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Emergency medical response

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https://www.readbyqxmd.com/read/28817750/the-surgeon-on-service-model-for-timely-economically-viable-inpatient-care-of-tracheostomy-patients-in-academic-pediatric-otolaryngology
#1
Jennifer M Lavin, James W Schroeder, Dana M Thompson
Importance: The traditional practice model for pediatric otolaryngologists at high-volume academic centers is to simultaneously balance outpatient care responsibilities with those of the inpatient service, emergency department, and ambulatory care clinics. This model leads to challenges with care coordination, timeliness of nonemergency operative care, and consistent participation in care and consultation at the attending surgeon level. The "surgeon on service" (SOS) model-where faculty members rotate to manage the inpatient service in lieu of outpatient responsibilities-has been described as one method to address this conundrum...
August 17, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28815660/absorption-and-tolerability-of-taste-masked-hydrocortisone-granules-in-neonates-infants-and-children-under-6-years-of-age-with-adrenal-insufficiency
#2
Uta Neumann, Martin J Whitaker, Susanna Wiegand, Heiko Krude, John Porter, Madhu Davies, Dena Digweed, Bernard Voet, Richard J Ross, Oliver Blankenstein
OBJECTIVES: There is no licensed, dose-appropriate formulation of hydrocortisone for children with adrenal insufficiency (AI) and patients rely on compounded adult medication. The aim of this study was to evaluate the absorption, palatability and safety of Infacort(®) , an immediate-release, granule formulation of hydrocortisone with taste masking. STUDY DESIGN: Single site with satellites attended by a "flying" doctor from investigator site. Open-label, single-dose study in three consecutive child cohorts (n=24) with AI; Cohort 1, children aged 2 to <6 years (n=12); Cohort 2, infants aged 28 days to <2 years (n=6); Cohort 3, neonates aged 1 to <28 days (n=6)...
August 16, 2017: Clinical Endocrinology
https://www.readbyqxmd.com/read/28812053/emergency-medical-service-personnel-recognize-pediatric-concussions
#3
Joshua N Speirs, Matthew I Lyons, Bert E Johansson
Concussions are a major cause of morbidity in pediatrics. Many concussions occur during activities with emergency medical service (EMS) providers present to determine if a higher level of care is needed. Data are limited on how capable these providers are. We assessed the ability of EMS providers to recognize pediatric concussions. Fifty-six total responses were included, 38 from EMS and 18 from our MD/RN (medical doctor/registered nurse) group. No statistical differences were found between the 2 groups when adjusted for age, gender, number of years in practice, and number of pediatric concussions managed...
2017: Global Pediatric Health
https://www.readbyqxmd.com/read/28811394/overview-and-current-management-of-computerized-adaptive-testing-in-licensing-certification-examinations
#4
Dong Gi Seo
Computerized adaptive testing (CAT) has been implemented in the high stakes examinations such as National Council Licensure Examination-Registered Nurses (NCLEX-RN) in the United States since 1994. After that, The National Registry Emergency Medical Technician (NREMT) in the United States adopted a CAT to certify an Emergency Medical Technician (EMT) in 2007. It aimed at introducing CAT for the implementation in the medical health licensing examinations. Most CATs are based on the item response theory (IRT) which hypothesizes that both examinee and item has own characteristics that does not change...
July 26, 2017: Journal of Educational Evaluation for Health Professions
https://www.readbyqxmd.com/read/28810997/cutaneous-leishmaniasis-in-a-saudi-arabian-soldier-stationed-in-the-united-states
#5
Kelly Laurent, Jason Susong, Eric Fillman, Simon Ritchie
BACKGROUND: Leishmaniasis is a common parasitic disease seen in many parts of the world, especially in areas where current U.S. and international forces are deployed. Approximately 350 million people are thought to be at risk of cutaneous leishmaniasis (CL) with an annual incidence of 1.5 million cases. Over 90% of cutaneous infections with Leishmania occur in the Middle East, Brazil, and Peru. Outbreaks of CL may occur in military personnel deployed to endemic areas. Since the incubation period for symptomatic CL ranges from weeks to months, symptoms may not appear until well after returning to the United States...
