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https://www.readbyqxmd.com/read/29226815/integrative-assessment-of-congestion-in%C3%A2-heart-failure-throughout-the-patient%C3%A2-journey
#1
REVIEW
Nicolas Girerd, Marie-France Seronde, Stefano Coiro, Tahar Chouihed, Pascal Bilbault, François Braun, David Kenizou, Bruno Maillier, Pierre Nazeyrollas, Gérard Roul, Ludivine Fillieux, William T Abraham, James Januzzi, Laurent Sebbag, Faiez Zannad, Alexandre Mebazaa, Patrick Rossignol
Congestion is one of the main predictors of poor patient outcome in patients with heart failure. However, congestion is difficult to assess, especially when symptoms are mild. Although numerous clinical scores, imaging tools, and biological tests are available to assist physicians in ascertaining and quantifying congestion, not all are appropriate for use in all stages of patient management. In recent years, multidisciplinary management in the community has become increasingly important to prevent heart failure hospitalizations...
November 27, 2017: JACC. Heart Failure
https://www.readbyqxmd.com/read/29226232/connecting-undergraduate-and-postgraduate-medical-education-through-an-elective-epa-based-transitional-year-in-acute-care-an-early-project-report
#2
Gersten Jonker, Reinier G Hoff, Stefan Max, Cor J Kalkman, Olle Ten Cate
Objective: A well-designed final year may ease the transition from medical school to postgraduate training, if it has enough depth to enable the acquisition of early specialty expertise, while keeping enough breadth to support the graduation as all-round physician. Aim of this article is to describe the design of a multidisciplinary dedicated transitional year (DTY) around the theme of recognition and initial treatment of vitally threatened patients. Methods: Undergraduate and postgraduate training directors from the departments of Anaesthesiology, Cardiology, Emergency Medicine, Intensive Care Medicine and Respiratory Medicine at UMC Utrecht and partnering hospitals have collaboratively developed and implemented a curriculum for a final year focusing on three entrustable professional activities (EPAs) in the domain of acute care...
2017: GMS Journal for Medical Education
https://www.readbyqxmd.com/read/29226185/parental-and-pediatricians-perception-of-need-for-subspecialty-training-in-pediatric-emergency-medicine-for-delivering-emergency-care-to-pediatric-patients
#3
Ernest G Leva, Diane Bunn Vanarsdale, Niel F Miele, Anna Petrova
The quality of pediatric emergency care may depend on the competence of the emergency department physicians. It is important to know whether parents and general pediatricians associate the quality of pediatric emergency care with the pediatric emergency medicine (PEM) training of the emergency department physicians. We designed the study to determine parental and pediatricians' opinion and expectation in regard to this question. Most of the surveyed parents' and pediatricians' recognize the importance of PEM training and believed that physicians trained in PEM can provide better emergency care for children...
2017: Global Pediatric Health
https://www.readbyqxmd.com/read/29226050/determinants-of-computed-tomography-head-scan-ordering-for-patients-with-low-risk-headache-in-the-emergency-department
#4
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/29225438/influence-of-language-and-culture-in-the-primary-care-of-spanish-speaking-latino-adults-with-poorly-controlled-diabetes-a-qualitative-study
#5
Cindy D Zamudio, Gabriela Sanchez, Andrea Altschuler, Richard W Grant
Background: We examined the role of language and culture in the interactions between Spanish-speaking Latino patients with poorly controlled diabetes - a fast-growing population in the United States - and their primary care providers. Methods: We conducted four focus groups with 36 non-US born Spanish-speaking patients with elevated HbA1c. Participants were insured health plan members with either English-speaking (2 groups) or Spanish-speaking (2 groups) primary care providers...
