Read by QxMD icon Read


James A Town, Paul A Bergl, Akhil Narang, John F McConville
BACKGROUND : The long-term retention of knowledge and skills in bedside ultrasound by internal medicine residents after ultrasound training is not well understood. OBJECTIVE : We sought to determine whether knowledge and skills acquired from focused training in bedside ultrasound are retained over time, and whether retention is related to independent practice. METHODS : We conducted a prospective observational trial of 101 internal medicine residents at an academic medical center who participated in a bedside ultrasound workshop followed by 12 months of independent practice...
October 2016: Journal of Graduate Medical Education
M Bodí, I Oliva, M C Martín, G Sirgo
Real-time random safety audits constitute a tool designed to transfer knowledge from the sources of scientific evidence to the patient bedside. It has proven useful in critically ill patients, improving safety in the process of critical patient care, turning unsafe situations into safe ones in daily practice, and ensuring adherence to scientific evidence. In parallel, the design and methodology involved affords process indicators that will make it possible to know how we provide care for our patients, evolution over time (with regular feedback for professionals), the impact of our interventions, and benchmarking...
October 21, 2016: Medicina Intensiva
Giorgio Cozzi, Sara Lega, Rita Giorgi, Egidio Barbi
We describe 2 patients with acute asthma exacerbation who were admitted to the emergency department (ED) with severe agitation and restlessness as a prominent finding, for which bedside asthma treatment sedation with intranasal dexmedetomidine was performed. In both cases, dexmedetomidine allowed the patients to rest and improved tolerance to treatment. Dexmedetomidine is a unique sedative with an excellent safety profile and minimal effect on respiratory function. These properties render it particularly promising for the management of severe agitation in children admitted to the ED with acute asthma exacerbation...
October 5, 2016: Annals of Emergency Medicine
Nawal Salahuddin, Alaa Mohamed, Nadia Alharbi, Hamad Ansari, Khaled J Zaza, Qussay Marashly, Iqbal Hussain, Othman Solaiman, Torbjorn V Wetterberg, Khalid Maghrabi
BACKGROUND: Unexplained coma after critical illness can be multifactorial. We evaluated the diagnostic ability of bedside Optic Nerve Sheath Diameter [ONSD] as a screening test for non-traumatic radiographic cerebral edema. METHODS: In a prospective study, mixed medical-surgical intensive care units [ICU] patients with non-traumatic coma [GCS < 9] underwent bedside ultrasonographic ONSD measurements. Non-traumatic radiographic cerebral edema [NTRCE] was defined as > 5 mm midline shift, cisternal, sulcal effacement, or hydrocephalus on CT...
October 25, 2016: BMC Anesthesiology
Jingjing Wu, Mingzhi Zhang, Delong Liu
The Bruton tyrosine kinase (BTK) inhibitor, ibrutinib, has been approved for the treatment of chronic lymphocytic leukemia, mantle cell lymphoma, and Waldenstrom's macroglobulinemia. Acquired resistance to ibrutinib due to BTK C481S mutation has been reported. Mutations in PLCγ2 can also mediate resistance to ibrutinib. Untoward effects due to off-target effects are also disadvantages of ibrutinib. More selective and potent BTK inhibitors (ACP-196, ONO/GS-4059, BGB-3111, CC-292) are being investigated. This review summarized the preclinical research and clinical data of ONO/GS-4059...
October 20, 2016: Oncotarget
Maeve Leonard, Henry O'Connell, Olugbenga Williams, Fahad Awan, Chris Exton, Margaret O'Connor, Dimitrios Adamis, Colum Dunne, Walter Cullen, David J Meagher
OBJECTIVE: Efficient detection of neurocognitive disorders is a key diagnostic challenge. We explored how simple bedside tests of attention, vigilance and visuospatial function might assist in identifying delirium in hospitalized patients. METHODS: Performance on a battery of bedside cognitive tests was compared in elderly medical inpatients with DSM-IV delirium, dementia, comorbid delirium-dementia, and no neurocognitive disorder. RESULTS: 193 patients [mean age 79...
November 2016: Journal of Psychosomatic Research
Noriko Itoh, Roy Kim, Mavis Peng, Emma DiFilippo, Hadley Johnsonbaugh, Allan MacKenzie-Graham, Rhonda R Voskuhl
Protective effects of pregnancy during MS have led to clinical trials of estriol, the pregnancy estrogen, in MS. Since estriol binds to estrogen receptor (ER) beta, ER beta ligand could represent a "next generation estriol" treatment. Here, ER beta ligand treatment was protective in EAE in both sexes and across genetic backgrounds. Neuroprotection was shown in spinal cord, sparing myelin and axons, and in brain, sparing neurons and synapses. Longitudinal in vivo MRIs showed decreased brain atrophy in cerebral cortex gray matter and cerebellum during EAE...
