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Anthony Nash, Thomas Sewell, Rhys A Farrer, Alireza Abdolrasouli, Jennifer M G Shelton, Matthew C Fisher, Johanna Rhodes
Summary: The increase of antifungal drug resistance is a major global human health concern and threatens agriculture and food security; in order to tackle these concerns, it is important to understand the mechanisms that cause antifungal resistance. The curated Mycology Antifungal Resistance Database (MARDy) is a web-service of antifungal drug resistance mechanisms, including amino acid substitutions, tandem repeat sequences and genome ploidy. MARDy is implemented on a Linux, Apache, MySQL and PHP web development platform and includes a local installation of BLASTn of the database of curated genes...
April 20, 2018: Bioinformatics
Jude Kornelsen, Brent Hobbs, Holly Buhler, Rebecca Kaus, Kari Grant, Scott C Lamont, Stefan Grzybowski
INTRODUCTION: The High Acuity Response Team (HART) was introduced in British Columbia (BC), Canada, to fill a gap in transport for rural patients that was previously being met by nurses and physicians leaving their communities to escort patients in need of critical care. The HART team consists of a critical care registered nurse (CCRN) and registered respiratory therapist (RRT) and attends acute care patients in rural sites by either stabilizing them in their community or transporting them...
June 2018: Rural and Remote Health
Ross Coomber, Leah Moyle, Vendula Belackova, Tom Decorte, Pekka Hakkarainen, Andrew Hathaway, Karen Joe Laidler, Simon Lenton, Sheigla Murphy, John Scott, Michaela Stefunkova, Katinka van de Ven, Marieke Vlaemynck, Bernd Werse
BACKGROUND: It is now commonly accepted that there exists a form of drug supply, that involves the non-commercial supply of drugs to friends and acquaintances for little or no profit, which is qualitatively different from profit motivated 'drug dealing proper'. 'Social supply', as it has become known, has a strong conceptual footprint in the United Kingdom, shaped by empirical research, policy discussion and its accommodation in legal frameworks. Though scholarship has emerged in a number of contexts outside the UK, the extent to which social supply has developed as an internationally recognised concept in criminal justice contexts is still unclear...
June 8, 2018: International Journal on Drug Policy
Sanders Chang, Keith Sigel, Nathan E Goldstein, Juan Wisnivesky, Kavita V Dharmarajan
CONTEXT: The American Society of Clinical Oncology recommends that all patients with metastatic disease receive dedicated palliative care (PC) services early in their illness, ideally via interdisciplinary care teams. OBJECTIVES: We investigated the time trends of specialty palliative care consultations from the date of metastatic cancer diagnosis among patients receiving palliative radiation therapy (PRT). A shorter time interval between metastatic diagnosis and first PC consultation suggests earlier involvement of palliative care in a patient's life with metastatic cancer...
June 6, 2018: Journal of Pain and Symptom Management
Connor Maly, Kenneth L Fan, Gary F Rogers, Benjamin Mitchell, June Amling, Kara Johnson, Laura Welch, Albert K Oh, Jerry W Chao
Intravenous therapy is a common practice among many specialties. Intravenous therapy extravasation is a potential complication to such therapy. Hospitals without a dedicated wound care team trained in these interventions will often default to plastic surgical consultation, making an understanding of available interventions essential to the initial evaluation and management of these injuries. The goal of this article was to provide plastic surgeons and health care providers with a general overview of the acute management of intravenous infiltration and extravasation injuries...
April 2018: Plastic and Reconstructive Surgery. Global Open
Alessandro Salustri, Salah El Badri, Abdul Haleem Shawky, Hakam Alzaeem
The incidence of degenerative heart valve disease is rising in developing countries and diagnosis, assessment and management are becoming increasingly complex. The availability of new interventional procedures has further expanded the therapeutic armamentarium, but at the same time, it has increased the proportion of high-risk patients, in whom risk-benefit analysis and the choice of the most appropriate therapy are particularly difficult. Accordingly, international societies have recommended dedicated heart valve clinics (HVCs) to meet these needs...
