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https://www.readbyqxmd.com/read/29236277/clouds-of-different-colors-a-prospective-look-at-head-and-neck-surgical-resident-call-experience
#1
Jonathan Melzer
Graduate medical education programs typically set up call under the assumption that residents will have similar experiences. The terms black cloud and white cloud have frequently been used to describe residents with more difficult (black) or less difficult (white) call experiences. This study followed residents in the department of head and neck surgery during call to determine whether certain residents have a significantly different call experience than the norm. It is a prospective observational study conducted over 16 months in a tertiary care center with a resident training program in otolaryngology...
December 2017: Ear, Nose, & Throat Journal
https://www.readbyqxmd.com/read/29236202/sentinel-lymph-node-biopsy-and-management-of-regional-lymph-nodes-in-melanoma-american-society-of-clinical-oncology-and-society-of-surgical-oncology-clinical-practice-guideline-update
#2
Sandra L Wong, Mark B Faries, Erin B Kennedy, Sanjiv S Agarwala, Timothy J Akhurst, Charlotte Ariyan, Charles M Balch, Barry S Berman, Alistair Cochran, Keith A Delman, Mark Gorman, John M Kirkwood, Marc D Moncrieff, Jonathan S Zager, Gary H Lyman
PURPOSE: To update the American Society of Clinical Oncology (ASCO)-Society of Surgical Oncology (SSO) guideline for sentinel lymph node (SLN) biopsy in melanoma. METHODS: An ASCO-SSO panel was formed, and a systematic review of the literature was conducted regarding SLN biopsy and completion lymph node dissection (CLND) after a positive sentinel node in patients with melanoma. RESULTS: Nine new observational studies, two systematic reviews and an updated randomized controlled trial (RCT) of SLN biopsy, as well as two randomized controlled trials of CLND after positive SLN biopsy, were included...
December 13, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/29236099/inpatient-management-of-diabetic-foot-infections-a-review-of-the-guidelines-for-hospitalists
#3
Emilia G Thurber, Flora Kisuule, Casey Humbyrd, Jennifer Townsend
Diabetic foot infections (DFIs) are common and represent the leading cause for hospitalization among diabetic complications. Without proper management, DFIs may lead to amputation, which is associated with a decreased quality of life and increased mortality. However, there is currently significant variation in the management of DFIs, and many providers fail to perform critical prevention and assessment measures. In this review, we will provide an overview of the diagnosis, management, and discharge planning of hospitalized patients with DFIs to guide hospitalists in the optimal inpatient care of patients with this condition...
December 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29236094/hospital-perceptions-of-medicare-s-sepsis-quality-reporting-initiative
#4
Ian J Barbash, Kimberly J Rak, Courtney C Kuza, Jeremy M Kahn
BACKGROUND: In October 2015, the Centers for Medicare and Medicaid Services (CMS) implemented the Sepsis CMS Core Measure (SEP-1) program, requiring hospitals to report data on the quality of care for their patients with sepsis. OBJECTIVE: We sought to understand hospital perceptions of and responses to the SEP-1 program. DESIGN: A thematic content analysis of semistructured interviews with hospital quality officials. SETTING: A stratified random sample of short-stay, nonfederal, general acute care hospitals in the United States...
December 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29236093/trends-in-troponin-only-testing-for-ami-in-academic-teaching-hospitals-and-the-impact-of-choosing-wisely%C3%A2
#5
Micah T Prochaska, Samuel F Hohmann, Matthew Modes, Vineet M Arora
BACKGROUND: Identifying hospitals that are both early and consistent adopters of high-value care can help shed light on the culture and practices at those institutions that are necessary to promote high-value care nationwide. The use of troponin to diagnose acute myocardial infarction (AMI), and not to test for myoglobin or creatine kinase-MB (CK-MB), is a high-value recommendation of the Choosing Wisely® campaign. OBJECTIVE: To examine the variation in cardiac biomarker testing and the effect of the Choosing Wisely® troponin-only recommendation for the diagnosis of AMI...
