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Emergency medicine

Nicola Liguori, Nicola Tarque, Celso Bambaren, Sandra Santa-Cruz, Juan Palomino, Michelangelo Laterza
OBJECTIVE: The objective of the study was to research the basic seismic response capability (BSRC) of hospitals in Lima Metropolitana. A large number of wounded could be registered in case of an earthquake; therefore, operational hospitals are necessary to cure the injured. The study focused on the operational performance of the hospitals, autonomies of essential resources such as power, water, medical gases, and medicine, in addition to the availability of emergency communication system and ambulances...
July 19, 2018: Disaster Medicine and Public Health Preparedness
Yimeng Zhou, Ning Li, Zhixia Qiu, Xiaoyu Lu, Min Fang, Xijing Chen, Lili Ren, Guangji Wang, Pingkai Ouyang
Triacontanol (TA, C30 H62 O), abundantly present in plant cuticle waxes and bee waxes, has been found to display promising anti-neoplastic potentials. As a long chain fatty alcohol, TA possesses limited aqueous solubility, which hinders its medicinal application. To overcome its solubility barrier, a polymer prodrug was synthesized through attaching TA to poly ethylene glycol (PEG), using succinic acid as a linker with bifunctional amide and ester bonds. Anti-neoplastic effects of PEG-TA were assessed in LoVo and MCF7 cells, anti-proliferative and apoptosis-inducing activities were subsequently confirmed in mouse xenograft model...
November 2018: Drug Delivery
Hendrik B Feys, Britt Van Aelst, Veerle Compernolle
Pathogen inactivation (PI) for platelet concentrates (PC) is a fairly recent development in transfusion medicine that is intended to decrease infectious disease transmission from the donor to the receiving patient. Effective inactivation of viruses, bacteria and eukaryotic parasites adds a layer of safety, protecting the blood supply against customary and emerging pathogens. Three PI methods have been described for platelets. These are based on photochemical damage of nucleic acids which prevents replication of most infectious pathogens and contaminating donor leukocytes...
June 27, 2018: Transfusion Medicine Reviews
Jean-Lionel Bagot, Natalia Marechaud, Nicolas Deana, Julie Wendling
BACKGROUND:  During chemotherapy, the correlation between insomnia and fatigue, anxiety, pain, depressed mood, and cognitive disorders makes these subjective complaints a 'symptom cluster' with common biological mechanisms. The theory of cerebral inflammation following the production of pro-inflammatory cytokines (high level of interleukin 1-β [IL1-β], IL6 and tumour necrosis factor-alpha) is currently the most generally accepted. Understanding these mechanisms should allow us to propose a chemoprotective homeopathic treatment of the nervous system...
July 18, 2018: Homeopathy: the Journal of the Faculty of Homeopathy
Nurul Hannim Zaidun, Zar Chi Thent, Azian Abd Latiff
The incidence of diseases related to oxidative stress disorders have been increased dramatically. Alternatives medicine or the active compound extracted from the natural products received great attention among researches at the present era. Naringenin (NG), a common dietary flavanone, found in the citrus fruits such as oranges, bergamots, lemons and grapefruit. It is used in the several oxidative stress disorders as the nutraceutical value of the compound emerges. Functionally, the antioxidants effect of NG is primarily attributed by reducing the free radical like reactive oxygen species (ROS) and enhancing the antioxidants activity such as superoxide dismutase (SOD), catalase, glutathione (GSH) in chronic diseases such as cardiovascular, neurodegenerative, diabetes, pulmonary, cancer and nephropathy...
July 15, 2018: Life Sciences
Karen E Joynt Maddox, E John Orav, Jie Zheng, Arnold M Epstein
BACKGROUND: The Center for Medicare and Medicaid Innovation (CMMI) launched the Bundled Payments for Care Improvement (BPCI) initiative in 2013. A subsequent study showed that the initiative was associated with reductions in Medicare payments for total joint replacement, but little is known about the effect of BPCI on medical conditions. METHODS: We used Medicare claims from 2013 through 2015 to identify admissions for the five most commonly selected medical conditions in BPCI: congestive heart failure (CHF), pneumonia, chronic obstructive pulmonary disease (COPD), sepsis, and acute myocardial infarction (AMI)...
July 19, 2018: New England Journal of Medicine
Christopher B Davis, Lucas N Marzec, Zachary Blea, Diana Godfrey, Daniel Bickley, Sean S Michael, Elaine Reno, Kelly Bookman, John J Lemery
BACKGROUND: Direct-to-consumer virtual visits are increasingly popular across both for-profit and nonprofit healthcare systems. INTRODUCTION: Virtual visits offer a convenient affordable way for patients to obtain medical care for simple conditions such as sinusitis and uncomplicated urinary tract infections. However, virtual visits have been associated with increased antibiotic utilization when compared with traditional in-person care. METHODS: In this retrospective cohort study, antibiotic utilization for acute sinusitis was compared between patients treated through a direct-to-consumer virtual urgent care versus a matched cohort treated through traditional urgent care...
