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Bedside report

James A Town, Paul A Bergl, Akhil Narang, John F McConville
BACKGROUND : The long-term retention of knowledge and skills in bedside ultrasound by internal medicine residents after ultrasound training is not well understood. OBJECTIVE : We sought to determine whether knowledge and skills acquired from focused training in bedside ultrasound are retained over time, and whether retention is related to independent practice. METHODS : We conducted a prospective observational trial of 101 internal medicine residents at an academic medical center who participated in a bedside ultrasound workshop followed by 12 months of independent practice...
October 2016: Journal of Graduate Medical Education
Jingjing Wu, Mingzhi Zhang, Delong Liu
The Bruton tyrosine kinase (BTK) inhibitor, ibrutinib, has been approved for the treatment of chronic lymphocytic leukemia, mantle cell lymphoma, and Waldenstrom's macroglobulinemia. Acquired resistance to ibrutinib due to BTK C481S mutation has been reported. Mutations in PLCγ2 can also mediate resistance to ibrutinib. Untoward effects due to off-target effects are also disadvantages of ibrutinib. More selective and potent BTK inhibitors (ACP-196, ONO/GS-4059, BGB-3111, CC-292) are being investigated. This review summarized the preclinical research and clinical data of ONO/GS-4059...
October 20, 2016: Oncotarget
Rocío Rojí, Antonio Noguera-Tejedor, Fernando Pikabea-Díaz, José Miguel Carrasco, Carlos Centeno
CONTEXT: A mandatory course in palliative care (PC) is organized for all final-year medical students at the University of Navarre. It consists of 24 lectures, 4 workshops, and 1 scheduled five hour clinical PC service experience at two different sites. In the 48 hours after the visit and related to the clinical experience, each student has to complete a 500-word reflective writing (RW) piece. OBJECTIVE: To investigate how a brief PC clinical experience helps equip the medical student...
October 18, 2016: Journal of Palliative Medicine
Injune Park, Youn Jung Kim, Shin Ahn, Chang Hwan Sohn, Dong Woo Seo, Won Young Kim
Electrocardiogram changes in subarachnoid hemorrhage (SAH) have been described as ST-T changes that mimic acute coronary syndrome and even acute ST-segment elevation myocardial infarction. Elevation of cardiac enzymes and abnormality of regional myocardial wall motion have been reported frequently for SAH. We report a case of an out-of-hospital cardiac arrest survivor with high suspicion of ST-segment elevation myocardial infarction based on the electrocardiogram and bedside echocardiography, who had normal coronary arteries on emergent coronary angiography...
December 2015: Clin Exp Emerg Med
Pilar Anton-Martin, Bruno Braga, Stephen Megison, Janna Journeycake, Jessica Moreland
Severe trauma may cause refractory life-threatening respiratory failure requiring extracorporeal membrane oxygenation (ECMO). Concurrent traumatic brain injury, however, complicates the use of ECMO because of the major risk of intracranial bleeding with systemic anticoagulation. Craniotomy and/or craniectomy for hematoma evacuation during ECMO are extremely high-risk procedures secondary to ongoing anticoagulation, and there are only a few such case reports in the literature.We present the case of a child with multiple thoracic injuries and life-threatening respiratory failure supported on ECMO...
October 4, 2016: Pediatric Emergency Care
Najate Achamrah, Pierre Déchelotte, Moïse Coëffier
PURPOSE OF REVIEW: Glutamine is the most abundant amino acid in plasma and plays a key role in maintaining the integrity of intestinal barrier. RECENT FINDINGS: Experimental studies showed that glutamine is able to modulate intestinal permeability and tight junction protein expression in several conditions. Recent articles underlined its putative beneficial role in gastrointestinal disorders such as irritable bowel syndrome. SUMMARY: Glutamine is a major nutrient to maintain intestinal barrier function in animals and humans...
October 5, 2016: Current Opinion in Clinical Nutrition and Metabolic Care
Jianlei Zheng, Jingyang Lin, Naiji Shen, Baiming Qu
BACKGROUND: It is well known that cardiologists empirically judge the culprit lesion of acute ST-segment elevation myocardial infarction (STEMI) according to the corresponding electrocardiographic leads. However, In addition to the obstruction of left anterior descending (LAD) coronary artery, rare cases with the occlusion of proximal right coronary artery (RCA) and/or isolated right ventricular (RV) branch showed the ST-segment elevation in precordial leads V1-V3 as well. CASE SUMMARY: We reported a patient complaining of acute chest pain and suffering ventricular fibrillation (VF) on admission...