December 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29235986/managing-diabetes-in-people-with-dementia-a-realist-review
#6
Frances Bunn, Claire Goodman, Peter Reece Jones, Bridget Russell, Daksha Trivedi, Alan Sinclair, Antony Bayer, Greta Rait, Jo Rycroft-Malone, Chris Burton
BACKGROUND: Dementia and diabetes mellitus are common long-term conditions that coexist in a large number of older people. People living with dementia and diabetes may be at increased risk of complications such as hypoglycaemic episodes because they are less able to manage their diabetes. OBJECTIVES: To identify the key features or mechanisms of programmes that aim to improve the management of diabetes in people with dementia and to identify areas needing further research...
December 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/29235944/experience-of-touch-in-health-care-a-meta-ethnography-across-the-health-care-professions
#7
Martina Ann Kelly, Lara Nixon, Caitlin McClurg, Albert Scherpbier, Nigel King, Tim Dornan
Touch mediates health professionals' interactions with patients. Different professionals have reported their practices but what is currently lacking is a well-theorized, interprofessional synthesis. We systematically searched eight databases, identified 41 studies in seven professions-nursing (27), medicine (4), physiotherapy (5), osteopathy (1), counseling (2), psychotherapy (1), dentistry (1)-and completed a meta-ethnographic line-of-argument synthesis. This found that touch is caring, exercises power, and demands safe space...
January 2018: Qualitative Health Research
https://www.readbyqxmd.com/read/29235940/slc9b1-methylation-predicts-fetal-intolerance-of-labor
#8
Anna K Knight, Karen N Conneely, Varun Kilaru, Dawayland Cobb, Jennifer L Payne, Samantha Meilman, Elizabeth J Corwin, Zachary A Kaminsky, Anne L Dunlop, Alicia K Smith
Fetal intolerance of labor is a common indication for delivery by Caesarean section. Diagnosis is based on the presence of category III fetal heart rate tracing, which is an abnormal heart tracing associated with increased likelihood of fetal hypoxia and metabolic acidemia. This study analyzed data from 177 unique women who, during their prenatal visits (7-15 weeks and/or 24-32 weeks) to Atlanta area prenatal care clinics, consented to provide blood samples for DNA methylation (HumanMethylation450 BeadChip) and gene expression (Human HT-12 v4 Expression BeadChip) analyses...
December 13, 2017: Epigenetics: Official Journal of the DNA Methylation Society
https://www.readbyqxmd.com/read/29235781/addressing-the-social-determinants-of-health-through-medicaid-managed-care
#9
David Machledt
Issue: With its emphasis on coordinated care and prevention, managed care should be tailor-made to tackle social determinants of health. But various challenges discourage Medicaid health plans and providers from assisting beneficiaries with nonmedical concerns such as housing insecurity or parenting skills that are integral to improving health outcomes and lowering costs. To better address these social factors, the Centers for Medicare and Medicaid Services (CMS) updated its Medicaid managed care rule in early 2016...
November 1, 2017: Issue Brief of the Commonwealth Fund
https://www.readbyqxmd.com/read/29235740/thalassemia-major-and-intermedia-in-patients-older-than-35-years-a-single-center-experience
#10
Liat Shargian-Alon, Oren Pasvolsky, Pia Raanani
BACKGROUND: During the past decades, beta thalassemia major (TM) and beta thalassemia intermedia (TI) have transformed from a universally fatal disease at a young age into a chronic disease. This advancement is attributed to improved chelation therapy as well as enhanced management strategies, with focused attention on disease and treatment-related complications. OBJECTIVES: To describe characteristics of adults with thalassemia as well as treatment modalities, disease and treatment-related complications, and socioeconomic information of the patients...
