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https://www.readbyqxmd.com/read/29044455/use-of-an-app-controlled-neuromuscular-electrical-stimulation-system-for-improved-self-management-of-knee-conditions-and-reduced-costs
#1
Morad Chughtai, Nicholas Piuzzi, George Yakubek, Anton Khlopas, Nipun Sodhi, Assem A Sultan, Salahuddin Nasir, Benjamin S T Yates, Anil Bhave, Michael A Mont
Patients suffering from quadriceps muscle weakness secondary to osteoarthritis or after surgeries, such as total knee arthroplasty, appear to benefit from the use of neuromuscular electrical stimulation (NMES), which can improve muscle strength and function, range of motion, exercise capacity, and quality of life. Several modalities exist that deliver this therapy. However, with the ever-increasing demand to improve clinical efficiency and costs, digitalize healthcare, optimize data collection, improve care coordination, and increase patient compliance and engagement, newer devices incorporating technologies that facilitate these demands are emerging...
October 12, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/29043283/barriers-to-pap-smear-test-for-the-second-time-in-women-referring-to-health-care-centers-in-the-south-of-tehran-a-qualitative-approach
#2
Laleh Hassani, Tahereh Dehdari, Ebrahim Hajizadeh, Davoud Shojaeizadeh, Mehrandokht Abedini, Saharnaz Nedjat
BACKGROUND: Cervical cancer is a preventable disease with a regular screening program. Many studies have reported a large number of barriers that women had for the first time, but this study decided to find other barriers for the second time pap smear. METHODS: In this qualitative research, data were gathered through in-depth interviews and expressed through conventional content analysis in the form of constant comparison. The participants were 15 women with family profile at 30 health care centers who lived in the south of Tehran and had done Pap smear for one time but didn't do it for the second time...
October 2017: International Journal of Community Based Nursing and Midwifery
https://www.readbyqxmd.com/read/29042808/first-visit-patients-without-a-referral-to-the-department-of-internal-medicine-at-a-medium-sized-acute-care-hospital-in-japan-an-observational-study
#3
Nobuyuki Kajiwara, Kazuyuki Hayashi, Masahiro Misago, Shinichiro Murakami, Takato Ueoka
PURPOSE: We sought to profile first-time patients without a referral who sought medical care at the Department of Internal Medicine at a medium-sized acute care hospital in Japan. We anticipated that the analysis would highlight the demand for medical care needs from acute care hospitals and help confirm one of the problems associated with primary care in Japan. PATIENTS AND METHODS: The study population comprised 765 patients who sought outpatient consultation without a referral at "the Department of General Internal Medicine" at the Ikeda City Hospital on Fridays over 4 years...
2017: International Journal of General Medicine
https://www.readbyqxmd.com/read/29042095/can-emergency-physicians-accurately-distinguish-retinal-detachment-from-posterior-vitreous-detachment-with-point-of-care-ocular-ultrasound
#4
Nicola Baker, Richard Amini, Elaine H Situ-LaCasse, Josie Acuña, Tomas Nuño, Uwe Stolz, Srikar Adhikari
STUDY OBJECTIVE: There is significant overlap between the symptoms of patients presenting with retinal detachment (RD) and posterior vitreous detachment (PVD). Urgency to obtain consultation and treatment are dependent on the ability to accurately distinguish these two conditions. The objective of this study was to determine the ability of emergency physicians to differentiate RDs from PVDs using point-of-care (POC) ocular ultrasound. METHODS: Single blinded cross-sectional study at an academic medical center...
October 13, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29040811/mobile-emergency-simulation-training-for-rural-health-providers
#5
Douglas Martin, Brent Bekiaris, Gregory Hansen
INTRODUCTION: Mobile emergency simulation offers innovative continuing medical educational support to regions that may lack access to such opportunities. Furthermore, satisfaction is a critical element for active learning. Together, the authors evaluated Canadian rural healthcare providers' satisfaction from high fidelity emergency simulation training using a modified motorhome as a mobile education unit (MEU). METHODS: Over a 5-month period, data was collected during 14 educational sessions in nine different southern Manitoban communities...
