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Emergency medical response

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https://www.readbyqxmd.com/read/29332773/does-medical-staffing-influence-perceived-safety-an-international-survey-on-medical-crew-models-in-helicopter-emergency-medical-services
#1
Kristen Rasmussen, Jo Røislien, Stephen J M Sollid
OBJECTIVE: The competence, composition, and number of crewmembers have generally been considered to influence the degree of patient care and safety in helicopter emergency medical services (HEMS), but evidence to support the advantages of one crew concept over another is ambiguous; additionally, the benefit of physicians as crewmembers is still highly debated. METHODS: To compare perceived safety in different medical crew models, we surveyed international HEMS medical directors regarding the types of crew compositions their system currently used and their supportive rationales and to evaluate patient and flight safety within their services...
January 2018: Air Medical Journal
https://www.readbyqxmd.com/read/29332000/how-good-are-doctors-at-introducing-themselves-hellomynameis
#2
Peter Gillen, Sue Faye Sharifuddin, Muireann O'Sullivan, Alison Gordon, Eva M Doherty
BACKGROUND: This explorative study was triggered by the '#hellomynameis' campaign initiated by Dr Kate Granger in the UK. Our objectives were twofold: first, to measure rates of introduction in an Irish hospital setting by both consultant and non-consultant hospital doctors. Second to establish whether such practices were associated with patient perceptions of the doctor/patient interaction. METHOD: A patient 'exit' survey was undertaken following doctor-patient consultations in both acute (surgical and medical assessment units) and elective settings (outpatient clinics)...
January 13, 2018: Postgraduate Medical Journal
https://www.readbyqxmd.com/read/29329493/a-randomized-double-blind-controlled-trial-of-intravenous-meloxicam-in-the-treatment-of-pain-following-dental-impaction-surgery
#3
Steven E Christensen, Stephen A Cooper, Randall J Mack, Stewart W McCallum, Wei Du, Alex Freyer
This randomized, controlled phase 2 study was conducted to evaluate the analgesic efficacy, safety, and tolerability of single intravenous (IV) doses of 15 mg, 30 mg, and 60 mg meloxicam compared with oral ibuprofen 400 mg and placebo after dental impaction surgery. The primary efficacy end point was the sum of time-weighted pain intensity differences for 0-24 hours postdose. Among 230 evaluable subjects, meloxicam IV 60 mg produced the greatest reduction in pain, followed by the 30-mg and 15-mg doses. Statistically significant differences in summed pain intensity differences over 24 hours were demonstrated for each active-treatment group vs placebo (favoring active treatment) and for meloxicam IV 30 mg and 60 mg vs ibuprofen 400 mg (favoring meloxicam IV)...
January 12, 2018: Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29329440/executive-function-and-internalizing-symptoms-in-adolescents-and-young-adults-with-congenital-heart-disease-the-role-of-coping
#4
Jamie L Jackson, Gina M Gerardo, Jennifer D Monti, Kyle A Schofield, Kathryn Vannatta
Executive functioning deficits have been documented among congenital heart disease (CHD) survivors and may contribute to emotional distress. Little research has investigated the role of coping in this association. This study examined the role of coping in accounting for the association between self-reported executive function problems and internalizing symptoms among adolescents and emerging adults (AEAs), as well as young adults (YAs) with CHD. Participants included 74 AEA ( M age  = 19.32  ±  3.47 years, range 15-25 years) and 98 YA CHD survivors ( M age  = 32...
January 10, 2018: Journal of Pediatric Psychology
https://www.readbyqxmd.com/read/29325894/reference-values-for-the-creatine-kinase-response-to-professional-australian-football-match-play
#5
Luke A G Inman, Michael J Rennie, Mark L Watsford, Nathan J Gibbs, James Green, Robert W Spurrs
OBJECTIVES: Due to the importance of monitoring markers of muscle damage in high-level sport from a medical and athlete recovery perspective, this study aimed to determine the upper limits of normal (ULN) for post-match plasma creatine kinase (CK) in professional Australian footballers. Raw CK values were considered, along with intra-individual deviations from the season-mean. DESIGN: Case series. METHODS: CK was collected between 36-48h following professional Australian football match-play...