December 2017: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/29235386/how-is-palliative-care-understood-in-the-context-of-dementia-results-from-a-massive-open-online-course
#11
Fran McInerney, Kathleen Doherty, Aidan Bindoff, Andrew Robinson, James Vickers
BACKGROUND: A palliative approach to the care of people with dementia has been advocated, albeit from an emergent evidence base. The person-centred philosophy of palliative care resonates with the often lengthy trajectory and heavy symptom burden of this terminal condition. AIM: To explore participants' understanding of the concept of palliative care in the context of dementia. The participant population took an online course in dementia. DESIGN: The participant population took a massive open online course on 'Understanding Dementia' and posted answers to the question: 'palliative care means …' We extracted these postings and analysed them via the dual methods of topic modelling analysis and thematic analysis...
November 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/29235252/closure-of-the-cystic-duct-orifice-in-laparoscopic-subtotal-cholecystectomy-for-severe-cholecystitis
#12
Tatsuki Matsumura, Shunichiro Komatsu, Kenichi Komaya, Keiichi Ando, Takashi Arikawa, Seiji Ishiguro, Takuya Saito, Takaaki Osawa, Shintaro Kurahashi, Tairin Uchino, Kohei Yasui, Shoko Kato, Kenta Suzuki, Yoko Kato, Tsuyoshi Sano
INTRODUCTION: Laparoscopic subtotal cholecystectomy (LSC) has been recognized as an alternative to conversion to laparotomy for severe cholecystitis. However, it may be associated with an increased risk of recurrent stones in the gallbladder remnant. The objective of this study was to evaluate the safety and feasibility of the complete removal of the gallbladder cavity in LSC for severe cholecystitis using the cystic duct orifice suturing (CDOS) technique. METHODS: In a consecutive series of 412 laparoscopic cholecystectomies that were performed from January 2015 to June 2017, 12 patients who underwent LSC with CDOS were enrolled in this retrospective study...
December 13, 2017: Asian Journal of Endoscopic Surgery
https://www.readbyqxmd.com/read/29235235/review-article-best-practice-management-of-common-ankle-and-foot-injuries-in-the-emergency-department-part-2-of-the-musculoskeletal-injuries-rapid-review-series
#13
REVIEW
Kirsten Strudwick, Megan McPhee, Anthony Bell, Melinda Martin-Khan, Trevor Russell
Ankle and foot injuries are the most common musculoskeletal injuries presenting to Australian EDs and are associated with a large societal and economic impact. The quality of ED care provided to patients with ankle and foot fractures or soft tissue injuries is critical to ensure the best possible outcomes for the patient. This rapid review investigated best practice for the assessment and management of common ankle and foot injuries in the ED. Databases including PubMed, CINAHL, EMBASE, TRIP and the grey literature, including relevant organisational websites, were searched in 2017...
December 13, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29235234/-holding-on-to-life-an-ethnographic-study-of-living-well-at-home-in-old-age
#14
Kristin Bjornsdottir
In recent years, much attention has been paid to how older people living at home can remain independent and manage their illness themselves, while less attention has been given to those who have become frail and need assistance with challenges of everyday life. In this article, I drew on Latimer's formulation of care for frail older people as relational and world-making and on Foucault's work related to the care of the self in developing an understanding of how frail older persons manage to live well at home in the final years of their lives...
December 13, 2017: Nursing Inquiry
https://www.readbyqxmd.com/read/29234973/decompressive-craniectomy-in-traumatic-brain-injury-usage-and-clinical-outcome-in-a-single-centre
#15
Teodor Svedung Wettervik, Samuel Lenell, Lena Nyholm, Tim Howells, Anders Lewén, Per Enblad
BACKGROUND: Two randomised controlled trials (RCTs) of decompressive craniectomy (DC) in traumatic brain injury (TBI) have shown poor outcome, but there are considerations of how these protocols relate to real practice. The aims of this study were to evaluate usage and outcome of DC and thiopental in a single centre. METHOD: The study included all TBI patients treated at the neurointensive care unit, Akademiska sjukhuset, Uppsala, Sweden, between 2008 and 2014. Of 609 patients aged 16 years or older, 35 treated with DC and 23 treated with thiopental only were studied in particular...
