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https://www.readbyqxmd.com/read/28096313/opportunities-to-reduce-ct-radiation-exposure-experience-over-5-years-at-the-nih-clinical-center
#1
William C Kovacs, Jianhua Yao, David A Bluemke, Les R Folio
Our current study was undertaken in order to compare CT exposures during various dose-reduction initiatives at the National Institutes of Health Clinical center, to show trends in exposure reduction over a 5-y period, and to provide benchmarks that other facilities may use. Using an in-house extraction tool (Radiation Exposure Extraction Engine), we derived CT exposure data from Digital Imaging and Communications in Medicine (DICOM) headers over 5 y. We present parameters used and compare most common exams between 2010 and 2015...
January 16, 2017: Radiation Protection Dosimetry
https://www.readbyqxmd.com/read/28092990/in-hospital-statin-underutilization-among-high-risk-patients-delayed-uptake-of-the-2013-cholesterol-guidelines-in-a-u-s-cohort
#2
Subeer K Wadia, Mark Belkin, Kelsey Chow, Jonathan Nattiv, Andrew Appis, Steven B Feinstein, Kim Allan Williams
OBJECTIVES: Clinician utilization of the 2013 cholesterol lowering guidelines remains variable and unknown. We sought to examine statin prescribing patterns and compare rates among specialists who treat high-risk cardiovascular patients admitted to the hospital. METHODS: We retrospectively (via chart review) examined four specialty groups: (i) Cardiology, (ii) Cardiovascular or Vascular (CV) Surgery, (iii) Neurology, and (iv) Internal Medicine. Adult patients were included based on a discharge diagnosis of acute coronary syndrome, coronary artery bypass graft surgery, carotid endarterectomy, acute ischemic stroke, transient ischemic attack, or high-risk chest pain...
January 17, 2017: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/28077904/regadenoson-in-myocardial-perfusion-study-first-institutional-experiences-in-bosnia-and-herzegovina
#3
Nermina Beslic, Renata Milardovic, Amera Sadija, Sejla Ceric, Zeljka Raic
INTRODUCTION: Myocardial perfusion imaging (MPI) is widely used in the evaluation of known and suspected coronary artery disease (CAD). Imaging of heart in stress and rest enables the comparison of myocardial uptake of radiotracer in proportion to the needs and coronary flow, which is used for detection of perfusion defects. Exercise stress and pharmacologic agents are used for the stressing purpose. Novel pharmacologic stressor regadenoson is A2A selective adenosine agonist, which selectively binds to the adenosine receptors in coronary arteries causing coronary dilatation...
December 2016: Acta Informatica Medica: AIM
https://www.readbyqxmd.com/read/28065248/giants-in-chest-medicine-claude-lenfant-md
#4
EDITORIAL
Edward J Roccella
No abstract text is available yet for this article.
January 2017: Chest
https://www.readbyqxmd.com/read/28057790/novel-risk-markers-and-risk-assessments-for-cardiovascular-disease
#5
REVIEW
Mark R Thomas, Gregory Y H Lip
The use of risk markers has transformed cardiovascular medicine, exemplified by the routine assessment of troponin, for both diagnosis and assessment of prognosis in patients with chest pain. Clinical risk factors form the basis for risk assessment of cardiovascular disease and the addition of biochemical, cellular, and imaging parameters offers further refinement. Identifying novel risk factors may allow greater risk stratification and a steady, but gradual progression toward precision medicine. Indeed, the generation of data in this area of research is explosive and when combined with new technologies and techniques provides the potential for more refined, targeted approaches to cardiovascular medicine...
January 6, 2017: Circulation Research
https://www.readbyqxmd.com/read/28050997/mortality-among-homeless-women-who-remain-unclaimed-after-death-an-insight
#6
Aayushi Garg, Chittaranjan Behera, Saurav Chopra, D N Bhardwaj
BACKGROUND: Some homeless people remain unclaimed after death. Although women constitute a minor proportion among the homeless, they represent a more vulnerable section. We reviewed the major autopsy characteristics and causes of death among women whose bodies remained unclaimed after death. METHODS: We analysed the autopsy records and inquest papers of unclaimed bodies of women for the period 2006-12 at the Department of Forensic Medicine and Toxicology, All India Institute of Medical Sciences, New Delhi...
