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Management in emergency medicine

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https://www.readbyqxmd.com/read/29776627/introduction-molecular-medicine-in-the-common-era-applications-and-impact-of-molecular-pathology-in-health-and-disease
#1
REVIEW
Martin H Bluth
The unprecedented expansion of molecular pathology continues to affect and influence the clinical laboratory. Technological advances in high-throughput automation, cost containment, and refined methodology have improved the understanding of pathobiology through application of molecular pathology to multiple disease spaces. Incorporation of this field to emerging omics platforms, pharmacovigilance and biomarker discovery, and accessibility by lay consumers demonstrates the widespread reach of molecular pathology in the clinical marketplace...
June 2018: Clinics in Laboratory Medicine
https://www.readbyqxmd.com/read/29767451/feline-ureteral-obstructions-part-1-medical-management
#2
REVIEW
D L Clarke
Feline ureteral obstructions are an increasingly recognised and challenging diagnostic and management problem. Many cats with ureteral obstructions are critically ill at the time of diagnosis, especially if there is dysfunction of the contralateral kidney. They may present with varying severities of acute kidney injury, electrolyte disturbances, and may have comorbidities such as heart disease that complicate perioperative and long-term management. Medical management, which may consist of rehydration and restoration of intravascular volume with intravenous fluid therapy, osmotic diuresis, ureteral muscle relaxation, and antimicrobials for infection, is important in feline ureteral obstruction patients...
May 16, 2018: Journal of Small Animal Practice
https://www.readbyqxmd.com/read/29765871/optimizing-medicine-use-for-people-who-are-homebound-an-evaluation-of-a-pilot-domiciliary-medicine-use-review-dmur-service-in-england
#3
Asam Latif, Baguiasri Mandane, Emma Anderson, Caroline Barraclough, Samantha Travis
Background: As global life expectancy increases, older people with chronic diseases are being required to manage multiple and complex medicine regimes. However, polypharmacy raises the risk of medicine-related problems and preventable hospital admissions. To improve medicine use, English community pharmacies are commissioned to deliver Medicines Use Reviews (MURs), which are typically delivered from the pharmacy. People who are homebound rarely receive the service. This paper describes the uptake and impact of a pilot project that seeks to provide domiciliary Medicines Use Reviews (dMURs)...
2018: Integrated Pharmacy Research and Practice
https://www.readbyqxmd.com/read/29765259/shadowing-emergency-medicine-residents-by-medical-education-specialists-to-provide-feedback-on-non-medical-knowledge-based-acgme-sub-competencies
#4
Anna L Waterbrook, Karen C Spear Ellinwood, T Gail Pritchard, Karen Bertels, Ariel C Johnson, Alice Min, Lisa R Stoneking
Objective: Non-medical knowledge-based sub-competencies (multitasking, professionalism, accountability, patient-centered communication, and team management) are challenging for a supervising emergency medicine (EM) physician to evaluate in real-time on shift while also managing a busy emergency department (ED). This study examines residents' perceptions of having a medical education specialist shadow and evaluate their nonmedical knowledge skills. Methods: Medical education specialists shadowed postgraduate year 1 and postgraduate year 2 EM residents during an ED shift once per academic year...
2018: Advances in Medical Education and Practice
https://www.readbyqxmd.com/read/29762757/how-are-real-time-opioid-prescribing-cognitions-by-emergency-providers-influenced-by-reviewing-the-state-prescription-drug-monitoring-program
#5
Aaron Landau, Michael Lynch, Clifton Callaway, Brian Suffoletto
Objective: To understand how real-time opioid prescribing cognitions by emergency medicine (EM) providers are influenced by review of the state prescription drug monitoring program (PDMP). Methods: We collected prospective data from a convenience sample of 103 patient encounters for pain from 23 unique EM providers. After seeing the patient, before and immediately after reviewing the PDMP, EM providers answered how much they thought "the patient need[ed] an opioid to help manage their pain?", how concerned they were "about drug abuse and/or diversion?", and whether they planned to prescribe an opioid (yes/no)...
May 11, 2018: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29757916/filling-the-gaps-preparing-nurse-practitioners-for-hospitalist-practice
#6
Sharon E Bryant
Over the last 20 years, the emergence of the hospitalist has changed the face of medicine. Hospitalists may serve as either general or specialty-focused providers caring for acutely ill patients in the hospital setting. As the demands and constraints of hospital-specific patient management have continued to grow, an increased need for inclusion of nurse practitioners (NP) into current hospitalist staffing models has occurred. A hospitalist-focused educational model has been developed to better prepare NP students for a variety of hospitalist roles after graduation...