December 12, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/29234971/elective-ambulatory-surgical-care-in-ireland-why-it-needs-to-be-better-coded-classified-and-managed
#16
Frank Keane, Laura Hammond, Gerry Kelliher, Ken Mealy
BACKGROUND: In the year to July 2017, surgical disciplines accounted for 73% of the total national inpatient and day case waiting list and, of these, day cases accounted for 72%. Their proper classification is therefore important so that patients can be managed and treated in the most suitable and efficient setting. AIMS: We set out to sub-classify the different elective surgical day cases treated in Irish public hospitals in order to assess their need to be managed as day cases and the consistency of practice between hospitals...
December 12, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/29234706/adsorption-of-diclofenac-onto-different-biochar-microparticles-dataset-characterization-and-dosage-of-biochar
#17
Linson Lonappan, Tarek Rouissi, Satinder Kaur Brar, Mausam Verma, Rao Y Surampalli
Due to its wide occurrence in water resources and toxicity, pharmaceuticals and personal care products are becoming an emerging concern throughout the world. Application of residual/waste materials for water remediation can be a good strategy in waste management as well as in waste valorization. Herein, this dataset provides information on biochar application for the removal of emerging contaminant, diclofenac from water matrices. The data presented here is an extension of the research article explaining the mechanisms of adsorption diclofenac on biochars (Lonappan et al...
February 2018: Data in Brief
https://www.readbyqxmd.com/read/29234639/hepatocellular-carcinoma-with-macrovascular-invasion-defining-the-optimal-treatment-strategy
#18
REVIEW
Charlotte E Costentin, Cristina R Ferrone, Ronald S Arellano, Suvranu Ganguli, Theodore S Hong, Andrew X Zhu
Background: Tumoral macrovascular invasion (MVI) of hepatic and/or portal vein branches is a common phenomenon in hepatocellular carcinoma (HCC) and is associated with poorer prognosis when compared to HCC without MVI. Summary: Current international guidelines for the management of HCC recommend sorafenib as the only treatment option in case of MVI. Despite guideline recommendations, several alternative options have been tested to manage HCC with MVI: surgery, transarterial chemoembolization, external or internal radiation, hepatic arterial infusion chemotherapy, percutaneous treatment, cryotherapy, or the combination of two or more of these strategies, with or without sorafenib...
November 2017: Liver Cancer
https://www.readbyqxmd.com/read/29234631/sorafenib-versus-hepatic-arterial-infusion-chemotherapy-as-initial-treatment-for-hepatocellular-carcinoma-with-advanced-portal-vein-tumor-thrombosis
#19
Michihisa Moriguchi, Takeshi Aramaki, Hideyuki Nishiofuku, Rui Sato, Koiku Asakura, Kanji Yamaguchi, Toshihiro Tanaka, Masahiro Endo, Yoshito Itoh
Objective: To investigate the validity of hepatic arterial infusion chemotherapy with low-dose 5-fluorouracil and cisplatin (LFP) versus sorafenib as first-line treatment for hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (Vp3, Vp4). Patients and Methods: We retrospectively reviewed the cases of Child-Pugh A advanced HCC with Vp3 or Vp4 treated with LFP or sorafenib between October 2002 and December 2013. Results: There were 32 patients in the LFP group and 14 patients in the sorafenib group...
November 2017: Liver Cancer
https://www.readbyqxmd.com/read/29234603/a-retrospective-study-of-clinico-epidemiological-profile-of-snakebite-related-deaths-at-a-tertiary-care-hospital-in-midnapore-west-bengal-india
#20
Rituparna Ghosh, Koushik Mana, Kripasindhu Gantait, Sumana Sarkhel
Objective: Snakebite is one of the neglected tropical diseases that World Health Organization (WHO) aimed to eradicate. The objective of the study is to investigate the mortality and morbidity due to snakebite at Midnapore Medical College & Hospital in Paschim Medinipur district, West Bengal, India. Methods & materials: This is a record-based, retrospective, descriptive epidemiological study conducted from January 2012 to December 2016 at Midnapore Medical College and Hospital(MMCH), Paschim Medinipur district, West Bengal...
2018: Toxicology Reports
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