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https://www.readbyqxmd.com/read/29682748/successful-practice-transitioning-between-hemodialysis-and-hemodiafiltration-in-outpatient-units-ten-key-issues-for-physicians-to-remember
#1
Tibor Fülöp, Mihály B Tapolyai, Lajos Zsom, Miklos Z Molnar, Sohail Abdul Salim, László Újhelyi, Gergely Becs, József Balla, Mehrdad Hamrahian
Hemodiafiltration (HDF) during chronic renal replacement therapy (RRT) is a relatively new practice phenomenon, emerging over the last two decades. While the technological platforms utilized during chronic RRT are in many cases similar or effectively identical to conventional hemodialysis (HD), significant differences may emerge in daily practice. Several authors of this review moved practice site between the United States and the European Union and transitioned from an HD-based practice to predominantly HDF-practicing networks...
April 22, 2018: Artificial Organs
https://www.readbyqxmd.com/read/29682619/path-of-least-resistance-how-computerised-provider-order-entry-can-lead-to-and-reduce-wasteful-practices
#2
Joseph Choi, Cori Rebecca Atlin
Background: Computerised provider order entry (CPOE) is rapidly becoming the mainstay in clinical care and has the potential to improve provider efficiency and accuracy. However, this hinges on careful planning and implementation. Poorly planned CPOE order sets can lead to undetected errors and waste. In our emergency department (ED), lactate dehydrogenase (LDH) was bundled into various blood work panels but had little clinical value. Objectives: This quality improvement initiative aimed to reduce unnecessary LDH testing in the ED...
2018: BMJ Open Quality
https://www.readbyqxmd.com/read/29681446/reduction-of-radiography-with-point-of-care-elbow-ultrasonography-for-elbow-trauma-in-children
#3
Julia Tokarski, Jeffrey R Avner, Joni E Rabiner
OBJECTIVES: To determine whether point-of-care elbow ultrasound (US), with history and physical examination, can decrease radiography for patients with elbow trauma. Secondary outcomes included evaluation of pediatric emergency department (PED) length of stay (LOS) and test performance characteristics. STUDY DESIGN: This was a prospective study of patients up to age 21 years with elbow trauma necessitating radiography. After clinical examination and before radiography, pediatric emergency physicians performed elbow ultrasonography of the posterior fat pad and determined whether radiography was required...
April 19, 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29681420/elbow-dislocations-in-the-emergency-department-a-review-of-reduction-techniques
#4
Michael Gottlieb, Jessen Schiebout
BACKGROUND: Elbow dislocations are one of the most common large joint dislocations and they require urgent reduction in the emergency department. Posterior dislocations are the most common type, with anterior dislocations occurring in rare cases. DISCUSSION: Reduction techniques include traction-countertraction, patient-assisted countertraction, the leverage approach, and the modified Stimson technique. Complications can include nerve injury, vascular injury, and compartment syndrome...
April 19, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29681419/physostigmine-reversal-of-dysarthria-and-delirium-after-iatrogenic-atropine-overdose-from-a-dental-procedure
#5
Jon B Cole, Benjamin S Orozco, Ann M Arens
BACKGROUND: Sublingual atropine, dosed at 0.4-0.8 mg, is used by dentists as an antisialogogue to facilitate and increase the speed of procedures. Concentrated ophthalmic atropine drops (10 mg/mL) are commonly used off-label for this purpose. These highly concentrated drops may result in medication errors, atropine toxicity, and the antimuscarinic toxidrome. We report a case of a man who suffered acute delirium and dysarthria (from dry mouth) after an iatrogenic overdose from a dental procedure...
April 19, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29681323/the-role-of-social-and-interpersonal-factors-in-placebo-analgesia
#6
Elizabeth A Necka, Lauren Y Atlas
Placebo effects are beneficial clinical outcomes that emerge as a result of nonspecific contextual factors, transmitted primarily by the treating physician and the social, physical, and behavioral cues he or she displays. The patient-provider therapeutic alliance is critical for determining placebo effects and health outcomes. In this chapter, we review the recent literature, suggesting that provider social characteristics modulate placebo and clinical outcomes. We highlight the importance of studying not only the provider but also the patient's perception of the provider, which is subject to the influence of the patient's psychosocial orientation, such as their psychosocial motivations and perceptions of their interpersonal relationships broadly...
