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https://www.readbyqxmd.com/read/28229398/stroke-chameleons-and-stroke-mimics-in-the-emergency-department
#1
REVIEW
Ava L Liberman, Shyam Prabhakaran
PURPOSE OF REVIEW: We discuss the frequency of stroke misdiagnosis in the emergency department (ED), identify common diagnostic pitfalls, describe strategies to reduce diagnostic error, and detail ongoing research. RECENT FINDINGS: The National Academy of Medicine has re-defined and highlighted the importance of diagnostic errors for patient safety. Recent rates of stroke under-diagnosis (false-negative cases, "stroke chameleons") range from 2-26% and 30-43% for stroke over-diagnosis (false-positive cases, "stroke mimics")...
February 2017: Current Neurology and Neuroscience Reports
https://www.readbyqxmd.com/read/28225698/reasonableness-credibility-and-clinical-disagreement
#2
Mary Jean Walker, Wendy A Rogers
Evidence in medicine can come from more or less trustworthy sources and be produced by more or less reliable methods, and its interpretation can be disputed. As such, it can be unclear when disagreements in medicine result from different, but reasonable, interpretations of the available evidence and when they result from unreasonable refusals to consider legitimate evidence. In this article, we seek to show how assessments of the relevance and implications of evidence are typically affected by factors beyond that evidence itself, such as our beliefs about the credibility of the speaker or source of the evidence...
February 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/28225541/perceived-barriers-to-adherence-to-tuberculosis-infection-control-measures-among-health-care-workers-in-the-dominican-republic
#3
Helena J Chapman, Bienvenido A Veras-Estévez, Jamie L Pomeranz, Eddy N Pérez-Then, Belkys Marcelino, Michael Lauzardo
INTRODUCTION Health care workers have an increased risk of infection due to occupational Mycobacterium tuberculosis exposure, including multidrug-resistant strains. Health care workers' risk of developing tuberculosis is greater than that of the general population, whether in low-, intermediate- or high-incidence countries. Adherence to infection control measures (administrative controls, environmental controls, and personal respiratory protection) is essential to reduce risk of disease transmission between suspected tuberculosis patients and health care workers, but for different reasons, both objective and subjective, adherence is low...
January 2017: MEDICC Review
https://www.readbyqxmd.com/read/28214568/training-health-professionals-to-deliver-healthy-living-medicine
#4
REVIEW
Marie-France Hivert, Amy McNeil, Carl J Lavie, Ross Arena
The growing incidence and prevalence of unhealthy living behaviors leading to compromised health, along with unhealthy supportive environments, are the primary reasons for the current chronic disease crisis in almost all countries. Over the course of health professions training across disciplines, a large amount about information regarding various aspects of chronic disease is introduced, from pathophysiology to a broad array of approaches to examinations (focused on diagnosis and prognosis) and interventions...
February 15, 2017: Progress in Cardiovascular Diseases
https://www.readbyqxmd.com/read/28212175/advances-in-epilepsy-gene-discovery-and-implications-for-epilepsy-diagnosis-and-treatment
#5
Joseph D Symonds, Sameer M Zuberi, Michael R Johnson
PURPOSE OF REVIEW: Epilepsy genetics is shifting from the academic pursuit of gene discovery to a clinical discipline based on molecular diagnosis and stratified medicine. We consider the latest developments in epilepsy genetics and review how gene discovery in epilepsy is influencing the clinical classification of epilepsy and informing new therapeutic approaches and drug discovery. RECENT FINDINGS: Recent studies highlighting the importance of mutation in GABA receptors, NMDA receptors, potassium channels, G-protein coupled receptors, mammalian target of rapamycin pathway and chromatin remodeling are discussed...
