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Emergency medicine, ER

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https://www.readbyqxmd.com/read/29226050/determinants-of-computed-tomography-head-scan-ordering-for-patients-with-low-risk-headache-in-the-emergency-department
#1
Meaghan J Mackenzie, Rashi Hiranandani, Dongmei Wang, Tak Fung, Eddy Lang
Background Many specialty societies have found that neuroimaging in headache is a low-value intervention for benign presentations. This study describes factors that influence Emergency Room (ER) physicians' adherence to Choosing Wisely (CW) recommendations for low-risk headache patients presenting to Calgary's Emergency Departments (EDs). Emergency medicine has yet to address imaging in headache as a CW topic; however, this study may inform that decision. Methods Data were retrospectively collected for all patients presenting to Calgary EDs with headaches from April 1, 2014 to March 31, 2016...
October 9, 2017: Curēus
https://www.readbyqxmd.com/read/29224920/-cognitive-doping-in-students-a-chim-er-ical-way-to-get-full-head
#2
Louise Carton, Nicolas Cabé, Olivier Ménard, Sylvie Deheul, Anne-Sylvie Caous, David Devos, Olivier Cottencin, Régis Bordet
For students, the requirements for memorization, increased performance and peer competition may encourage cognitive doping behaviors. We aimed to describe recent practices and the benefit/risk ratio of such behavior to discuss the different issues. The prevalence of cognitive doping among students was 1.3% to 33% according to the studies, depending on the country concerned and the definition of cognitive doping used. The therapeutic classes most frequently cited as being diverted were psychostimulants and nootropics (methylphenidate, modafinil, piracetam), corticosteroids, sedative drugs and beta-blockers...
November 22, 2017: Thérapie
https://www.readbyqxmd.com/read/29187671/bavachin-induces-apoptosis-through-mitochondrial-regulated-er-stress-pathway-in-hepg2-cells
#3
Ying Yang, Xianglin Tang, Feiran Hao, Zengchun Ma, Yuguang Wang, Lili Wang, Yue Gao
As a traditional herbal medicine, the fruits of Psoralea corylifolia L. (FP) have been widely used for the treatment of various skin diseases for hundred years. Recently, the emerging FP-induced toxic effects, especially hepatotoxicity, in clinic are getting the public's attention. However, its exact toxic components and mechanisms underlying remain unclear. Bavachin, one of flavonoids in FP, has been documented as a hepatotoxic substance, and the present study aimed to determine the toxicity caused by bavachin and the possible toxic mechanisms involved using HepG2 cells...
November 29, 2017: Biological & Pharmaceutical Bulletin
https://www.readbyqxmd.com/read/29152831/laser-treatment-of-cutaneous-angiokeratomas-a-systematic-review
#4
REVIEW
Jannett Nguyen, Lance W Chapman, Dorota Z Korta, Christopher B Zachary
Angiokeratomas can present therapeutic challenges, especially in cases of extensive lesions, where traditional surgical methods carry high risks of scarring and hemorrhage. Argon, pulsed dye (PDL), neodymium-doped yttrium aluminum garnet (Nd:YAG), copper vapor, potassium titanyl phosphate, carbon dioxide, and erbium-doped yttrium aluminum garnet (Er:YAG) lasers have emerged as alternative options. To review the use and efficacy of lasers in treating angiokeratomas. A PubMed search identified randomized clinical trials, cohort studies, case series, and case reports involving laser treatment of cutaneous angiokeratomas...
November 19, 2017: Dermatologic Therapy
https://www.readbyqxmd.com/read/29119328/endoplasmic-reticulum-stress-and-allergic-diseases
#5
REVIEW
Jae Seok Jeong, So Ri Kim, Seong Ho Cho, Yong Chul Lee
PURPOSE OF REVIEW: In this review, we will integrate recent knowledge on endoplasmic reticulum (ER) stress and allergy, thereby highlighting the therapeutic potential of ER stress in the context of precision medicine for allergic diseases. RECENT FINDINGS: Emerging evidence suggests that allergic diseases are very heterogeneous having numerous endotypes. This leads to the new era of modern medicine, which assumes that a particular endotype-driven therapy, called precision medicine, would be more efficacious in a specific group of patients rather than in all patients...
