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https://www.readbyqxmd.com/read/28437795/effect-of-using-the-heart-score-in-patients-with-chest-pain-in-the-emergency-department-a-stepped-wedge-cluster-randomized-trial
#1
Judith M Poldervaart, Johannes B Reitsma, Barbra E Backus, Hendrik Koffijberg, Rolf F Veldkamp, Monique E Ten Haaf, Yolande Appelman, Herman F J Mannaerts, Jan-Melle van Dantzig, Madelon van den Heuvel, Mohamed El Farissi, Bernard J W M Rensing, Nicolette M S K J Ernst, Ineke M C Dekker, Frank R den Hartog, Thomas Oosterhof, Ghizelda R Lagerweij, Eugene M Buijs, Maarten W J van Hessen, Marcel A J Landman, Roland R J van Kimmenade, Luc Cozijnsen, Jeroen J J Bucx, Clara E E van Ofwegen-Hanekamp, Maarten-Jan Cramer, A Jacob Six, Pieter A Doevendans, Arno W Hoes
Background: The HEART (History, Electrocardiogram, Age, Risk factors, and initial Troponin) score is an easy-to-apply instrument to stratify patients with chest pain according to their short-term risk for major adverse cardiac events (MACEs), but its effect on daily practice is unknown. Objective: To measure the effect of use of the HEART score on patient outcomes and use of health care resources. Design: Stepped-wedge, cluster randomized trial...
April 25, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28435507/blog-and-podcast-watch-orthopedic-emergencies
#2
Andrew Grock, Salim Rezaie, Anand Swaminathan, Alice Min, Kaushal H Shah, Michelle Lin
INTRODUCTION: The WestJEM Blog and Podcast Watch presents high quality open-access educational blogs and podcasts in emergency medicine (EM) based on the ongoing ALiEM Approved Instructional Resources (AIR) and AIR-Professional series. Both series critically appraise resources using an objective scoring rubric. This installment of the Blog and Podcast Watch highlights the topic of orthopedic emergencies from the AIR series. METHODS: The AIR series is a continuously building curriculum that follows the Council of Emergency Medicine Residency Directors (CORD) annual testing schedule...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28434269/electronic-adherence-monitoring-device-performance-and-patient-acceptability-a-randomized-control-trial
#3
Amy Hai Yan Chan, Alistair William Stewart, Jeff Harrison, Peter Nigel Black, Edwin Arthur Mitchell, Juliet Michelle Foster
BACKGROUND: To investigate the performance and patient acceptability of an inhaler electronic monitoring device in a real-world childhood asthma population. METHODS: Children 6 to 15 years presenting with asthma to the hospital emergency department and prescribed inhaled corticosteroids were included. Participants were randomized to receive a device with reminder features enabled or disabled for use with their preventer. Device quality control tests were conducted...
April 24, 2017: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/28433673/montreal-accord-on-patient-reported-outcomes-use-series-paper-2-terminology-proposed-to-measure-what-matters-in-health
#4
Nancy E Mayo, Sabrina Figueiredo, Sara Ahmed, Susan Bartlett
BACKGROUND: We outline different health outcomes and describe how multiple perspectives can be harnessed to optimize accuracy of key data collected about patients with chronic conditions. The terms health status, health-related quality of life, and quality of life are often used interchangeably without recognizing that they have different meanings, as are the terms used to refer to the different components of function. While the advantages and limitations of existing frameworks and perspectives are largely understood, greater precision is needed when using health outcome terminology and identifying optimal sources of information...
April 19, 2017: Journal of Clinical Epidemiology
https://www.readbyqxmd.com/read/28433498/long-term-effectiveness-of-aripiprazole-once-monthly-for-schizophrenia-is-maintained-in-the-qualify-extension-study
#5
Dieter Naber, Ross A Baker, Anna Eramo, Carlos Forray, Karina Hansen, Christophe Sapin, Timothy Peters-Strickland, Anna-Greta Nylander, Peter Hertel, Simon Nitschky Schmidt, Jean-Yves Loze, Steven G Potkin
OBJECTIVE: To evaluate long-term safety and effectiveness of continued treatment with aripiprazole once-monthly 400mg (AOM 400) in patients with schizophrenia. METHODS: Patients who completed the QUALIFY study (NCT01795547) in the AOM 400 arm were eligible for 6 additional once-monthly injections of AOM 400 during an open-label, 24-week extension (NCT01959035). Safety data were collected at each visit. Effectiveness measures included change from baseline in health-related qualify of life and functioning on the Heinrichs-Carpenter Quality of Life scale (QLS) and Clinical Global Impression - Severity (CGI-S) scale...