February 15, 2017: Current Opinion in Neurology
https://www.readbyqxmd.com/read/28202622/the-hypertension-pandemic-an-evolutionary-perspective
#6
REVIEW
Bernard C Rossier, Murielle Bochud, Olivier Devuyst
Hypertension affects over 1.2 billion individuals worldwide and has become the most critical and expensive public health problem. Hypertension is a multifactorial disease involving environmental and genetic factors together with risk-conferring behaviors. The cause of the disease is identified in ∼10% of the cases (secondary hypertension), but in 90% of the cases no etiology is found (primary or essential hypertension). For this reason, a better understanding of the mechanisms controlling blood pressure in normal and hypertensive patients is the aim of very active experimental and clinical research...
March 2017: Physiology
https://www.readbyqxmd.com/read/28202076/developing-quality-indicators-for-physician-staffed-emergency-medical-services-a-consensus-process
#7
Helge Haugland, Marius Rehn, Pål Klepstad, Andreas Krüger
BACKGROUND: There is increasing interest for quality measurement in health care services; pre-hospital emergency medical services (EMS) included. However, attempts of measuring the quality of physician-staffed EMS (P-EMS) are scarce. The aim of this study was to develop a set of quality indicators for international P-EMS to allow quality improvement initiatives. METHODS: A four-step modified nominal group technique process (expert panel method) was used. RESULTS: The expert panel reached consensus on 26 quality indicators for P-EMS...
February 15, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28201852/the-probability-of-probability-and-research-truths
#8
Daniel M Fatovich, Michael Phillips
The foundation of much medical research rests on the statistical significance of the P-value, but we have fallen prey to the seductive certainty of significance. Other scientific disciplines work to a different standard. This may partly explain why medical reversal is an increasing phenomenon, whereby new studies (based on the 0.05 standard) overturn previous significant findings. This has generated a crisis in the rigour of evidence-based medicine, as many people erroneously believe that a P < 0.05 means the treatment effect is clinically important...
February 15, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28198728/personalized-medicine-in-interstitial-lung-diseases
#9
Paolo Spagnolo, Justin M Oldham, Mark G Jones, Joyce S Lee
PURPOSE OF REVIEW: A number of recent studies have explored the possibility to apply personalized medicine to interstitial lung diseases (ILDs), particularly idiopathic pulmonary fibrosis (IPF), the most common and deadly of the idiopathic interstitial pneumonias. In our review, we summarize and discuss the most recent literature on personalized medicine in IPF as well as hypersensitivity pneumonitis and sarcoidosis, with emphasis on patient subgroups for which a personalized approach to disease prognostication and management may become a reality in the near future...
February 13, 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28194689/exploring-physician-perspectives-of-residency-holdover-handoffs-a-qualitative-study-to-understand-an-increasingly-important-type-of-handoff
#10
Jonathan A Duong, Trevor P Jensen, Sasha Morduchowicz, Michelle Mourad, James D Harrison, Sumant R Ranji
BACKGROUND: The term "holdover admissions" refers to patients admitted by an overnight physician and whose care is then transferred to a new primary team the next morning. Descriptions of the holdover process in internal medicine are sparse. OBJECTIVE: To identify important factors affecting the quality of holdover handoffs at an internal medicine (IM) residency program and to compare them to previously identified factors for other handoffs. DESIGN: We undertook a qualitative study using structured focus groups and interviews...
February 13, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28188946/integration-of-cognitive-skills-as-a-cross-cutting-theme-into-the-undergraduate-medical-curriculum-at-tehran-university-of-medical-sciences
#11
Akbar Soltani, Maryam Allaa, Hamideh Moosapour, Azadeh Aletaha, Farzaneh Shahrtash, Alireza Monajemi, Tohid Arastoo, Maryam Ahmadinejad, Azim Mirzazadeh, Mahboobeh Khabaz Mafinejad
Nowadays, improvement of thinking skills of students is one of the universally supported aims in the majority of medical schools. This study aims to design longitudinal theme of reasoning, problem-solving and decision-making into the undergraduate medical curriculum at Tehran University of Medical Sciences (TUMS). A participatory approach was applied to design the curriculum during 2009-2011. The project was conducted by the contribution of representatives of both basic and clinical faculty members, students and graduates at Tehran University of Medical Sciences...
