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Emergency medicine, ER

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https://www.readbyqxmd.com/read/29602433/improving-resident-s-skills-in-the-management-of-circulatory-shock-with-a-knowledge-based-e-learning-tool
#1
David Riaño, Francis Real, Jose Ramon Alonso
BACKGROUND: Correct clinical management of circulatory shock in emergency departments (ER) and intensive care units (ICU) is critical. In this context, the transmission of professional skills by means of the practical supervision of real cases at the point of care entails important issues that can be widely overcome with the use of computer knowledge-based e-learning tools. OBJECTIVE: Shock-Instructor is a web-based e-learning tool implementing the already tested training program model (TPM) that uses a knowledge base about the evidence found in the clinical practice guidelines about seven types of shock...
May 2018: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/29514557/incremental-health-care-services-and-expenditures-associated-with-depression-among-individuals-with-cutaneous-lupus-erythematosus-cle
#2
M E Ogunsanya, S O Nduaguba, C M Brown
Objectives The objective of this paper is to describe the annual direct medical expenditures for cutaneous lupus erythematosus (CLE) patients, and to estimate the incremental health care expenditures and utilization associated with depression among adults with CLE, while controlling for covariates. Methods Using the 2014 Medical Expenditure Panel Survey (MEPS), we compared CLE patients with and without depression to determine differences in: (a) health care utilization-inpatient, outpatient, office-based and emergency room (ER) visits, and prescriptions filled; and (b) expenditures-total costs, inpatient, outpatient, office-based, ER, and prescription medication costs, and other costs using demography-adjusted and comorbidity-adjusted multivariate models (age, gender, race/ethnicity, marital status, education, perception of health status, poverty category, smoking status, and Charlson Comorbidity Index)...
January 1, 2018: Lupus
https://www.readbyqxmd.com/read/29508476/-strangers-in-the-er-quality-indicators-and-third-party-interference-in-dutch-emergency-care
#3
Floortje B Moes, Eddy S Houwaart, Diana M J Delnoij, Klasien Horstman
RATIONALE, AIMS, AND OBJECTIVES: This paper examines a remarkable dispute between Dutch insurers, hospitals, doctors, and patients about a set of quality indicators. In 2013, private insurers planned to drastically reform Dutch emergency care using quality indicators they had formulated drawing from clinical guidelines, RCTs, and systematic reviews. Insurers' plans caused much debate in the field of emergency care. As quality indicators have come to play a more central role in health care governance, the questions what constitutes good evidence for them, how they ought to be used, and who controls them have become politically and morally charged...
March 6, 2018: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/29464222/nivolumab-a-new-immunomodulatory-drug-a-new-adverse-effect-adrenal-crisis
#4
Funda Karbek Akarca, Ozge Can, Sercan Yalcinli, Yusuf Ali Altunci
Owing to the advancements in medicine, new information is obtained regarding cancer, new antineoplastic agents are developed. Frequent use of these new pharmacological agents emergency physicians to be vigilant about their side effects. We present a case of adrenal crisis in a patient with non-small cell lung cancer (NSCLC), caused by an immunomodulatory drug; nivolumab. While adverse events are related to other immunomodulatory drugs have been reported in literature, our case is the first nivolumab-related adrenal failure to be reported...
December 2017: Turkish Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29416826/role-of-ginsenosides-in-reactive-oxygen-species-mediated-anticancer-therapy
#5
REVIEW
Islam M D Sodrul, Chenying Wang, Xiangfeng Chen, Jing Du, Hongxiang Sun
Cancer is still a global public health problem, which is the leading cause of death in most countries. Ginseng has been used for centuries all over the world as a panacea that promotes longevity. As the king of herb plants, ginseng holds great promise as a new treatment option which is used either by itself or in combination with other medicinal ingredients that is widely accepted as complementary and alternative medicine in cancer therapy. Ginsenosides, the major pharmacologically active ingredients of ginseng, have been shown to have multiple medicinal effects including prominent anticancer activity...
January 5, 2018: Oncotarget
https://www.readbyqxmd.com/read/29382106/targeting-cellular-stress-mechanisms-and-metabolic-homeostasis-by-chinese-herbal-drugs-for-neuroprotection
#6
REVIEW
Hsiao-Chien Ting, Chia-Yu Chang, Kang-Yun Lu, Hong-Meng Chuang, Sheng-Feng Tsai, Mao-Hsuan Huang, Ching-Ann Liu, Shinn-Zong Lin, Horng-Jyh Harn
Traditional Chinese medicine has been practiced for centuries in East Asia. Herbs are used to maintain health and cure disease. Certain Chinese herbs are known to protect and improve the brain, memory, and nervous system. To apply ancient knowledge to modern science, some major natural therapeutic compounds in herbs were extracted and evaluated in recent decades. Emerging studies have shown that herbal compounds have neuroprotective effects or can ameliorate neurodegenerative diseases. To understand the mechanisms of herbal compounds that protect against neurodegenerative diseases, we summarize studies that discovered neuroprotection by herbal compounds and compound-related mechanisms in neurodegenerative disease models...
January 28, 2018: Molecules: a Journal of Synthetic Chemistry and Natural Product Chemistry
https://www.readbyqxmd.com/read/29306883/clinical-decisions-presented-to-patients-in-hospital-encounters-a-cross-sectional-study-using-a-novel-taxonomy
#7
Eirik Hugaas Ofstad, Jan C Frich, Edvin Schei, Richard M Frankel, Jūratė Šaltytė Benth, Pål Gulbrandsen
OBJECTIVE: To identify and classify all clinical decisions that emerged in a sample of patient-physician encounters and compare different categories of decisions across clinical settings and personal characteristics. DESIGN: Cross-sectional descriptive evaluation of hospital encounters videotaped in 2007-2008 using a novel taxonomy to identify and classify clinically relevant decisions (both actions and judgements). PARTICIPANTS AND SETTING: 372 patients and 58 physicians from 17 clinical specialties in ward round (WR), emergency room (ER) and outpatient (OP) encounters in a Norwegian university hospital...
January 5, 2018: BMJ Open
https://www.readbyqxmd.com/read/29226050/determinants-of-computed-tomography-head-scan-ordering-for-patients-with-low-risk-headache-in-the-emergency-department
#8
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/-pharmaceutical-cognitive-doping-in-students-a-chimeric-way-to-get-a-head
#9
Louise Carton, Nicolas Cabé, Olivier Ménard, Sylvie Deheul, Anne-Sylvie Caous, David Devos, Olivier Cottencin, Régis Bordet
For students, the pressing demands for memorization, top-level performance, and peer competition create an environment favorable for pharmaceutical cognitive doping behavior. We aimed to describe recent practices and the benefit / risk ratio of such behavior and to discuss the issues at stake. The prevalence of pharmaceutical cognitive doping among students has been reported from 1.3% to 33% across studies, with variations depending on country and definition of pharmaceutical cognitive doping. The therapeutic classes most frequently cited as being diverted for doping purposes are 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
#10
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. (Fructus Psoraleae (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 human hepatocellular carcinoma (HepG2) cells...
February 1, 2018: Biological & Pharmaceutical Bulletin
https://www.readbyqxmd.com/read/29152831/laser-treatment-of-cutaneous-angiokeratomas-a-systematic-review
#11
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 2017: Dermatologic Therapy
https://www.readbyqxmd.com/read/29119328/endoplasmic-reticulum-stress-and-allergic-diseases
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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