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Point-of-care systems and emergency medicine

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https://www.readbyqxmd.com/read/27910751/recent-advances-in-pharmacotherapeutic-paradigm-of-mild-to-recalcitrant-atopic-dermatitis
#1
Zahid Hussain, Shariza Sahudin, Hnin Ei Thu, Ahmad Nazrun Shuid, Syed Nasir Abbas Bukhari, Endang Kumolosasi
Atopic dermatitis (AD) is a common, chronic skin inflammatory disorder characterized by perivascular infiltration of immunoglobulin E (IgE), T lymphocytes, and mast cells. The key factors responsible for the pathophysiology of this disease are immunological disorders and defects in epidermal barrier properties. Pruritus, intense itching, psychological stress, deprived physical and mental performance, and sleep disturbance are the hallmark features of this dermatological disorder. Preventive interventions such as educational programs, avoidance of allergens, and exclusive care toward the skin could play a partial role in suppressing the symptoms...
2016: Critical Reviews in Therapeutic Drug Carrier Systems
https://www.readbyqxmd.com/read/27888601/key-issues-in-the-infected-patient-care-in-the-emergency-department
#2
F Chiarella, J González-Del Castillo, F J Candel, E J García-Lamberechts, M J Núñez-Orantos, F J Martín-Sánchez
OBJECTIVE: To develop a set of recommendations, by consensus of Emergency Medicine experts, on key aspects related to the care of adult patients with acute infection attended in Spanish emergency departments (ED). METHODS: The study was divided into three phases: 1) To design a questionnaire by a coordinating group; 2) To conduct a survey in ED physicians in order to know their opinion on the issues raised by the coordinating group; 3) To develop a number of recommendations based on the responses to the questionnaire and their subsequent discussion...
December 2016: Revista Española de Quimioterapia: Publicación Oficial de la Sociedad Española de Quimioterapia
https://www.readbyqxmd.com/read/27864204/integrating-pharmacogenomics-into-electronic-health-records-with-clinical-decision-support
#3
J Kevin Hicks, Henry M Dunnenberger, Karl F Gumpper, Cyrine E Haidar, James M Hoffman
PURPOSE: Existing pharmacogenomic informatics models, key implementation steps, and emerging resources to facilitate the development of pharmacogenomic clinical decision support (CDS) are described. SUMMARY: Pharmacogenomics is an important component of precision medicine. Informatics, especially CDS in the electronic health record (EHR), is a critical tool for the integration of pharmacogenomics into routine patient care. Effective integration of pharmacogenomic CDS into the EHR can address implementation challenges, including the increasing volume of pharmacogenomic clinical knowledge, the enduring nature of pharmacogenomic test results, and the complexity of interpreting results...
December 1, 2016: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/27834818/the-knowledge-awareness-and-practices-of-portuguese-general-practitioners-regarding-multimorbidity-and-its-management-qualitative-perspectives-from-open-ended-questions
#4
Filipe Prazeres, Luiz Santiago
Multimorbidity's high prevalence and negative impact has made it a subject of worldwide interest. The main aim of this study was to access the Portuguese knowledge, awareness, and practices of general practitioners (GPs) regarding multimorbidity and its management, in order to aid in the development of interventions for improving outcomes in multimorbid patients in primary care. A web-based qualitative descriptive study was carried out in the first trimester of 2016 with primary care physicians working in two districts of the Centre region of Portugal...
November 8, 2016: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/27748042/in-situ-simulation-in-emergency-medicine-moving-beyond-the-simulation-lab
#5
Andrew Petrosoniak, Marc Auerbach, Ambrose H Wong, Christopher M Hicks
In situ simulation (ISS), a point of care training strategy that occurs within the patient care environment involving actual healthcare team members, provides additional benefits to centre-based simulation. ISS can serve several roles within emergency medicine (EM): improves provider/team performance, identifies and mitigates threats to patient safety and improves systems and infrastructure. The effective use of ISS fosters inter-professional team training and a culture of safety essential for high performance EM teams and resilient systems...
