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Medical Simulation

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https://www.readbyqxmd.com/read/28092926/effect-of-gravity-and-microgravity-on-intracranial-pressure
#1
Justin S Lawley, Lonnie G Petersen, Erin J Howden, Satyam Sarma, William K Cornwell, Rong Zhang, Louis A Whitworth, Michael A Williams, Benjamin D Levine
Astronauts have recently been discovered to have impaired vision, with a presentation that resembles syndromes of elevated intracranial pressure (ICP). This syndrome is considered the most mission critical medical problem identified in the past decade of manned spaceflight. We recruited five men and three women who had an Ommaya reservoir inserted for the delivery of prophylactic central nervous system chemotherapy, but were free of their malignant disease for at least 1 year. ICP was assessed by placing a fluid-filled 25 ga butterfly needle into the Ommaya reservoir...
January 16, 2017: Journal of Physiology
https://www.readbyqxmd.com/read/28091704/medical-students-medication-communication-skills-regarding-drug-prescription-a-qualitative-analysis-of-simulated-physician-patient-consultations
#2
Katarina Hauser, Jan Matthes
PURPOSE: Poor medication communication of physicians to patients is detrimental, e.g. for medication adherence. Reasons for physicians' deficits in medication communication may be unfavourable conditions in daily practice or already insufficient training during their (undergraduate) medical studies. We explored medical students' communication on new medications in simulated physician-patient conversations to identify actual deficits indicating apparent educational needs. METHODS: Fifth year medical students attending a mandatory course at the University of Cologne had simulated physician-patient consultations aiming at drug prescription...
January 14, 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28090509/innovations-in-surgery-simulation-a-review-of-past-current-and-future-techniques
#3
REVIEW
Ido Badash, Karen Burtt, Carlos A Solorzano, Joseph N Carey
As a result of recent work-hours limitations and concerns for patient safety, innovations in extraclinical surgical simulation have become a desired part of residency education. Current simulation models, including cadaveric, animal, bench-top, virtual reality (VR) and robotic simulators are increasingly used in surgical training programs. Advances in telesurgery, three-dimensional (3D) printing, and the incorporation of patient-specific anatomy are paving the way for simulators to become integral components of medical training in the future...
December 2016: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28089562/sequential-multiple-assignment-randomized-trials-an-opportunity-for-improved-design-of-stroke-reperfusion-trials
#4
William J Meurer, Nicholas J Seewald, Kelley Kidwell
BACKGROUND: Modern clinical trials in stroke reperfusion fall into 2 categories: alternative systemic pharmacological regimens to alteplase and "rescue" endovascular approaches using targeted thrombectomy devices and/or medications delivered directly for persistently occluded vessels. Clinical trials in stroke have not evaluated how initial pharmacological thrombolytic management might influence subsequent rescue strategy. A sequential multiple assignment randomized trial (SMART) is a novel trial design that can test these dynamic treatment regimens and lead to treatment guidelines that more closely mimic practice...
January 12, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28089473/box-or-virtual-reality-trainer-which-tool-results-in-better-transfer-of-laparoscopic-basic-skills-a-prospective-randomized-trial
#5
Christian Brinkmann, Mathias Fritz, Ulrich Pankratius, Ralf Bahde, Philipp Neumann, Steffen Schlueter, Norbert Senninger, Emile Rijcken
OBJECTIVE: Simulation training improves laparoscopic performance. Laparoscopic basic skills can be learned in simulators as box- or virtual-reality (VR) trainers. However, there is no clear recommendation for either box or VR trainers as the most appropriate tool for the transfer of acquired laparoscopic basic skills into a surgical procedure. DESIGN: Both training tools were compared, using validated and well-established curricula in the acquirement of basic skills, in a prospective randomized trial in a 5-day structured laparoscopic training course...