December 30, 2017: Journal of Science and Medicine in Sport
https://www.readbyqxmd.com/read/29325000/alcohol-tobacco-and-health-care-costs-a-population-wide-cohort-study-n-606-947-patients-of-current-drinkers-based-on-medical-and-administrative-health-records-from-catalonia
#6
Laia Miquel, Jürgen Rehm, Kevin D Shield, Emili Vela, Montserrat Bustins, Lidia Segura, Joan Colom, Peter Anderson, Antoni Gual
Background: Most cost of illness studies are based on models where information on exposure is combined with risk information from meta-analyses, and the resulting attributable fractions are applied to the number of cases. Methods: This study presents data on alcohol and tobacco use for 2011 and 2012 obtained from a routine medical practice in Catalonia of 606 947 patients, 18 years of age and older, as compared with health care costs for 2013 (all costs from the public health care system: primary health care visits, hospital admissions, laboratory and medical tests, outpatient visits to specialists, emergency department visits and pharmacy expenses)...
January 8, 2018: European Journal of Public Health
https://www.readbyqxmd.com/read/29323930/the-economic-burden-of-asthma-in-the-united-states-2008-2013
#7
Tursynbek Nurmagambetov, Robin Kuwahara, Paul Garbe
RATIONALE: Asthma is a chronic disease that affects quality of life, productivity at work and school, healthcare use, and can result in death. Measuring the current economic burden of asthma provides important information on the impact of asthma on society. This information can be used to make informed decisions about allocation of limited public health resources. OBJECTIVES: In this paper, we provide a comprehensive approach to estimate current prevalence, medical costs, cost of absenteeism (missed work and schooldays) and mortality attributable to asthma from a national perspective...
January 11, 2018: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/29323605/outcomes-for-gestational-carriers-versus-traditional-surrogates-in-the-united-states
#8
Erika L Fuchs, Abbey B Berenson
BACKGROUND: Little is known about the obstetric and procedural outcomes of traditional surrogates and gestational carriers. MATERIALS AND METHODS: Participants included 222 women living in the United States who completed a brief online survey between November 2015 and February 2016. Differences between gestational carriers (n = 204) and traditional surrogates (n = 18) in demographic characteristics, pregnancy outcomes, and procedural outcomes were examined using chi-squared tests, Fisher's exact tests, and t-tests...
January 11, 2018: Journal of Women's Health
https://www.readbyqxmd.com/read/29323027/micrornas-in-parkinson-s-disease-and-emerging-therapeutic-targets
#9
REVIEW
Bridget Martinez, Philip V Peplow
Parkinson's disease (PD) is the second most common age-related neurodegenerative disorder, with the clinical main symptoms caused by a loss of dopaminergic neurons in the substantia nigra, corpus striatum and brain cortex. Over 90% of patients with PD have sporadic PD and occur in people with no known family history of the disorder. Currently there is no cure for PD. Treatment with medications to increase dopamine relieves the symptoms but does not slow down or reverse the damage to neurons in the brain. Increasing evidence points to inflammation as a chief mediator of PD with inflammatory response mechanisms, involving microglia and leukocytes, activated following loss of dopaminergic neurons...
December 2017: Neural Regeneration Research
https://www.readbyqxmd.com/read/29322848/inpatient-satisfaction-at-different-public-sector-hospitals-of-a-metropolitan-city-in-pakistan-a-comparative-cross-sectional-study
#10
Mehwish Hussain, Rehana Rehman, Zia Ikramuddin, Nava Asad, Ayesha Farooq
OBJECTIVE: To observe inpatient satisfaction at different public sector hospitals of Karachi, Pakistan. METHODS: A cross sectional study was carried out during 2010-2012 in four major public sector hospitals of Karachi. A total of 710 patients completed the study. Responses were gathered in a self-structured questionnaire that comprised of four dimensions of satisfaction with doctor, staff, administration and treatment. Average Score of each dimension was taken and compared using one way analysis of variance...