October 17, 2016: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/27724970/the-pre-hospital-administration-of-tranexamic-acid-to-patients-with-multiple-injuries-and-its-effects-on-rotational-thrombelastometry-a-prospective-observational-study-in-pre-hospital-emergency-medicine
#6
Nils Kunze-Szikszay, Lennart A Krack, Pauline Wildenauer, Saskia Wand, Tim Heyne, Karoline Walliser, Christopher Spering, Martin Bauer, Michael Quintel, Markus Roessler
BACKGROUND: Hyperfibrinolysis (HF) is a major contributor to coagulopathy and mortality in trauma patients. This study investigated (i) the rate of HF during the pre-hospital management of patients with multiple injuries and (ii) the effects of pre-hospital tranexamic acid (TxA) administration on the coagulation system. METHODS: From 27 trauma patients with pre-hospital an estimated injury severity score (ISS) ≥16 points blood was obtained at the scene and on admission to the emergency department (ED)...
October 10, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/27698180/use-of-point-of-care-ultrasound-in-the-emergency-department-insights-from-the-2012-medicare-national-payment-data-set
#7
M Kennedy Hall, Jane Hall, Cary P Gross, Nir J Harish, Rachel Liu, Sean Maroongroge, Christopher L Moore, Christopher C Raio, R Andrew Taylor
OBJECTIVES: Point-of-care ultrasound is a valuable tool with potential to expedite diagnoses and improve patient outcomes in the emergency department. However, little is known about national patterns of adoption. This study examined nationwide point-of-care ultrasound reimbursement among emergency medicine (EM) practitioners and examined regional and practitioner level variations. METHODS: Data from the 2012 Center for Medicare and Medicaid Services Fee-for-Service Provider Utilization and Payment Data include all practitioners who received more than 10 Medicare Part B fee-for-service reimbursements for any Healthcare Common Procedure Coding System code in 2012...
November 2016: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/27697977/emerging-issues-and-opportunities-in-health-information-technology
#8
Elizabeth A Nardi, Lisa Korin Lentz, Katherine Winckworth-Prejsnar, Amy P Abernethy, Robert W Carlson
When used effectively, health information technology (HIT) can transform clinical care and contribute to new research discoveries. Despite advances in HIT and increased electronic health record adoption, many challenges to optimal use, interoperability, and data sharing exist. Data standardization across systems is limited, and scanned medical note documents result in unstructured data that make reporting on quality measures for reimbursement burdensome. Different policies and initiatives, including the Health Information Technology for Economic and Clinical Health Act, the Medicare Access and CHIP Reauthorization Act, and the National Cancer Moonshot initiative, among others, all recognize the impact that HIT can have on cancer care...
October 2016: Journal of the National Comprehensive Cancer Network: JNCCN
https://www.readbyqxmd.com/read/27571334/-anmco-sic-consensus-document-the-heart-failure-network-organization-of-outpatient-care
#9
Nadia Aspromonte, Michele Massimo Gulizia, Andrea Di Lenarda, Andrea Mortara, Ilaria Battistoni, Renata De Maria, Michele Gabriele, Massimo Iacoviello, Alessandro Navazio, Daniela Pini, Giuseppe Di Tano, Marco Marini, Renato Pietro Ricci, Gianfranco Alunni, Donatella Radini, Marco Metra, Francesco Romeo
Changing demographics and an increasing burden of multiple chronic comorbidities in western countries dictate refocusing of heart failure (HF) services from acute in-hospital care to better support the long inter-critical out-of-hospital phases of HF. The needs of the HF population are not adequately addressed by current HF outpatient services, as documented by differences in age, gender, comorbidities and recommended therapies between patients discharged for hospitalized HF and those followed up at HF clinics...