January 2017: Acta Medica Iranica
https://www.readbyqxmd.com/read/28185306/antimicrobial-use-guidelines-for-treatment-of-respiratory-tract-disease-in-dogs-and-cats-antimicrobial-guidelines-working-group-of-the-international-society-for-companion-animal-infectious-diseases
#12
M R Lappin, J Blondeau, D Booth, E B Breitschwerdt, L Guardabassi, D H Lloyd, M G Papich, S C Rankin, J E Sykes, J Turnidge, J S Weese
Respiratory tract disease can be associated with primary or secondary bacterial infections in dogs and cats and is a common reason for use and potential misuse, improper use, and overuse of antimicrobials. There is a lack of comprehensive treatment guidelines such as those that are available for human medicine. Accordingly, the International Society for Companion Animal Infectious Diseases convened a Working Group of clinical microbiologists, pharmacologists, and internists to share experiences, examine scientific data, review clinical trials, and develop these guidelines to assist veterinarians in making antimicrobial treatment choices for use in the management of bacterial respiratory diseases in dogs and cats...
February 10, 2017: Journal of Veterinary Internal Medicine
https://www.readbyqxmd.com/read/28184087/learning-to-look-from-different-perspectives-what-can-dental-undergraduates-learn-from-an-arts-and-humanities-based-teaching-approach
#13
F Smyth Zahra, K Dunton
By its nature, clinical teaching involves supporting small groups of dental students at the chairside as they treat their own patients. Scaffolding their learning in this way enables observation at close quarters of the various stages of development from early novice, just commencing clinical treatment of patients, to those approaching qualification. The students' main concerns throughout are not primarily with the technical skills required, which they have already been taught in the clinical skills laboratories, but dealing with the complex realities and ambiguities of clinical practice; the 'hidden curriculum' of decision making, judgement calls, issues of communication and what it actually means to be professional...
February 10, 2017: British Dental Journal
https://www.readbyqxmd.com/read/28179431/repeated-cell-therapy-a-paradigm-shift-whose-time-has-come
#14
Roberto Bolli
Although treatment with stem/progenitor cells is a promising approach to heart disease, enthusiasm for cell therapy has been dampened by the inconsistent, modest, borderline, or undetectable benefits reported in clinical trials (all of which have used one dose of cells). As a result, clinical translation has not occurred (no cell-based therapy is close to being approved for heart disease), and a rising tide of skepticism has bedeviled the field,leading some critics even to question whether clinical studies should continue...
February 8, 2017: Circulation Research
https://www.readbyqxmd.com/read/28179418/assessing-the-potential-clinical-impact-of-reciprocal-drug-approval-legislation-on-access-to-novel-therapeutics-in-the-usa-a-cohort-study
#15
Matthieu Larochelle, Nicholas S Downing, Joseph S Ross, Frank S David
OBJECTIVE: To quantify the potential effect of reciprocal approval legislation on access to clinically impactful therapeutics in the USA. DESIGN: A cohort study. SETTING: New therapeutics approved by the Food and Drug Administration (FDA), European Medicines Agency (EMA) and/or Health Canada between 2000 and 2010. MAIN OUTCOME MEASURES: Characteristics of new therapeutics approved by the EMA and/or Health Canada before the FDA, including mechanistic novelty, likely clinical impact, size of the affected population and FDA review outcome...
February 8, 2017: BMJ Open
https://www.readbyqxmd.com/read/28176890/contextualizing-the-relevance-of-basic-sciences-small-group-simulation-with-debrief-for-first-and-second-year-medical-students-in-an-integrated-curriculum
#16
Samara B Ginzburg, Judith Brenner, Michael Cassara, Thomas Kwiatkowski, Joanne M Willey
AIM: There has been a call for increased integration of basic and clinical sciences during preclinical years of undergraduate medical education. Despite the recognition that clinical simulation is an effective pedagogical tool, little has been reported on its use to demonstrate the relevance of basic science principles to the practice of clinical medicine. We hypothesized that simulation with an integrated science and clinical debrief used with early learners would illustrate the importance of basic science principles in clinical diagnosis and management of patients...