January 2018: Journal of the American Association of Nurse Practitioners
https://www.readbyqxmd.com/read/29753519/state-of-the-national-emergency-department-workforce-who-provides-care-where
#7
M Kennedy Hall, Kevin Burns, Michael Carius, Mitchel Erickson, Jane Hall, Arjun Venkatesh
STUDY OBJECTIVE: We describe the current US emergency medicine workforce in terms of clinician type and examine rural and urban emergency medicine workforce differences. METHODS: Using the 2014 Medicare Public Use Files, we performed a cross-sectional study of all clinicians receiving reimbursement for evaluation and management (E/M) services (levels 1 to 5) to Medicare fee-for-service Part B beneficiaries in the emergency department. Providers were defined as emergency physicians, nonemergency physicians, or advanced practice providers, corresponding with the Medicare Public Use Files data set...
May 9, 2018: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/29752833/understanding-diagnostic-safety-in-emergency-medicine-a-case-by-case-review-of-closed-ed-malpractice-claims
#8
Nancy Lemoine, Antonio Dajer, Joseph Konwinski, Dianne Cavanaugh, Catherine Besthoff, Hardeep Singh
The report Improving Diagnosis in Health Care calls for collaboration between professional liability insurance carriers and health care providers to identify opportunities to improve diagnostic performance. We used this collaborative approach and involved risk management/patient safety professionals and emergency medicine physician reviewers to analyze diagnosis-related emergency medicine closed claims from a large malpractice insurer. Our aim was to identify opportunities for risk reduction and to develop an approach for improving at-risk processes...
May 12, 2018: Journal of Healthcare Risk Management: the Journal of the American Society for Healthcare Risk Management
https://www.readbyqxmd.com/read/29747035/microscale-radiosynthesis-preclinical-imaging-and-dosimetry-study-of-18-f-ambf-3-tate-a-potential-pet-tracer-for-clinical-imaging-of-somatostatin-receptors
#9
Ksenia Lisova, Maxim Sergeev, Susan Evans-Axelsson, Andreea D Stuparu, Seval Beykan, Jeffrey Collins, Jason Jones, Michael Lassmann, Ken Herrmann, David Perrin, Jason T Lee, Roger Slavik, R Michael van Dam
BACKGROUND: Peptides labeled with positron-emitting isotopes are emerging as a versatile class of compounds for the development of highly specific, targeted imaging agents for diagnostic imaging via positron-emission tomography (PET) and for precision medicine via theranostic applications. Despite the success of peptides labeled with gallium-68 (for imaging) or lutetium-177 (for therapy) in the clinical management of patients with neuroendocrine tumors or prostate cancer, there are significant advantages of using fluorine-18 for imaging...
April 20, 2018: Nuclear Medicine and Biology
https://www.readbyqxmd.com/read/29743054/australian-integrative-oncology-services-a-mixed-method-study-exploring-the-views-of-cancer-survivors
#10
Jennifer Hunter, Jane Ussher, Chloe Parton, Andrew Kellett, Caroline Smith, Geoff Delaney, Eleanor Oyston
BACKGROUND: The significant use of traditional and complementary medicine (T&CM) by cancer survivors is well documented. The aim of this study was to explore cancer survivors' views on integrating T&CM services with conventional cancer care. METHOD: A mixed-method study design with an emphasis on qualitative methodology was used to conduct and analyse four focus group interviews and an on-line survey. Purposive sampling recruited 33 cancer survivors and caregivers from Arabic, Vietnamese, Chinese and Anglo-European Australian backgrounds who participated in one of four focus group interviews, and 121 cancer survivors who responded to an on-line survey...
May 9, 2018: BMC Complementary and Alternative Medicine
https://www.readbyqxmd.com/read/29738675/the-role-of-technology-and-telemetry-medicine-in-the-initial-management-of-a-st-segment-elevated-myocardial-infarction-in-a-rural-emergency-department
#11
Michael L Hood
CONTEXT: The 12-lead electrocardiogram (ECG) is an integral part of the diagnostic tools available for recognising a patient who is experiencing an ST-segment elevated myocardial infarction (STEMI). Consequently, a great emphasis is placed on the rapid acquisition and expert interpretation of the 12-lead ECG so that the appropriate reperfusion management might be commenced to optimise patient outcomes by preventing further damage to the myocardium. With the advancement of telemetric and diagnostic abilities of the modern ECG machine, the role of frontline rural emergency clinicians is as important as ever...