January 11, 2018: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/29320313/acute-radiologic-manifestations-of-america-s-opioid-epidemic
#11
David D B Bates, Katherine Gallagher, HeiShun Yu, Jennifer Uyeda, Akira M Murakami, Bindu N Setty, Stephan W Anderson, Mariza O Clement
The United States is in the midst of an opioid use epidemic, which has severe medical, social, and economic consequences. Addictions to and abuse of prescription and illicit opioids are increasing, and emergency department radiologists are increasingly being faced with the task of examining patients who present with opioid-related complications. These complications may be the result of direct drug toxicity or nonsterile injection of the drugs. Neurologic, musculoskeletal, cardiopulmonary, genitourinary, and gastrointestinal complications may be evident at diagnostic imaging in emergent settings...
January 2018: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/29319049/mechanisms-of-resistance-to-immune-checkpoint-inhibitors
#12
REVIEW
Russell W Jenkins, David A Barbie, Keith T Flaherty
Immune checkpoint inhibitors (ICI) targeting CTLA-4 and the PD-1/PD-L1 axis have shown unprecedented clinical activity in several types of cancer and are rapidly transforming the practice of medical oncology. Whereas cytotoxic chemotherapy and small molecule inhibitors ('targeted therapies') largely act on cancer cells directly, immune checkpoint inhibitors reinvigorate anti-tumour immune responses by disrupting co-inhibitory T-cell signalling. While resistance routinely develops in patients treated with conventional cancer therapies and targeted therapies, durable responses suggestive of long-lasting immunologic memory are commonly seen in large subsets of patients treated with ICI...
January 2018: British Journal of Cancer
https://www.readbyqxmd.com/read/29318085/exploring-older-adult-ed-fall-patients-understanding-of-their-fall-a-qualitative-study
#13
Kalpana N Shankar, Devon Taylor, Caroline T Rizzo, Shan W Liu
Objective: We sought to understand older patients' perspectives about their fall, fall risk factors, and attitude toward emergency department (ED) fall-prevention interventions. Methods: We conducted semistructured interviews between July 2015 and January 2016 of community-dwelling, nondemented patients in the ED, who presented with a fall to an urban, teaching hospital. Interviews were halted once we achieve thematic saturation with the data coded and categorized into themes...
December 2017: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/29318006/naloxone-dosage-for-opioid-reversal-current-evidence-and-clinical-implications
#14
REVIEW
Rachael Rzasa Lynn, J L Galinkin
Opioid-related mortality is a growing problem in the United States, and in 2015 there were over 33,000 opioid-related deaths. To combat this mortality trend, naloxone is increasingly being utilized in a pre-hospital setting by emergency personnel and prescribed to laypersons for out-of-hospital administration. With increased utilization of naloxone there has been a subsequent reduction in mortality following an opioid overdose. Reversal of opioid toxicity may precipitate an opioid-withdrawal syndrome. At the same time, there is a risk of inadequate response or re-narcotization after the administration of a single dose of naloxone in patients who have taken large doses or long-acting opioid formulations, as the duration of effect of naloxone is shorter than that of many opioid agonists...
January 2018: Therapeutic Advances in Drug Safety
https://www.readbyqxmd.com/read/29317154/mobile-integrated-health-to-reduce-post-discharge-acute-care-visits-a-pilot-study
#15
Jennica Siddle, Peter S Pang, Christopher Weaver, Elizabeth Weinstein, Daniel O'Donnell, Thomas P Arkins, Charles Miramonti
BACKGROUND: Mobile Integrated Health (MIH) leverages specially trained paramedics outside of emergency response to bridge gaps in local health care delivery. STUDY OBJECTIVE: To evaluate the efficacy of a MIH led transitional care strategy to reduce acute care utilization. METHODS: This was a retrospective cohort analysis of a quality improvement pilot of patient patients from an urban, single county EMS, MIH transitional care initiative. We utilized a paramedic/social worker (or social care coordinator) dyad to provide in home assessments, medication review, care coordination, and improve access to care...