2017: Ethnicity & Disease
https://www.readbyqxmd.com/read/29224411/change-in-quantitative-eeg-theta-cordance-as-a-potential-predictor-of-repetitive-transcranial-magnetic-stimulation-clinical-outcome-in-major-depressive-disorder
#6
Aimee M Hunter, Thien X Nghiem, Ian A Cook, David E Krantz, Michael J Minzenberg, Andrew F Leuchter
Repetitive transcranial magnetic stimulation (rTMS) has demonstrated efficacy in major depressive disorder (MDD), although clinical outcome is variable. Change in the resting-state quantitative electroencephalogram (qEEG), particularly in theta cordance early in the course of treatment, has been linked to antidepressant medication outcomes but has not been examined extensively in clinical rTMS. This study examined change in theta cordance over the first week of clinical rTMS and sought to identify a biomarker that would predict outcome at the end of 6 weeks of treatment...
November 1, 2017: Clinical EEG and Neuroscience: Official Journal of the EEG and Clinical Neuroscience Society (ENCS)
https://www.readbyqxmd.com/read/29223870/validation-of-an-algorithm-to-detect-severe-ms-relapses-in-administrative-health-databases
#7
James John Marriott, Hui Chen, Randall Fransoo, Ruth Ann Marrie
BACKGROUND: Severe relapses that required treatment were important outcomes in the sentinel trials of disease-modifying therapy (DMT). Identifying such relapses in administrative data would allow comparative-effectiveness studies of DMTs to be conducted in real-world clinical settings. METHODS: All relapsing-remitting (RRMS) and secondary-progressive (SPMS) patients living in Manitoba between 1999 and 2015 were identified using a validated case definition and linkage to the Manitoba MS Clinic database...
December 2, 2017: Multiple Sclerosis and related Disorders
https://www.readbyqxmd.com/read/29223696/key-players-in-key-roles-the-baystate-patient-progress-initiative-to-improve-emergency-department-efficiency-and-productivity
#8
Niels K Rathlev, Jacqualyn Anderson, Joseph Schmidt, Joeli Hettler, Lynn Garreffi, Molly Gray, Douglas Neal, Paul Visintainer
BACKGROUND: The percentage of patients who leave the emergency department without being seen by a provider is a measure of efficiency and presents risk-management concerns. The number of patients actually "seen" by a provider is a measure of productivity. The opening of our new emergency department in December 2012, resulted in increases in both demand and the percentage of patients who left without being seen. Operational nursing leadership managed ED patient flow, but the structure was loosely organized on an ad hoc basis...
December 6, 2017: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
https://www.readbyqxmd.com/read/29223612/predictive-value-of-focused-assessment-with-sonography-for-trauma-fast-for-laparotomy-in-unstable-polytrauma-egyptians-patients
#9
Adel Hamed Elbaih, Sameh T Abu-Elela
PURPOSE: The emergency physicians face significant clinical uncertainty when multiple trauma patients arrive in the emergency department (ED). The priorities for assessment and treatment of polytrauma patients are established in the primary survey. Focused assessment with sonography for trauma (FAST) is very essential clinical skill during trauma resuscitation. Use of point of care ultrasound among the trauma team working in the primary survey in emergency care settings is lacking in Suez Canal University Hospitals even ultrasound machine not available in ED...
November 23, 2017: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/29223594/femoral-neck-fractures-after-removal-of-hardware-in-healed-trochanteric-fractures
#10
REVIEW
Antonio Barquet, Peter V Giannoudis, Andrés Gelink
INTRODUCTION: Hardware removal in healed trochanteric fractures (TF) in the absence of infection or significant mechanical complications is rarely indicated. However, in patients with persistent pain, prominent material and discomfort in the activities of daily living, the implant is eventually removed. Publications of ipsilateral femoral neck fracture after removal of implants from healed trochanteric fractures (FNFARIHTF) just because of pain or discomfort are rare. The purpose of this systematic review of the literature is to report on the eventual risk factors, the mechanisms, the clinical presentation, and frequency, and to pay special emphasis in their prevention...