October 3, 2016: Journal of Neuroimmunology
Robert Thompson Stone, Christopher Mooney, Erika Wexler, Jonathan Mink, Jennifer Post, Ralph F Jozefowicz
OBJECTIVE: To evaluate the feasibility and utility of instituting a formalized bedside skills evaluation (BSE) for 3rd-year medical students on the neurology clerkship. METHODS: A neurologic BSE was developed for 3rd(-)year neurology clerks at the University of Rochester for the 2012-2014 academic years. Faculty directly observed 189 students completing a full history and neurologic examination on real inpatients. Mock grades were calculated utilizing the BSE in the final grade, and number of students with a grade difference was determined when compared to true grade...
October 21, 2016: Neurology
Damien Lesenfants, Dina Habbal, Camille Chatelle, Caroline Schnakers, Steven Laureys, Quentin Noirhomme
OBJECTIVE: To propose a new methodology based on single-trial analysis for detecting residual response to command with EMG in patients with disorders of consciousness (DOC), overcoming the issue of trial dependency and decreasing the influence of a patient's fluctuation of vigilance or arousal over time on diagnostic accuracy. METHODS: Forty-five patients with DOC (18 with vegetative/unresponsive wakefulness syndrome [VS/UWS], 22 in a minimally conscious state [MCS], 3 who emerged from MCS [EMCS], and 2 with locked-in syndrome [LIS]) and 20 healthy controls were included in the study...
October 21, 2016: Neurology
Ricardo Ferrer, Rafael Zaragoza, Alejandro H Rodríguez, Emilio Maseda, Pedro Llinares, Santiago Grau, Francisco Álvarez-Lerma, Guillermo Quindós, Miguel Salavert, Rafael Huarte
BACKGROUND: Although the management of invasive fungal infection (IFI) has improved, a number of controversies persist regarding the approach to invasive fungal infection in non-neutropenic medical ward patients. AIMS: To identify the essential clinical knowledge to elaborate a set of recommendations with a high level of consensus necessary for the management of IFI in non-neutropenic medical ward patients. METHODS: A prospective, Spanish questionnaire, which measures consensus through the Delphi technique, was anonymously answered and e-mailed by 30 multidisciplinary national experts, all specialists (intensivists, anesthesiologists, microbiologists, pharmacologists and specialists in infectious diseases) in IFI and belonging to six scientific national societies...
October 18, 2016: Revista Iberoamericana de Micología
Isabell B Purdy, Mary Alice Melwak, Joan R Smith, Carole Kenner, Rebecca Chuffo-Siewert, Donna J Ryan, Sue Hall
BACKGROUND: The neonatal intensive care unit (NICU) can be a stressful environment for infants, their families, and the healthcare team. There is an immediate need for neonatal nurses to embrace and translate the new National Perinatal Association recommendations for psychosocial support of NICU parents into clinical practice to demonstrate best practices for infants, their families, and the whole team. PURPOSE: To summarize the current evidence-based practice recommendations and to provide suggestions for team members to develop strategies to adopt and implement them through quality improvement (QI) projects...
October 19, 2016: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
Cui Hongzhou, Guo Shuping, Wang Wenju, Li Li, Wei Lulu, Deng Linjun, Li Jingmin, Ren Xiaoli, Bai Li
In recent years, molecular biology has proven to be a great asset in our understanding of mechanisms in genodermatoses. However, bench to bedside translation research lags far behind. Advances in lab-on-a-chip technologies enabled programmable, reconfigurable, and scalable manipulation of a variety of laboratory procedures. Sample preparation, microfluidic reactions, and continuous monitoring systems can be integrated on a small chip. These advantages have attracted attention in various fields of clinical application including diagnosis of inherited skin diseases...
September 13, 2016: Journal of Dermatological Science
Joyce J Fitzpatrick, Mary Beth Modic, Jennifer Van Dyk, K Kelly Hancock
OBJECTIVE: The Leadership Education and Development (LEAD) Program was designed to transform care at the bedside by empowering clinical nurses as leaders. BACKGROUND: The heart of LEAD was enhancing communication skills of clinical nurses with clinical colleagues and, most importantly, patients and families. Key concepts of leadership/management were included: personal awareness, personal leadership skills/abilities, leading change, leading others individually and in teams, enhancing the patient/provider experience, and the leadership role in outcomes management...
