduced evidence-based interventions in accordance with the Triple AIM3 focused on patient-centered health care, prevention, health maintenance, and safe transitions across the care continuum...
2017: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/28464172/initial-experience-of-a-primary-urgent-care-clinic-curriculum-and-subspecialty-lectureship-series-implementation-in-a-los-angeles-county-hospital
#6
Harsh Agrawal, Anna Martinez, Elizabeth R Volkmann, Oleg Melamed, Soma Wali
OBJECTIVES: Urgent care clinics are extremely busy in the University of California-Los Angeles (UCLA) County hospital system. We determined that residents and medical students in the internal medicine residency program who are rotating through these clinics did not receive enough teaching during their rotation. We decided to create and implement an urgent care curriculum and lectures to help achieve structure for the rotation. The goal of this series was to educate and assist residents in the primary care setting to comfortably manage subspecialty conditions, help reduce the already-overwhelmed county subspecialty referral system, and promote learning...
May 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28456338/urgent-care-medicine-and-the-role-of-the-app-within-this-specialty
#7
Jessica Memmel, Marcy Spalsbury
The field of urgent care medicine offers an additional medical pathway for patients who have immediate, but non-life-threatening, medical concerns. Urgent care medicine offers a more varied set of resources and services than a physician office setting, with more flexible hours. This gives patients an opportunity to not have to go to the emergency department for non-emergent care. As a newer specialty within the medical field, certain roles of healthcare providers other than physicians are becoming established, including the advanced practice provider (APP)...
May 2017: Disease-a-month: DM
https://www.readbyqxmd.com/read/28448781/assessment-of-clinical-pharmacy-interventions-to-reduce-outpatient-use-of-high-risk-medications-in-the-elderly
#8
Sarah C Weddle, A Shaun Rowe, Julie W Jeter, Rachel C Renwick, Shaunta' M Chamberlin, Andrea S Franks
BACKGROUND: Use of high-risk medications in the elderly (HRME) and drug-disease (Rx-DIS) interactions in the elderly, as defined by the Healthcare Effectiveness Data and Information Set (HEDIS) Measures, are significantly associated with mortality, hospital admission, and need for emergency care. No published studies to date evaluate interventions to reduce the use of HEDIS-defined HRME, although many studies have postulated a beneficial effect of such interventions. OBJECTIVE: To evaluate the effect of pharmacist interventions on use of HRME and Rx-DIS interactions in the outpatient elderly population...
May 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28437370/ethics-guide-recommendations-for-organ-donation-focused-physicians-endorsed-by-the-canadian-medical-association
#9
Sam D Shemie, Christy Simpson, Jeff Blackmer, Shavaun MacDonald, Sonny Dhanani, Sylvia Torrance, Paul Byrne
Donation physicians are specialists with expertise in organ and tissue donation and have been recognized internationally as a key contributor to improving organ and tissue donation services. Subsequent to a 2011 Canadian Critical Care Society-Canadian Blood Services consultation, the donation physician role has been gradually implemented in Canada. These professionals are generally intensive care unit physicians with an enhanced focus and expertise in organ/tissue donation. They must manage the dual obligation of caring for dying patients and their families while providing and/or improving organ donation services...
May 2017: Transplantation
https://www.readbyqxmd.com/read/28433453/attending-documentation-contribution-to-billing-at-an-academic-emergency-department-with-an-electronic-health-record
#10
Brian J Yun, Stephen C Dorner, Brian M Baccari, John Brennan, Karen Smith, Ali S Raja, Benjamin A White
INTRODUCTION: In emergency medicine (EM), patient care documentation serves many functions, including supporting reimbursement. In addition, many electronic health record systems facilitate automatically populating certain data fields. As a result, in the academic model, the attending's note may now more often recapitulate many of the same elements found in the resident's or physician assistant's (PA) note. We sought to determine the value of additional attending documentation, and how often the attending documentation prevented a downcoding event...
April 14, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28421563/the-current-utilization-and-perceptions-of-prescription-drug-monitoring-programs-among-emergency-medicine-providers-in-florida
#11
Henry W Young, Joseph A Tyndall, Linda B Cottler
BACKGROUND: Pain is among the most commonly treated symptoms in the emergency department, and opioids are commonly prescribed from the emergency department to treat moderate to severe pain. Prescription drug monitoring programs (PDMP) can be used to assist physicians identify individuals at increased risk to misuse or abuse opioids. While the use of the PDMP has been shown useful among clinicians, in the past, utilization of the PDMP has been less than optimal. The objective of this study was to assess the current utilization and perceptions of the prescription drug monitoring program among emergency medicine providers in Florida...
December 2017: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28419618/correspondence
#12
LETTER
Michael Gorn
No abstract text is available yet for this article.
April 17, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28410189/ehealth-acceptance-and-new-media-preferences-for-therapy-assistance-among-breast-cancer-patients
#13
Caroline Drewes, Thomas Kirkovits, Daniel Schiltz, Timo Schinkoethe, Renate Haidinger, Ursula Goldmann-Posch, Nadia Harbeck, Rachel Wuerstlein
BACKGROUND: Electronic health (eHealth) and mobile communication-based health care (mHealth) applications have been increasingly utilized in medicine over the last decade, and have facilitated improved adherence to therapy regimens in patients with chronic conditions. Due to the long duration of breast cancer therapy, and the long course of disease in metastatic breast cancer, a need for more intensified physician-patient communication has emerged. Various support mechanisms, including new media such as mHealth and eHealth, have been proposed for this purpose...