November 8, 2017: Current Allergy and Asthma Reports
https://www.readbyqxmd.com/read/28829517/assessing-the-impact-of-the-extended-release-long-acting-opioid-an-algesics-risk-evaluation-and-mitigation-strategies-on-opioid-prescrip-tion-volume
#6
Victoria Divino, Soledad Cepeda, Paul Coplan, Jean-Yves Maziere, Yingli Yuan, Rolin L Wade
OBJECTIVE: The Food and Drug Administration approved the extended-release/long-acting (ER/LA) opioid analgesics risk evaluation and mitigation strategies (REMS) in July 2012 to educate healthcare providers and patients about safe and appropriate opioid analgesic use. The authors evaluated the impact of the REMS on ER/LA opioid analgesic utilization, overall and stratified by patient characteristics and prescriber type associated with greater expected need for analgesia. DESIGN: Retrospective repeated cross-sectional study...
May 2017: Journal of Opioid Management
https://www.readbyqxmd.com/read/28765247/a-longitudinal-study-of-ambulatory-physician-encounters-emergency-room-visits-and-hospitalizations-by-patients-with-rheumatoid-arthritis-a-13-year-population-health-study
#7
John G Hanly, Kara Thompson, Chris Skedgel
OBJECTIVE: To determine total physician encounters, emergency room (ER) visits, and hospitalizations in an incident cohort of rheumatoid arthritis (RA) cases and matched control patients over 13 years. METHODS: A retrospective cohort study was performed using administrative healthcare data from about 1 million people with access to universal healthcare. Using the International Classification of Diseases, 9th ed (ICD-9) and ICD-10 diagnostic codes, 7 RA case definitions were used...
October 2017: Journal of Rheumatology
https://www.readbyqxmd.com/read/28761637/evaluating-validity-of-current-criteria-for-judgment-passing-er-rotation-among-internee-medical-students
#8
Hooman Hoseinnejad, Noushin Kohan, Akram Mirzaee
BACKGROUND: Passing the emergency medicine internship is an essential process for all graduates of medical schools. The main purpose of this study was to evaluate validity of current criteria for judgment passing ER rotation among internee medical students. METHODS: In this cross-sectional study, a total of 200 students in the emergency departments (ED) of the teaching hospitals at Tehran University of Medical Sciences (TUMS) were included. The data were gathered using by a valid self-assessment questionnaire including demographic information and 12-items about the students' level of confidence with the skills and procedures under study...
August 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/28737187/recent-advances-in-asymmetric-total-synthesis-of-prostaglandins
#9
REVIEW
Haihui Peng, Fen-Er Chen
Prostaglandins (PGs) are a series of hormone-like chemical messengers and play a critical role in regulating physiological activity. The diversified therapeutic activities and complex molecular architectures of PGs have attracted special attention, and huge progress has been made in asymmetric total synthesis and discovery of pharmaceutically useful drug candidates. In the last 10 years, several powerful syntheses have emerged as new solutions to the problem of building PGs and represent major breakthroughs in this area...
August 2, 2017: Organic & Biomolecular Chemistry
https://www.readbyqxmd.com/read/28722334/potential-emerging-treatment-in-vitiligo-using-er-yag-in-combination-with-5fu-and-clobetasol
#10
Fatemeh Mokhtari, Anis Bostakian, Zabihollah Shahmoradi, Tohid Jafari-Koshki, Fariba Iraji, Gita Faghihi, Sayed Mohsen Hosseini, Behzad Bafandeh
BACKGROUND: Vitiligo is a pigmentary disorder of skin affecting at least 1% of the world population of all races in both sexes. Its importance is mainly due to subsequent social and psychological problems rather than clinical complications. Various treatment choices are available for vitiligo; however, laser-based courses have shown to give more acceptable results. OBJECTIVE: The aim of this trial was to evaluate the efficacy of Er:YAG laser as a supplementary medicine to topical 5FU and clobetasol in vitiligo patients...
July 19, 2017: Journal of Cosmetic Dermatology
https://www.readbyqxmd.com/read/28693420/differential-proteomic-analysis-of-replanted-rehmannia-glutinosa-roots-by-itraq-reveals-molecular-mechanisms-for-formation-of-replant-disease
#11
Mingjie Li, Yanhui Yang, Fajie Feng, Bao Zhang, Shuqiang Chen, Chuyun Yang, Li Gu, Fengqing Wang, Junyi Zhang, Aiguo Chen, Wenxiong Lin, Xinjian Chen, Zhongyi Zhang
BACKGROUND: The normal growth of Rehmannia glutinosa, a widely used medicinal plant in China, is severely disturbed by replant disease. The formation of replant disease commonly involves interactions among plants, allelochemicals and microbes; however, these relationships remain largely unclear. As a result, no effective measures are currently available to treat replant disease. RESULTS: In this study, an integrated R. glutinosa transcriptome was constructed, from which an R...
