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Physician's assistant

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https://www.readbyqxmd.com/read/28106747/design-of-wearable-breathing-sound-monitoring-system-for-real-time-wheeze-detection
#1
Shih-Hong Li, Bor-Shing Lin, Chen-Han Tsai, Cheng-Ta Yang, Bor-Shyh Lin
In the clinic, the wheezing sound is usually considered as an indicator symptom to reflect the degree of airway obstruction. The auscultation approach is the most common way to diagnose wheezing sounds, but it subjectively depends on the experience of the physician. Several previous studies attempted to extract the features of breathing sounds to detect wheezing sounds automatically. However, there is still a lack of suitable monitoring systems for real-time wheeze detection in daily life. In this study, a wearable and wireless breathing sound monitoring system for real-time wheeze detection was proposed...
January 17, 2017: Sensors
https://www.readbyqxmd.com/read/28106637/educating-nurses-in-the-united-states-about-pressure-injuries
#2
Elizabeth A Ayello, Karen Zulkowski, Elizabeth Capezuti, Wendy Harris Jicman, R Gary Sibbald
GENERAL PURPOSE: To provide information about the current state of educating nurses about wound care and pressure injuries with recommendations for the future. TARGET AUDIENCE: This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care. LEARNING OBJECTIVES/OUTCOMES: After participating in this educational activity, the participant should be better able to:1...
February 2017: Advances in Skin & Wound Care
https://www.readbyqxmd.com/read/28105767/investigations-and-referral-for-suspected-cancer-in-primary-care-in-new-zealand-a-survey-linked-to-the-international-cancer-benchmarking-partnership
#3
H W Htun, J M Elwood, S J Ioannides, T Fishman, R Lawrenson
A national internet-based survey of New Zealand (NZ) primary care physicians (n = 192) used the survey instrument developed by the International Cancer Benchmarking Partnership (ICBP). Practitioners were recruited by a range of methods assisted by NZ general practice networks and contacts. Compared to 11 other ICBP jurisdictions, direct access to diagnostic tests was more limited and took more time than in most other areas; the average wait for a test to be done and reported was 3.0 weeks for X-rays and 8...
January 20, 2017: European Journal of Cancer Care
https://www.readbyqxmd.com/read/28105542/hospice-in-heart-failure-why-when-and-what-then
#4
Jeffrey L Spiess
Hospice is a model of care for patients nearing the end of their lives that emphasizes symptom management, quality of life (QOL), and support of the patient and caregiving family through the death of the patient and the family's bereavement. It is associated with high patient and caregiver satisfaction and appears to not shorten lifespan for appropriately referred patients. Patients with advanced heart failure are being referred to hospice care more often than in the past, but the majority of deaths occur without this benefit...
January 20, 2017: Heart Failure Reviews
https://www.readbyqxmd.com/read/28104730/the-effect-of-family-presence-on-rounding-duration-in-the-picu
#5
Priya R Gupta, R Serene Perkins, Rebecca L Hascall, Carolyn F Shelak, Shaban Demirel, Mark T Buchholz
BACKGROUND AND OBJECTIVE: The incorporation of family-centered rounds has become standard in PICUs across the United States. We compared rounding times in our institution, with and without family members present, to determine the effect on total rounding time and work flow. METHODS: This observational study of a convenience sample was conducted over a 17-month period (May 2014-October 2015), accounting for typical seasonal variation in the PICU. The individual patient rounding times for 2657 encounters were recorded...
January 19, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28102968/thoracic-ultrasound-recognition-of-competence-a-position-paper-of-the-thoracic-society-of-australia-and-new-zealand
#6
Jonathan P Williamson, Scott H Twaddell, Y C Gary Lee, Matthew Salamonsen, Mark Hew, David Fielding, Phan Nguyen, Daniel Steinfort, Peter Hopkins, Nicola Smith, Christopher Grainge
The ability to perform bedside thoracic ultrasound is increasingly recognized as an essential skill for thoracic clinicians, extending the clinical examination and aiding diagnostic and therapeutic procedures. Thoracic ultrasound reduces complications and increases success rates when used prior to thoracentesis or intercostal chest tube insertion. It is increasingly difficult to defend performing these procedures without real or near-real time image guidance. To assist thoracic physicians and others achieve and demonstrate thoracic ultrasound competence, the Interventional Pulmonology Special Interest Group (IP-SIG) of the Thoracic Society of Australia and New Zealand (TSANZ) has developed a new pathway with four components: (i) completion of an approved thoracic ultrasound theory and hands-on teaching course...
February 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/28102479/peripherally-inserted-central-catheter-related-bloodstream-infection-caused-by-kocuria-marina-in-an-elderly-man
#7
Nobuaki Mori, Yuichi Nishihara, Hideki Tayama, Akiko Higuchi, Yasuko Aoki
BACKGROUND: Kocuria species are Gram-positive, aerobic cocci, and members of the Micrcoccaceae family that are known to be opportunistic pathogens. Although there have been sporadic reports of infections caused by Kocuria species, little is known regarding their human pathogenicity and clinical characteristics. CASE REPORT: We herein report a case of a peripherally inserted central catheter (PICC)-related bloodstream infection caused by Kocuria marina in a 90-year-old Japanese with multiple cancer...
