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https://www.readbyqxmd.com/read/29161394/managing-anaesthetic-provision-for-global-disasters
#1
R M Craven
The numbers of people affected by large-scale disasters has increased in recent decades. Disasters produce a huge burden of surgical morbidity at a time when the affected country is least able to respond. For this reason an international disaster response is often required. For many years this disaster response was not coordinated. The response consisted of what was available not what was needed and standards of care varied widely producing a healthcare lottery for the affected population. In recent years the World Health organisation has initiated the Emergency Medical Team programme to coordinate the response to disasters and set minimum standards for responding teams...
December 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29159766/incidence-of-immune-related-adverse-events-and-its-association-with-treatment-outcomes-the-md-anderson-cancer-center-experience
#2
Takeo Fujii, Rivka R Colen, Mehmet Asim Bilen, Kenneth R Hess, Joud Hajjar, Maria E Suarez-Almazor, Anas Alshawa, David S Hong, Apostolia Tsimberidou, Filip Janku, Jing Gong, Bettzy Stephen, Vivek Subbiah, Sarina A Piha-Paul, Siqing Fu, Padmanee Sharma, Tito Mendoza, Anisha Patel, Selvi Thirumurthi, Ajay Sheshadri, Funda Meric-Bernstam, Aung Naing
Background Immunotherapy is emerging as the cornerstone for treatment of patients with advanced cancer, but significant toxicity (immune-related adverse events [irAEs]) associated with unbridled T cell activity remains a concern. Patients and methods A retrospective review of the electronic medical records of 290 patients with advanced cancer treated on an immunotherapy-based clinical trial in the Department of Investigational Cancer Therapeutics at The University of Texas MD Anderson Cancer Center between February 2010 and September 2015 was performed...
November 21, 2017: Investigational New Drugs
https://www.readbyqxmd.com/read/29159756/patient-provider-communication-and-health-outcomes-among-individuals-with-hepato-pancreato-biliary-disease-in-the-usa
#3
Qinyu Chen, Eliza W Beal, Eric B Schneider, Victor Okunrintemi, Xu-Feng Zhang, Timothy M Pawlik
BACKGROUND: Patient-provider communication (PPC) is utilized as a value-based metric in pay-for-performance programs. We sought to evaluate the association of PPC with patient-reported health outcomes, as well as healthcare resource utilization among a nationally representative cohort of patients with hepato-pancreato-biliary (HPB) diagnoses. METHODS: Patients with HPB diseases were identified from the 2008-2014 Medical Expenditure Panel Survey cohort. A weighted PPC composite score was categorized using the responses from the CAHPS (Consumer Assessment of Healthcare Providers and Systems) survey as optimal, average, or poor...
November 20, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29157945/food-allergy-a-review-and-update-on-epidemiology-pathogenesis-diagnosis-prevention-and-management
#4
Scott H Sicherer, Hugh A Sampson
This review provides general information to serve as a primer for those embarking on understanding food allergy and also details advances and updates in epidemiology, pathogenesis, diagnosis and treatment that have occurred over the four years since our last comprehensive review. Although firm prevalence data are lacking, there is a strong impression that food allergy has increased, and rates as high as ∼10% have been documented. Genetic, epigenetic and environmental risk factors are being increasingly elucidated, opening the potential for improved prevention and treatment strategies targeted to those at risk...
November 17, 2017: Journal of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/29157501/evaluation-and-management-of-autoimmune-encephalitis-a-clinical-overview-for-the-practicing-child-psychiatrist
#5
REVIEW
GenaLynne C Mooneyham, William Gallentine, Heather Van Mater
Medical conditions that present with psychiatric symptoms are becoming increasingly well-recognized in response to the emergence of the field of neuroimmunology. As the availability of testing for novel antineuronal antibodies has increased, so too has the clinical awareness of this diagnostic spectrum. Psychiatrists may have little exposure to this area of expertise, yet may be called on to assist in the diagnosis and treatment of patients with complex neuropsychiatric syndromes secondary to autoimmune encephalitis...