2018: International Review of Neurobiology
https://www.readbyqxmd.com/read/29681319/clinical-policy-critical-issues-in-the-evaluation-and-management-of-adult-patients-presenting-to-the-emergency-department-with-suspected-acute-venous-thromboembolic-disease
#7
REVIEW
Stephen J Wolf, Sigrid A Hahn, Lauren M Nentwich, Ali S Raja, Scott M Silvers, Michael D Brown
No abstract text is available yet for this article.
May 2018: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/29680811/does-the-age-of-acute-care-physicians-impact-their-1-crisis-management-performance-and-2-learning-after-simulation-based-education-a-protocol-for-a-multicentre-prospective-cohort-study-in-toronto-and-ottawa-canada
#8
Fahad Alam, Vicki R LeBlanc, Alan Baxter, Jordan Tarshis, Dominique Piquette, Yuqi Gu, Caroline Filipkowska, Ashley Krywenky, Nicole Kester-Greene, Pierre Cardinal, Shelly Au, Sandy Lam, Sylvain Boet, Perioperative Anesthesia Clinical Trials Group
INTRODUCTION: The proportion of older acute care physicians (ACPs) has been steadily increasing. Ageing is associated with physiological changes and prospective research investigating how such age-related physiological changes affect clinical performance, including crisis resource management (CRM) skills, is lacking. There is a gap in the literature on whether physician's age influences baseline CRM performance and also learning from simulation. We aim to investigate whether ageing is associated with baseline CRM skills of ACPs (emergency, critical care and anaesthesia) using simulated crisis scenarios and to assess whether ageing influences learning from simulation-based education...
April 21, 2018: BMJ Open
https://www.readbyqxmd.com/read/29679999/emerging-newly-approved-treatments-for-lower-urinary-tract-symptoms-secondary-to-benign-prostatic-hypertrophy
#9
Hannah Pham, Pranav Sharma
INTRODUCTION: Oral therapy with alpha-blockers or 5-alpha reductase inhibitors remains the most common treatment in men with lower urinary tract symptoms (LUTS) secondary to benign prostatic hypertrophy (BPH). For patients who progress or fail medical therapy, the standard of care surgical treatment continues to be transurethral resection of the prostate (TURP), which has long-studied and durable outcomes. Emerging, minimally invasive options for LUTS secondary to the BPH, however, have been developed over the last decade with promising results and minimal side effects typically associated with TURP, such as retrograde ejaculation and erectile dysfunction...
April 2018: Canadian Journal of Urology
https://www.readbyqxmd.com/read/29679952/injuries-to-cyclists-due-to-a-dog-bicycle-interaction
#10
Randall T Loder, Alan P Yaacoub
BACKGROUND:  Both dogs and bicycles are common in our society and thus a dog-bicycle interaction resulting in an injury to a cyclist is possible. It was the purpose of this study to investigate such injuries. METHODS:  The National Electronic Injury Surveillance System (NEISS) data for the 10-year period from 2006 through 2015 associated with bicycles were accessed. Injuries involving dogs were identified and the mechanism of injury determined. Due to the stratified and weighted nature of the NEISS data, statistical analyses were performed with SUDAAN 10 software (RTI International, Research Triangle Park, North Carolina, United States)...
April 21, 2018: Veterinary and Comparative Orthopaedics and Traumatology: V.C.O.T
https://www.readbyqxmd.com/read/29679265/focus-groups-and-in-depth-interviews-to-guide-the-development-of-lung-cancer-screening-informational-materials
#11
Anushree Sharma, Richard O'Connor, Paula Celestino, Samantha Killion, Laurie Griswold-Krupski, Maansi Bansal-Travers
Lung cancer is one of the most lethal cancers in the USA. In 2013, new guidelines issued by the United States Preventive Services Task Force recommended lung cancer screening using low-dose computed tomography among a selected group of high-risk individuals. Specifically, lung cancer screening is recommended for heavy smokers between the ages of 55 to 79, with at least 30 pack-year smoking exposure. Former smokers who meet these guidelines and stopped smoking ≤ 15 years ago are also eligible. There is a need to promote lung cancer screening to increase early diagnosis rates and treatment options, thereby decreasing disease-specific mortality...
