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Management in emergency medicine

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https://www.readbyqxmd.com/read/28938102/self-management-support-at-the-end-of-life-patients-carers-and-professionals-perspectives-on-managing-medicines
#1
N Campling, A Richardson, M Mulvey, M Bennett, B Johnston, S Latter
BACKGROUND: Pain is a frequently reported symptom by patients approaching the end of life and well-established that patients and carers hold fears relating to opioids, and experience side effects related to their use. The management of medicines is intrinsic to achieving effective pain relief. The concept of self-management support whilst well characterised in the context of chronic illness has not been elaborated with respect to end of life care. AIM: To identify patient, carer and professional views on the concept of self-management support at end of life, specifically in relation to analgesia and related medicines (for side-effect management) in order to describe, characterise and explain self-management support in this context...
September 6, 2017: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/28933808/pediatric-orthopedic-injuries-evidence-based-management-in-the-emergency-department-digest
#2
Jamie Lien, Kathryn H Pade
Upper and lower extremity injuries are common in children, with an overall risk of fracture estimated at just under 1 in 5 children. Pediatric bone anatomy and physiology produce age specific injury patterns and conditions that are unique to children, which can make accurate diagnosis difficult for emergency clinicians. This issue reviews the etiology and pathophysiology of child-specific fractures, as well as common injuries of the upper and lower extremities. Evidence-based recommendations for management of pediatric fractures, including appropriate diagnostic studies and treatment, are also discussed...
September 22, 2017: Pediatric Emergency Medicine Practice
https://www.readbyqxmd.com/read/28933807/recognizing-and-managing-adrenal-disorders-in-the-emergency-department-digest
#3
Amy Cutright, Stephen Ducey, Claudia L Barthold, Jeremy Kim
Primary and secondary adrenal insufficiency are underrecognized conditions among emergency department patients, affecting an estimated 10% to 20% of critically ill patients. The signs and symptoms of cortisol deficit can be nonspecific and wide-ranging, and identification and swift treatment with stress-dosing of hydrocortisone is vital to avoid life-threatening adrenal crisis. Laboratory evaluation focuses on identification of electrolyte abnormalities typical of adrenal insufficiency, and while additional testing may depend on the type and severity of symptoms, it should not delay corticosteroid replacement...
September 22, 2017: Emergency Medicine Practice
https://www.readbyqxmd.com/read/28932302/predictive-value-of-tracheal-rapid-ultrasound-exam-performed-in-the-emergency-department-for-verification-of-tracheal-intubation
#4
Babak Masoumi, Reza Azizkhani, Gilava Hedayati Emam, Morteza Asgarzadeh, Behrouz Zargar Kharazi
BACKGROUND: Verification of the correct placement of the endotracheal tube (ETT) has been one of the most challenging issues of airway management in the field of emergency medicine. Early detection of oesophagal intubation through a reliable method is important for emergency physicians. AIM: The aim of this study was to assess the diagnostic accuracy of tracheal rapid ultrasound exam (TRUE) to assess endotracheal tube misplacement during emergency intubation. METHODS: This was an observational prospective study performed in the emergency department of the major tertiary referral hospital in the city...
August 15, 2017: Open Access Macedonian Journal of Medical Sciences
https://www.readbyqxmd.com/read/28931128/6-year-review-of-redivi-a-prospective-registry-of-imported-infectious-diseases-in-spain
#5
José A Pérez-Molina, Ana López-Polín, Begoña Treviño, Israel Molina, Josune Goikoetxea, Marta Díaz-Menéndez, Diego Torrús, Eva Calabuig, Agustín Benito, Rogelio López-Vélez
Background: Understanding and detecting imported diseases is a priority in the prevention and management of prevalent and emergent infectious diseases acquired abroad. The +Redivi network measures the burden of imported infections in Spain and is essential for closing the gap in travel medicine. Methods: Demographic characteristics, travel information, syndromes and confirmed travel-related diagnoses were registered in a standardised online database. Results: A total of 10 767 cases of imported infectious diseases were registered between October 2009 and December 2015...