December 29, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29316937/estimate-of-incidence-and-cost-of-recreational-waterborne-illness-on-united-states-surface-waters
#16
Stephanie DeFlorio-Barker, Coady Wing, Rachael M Jones, Samuel Dorevitch
BACKGROUND: Activities such as swimming, paddling, motor-boating, and fishing are relatively common on US surface waters. Water recreators have a higher rate of acute gastrointestinal illness, along with other illnesses including respiratory, ear, eye, and skin symptoms, compared to non-water recreators. The quantity and costs of such illnesses are unknown on a national scale. METHODS: Recreational waterborne illness incidence and severity were estimated using data from prospective cohort studies of water recreation, reports of recreational waterborne disease outbreaks, and national water recreation statistics...
January 9, 2018: Environmental Health: a Global Access Science Source
https://www.readbyqxmd.com/read/29310960/cannabinoid-hyperemesis-syndrome-pathophysiology-and-treatment-in-the-emergency-department
#17
John R Richards
BACKGROUND: Cannabinoid hyperemesis syndrome (CHS) is a challenging clinical disorder. CHS patients frequently present to the emergency department and may require treatment for intractable emesis, dehydration, and electrolyte abnormalities. Thought to be a variant of cyclic vomiting syndrome, CHS has become more prevalent with increasing cannabis potency and use, as enabled by various states having legalized the recreational use of cannabis. OBJECTIVE: This aim of this review is to investigate the pathophysiology of CHS and evaluate the published literature on pharmacologic treatment in the emergency department...
January 5, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29306690/differential-change-on-depressive-symptom-factors-with-antidepressant-medication-and-cognitive-behavior-therapy-for-major-depressive-disorder
#18
Boadie W Dunlop, Steven P Cole, Charles B Nemeroff, Helen S Mayberg, W Edward Craighead
BACKGROUND: Major depressive disorder (MDD) is a heterogeneous condition and individual patients are likely to be differentially responsive to specific treatments. In an exploratory factor analysis of three rating scales, the Genome-based Therapeutic Drugs for Depression (GENDEP) trial identified three factors that were differentially associated with outcome to nortriptyline and escitalopram. However, this factor analysis has neither been replicated or applied to a psychotherapy treatment...
December 27, 2017: Journal of Affective Disorders
https://www.readbyqxmd.com/read/29306373/benefit-risk-communication-in-paediatric-imaging-what-do-referring-physicians-radiographers-and-radiologists-think-say-and-do
#19
J L Portelli, J P McNulty, P Bezzina, L Rainford
INTRODUCTION: To assess how referrers and practitioners disclose benefit-risk information about medical imaging examinations to paediatric patients and their parents/guardians; to gauge their confidence in doing so; and to seek their opinion about who is responsible for disclosing such information. METHODS: This study followed on from a previously published study, with a questionnaire distributed in staggered phases to 146 radiographers, 22 radiology practitioners, 55 emergency physicians and 43 paediatricians at a primary paediatric referral centre in Malta...
February 2018: Radiography
https://www.readbyqxmd.com/read/29305302/actual-state-of-knowledge-in-the-field-of-diseases-related-with-defective-nucleotide-excision-repair
#20
REVIEW
Barbara Bukowska, Bolesław T Karwowski
Xeroderma pigmentosum (XP), trichothiodystrophy (TTD) and Cockayne syndrome (CS) are rare genetic diseases characterized by a large range of clinical symptoms. However, they are all associated with defects in nucleotide excision repair (NER), the system responsible for removing bulky DNA lesions such as those generated by UV light: cyclobutane pyrimidine dimers (CPDs) and pyrimidine-pyrimidone photoproducts (6-4 PPs). Over the past years, detailed structural and biochemical information on NER-associated proteins has emerged...
January 2, 2018: Life Sciences
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