April 20, 2018: Journal of Cancer Education: the Official Journal of the American Association for Cancer Education
https://www.readbyqxmd.com/read/29679152/treatment-of-acute-uncomplicated-diverticulitis-without-antibiotics-risk-factors-for-treatment-failure
#12
H E Bolkenstein, W A Draaisma, Bjm van de Wall, Ecj Consten, Iamj Broeders
PURPOSE: Conservative treatment strategy without antibiotics in patients with uncomplicated diverticulitis (UD) has proven to be safe. The aim of the current study is to assess the clinical course of UD patients who were initially treated without antibiotics and to identify risk factors for treatment failure. METHODS: A retrospective cohort study was performed including all patients with a CT-proven episode of UD (defined as modified Hinchey 1A). Only non-immunocompromised patients who presented without signs of sepsis were included...
April 21, 2018: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/29678895/healthcare-utilization-after-acute-kidney-injury-in-the-pediatric-intensive-care-unit
#13
Erin Hessey, Geneviève Morissette, Jacques Lacroix, Sylvie Perreault, Susan Samuel, Marc Dorais, Véronique Phan, Philippe Jouvet, Jean-Philippe Lafrance, Jacques LeLorier, Ana Palijan, Michael Pizzi, Louise Roy, Michael Zappitelli
BACKGROUND AND OBJECTIVES: Little is known about the long-term burden of AKI in the pediatric intensive care unit. We aim to evaluate if pediatric AKI is associated with higher health service use post-hospital discharge. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: This is a retrospective cohort study of children (≤18 years old) admitted to two tertiary centers in Montreal, Canada. Only the first admission per patient was included. AKI was defined in two ways: serum creatinine alone or serum creatinine and/or urine output...
April 20, 2018: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/29678885/the-burden-of-neurothrombectomy-call-a-multicenter-prospective-study
#14
Michelle M Williams, Taylor A Wilson, Thabele Leslie-Mazwi, Joshua A Hirsch, Ryan T Kellogg, Alejandro M Spiotta, Reade De Leacy, J Mocco, Felipe Albuquerque, Andrew F Ducruet, Adam Arthur, Visish M Srinivasan, Peter Kan, Maxim Mokin, Travis M Dumont, Alan Reeves, Jasmeet Singh, Stacey Q Wolfe, Kyle M Fargen
INTRODUCTION: Neurothrombectomy frequency is increasing, and a better understanding of the neurothrombectomy call burden is needed. METHODS: Neurointerventional physicians at nine participating stroke centers prospectively recorded time requirements for all neurothrombectomy (NT) consultations over 30 consecutive 24 hour call periods. RESULTS: Data were collected from a total of 270 days of call. 214 NT consultations were reported (mean 0...
April 20, 2018: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29678365/comparison-of-expulsions-following-intracesarean-placement-of-an-innovative-frameless-copper-releasing-iud-gyn-cs%C3%A2-versus-the-tcu380a-a-randomized-trial
#15
Ceren Unal, Ahmet Eser, Elif Tozkir, D Wildemeersch
OBJECTIVE: The intent of this study (primary outcome measure) is to assess the expulsion rate of a newly developed copper releasing frameless intrauterine IUD GyneFix® Cesarean Section (Gyn-CS®) at 3months' follow-up, compared to the TCu-380A IUD, inserted immediately postplacental expulsion following cesarean section delivery. STUDY DESIGN: This is a randomized trial from one hospital research center in Istanbul, Turkey. Eligible pregnant women, the majority undergoing elective cesarean delivery (n=106), and the remaining emergency cesarean section cases (n=34), received intracesarean insertion of Gyn-CS or TCu380A insertion...