January 12, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28087355/generation-of-quercetin-cellulose-acetate-phthalate-systems-for-delivery-by-supercritical-antisolvent-process
#6
I García-Casas, A Montes, C Pereyra, E J Martínez de la Ossa
Supercritical antisolvent process (SAS) has been used to precipitate microparticles of quercetin, a plant pigment found in many foods and used for medical treatments, pharmaceutical and cosmetic industries, together with nanoparticles of cellulose acetate phthalate (CAP), a polymer quite frequently used in drug delivery. Previously, precipitation of nanoparticles of CAP by the same process was studied at different conditions of pressure, temperature, CO2and solution flow rates, nozzle diameter and initial concentration of the solution...
January 10, 2017: European Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/28087244/practice-makes-perfect-correlations-between-prior-experience-in-high-level-athletics-and-robotic-surgical-performance-do-not-persist-after-task-repetition
#7
Kevin Shee, Fady M Ghali, Elias S Hyams
OBJECTIVE: Robotic surgical skill development is central to training in urology as well as in other surgical disciplines. Here, we describe a pilot study assessing the relationships between robotic surgery simulator performance and 3 categories of activities, namely, videogames, musical instruments, and athletics. DESIGN: A questionnaire was administered to preclinical medical students for general demographic information and prior experiences in surgery, videogames, musical instruments, and athletics...
January 10, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28079581/assessing-the-impact-of-the-anesthesia-medication-template-on-medication-errors-during-anesthesia-a-prospective-study
#8
Eliot B Grigg, Lizabeth D Martin, Faith J Ross, Axel Roesler, Sally E Rampersad, Charles Haberkern, Daniel K W Low, Kristen Carlin, Lynn D Martin
BACKGROUND: Medication errors continue to be a significant source of patient harm in the operating room with few concrete countermeasures. The organization and identification of medication syringes may have an impact on the commission of medication errors in anesthesia, so a team of physicians and designers at the University of Washington created the Anesthesia Medication Template (AMT) to define a formal way of organizing the anesthesia workspace. The purpose of this study is to assess the ability of the AMT to reduce perioperative medication errors by anesthesia providers...
January 11, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28078985/designing-isoform-selective-inhibitors-against-classical-hdacs-for-effective-anticancer-therapy-insight-and-perspectives-from-in-silico
#9
Shabir Ahmad Ganai
Histone deacetylase inhibitors, the small molecules modulating the biological activity of histone deacetylases are emerging as potent chemotherapeutic agents. Despite their considerable therapeutic benefits in disease models, the lack of isoform specificity culminates in debilitating off target effects, raising serious concerns regarding their applicability. This emphasizes the pressing and unmet medical need of designing isoform selective inhibitors for safe and effective anticancer therapy. Keeping these grim facts in view, the current article sheds light on structural basis of off-targeting...
12, 2017: Current Drug Targets
https://www.readbyqxmd.com/read/28078530/evaluation-of-the-population-pharmacokinetic-properties-of-lidocaine-and-its-metabolites-after-long-term-multiple-applications-of-a-lidocaine-plaster-in-post-herpetic-neuralgia-patients
#10
Roberta Bursi, Chiara Piana, Joachim Grevel, Dymphy Huntjens, Irmgard Boesl
BACKGROUND AND OBJECTIVES: Lidocaine 5% medicated plaster is the first lidocaine containing product for chronic use. As no previous investigations have been conducted to evaluate the population pharmacokinetics of long-term exposure to lidocaine 5% medicated plasters, further insights into the evaluation of the pharmacokinetic properties of lidocaine and its metabolites were needed for the assessment of its safety. METHODS: The population pharmacokinetic properties of lidocaine and its metabolites were evaluated after multiple applications of lidocaine 5% medicated plasters based on data collected for up to 14...
January 12, 2017: European Journal of Drug Metabolism and Pharmacokinetics
https://www.readbyqxmd.com/read/28078455/retention-of-laparoscopic-and-robotic-skills-among-medical-students-a-randomized-controlled-trial
#11
Megan S Orlando, Lauren Thomaier, Melinda G Abernethy, Chi Chiung Grace Chen
BACKGROUND: Although simulation training beneficially contributes to traditional surgical training, there are less objective data on simulation skills retention. OBJECTIVE: To investigate the retention of laparoscopic and robotic skills after simulation training. METHODS: We present the second stage of a randomized single-blinded controlled trial in which 40 simulation-naïve medical students were randomly assigned to practice peg transfer tasks on either laparoscopic (N = 20, Fundamentals of Laparoscopic Surgery, Venture Technologies Inc...