September 14, 2016: JMIR Cancer
https://www.readbyqxmd.com/read/28408071/error-contradiction-and-reversal-in-science-and-medicine
#14
Sergio Coccheri
Error and contradictions are not "per se" detrimental in science and medicine. Going back to the history of philosophy, Sir Francis Bacon stated that "truth emerges more readily from error than from confusion", and recently Popper introduced the concept of an approximate temporary truth that constitutes the engine of scientific progress. In biomedical research and in clinical practice we assisted during the last decades to many overturnings or reversals of concepts and practices. This phenomenon may discourage patients from accepting ordinary medical care and may favour the choice of alternative medicine...
April 10, 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/28382833/dr-john-mclennan-md-aberdeen-frcp-lond-1801-1874-and-the-medical-school-of-bombay-that-failed
#15
Sunil K Pandya
In 1826, Dr John McLennan was asked by Governor Mounstuart Elphinstone of Bombay to set up the first school to teach modern medicine to Indian citizens. He was expected to create textbooks on a variety of subjects in local languages and teach medicine to poorly educated students in their native tongues. Despite his valiant efforts, the school was deemed a failure and was abolished by the Government in 1832. Sir Robert Grant, appointed Governor of Bombay in 1835, analysed records pertaining to this medical school and concluded that the school failed since Dr McLennan was not provided the assistance he needed and as his suggestions for access to a hospital to teach medicine were not heeded...
January 1, 2017: Journal of Medical Biography
https://www.readbyqxmd.com/read/28355527/feasibility-evaluation-of-a-pilot-scribe-training-program-in-an-australian-emergency-department
#16
Katherine Walker, Matthew Johnson, William Dunlop, Margaret Staples, Hamish Rodda, Ian Turner, Michael Ben-Meir
Objective Medical scribes have an emerging and expanding role in health, particularly in Emergency Medicine in the US. Scribes assist physicians with documentation and clerical tasks at the bedside while the physician consults with his or her patient. Scribes increase medical productivity. The aim of the present study was to examine the feasibility of a pilot hospital-administered scribe-training program in Australia and to evaluate the ability of an American training course (Medical Scribe Training Systems) to prepare trainee scribes for clinical training in an emergency department in Australia...
March 7, 2017: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/28342441/building-a-community-of-practice-in-rural-medical-education-growing-our-own-together
#17
Randall L Longenecker, David Schmitz
CONTEXT: This article chronicles the rise, decline, and recent resurgence of rural training track residency programs (RTTs) in the USA over the past 30 years and the emergence of a healthy community of practice in rural medical education. This has occurred during a time in the USA when federal and state funding of graduate medical education has been relatively stagnant and the rules around finance and accreditation of rural programs have been challenging. ISSUE: Many of the early family residency programs developed in the 1970s included a curricular focus on rural practice...
January 2017: Rural and Remote Health
https://www.readbyqxmd.com/read/28315025/practices-and-attitudes-towards-radiation-risk-disclosure-for-computed-tomography-survey-of-emergency-medicine-residency-program-directors
#18
Jennifer R Marin, Karen E Thomas, Angela M Mills, Joshua S Broder, Kathy Boutis
PURPOSE: The purposes of this study were to evaluate the frequency with which emergency physicians involved in residency leadership disclose potential malignancy risks from computed tomography (CT), assess comfort with these discussions, and evaluate factors influencing risk disclosure. METHODS: We surveyed emergency medicine residency program directors and associate/assistant directors. Primary outcome was the proportion who "almost always" or "most of the time" discussed potential risks...
March 17, 2017: Emergency Radiology
https://www.readbyqxmd.com/read/28255637/involuntary-processes-knowledge-base-of-health-care-professionals-in-a-tertiary-medical-center-in-upstate-south-carolina
#19
Sharon M Holder, Calvert Warren, Kenneth Rogers, Benjamin Griffeth, Eunice Peterson, Dawn Blackhurst, Christian Ochonma
The involuntary hospitalization law provides a means by which love ones, caregivers and healthcare professionals can intervene when a mentally ill patient is a danger to self or others. Our study assessed the knowledge of professionals in one of the Greenville Health System (GHS) emergency department (ED) about the involuntary hospitalization process of mental health patients in South Carolina (SC). An eight item survey on the South Carolina involuntary hospitalization and commitment process was developed and distributed to GHS ED staff including: physicians, physician assistants, nurse practitioners, nurses, social workers and technicians...
March 2, 2017: Community Mental Health Journal
https://www.readbyqxmd.com/read/28238497/structured-clinical-decision-aids-are-seldom-compared-with-subjective-physician-judgment-and-are-seldom-superior
#20
David L Schriger, Joshua W Elder, Richelle J Cooper
STUDY OBJECTIVE: We determine how often studies that evaluate the performance of an aid for decisionmaking, be it a simple laboratory or imaging test or a complex multielement decision instrument, compare the aid's performance to independent, unaided physician judgment. METHODS: This was a cross-sectional survey of all Original Research and Brief Research Report articles in Annals of Emergency Medicine from 1998 to 2015. We included all articles that evaluated the performance of an aid for decisionmaking in assisting a physician with a decision about testing, treatment, diagnosis, or disposition...
February 23, 2017: Annals of Emergency Medicine
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