April 17, 2018: Contraception
https://www.readbyqxmd.com/read/29678207/risk-factors-associated-with-short-term-mortality-changes-over-time-after-arrival-to-the-emergency-department
#16
Camilla Nørgaard Bech, Mikkel Brabrand, Søren Mikkelsen, Annmarie Lassen
BACKGROUND: Preventing death is the most important outcome pursued in the Emergency Department. Prompt accurate assessment, followed by competent and efficient investigation and treatment is the recipe sought. Abnormal physiological measurements are common antecedents to deterioration and therefore a cornerstone in many risk stratification tools. Some risk factors have their impact during the first few days after admittance, others have higher impact on 30 day mortality. Understanding the variance in impact of risk factors is relevant for future composition of risk stratification models...
April 20, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29678197/resuscitative-endovascular-balloon-occlusion-of-the-aorta-performed-by-emergency-physicians-for-traumatic-hemorrhagic-shock-a-case-series-from-japanese-emergency-rooms
#17
Ryota Sato, Akira Kuriyama, Rei Takaesu, Nobuhiro Miyamae, Wataru Iwanaga, Hayato Tokuda, Takehiro Umemura
BACKGROUND: Resuscitative endovascular balloon occlusion of the aorta (REBOA), which has been increasingly used for the management of hemorrhagic shock, is a less invasive strategy for the management of patients with very severe hemorrhage. However, its effectiveness remains controversial. METHODS: This retrospective case series included trauma patients who underwent REBOA for hemorrhagic shock due to trauma in four Japanese tertiary care emergency centers from January 2013 to March 2017...
April 21, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29678003/preliminary-evaluation-of-an-electronic-patient-prioritization-tool-for-pediatric-emergency-department
#18
Jessica Schiro, Pierre-François Gauthier, François Dubos, Sylvia Pelayo, Romaric Marcilly
The study presents the evaluation of the reliability of the information displayed on the user interface of a homegrown electronic patient prioritization tool dedicated to pediatric emergency department (namely Optimum). Two ergonomists shadowed physicians and nurses throughout their shift in order to (i) identify consistencies and discrepancies between the actual step of the patients in the care process and their assigned step in Optimum and (ii) to understand the causes of the discrepancies. Even if some discrepancies are noted, results show that Optimum provides a quite good reflection of the actual position of the patients in the care process...
2018: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/29677983/the-importance-of-data-quality-and-context-information-in-indicator-production-proof-of-concept-in-a-metropolitan-paediatric-emergency-department
#19
João Viana, Almeida Santos, Alberto Freitas
In the Paediatric emergency department scenario there were considerable efforts developing indicators over the past decade, specially referring to process, e.g. timeliness. Nevertheless, to fully characterize quality in Paediatric emergency department, indicators are developed but require further assessment and a more complete validation. This paper's aim is to emphasise the importance of data quality, data cleaning and the indicator choice in indicator production. The dataset provided for this analysis is from the São João Hospital Centre's information system and is composed by records of all the visits to the paediatrics emergency department from the 1st of January of 2014 to the 31st of December 2016...
2018: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/29677915/xploit-an-ontology-based-data-integration-platform-supporting-the-development-of-predictive-models-for-personalized-medicine
#20
Gabriele Weiler, Ulf Schwarz, Jochen Rauch, Kerstin Rohm, Thorsten Lehr, Stefan Theobald, Stephan Kiefer, Katharina Götz, Katharina Och, Nico Pfeifer, Lisa Handl, Sigrun Smola, Matthias Ihle, Amin T Turki, Dietrich W Beelen, Jürgen Rissland, Jörg Bittenbring, Norbert Graf
Predictive models can support physicians to tailor interventions and treatments to their individual patients based on their predicted response and risk of disease and help in this way to put personalized medicine into practice. In allogeneic stem cell transplantation risk assessment is to be enhanced in order to respond to emerging viral infections and transplantation reactions. However, to develop predictive models it is necessary to harmonize and integrate high amounts of heterogeneous medical data that is stored in different health information systems...
2018: Studies in Health Technology and Informatics
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