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https://www.readbyqxmd.com/read/29165122/decreased-blood-pressure-associated-with-in-vehicle-exposure-to-carbon-monoxide-in-korean-volunteers
#1
Geon-Woo Lee, Mun-Joo Bae, Ji-Yeon Yang, Jung-Woo Son, Jae-Lim Cho, Sang-Gyu Lee, Bo-Mi Jang, Hyun-Woo Lee, Jong-Soon Lim, Dong-Chun Shin, Young-Wook Lim
BACKGROUND: Carbon monoxide (CO) is one of the primary components of emissions from light-duty vehicles, and reportedly comprises 77% of all pollutants emitted in terms of concentration. Exposure to CO aggravates cardiovascular disease and causes other health disorders. The study was aimed to assess the negative effects by injecting different amounts of CO concentration directly to human volunteers boarding in the car. METHODS: Human volunteers were exposed to CO concentrations of 0, 33...
April 5, 2017: Environmental Health and Preventive Medicine
https://www.readbyqxmd.com/read/29161170/examining-the-implementation-of-collaborative-competencies-in-a-critical-care-setting-key-challenges-for-enacting-competency-based-education
#2
Joanne Goldman, Simon Kitto, Scott Reeves
Interprofessional collaboration is recognised as an important factor in improving patient care in intensive care units (ICUs). Competency frameworks, and more specifically interprofessional competency frameworks, are a key strategy being used to support the development of attitudes, knowledge, skills, and behaviours needed for an interprofessional approach to care. However, evidence for the application of competencies is limited. This study aimed to extend our empirically based understanding of the significance of interprofessional competencies to actual clinical practice in an ICU...
November 21, 2017: Journal of Interprofessional Care
https://www.readbyqxmd.com/read/29143074/-additional-emergency-medical-measures-in-trauma-associated-cardiac-arrest
#3
B Ondruschka, C Baier, J Dreßler, A Höch, M Bernhard, C Kleber, C Buschmann
INTRODUCTION: More than half of all traumatic deaths happen in prehospital settings. Until now, there have been no long-term studies examining the actual additive treatment during trauma-associated cardiopulmonary resuscitation (tCPR), including pleural decompression, pericardiocentesis, tourniquets and external stabilization of the pelvis. The present cohort study evaluated forensic autopsy reports of trauma deaths occurring at the scene with respect to additive actions in preclinical tCPR as well as the potentially preventable nature of the individual death cases...
November 15, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/29119070/superior-ophthalmic-vein-access-for-embolization-of-an-indirect-carotid-cavernous-fistula
#4
Ali S Haider, Prabhat Garg, Dean Leonard, Tijani Osumah, Umair Khan, Steven Vayalumkal, Lyndon K Lee, Phu Nguyen, Grant Gilliland, Kennith F Layton
Carotid cavernous fistulae (CCF) are defined as abnormal connections between the carotid circulation and cavernous sinus. CCFs can be categorized as being direct or indirect. Direct CCFs are usually associated with trauma, whereas indirect CCFs are associated with revascularization following cavernous sinus thrombosis. We present a case of a 53-year-old male who presented with tinnitus, proptosis, conjunctivitis, and blurry vision. The patient had a recent endovascular transvenous embolization that was only partially successful, with a residual carotid cavernous fistula draining to the left superior ophthalmic vein and multiple cortical veins...
September 1, 2017: Curēus
https://www.readbyqxmd.com/read/29102036/coronary-computed-tomographic-angiography-derived-fractional-flow-reserve-for-therapeutic-decision-making
#5
Christian Tesche, Rozemarijn Vliegenthart, Taylor M Duguay, Carlo N De Cecco, Moritz H Albrecht, Domenico De Santis, Marcel C Langenbach, Akos Varga-Szemes, Brian E Jacobs, David Jochheim, Moritz Baquet, Richard R Bayer, Sheldon E Litwin, Ellen Hoffmann, Daniel H Steinberg, U Joseph Schoepf
This study investigated the performance of coronary computed tomography angiography (cCTA) with cCTA-derived fractional flow reserve (CT-FFR) compared with invasive coronary angiography (ICA) with fractional flow reserve (FFR) for therapeutic decision making in patients with suspected coronary artery disease (CAD). Seventy-four patients (62 ± 11 years, 62% men) with at least 1 coronary stenosis of ≥50% on clinically indicated dual-source cCTA, who had subsequently undergone ICA with FFR measurement, were retrospectively evaluated...