July 18, 2018: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
Rita Ac Uacute Rcio, Anna Scomparin, Joao Conniot, Jorge A R Salvador, Ronit Satchi-Fainaro, Helena F Florindo, Rita Cardoso Guedes
The modulation of immune checkpoint receptors has been one of the most successful, exciting and explored approaches for cancer immunotherapy. Currently several immune checkpoint modulators, mainly monoclonal antibodies, are showing remarkable results. However, the failure to show a response in most patients and the induction of severe immune-related adverse effects are the major drawbacks. Novel approaches concerning the development of immune modulatory small molecules have emerged as an alternative. Nevertheless, the lack of structural information about immune checkpoint receptors has hindered the rational design of those small-molecule modulators, by preventing the use of methodologies such as computer-aided drug design...
July 18, 2018: Journal of Medicinal Chemistry
Joyce Li
Nearly 50% of children will experience dental trauma by the age of 4 years. Timely and effective care is important in the management of dental injuries, as several studies have shown poor outcomes with delayed treatment. The current evidence in the management of dental injuries is primarily from a dentist's perspective, with limited evidence specific to management in the emergency department. The goal of pediatric dental injury management is dictated largely by whether the dentition is primary or permanent...
August 2018: Pediatric Emergency Medicine Practice
Saurabh Saluja, Swagoto Mukhopadhyay, Julia R Amundson, Allison Silverstein, Jessica Gelman, Hillary Jenny, Yihan Lin, Anthony Moccia, Ramy Rashad, Rachita Sood, Nakul P Raykar, Mark G Shrime
Purpose: Quality of care is an emerging area of focus in the surgical disciplines. However, much of the emphasis on quality is limited to high-income countries. To address this gap, we conducted a systematic review of the literature on the quality of essential surgical care in low- and middle- income countries (LMIC). Data sources: We searched PubMed, Cinahl, Embase and CAB Abstracts using three domains: quality of care, surgery and LMIC. Study selection: We limited our review to studies of essential surgeries that pertained to all three search domains...
July 18, 2018: International Journal for Quality in Health Care
Paula da Silva Freitas, Samara Ramalho Matta, Luiz Villarinho Pereira Mendes, Vera Lucia Luiza, Monica Rodrigues Campos
This study aimed to describe and analyze factors associated with emergency care and hospitalization of hypertensive and diabetic patients in the municipality of Rio de Janeiro, especially those related to the use of medicines. This is across-sectional study using secondary database from a household survey that approached hypertensive and diabetic patients. The outcome variables were: 1) seek for emergency careasa resultof complications related to hypertension and diabetes in the 12months preceding the interviews; 2) hospitalizationin the same period andfor the same reasons...
July 2018: Ciência & Saúde Coletiva
Luciana Kase Tanno, Ignacio Ansotegui, Pascal Demoly
PURPOSE OF REVIEW: To understand the impact of globalization in the management of anaphylaxis and identify potential strategies to improve patients' care and prevention. RECENT FINDINGS: Developments in the field of anaphylaxis have been consistently following these globalization trends offering possibilities of collaborations of the allergy community and integrated international initiatives to reach quality care of allergic patients worldwide. SUMMARY: Globalization is the process of interaction and integration between people, companies, and governments worldwide...
July 16, 2018: Current Opinion in Allergy and Clinical Immunology
Steven C Marcus, Richard C Hermann, Sara Wiesel Cullen
OBJECTIVES: The past 20 years have seen the emergence of a national movement to improve hospital-based healthcare safety in the United States. However, much of the foundational work and subsequent research have neglected inpatient psychiatry. The aim of this article was to advance a comprehensive approach for conceptualizing patient safety in inpatient psychiatry as framed by an application of the Institute of Medicine patient safety framework. METHODS: This article develops a framework for characterizing patient safety in hospital-based mental health care...
July 17, 2018: Journal of Patient Safety
Tyler Sugerman-McGiffin, Gabrielle C Hybki, Jesse Castro, Lisa A Murphy, Colleen Tansey, Jeffrey E Patlogar, Reid K Nakamura, Dillon Y Chen
OBJECTIVE To determine how veterinarians' attire affected clients' perceptions and trust in the small animal emergency medicine setting. DESIGN Cross-sectional study. SAMPLE 154 clients of a 24-hour small animal emergency clinic in a rural location. PROCEDURES A survey was administered to clients in the waiting room over a 1-month period to elicit their impressions of veterinarians' attire in various clinical scenarios and whether that attire would affect their perceptions. Respondents completed the survey after examining photographs of 1 male and 1 female veterinarian in 5 styles of attire (business, professional, surgical, clinical, and smart casual)...