April 19, 2017: Schizophrenia Research
https://www.readbyqxmd.com/read/28433454/a-randomized-comparison-of-three-chest-compression-techniques-and-associated-hemodynamic-effect-during-infant-cpr-a-randomized-manikin-study
#6
Jacek Smereka, Lukasz Szarpak, Antonio Rodríguez-Núñez, Jerzy R Ladny, Steve Leung, Kurt Ruetzler
INTRODUCTION: Pediatric cardiac arrest is an uncommon but critical life-threatening event requiring effective cardiopulmonary resuscitation. High-quality cardio-pulmonary resuscitation (CPR) is essential, but is poorly performed, even by highly skilled healthcare providers. The recently described two-thumb chest compression technique (nTTT) consists of the two thumbs directed at the angle of 90° to the chest while having the fingers fist-clenched. This technique might facilitate adequate chest-compression depth, chest-compression rate and rate of full chest-pressure relief...
April 14, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28429977/are-some-areas-more-equal-than-others-socioeconomic-inequality-in-potentially-avoidable-emergency-hospital-admissions-within-english-local-authority-areas
#7
Jessica Sheringham, Miqdad Asaria, Helen Barratt, Rosalind Raine, Richard Cookson
Objectives Reducing health inequalities is an explicit goal of England's health system. Our aim was to compare the performance of English local administrative areas in reducing socioeconomic inequality in emergency hospital admissions for ambulatory care sensitive chronic conditions. Methods We used local authority area as a stable proxy for health and long-term care administrative geography between 2004/5 and 2011/12. We linked inpatient hospital activity, deprivation, primary care, and population data to small area neighbourhoods (typical population 1500) within administrative areas (typical population 250,000)...
April 2017: Journal of Health Services Research & Policy
https://www.readbyqxmd.com/read/28427782/prospective-study-of-a-non-restrictive-decision-rule-for-acute-aortic-syndrome
#8
Judah Goldschmiedt, Jeffrey M Levsky, Eran Y Bellin, Esther Mizrachi, David Esses, Linda B Haramati
OBJECTIVES: To determine the impact of a non-restrictive clinical decision rule on CT utilization for Emergency Department patients suspected of having an acute aortic syndrome (AAS). METHODS: We prospectively assessed the performance of a previously described, collaboratively designed, non-restrictive clinical decision rule for AAS. Emergency Department patients with suspected AAS were stratified into low and high-risk groups based on decision rule results, from July 2013-August 2014...
April 6, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28427766/evaluation-of-a-model-of-integrated-care-for-patients-with-chronic-medical-and-psychiatric-illness
#9
Aghaegbulam Uga, Shreedhar Kulkarni, Vineka Heeramun, Kathy Bottum
BACKGROUND: Chronic illnesses are prevalent in general medical and psychiatric practices, causing significant disease burden to care givers and providers. Systems of care that treat individuals with mental illness are often separate from general medical systems of care. OBJECTIVE: This study sought to compare the quality of life, satisfaction with care, and utilization of care in patients with comorbid chronic medical and mental illnesses. METHODS: A total of 64 participants from an integrated medicine and psychiatry clinic (med/psych), were compared with 52 patients from separate internal medicine and psychiatry clinics (within the same institution) for quality of life, satisfaction with care, and utilization of care...
February 20, 2017: Psychosomatics
https://www.readbyqxmd.com/read/28426563/routine-inclusion-of-long-term-functional-and-patient-reported-outcomes-pros-into-trauma-registries-the-forte-project
#10
Arturo J Rios-Diaz, Juan P Herrera-Escobar, Elizabeth J Lilley, Jessica R Appelson, Belinda Gabbe, Karen Brasel, Terri deRoon-Cassini, Eric B Schneider, George Kasotakis, Haytham Kaafarani, George Velmahos, Ali Salim, Adil H Haider
BACKGROUND: The National Academies of Sciences, Engineering, and Medicine (formerly the Institute of Medicine) recently recommended inclusion of post-discharge health-related quality of life (HRQoL) and patient-reported outcomes (PROs) metrics to benchmark the quality of trauma care. Currently, these measures are not routinely collected at most trauma centers. We sought to determine the feasibility and value of adding such long-term outcome measures to trauma registries. METHODS: As part of the Functional Outcomes and Recovery after Trauma Emergencies (FORTE) project we included patients with an ISS ≥9, admitted to the Brigham and Women's Hospital in Boston, MA who were identified retrospectively using the institutional trauma registry and contacted 6 or 12-months post-injury to participate in a telephone survey evaluating: HRQoL (Short Form-12 [SF-12]), PROs (Trauma Quality of Life [T-QoL]), post-traumatic stress disorder (PTSD), return to work, residential status, and healthcare utilization...