January 11, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28076953/effects-of-lithium-and-other-monovalent-ions-on-palmitoyl-oleoyl-phosphatidylcholine-bilayer
#12
James Kruczek, See-Wing Chiu, Eric Jakobsson, Sagar A Pandit
Interations of monovalent salts with lipid membranes are explored with Molecular Dynamic (MD) simulations. The simulations included the monovalent ions Na(+) and K(+), for their importance in physiology, Li(+) for its small size and importance in several medical conditions including bipolar disorder, and Rb(+) for its large size. All the simulations included Cl(-) as counter ions. One bilayer was simulated without salt as a control. POPC bilayers experienced reductions in area per lipid with the addition of salt, the smaller the ion the smaller the area, with the exception of Li(+)...
January 11, 2017: Langmuir: the ACS Journal of Surfaces and Colloids
https://www.readbyqxmd.com/read/28076295/convolutive-blind-source-separation-of-surface-emg-measurements-of-the-respiratory-muscles
#13
Eike Petersen, Herbert Buchner, Marcus Eger, Philipp Rostalski
Electromyography (EMG) has long been used for the assessment of muscle function and activity and has recently been applied to the control of medical ventilation. For this application, the EMG signal is usually recorded invasively by means of electrodes on a nasogastric tube which is placed inside the esophagus in order to minimize noise and crosstalk from other muscles. Replacing these invasive measurements with an EMG signal obtained non-invasively on the body surface is difficult and requires techniques for signal separation in order to reconstruct the contributions of the individual respiratory muscles...
January 11, 2017: Biomedizinische Technik. Biomedical Engineering
https://www.readbyqxmd.com/read/28075182/dispersing-the-mists-an-experimental-history-of-medicine-study-into-the-quality-of-volatile-inhalations
#14
Barry Murnane, Cathal T Gallagher, Noel Snell, Mark Sanders, Ramin Moshksar, Darragh Murnane
BACKGROUND: Dr. Nelson's Improved Inhaler was first marketed with an advertisement in The Lancet in 1865. Revolutionary at the time for its ease of use and patient-friendliness, the inhaler is still in use for self-treatment by many all over the world. On the occasion of its 150th anniversary, this study reports an experimental historical medicine approach to identify evidence for the quality of vapor inhalers. METHODS: Through accessing reviews of the device's use by the contemporary medical establishment, it was established that Dr...
January 11, 2017: Journal of Aerosol Medicine and Pulmonary Drug Delivery
https://www.readbyqxmd.com/read/28074564/sustaining-sbirt-in-the-wild-simulating-revenues-and-costs-for-screening-brief-intervention-and-referral-to-treatment-programs
#15
Alexander J Cowell, William N Dowd, Michael J Mills, Jesse M Hinde, Jeremy W Bray
AIMS: To examine the conditions under which Screening, Brief Intervention and Referral to Treatment (SBIRT) programs can be sustained by health insurance payments. DESIGN: A mathematical model was used to estimate the number of patients needed for revenues to exceed costs. SETTING: Three medical settings in the United States were examined: in-patient, out-patient and emergency department. Components of SBIRT were delivered by combinations of health-care practitioners (generalists) and behavioral health specialists...
February 2017: Addiction
https://www.readbyqxmd.com/read/28074337/economic-burden-of-rheumatoid-arthritis-in-italy-possible-consequences-on-anti-citrullinated-protein-antibody-positive-patients
#16
Francesco Saverio Mennini, Andrea Marcellusi, Lara Gitto, Florenzo Iannone
BACKGROUND: Rheumatoid arthritis (RA) is an autoimmune disease with a substantial medical and economic burden. In Italy, it affects approximately 280,000 people, therefore representing the musculoskeletal disease with the highest economic impact in terms of costs for the National Health Service and the social security system. OBJECTIVE: The aim of this study was to estimate the annual economic burden of RA in Italy and determine the potential cost reduction considering the most effective biologic treatment for early rapidly progressing RA (ERPRA) patients...