July 2016: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/27570671/towards-evidence-based-precision-medicine-extracting-population-information-from-biomedical-text-using-binary-classifiers-and-syntactic-patterns
#10
Kalpana Raja, Naman Dasot, Pawan Goyal, Siddhartha R Jonnalagadda
Precision Medicine is an emerging approach for prevention and treatment of disease that considers individual variability in genes, environment, and lifestyle for each person. The dissemination of individualized evidence by automatically identifying population information in literature is a key for evidence-based precision medicine at the point-of-care. We propose a hybrid approach using natural language processing techniques to automatically extract the population information from biomedical literature. Our approach first implements a binary classifier to classify sentences with or without population information...
2016: AMIA Summits on Translational Science Proceedings
https://www.readbyqxmd.com/read/27506448/sexual-assault-what-every-emergency-provider-needs-to-know
#11
Rebecca Barron, Elena Kapilevich, Susan Duffy, Alyson J McGregor
No abstract text is available yet for this article.
October 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/27313807/application-of-scoring-systems-with-point-of-care-ultrasonography-for-bedside-diagnosis-of-appendicitis
#12
Erden Erol Ünlüer, Rıfat Urnal, Utku Eser, Serkan Bilgin, Mehmet Hacıyanlı, Orhan Oyar, Haldun Akoğlu, Arif Karagöz
BACKGROUND: Appendicitis is a common disease requiring surgery. Bedside ultrasound (BUS) is a core technique for emergency medicine (EM). The Alvarado score is a well-studied diagnostic tool for appendicitis. This study aimed to investigate the relationship between patients' symptoms, Alvarado score and ultrasound (US) findings, as performed by emergency physicians (EPs) and radiologists, of patients with suspected appendicitis. METHODS: Three EM specialists underwent the BUS course and core course for appendicitis assessment...
2016: World Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27239306/a-quality-improvement-project-to-assess-timing-of-initial-investigations-in-stroke-medicine
#13
Sarah Thompson, Rhian Jones
There are several investigations that can be completed in the acute phase of admission for patients with suspected stroke.These include receiving a CT Head scan and also blood tests specific for stroke. The national guidelines regarding CT Head scans detail they should be completed within 12 hours of admission(1) and the trust guidelines, local to where this quality improvement project was based, advise a CT Head should be completed within four hours of admission.(2) The current national guidelines do not specify exact stroke blood tests, however trust guidelines give a specific set of blood tests that would be appropriate to be taken when a patient presents to A&E with a suspected stroke...
2016: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/27222012/spontaneous-resolving-s1q3t3-in-pulmonary-embolism-a-case-report-and-literature-review-on-prognostic-value-of-electrocardiography-score-for-pulmonary-embolism
#14
Lukasz D Cygan, Moshe Weizberg, Barry Hahn
BACKGROUND: Electrocardiography findings in patients with pulmonary embolism have been investigated since 1935. As medicine has evolved, more effective modalities have surpassed the electrocardiogram in diagnostic utility. Despite the advent of these other modalities, the diagnosis of pulmonary embolism remains elusive and the prognosis is variable amongst each clinical presentation of its pathology. CASE REPORT AND LITERATURE REVIEW: After presenting a case of a resolving S1Q3T3 in subsequent electrocardiogram findings of a patient with pulmonary embolism, this literature review will provide information on a 21-point electrocardiogram scoring system that helps the emergency physician stratify the risk of a patient with an acute presentation of pulmonary embolism...
September 2016: International Emergency Nursing
https://www.readbyqxmd.com/read/27162294/-the-evolution-of-the-emergency-medical-services-system-from-ancient-to-modern-times
#15
Mariusz Goniewicz, Krzysztof Goniewicz
The paper discusses the historical perspective - from ancient to modern times - on the evolution of military medicine and its support during the wars and battles as well as its impact on the development of civilian health care and emergency medical services. Indicated breakthroughs related to conducting military operations and pointed to the visionaries who have developed new paradigms of medical care, including programs designed to assess the health status of patients, treatment in the battlefield, medical transport, anesthesia, surgery and emergency procedures...