July 2016: National Medical Journal of India
https://www.readbyqxmd.com/read/28040479/chest-imaging-in-cystic-fibrosis-studies-what-counts-and-can-be-counted
#7
REVIEW
Rhonda Szczesniak, Lidija Turkovic, Eleni-Rosalina Andrinopoulou, Harm A W M Tiddens
BACKGROUND: The dawn of precision medicine and CFTR modulators require more detailed assessment of lung structure in cystic fibrosis (CF) clinical studies. Various imaging markers have emerged and are measurable, but clarity is needed to identify what markers should count for clinical studies. High-resolution chest computed tomography (CT) scoring has yielded sensitive markers for the study of CF disease progression. Once completed, CT scores from ongoing randomized controlled trials can be used to examine relationships between imaging endpoints and therapeutic effectiveness...
December 28, 2016: Journal of Cystic Fibrosis: Official Journal of the European Cystic Fibrosis Society
https://www.readbyqxmd.com/read/28039499/omega-%C3%AE-advancement-flap-a-circular-flap-design-for-the-aesthetic-closure-of-circular-skin-defect
#8
Enver Arpaci, Serdar Altun, Nilgün Markal Ertas, Ahmet Cagri Uysal, Emre Inozu
BACKGROUND: Most skin defects that require reconstruction with a local skin flap have a circular- or oval-shaped pattern. The majority of the skin flaps are planned in an angled shape. Therefore, it may be necessary to modify the shape of the defect or the distal flap border to minimize tissue distortion. We have designed a circular-shaped advancement flap to be compatible with the circular defect. METHODS: Eighteen cases of reconstruction of skin defects in the face, chest wall, hand and buttock area were performed using the omega advancement flap between 2010 and 2014...
December 30, 2016: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28031830/development-of-diffuse-alveolar-damage-after-initiation-of-nijutsuto
#9
Motoyasu Kato, Shinichi Sasaki, Hiroshi Izumi, Toshimasa Uekusa, Shigeru Tominaga, Kazuhisa Takahashi
Chinese traditional medicine, Nijutsuto, is used to treat patients with frozen shoulder and osteoarthritis. Herbal medicine is often linked to the development of interstitial lung disease. An 83-year-old Japanese man with osteoarthritis who was on Nijutsuto was admitted to our hospital with dyspnoea and severe cough after 2 weeks from initiation of Nijutsuto. A chest computed tomography scan on admission showed diffuse ground glass opacity with traction bronchiectasis. Thus, he was diagnosed with Nijutsuto-induced interstitial lung disease, and was treated with a high dose of methylprednisolone and cyclophosphamide...
November 2016: Respirology Case Reports
https://www.readbyqxmd.com/read/28029667/outcomes-bronchoscopic-evaluation-in-a-university-hospital
#10
R H Ghimire, N Bhatta, P Koirala, B Bista, D R Misra, B Shah
INTRODUCTION: Study of clinical profile of the patients and diagnostic yield of the selected bronchoscopic procedures gives us important information in clinical decision making and better patient care. There are hardly very few studies regarding these entities. Therefore, we decided to study clinical characteristics and outcomes of the patients who underwent bronchoscopic evaluation in our setting. METHODS: This was a cross-sectional study the consecutive patients who underwent bronchoscopy from 1st May 2013- 30th April 2015 in division of pulmonary, critical care and sleep medicine...
October 2016: JNMA; Journal of the Nepal Medical Association
https://www.readbyqxmd.com/read/28010994/pelvic-floor-muscle-training-for-secondary-prevention-of-pelvic-organ-prolapse-prevprol-a-multicentre-randomised-controlled-trial
#11
Suzanne Hagen, Cathryn Glazener, Doreen McClurg, Christine Macarthur, Andrew Elders, Peter Herbison, Don Wilson, Philip Toozs-Hobson, Christine Hemming, Jean Hay-Smith, Marissa Collins, Sylvia Dickson, Janet Logan
BACKGROUND: Pelvic floor muscle training can reduce prolapse severity and symptoms in women seeking treatment. We aimed to assess whether this intervention could also be effective in secondary prevention of prolapse and the need for future treatment. METHODS: We did this multicentre, parallel-group, randomised controlled trial at three centres in New Zealand and the UK. Women from a longitudinal study of pelvic floor function after childbirth were potentially eligible for inclusion...