January 10, 2017: Clinical Drug Investigation
https://www.readbyqxmd.com/read/28073958/rudeness-and-medical-team-performance
#17
Arieh Riskin, Amir Erez, Trevor A Foulk, Kinneret S Riskin-Geuz, Amitai Ziv, Rina Sela, Liat Pessach-Gelblum, Peter A Bamberger
OBJECTIVES: Rudeness is routinely experienced by medical teams. We sought to explore the impact of rudeness on medical teams' performance and test interventions that might mitigate its negative consequences. METHODS: Thirty-nine NICU teams participated in a training workshop including simulations of acute care of term and preterm newborns. In each workshop, 2 teams were randomly assigned to either an exposure to rudeness (in which the comments of the patient's mother included rude statements completely unrelated to the teams' performance) or control (neutral comments) condition, and 2 additional teams were assigned to rudeness with either a preventative (cognitive bias modification [CBM]) or therapeutic (narrative) intervention...
January 10, 2017: Pediatrics
https://www.readbyqxmd.com/read/28073934/the-influence-of-customer-medicine-seller-transactional-dynamics-on-childhood-diarrhoea-management-a-qualitative-study-in-ghana
#18
Lauren Rosapep, Emily Sanders, Kathryn Banke
In 2004, the World Health Organization (WHO) and United Nations Children's Fund (UNICEF) jointly revised the recommended treatment for acute paediatric diarrhoea to specify supplementing reduced osmolarity oral rehydration salts (ORS) with zinc. In many countries, however, a significant knowledge-practice gap persists in appropriate diarrhoea management among private healthcare providers. For example, the United States Agency for International Development (USAID)-funded Strengthening Health Outcomes through the Private Sector (SHOPS) project recently demonstrated that over-the-counter medicine sellers (MS) in Ghana recommended inappropriate diarrhoea treatments, despite their demonstrated knowledge of appropriate treatment protocols...
January 10, 2017: Health Policy and Planning
https://www.readbyqxmd.com/read/28072394/three-dimensional-cascaded-system-analysis-of-a-50-%C3%A2%C2%B5m-pixel-pitch-wafer-scale-cmos-active-pixel-sensor-x-ray-detector-for-digital-breast-tomosynthesis
#19
Chumin Zhao, Nikita Vassiljev, Anastasios Konstantinidis, Robert Speller, Jerzy Kanicki
High-resolution, low-noise x-ray detectors based on the complementary metal-oxide-semiconductor (CMOS) active pixel sensor (APS) technology have been developed and proposed for digital breast tomosynthesis (DBT). In this study, we evaluated the three-dimensional (3D) imaging performance of a 50 ��m pixel pitch CMOS APS x-ray detector named DynAMITe (Dynamic Range Adjustable for Medical Imaging Technology). The two-dimensional (2D) angle-dependent modulation transfer function (MTF), normalized noise power spectrum (NNPS), and detective quantum efficiency (DQE) were experimentally characterized and modeled using the cascaded system analysis at oblique incident angles up to 30��...
January 10, 2017: Physics in Medicine and Biology
https://www.readbyqxmd.com/read/28068518/impact-of-space-environment-on-stability-of-medicines-challenges-and-prospects
#20
REVIEW
Priti Mehta, Dhara Bhayani
To upkeep health of astronauts in a unique, isolated, and extreme environment of space is the primary goal for a successful space mission, hence, safe and efficacious medications are essential for the wellness of astronauts. Space medication has been challenged with problems related to efficacy. Along with altered physiology, one of the possible reasons could be instability of space medications in the presence of harsh spaceflight environmental conditions. Altered physical and chemical stability can result in reduced potency which can result in reduced efficacy...
January 3, 2017: Journal of Pharmaceutical and Biomedical Analysis
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