January 2018: Heart Views: the Official Journal of the Gulf Heart Association
Maria Teresa Montagna, Osvalda De Giglio, Christian Napoli, Giusy Diella, Serafina Rutigliano, Antonella Agodi, Francesco Auxilia, Tatjana Baldovin, Francesco Bisetto, Luca Arnoldo, Silvio Brusaferro, Marina Busetti, Gioia Calagreti, Beatrice Casini, Maria Luisa Cristina, Rossano Di Luzio, Maurizio Fiorio, Maurizio Formoso, Giorgio Liguori, Enrica Martini, Andrea Molino, Placido Mondello, Ida Mura, Roberto Novati, Giovanni Battista Orsi, Andrea Patroni, Anna Poli, Gaetano Privitera, Giancarlo Ripabelli, Andrea Rocchetti, Francesco Rose, Mario Sarti, Sandra Savini, Antonio Silvestri, Luisa Sodano, Anna Maria Spagnolo, Stefano Tardivo, Valeria Teti, Maria Valeria Torregrossa, Emanuele Torri, Licia Veronesi, Raffaele Zarrilli, Claudia Pacifico, Antonio Goglio, Matteo Moro, Cesira Pasquarella
Risk assessment, environmental monitoring, and the disinfection of water systems are the key elements in preventing legionellosis risk. The Italian Study Group of Hospital Hygiene of the Italian Society of Hygiene, Preventive Medicine, and Public Health and the Italian Multidisciplinary Society for the Prevention of Health Care-Associated Infections carried out a national cross-sectional survey to investigate the measures taken to prevent and control legionellosis in Italian hospitals. A multiple-choice questionnaire was developed, comprising 71 questions regarding hospital location, general characteristics, clinical and environmental surveillance, and control and preventive measures for legionellosis in 2015...
June 1, 2018: Environmental Research
Raúl A Borracci, Julio Baldi, Daniel Yñon, Miguel Rubio
OBJECTIVE: To present the current in-hospital outcomes and mid-term survival of acute type A aortic dissection (AAAD) surgery performed by a group of dedicated high-volume thoracic aortic surgeons in a University Hospital in Argentina. METHODS: A retrospective analysis of prospectively collected data over a 6-year period (2011-2016) was performed on a consecutive series of 53 adult patients who underwent emergency cardiac surgery for AAAD in the Buenos Aires University Hospital in Argentina...
May 29, 2018: Archivos de Cardiología de México
Maya Beganovic, Kerry L LaPlante
Up to 50% of hospital-administered and 70% of nursing home-administered antimicrobials are inappropriately prescribed. There is a great need to focus local, national and global efforts on appropriate antibiotic use. Formal programs dedicated to appropriate antibiotic use have been established in most US hospitals. These antimicrobial stewardship programs (ASP) exist to ensure that the correct drug, dose and duration of an antimicrobial is given, and only when there is a true bacterial infection (as opposed to bacterial colonization or a viral infection)...
June 1, 2018: Rhode Island Medical Journal
Sally Eames, Sally Bennett, Mary Whitehead, Jennifer Fleming, Shanling Olivia Low, Sharon Mickan, Elizabeth Caldwell
BACKGROUND/AIM: Knowledge translation (KT) aims to reduce research-practice gaps. Few studies have investigated methods to build clinicians' capacity for KT. To: (i) evaluate the impact of a multifaceted KT capacity-building intervention; (ii) understand barriers and enablers to clinicians' use of KT; and (iii) identify useful strategies. METHODS: A pre-post study to develop KT capacity amongst occupational therapy clinicians (n = 46) in a large metropolitan hospital...
May 31, 2018: Australian Occupational Therapy Journal
Jonathan Carter, Selvan Pather, Marcelo Nascimento
In Australia, ovarian cancer remains the most common cause of death among all the gynaecological malignancies, largely due to the fact that patients present at an advanced stage. Cytoreductive surgery has for a number of decades been the cornerstone of initial treatment for patients with advanced disease, where a smaller volume of residual disease (optimal cytoreduction) results in an improved outcome. Evidence indicates that optimal cytoreduction is best achieved by a certified gynaecological oncologist, and that subsequent management by a dedicated multidisciplinary team (MDT) results in patients more likely to receive 'evidenced based guideline care' and be offered participation in clinical trials...
May 31, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
Rose Bruce, Cheryl Forry
In recent years, early progressive mobilization programs have become mainstays in intensive care units (ICUs). Significant evidence exists that early mobility programs decrease length of stay, reduce time on the ventilator, and decrease the development of delirium in ICU patients. Yet, current literature still describes many barriers to performing early mobility, such as the time required, staffing pressures, and increased workload. Our critical care leaders found that defining and implementing a dedicated mobility champion team member was successful in improving the effectiveness of our early mobility program...
July 2018: Dimensions of Critical Care Nursing: DCCN
Courtney R Lyles, Reena Gupta, Lina Tieu, Alicia Fernandez
Background: After-visit summary (AVS) documents presenting key information from each medical encounter have become standard in the USA due to federal health care reform. Little is known about how they are used or whether they improve patient care. Methods: First, we completed a literature review and described the totality of the literature on AVS by article type and major outcome measures. Next, we used reputational sampling from large-scale US studies on primary care to identify and interview nine stakeholders on their perceptions of AVS across high-performing primary care practices...