December 20, 2016: Lancet
https://www.readbyqxmd.com/read/27998322/international-federation-for-emergency-medicine-consensus-statement-sonography-in-hypotension-and-cardiac-arrest-shoc-an-international-consensus-on-the-use-of-point-of-care-ultrasound-for-undifferentiated-hypotension-and-during-cardiac-arrest
#12
Paul Atkinson, Justin Bowra, James Milne, David Lewis, Mike Lambert, Bob Jarman, Vicki E Noble, Hein Lamprecht, Tim Harris, Jim Connolly
: Introduction The International Federation for Emergency Medicine (IFEM) Ultrasound Special Interest Group (USIG) was tasked with development of a hierarchical consensus approach to the use of point of care ultrasound (PoCUS) in patients with hypotension and cardiac arrest. METHODS: The IFEM USIG invited 24 recognized international leaders in PoCUS from emergency medicine and critical care to form an expert panel to develop the sonography in hypotension and cardiac arrest (SHoC) protocol...
December 21, 2016: CJEM
https://www.readbyqxmd.com/read/27993937/validity-of-the-manchester-triage-system-in-patients-with-sepsis-presenting-at-the-ed-a-first-assessment
#13
Ingo Gräff, Bernd Goldschmidt, Procula Glien, Ramona C Dolscheid-Pommerich, Rolf Fimmers, Daniel Grigutsch
BACKGROUND: The Manchester Triage System (MTS) does not have a specific presentational flow chart for sepsis. The goal of this investigation was to determine adequacy of acuity assignment for patients with sepsis presenting at the ED and triaged using the MTS. MATERIALS AND METHODS: This retrospective analysis included patients >16 presenting to an ED in Bonn, Germany, on the first 12 days of each month between June 2012 and March 2014. Patients were classified into one of three septic groups, or no sepsis...
December 19, 2016: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/27993826/minimal-change-disease-associated-with-malignant-pleural-mesothelioma-case-report-and-review-of-the-literature
#14
Halil Yildiz, Stoian Ioana Andreea, Delphine Hoton, Jean Cyr Yombi
A 77-year-old man with a history of asbestos exposure was admitted to our internal medicine division for generalised weakness, fatigue, loss of weight, night sweats and difficulty for breathing since 3 months. Clinical examination revealed left fine crackles and bilateral leg oedema. Blood test showed elevated C reactive protein level at 142 mg/L, lactate dehydrogenase level at 421 UI, creatinine level at 5.75 mg/dL. Serum albumin level at 30 g/L, urinalysis showed significant proteinuria at 6.4 g/L...
December 19, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27979724/a-peer-reviewed-instructional-video-is-as-effective-as-a-standard-recorded-didactic-lecture-in-medical-trainees-performing-chest-tube-insertion-a-randomized-control-trial
#15
Tomas J Saun, Scott Odorizzi, Celine Yeung, Marjorie Johnson, Glen Bandiera, Shelly P Dev
OBJECTIVE: Online medical education resources are becoming an increasingly used modality and many studies have demonstrated their efficacy in procedural instruction. This study sought to determine whether a standardized online procedural video is as effective as a standard recorded didactic teaching session for chest tube insertion. DESIGN: A randomized control trial was conducted. Participants were taught how to insert a chest tube with either a recorded didactic teaching session, or a New England Journal of Medicine (NEJM) video...
