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https://www.readbyqxmd.com/read/29135621/efficacy-of-implementation-of-a-chest-pain-center-at-a-community-hospital
#1
Alexandra Davis, Jason Chiu, Stanley K Lau, Yih Jen Kok, Jonathan Y H Wu
INTRODUCTION: Chest pain is the second leading cause for emergency department (ED) visits in the United States; however, <20% of the patients have acute coronary syndrome that require immediate attention. The HEART score is designed for rapid risk stratification of ED chest pain patients using the following criteria: history, electrocardiogram, age, risk factors, and troponin. It has been shown to be superior in identifying patients with low (HEART score 0-3) and high (7-10) risk of major adverse cardiac events, who can then be rapidly discharged or admitted for intervention...
December 2017: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/29109872/severe-decompression-illness-case-report-prehospital-recognition-and-regional-transport-considerations
#2
Julie Estrada, David Meurer, Kevin De Boer, Karl Huesgen
A 46-year-old male presented to our tertiary care emergency department (ED) with shortness of breath and chest pain following an uneventful four-hour SCUBA dive at 100 feet. His prehospital emergency medical services (EMS) assessment revealed transient hypotension and hypoxia. He later developed progressive skin mottling. Serology was significant for acute kidney injury, transaminitis, hemoconcentration, and hypoxia on an arterial blood gas. Computed tomography (CT) angiography demonstrated intravascular gas throughout the mesenteric and pulmonary arteries as well as the portal venous system...
2017: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/29106649/pain-management-for-primary-care-providers-a-narrative-review-of-high-impact-studies-2014-2016
#3
William C Becker, Matthew J Bair, Michael Picchioni, Joanna L Starrels, Joseph W Frank
Objective: This manuscript reviews high-impact, peer-reviewed studies published from January 2014 to March 2016 that are relevant to pain management in primary care. Given the recent release of the US Centers for Disease Control and Prevention's "Guideline for Prescribing Opioids for Chronic Pain" emphasizing the primacy of nonopioid treatment, we focused our review on nonopioid pain management. Design: Narrative review of peer-reviewed literature. Methods: We searched three article summary services and queried expert contacts for high-impact, English-language studies related to the management of pain in adults in primary care...
July 3, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29103573/practical-management-of-a-regional-anesthesia-driven-acute-pain-service
#4
REVIEW
Stephen F Goldberg, John-Paul J Pozek, Eric S Schwenk, Jaime L Baratta, David H Beausang, Andrew K Wong
No abstract text is available yet for this article.
2017: Advances in Anesthesia
https://www.readbyqxmd.com/read/29098095/medical-approach-to-right-colon-diverticulitis-with-perforation
#5
James Espinosa, Rahul Sharma, Alan Lucerna, Doug Stranges
We report a case of a 71-year-old female who presented with right lower quadrant (RLQ) abdominal pain and was diagnosed on CT scan with right-sided diverticulitis with perforation. She was admitted under the surgical service after consultation and received intravenous fluids, intravenous antibiotics, and pain medications as needed. The patient was discharged 2 days after admission in stable condition with follow-up with gastroenterology. The differential diagnosis of right lower quadrant abdominal pain is vast...
2017: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/29093588/-complicated-jejunoileal-diverticular-disease-a-12-cases-serie-and-literature-review
#6
Aylhin Joana López Marcano, José Manuel Ramia, Roberto De la Plaza Llamas, Soledad Alonso, Johnny David Gonzales Aguilar, Andree Wolfgang Kühnhardt Barrantes
OBJECTIVE: To perform a retrospective analysis of a series of complicated JID (jejunoileal diverticulitis) cases surgically treated in our service during the period from 2002 to 2015. MATERIALS AND METHODS: We treated 12 cases of jejunoileal complicated diverticulosis. 7 women and 5 men. The mean age was 76 years. The clinical presentation in all cases was acute abdominal pain, one with gastrointestinal bleeding. All cases had leukocytosis, neutrophilia and increased acute phase reactants...
July 2017: Revista de Gastroenterología del Perú: órgano Oficial de la Sociedad de Gastroenterología del Perú
https://www.readbyqxmd.com/read/29083966/opioid-abuse-a-detailed-examination-of-cost-drivers-over-a-24-month-follow-up-period
#7
Lauren M Scarpati, Noam Y Kirson, Zitong B Jia, Jody Wen, Jaren Howard
BACKGROUND: Previous work has documented the considerable economic burden associated with opioid abuse, dependence, and overdose/poisoning (hereafter, "abuse"). Recent analyses have provided insights into the trajectory and drivers of the excess costs of abuse both before and after diagnosis, showing the important role of other substance abuse, mental health issues, and painful conditions. OBJECTIVE: To build on the recently published study by Kirson et al. (2017) and extend its findings by (a) evaluating the trajectory of excess costs of abuse for an additional year after an incident abuse diagnosis and (b) exploring the diagnosis-level drivers of excess costs over time in greater detail...