July 2017: Military Medicine
https://www.readbyqxmd.com/read/28808948/tiotropium-bromide-in-children-and-adolescents-with-asthma
#6
Hengameh H Raissy, H William Kelly
Evidence is emerging on the use of long-acting muscarinic antagonists (LAMAs) in the management of asthma. Tiotropium bromide (Spiriva(®) Respimat(®)) is the only LAMA approved in children and adolescents. As the use of tiotropium becomes more common in clinical practice, it is necessary to review the existing data to identify patients who may benefit from the addition of this medication to their daily asthma regimen. This review discusses recent evidence on the safety and efficacy of tiotropium bromide in the management of asthma in children and adolescents...
August 14, 2017: Paediatric Drugs
https://www.readbyqxmd.com/read/28808418/emerging-roles-of-sirt1-in-fatty-liver-diseases
#7
REVIEW
Ren-Bo Ding, Jiaolin Bao, Chu-Xia Deng
Fatty liver diseases, which are commonly associated with high-fat/calorie diet, heavy alcohol consumption and/or other metabolic disorder causes, lead to serious medical concerns worldwide in recent years. It has been demonstrated that metabolic homeostasis disruption is most likely to be responsible for this global epidemic. Sirtuins are a group of conserved nicotinamide adenine dinucleotide (NAD(+)) dependent histone and/or protein deacetylases belonging to the silent information regulator 2 (Sir2) family...
2017: International Journal of Biological Sciences
https://www.readbyqxmd.com/read/28807018/the-neglected-burden-of-snakebites-in-cameroon-a-review-of-the-epidemiology-management-and-public-health-challenges
#8
Joel Noutakdie Tochie, Mazou N Temgoua, Tsi Njim, Danwang Celestin, Ronni Tankeu, Njinkeng J Nkemngu
OBJECTIVES: Snakebite is an underestimated medical and surgical emergency in developing countries responsible for a high disease burden. Optimal management of snake envenomation in these resource-limited settings is precluded by several public health challenges. In this review, we discuss the disease burden of snakebites in Cameroon and the public health challenges of its management in view of making recommendations essential for policy-making. MEDLINE, African Journals Online and Google Scholar were searched from January 1990 to February 2017 for studies addressing snakebite in Cameroon...
August 14, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28806786/an-economic-evaluation-of-vector-control-in-the-age-of-a-dengue-vaccine
#9
Christopher Fitzpatrick, Alexander Haines, Mathieu Bangert, Andrew Farlow, Janet Hemingway, Raman Velayudhan
INTRODUCTION: Dengue is a rapidly emerging vector-borne Neglected Tropical Disease, with a 30-fold increase in the number of cases reported since 1960. The economic cost of the illness is measured in the billions of dollars annually. Environmental change and unplanned urbanization are conspiring to raise the health and economic cost even further beyond the reach of health systems and households. The health-sector response has depended in large part on control of the Aedes aegypti and Ae...
August 14, 2017: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/28806405/characterizing-the-influence-of-transportation-infrastructure-on-emergency-medical-services-ems-in-urban-area-a-case-study-of-seoul-south-korea
#10
Jungwoo Cho, Myoungsoon You, Yoonjin Yoon
In highly urbanized area where traffic condition fluctuates constantly, transportation infrastructure is one of the major contributing factors to Emergency Medical Service (EMS) availability and patient outcome. In this paper, we assess the impact of traffic fluctuation to the EMS first response availability in urban area, by evaluating the k-minute coverage under 21 traffic scenarios. The set of traffic scenarios represents the time-of-day and day-of-week effects, and is generated by combining road link speed information from multiple historical speed databases...