December 12, 2016: Journal of Surgical Education
https://www.readbyqxmd.com/read/27965042/do-sanitary-ceramic-workers-have-a-worse-presentation-of-chest-radiographs-or-pulmonary-function-tests-than-other-ceramic-workers
#16
Yu-Chung Tsao, Su-Hsun Liu, I-Shiang Tzeng, Tsung-Han Hsieh, Jau-Yuan Chen, Jiin-Chyuan John Luo
BACKGROUND/PURPOSE: Silicosis remains the most prevalent occupational disease worldwide. There have been no specific studies focusing on the association between exposure settings at work and the clinical severity in silicosis patients. In this study, we describe and compare the clinical characteristics and silicosis-associated exposure history at work among workers from several types of ceramic production facilities in Taiwan. METHODS: We reviewed the medical records of 221 patients who were first diagnosed with silicosis at the Occupational Medicine Clinic of Northern Taiwan in 2012...
December 10, 2016: Journal of the Formosan Medical Association, Taiwan Yi Zhi
https://www.readbyqxmd.com/read/27955985/quarterly-reporting-of-computed-tomography-ordering-history-reduces-the-use-of-imaging-in-an-emergency-department
#17
Richard Ehrlichman, Zachary Dezman, Joel Klein, Jean Jeudy, Daniel Lemkin
BACKGROUND: Computed tomography (CT) is a useful and necessary part of many emergency department (ED) assessments. However, the costs of imaging and the health risks associated with radiation exposure have sparked national efforts to reduce CT ordering in EDs. STUDY OBJECTIVE: We analyzed CT ordering habits prior to and following implementation of a feedback tool at a community hospital. METHODS: In this intervention study, we identified the CT-ordering habits of physicians and mid-level care providers (physician assistants and nurse practitioners) at baseline and after implementation of a system that sent quarterly feedback reports comparing their ordering habits with those of their peers...
December 9, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27916065/-clinical-analysis-of-hypersensitivity-reaction-of-platinum-in-ovarian-cancer-and-cervical-cancer-patients
#18
L Li, M Wu, J X Yang, X R Wan, H F Huang, L Y Pan, K Shen, J H Lang, Y Xiang
Objective: To investigate the incidence, risk factors, management and prognosis of hypersensitivity reaction (HSR) of platinum-based chemotherapy in patients of ovarian cancer and cervical cancer. Methods: Cases from Peking Union Medical College Hospital from Jan. 2013 to Jan. 2016 were checked for patients' data of epithelial ovarian cancer treated with carboplatin/paclitaxel (every 3 weeks) and patients of cervical cancer treated with concurrent radiochemotherapy using cisplatin (every week). General characters, pathological features, treatment and prognosis of patients were analyzed to determine the severity, symptoms, outcomes and risk factors of HSR...
November 25, 2016: Zhonghua Fu Chan Ke za Zhi
https://www.readbyqxmd.com/read/27902153/nurse-led-medicines-monitoring-a-study-examining-the-effects-of-the-west-wales-adverse-drug-reaction-profile
#19
Richard Jones, Christopher Moyle, Sue Jordan
Aim The physical health of people with mental health conditions is often suboptimal, and in many cases this may be related to their prescription medicines. One issue is that patients are monitored inconsistently for adverse drug reactions (ADRs). The aim of this study was to explore whether the nurse-led West Wales Adverse Drug Reaction (WWADR) Profile for Mental Health Medicines could improve recognition and management of ADRs in a crisis resolution home treatment service. Method The WWADR Profile was implemented in addition to usual care, in a one-group 'before and after' comparison study (n=20)...
November 30, 2016: Nursing Standard
https://www.readbyqxmd.com/read/27898253/establishing-equipoise-national-survey-of-the-treatment-of-pediatric-para-pneumonic-effusion-and-empyema
#20
Morgan K Richards, Jarod P Mcateer, Todd C Edwards, Lucas R Hoffman, Matthew P Kronman, Dennis W Shaw, Adam B Goldin
BACKGROUND: Despite six randomized trials of various treatments for pediatric para-pneumonic effusion (PPE), management approaches differ. The purpose of this study was to gain insight into opinions on PPE treatment with the goal of designing a definitive trial to generate consensus intervention guidelines. METHODS: To evaluate physician opinions regarding PPE management, we developed a survey based on input from a nationwide, multi-disciplinary advisory group that established content validity...
November 29, 2016: Surgical Infections
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