July 2017: Rural and Remote Health
https://www.readbyqxmd.com/read/29040244/a-prospective-study-of-the-causes-of-bruises-in-premobile-infants
#6
Kenneth W Feldman, Tricia M Tayama, Leslie E Strickler, Lee A Johnson, Gauri Kolhatkar, Catherine A DeRidder, Dana C Matthews, Robert Sidbury, James A Taylor
OBJECTIVE: This study had 2 objectives. First, to determine the behavior of physicians evaluating premobile infants with bruises. Second, and most importantly, to learn whether infants with unexplained bruising who had been initially evaluated by primary care and emergency department (ED) physicians are as likely to have their bruises attributed to child abuse as those children evaluated by child abuse physicians. METHODS: Primary care, ED, and child abuse pediatricians (CAPs) in King County, Washington, San Mateo, Calif, Albuquerque, NM, La Crosse, Wis, and Torrance, Calif prospectively identified and studied infants younger than 6 months with less than 6 bruises, which were judged by the evaluating clinician to be explained or unexplained after their initial clinical examination...
October 16, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29040243/toxic-shock-syndrome-still-a-timely-diagnosis
#7
Kira L Gossack-Keenan, April J Kam
BACKGROUND: Toxic shock syndrome (TSS) is an acute, severe, toxin-mediated disease, characterized by fever, hypotension, and multiorgan system involvement. Toxic shock syndrome has made headlines because of its high associated morbidity and mortality rate in previously healthy young females. Incidence peaked in the early 1980s owing to increased usage of ultra-absorbent tampons. After improved patient education and tampon labeling, the incidence of menstrual TSS has declined. CASE: A previously healthy 14-year-old girl presented to an urgent care center with a 2-day history of fever, erythematous maculopapular rash, vomiting, diarrhea, and malaise...
October 16, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29039621/supporting-emergency-medical-care-teams-with-an-integrated-status-display-providing-real-time-access-to-medical-best-practices-workflow-tracking-and-patient-data
#8
PoLiang Wu, Min-Young Nam, Jeonghwan Choi, Alex Kirlik, Lui Sha, Richard B Berlin
The work of a hospital's medical staff is safety critical and often occurs under severe time constraints. To provide timely and effective cognitive support to medical teams working in such contexts, guidelines in the form of best practice workflows for healthcare have been developed by medical organizations. However, the high cognitive load imposed in such stressful and rapidly changing environments poses significant challenges to the medical staff or team in adhering to these workflows. In collaboration with physicians and nurses from Carle Foundation Hospital, we first studied and modeled medical team's individual responsibilities and interactions in cardiac arrest resuscitation and decomposed their overall task into a set of distinct cognitive tasks that must be specifically supported to achieve successful human-centered system design...
October 17, 2017: Journal of Medical Systems
https://www.readbyqxmd.com/read/29038870/chiropractic-care-and-risk-for-acute-lumbar-disc-herniation-a-population-based-self-controlled-case-series-study
#9
Cesar A Hincapié, George A Tomlinson, Pierre Côté, Y Raja Rampersaud, Alejandro R Jadad, J David Cassidy
PURPOSE: Chiropractic care is popular for low back pain, but may increase the risk for acute lumbar disc herniation (LDH). Low back pain is a common early (prodromal) symptom of LDH and commonly precedes LDH diagnosis. Our objective was to investigate the association between chiropractic care and acute LDH with early surgical intervention, and contrast this with the association between primary care physician (PCP) care and acute LDH with early surgery. METHODS: Using a self-controlled case series design and population-based healthcare databases in Ontario, Canada, we investigated all adults with acute LDH requiring emergency department (ED) visit and early surgical intervention from April 1994 to December 2004...