2017: PloS One
https://www.readbyqxmd.com/read/28804662/fungal-bezoar-a-rare-cause-of-ureteral-obstruction
#11
Nabil Zeineddine, Wissam Mansour, Sandy El Bitar, Marco Campitelli, Neville Mobarakai
A 52-year-old male, with diabetes mellitus and alcoholic liver disease, presented to the Emergency Room for right flank pain of 3 days' duration, associated with dysuria. Physical examination revealed right flank tenderness with fever and hypotension; laboratory findings showed acute kidney injury and large blood and leucocytes in the urine. A CT abdomen and pelvis showed hydronephrosis of the right collecting system of a horseshoe kidney with air and hyperdense debris in the renal pelvis. Patient was treated for multisensitive Proteus mirabilis emphysematous pyelonephritis, and a right nephrostomy tube was inserted...
2017: Case Reports in Infectious Diseases
https://www.readbyqxmd.com/read/28803665/-teledermatology-between-two-french-hospitals-two-years-of-experience
#12
C Bertin, A Diakite, B Carton, C Wozniak, S Nathanson, S Monnier, C Sin, M-A Dommergues, J Parigot, F Moreau, M-L Sigal, P Foucaud, A Greder, E Mahé
BACKGROUND: Teledermatology is currently booming. Due to the shortage of dermatologists in hospitals access to dermatological consultations is very limited in some hospitals. We present our experience of collaboration between an expert center, the dermatology department of the Victor-Dupouy Hospital Centre in Argenteuil, and all medical structures under the André-Mignot Hospital in Versailles (CHV), including 2 prison medical centers (UCSA), traditional departments and emergency department...
August 10, 2017: Annales de Dermatologie et de Vénéréologie
https://www.readbyqxmd.com/read/28802938/impulse-control-and-related-disorders-in-parkinson-s-disease
#13
Daniel Weintraub, Daniel O Claassen
Impulse control disorders (ICDs), such as compulsive gambling, buying, sexual, and eating behaviors, are a serious and increasingly recognized complication in Parkinson's disease (PD), occurring in up to 20% of PD patients over the course of their illness. Related behaviors include punding (stereotyped, repetitive, purposeless behaviors), dopamine dysregulation syndrome (DDS) (compulsive medication overuse), and hobbyism (e.g., compulsive internet use, artistic endeavors, and writing). These disorders have a significant impact on quality of life and function, strain interpersonal relationships, and worsen caregiver burden, and are associated with significant psychiatric comorbidity...
2017: International Review of Neurobiology
https://www.readbyqxmd.com/read/28801399/a-randomised-controlled-pilot-trial-evaluating-feasibility-and-acceptability-of-a-computer-based-tool-to-identify-and-reduce-harmful-and-hazardous-drinking-among-adolescents-with-alcohol-related-presentations-in-canadian-pediatric-emergency-departments
#14
Amanda S Newton, Nadia Dow, Kathryn Dong, Eleanor Fitzpatrick, T Cameron Wild, David W Johnson, Samina Ali, Ian Colman, Rhonda J Rosychuk
OBJECTIVE: This study piloted procedures and obtained data on intervention acceptability to determine the feasibility of a definitive randomised controlled trial (RCT) of the effectiveness of a computer-based brief intervention in the emergency department (ED). DESIGN: Two-arm, multi-site, pilot RCT. SETTING AND PARTICIPANTS: Adolescents aged 12-17 years presenting to three Canadian pediatric EDs from July 2010 to January 2013 for an alcohol-related complaint...
August 11, 2017: BMJ Open
https://www.readbyqxmd.com/read/28801082/-how-to-videos-improve-residents-performance-of-essential-perioperative-electronic-medical-records-and-clinical-tasks
#15
Veronica Zoghbi, Robert C Caskey, Kristoffel R Dumon, Jacqueline M Soegaard Ballester, Ari D Brooks, Jon B Morris, Daniel T Dempsey
OBJECTIVE: The ability to use electronic medical records (EMR) is an essential skill for surgical residents. However, frustration and anxiety surrounding EMR tasks may detract from clinical performance. We created a series of brief, 1-3 minutes "how to" videos demonstrating 7 key perioperative EMR tasks: booking OR cases, placing preprocedure orders, ordering negative-pressure wound dressing supplies, updating day-of-surgery history and physical notes, writing brief operative notes, discharging patients from the postanesthesia care unit, and checking vital signs...