May 28, 2018: Family Practice
Hayeon Kim, Christopher J Houser, Ronny Kalash, Carly A Maceil, Brett Palestra, Deborah Malush, Sushil Beriwal
PURPOSE: We report the clinical workflow and time required for MRI-based image-guided brachytherapy (MR-IGBT) of cervical cancer patients in a high-volume brachytherapy center with 10 years of experiences to provide a practical guideline for implementing MR-IGBT into clinical use. METHODS AND MATERIALS: We recorded the time and workflow of each procedure step within the 40 consecutive ring and tandem applicator fractions of MR-IGBT by our multidisciplinary team...
May 26, 2018: Brachytherapy
Y S Wong, K K Pang, Y H Tam
INTRODUCTION: Children in Hong Kong are generally hospitalised for 1 to 2 weeks after hypospadias repairs. In July 2013, we introduced a new service model that featured an enhanced recovery pathway and a dedicated surgical team responsible for all perioperative services. In this study, we investigated the outcomes of hypospadias repair after the introduction of the new service model. METHODS: We conducted a retrospective study on consecutive children who underwent primary hypospadias repair from January 2006 to August 2016, comparing patients under the old service with those under the new service...
May 21, 2018: Hong Kong Medical Journal, Xianggang Yi Xue za Zhi
Srinivas R Mummadi, Peter Y Hahn
Background and Objectives: Clinical pathways are evidence based multidisciplinary team approaches to optimize patient care. Pleural diseases are common and accounted for 3.4 billion US $ in 2014 US inpatient aggregate charges (HCUPnet data). An institutional clinical pathway ("pleural pathway") was implemented in conjunction with a dedicated pleural service. Design, implementation, and outcomes of the pleural pathway (from August 1, 2014, to July 31, 2015) in comparison to a previous era (from August 1, 2013, to July 31, 2014) are described...
2018: Pulmonary Medicine
Fei Wang, Beth Prier, Karri A Bauer, John Mellett
PURPOSE: The development and implementation of a clinical decision support system (CDSS) for pharmacists to use for identification of and intervention on patients with Staphylococcus aureus bacteremia (SAB) are described. SUMMARY: A project team consisting of 3 informatics pharmacists and 2 infectious diseases (ID) pharmacists was formed to develop the CDSS. The primary CDSS component was a scoring system that generates a score in real time for a patient with a positive blood culture for S...
June 1, 2018: American Journal of Health-system Pharmacy: AJHP
Asif Dhar, Beth Meagher, Andrew Ryscavage
Inspired by the Cancer Moonshot, a dedicated team of professionals worked with leaders across the cancer ecosystem to look for an opportunity to radically reduce cancer mortality globally by focusing on early cancer detection. After an initial survey of cancer innovation, progress, and pitfalls, the team believed that if new rapid, affordable, and accurate early detection solutions were appropriately brought to market, it would be possible to intervene earlier when cancer is most treatable.An extensive process began, informed by dozens of experts in the cancer ecosystem...
May 2018: Cancer Journal
Andrea N Leep Hunderfund, Stephanie R Starr, Liselotte N Dyrbye, Jed D Gonzalo, Paul George, Bonnie M Miller, Helen K Morgan, Ari Hoffman, Elizabeth G Baxley, Bradley L Allen, Tonya L Fancher, Jay Mandrekar, Susan E Skochelak, Darcy A Reed
PURPOSE: To describe attitudes of first- and second-year U.S. medical students toward value-added medical education, assess their self-reported desire to participate in various value-added activities, and identify potentially modifiable factors influencing their engagement. METHOD: The authors conducted a cross-sectional survey of first- and second-year students at nine U.S. medical schools in 2017. Survey items measured students' attitudes toward value-added medical education (n = 7), desire to participate in value-added activities (n = 20), and factors influencing potential engagement (n = 18)...
May 22, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
Ehtisham Mahmud, Michael M Madani, Nick H Kim, David Poch, Lawrence Ang, Omid Behnamfar, Mitul P Patel, William R Auger
Chronic thromboembolic pulmonary hypertension (CTEPH), a rare consequence of an acute pulmonary embolism, is a disease that is underdiagnosed, and surgical pulmonary thromboendarterectomy (PTE) remains the preferred therapy. However, determination of operability is multifactorial and can be challenging. There is growing excitement for the percutaneous treatment of inoperable CTEPH with data from multiple centers around the world showing the clinical feasibility of balloon pulmonary angioplasty. Riociguat remains the only approved medical therapy for CTEPH patients deemed inoperable or with persistent pulmonary hypertension after PTE...
May 29, 2018: Journal of the American College of Cardiology
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