October 16, 2017: European Spine Journal
https://www.readbyqxmd.com/read/29038132/provider-perspectives-of-high-quality-pediatric-hospital-to-home-transitions-for-children-and-youth-with-chronic-disease
#10
Carolyn C Foster, Elizabeth Jacob-Files, Kimberly C Arthur, Stephanie A Hillman, Todd C Edwards, Rita Mangione-Smith
OBJECTIVE: The objective of this study was to describe health care providers' and hospital administrators' perspectives on how to improve pediatric hospital-to-home transitions for children and youth with chronic disease (CYCD). METHODS: Focus groups and key informant interviews of inpatient attending physicians, primary care physicians, pediatric residents, nurses, care coordinators, and social workers were conducted at a tertiary care children's hospital. Key informant interviews were performed with hospital administrators...
October 16, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/29038045/effects-of-procalcitonin-guided-treatment-on-antibiotic-use-and-need-for-mechanical-ventilation-in-patients-with-acute-asthma-exacerbation-meta-analysis-of-randomized-controlled-trials
#11
Wanis H Ibrahim, Kamran Mushtaq, Tasleem Raza, Anand Kartha, Ahmed O Saleh, Rayaz A Malik
OBJECTIVE: The primary outcome was to determine whether serum procalcitonin-guided antibiotic therapy can reduce antibiotic exposure in patients with an acute exacerbation of asthma presenting to the primary care facility, emergency department or during hospital admission. The secondary outcome was the need for mechanical ventilation. METHODS: In this meta-analysis, we performed extensive literature search for randomized controlled clinical trials (published in English) that compared serum procalcitonin-guided antibiotic therapy versus antibiotic use according to physician's discretion for adult participants with mild, moderate or severe acute asthma exacerbations...
October 13, 2017: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/29037757/testing-smart-glasses-in-urology-clinical-and-surgical-potential-applications
#12
E García-Cruz, A Bretonnet, A Alcaraz
OBJECTIVES: We aimed to explore the potential benefits of using smart glasses - wearable computer optical devices with touch-less command features - in the surgery room and in outpatient care settings in urology. MATERIALS AND METHODS: Between April and November 2015, 80 urologists were invited to use Google Glass in their daily surgical and clinical practice, and to share them with other urologists. Participants rated the usefulness of smart glasses on a 10-point scale, and provided insights on their potential benefits in a telephone interview...
October 13, 2017: Actas Urologicas Españolas
https://www.readbyqxmd.com/read/29037168/locating-helicopter-emergency-medical-service-bases-to-optimise-population-coverage-versus-average-response-time
#13
Alan A Garner, Pieter L van den Berg
BACKGROUND: New South Wales (NSW), Australia has a network of multirole retrieval physician staffed helicopter emergency medical services (HEMS) with seven bases servicing a jurisdiction with population concentrated along the eastern seaboard. The aim of this study was to estimate optimal HEMS base locations within NSW using advanced mathematical modelling techniques. METHODS: We used high resolution census population data for NSW from 2011 which divides the state into areas containing 200-800 people...
October 16, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/29036253/understanding-state-regulation-of-biosimilars-and-effect-on-prescribers
#14
Katerina Yale, Olabola Awosika, Monica Rengifo-Pardo, Alison Ehrlich
Biologics are a mainstay of treatment for many dermatologic conditions, however the high costs can be prohibitive for many patients. A growing market of biosimilar drugs is emerging with the hope of providing patients access to more affordable medications. While the FDA has created an abbreviated licensure pathway for these drugs, states are still in the process of creating regulations regarding their substitution for reference biologics. This article looks to raise awareness of the current federal regulations and the differences among state regulations regarding the use of biosimilars...
October 1, 2017: Journal of Drugs in Dermatology: JDD
https://www.readbyqxmd.com/read/29034865/patients-attending-emergency-departments
#15
Martin Scherer, Dagmar Lühmann, Agata Kazek, Heike Hansen, Ingmar Schäfer
BACKGROUND: The number of patients in emergency departments has risen steadily in recent years, with a particular increase in patients not requiring urgent treatment. The aim of this study is to characterize this group of patients with respect to their sociodemographic features, health status, and reasons for attending an emergency department. METHODS: PiNo Nord is a cross-sectional observational study representing two full working weeks in five different hospitals...