April 20, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28426138/incremental-burden-of-cardiovascular-comorbidity-and-psoriatic-arthritis-among-adults-with-moderate-to-severe-psoriasis-in-five-european-countries
#11
M Augustin, J Vietri, H Tian, I Gilloteau
BACKGROUND: Moderate-to-severe psoriasis is associated with reduced health-related quality of life (HRQoL). Individuals with psoriasis are at increased risk for other medical conditions, but little information quantifies the incremental burden of psoriasis-associated comorbidity among European adults, and data have generally been limited to clinical samples. OBJECTIVE: To quantify the incremental burden of cardiovascular comorbidity and psoriatic arthritis among adults with moderate-to-severe psoriasis in the general population of France, Germany, Italy, Spain, and the United Kingdom (EU5)...
April 20, 2017: Journal of the European Academy of Dermatology and Venereology: JEADV
https://www.readbyqxmd.com/read/28424996/-quality-assurance-of-pain-care-in-austria-classification-of-management-facilities
#12
REVIEW
Wolfgang Jaksch, Rudolf Likar, Erika Folkes, Klaus Machold, Friedrich Herbst, Katharina Pils, Peter Stippl, Sandra Lettner, Mildred Alfons, Richard Crevenna, Christian Wiederer, Janina Dieber, Reinhold Glehr
In Austria there is no nationwide coverage of pain management, which meets even approximately international criteria. At present there are about 30 interdisciplinary pain management offices and clinics providing care according to a concept of the Austrian Pain Society (ÖSG), about 10 other outpatient pain clinics are located in district and country hospitals. A few years ago, there still were about 50 pain clinics. Yet closure of outpatient clinics and cost-cutting measures in the health sector jeopardize adequate pain relief for patients with chronic pain conditions...
April 19, 2017: Wiener Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28424704/draco-stem-an-automatic-tool-to-generate-high-quality-3d-meshes-of-shoot-apical-meristem-tissue-at-cell-resolution
#13
Guillaume Cerutti, Olivier Ali, Christophe Godin
Context: The shoot apical meristem (SAM), origin of all aerial organs of the plant, is a restricted niche of stem cells whose growth is regulated by a complex network of genetic, hormonal and mechanical interactions. Studying the development of this area at cell level using 3D microscopy time-lapse imaging is a newly emerging key to understand the processes controlling plant morphogenesis. Computational models have been proposed to simulate those mechanisms, however their validation on real-life data is an essential step that requires an adequate representation of the growing tissue to be carried out...
2017: Frontiers in Plant Science
https://www.readbyqxmd.com/read/28422415/impact-of-hospitalization-in-an-acute-geriatric-unit-on-polypharmacy-and-potentially-inappropriate-prescriptions-a-retrospective-study
#14
Marta Gutiérrez-Valencia, Mikel Izquierdo, Vincenzo Malafarina, Javier Alonso-Renedo, Belén González-Glaría, Beatriz Larrayoz-Sola, María Pilar Monforte-Gasque, Pello Latasa-Zamalloa, Nicolás Martínez-Velilla
AIM: Polypharmacy is a highly prevalent geriatric syndrome, and hospitalizations can worsen it. The aim of the present study was to analyze the influence of hospitalization on polypharmacy and indicators of quality of prescribing, and their possible association with health outcomes. METHODS: A retrospective study of 200 patients discharged from an acute geriatric unit was carried out. Indicators of quality of prescription were registered at admission and discharge: polypharmacy defined as ≥5 medications, hyperpolypharmacy (≥10), potentially inappropriate prescribing by Beers and Screening Tool of Older Persons' potentially inappropriate Prescriptions (STOPP) criteria, potentially prescribing omissions by Screening Tool to Alert doctors to the Right Treatment (START) criteria, drug interactions and anticholinergic burden measured with the Anticholinergic Risk Scale...
April 19, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28420367/rationale-and-methods-of-the-ifightdepression-study-a-double-blind-randomized-controlled-trial-evaluating-the-efficacy-of-an-internet-based-self-management-tool-for-moderate-to-mild-depression
#15
Azucena Justicia, Matilde Elices, Ana Isabel Cebria, Diego J Palao, Jesús Gorosabel, Dolors Puigdemont, Javier de Diego-Adeliño, Andrea Gabilondo, Alvaro Iruin, Ulrich Hegerl, Víctor Pérez
BACKGROUND: During the last decade online interventions have emerged as a promising approach for patients with mild/moderate depressive symptoms, reaching at large populations and representing cost-effective alternatives. The main objective of this double-blind, randomized controlled trial is to examine the efficacy of an internet-based self-management tool (iFightDepression) for mild to moderate depression as an add-on to treatment as usual (TAU) versus internet-based psychoeducation plus TAU...