May 2018: Rural and Remote Health
https://www.readbyqxmd.com/read/29736833/are-clinicians-ready-for-safe-use-of-stratified-therapy-in-primary-biliary-cholangitis-pbc-a-study-of-educational-awareness
#12
Laura Jopson, Amardeep Khanna, Patricia Peterson, Elaine Rudell, Margaret Corrigan, David Jones
BACKGROUND: Primary Biliary Cholangitis (PBC, formerly cirrhosis), is a chronic cholestatic liver disease which until spring 2016 had a single licensed therapy, Ursodeoxycholic acid (UDCA). Approximately 30% of patients do not respond to UDCA, and are high-risk for progressing to end stage liver disease, transplantation or death. A new era of stratified medicine with second-line therapies to treat high-risk disease is emerging, with the first such second-line agent obeticholic acid recently receiving FDA and EMA approval and entering practice...
May 8, 2018: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/29736568/emerging-concepts-in-treating-cartilage-osteochondral-defects-and-osteoarthritis-of-the-knee-and-ankle
#13
Hélder Pereira, Ibrahim Fatih Cengiz, Carlos Vilela, Pedro L Ripoll, João Espregueira-Mendes, J Miguel Oliveira, Rui L Reis, C Niek van Dijk
The management and treatment of cartilage lesions, osteochondral defects, and osteoarthritis remain a challenge in orthopedics. Moreover, these entities have different behaviors in different joints, such as the knee and the ankle, which have inherent differences in function, biology, and biomechanics. There has been a huge development on the conservative treatment (new technologies including orthobiologics) as well as on the surgical approach. Some surgical development upraises from technical improvements including advanced arthroscopic techniques but also from increased knowledge arriving from basic science research and tissue engineering and regenerative medicine approaches...
2018: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/29734118/multidose-formulation-of-ready-to-use-177-lu-psma-617-in-a-centralized-radiopharmacy-set-up
#14
Sudipta Chakraborty, K V Vimalnath, Rubel Chakravarty, H D Sarma, Ashutosh Dash
Lutetium-177-labeled PSMA inhibitor has emerged as a promising modality for targeted therapy of prostate carcinoma. A protocol for regular multidose formulation of ready-to-use 177 Lu-PSMA-617 has been developed based on detailed and systematic radiochemical investigations. The formulation meets the requirements of clinical use and can be shipped to nuclear medicine centres for administration up to 4 days from the date of formulation. The reported protocol would be useful toward facilitating widespread clinical utilization of 177 Lu-PSMA-617 in the management of prostate cancer...
April 26, 2018: Applied Radiation and Isotopes
https://www.readbyqxmd.com/read/29733722/patient-centered-precision-health-in-a-learning-health-care-system-geisinger-s-genomic-medicine-experience
#15
Marc S Williams, Adam H Buchanan, F Daniel Davis, W Andrew Faucett, Miranda L G Hallquist, Joseph B Leader, Christa L Martin, Cara Z McCormick, Michelle N Meyer, Michael F Murray, Alanna K Rahm, Marci L B Schwartz, Amy C Sturm, Jennifer K Wagner, Janet L Williams, Huntington F Willard, David H Ledbetter
Health care delivery is increasingly influenced by the emerging concepts of precision health and the learning health care system. Although not synonymous with precision health, genomics is a key enabler of individualized care. Delivering patient-centered, genomics-informed care based on individual-level data in the current national landscape of health care delivery is a daunting challenge. Problems to overcome include data generation, analysis, storage, and transfer; knowledge management and representation for patients and providers at the point of care; process management; and outcomes definition, collection, and analysis...
May 2018: Health Affairs
https://www.readbyqxmd.com/read/29732653/the-regenerative-journey-of-pericytes-towards-clinical-translation
#16
REVIEW
William Cathery, Ashton Faulkner, Davide Maselli, Paolo Madeddu
Coronary artery disease (CAD) is the single leading cause of death worldwide. Advances in treatment and management have significantly improved patient outcomes. On the other hand, although mortality rates have decreased, more people are left with sequelae that require additional treatment and hospitalization. Moreover, patients with severe nonrevascularizable CAD remain with the only option of heart transplantation, which is limited by the shortage of suitable hearts. In recent years, cell-based regenerative therapy has emerged as a possible alternative treatment, with several regenerative medicinal products already in the clinical phase of development and other emerging as competitive preclinical solutions...
