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https://www.readbyqxmd.com/read/28731926/history-of-anaesthesia-the-ketamine-story-past-present-and-future
#1
Georges Mion
: Ketamine's history begins in the 1950s in Detroit, Michigan, at Parke-Davis Laboratories. On 26 March 1956, Harold V. Maddox synthesised phencyclidine or PCP. Domino studied PCP effects in animals and in 1958, Greifenstein made the first trials of PCP in humans under the name of Sernyl. Sernyl did not cause depression of cardiovascular and respiratory functions, but elicited severe excitation with a very prolonged postoperative recovery. Because of its psychedelic effects, it became a street drug under the name of 'angel dust' and was placed on schedule II of Federal Controlled Substance Act (CSA) in 1978...
July 20, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28727609/atrial-natriuretic-peptide-a-potential-early-therapy-for-the-prevention-of-multiple-organ-dysfunction-syndrome-following-severe-trauma
#2
Rong-Wei Zhang, Li-Li Liu, Lan-Lan Zeng, Rui-Jie Li, Ye-Hua Shen, Bin Zhang, Zi-Zhuo Liu, Meng-Fei Chen, Sheng-Mao Jiang, Li-Bing Jiang, Xiao-Gang Zhao, Shou-Yin Jiang
Trauma remains a tremendous medical burden partly because of increased expenditure for the management of multiple organ dysfunction syndrome (MODS) developed during hospital stay. The intestinal barrier injury continues to be a second insult resulting in MODS which currently lacks efficient strategies for prevention. Recent studies have uncovered multi-organ protective benefits of atrial natriuretic peptide (ANP) in cardiovascular disease. However, the role of ANP in prevention of MODS following severe trauma has not been understood...
July 19, 2017: Shock
https://www.readbyqxmd.com/read/28725792/entrustable-professional-activities-for-pathology-recommendations-from-the-college-of-american-pathologists-graduate-medical-education-committee
#3
Cindy B McCloskey, Ronald E Domen, Richard M Conran, Robert D Hoffman, Miriam D Post, Mark D Brissette, Dita A Gratzinger, Patricia M Raciti, David A Cohen, Cory A Roberts, Amyn M Rojiani, Christina S Kong, Jo Elle G Peterson, Kristen Johnson, Sue Plath, Suzanne Zein-Eldin Powell
Competency-based medical education has evolved over the past decades to include the Accreditation Council for Graduate Medical Education Accreditation System of resident evaluation based on the Milestones project. Entrustable professional activities represent another means to determine learner proficiency and evaluate educational outcomes in the workplace and training environment. The objective of this project was to develop entrustable professional activities for pathology graduate medical education encompassing primary anatomic and clinical pathology residency training...
January 2017: Acad Pathol
https://www.readbyqxmd.com/read/28723945/haematological-and-cd4-t-cells-reference-ranges-in-healthy-adult-populations-in-gojjam-zones-in-amhara-region-ethiopia
#4
Wondemagegn Mulu, Bayeh Abera, Zewdie Mekonnen, Yesuf Adem, Mulat Yimer, Yohannes Zenebe, Asmare Amuamuta, Wondimu Gebeyehu
INTRODUCTION: Establishing national population haematological and immunological reference ranges are essential for clinical management of patients. However, there is scarcity of information on community based haematological reference ranges established from Ethiopian population. Therefore, this study aimed at determining haematological and CD4+ T cells reference ranges in healthy adults from East and West Gojjam zones, Ethiopia. METHODS: Community based cross-sectional study was conducted from May 2015 to December 2015 in healthy adult residents of Gojjam zone...
2017: PloS One
https://www.readbyqxmd.com/read/28720632/improving-efficiency-while-improving-patient-care-in-a-student-run-free-clinic
#5
Jason S Lee, Kristen Combs, Magdalena Pasarica
INTRODUCTION: Student-run free clinics (SRFCs) have the capacity to decrease health care inequity in underserved populations. These facilities can benefit from improved patient experience and outcomes. We implemented a series of quality improvement interventions with the objectives to decrease patient wait times and to increase the variety of services provided. METHODS: A needs assessment was performed. Problems related to time management, communication between staff and providers, clinic resources, and methods for assessing clinic performance were identified as targets to reduce wait times and improve the variety of services provided...