September 29, 2017: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/29033764/non-meckel-small-intestine-diverticulitis
#16
Shamim Ejaz, Raghu Vikram, John R Stroehlein
Non-Meckel small intestine diverticulitis can have many manifestations and its management is not well-defined. We report 4 unselect cases of small intestine diverticulitis; all patients were seen by the same physician at the Emergency Center at The University of Texas MD Anderson Cancer Center between 1999 and 2014. The median age at diagnosis of these patients was 82 years (range, 76-87 years). All 4 patients presented with acute onset of abdominal pain, and computed tomography scans showed characteristics of small intestine diverticulitis unrelated to cancer...
May 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/29033602/early-in-hospital-clinical-deterioration-is-not-predicted-by-severity-of-illness-functional-status-or-comorbidity
#17
Janice Wang, Stella S Hahn, Myriam Kline, Rubin I Cohen
BACKGROUND: Prior studies concentrated on unplanned intensive care unit (ICU) transfer to gauge deterioration occurring shortly following hospital admission. However, examining only ICU transfers is not ideal since patients could stabilize with treatment, refuse ICU admission, or not require ICU evaluation. To further explore etiologies of early clinical deterioration, we used rapid response team (RRT) activation within 48 hours of admission as an index of early clinical worsening. METHODS: A retrospective analysis of prospectively gathered admissions from the emergency department in an academic medical center was done...
2017: International Journal of General Medicine
https://www.readbyqxmd.com/read/29033344/a-prospective-study-of-ketamine-as-primary-therapy-for-prehospital-profound-agitation
#18
Jon B Cole, Lauren R Klein, Paul C Nystrom, Johanna C Moore, Brian E Driver, Brandon J Fryza, Justin Harrington, Jeffrey D Ho
OBJECTIVE: We investigated the effectiveness of ketamine as a primary therapy for prehospital profound agitation. METHODS: This was a prospective observational study of patients receiving 5mg/kg of intramuscular ketamine for profound agitation, defined as a score of +4 on the Altered Mental Status Scale (AMSS), a validated ordinal scale of agitation from -4 (unresponsive) to +4 (most agitated). The primary outcome was time to adequate sedation (AMSS<+1). Secondary outcomes included need for additional sedatives, intubation frequency, complications associated with ketamine, and mortality...
October 7, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29033297/no-easy-way-out-a-case-of-physician-assisted-dying-in-the-emergency-department
#19
David H Wang
Currently, 1 out of 6 Americans lives within a jurisdiction in which physician-assisted dying is legally authorized. In most cases, patients ingest lethal physician-assisted dying medications at home without involvement of emergency medical services (EMS) or the emergency department (ED). However, occasionally the dying process is interrupted as a result of incomplete ingestion or vomiting of medications, confusion about timing of dying trajectory, familial emotional distress, and other variables. A case is presented here of a patient who arrived by ambulance to an urban ED after ingesting physician-assisted dying medication...
October 12, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/29032876/clinical-value-of-triage-lactate-in-risk-stratifying-trauma-patients-using-interval-likelihood-ratios
#20
Bonny J Baron, Andrew Nguyen, Dimitre Stefanov, Amit Shetty, Shahriar Zehtabchi
Emergency physicians face the challenge of rapidly identifying high-risk trauma patients. Lactate (LAC) is widely used as a surrogate of tissue hypoperfusion. However, clinically important values for LAC as a predictor of mortality are not well defined. OBJECTIVES: 1. To assess the value of triage LAC in predicting mortality after trauma. 2. To compute interval likelihood ratios (LR) for LAC. METHODS: Retrospective chart review of trauma patients with a significant injury mechanism that warranted labs at an urban trauma center...
October 7, 2017: American Journal of Emergency Medicine
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