September 19, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/29096750/clinical-efficacy-and-mechanism-of-lymphoplasma-exchange-in-the-treatment-of-guillain-barre-syndrome
#6
M-C Luo, W-F Wang, W-F Yin, Y Li, B-J Li, W-W Duan, Q-M Zeng, Y-B Luo, X-S Yang, H Yang
Guillain-Barre syndrome (GBS) is an autoimmune disease of the nervous system and is the most common acute polyneuropathy. Both cellular and humoral immunity are believed to be involved in the pathogenesis of GBS, and various types of activated CD4+ T cells are thought to orchestrate the onset and progression of GBS. Lymphoplasma exchange (LPE) filtering out activated lymphocytes while exchanging plasma has been used for GBS treatment for years. However the treatment is still not yet optimal. In order to assess the efficacy of this treatment, we evaluate the effect of LPE and determine the appropriate frequency of LPE treatments for GBS patients through comparing the neurological deficit scores and the changes in related immunology indicators of GBS patients before and after LPE treatment...
October 31, 2017: Cellular and Molecular Biology
https://www.readbyqxmd.com/read/29088994/a-generic-simulation-model-of-the-relative-cost-effectiveness-of-icu-versus-step-down-imcu-expansion
#7
Amin Mahmoudian-Dehkordi, Somayeh Sadat
BACKGROUND: Many jurisdictions are facing increased demand for intensive care. There are two long-term investment options: intensive care unit (ICU) versus step-down or intermediate care unit (IMCU) capacity expansion. Relative cost-effectiveness of the two investment strategies with regard to patient lives saved has not been studied to date. METHODS: We expand a generic system dynamics simulation model of emergency patient flow in a typical hospital, populated with empirical evidence found in the medical and hospital administration literature, to estimate the long-term effects of expanding ICU versus IMCU beds on patient lives saved under a common assumption of 2...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29055662/organization-in-response-to-massive-afflux-of-war-victims-in-civilian-practice%C3%A2-%C3%A2-experimental-feedback-from-the-november-2015-paris-terrorist-attacks
#8
M Borel, R Rousseau, F Le Saché, D Pariente, S Castro, M Delay, P Hausfater, M Raux, F Menegaux
The arrival of a large number of war-weapon casualties at a civilian trauma center requires anticipation. A plan defining the management principles and the respective roles of the involved physicians and nurses and their interaction with each other is essential. Uni-directional patient flow associated with adequate numbers of staff physicians and nurses under the leadership of a medical director is essential to prevent the overwhelming of the trauma center. Routine and regular interaction between the pre-hospital medical flow control system and the medical director, on one hand, and between surgical teams and the medical director, on the other, are necessary to know when to apply "damage control" surgical techniques...
October 18, 2017: Journal of Visceral Surgery
https://www.readbyqxmd.com/read/29049564/a-new-technique-to-implant-a-transcatheter-inflatable-fully-repositionable-prosthesis-in-aortic-stenosis-with-severe-asymmetric-calcification
#9
Hasan Bushnaq, Christoph Raspé, Alper Öner, Seyrani Yücel, Hüseyin Ince, Sebastian-Patrick Sommer
OBJECTIVES: In contrast to stented transcatheter aortic valves, the Direct Flow Medical (DFM) valve is a stentless bovine aortic bioprosthesis mounted in a non-metallic inflatable frame. Hence, severe asymmetric annular calcification may result in residually elevated transaortic pressure gradients after DFM implantation. We present a novel intraprocedural dilatation (IDIL) technique for successful implantation of the DFM valve in the presence of complex annular calcification. METHODS: Between January 2014 and May 2015, 55 patients underwent DFM valve-based transcatheter aortic valve implantation at our institution...