August 8, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28799002/intolerance-and-violence-against-doctors
#16
REVIEW
Meharban Singh
Intolerance and grouse against doctors is a global phenomenon but India seems to lead the world in violence against doctors. According to World Health Organization, about 8-38% healthcare workers suffer physical violence at some point in their careers. Many more are verbally abused or threatened. Public is almost behaving like health sector terrorists. The spate of increasing attacks on doctors by damaging their property and causing physical injury is not acceptable by any civilized society. The public is becoming increasingly intolerant to a large number of social issues because of poor governance and vote bank politics...
August 11, 2017: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/28797248/the-role-of-bariatric-surgery-to-treat-diabetes-current-challenges-and-perspectives
#17
REVIEW
Chrysi Koliaki, Stavros Liatis, Carel W le Roux, Alexander Kokkinos
Bariatric surgery is emerging as a powerful weapon against severe obesity and type 2 diabetes mellitus (T2DM). Given its role in metabolic regulation, the gastrointestinal tract constitutes a meaningful target to treat T2DM, especially in light of accumulating evidence that surgery with gastrointestinal manipulations may result in T2DM remission (metabolic surgery). The major mechanisms mediating the weight loss-independent effects of bariatric surgery comprise effects on tissue-specific insulin sensitivity, β-cell function and incretin responses, changes in bile acid composition and flow, modifications of gut microbiota, intestinal glucose metabolism and increased brown adipose tissue metabolic activity...
August 10, 2017: BMC Endocrine Disorders
https://www.readbyqxmd.com/read/28794834/anesthesia-for-ambulatory-surgery
#18
REVIEW
Jeong Han Lee
Ambulatory anesthesia allows quick recovery from anesthesia, leading to an early discharge and rapid resumption of daily activities, which can be of great benefit to patients, healthcare providers, third-party payers, and hospitals. Recently, with the development of minimally invasive surgical techniques and short-acting anesthetics, the use of ambulatory surgery has grown rapidly. Additionally, as the indications for ambulatory surgery have widened, the surgical methods have become more complex and the number of comorbidities has increased...
August 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/28794822/overview-of-glucagon-like-peptide-1-receptor-agonists-for-the-treatment-of-patients-with-type-2-diabetes
#19
Kelvin Lingjet Tran, Young In Park, Shalin Pandya, Navin John Muliyil, Brandon David Jensen, Kovin Huynh, Quang T Nguyen
BACKGROUND: It is estimated that 29.1 million people or 9.3% of the US population have diabetes, which contributes to considerable medical and financial burden. Type 2 diabetes mellitus is characterized by insulin resistance and insulin secretion impairment leading to hyperglycemia. The presence of insulin resistance is strongly correlated with obesity. OBJECTIVE: This article reviews the available glucagon-like peptide-1 (GLP-1) receptor agonists and their role in the management of patients with diabetes, to help guide the selection of the most suitable agent for the individualized treatment of patients with type 2 diabetes...
June 2017: American Health & Drug Benefits
https://www.readbyqxmd.com/read/28790039/answering-medical-questions-at-the-point-of-care-a-cross-sectional-study-comparing-rapid-decisions-based-on-pubmed-and-epistemonikos-searches-with-evidence-based-recommendations-developed-with-the-grade-approach
#20
Ariel Izcovich, Juan Martín Criniti, Federico Popoff, Martín Alberto Ragusa, Cristel Gigler, Carlos Gonzalez Malla, Manuela Clavijo, Matias Manzotti, Martín Diaz, Hugo Norberto Catalano, Ignacio Neumann, Gordon Guyatt
INTRODUCTION: Using the best current evidence to inform clinical decisions remains a challenge for clinicians. Given the scarcity of trustworthy clinical practice guidelines providing recommendations to answer clinicians' daily questions, clinical decision support systems (ie, assistance in question identification and answering) emerge as an attractive alternative. The trustworthiness of the recommendations achieved by such systems is unknown. OBJECTIVE: To evaluate the trustworthiness of a question identification and answering system that delivers timely recommendations...
August 7, 2017: BMJ Open
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