November 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/29078868/hospital-readmission-after-ambulatory-laparoscopic-cholecystectomy-incidence-and-predictors
#8
Eric B Rosero, Girish P Joshi
BACKGROUND: The aim of the study was to assess the rate of 30-d hospital readmissions after ambulatory laparoscopic cholecystectomy. MATERIALS AND METHODS: The 2009 to 2011 State Ambulatory Surgery and Services and State Inpatient Databases from California, Florida, and New York were analyzed to evaluate the incidence of 30-d readmissions after laparoscopic cholecystectomy performed in outpatient settings. Hospital transfers and the principal diagnoses of hospital readmission were analyzed as secondary outcomes...
November 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/29070499/identifying-and-characterizing-preventable-adverse-drug-events-for-prioritizing-pharmacist-intervention-in-hospitals
#9
Nakyung Jeon, Ben Staley, Thomas Johns, Glori Pflugfelder Lipori, Babette Brumback, Richard Segal, Almut G Winterstein
PURPOSE: The approach and results for identifying and characterizing preventable adverse drug events (pADEs) that are key targets for pharmacist medication therapy management (MTM) are summarized. METHODS: This study was part of a larger effort aimed at developing an electronic health record-based prediction model (the complexity score, or C-score) that ranks hospitalized patients according to their risk for pADEs. An environmental scan of published epidemiologic pADE studies and national patient safety priority areas was conducted...
November 1, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/29066616/precommitting-to-choose-wisely-about-low-value-services-a-stepped-wedge-cluster-randomised-trial
#10
Jeffrey Todd Kullgren, Erin Krupka, Abigail Schachter, Ariel Linden, Jacquelyn Miller, Yubraj Acharya, James Alford, Richard Duffy, Julia Adler-Milstein
BACKGROUND: Little is known about how to discourage clinicians from ordering low-value services. Our objective was to test whether clinicians committing their future selves (ie, precommitting) to follow Choosing Wisely recommendations with decision supports could decrease potentially low-value orders. METHODS: We conducted a 12-month stepped wedge cluster randomised trial among 45 primary care physicians and advanced practice providers in six adult primary care clinics of a US community group practice...
October 24, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/29046774/role-of-whatsapp-based-discussions-in-improving-residents-knowledge-of-post-operative-pain-management-a-pilot-study
#11
Sumitra G Bakshi, Pranay Bhawalkar
BACKGROUND: To provide a platform for the dissemination of basic knowledge of pain management, a WhatsApp group was created by residents and consultants. Common clinical scenarios, resident queries, and important instructions to be followed by residents with respect to running the Acute Pain Service were discussed in the group. This study evaluates the benefits of this interaction. METHODS: This study was approved by the hospital ethics board and was registered with the Clinical Trial Registry of India...
October 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/29030935/rapid-response-team-activation-for-pediatric-patients-on-the-acute-pain-service
#12
Maxwell Teets, Dmitry Tumin, Hina Walia, Jenna Stevens, Sharon Wrona, David Martin, Tarun Bhalla, Joseph D Tobias
INTRODUCTION: Untreated pain or overly aggressive pain management may lead to adverse physiologic consequences and activation of the hospital's Rapid Response Team. This study is a quality improvement initiative that attempts to identify patient demographics and patterns associated with Rapid Response Team consultations for patients on the acute pain service. METHODS: A retrospective review of all patients on the acute pain service from February 2011 until June 2015 was cross-referenced with inpatients requiring consultation from the Rapid Response Team...
November 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29028793/clinico-pathological-features-of-erythema-nodosum-leprosum-a-case-control-study-at-alert-hospital-ethiopia
#13
Edessa Negera, Stephen L Walker, Selfu Girma, Shimelis N Doni, Degafe Tsegaye, Saba M Lambert, Munir H Idriss, Yohanis Tsegay, Hazel M Dockrell, Abraham Aseffa, Diana N Lockwood
BACKGROUND: Leprosy reactions are a significant cause of morbidity in leprosy population. Erythema nodosum leprosum (ENL) is an immunological complication affecting approximately 50% of patients with lepromatous leprosy (LL) and 10% of borderline lepromatous (BL) leprosy. ENL is associated with clinical features such as skin lesions, neuritis, arthritis, dactylitis, eye inflammation, osteitis, orchitis, lymphadenitis and nephritis. ENL is treated mainly with corticosteroids and corticosteroids are often required for extended periods of time which may lead to serious adverse effects...
October 2017: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/29025128/opioid-therapy-for-chronic-pain-overview-of-the-2017%C3%A2-us-department-of-veterans-affairs-and-us-department-of-defense-clinical-practice-guideline
#14
Jack M Rosenberg, Brandon M Bilka, Sara M Wilson, Christopher Spevak
Description: The US Department of Veterans Affairs (VA) and US Department of Defense (DoD) revised the 2010 clinical practice guideline (CPG) for the management of opioid therapy for chronic pain, considering the specific needs of the VA and DoD and new evidence regarding prescribing opioid medication for non-end-of-life-related chronic pain. This paper summarizes the major recommendations and compares them with the US Centers for Disease Control and Prevention (CDC) guideline for prescribing opioids...