September 1, 2017: Journal of Travel Medicine
https://www.readbyqxmd.com/read/28927763/imaging-considerations-and-interprofessional-opportunities-in-the-care-of-breast-cancer-patients-in-the-neoadjuvant-setting
#6
REVIEW
Anna G Sorace, Sara Harvey, Anum Syed, Thomas E Yankeelov
OBJECTIVE: To discuss standard-of-care and emerging imaging techniques employed for screening and detection, diagnosis and staging, monitoring response to therapy, and guiding cancer treatments. DATA SOURCES: Published journal articles indexed in the National Library of Medicine database and relevant websites. CONCLUSION: Imaging plays a fundamental role in the care of cancer patients and specifically, breast cancer patients in the neoadjuvant setting, providing an excellent opportunity for interprofessional collaboration between oncologists, researchers, radiologists, and oncology nurses...
September 15, 2017: Seminars in Oncology Nursing
https://www.readbyqxmd.com/read/28922959/compliance-to-the-primary-health-care-treatment-guidelines-and-the-essential-medicines-list-in-the-management-of-sexually-transmitted-infections-in-correctional-centres-in-south-africa-findings-and-implications
#7
Tammy B Matsitse, Elvera Helberg, Johanna C Meyer, Brian Godman, Amos Massele, Natalie Schellack
BACKGROUND: The emergence of antimicrobial resistance (AMR) is a global concern and a growing health crisis. Additionally, evidence has shown that non-compliance to treatment guidelines, especially in the management of communicable diseases such as sexually transmitted infections (STIs), has the potential of further enhancing AMR rates. Data on the extent of these challenges in Primary Health Care (PHC) facilities in correctional centres in South Africa (SA) is limited. Hence this study was conducted to determine the level of compliance with the 2008 PHC Standard Treatment Guidelines and Essential Medicines List (PHC STGs/EML) in the management of STIs, and to identify potential factors contributing to the compliance and non-compliance to guide future strategies...
September 19, 2017: Expert Review of Anti-infective Therapy
https://www.readbyqxmd.com/read/28919404/emergency-in-the-clinic-a-simulation-curriculum-to-improve-outpatient-safety
#8
Eve Espey, Gillian Baty, John Rask, Michelle Chungtuyco, Brenda Pereda, Lawrence Leeman
BACKGROUND: Emergency response skills are essential when events such as seizure, anaphylaxis or hemorrhage occur in the outpatient setting. As services and procedures increasingly move outside the hospital, training to manage complications may improve outcomes. OBJECTIVE: The objective of this study was to evaluate a simulation-based curriculum in outpatient emergency management skills with the outcome measures of graded objective performance and learner self-efficacy...
September 14, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28914069/the-role-of-a%C3%A2-hospital-pharmacist-in-the-management-of-asthma-in-great-britain
#9
Inka Sembol, Božena Macešková
The role of the pharmacist in the asthma management is well established. However, there is still a considerable number of patients with suboptimal asthma control affecting patients quality of life and resulting in poor outcomes, morbidity and mortality. The aim was to identify patients factors, explore the hospital pharmacists role in the asthma management and identify any areas for improvement in Great Britain. Qualitative data collection was selected. Patients case studies and semi-structured open interviews with the hospital multi-disciplinary team (MDT) were applied...
2017: Ceská a Slovenská Farmacie
https://www.readbyqxmd.com/read/28903545/the-road-from-development-to-approval-evaluating-the-body-of-evidence-to-confirm-biosimilarity
#10
Paul Declerck, Mourad Farouk Rezk
Biosimilars are products that contain a similar version of the active substance of an already authorized original biologic medicinal product (reference medicinal product). Their development requires special consideration, as similarity to the reference agent needs to be established through a comprehensive comparability exercise. Given the complex nature of these agents, minor structural differences may emerge, but the process of biosimilarity determination is designed to ascertain that the nature and impact of these differences are not clinically significant...