April 19, 2017: BMC Psychiatry
https://www.readbyqxmd.com/read/28417336/treatment-of-depression-in-adults-with-fabry-disease
#16
Nadia Ali, Scott Gillespie, Dawn Laney
Fabry disease (FD) is a genetic X-linked, multisystemic, progressive lysosomal storage disorder (LSD). Depression has emerged as a disease complication, with prevalence estimates ranging from 15 to 62%. This is a pilot study examining the effects of psychological counseling for depression in FD on depression, adaptive functioning (AF), quality of life (QOL), and subjective pain experience. Telecounseling was also piloted, as it has beneficial effects in other chronic diseases which make in-person counseling problematic...
April 18, 2017: JIMD Reports
https://www.readbyqxmd.com/read/28414509/sleep-and-cognitive-functioning-in-childhood-ethnicity-socioeconomic-status-and-sex-as-moderators
#17
Lauren E Philbrook, J Benjamin Hinnant, Lori Elmore-Staton, Joseph A Buckhalt, Mona El-Sheikh
We examined children's sleep at age 9 as a predictor of developmental trajectories of cognitive performance from ages 9 to 11 years. The effects of sleep on cognition are not uniform and thus we tested race/ethnicity, socioeconomic status (SES), and sex as moderators of these associations. At the first assessment, 282 children aged 9.44 years (52% boys, 65% European American [EA], 35% African American [AA]) participated. Two more waves of data collection spaced 1 year apart followed. The majority of children (63%) were living at or below the poverty line...
April 17, 2017: Developmental Psychology
https://www.readbyqxmd.com/read/28414238/template-approach-to-crystalline-gan-nanosheets
#18
Baodan Liu, Wenjin Yang, Jing Li, Xinglai Zhang, Pingjuan Niu, Xin Jiang
Crystalline GaN nanosheets hold great challenge in growth and promising application in optoelectronic nanodevices. In this work, we reported an accessible template approach toward the rational synthesis of GaN nanosheets through the nitridation of metastable γ-Ga2O3 nanosheets synthesized from a hydrothermal reaction. The cubic γ-Ga2O3 nanosheets with smooth surface and decent crystallinity can be directly converted into hexagonal GaN nanosheets with similar morphology framework and comparable crystal quality in NH3 at 850 °C...
April 20, 2017: Nano Letters
https://www.readbyqxmd.com/read/28413941/psychobiological-protective-factors-modifying-the-association-between-age-and-sexual-health-in-men-findings-from-the-men-s-health-40-study
#19
Andreas Walther, Fiona Mahler, Rudolf Debelak, Ulrike Ehlert
Sexual health severely decreases with age. For males older than 40 years, erectile dysfunction (ED) is the most common sexual disorder. Although physical and psychological risk factors for ED have been identified, protective factors are yet to be determined. To date, no study has examined endocrine and psychosocial factors in parallel with regard to their modifying effect on the age-related increase in ED. Two hundred and seventy-one self-reporting healthy men aged between 40 and 75 years provided both psychometric data on sexual function and a set of potential psychosocial protective factors, and saliva samples for the analysis of steroid hormones and proinflammatory cytokines...
May 2017: American Journal of Men's Health
https://www.readbyqxmd.com/read/28412275/achieving-the-bptruth-emergency-department-hypertension-screening-and-the-centers-for-medicare-medicaid-services-quality-measure
#20
Elizabeth M Goldberg, Taneisha Wilson, Cory Saucier, Aaron M Brody, Phillip D Levy, Charles B Eaton, Roland C Merchant
In 2012, the Centers for Medicare & Medicaid Services (CMS) instituted a Physician Quality Reporting System measure for screening and referring patients with elevated blood pressure (BP). The aims of this study were to (1) assess the reliability of ED triage BP as a metric to establish when the CMS threshold (≥120/80 mm Hg), and other clinically relevant BP thresholds (≥140/90 and ≥160/100 mm Hg) have been met, using BP measured with a highly accurate device (BpTRU) in the emergency department as the gold standard; and (2) determine whether correct identification varies by gender, race, or triage acuity...
March 30, 2017: Journal of the American Society of Hypertension: JASH
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