January 2018: Child and Adolescent Psychiatric Clinics of North America
https://www.readbyqxmd.com/read/29157447/the-usefulness-and-actual-use-of-wearable-devices-among-the-elderly-population
#6
Shwetambara Kekade, Chung-Ho Hseieh, Md Mohaimenul Islam, Suleman Atique, Abdulwahed Mohammed Khalfan, Yu-Chuan Li, Shabbir Syed Abdul
BACKGROUND AND OBJECTIVE: Elderly populations are more prone to diseases and need continuous monitoring of parameters to ensure good health. Wearable devices (WDs) can be helpful in the early detection and management of medical conditions. However, less is known about the use of currently available WDs among elderly populations. The objectives of this study were to determine the usefulness and actual use of wearable devices among the elderly population. METHODS: Our methodology was based on a systematic review and a survey questionnaire...
January 2018: Computer Methods and Programs in Biomedicine
https://www.readbyqxmd.com/read/29156711/multiple-regulatory-aspects-of-histone-methyltransferase-ezh2-in-pb-induced-neurotoxicity
#7
Wei-Zhen Xue, Xiaozhen Gu, Yulan Wu, Danyang Li, Yi Xu, Hui-Li Wang
Pb is a pervasive environmental threat to human health. Although remarkable progress has been made in its neurotoxicity, the precise molecular mechanisms underlying this widespread toxicant still remain elusive. In this study, the detailed roles of EZH2, a transcriptional repressor, in the regulation of Pb-led neurotoxicity were investigated, highlighting its sub-functionalization, compartmentalization, functional chaperones and downstream partners. Based on the findings, EZH2's protein levels were significantly reduced in response to Pb treatment; EZH2's gain-of-function trials recovered the dampened neurite outgrowth; EZH2' recruitment to ploycomb complex, as well as its interaction with cytosolic Vav1, was altered in a distinct manner, suggesting that EZH2's multiple roles were markedly redistributed in this context; EZH2's cytosolic and nuclear presence differed in their respective response towards Pb treatment; EZH2 directly occupied the promoters of EGR2, NGFR and CaMKK2, genes responsible for various nerve functions and repair mechanisms, and essentially contributed to their aberrant expression...
October 17, 2017: Oncotarget
https://www.readbyqxmd.com/read/29156540/the-new-old-and-old-new-medical-model-four-decades-navigating-the-biomedical-and-psychosocial-understandings-of-health-and-illness
#8
REVIEW
Albert Farre, Tim Rapley
The importance of how disease and illness are conceptualised lies in the fact that such definition is paramount to understand the boundaries and scope of responsibility associated with medical work. In this paper, we aim to provide an overview of the interplay of these understandings in shaping the nature of medical work, philosophically, and in practice. We first discuss the emergence of the biopsychosocial model as an attempt to both challenge and broaden the traditional biomedical model. Then, we outline the main criticisms associated with the biopsychosocial model and note a range of contributions addressing the shortcomings of the model as initially formulated...
November 18, 2017: Healthcare (Basel, Switzerland)
https://www.readbyqxmd.com/read/29155443/the-philosophy-of-practice-for-comprehensive-medication-management-evaluating-its-meaning-and-application-by-practitioners
#9
Deborah L Pestka, Lindsay A Sorge, Mary Roth McClurg, Todd D Sorensen
OBJECTIVE: Philosophy of practice is the foundation to any patient care practice as it provides a set of professional values and beliefs that guide actions and decisions in practice. Study objectives were to understand how pharmacists providing comprehensive medication management (CMM) describe their philosophy of practice and compare how participants' philosophies align with predefined tenets of a CMM philosophy of practice. METHODS: An instrument with closed and open-ended items was developed and administered online to the lead pharmacist at 36 clinics participating in a large CMM study...
November 20, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/29154748/cdc-safety-training-course-for-ebola-virus-disease-healthcare-workers
#10
Rupa Narra, Jeremy Sobel, Catherine Piper, Deborah Gould, Nahid Bhadelia, Mary Dott, Anthony Fiore, William A Fischer, Mary Jo Frawley, Patricia M Griffin, Douglas Hamilton, Barbara Mahon, Satish K Pillai, Emily F Veltus, Robert Tauxe, Michael Jhung
Response to sudden epidemic infectious disease emergencies can demand intensive and specialized training, as demonstrated in 2014 when Ebola virus disease (EVD) rapidly spread throughout West Africa. The medical community quickly became overwhelmed because of limited staff, supplies, and Ebola treatment units (ETUs). Because a mechanism to rapidly increase trained healthcare workers was needed, the US Centers for Disease Control and Prevention developed and implemented an introductory EVD safety training course to prepare US healthcare workers to work in West Africa ETUs...