December 2017: Injury
https://www.readbyqxmd.com/read/29223461/antenatal-consultations-at-extreme-prematurity-a-systematic-review-of-parent-communication-needs
#11
Ashraf Kharrat, Gregory P Moore, Stéphanie Beckett, Stuart G Nicholls, Margaret Sampson, Thierry Daboval
OBJECTIVE: To synthesize and describe parental expectations on how healthcare professionals should interact with them during a peripartum, antenatal consultation for extremely preterm infants. STUDY DESIGN: For this systematic literature review with textual narrative synthesis, we included studies that explored parental perspectives regarding the antenatal consultation for an extremely preterm infant. Electronic searches of Medline, CINAHL, PsycInfo, and Embase were conducted, along with a search of the grey literature...
December 6, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/29221976/modeling-patient-specific-deformable-mitral-valves
#12
REVIEW
Olivia Ginty, John Moore, Terry Peters, Daniel Bainbridge
Medical imaging has advanced enormously over the last few decades, revolutionizing patient diagnostics and care. At the same time, additive manufacturing has emerged as a means of reproducing physical shapes and models previously not possible. In combination, they have given rise to 3-dimensional (3D) modeling, an entirely new technology for physicians. In an era in which 3D imaging has become a standard for aiding in the diagnosis and treatment of cardiac disease, this visualization now can be taken further by bringing the patient's anatomy into physical reality as a model...
September 7, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29221814/use-of-interventional-radiology-as-initial-hemorrhage-control-to-improve-outcomes-for-potentially-lethal-multiple-blunt-injuries
#13
Hiroyuki Otsuka, Toshiki Sato, Keiji Sakurai, Hiromichi Aoki, Takeshi Yamagiwa, Shinichi Iizuka, Sadaki Inokuchi
INTRODUCTION: Recently, trauma management has been markedly improved with interventional radiology (IVR) and damage-control strategies. However, the indications for its use in hemodynamically unstable patients with severe trauma remains unclear. In some cases, IVR may be more effective than surgery for damage-control hemostasis; however, performing IVR in life-threatening trauma settings is challenging. To address this, we practiced and evaluated a trauma-management system with emergency physicians who trained for both severe trauma management, and techniques of surgery and IVR...
December 6, 2017: Injury
https://www.readbyqxmd.com/read/29221536/exploration-of-global-health-careers-across-the-medical-fields
#14
Ernest Barthélemy, Vanessa Mallol, Alisse Hannaford, Christian Pean, Rehema Kutua, Christopher de Haydu, Natasha Anandaraja, Ramin Asgary, Ebrahim Elahi, Braden Hexom, Philip Landrigan, Taraneh Shirazian, Craig Katz
BACKGROUND: Despite expansion of interest among American medical students in global health (GH), academic medical centers face multiple obstacles to the development of structured GH curricula and career guidance. To meet these demands we sought to provide a systematic analysis of the accounts of GH experts. METHODS: We developed a collaborative, interview-based, qualitative analysis of GH experiences across six career-related themes that are relevant to medical students interested in GH: justification, medical education, economics, research prospects, law and ethics, and work-life balance...
May 2017: Annals of Global Health
https://www.readbyqxmd.com/read/29220618/psychological-comfort-of-paramedics-with-field-death-pronouncement-a-national-asian-study-to-prepare-paramedics-for-field-termination-of-resuscitation
#15
Desmond R H Mao, Marcus E H Ong, Chungli Bang, Mohamed D T Salim, Yih Yng Ng, Desiree A Lie
OBJECTIVES: Paramedics' decision to terminate field resuscitation without a physician present may depend on personal and external factors. This study investigates factors associated with paramedic psychological comfort with termination of resuscitation (TOR) to inform future training. METHODS: We administered an anonymous survey to all practicing paramedics in a large urban Asian Emergency Medical Services system where formal TOR training had not yet been conducted and field TOR was not routinely applied...