2017: Advances in Medical Education and Practice
https://www.readbyqxmd.com/read/28173862/pre-travel-malaria-chemoprophylaxis-counselling-in-a-public-travel-medicine-clinic-in-s%C3%A3-o-paulo-brazil
#17
Tânia do Socorro Souza Chaves, Wuelton Marcelo Monteiro, Jessé Reis Alves, Marcus Lacerda, Marta Heloisa Lopes
BACKGROUND: Malaria is one of the most prevalent parasitic diseases in the world and represents a threat to travellers visiting endemic areas. Chemoprophylaxis is the prevention measure used in travel medicine, avoiding clinical manifestations and protecting against the development of severe disease and death. METHODS: Retrospective and descriptive analysis of malaria prevention data in travellers was recorded from a travel medicine clinic in São Paulo, Brazil, between January 2006 and December 2010...
February 7, 2017: Malaria Journal
https://www.readbyqxmd.com/read/28173850/new-horizons-in-treatment-of-osteoporosis
#18
REVIEW
Ozra Tabatabaei-Malazy, Pooneh Salari, Patricia Khashayar, Bagher Larijani
BACKGROUND: Prevalence of osteoporosis is increasing both in developed and developing countries. Due to rapid growth in the burden and cost of osteoporosis, worldwide, it seems reasonable to focus on the reduction of fractures as the main goal of treatment. Although, efficient pharmacological agents are available for the treatment of osteoporosis, there still remains a need to more specific drugs with less adverse effects. MAIN BODY: This review article provides a brief update on the pathogenesis, presenting current pharmacological products approved by the US Food and Drug Administration (FDA) or Europe, and also newer therapeutic agents to treat osteoporosis according to the clinical trial data available at PubMed, UpToDate, International Osteoporosis Foundation (IOF), and clinical practice guidelines...
February 7, 2017: Daru: Journal of Faculty of Pharmacy, Tehran University of Medical Sciences
https://www.readbyqxmd.com/read/28167749/evaluation-of-demands-usage-and-unmet-needs-for-emergency-care-in-yaound%C3%A3-cameroon-a-cross-sectional-study
#19
Young Sun Ro, Sang Do Shin, Joongsik Jeong, Min Jung Kim, Young Hee Jung, Joseph Kamgno, Etoundi Mballa Georges Alain, Bonaventure Hollong
OBJECTIVES: To assess the burden of emergent illnesses and emergency care system usage by Yaoundé residents and to evaluate unmet needs for emergency care and associated barriers. DESIGN: A cross-sectional study using a community-based survey. SETTING: Yaoundé, Cameroon. PARTICIPANTS: All residents living in Yaoundé were selected as the target population to investigate the needs and usage of emergency care in Yaoundé...
February 6, 2017: BMJ Open
https://www.readbyqxmd.com/read/28164789/preliminary-data-on-antibacterial-activity-of-echinacea-purpurea-associated-bacterial-communities-against-burkholderia-cepacia-complex-strains-opportunistic-pathogens-of-cystic-fibrosis-patients
#20
Carolina Chiellini, Isabel Maida, Valentina Maggini, Emanuele Bosi, Stefano Mocali, Giovanni Emiliani, Elena Perrin, Fabio Firenzuoli, Alessio Mengoni, Renato Fani
Burkholderia cepacia complex bacteria (Bcc) represent a serious threat for immune-compromised patient affected by Cystic Fibrosis (CF) since they are resistant to many substances and to most antibiotics. For this reason, the research of new natural compounds able to inhibit the growth of Bcc strains has raised new interest during the last years. A source of such natural compounds is represented by medicinal plants and, in particular, by bacterial communities associated with these plants able to produce molecules with antimicrobial activity...
March 2017: Microbiological Research
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