October 2016: Medicine (Baltimore)
Lori A Stolz, Uwe Stolz, J Matthew Fields, Turandot Saul, Michael Secko, Matthew J Flannigan, Johnathan M Sheele, Robert P Rifenburg, Anthony J Weekes, Elaine B Josephson, John Bedolla, Dana M Resop, Jonathan Dela Cruz, Megan Boysen-Osborn, Terrell Caffery, Charlotte Derr, Rimon Bengiamin, Gerardo Chiricolo, Brandon Backlund, Jagdipak Heer, Robert J Hyde, Srikar Adhikari
OBJECTIVES: Emergency ultrasound (EUS) has been recognized as integral to the training and practice of emergency medicine (EM). The Council of Emergency Medicine Residency-Academy of Emergency Ultrasound (CORD-AEUS) consensus document provides guidelines for resident assessment and progression. The Accredited Council for Graduate Medical Education (ACGME) has adopted the EM Milestones for assessment of residents' progress during their residency training which includes demonstration of procedural competency in bedside ultrasound...
October 14, 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Danielle Cotter, Michael J Turner, Fionnuala M McAuliffe, Mary F Higgins
OBJECTIVE: To study the educational value to medical students of a labour ward rotation. DESIGN: Qualitative research study was performed in two tertiary level obstetric hospitals attached to a large medical school in Dublin. Medical students attending a six-week rotation in Obstetrics and Gynaecology in University College Dublin were invited to participate. As part of this rotation, students spend one week as part of the clinical team working on the labour ward...
September 21, 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Mesut Mutluoglu, Gunalp Uzun, Michael Bennett, Peter Germonpré, David Smart, Daniel Mathieu
Diabetic foot ulcers (DFUs) are one of the most common indications for hyperbaric oxygen treatment (HBOT). The role of HBOT in DFUs is often debated. Recent evidence based guidelines, while recommending its use, urge further studies to identify the patient subgroups most likely to benefit from HBOT. A recent study in Diabetes Care aimed to assess the efficacy of HBOT in reducing the need for major amputation and improving wound healing in patients with chronic DFUs. In this study, patients with Wagner grade 2-4 diabetic foot lesions were randomly assigned to have HBOT (30 sessions/90 min/244 kPa) or sham treatment (30 sessions/90 min/air/125 kPa)...
September 2016: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
Igal Kushnir, Alon Kushnir, Thomas E Serena, Doron Garfinkel
INTRODUCTION: The objective of this pilot study was to evaluate the efficacy and safety of a novel method using an autologous whole blood clot formed with the RedDress Wound Care System (RD1, RedDress Ltd, Israel), a provisional whole blood clot matrix used in the treatment of chronic wounds of various etiologies. METHODS AND MATERIALS: Patients were treated at the bedside with the whole blood clot matrix. Blood was withdrawn from each patient using citrate, mixed with a calcium gluconate/kaolin suspension, and injected into an RD1 clotting tray...
September 2016: Wounds: a Compendium of Clinical Research and Practice
Xiaoping Lin, Zhijun Xu, Pengfei Wang, Yan Xu, Gensheng Zhang
Neurogenic pulmonary edema (NPE) is occasionally observed in patients with traumatic brain injury (TBI); however, this condition is often underappreciated. NPE is frequently misdiagnosed due to its atypical clinical performance, thus delaying appropriate treatment. A comprehensive management protocol of NPE in patients with TBI has yet to be established. The current study reported the case of a 67-year-old man with severe TBI who was transferred to our intensive care unit (ICU). On day 7 after hospitalization, the patient suddenly suffered tachypnea, tachycardia, systemic hypertension and hypoxemia during lumbar cistern drainage...
October 2016: Experimental and Therapeutic Medicine
T Rajendra Kumar
Gonadotropins play fundamental roles in reproduction. More than 30years ago, Cga transgenic mice were generated, and more than 20years ago, the phenotypes of Cga null mice were reported. Since then, numerous mouse strains have been generated and characterized to address several questions in reproductive biology involving gonadotropin synthesis, secretion, and action. More recently, extragonadal expression, and in some cases, functions of gonadotropins in nongonadal tissues have been identified. Several genomic and proteomic approaches including novel mouse genome editing tools are available now...