August 1, 2017: Rheumatology
https://www.readbyqxmd.com/read/28894624/use-of-traditional-plants-in-management-of-halitosis-in-a-moroccan-population
#11
Sanae Akkaoui, Oum Keltoum Ennibi
INTRODUCTION: The use of medicinal plants was a very spread therapeutic way. At present, several studies are moving toward this ancestral option, seen the emergence of several bacterial resistance and for the large number of side effects of some synthetic drugs. OBJECTIVE: The objective of this study was to collect and evaluate information on medicinal plants commonly used in five Moroccan cities: Rabat, Salé, Témara, Khémisset, and Tiflet for the management of halitosis...
July 2017: Journal of Intercultural Ethnopharmacology
https://www.readbyqxmd.com/read/28893450/emergency-medicine-evaluation-and-management-of-the-end-stage-renal-disease-patient
#12
REVIEW
Brit Long, Alex Koyfman, Courtney M Lee
BACKGROUND: End stage renal disease (ESRD) is increasing in the U.S., and these patients demonstrate greater all-cause mortality, cardiovascular events, and hospitalization rates when compared to those with normal renal function. These patients may experience significant complications associated with loss of renal function and dialysis. OBJECTIVE: This review evaluates complications of ESRD including cardiopulmonary, neurologic, infectious disease, vascular, and access site complications, as well as medication use in this population...
September 5, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28891406/clinical-practice-guideline-evaluation-of-the-neck-mass-in-adults
#13
Melissa A Pynnonen, M Boyd Gillespie, Benjamin Roman, Richard M Rosenfeld, David E Tunkel, Laura Bontempo, Itzhak Brook, Davoren Ann Chick, Maria Colandrea, Sandra A Finestone, Jason C Fowler, Christopher C Griffith, Zeb Henson, Corinna Levine, Vikas Mehta, Andrew Salama, Joseph Scharpf, Deborah R Shatzkes, Wendy B Stern, Jay S Youngerman, Maureen D Corrigan
Objective Neck masses are common in adults, but often the underlying etiology is not easily identifiable. While infections cause most of the neck masses in children, most persistent neck masses in adults are neoplasms. Malignant neoplasms far exceed any other etiology of adult neck mass. Importantly, an asymptomatic neck mass may be the initial or only clinically apparent manifestation of head and neck cancer, such as squamous cell carcinoma (HNSCC), lymphoma, thyroid, or salivary gland cancer. Evidence suggests that a neck mass in the adult patient should be considered malignant until proven otherwise...
September 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28891235/financial-arrangements-for-health-systems-in-low-income-countries-an-overview-of-systematic-reviews
#14
REVIEW
Charles S Wiysonge, Elizabeth Paulsen, Simon Lewin, Agustín Ciapponi, Cristian A Herrera, Newton Opiyo, Tomas Pantoja, Gabriel Rada, Andrew D Oxman
BACKGROUND: One target of the Sustainable Development Goals is to achieve "universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all". A fundamental concern of governments in striving for this goal is how to finance such a health system. This concern is very relevant for low-income countries. OBJECTIVES: To provide an overview of the evidence from up-to-date systematic reviews about the effects of financial arrangements for health systems in low-income countries...
September 11, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28888217/epidermal-growth-factor-receptor-inhibitors-cutaneous-side-effects-and-their-management
#15
S Monjazeb, J Wilson
Epidermal growth factor receptor (EGFR) inhibitors are part of an emerging class of anticancer medicines known as "targeted therapy," which target pathways more specific to neoplastic proliferation than traditional chemotherapeutic agents. Adverse effects of such treatments are thought to be less severe, but can still be significant. Because EGFR is preferentially expressed in epithelial tissues, including the skin and hair follicle, cutaneous side effects of these agents are quite common. Not only can these toxicities severely affect patients' quality of life, but in some specific instances, they can be associated with increased response to therapy...
September 2017: Skin Therapy Letter
https://www.readbyqxmd.com/read/28884282/efficiency-analysis-of-integrated-public-hospital-networks-in-outpatient-internal-medicine
#16
Miguel Angel Ortíz-Barrios, Juan P Escorcia-Caballero, Fabián Sánchez-Sánchez, Fabio De Felice, Antonella Petrillo
Healthcare systems are evolving towards a complex network of interconnected services due to the increasing costs and the increasing expectations for high service levels. It is evidenced in the literature the importance of implementing management techniques and sophisticated methods to improve the efficiency of healthcare systems, especially in emerging economies. This paper proposes an integrated collaboration model between two public hospitals to reach the reduction of weighted average lead time in outpatient internal medicine department...