July 10, 2017: BMC Plant Biology
https://www.readbyqxmd.com/read/28666921/intratumoral-heterogeneity-and-subclonal-diversification-of-early-breast-cancer
#12
Lucy R Yates
Heterogeneity has long been recognized as a feature of some primary breast cancers manifesting as mixed histopathological subtypes or variable expression of the therapeutic targets ER, PgR and HER2. The recent emergence of next generation sequencing (NGS) technologies has revolutionized our understanding of the extent and nature of subclonal diversification. Careful examination of primary breast cancers often reveals multiple genomically distinct subclones that may contain driver alterations that follow spatial patterns of segregation...
August 2017: Breast: Official Journal of the European Society of Mastology
https://www.readbyqxmd.com/read/28647567/stearoyl-coa-desaturase-regulates-sorafenib-resistance-via-modulation-of-er-stress-induced-differentiation
#13
Mark Kin Fai Ma, Eunice Yuen Ting Lau, Doris Hoi Wing Leung, Jessica Lo, Nicole Pui Yu Ho, Lily Kwan Wai Cheng, Stephanie Ma, Chi Ho Lin, John A Copland, Jin Ding, Regina Cheuk Lam Lo, Irene Oi Lin Ng, Terence Kin Wah Lee
BACKGROUND & AIMS: We investigated the functional role and clinical significance of stearoyl-CoA desaturase-1 (SCD1) mediated endoplasmic reticulum (ER) stress in regulating liver tumor-initiating cells (T-ICs) and sorafenib resistance, with the aim of developing a novel therapeutic strategy against hepatocellular carcinomas (HCCs). METHODS: We evaluated the clinic-pathological relevance of SCD1 and its correlation with sorafenib resistance in large cohorts of HCC clinical samples by qPCR and immunohistochemical analyses...
June 22, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/28509853/predictors-of-caregiver-burden-among-mothers-of-children-with-chronic-conditions
#14
Karina Javalkar, Eniko Rak, Alexandra Phillips, Cara Haberman, Maria Ferris, Miranda Van Tilburg
OBJECTIVE: The complex medical regimens of children and adolescents with chronic conditions can have a significant impact on families and households. Caregivers may experience burden, which can lead to negative health consequences and poor quality of life. The objective of this study was to determine child-related predictors and risk factors for caregiver burden among parents of children with chronic conditions. METHODS: We distributed an institutional review board (IRB)-approved, online cross-sectional survey to parents of children who attended the Victory Junction therapeutic camp...
May 16, 2017: Children
https://www.readbyqxmd.com/read/28497661/medication-related-osteonecrosis-of-the-jaw-risk-factors-in-patients-under-biphosphonate-versus-patients-under-antiresorptive-antiangiogenic-drugs
#15
Giulia Ghidini, Maddalena Manfredi, Ilaria Giovannacci, Giovanni Mergoni, Amin Sarraj, Maura Mureddu, Giovanna Giunta, Mauro Bonanini, Marco Meleti, Paolo Vescovi
BACKGROUND: Biphosphonate-Related Osteonecrosis of the Jaw (BRONJ) is a potential side effect associated with the administration of bisphosphonates; the aim of this work is to highlight the possible epidemiological differences between two groups of patients affected by MRONJ treated at the Center of Oral Medicine, Pathology and Laser Surgery of the Academic Hospital at the University of Parma, Italy, between January 2004 and June 2016. METHODS: Medical charts of 303 patients (214 Females and 89 Males, mean age 67y) treated at the Center of Oral Medicine, Pathology and Laser Surgery of the Academic Hospital at the University of Parma, between January 2004 and June 2016, were retrospectively analyzed...
May 10, 2017: Minerva Stomatologica
https://www.readbyqxmd.com/read/28430550/round-table-on-malignant-hyperthermia-in-physically-active-populations-meeting-proceedings
#16
Yuri Hosokawa, Douglas J Casa, Henry Rosenberg, John F Capacchione, Emmanuel Sagui, Sheila Riazi, Luke N Belval, Patricia A Deuster, John F Jardine, Stavros A Kavouras, Elaine C Lee, Kevin C Miller, Sheila M Muldoon, Francis G O'Connor, Scott R Sailor, Nyamkhishig Sambuughin, Rebecca L Stearns, William M Adams, Robert A Huggins, Lesley W Vandermark
CONTEXT:   Recent case reports on malignant hyperthermia (MH)-like syndrome in physically active populations indicate potential associations among MH, exertional heat stroke (EHS), and exertional rhabdomyolysis (ER). However, an expert consensus for clinicians working with these populations is lacking. OBJECTIVE:   To provide current expert consensus on the (1) definition of MH; (2) history, etiology, and pathophysiology of MH; (3) epidemiology of MH; (4) association of MH with EHS and ER; (5) identification of an MH-like syndrome; (6) recommendations for acute management of an MH-like syndrome; (7) special considerations for physically active populations; and (8) future directions for research...