November 1, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28983835/biomedical-big-data-new-models-of-control-over-access-use-and-governance
#10
Effy Vayena, Alessandro Blasimme
Empirical evidence suggests that while people hold the capacity to control their data in high regard, they increasingly experience a loss of control over their data in the online world. The capacity to exert control over the generation and flow of personal information is a fundamental premise to important values such as autonomy, privacy, and trust. In healthcare and clinical research this capacity is generally achieved indirectly, by agreeing to specific conditions of informational exposure. Such conditions can be openly stated in informed consent documents or be implicit in the norms of confidentiality that govern the relationships of patients and healthcare professionals...
October 5, 2017: Journal of Bioethical Inquiry
https://www.readbyqxmd.com/read/28980029/-current-cases-of-falsified-medicinal-products-within-the-competence-of-the-federal-institute-for-drugs-and-medical-devices-bfarm-case-studies-and-extent
#11
REVIEW
Marcus Wittstock, Norbert Paeschke
The nature of a falsification of a medicinal product can vary a lot. Therefore the means to detect them and the potential risk to patient safety can also be very different. The whole range of falsification will be described using observed cases from the Federal Institute for Drugs and Medical Devices (BfArM).Based on the relatively low number of detected cases of falsified medicines, the legal supply chain can still be regarded as safe. It has to be assumed that in the illegal supply chain, e. g. illegal internet trade, the majority of the offered medicinal products are not only falsifications due to illegal trade but because they are completely falsified...
October 4, 2017: Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz
https://www.readbyqxmd.com/read/28972588/the-impact-of-bulimia-nervosa-on-oral-health-a-review-of-the-literature
#12
A Rosten, T Newton
Eating disorders are a potentially life-threatening group of mental disorders, which affect a patient's relationship with food and their body. This manifests itself through chaotic and disordered eating habits. One such eating disorder is bulimia nervosa, which has a lifetime prevalence of 1%. While there is consensus that bulimic behaviour directly causes dental erosion due to vomiting and acidic food choices, there is less clear evidence for a direct link between bulimia nervosa and dental caries, although there does still appear to be an association...
November 2017: British Dental Journal
https://www.readbyqxmd.com/read/28970744/analysing-a-chinese-regional-integrated-healthcare-organisation-reform-failure-using-a-complex-adaptive-system-approach
#13
Wenxi Tang, Lai Wei, Liang Zhang
INTRODUCTION: China's organised health system has remained outdated for decades. Current health systems in many less market-oriented countries still adhere to traditional administrative-based directives and linear planning. Furthermore, they neglect the responsiveness and feedback of institutions and professionals, which often results in reform failure in integrated care. Complex adaptive system theory (CAS) provides a new perspective and methodology for analysing the health system and policy implementation...
June 19, 2017: International Journal of Integrated Care
https://www.readbyqxmd.com/read/28962636/strategies-for-patient-empowerment-through-the-promotion-of-medicines-in-israel-regulatory-framework-for-the-pharmaceutical-industry
#14
Eyal Schwartzberg, Zohar Barnett-Itzhaki, Itamar Grotto, Eli Marom
The correct and rational use of medications can have a positive direct impact on disease outcomes, as well on the utilization of the health system resources. Unfortunately, 50% of the patients do not take their medications as prescribed, largely due to lack of patients' understanding of their medical condition, as well as the lack of reliable medicine information.There are multiple strategies implemented in many countries to tackle this challenge including: disease awareness campaigns (DAC) to raise the public awareness to specific diseases, direct-to-consumer advertisement (DTCA) to raise the public awareness to prescription medicines, specific treatments and over-the-counter (OTC) products to improve the accessibility of patients to specific medicines...
September 29, 2017: Israel Journal of Health Policy Research
https://www.readbyqxmd.com/read/28962493/first-results-of-heartware-left-ventricular-assist-device-implantation-with-tunnelling-of-the-outflow-graft-through-the-transverse-sinus
#15
Jasmin S Hanke, Sebastian V Rojas, Tomislav Cvitkovic, Bettina Wiegmann, Alexander Horke, Gregor Warnecke, Axel Haverich, Jan D Schmitto
OBJECTIVES: The number of left ventricular assist device (LVAD) implants for the treatment of advanced heart failure is increasing tremendously. The main therapeutic goal of this operation is to provide a bridge to transplant for patients awaiting a donor heart. In 2011, we developed a novel, minimally invasive surgical technique for LVAD implantation. To avoid possible outflow graft injuries during redo sternotomies as well as to provide a more physiological outflow towards the aortic arch, a further modification of this approach was made with outflow graft tunnelling through the transverse sinus...