July 2017: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/28718873/clinical-features-of-drug-reaction-with-eosinophilia-and-systemic-symptoms-dress-syndrome-a-study-of-25-patients-in-korea
#6
Jin Y Lee, Suh-Young Lee, Ji E Hahm, Jae W Ha, Chul W Kim, Sang S Kim
BACKGROUND: Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a rare adverse drug reaction. This study aimed to evaluate the incidence of association with individual drugs, clinical manifestations, disease course, and outcomes of DRESS. METHODS: Using the criteria of the European Registry of Severe Cutaneous Adverse Reactions (RegiSCAR), the medical records of 25 patients diagnosed with DRESS between 2006 and 2015 were retrospectively reviewed...
July 18, 2017: International Journal of Dermatology
https://www.readbyqxmd.com/read/28717776/a-retrospective-study-of-emergency-department-potassium-disturbances-severity-treatment-and-outcomes
#7
Adam J Singer, Henry C Thode, W Frank Peacock
OBJECTIVE: Disturbances in potassium (K) levels are relatively common and may be associated with significant morbidity and mortality; however, treatments vary. Our purpose was to determine the incidence, treatments, and outcomes associated with hyperkalemia and hypokalemia in emergency department (ED) patients. METHODS: We performed a structured, retrospective review of electronic medical records of consecutive adult ED patients with K measured while in the ED. Demographic, clinical, and laboratory data as well as treatments, disposition, and in-hospital complications were collected...
June 2017: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/28716156/generic-atorvastatin-is-as-effective-as-the-brand-name-drug-lipitor-%C3%A2-in-lowering-cholesterol-levels-a-cross-sectional-retrospective-cohort-study
#8
Alexander Loch, Jan Philipp Bewersdorf, Daniel Kofink, Dzafir Ismail, Imran Zainal Abidin, Ramesh Singh Veriah
BACKGROUND: In a world of ever increasing health care costs, generic drugs represent a major opportunity to ensure access to essential medicines for people who otherwise would be unable to afford them. However, some clinicians and patients are still questioning the safety and effectiveness of generic formulations compared to the proprietary drugs necessitating further systematic research analyzing the generic drugs' efficacy. Our objective was to compare the lipid lowering effects of generic and branded atorvastatin...
July 17, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28715306/a-data-rich-longitudinal-wellness-study-for-the-digital-age-fixing-a-broken-medical-system-requires-data-about-each-patient
#9
Gustavo Glusman
We live in an age of plentiful information, collected continuously by pervasive gadgetry, distributed through digital and social networks, and mined deeply by ever-more-powerful analytics systems. And yet, one of the things we know the least about is our bodies. When it comes to our own health, we are driving blindly. Modern medicine has clearly been remarkably successful, as evidenced by continually growing life expectancies. For example, the number of people 65 and older in the United States has seen a steady increase over the last century, rising from 3...
July 2017: IEEE Pulse
https://www.readbyqxmd.com/read/28714377/ibrutinib-associated-tumor-lysis-syndrome-in-chronic-lymphocytic-leukemia-small-lymphocytic-lymphoma-and-mantle-cell-lymphoma-a-case-series-and-review-of-the-literature
#10
Krystal S Titus-Rains, Jamie N Brown, Julia M Hammond
Background Tumor lysis syndrome results when intracellular contents are released during cell lysis. Ibrutinib, a Bruton tyrosine kinase inhibitor, is used for the treatment of chronic lymphocytic leukemia, small lymphocytic lymphoma, Waldenström's macroglobulinemia, mantle cell lymphoma, and marginal zone lymphoma. Tumor lysis syndrome caused by ibrutinib therapy is potentially life threatening, but is rare and not often reported in clinical trials. Objective The purpose of this case series is to describe the occurrence of tumor lysis syndrome in two patients initiated on ibrutinib, and to highlight the importance of close monitoring during therapy...
January 1, 2017: Journal of Oncology Pharmacy Practice
https://www.readbyqxmd.com/read/28709561/factors-associated-with-need-for-revascularisation-in-non-coronary-arterial-occlusive-lesions-secondary-to-takayasu-s-arteritis
#11
C A Hinojosa, J E Anaya-Ayala, Z Gomez-Arcive, H Laparra-Escareno, A Torres-Machorro, R Lizola
OBJECTIVE/BACKGROUND: Takayasu's arteritis (TA) is rare inflammatory large vessel form of vasculitis. The objective of this study was to evaluate experience in the management of TA patients and to identify the influence of inflammatory markers and clinical variables associated with disease progression, worsening ischaemic symptoms, and the need for interventions. METHODS: Demographics, and laboratory and clinical variables in patients that required revascularisation procedures were compared with those who had adequate symptomatic control with medical management...