September 7, 2017: Journal of Medical Systems
https://www.readbyqxmd.com/read/28883977/management-of-plasmodium-vivax-risk-and-illness-in-travelers
#17
EDITORIAL
J Kevin Baird
Malaria poses an exceptionally complex problem for providers of travel medicine services. Perceived high risk of exposure during travel typically prompts prescribing protective antimalarial drugs. Suppressive chemoprophylactic agents have dominated strategy for that practice for over 70 years. This broad class of therapeutic agents kills parasites after they emerge from the liver and attempt development in red blood cells. The dominance of suppressive chemoprophylaxis in travel medicine stems largely from the view of Plasmodium falciparum as the utmost threat to the patient - these drugs are poorly suited to preventing Plasmodium vivax and Plasmodium ovale due to inactivity against the latent liver stages of these species not produced by P...
2017: Tropical Diseases, Travel Medicine and Vaccines
https://www.readbyqxmd.com/read/28882376/a-novel-approach-to-improving-the-interpretation-of-ct-brain-in-trauma
#18
L R Evans, M C Fitzgerald, D Varma, B Mitra
BACKGROUND: Computed tomography of the brain (CTB) has a fundamental role in the diagnosis and management of traumatic brain injury (TBI). There may be substantial discordance between initial CTB interpretation by emergency clinicians and the final radiology report. This study aimed to assess the utility of a structured reporting template in improving the accuracy of CTB interpretation by emergency clinicians. METHOD: A prospective pre- and post-intervention cohort study was undertaken using a study population of emergency medicine trainees...
September 4, 2017: Injury
https://www.readbyqxmd.com/read/28881815/clinicopathological-characteristics-of-ros1-and-ret-rearranged-nsclc-in-caucasian-patients-data-from-a-cohort-of-713-non-squamous-nsclc-lacking-kras-egfr-her2-braf-pik3ca-alk-alterations
#19
Frédéric Dugay, Francisco Llamas-Gutierrez, Marjory Gournay, Sarah Medane, François Mazet, Dan Christian Chiforeanu, Emmanuelle Becker, Régine Lamy, Hervé Léna, Nathalie Rioux-Leclercq, Marc-Antoine Belaud-Rotureau, Florian Cabillic
Targeted therapies have substantially changed the management of non-small cell lung cancer (NSCLC) patients with driver oncogenes. Given the high frequency, EGFR and ALK aberrations were the first to be detected and paved the way for tyrosine kinase inhibitor (TKI) treatments. Other kinases such as ROS1 and more recently RET have emerged as promising targets, and ROS1 and RET TKIs are already available for precision medicine. We screened a large cohort of 713 Caucasian non-squamous NSCLC patients lacking EGFR/KRAS/BRAF/HER2/PI3KCA/ALK aberrations for ROS1 and RET rearrangements using fluorescence in situ hybridization to determine the frequency and clinicopathological characteristics of ROS1- and RET-positive patients...
August 8, 2017: Oncotarget
https://www.readbyqxmd.com/read/28877135/want-correct-percentage-of-tbsa-burned-let-a-layman-do-the-assessment
#20
Ilaria Tocco-Tussardi, Benjamin Presman, Fredrik Huss
Accurate determination of burn size significantly impacts both immediate management and long-term outcome. In the era of evidence-based medicine, the variability in TBSA% assessment shown by traditional methods may prove unacceptable and technology-aided systems become the "accepted standard." The objective of this study was to push this scenario to the limit by investigating the accuracy and consistency of TBSA% estimations using a computer-aided tool. Five Laymen (health care-burn management naïve people) were trained on the handling of the technology-aided assessment tool Burn Case 3D and asked to calculate TBSA% for 18 clinical pictures of burns with different patterns and sizes...
August 31, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
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