January 19, 2017: Infection
https://www.readbyqxmd.com/read/28102443/-new-options-for-the-practice-update-s1-s2-guidelines-on-rheumatoid-arthritis
#8
REVIEW
M Schneider
Guidelines are important tools for evidence-based pharmacological treatment of patients suffering from rheumatoid arthritis. Recommendations assist physicians in identifying the best form of treatment but ultimately, the final decision is based on joint participation by the patient and physician. Nowadays, general concepts, such as treat to target seem to be more important in rheumatoid arthritis than differencies between various drugs or drug classes. The universal recommendation to use methotrexate as the initial disease-modifying antirheumatic drug (DMARD) is driven more by economic reasons than by scientific data, which is not completely wrong but should be disclosed...
January 19, 2017: Zeitschrift Für Rheumatologie
https://www.readbyqxmd.com/read/28099788/deploying-and-measuring-a-risk-and-patient-safety-program
#9
Howard Orel, Molly McGroarty, Heather Marchegiani
Health care continues to evolve at a rapid rate. Over just the past decade, the industry has seen the introduction and widespread implementation of an electronic health record, increase in presence of nurse practitioners and physician assistants to help manage the shortage of physicians, and the introduction of accountable care organizations. It is with these changes that new challenges and opportunities emerge. One such challenge is the increase in the severity of medical malpractice claims throughout the nation...
January 2017: Journal of Healthcare Risk Management: the Journal of the American Society for Healthcare Risk Management
https://www.readbyqxmd.com/read/28098632/palliative-care-in-the-icu-and-the-role-for-physician-assisted-dying-or-lack-thereof
#10
J Randall Curtis, Mark R Tonelli
No abstract text is available yet for this article.
February 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28098622/physician-assisted-suicide-and-euthanasia-in-the-icu-a-dialogue-on-core-ethical-issues
#11
Ewan C Goligher, E Wesley Ely, Daniel P Sulmasy, Jan Bakker, John Raphael, Angelo E Volandes, Bhavesh M Patel, Kate Payne, Annmarie Hosie, Larry Churchill, Douglas B White, James Downar
OBJECTIVE: Many patients are admitted to the ICU at or near the end of their lives. Consequently, the increasingly common debate regarding physician-assisted suicide and euthanasia holds implications for the practice of critical care medicine. The objective of this article is to explore core ethical issues related to physician-assisted suicide and euthanasia from the perspective of healthcare professionals and ethicists on both sides of the debate. SYNTHESIS: We identified four issues highlighting the key areas of ethical tension central to evaluating physician-assisted suicide and euthanasia in medical practice: 1) the benefit or harm of death itself, 2) the relationship between physician-assisted suicide and euthanasia and withholding or withdrawing life support, 3) the morality of a physician deliberately causing death, and 4) the management of conscientious objection related to physician-assisted suicide and euthanasia in the critical care setting...
February 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28098133/-the-need-of-a-new-integral-approach-to-the-care-of-patient-with-severe-mental-disorder-thirty-years-after-the-psychiatric-reform
#12
Agustín Madoz-Gúrpide, Juan Carlos Ballesteros Martín, Mónica Leira Sanmartín, Ernesto García Yagüe
More than thirty years have passed since the beginning of the psychiatric reform, a period of intense and relevant social, scientific and cultural changes which have directly impacted on mental disorders and their management. Improvement in psychopharmacological treatment, a new model of physician-patient relationship, patient´s empowerment as a key issue and the fight against social stigma related to mental health disorders, changes in clinical governance and health policy, the assistential burden derived from the treatment of less severe pathology in mental health community centers, improvements in teamwork and coordination with other resources involved… are some of the relevant changes which determine the scene of community-based mental health assistance...
January 18, 2017: Revista Española de Salud Pública
https://www.readbyqxmd.com/read/28097934/automatic-and-quantitative-measurement-of-laryngeal-video-stroboscopic-images
#13
Chung-Feng Jeffrey Kuo, Joseph Kuo, Shang-Wun Hsiao, Chi-Lung Lee, Jih-Chin Lee, Bo-Han Ke
The laryngeal video stroboscope is an important instrument for physicians to analyze abnormalities and diseases in the glottal area. Stroboscope has been widely used around the world. However, without quantized indices, physicians can only make subjective judgment on glottal images. We designed a new laser projection marking module and applied it onto the laryngeal video stroboscope to provide scale conversion reference parameters for glottal imaging and to convert the physiological parameters of glottis. Image processing technology was used to segment the important image regions of interest...