October 1, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28962035/immune-cell-and-transcriptomic-analysis-of-the-human-decidua-in-term-and-preterm-parturition
#16
S F Rinaldi, S Makieva, P T Saunders, A G Rossi, J E Norman
STUDY QUESTION: Is labour, both at term and preterm, associated with alterations in decidual lymphocyte densities and widespread changes to the decidual transcriptome? SUMMARY ANSWER: The onset of parturition, both at term and preterm, is associated with widespread gene expression changes in the decidua, many of which are related to inflammatory signalling, but is not associated with changes in the number of any of the decidual lymphocyte populations examined. WHAT IS KNOWN ALREADY: Given its location, directly at the maternal-foetal interface, the decidua is likely to play a pivotal role in the onset of parturition, however, the molecular events occurring in the decidua in association with the onset of labour, both at term and preterm, remain relatively poorly defined...
August 18, 2017: Molecular Human Reproduction
https://www.readbyqxmd.com/read/28953294/job-satisfaction-among-academic-family-physicians
#17
Denny Fe Agana, Maribeth Porter, Robert Hatch, Daniel Rubin, Peter Carek
BACKGROUND AND OBJECTIVES: Family physicians report some of the highest rates of burnout among their physician peers. Over the past few years, this rate has increased and work-life balance has decreased. In academic medicine, many report lack of career satisfaction and have considered leaving academia. Our aim was to explore the factors that contribute to job satisfaction and burnout in faculty members in a family medicine department. METHODS: Six academic family medicine clinics were invited to participate in this qualitative study...
September 2017: Family Medicine
https://www.readbyqxmd.com/read/28952929/unambiguous-identification-and-visualization-of-an-acoustically-active-catheter-by-ultrasound-imaging-in-real-time-theory-algorithm-and-phantom-experiments
#18
Viksit Kumar, Richard Liu, Randall R Kinnick, Adriana Gregory, Azra Alizd, Marek Belohlavek, Mostafa Fatemi
OBJECTIVE: Ultrasound-guided biopsies and minimally invasive procedures have been used in numerous medical applications, including catheter guidance. The biggest challenge for catheter guidance by ultrasound lies in distinguishing the catheter from neighboring tissue, as well as the ability to differentiate the catheter body from its tip. METHODS: In our previous work, we introduced a functional prototype of an acoustically active catheter, in which a miniature piezoelectric crystal allowed accurate localization of the catheter tip by pulsed wave (PW) Doppler imaging and Doppler spectrogram...
September 25, 2017: IEEE Transactions on Bio-medical Engineering
https://www.readbyqxmd.com/read/28948696/benign-prostatic-hyperplasia-long-term-follow-up-of-prostate-volume-reduction-after-sclerotherapy-of-the-internal-spermatic-veins
#19
Y Gat, M Goren
The purpose was to examine the results of bilateral percutaneous sclerotherapy of the internal spermatic veins on prostate volume and prostatic symptoms. We previously showed that destruction of one-way valves in the internal spermatic veins (varicocele) elevates hydrostatic pressure in the vertical testicular venous drainage system in the erect human. This diverts free testosterone (FT) flow at high concentrations directly from the testes into the prostate. High intraprostatic FT prolongs prostate cell life and increases cell proliferation rate-synergistic effects resulting in increased cell population (BPH)...
September 25, 2017: Andrologia
https://www.readbyqxmd.com/read/28944749/keeping-communications-flowing-during-large-scale-disasters-leveraging-amateur-radio-innovations-for-disaster-medicine
#20
Victor H Cid, Andrew R Mitz, Stacey J Arnesen
Medical facilities may struggle to maintain effective communications during a major disaster. Natural and man-made disasters threaten connectivity by degrading or crippling Internet, cellular/mobile, and landline telephone services across wide areas. Communications among staff, between facilities, and to resources outside the disaster area may be lost for an extended time. A prototype communications system created by the National Library of Medicine (NLM) provides basic communication services that ensure essential connectivity in the face of widespread infrastructure loss...
September 25, 2017: Disaster Medicine and Public Health Preparedness
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