April 2017: Journal of Athletic Training
https://www.readbyqxmd.com/read/28302636/pharmacist-provided-medicines-reconciliation-within-24%C3%A2-hours-of-admission-and-on-discharge-a-randomised-controlled-pilot-study
#17
Brit Cadman, David Wright, Amanda Bale, Garry Barton, James Desborough, Eman A Hammad, Richard Holland, Helen Howe, Ian Nunney, Lisa Irvine
BACKGROUND: The UK government currently recommends that all patients receive medicines reconciliation (MR) from a member of the pharmacy team within 24 hours of admission and subsequent discharge. The cost-effectiveness of this intervention is unknown. A pilot study to inform the design of a future randomised controlled trial to determine effectiveness and cost-effectiveness of a pharmacist-delivered service was undertaken. METHOD: Patients were recruited 7 days a week from 5 adult medical wards in 1 hospital over a 9 month period and randomised using an automated system to intervention (MR within 24 hours of admission and at discharge) or usual care which may include MR (control)...
March 16, 2017: BMJ Open
https://www.readbyqxmd.com/read/28194478/-diagnostic-investigation-in-emergency-medicine-why-case-history-is-crucial
#18
M Mirus, A R Heller
We present the preclinical case of a patient reporting chest pain. Pain impeded physical examination. Reviewing the patient's detailed medical history after analgesia revealed a connection between the reported pain and vomiting. This led to a suspicion of organ perforation. Thus, the patient was admitted to a surgical emergency room (ER) and Boerhaave's Syndrome was diagnosed. After deterioration in the ER, cardiopulmonal reanimation (CPR), and successful surgical treatment, the patient was transferred to the intensive care unit (ICU) seven hours after first contact...
April 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28050641/children-presenting-in-delayed-fashion-after-minor-head-trauma-with-scalp-swelling-do-they-require-further-workup
#19
Jonathan N Sellin, Amee Moreno, Sheila L Ryan, Sandi K Lam, Marcella Donaruma-Kwoh, Thomas G Luerssen, Andrew Jea
PURPOSE: It is common to evaluate children who have sustained minor head trauma with computed tomography (CT) of the head. Scalp swelling, in particular, has been associated with intracranial injury. A subset of patients, however, present in delayed fashion, often days after the head trauma, as soft tissue edema progresses and their caregiver notices scalp swelling. We explore the value of further workup in this setting. METHODS: We conducted a retrospective review of a prospectively collected cohort of children ≤24 months of age presenting to the Texas Children's Hospital with scalp swelling more than 24 h following a head trauma...
April 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28027312/the-subclonal-architecture-of-metastatic-breast-cancer-results-from-a-prospective-community-based-rapid-autopsy-program-cascade
#20
Peter Savas, Zhi Ling Teo, Christophe Lefevre, Christoffer Flensburg, Franco Caramia, Kathryn Alsop, Mariam Mansour, Prudence A Francis, Heather A Thorne, Maria Joao Silva, Nnennaya Kanu, Michelle Dietzen, Andrew Rowan, Maik Kschischo, Stephen Fox, David D Bowtell, Sarah-Jane Dawson, Terence P Speed, Charles Swanton, Sherene Loi
BACKGROUND: Understanding the cancer genome is seen as a key step in improving outcomes for cancer patients. Genomic assays are emerging as a possible avenue to personalised medicine in breast cancer. However, evolution of the cancer genome during the natural history of breast cancer is largely unknown, as is the profile of disease at death. We sought to study in detail these aspects of advanced breast cancers that have resulted in lethal disease. METHODS AND FINDINGS: Three patients with oestrogen-receptor (ER)-positive, human epidermal growth factor receptor 2 (HER2)-negative breast cancer and one patient with triple negative breast cancer underwent rapid autopsy as part of an institutional prospective community-based rapid autopsy program (CASCADE)...
December 2016: PLoS Medicine
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