January 2017: Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine
https://www.readbyqxmd.com/read/28097444/obstetric-outcome-of-vanishing-twins-syndrome-a-systematic-review-and-meta-analysis
#14
REVIEW
Ling Sun, Ling X Jiang, Heng Z Chen
PURPOSE: Due to the high number of multiple embryo transfers into the uterus performed in assisted reproductive technology treatment (ART), the incidences of twin pregnancy and of vanishing twin syndrome (VTS) are correspondingly high. A number of studies have described the obstetric outcomes of the remaining fetus produced after the other twin had vanished compared with a singleton at the start following ART, but the results are mixed and contradictory. We performed a systematic review of the existing studies to explore the actual obstetric outcome of VTS to allow physicians to adequately advise their patients...
January 17, 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/28097305/enhanced-recovery-after-surgery-a-review
#15
Olle Ljungqvist, Michael Scott, Kenneth C Fearon
Importance: Enhanced Recovery After Surgery (ERAS) is a paradigm shift in perioperative care, resulting in substantial improvements in clinical outcomes and cost savings. Observations: Enhanced Recovery After Surgery is a multimodal, multidisciplinary approach to the care of the surgical patient. Enhanced Recovery After Surgery process implementation involves a team consisting of surgeons, anesthetists, an ERAS coordinator (often a nurse or a physician assistant), and staff from units that care for the surgical patient...
January 11, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28096482/chronic-disease-management-interventions-for-people-with-chronic-kidney-disease-in-primary-care-a-systematic-review-and-meta-analysis
#16
Lauren Galbraith, Casey Jacobs, Brenda R Hemmelgarn, Maoliosa Donald, Braden Manns, Min Jun
BACKGROUND: Primary care providers manage the majority of patients with chronic kidney disease (CKD), although the most effective chronic disease management (CDM) strategies for these patients are unknown. We assessed the efficacy of CDM interventions used by primary care providers managing patients with CKD. METHODS: MEDLINE, EMBASE and CENTRAL were systematically searched (inception to November 2014) for randomized controlled trials (RCTs) assessing education-based and computer-assisted CDM interventions targeting primary care providers managing patients with CKD in the community...
January 16, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28096006/immunizations-challenge-healthcare-personnel-and-affects-immunization-rates
#17
Pamela K Strohfus, Susan C Kim, Sara Palma, Russell A Duke, Richard Remington, Caleb Roberts
PURPOSE: This study measured 1. medical office immunization rates and 2. health care personnel competency in managing vaccine practices before and after evidence-based immunization education was provided. METHOD: This descriptive study compared 32 family medicine and pediatric offices and 178 medical assistants, licensed practical nurses, registered nurses, nurse practitioners, and physicians in knowledge-based testing pre-education, post-education, and 12-months post-education...
February 2017: Applied Nursing Research: ANR
https://www.readbyqxmd.com/read/28095566/prospective-evaluation-of-the-safety-and-efficacy-of-a-1060-nm-large-spot-size-vacuum-assisted-hair-removal-diode-laser-system-in-asian-pacific-fitzpatrick-s-skin-types-iv-v-patients
#18
Sushil T Tahiliani, Harsh S Tahiliani
Laser-based photoepilation of dark skin types demands a delicate combination of appropriate light wavelengths and spot size to achieve optimal epidermal-to-follicular energy absorption ratios. This prospective study assessed the axillary, arm, thigh, and back hair clearing ef cacy of the LightSheer In nity 1060 nm diode laser in 10 Fitzpatrick skin type IV-V patients. Each area was treated up to ve times, at 4-6-week intervals, after which immediate skin responses and adverse events were recorded. Hair count, color and coarseness were assessed before each treatment session, as well as 1, 3, and 6 months following the last session...
November 1, 2016: Journal of Drugs in Dermatology: JDD
https://www.readbyqxmd.com/read/28095555/megasessions-for-robotic-hair-restoration
#19
Joa O Carlos Pereira, Joa O Carlos Pereira Filho, Joa O Pedro Cabrera Pereira
A robotic system can select and remove individual hair follicles from the donor area with great precision and without fatigue. This report describes the use of the robotic system in a megasession for hair restoration. Patients were instructed to cut their hair to 1.0 to 1.2 mm before surgery. The robot selected and removed 600 to 800 grafts per hour so the follicular units (FU)s could be transplanted manually to recipient sites. The robot arm consists of a sharp inner punch and a blunt outer punch which together separate FUs from the sur- rounding tissue...
November 1, 2016: Journal of Drugs in Dermatology: JDD
https://www.readbyqxmd.com/read/28095550/the-diagnostic-role-of-optical-coherence-tomography-oct-in-measuring-the-depth-of-burn-and-traumatic-scars-for-more-accurate-laser-dosimetry-pilot-study
#20
Jill S Waibel, Ashley C Rudnick, Adam J Wulkan, Jon D Holmes
BACKGROUND: In recent decades, a number of optimal diagnostic technologies have emerged to assist in tissue visualization. Real-time monitoring of skin during laser therapies will help optimize laser parameters for more ef cient therapies. One of these technologies, optimal coherence tomography (OCT), may be used to help visualize burn and traumatic scars. When lasing severe scars, lasers have tunable pulse energies, which are made proportional to the scar thickness as estimated by palpation and the physician eye...
November 1, 2016: Journal of Drugs in Dermatology: JDD
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