October 12, 2016: Journal of Nursing Administration
Michael J Murray, Heidi DeBlock, Brian Erstad, Anthony Gray, Judi Jacobi, Che Jordan, William McGee, Claire McManus, Maureen Meade, Sean Nix, Andrew Patterson, M Karen Sands, Richard Pino, Ann Tescher, Richard Arbour, Bram Rochwerg, Catherine Friederich Murray, Sangeeta Mehta
OBJECTIVE: To update the 2002 version of "Clinical practice guidelines for sustained neuromuscular blockade in the adult critically ill patient." DESIGN: A Task Force comprising 17 members of the Society of Critical Medicine with particular expertise in the use of neuromuscular-blocking agents; a Grading of Recommendations Assessment, Development, and Evaluation expert; and a medical writer met via teleconference and three face-to-face meetings and communicated via e-mail to examine the evidence and develop these practice guidelines...
November 2016: Critical Care Medicine
Rocío Rojí, Antonio Noguera-Tejedor, Fernando Pikabea-Díaz, José Miguel Carrasco, Carlos Centeno
CONTEXT: A mandatory course in palliative care (PC) is organized for all final-year medical students at the University of Navarre. It consists of 24 lectures, 4 workshops, and 1 scheduled five hour clinical PC service experience at two different sites. In the 48 hours after the visit and related to the clinical experience, each student has to complete a 500-word reflective writing (RW) piece. OBJECTIVE: To investigate how a brief PC clinical experience helps equip the medical student...
October 18, 2016: Journal of Palliative Medicine
Chang Wei-Ting, Chen Zhih-Cherng, Cheng Juei-Tang
OBJECTIVE: Despite the threatening risks of diabetes-induced cardiac fibrosis, less is known to whether diabetes causes an altered cardiac phenotype independent of coronary atherosclerosis. Peroxisome proliferator-activated receptor δ (PPARδ) emerges as a versatile regulator of metabolic and inflammatory homeostasis. Potentially PPARδ may be a therapeutic target for diabetes induced cardiac fibrosis. In the present study, we investigated the effectiveness of Telmisartan, a unique angiotensin receptor blocker (ARB) that increased the expression of PPARδ, in the improvement of left ventricular remodeling in both diabetic human and rats...
September 2016: Journal of Hypertension
Injune Park, Youn Jung Kim, Shin Ahn, Chang Hwan Sohn, Dong Woo Seo, Won Young Kim
Electrocardiogram changes in subarachnoid hemorrhage (SAH) have been described as ST-T changes that mimic acute coronary syndrome and even acute ST-segment elevation myocardial infarction. Elevation of cardiac enzymes and abnormality of regional myocardial wall motion have been reported frequently for SAH. We report a case of an out-of-hospital cardiac arrest survivor with high suspicion of ST-segment elevation myocardial infarction based on the electrocardiogram and bedside echocardiography, who had normal coronary arteries on emergent coronary angiography...
December 2015: Clin Exp Emerg Med
Floriana Zennaro, Elena Neri, Federico Nappi, Daniele Grosso, Riccardo Triunfo, Francesco Cabras, Francesca Frexia, Stefania Norbedo, Pierpaolo Guastalla, Massino Gregori, Elisabetta Cattaruzzi, Daniela Sanabor, Egidio Barbi, Marzia Lazzerini
BACKGROUND: The use of point-of-care ultrasonography (POC US) in paediatrics is increasing. This study investigated the diagnostic accuracy of POC US in children accessing the emergency department (ED) when performed by paediatricians under the remote guidance of radiologists (TELE POC). METHODS: Children aged 0 to 18 years accessing the ED of a third level research hospital with eight possible clinical scenarios and without emergency/severity signs at the triage underwent three subsequent US tests: by a paediatrician guided remotely by a radiologist (TELE POC); by the same radiologist (UNBLIND RAD); by an independent blinded radiologist (BLIND RAD)...
2016: PloS One
Pilar Anton-Martin, Bruno Braga, Stephen Megison, Janna Journeycake, Jessica Moreland
Severe trauma may cause refractory life-threatening respiratory failure requiring extracorporeal membrane oxygenation (ECMO). Concurrent traumatic brain injury, however, complicates the use of ECMO because of the major risk of intracranial bleeding with systemic anticoagulation. Craniotomy and/or craniectomy for hematoma evacuation during ECMO are extremely high-risk procedures secondary to ongoing anticoagulation, and there are only a few such case reports in the literature.We present the case of a child with multiple thoracic injuries and life-threatening respiratory failure supported on ECMO...
October 4, 2016: Pediatric Emergency Care
Chen Zhan, Natalia Grundtvig, Bent Helmuth Klug
OBJECTIVES: Recent studies suggest that lung ultrasound is a good, radiation-free alternative to chest radiography in children with pneumonia. We investigated how bedside lung ultrasound performed by a pediatric resident compared with chest radiography in children with suspected pneumonia. METHODS: This was a prospective study comparing bedside lung ultrasound to chest radiography as the reference standard. Children aged 0 to 15 years with suspected pneumonia at a pediatric emergency department were included and underwent chest radiography and lung ultrasound...
October 4, 2016: Pediatric Emergency Care
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"