December 8, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29219828/improving-care-for-older-patients-in-the-acute-setting-a-qualitative-study-with-healthcare-providers
#16
C Brouwers, H Merten, M Willems, D J Habraken, F W Bloemers, T H Biesheuvel, L S van Galen, P W B Nanayakkara, C Wagner
BACKGROUND: The proportion of older people needing acute care is rapidly growing, thereby posing an increased burden on the acute care chain. The aim of this study is to gain more insight into the obstacles and potential improvement opportunities of the acute care process for older patients arriving at the hospital. METHODS: Semi-structured interviews were conducted to determine the experiences of 18 different primary (i.e. general practitioner, community nurse) and secondary healthcare professionals (i...
October 2017: Netherlands Journal of Medicine
https://www.readbyqxmd.com/read/29218615/advanced-ct-for-diagnosis-of-seizure-related-stroke-mimics
#17
Friederike Austein, Monika Huhndorf, Johannes Meyne, Helmut Laufs, Olav Jansen, Thomas Lindner
BACKGROUND AND PURPOSE: It is assumed that up to 30 % of clinically diagnosed acute ischaemic strokes (AIS) are actually stroke mimics (SM). Our aim was to evaluate the usefulness of advanced CT including CT angiography (CTA) and CT perfusion (CTP) findings when distinguishing AIS from seizure-related SM. METHODS: Over a 22-month period data were gathered of patients who presented to our stroke centre with AIS-like symptoms and were examined immediately with an advanced CT, analysed and evaluated by two experienced neuroradiologists who preferred SM rather than AIS...
December 7, 2017: European Radiology
https://www.readbyqxmd.com/read/29217021/practice-patterns-in-the-interdisciplinary-management-of-corneal-abrasions
#18
Michael Ross, Jean Deschênes
OBJECTIVE: To characterize the treatment and follow-up patterns of corneal abrasions at an academic health centre. METHODS: This is a retrospective review of 90 cases of corneal abrasions over a 2-year period at a tertiary care academic hospital, of which 75 were seen by the ophthalmology department. All consultations primarily for corneal abrasion, as determined by the emergency department physician, were included in the study. Information on treatment regimen, corneal findings by emergency and ophthalmology physicians, time between follow-ups, and final outcomes was collected...
December 2017: Canadian Journal of Ophthalmology. Journal Canadien D'ophtalmologie
https://www.readbyqxmd.com/read/29216664/-acute-scrotal-pain-in-childhood-legal-pitfalls
#19
Pia Bader, Christoph Hugemann, Detlef Frohneberg
Acute scrotal pain in childhood is an emergency.Sudden scrotal pain may be caused by a variety of diseases. Therefore, it is important to carefully consider the specific medical history and possible differential diagnoses in each case for fast and decisive action (e. g. in case of testicular torsion). As minors lack the capacity for consent, it is absolutely necessary to obtain consent from their legal guardian. However, obtaining consent in the available time frame can cause organisational challenges in an acute emergency, which may lead to situations in the daily routine where a therapeutic decision needs to be taken (including surgery) without legal security based on consent by the guardian...
December 2017: Aktuelle Urologie
https://www.readbyqxmd.com/read/29216331/combined-short-and-long-axis-ultrasound-guided-central-venous-catheterization-is-superior-to-conventional-techniques-a-cross-over-randomized-controlled-manikin-trial
#20
Jun Takeshita, Kei Nishiyama, Satoru Beppu, Nozomu Sasahashi, Nobuaki Shime
OBJECTIVES: Visualizing the needle tip using the short-axis (SA) ultrasound-guided central venous catheterization approach can be challenging. It has been suggested to start the process with the SA approach and then switch to the long-axis (LA); however, to our knowledge, this combination has not been evaluated. We compared the combined short- and long-axis (SLA) approach with the SA approach in a manikin study. METHODS: We performed a prospective randomized controlled cross-over study in an urban emergency department and intensive care unit...
2017: PloS One
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