December 2017: Emerging Infectious Diseases
https://www.readbyqxmd.com/read/29153919/patient-and-health-care-provider-responses-from-a-prospective-double-blind-randomized-controlled-trial-comparing-vapocoolant-spray-versus-placebo-spray-in-adults-undergoing-venipuncture-in-the-emergency-department
#11
Tracy Barbour, Sharon O'Keefe, Sharon E Mace
Painful medical procedures are common. Topical anesthetics are easily applied, rapid onset, inexpensive, and avoid injection pain and needlestick injury. The aims of this study, using patient and health care provider questionnaires, were to answer the following questions: (1) Does vapocoolant spray decrease venipuncture pain? (2) Would patients be satisfied with and use a vapocoolant spray in the future? (3) Would providers be satisfied with and use a vapocoolant spray in the future? Adults (18-80 years) in a hospital emergency department (ED) were randomly assigned to sterile water placebo spray (S) (N = 50) or vapocoolant spray (V) (N = 50) before venipuncture...
November 16, 2017: Pain Management Nursing: Official Journal of the American Society of Pain Management Nurses
https://www.readbyqxmd.com/read/29152594/-blaming-shaming-humiliation-stigmatising-medical-interactions-among-people-with-non-epileptic-seizures
#12
Catherine Robson, Olaug S Lian
Background: People with non-epileptic seizures (NES) describe challenging relationships with health professionals, and explain negative interactions as common and expected. Despite these difficulties, little is known about how people with NES experience difficult healthcare encounters. Methods: Using a thematic discourse analysis approach, we analysed the free-text survey responses of 135 people with NES and asked: what kind of challenges do people living with this condition encounter when interacting with health professionals, and how do they experience the consequences of difficult interactions? We explore their experiences by interpreting the latent meaning of participants' texts from a social-constructionist perspective on health and illness...
2017: Wellcome Open Research
https://www.readbyqxmd.com/read/29151053/protocol-of-the-sepsivit-study-a-prospective-observational-study-to-determine-whether-continuous-heart-rate-variability-measurement-during-the-first-48-hours-of-hospitalisation-provides-an-early-warning-for-deterioration-in-patients-presenting-with-infection
#13
Vincent M Quinten, Matijs van Meurs, Maurits H Renes, Jack J M Ligtenberg, Jan C Ter Maaten
INTRODUCTION: One in five patients with sepsis deteriorates within 48 hours after hospital admission. Regrettably, a clear tool for the early detection of deterioration is still lacking. The SepsiVit study aims to determine whether continuous heart rate variability (HRV) measurement can provide an early warning for deterioration in patients presenting with suspected infection or sepsis to the emergency department (ED). METHODS AND ANALYSIS: The protocol of a prospective observational study in the ED...
November 17, 2017: BMJ Open
https://www.readbyqxmd.com/read/29148607/the-art-of-oral-handovers-a-participant-observational-study-by-undergraduate-students-in-a-hospital-setting
#14
Tove Giske, Sunniva Nese Melås, Kari Anne Einarsen
AIMS AND OBJECTIVES: This study explores the conditions for oral handovers between shifts in a hospital setting, and how these impact patient safety and quality of care. BACKGROUND: Oral handovers transfer patient information and nursing responsibilities between shifts. Short written summaries of patients can complement an oral handover. How to find the balance between a standardised protocol for handovers and tailoring variations to specific patients and situations is debated in the literature...
November 17, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29148174/prehospital-transfusion-of-red-cell-concentrates-in-a-paramedic-staffed-helicopter-emergency-medical-service
#15
Stefan Heschl, Emily Andrew, Anthony de Wit, Stephen Bernard, Marcus Kennedy, Karen Smith
OBJECTIVE: The optimal volume and type of intravenous fluid for the treatment of blood loss in the prehospital setting is controversial. The use of red cell concentrates (RCCs) may be associated with improved outcomes; however, the administration of blood products is limited to physicians in many jurisdictions. We sought to describe the characteristics of RCC transfusions in a paramedic-staffed helicopter emergency medical system in Victoria, Australia. METHODS: We performed a retrospective analysis of all cases where paramedics consulted the responsible physician for approval of RCC transfusion between July 2011 and December 2015 in Victoria, Australia...