August 1, 2018: Journal of the American Veterinary Medical Association
Michael A Puskarich, Clif Callaway, Robert Silbergleit, Jesse M Pines, Ziad Obermeyer, David W Wright, Renee Y Hsia, Manish N Shah, Andrew A Monte, Alexander T Limkakeng, Zachary F Meisel, Phillip D Levy
For a variety of reasons including cheap computing, widespread adoption of electronic medical records, digitalization of imaging and biosignals, and rapid development of novel technologies, the amount of healthcare data being collected, recorded, and stored is increasing at an exponential rate. Yet despite these advances, methods for the valid, efficient, and ethical utilization of these data remain underdeveloped. Emergency care research, in particular, poses several unique challenges in this rapidly evolving field...
July 18, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Yating Zhao, Yanwen Lv, Wujiong Xia
Cyclic compounds constitute a great important class of substances in the science of medicine and biology, which renders the research on facile and efficient construction of such complex scaffolds from simple starting materials to be hot and appealing. Recently, the radical cascade reaction involving multiple bond formation/cleavage has emerged as an ideal and powerful route to give high-value cyclic products, along with diminished cost and waste. As a simple and benign methodology, photoredox catalysis offers a readily available access to the generation of radical species...
July 18, 2018: Chemical Record: An Official Publication of the Chemical Society of Japan ... [et Al.]
Diana Machado, Miriam Girardini, Miguel Viveiros, Marco Pieroni
The emergence of multi- and extensively drug resistant tuberculosis worldwide poses a great threat to human health and highlight the need to discover and develop new, effective and inexpensive antituberculosis agents. High-throughput screening assays against well-validated drug targets and structure based drug design have been employed to discover new lead compounds. However, the great majority fail to demonstrate any antimycobacterial activity when tested against Mycobacterium tuberculosis in whole-cell screening assays...
2018: Frontiers in Microbiology
Giselle C de Oliveira Santos, Cleydlenne C Vasconcelos, Alberto J O Lopes, Maria do S de Sousa Cartágenes, Allan K D B Filho, Flávia R F do Nascimento, Ricardo M Ramos, Emygdia R R B Pires, Marcelo S de Andrade, Flaviane M G Rocha, Cristina de Andrade Monteiro
The Candida genus comprises opportunistic fungi that can become pathogenic when the immune system of the host fails. Candida albicans is the most important and prevalent species. Polyenes, fluoropyrimidines, echinocandins, and azoles are used as commercial antifungal agents to treat candidiasis. However, the presence of intrinsic and developed resistance against azole antifungals has been extensively documented among several Candida species. The advent of original and re-emergence of classical fungal diseases have occurred as a consequence of the development of the antifungal resistance phenomenon...
2018: Frontiers in Microbiology
Foteini Christidi, Efstratios Karavasilis, Georgios Velonakis, Panagiotis Ferentinos, Michail Rentzos, Nikolaos Kelekis, Ioannis Evdokimidis, Peter Bede
Hippocampal pathology in Amyotrophic Lateral Sclerosis (ALS) remains surprisingly under recognized despite compelling evidence from neuropsychology, neuroimaging and neuropathology studies. Hippocampal dysfunction contributes significantly to the clinical heterogeneity of ALS and requires structure-specific cognitive and neuroimaging tools for accurate in vivo evaluation. Recent imaging studies have generated unprecedented insights into the presymptomatic and longitudinal processes affecting this structure and have contributed to the characterisation of both focal and network-level changes...
2018: Frontiers in Neurology
Yi-Heng Li, Yu-Chen Wang, Yi-Chih Wang, Ju-Chi Liu, Cheng-Han Lee, Chun-Chi Chen, I-Chang Hsieh, Feng-You Kuo, Wei-Chun Huang, Shih-Hsien Sung, Chiung-Zuan Chiu, Jung-Cheng Hsu, Shu-Long Jen, Juey-Jen Hwang, Jiunn-Lee Lin
In Taiwan, the incidence of non-ST segment elevation acute coronary syndrome (NSTE-ACS) continues to increase in recent years. The purpose of this guideline is to help health care professionals in Taiwan to use adequate tests and treatments for management of NSTE-ACS. For rapid diagnosis, in addition to history and physical examination, 0/3 h rapid diagnosis protocol with high sensitivity cardiac troponin assay is recommended in this guideline. Dual antiplatelet and anticoagulation therapies are important parts in the initial treatment...
July 12, 2018: Journal of the Formosan Medical Association, Taiwan Yi Zhi
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