September 1, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29023898/impact-of-ketamine-use-on-adjunctive-analgesic-and-sedative-medications-in-critically-ill-trauma-patients
#15
Kaitlin A Pruskowski, Kelly Harbourt, Mehrnaz Pajoumand, Sai-Ho Jason Chui, H Neal Reynolds
BACKGROUND: Ketamine may be used to manage pain and agitation that is refractory to "traditional" agents such as fentanyl, propofol, benzodiazepines, and dexmedetomidine; however, literature describing the use of ketamine continuous infusions for this purpose in critically ill trauma patients is limited. OBJECTIVES: The primary objective of this study was to determine the impact of the initiation of a ketamine continuous infusion on sedative and analgesic use in critically ill trauma patients...
October 10, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/29020996/quality-of-life-profile-of-general-vietnamese-population-using-eq-5d-5l
#16
Long Hoang Nguyen, Bach Xuan Tran, Quynh Ngoc Hoang Le, Tung Thanh Tran, Carl A Latkin
BACKGROUND: Health-related quality of life (HRQOL) is a vital benchmark to assess the effects of health interventions and policies. Measuring HRQOL of the general population is essential to establish a reference for health outcomes evaluations. However, evidence on HRQOL of general populations in low and middle income countries is very limited. This study aimed to measure HRQOL of the Vietnamese population by using the EuroQol-5 dimensions-5 levels (EQ-5D-5L) instrument and determine its associated factors...
October 11, 2017: Health and Quality of Life Outcomes
https://www.readbyqxmd.com/read/29017597/estimating-the-economic-and-social-consequences-for-patients-diagnosed-with-human-african-trypanosomiasis-in-muchinga-lusaka-and-eastern-provinces-of-zambia-2004-2014
#17
Allan Mayaba Mwiinde, Martin Simuunza, Boniface Namangala, Chitalu Miriam Chama-Chiliba, Noreen Machila, Neil Anderson, Alexandra Shaw, Susan C Welburn
BACKGROUND: Acute human African trypanosomiasis (rHAT) caused by Trypanosoma brucei rhodesiense is associated with high mortality and is fatal if left untreated. Only a few studies have examined the psychological, social and economic impacts of rHAT. In this study, mixed qualitative and quantitative research methods were used to evaluate the socio-economic impacts of rHAT in Mambwe, Rufunsa, Mpika and Chama Districts of Zambia. METHODS: Individuals diagnosed with rHAT from 2004 to 2014 were traced using hospital records and discussions with communities...
October 10, 2017: Infectious Diseases of Poverty
https://www.readbyqxmd.com/read/28993112/hospitalization-due-to-acute-exacerbation-of-chronic-pain-an-intervention-study-in-a-university-hospital
#18
Daniel W Wheeler, Sara Kinna, Andrew Bell, Peter J Featherstone, David J Sapsford, Sam P Bass
BACKGROUND AND AIMS: Hospitalization as a result of acute exacerbation of complex chronic pain is a largely hidden problem, as patients are often admitted to hospital under a variety of specialities, and there is frequently no overarching inpatient chronic pain service dedicated to their management. Our institution had established an inpatient acute pain service overseen by pain physicians and staffed by specialist nurses that was intended to focus on the management of perioperative pain...
October 6, 2017: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/28987133/implementing-change-evaluating-the-accelerated-chest-pain-risk-evaluation-acre-project
#19
William A Parsonage, Tanya Milburn, Sarah Ashover, Wade Skoien, Jaimi H Greenslade, Louise McCormack, Louise Cullen
OBJECTIVE: To evaluate hospital length of stay (LOS) and admission rates before and after implementation of an evidence-based, accelerated diagnostic protocol (ADP) for patients presenting to emergency departments (EDs) with chest pain. DESIGN: Quasi-experimental design, with interrupted time series analysis for the period October 2013 - November 2015. Setting, participants: Adults presenting with chest pain to EDs of 16 public hospitals in Queensland. INTERVENTION: Implementation of the ADP by structured clinical re-design...
August 4, 2017: Medical Journal of Australia
https://www.readbyqxmd.com/read/28972278/a-retrospective-study-of-ketamine-administration-and-the-development-of-acute-or-post-traumatic-stress-disorder-in-274-war-wounded-soldiers
#20
G Mion, J Le Masson, C Granier, C Hoffmann
The objective of this study was to explore whether ketamine prevents or exacerbates acute or post-traumatic stress disorders in military trauma patients. We conducted a retrospective study of a database from the French Military Health Service, including all soldiers surviving a war injury in Afghanistan (2010-2012). The diagnosis of post-traumatic stress disorder was made by a psychiatrist and patients were analysed according to the presence or absence of this condition. Analysis included the following covariables: age; sex; acute stress disorder; blast injury; associated fatality; brain injury; traumatic amputation; Glasgow coma scale; injury severity score; administered drugs; number of surgical procedures; physical, neurosensory or aesthetic sequelae; and the development chronic pain...
December 2017: Anaesthesia
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