May 7, 2018: Stem Cells
https://www.readbyqxmd.com/read/29730774/in-flight-cardiac-arrest-and-in-flight-cardiopulmonary-resuscitation-during-commercial-air-travel-consensus-statement-and-supplementary-treatment-guideline-from-the-german-society-of-aerospace-medicine-dglrm
#17
Jochen Hinkelbein, Lennert Böhm, Stefan Braunecker, Harald V Genzwürker, Steffen Kalina, Fabrizio Cirillo, Matthieu Komorowski, Andreas Hohn, Jörg Siedenburg, Michael Bernhard, Ilse Janicke, Christoph Adler, Stefanie Jansen, Eckard Glaser, Pawel Krawczyk, Mirko Miesen, Janusz Andres, Edoardo De Robertis, Christopher Neuhaus
By the end of the year 2016, approximately 3 billion people worldwide travelled by commercial air transport. Between 1 out of 14,000 and 1 out of 50,000 passengers will experience acute medical problems/emergencies during a flight (i.e., in-flight medical emergency). Cardiac arrest accounts for 0.3% of all in-flight medical emergencies. So far, no specific guideline exists for the management and treatment of in-flight cardiac arrest (IFCA). A task force with clinical and investigational expertise in aviation, aviation medicine, and emergency medicine was created to develop a consensus based on scientific evidence and compiled a guideline for the management and treatment of in-flight cardiac arrests...
May 5, 2018: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/29728925/student-perspectives-on-the-impact-of-an-undergraduate-work-integrated-learning-program-on-admission-and-transition-to-medical-school
#18
Rachel McDonald, Adam Bobrowski, Leah Drost, Leigha Rowbottom, Judene Pretti, Hany Soliman, Stephanie Chan, Edward Chow
Work-integrated learning (WIL) is a form of education that integrates academic and workplace study. Such programs provide students the opportunity to concurrently develop cognitive and non-cognitive competencies. The purpose of this study is to explore which experiences and skills learned in a WIL placement are useful in applying to medical school and transitioning into the first year of a Doctor of Medicine program. All individuals who worked in the Rapid Response Radiotherapy Program (RRRP; WIL placement) since 2004 and had completed at least 1 year of medical school were invited to participate...
May 5, 2018: Journal of Cancer Education: the Official Journal of the American Association for Cancer Education
https://www.readbyqxmd.com/read/29728831/time-trends-in-characteristics-clinical-course-and-outcomes-of-13-791-patients-with-acute-heart-failure
#19
Pere Llorens, Patricia Javaloyes, Francisco Javier Martín-Sánchez, Javier Jacob, Pablo Herrero-Puente, Víctor Gil, José Manuel Garrido, Eva Salvo, Marta Fuentes, Héctor Alonso, Fernando Richard, Francisco Javier Lucas, Héctor Bueno, John Parissis, Christian E Müller, Òscar Miró
OBJECTIVES: To analyse time trends in patient characteristics, clinical course, hospitalisation rate, and outcomes in acute heart failure along a 10-year period (2007-2016). METHODS: The EAHFE registry has prospectively collected 13,971 consecutive AHF patients diagnosed in 41 Spanish emergency departments (EDs) at five different time points (2007/2009/2011/2014/2016). Eighty patient-related variables and outcomes were described and statistically significant changes along time were evaluated...
May 4, 2018: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/29726431/telemedicine-in-diagnosis-treatment-and-management-of-diseases-in-children
#20
Abbas Sheikhtaheri, Farzaneh Kermani
The purpose of this study was to review different telemedicine services in diagnosis, treatment and management of various children diseases and providing an overview of systematic reviews conducted in this regard. We searched English articles published in peer-reviewed journals between 2000 to 2016. We found that tele-pediatric services have been reported in various areas such as cardiology, burn, diabetes, obesity, emergency medicine, speech and hearing loss, Ear, Nose and Throat, psychology and psychiatry, radiology, oncology, home healthcare, asthma, genetics and dentistry...
2018: Studies in Health Technology and Informatics
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