2016: Progress in Molecular Biology and Translational Science
Aaron Heller, John Dollerschell, Joshua Burk, Hailey Haines, Jonathan Kozinn
BACKGROUND: In the past decade, the rate and utilization of veno-venous extracorporeal membrane oxygenation (VV-ECMO) has increased dramatically. A single catheter technique has recently come into favour for providing VV-ECMO. Although it has been shown that intensivists can safely place these catheters, the safety of decannulation by intensivists has not been reported. OBJECTIVE: We describe a technique for safely decannulating the Avalon Elite VV-ECMO catheter at the bedside and assess the safety of this technique, as compared with the standard technique of decannulation in the operating room by a surgeon...
September 30, 2016: Anaesthesiology Intensive Therapy
Debra E Weese-Mayer, Casey M Rand, Amy Zhou, Michael S Carroll, Carl E Hunt
The "bedside-to-bench" CCHS research journey has led to increased phenotypic-genotypic knowledge regarding autonomic nervous system (ANS) regulation, and improved clinical outcomes. CCHS is a neurocristopathy characterized by hypoventilation and ANS dysregulation. Initially described in 1970, timely diagnosis and treatment remained problematic until the first large cohort report (1992), delineating clinical presentation and treatment options. A central role of ANS dysregulation (2001) emerged, precipitating evaluation of genes critical to ANS development, and subsequent 2003 identification of PHOX2B as the disease-defining gene for CCHS...
September 27, 2016: Pediatric Research
Allison Marrero, Scott Lawrence, Deborah Wilsker, Andrea Regier Voth, Robert J Kinders
Multiplex pharmacodynamic (PD) assays have the potential to increase sensitivity of biomarker-based reporting for new targeted agents, as well as revealing significantly more information about target and pathway activation than single-biomarker PD assays. Stringent methodology is required to ensure reliable and reproducible results. Common to all PD assays is the importance of reagent validation, assay and instrument calibration, and the determination of suitable response calibrators; however, multiplex assays, particularly those performed on paraffin specimens from tissue blocks, bring format-specific challenges adding a layer of complexity to assay development...
August 2016: Seminars in Oncology
Anoop Kuttikat, Maliha Shaikh, Amin Oomatia, Richard Parker, Nicholas Shenker
OBJECTIVES: Delays in diagnosis occur with Complex Regional Pain Syndrome (CRPS). We define and prospectively demonstrate that novel bedside tests measuring body perception disruption can identify patients with CRPS post-fracture. METHODS: The objectives of our study were to define and validate four bedside tests; to identify the prevalence of positive tests in patients with CRPS and other chronic pain conditions and to assess the clinical utility (Sensitivity; Specificity; Positive Predictive value; Negative Predictive Value) for identifying CRPS within a Fracture cohort...
September 21, 2016: Clinical Journal of Pain
John Grimshaw, Daniel Hatch, Melissa Willard, Sam Abraham
Concerns about patient bedside change-of-shift reporting at a community hospital in northern Indiana stimulated the development of this qualitative phenomenological study. A review of the literature revealed a research deficit in acute care nurses' perceptions of bedside reporting in relation to compliance. The research question addressed in this study was, "What are acute care nurses' perceptions of the change-of-shift report at the patients' bedside?" Personal interviews were conducted on 7 medical, surgical, and intensive care unit nurse participants at a community hospital in northern Indiana...
September 21, 2016: Health Care Manager
M Durila, J Schützner, T Vymazal
UNLABELLED: Warfarin overdose with unmeasurable values of the prothrombin time (PT-INR) is a significant problem in the preoperative preparation of the patient for acute invasive surgery. In contrast to conventional blood clotting assays, rotational thromboelastometry (ROTEM) evaluates the coagulation profile of the whole blood and provides a more complex view of the coagulation status of the patient. Thromboelastometry results are available within about 10 minutes and help us to provide targeted "bedside" therapy of coagulopathy in a bleeding patient...
2016: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
Katie Adams, Shyam A Sheth, Andrew J Meyr
INTRODUCTION AND OBJECTIVES: The gold standard for the diagnosis of lower extremity deep vein thrombosis (DVT) is reported to be venous duplex ultrasound (VDU) because it is noninvasive, sensitive, relatively inexpensive, and can be performed at a patients bedside. The objective of this investigation was to measure agreement in the interpretation of VDU between multiple medical specialties. METHODS: Agreement among different physicians who typically interpret VDU images were examined...
September 2016: Journal of the American Podiatric Medical Association
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