2016: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/27161044/assessing-severity-immediacy-and-ideal-setting-in-ed-patients-a-pilot-study-on-interrater-reliability
#16
Michael E McMullen, Jesse M Pines
OBJECTIVES: We conducted a pilot study to test the interrater reliability of emergency department (ED) physician assessments of 3 ED visit attributes-severity, immediacy, and ideal setting, with the long-term goal of developing a novel ED categorization system. METHODS: Using 2010 National Hospital Ambulatory Care Survey data, we randomly selected 300 ED patient records for review by 6 emergency medicine physicians. Each record was assessed by 2 physicians for severity and immediacy using a 7-point scale; "ideal" setting was chosen among 6 possible settings...
July 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27152604/a-regional-approach-to-unmet-needs-in-anaphylaxis
#17
P Minale, D Bignardi, C Troise, S Voltolini, P Dignetti
Allergic diseases are under-diagnosed and undertreated despite their wide prevalence, and particularly anaphylaxis is often under-estimated. Evidence-based anaphylaxis guidelines developed by principal allergy organizations agree on increased prevalence of anaphylaxis, especially in patients younger than 18 years (18-27,30): this trend highlights the need for actions on anaphylaxis management and prevention (3,4). Lack of prompt connection between emergency department and allergy unit after discharge, and of a dedicated ICD-9th identification code (18-26), can delay diagnosis and treatment of anaphylaxis (28,29)...
May 2016: European Annals of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/27121610/development-and-usage-of-wiki-based-software-for-point-of-care-emergency-medical-information
#18
Ross I Donaldson, Daniel G Ostermayer, Rosa Banuelos, Manpreet Singh
OBJECTIVE: To describe the creation and evaluate the usage of the first medical wiki linked to dedicated mobile applications. METHODS: With the support of multiple current and past contributors, we developed an emergency medicine wiki linked to offline mobile applications (WikEM) in 2009. First deployment was at the Harbor-UCLA Medical Center emergency medicine residency program, with the wiki later opened to public use. To evaluate the project, we performed a post hoc analysis of system use and surveyed 8 years of current and past residents...
November 2016: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/26981582/enabling-precision-medicine-with-digital-case-classification-at-the-point-of-care
#19
Patrick Obermeier, Susann Muehlhans, Christian Hoppe, Katharina Karsch, Franziska Tief, Lea Seeber, Xi Chen, Tim Conrad, Sindy Boettcher, Sabine Diedrich, Barbara Rath
Infectious and inflammatory diseases of the central nervous system are difficult to identify early. Case definitions for aseptic meningitis, encephalitis, myelitis, and acute disseminated encephalomyelitis (ADEM) are available, but rarely put to use. The VACC-Tool (Vienna Vaccine Safety Initiative Automated Case Classification-Tool) is a mobile application enabling immediate case ascertainment based on consensus criteria at the point-of-care. The VACC-Tool was validated in a quality management program in collaboration with the Robert-Koch-Institute...
February 2016: EBioMedicine
https://www.readbyqxmd.com/read/26977455/point-of-care-technologies-for-precision-cardiovascular-care-and-clinical-research-national-heart-lung-and-blood-institute-working-group
#20
Kevin King, Luanda P Grazette, Dina N Paltoo, John T McDevitt, Samuel K Sia, Paddy M Barrett, Fred S Apple, Paul A Gurbel, Ralph Weissleder, Hilary Leeds, Erin J Iturriaga, Anupama Rao, Bishow Adhikari, Patrice Desvigne-Nickens, Zorina S Galis, Peter Libby
Point-of-care technologies (POC or POCT) are enabling innovative cardiovascular diagnostics that promise to improve patient care across diverse clinical settings. The National Heart, Lung, and Blood Institute convened a working group to discuss POCT in cardiovascular medicine. The multidisciplinary working group, which included clinicians, scientists, engineers, device manufacturers, regulatory officials, and program staff, reviewed the state of the POCT field; discussed opportunities for POCT to improve cardiovascular care, realize the promise of precision medicine, and advance the clinical research enterprise; and identified barriers facing translation and integration of POCT with existing clinical systems...
January 2016: JACC. Basic to Translational Science
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