November 17, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29146143/reported-mistreatment-during-the-surgery-clerkship-varies-by-student-career-choice
#16
Michael T Kemp, Margaret Smith, Scott Kizy, Michael Englesbe, Rishindra M Reddy
BACKGROUND: Student mistreatment is often a major concern during the surgery clerkship. We hypothesized that mistreatment is decreasing and that career choice may reflect perceived mistreatment. METHODS: We surveyed 2319 physicians about their surgery clerkships. Mistreatment reporting was correlated to physician specialty and medical school graduation year. RESULTS: The response rate was 18.9% (440/2319). Recent graduates reported less mistreatment than more senior graduates (24...
November 13, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/29146122/health-and-wellbeing-of-indigenous-adolescents-in-australia-a-systematic-synthesis-of-population-data
#17
Peter S Azzopardi, Susan M Sawyer, John B Carlin, Louisa Degenhardt, Ngiare Brown, Alex D Brown, George C Patton
BACKGROUND: Indigenous populations have high rates of disease and premature mortality. Most Indigenous communities are young, and adolescence (age 10-24 years) provides great opportunities for population health gain. However, the absence of a comprehensive account of Indigenous adolescents' health has been a barrier to effective policy. We aimed to report a national health profile for Indigenous adolescents in Australia. METHODS: We undertook a systematic synthesis of population data to report the health and wellbeing of Indigenous adolescents in Australia...
November 10, 2017: Lancet
https://www.readbyqxmd.com/read/29144718/the-emerging-role-of-gammacore%C3%A2-in-the-management-of-cluster-headache-expert-panel-recommendations
#18
Stephen D Silberstein, Anne H Calhoun, Christina Treppendahl, David W Dodick, Alan M Rapoport, Avinash Mamidi, Peter Vargas, Thomas H Ebert, Stewart J Tepper
A panel of 9 experts, including neurologists, other headache specialists, and medical and pharmacy directors, from 4 health plans (1 integrated delivery network and 3 plans with commercial, Medicare, and Medicaid lines of business), convened to discuss cluster headache (CH). Topics covered included the current treatment landscape, treatment challenges, economic impact of disease, and gaps in care for patients with CH. One major challenge in the management of CH is that it is underrecognized and frequently misdiagnosed, leading to delays in and suboptimal treatment for patients who suffer from this painful and disabling condition...
November 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/29144147/pursued-for-their-prescription-exposure-to-compliance-gaining-strategies-predicts-stimulant-diversion-in-emerging-adults
#19
Laura J Holt, Paige N Marut, Ty S Schepis
Researchers have begun to identify predictors of who will divert their stimulant prescriptions, as most emerging adults (EAs) who use prescription stimulants nonmedically procure these drugs from a friend or acquaintance with a prescription. Far less research has examined how EAs with attention-deficit/hyperactivity disorder (ADHD) are approached for these medications, and their affective and behavioral responses to these requests. We hypothesized that EAs with a stimulant prescription who reported greater exposure to compliance-gaining attempts from peers, particularly rational appeals for academic work, would be more likely to divert, as would EAs who reported lower resistance to peer influence...
November 16, 2017: Psychology of Addictive Behaviors: Journal of the Society of Psychologists in Addictive Behaviors
https://www.readbyqxmd.com/read/29143190/role-of-magnetic-resonance-imaging-in-the-management-of-perianal-crohn-s-disease
#20
REVIEW
Jose C Gallego, Ana Echarri
Perianal fistulas are a major problem in many patients with Crohn's disease. These are usually complex fistulas that adversely affect patients' quality of life, and their clinical management is difficult. Medical treatment sometimes achieves cessation of discharge and closure of the external opening; however, it is difficult to assess the status of the rest of the fistula tract. Magnetic resonance imaging is the method of choice with which to evaluate the condition of perianal fistulas and allows for assessment of the status of inaccessible areas...
November 15, 2017: Insights Into Imaging
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