July 11, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28709455/barriers-and-facilitators-to-reducing-frequent-laboratory-testing-for-patients-who-are-stable-on-warfarin-a-mixed-methods-study-of-de-implementation-in-five-anticoagulation-clinics
#12
Geoffrey D Barnes, Sevan Misirliyan, Scott Kaatz, Elizabeth A Jackson, Brian Haymart, Eva Kline-Rogers, Jay Kozlowski, Gregory Krol, James B Froehlich, Anne Sales
BACKGROUND: Patients on chronic warfarin therapy require regular laboratory monitoring to safely manage warfarin. Recent studies have challenged the need for routine monthly blood draws in the most stable warfarin-treated patients, suggesting the safety of less frequent laboratory testing (up to every 12 weeks). De-implementation efforts aim to reduce the use of low-value clinical practices. To explore barriers and facilitators of a de-implementation effort to reduce the use of frequent laboratory tests for patients with stable warfarin management in nurse/pharmacist-run anticoagulation clinics, we performed a mixed-methods study conducted within a state-wide collaborative quality improvement collaborative...
July 14, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28705753/invasive-fungal-infections-secondary-to-traumatic-injury
#13
REVIEW
Ryan Kronen, Stephen Y Liang, Grant Bochicchio, Kelly Bochicchio, William G Powderly, Andrej Spec
Invasive fungal infection (IFI) is a rare but serious complication of traumatic injury. The purpose of this article is to review the epidemiology, natural history, mycology, risk factors, diagnosis, treatment, and outcomes associated with post-traumatic IFI in military and civilian populations. The epidemiology of post-traumatic IFI is poorly characterized, but incidence appears to be rising. Patients often suffer from severe injuries and require extensive medical interventions. Fungi belonging to the order Mucorales are responsible for most post-traumatic IFI in both civilian and military populations...
July 10, 2017: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/28696077/legionnaires-disease-in-transplant-recipients-a-15-year-retrospective-study-in-a-tertiary-referral-center
#14
Shobini Sivagnanam, Sara Podczervinski, Susan M Butler-Wu, Vivian Hawkins, Zach Stednick, Lois A Helbert, William A Glover, Estella Whimbey, Jeffrey Duchin, Guang-Shing Cheng, Steven A Pergam
Legionnaires' disease (LD) can be fatal among high-risk transplant recipients. To understand the epidemiology of LD, we reviewed 15-year, longitudinal data from a center in Seattle, Washington that cares for both solid organ transplant (SOT) and hematopoietic cell transplant (HCT) recipients. We identified all laboratory-confirmed LD and extracted data on species, diagnostic modalities, clinical presentation, management, and outcomes from medical records. Among 32 patients with LD, transplant recipients made up the majority of diagnoses (22, 69%; SOT 10, HCT 12)...
July 11, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28695483/diagnosis-and-management-of-treatment-refractory-hypothyroidism-an-expert-consensus-report
#15
REVIEW
M Centanni, S Benvenga, I Sachmechi
There is a frequently encountered subset of hypothyroid patients who are refractory to standard thyroid hormone replacement treatment and require unexpectedly high doses of levothyroxine. In addition to clinical situations where hypothyroid patients are non-compliant, or where there is the possibility of excipient-induced disease exacerbation (gluten/celiac disease), therapeutic failure may be due to impaired absorption of the administered drug. The common approach to managing patients with unusual thyroxine needs is to escalate the dose of levothyroxine until targeted TSH levels are achieved...
July 10, 2017: Journal of Endocrinological Investigation
https://www.readbyqxmd.com/read/28695354/mobile-health-clinic-for-the-medical-management-of-clinical-sequelae-experienced-by-survivors-of-the-2013-2016-ebola-virus-disease-outbreak-in-sierra-leone-west-africa
#16
R E Guetiya Wadoum, A Samin, N G Mafopa, M Giovanetti, G Russo, P Turay, J Turay, M Kargbo, M T Kanu, B Kargbo, J Akpablie, C J Cain, P Pasin, V Batwala, M S Sobze, M Potestà, A Minutolo, V Colizzi, C Montesano
An Ebola survivor Mobile Health Clinic (MHC) was established to implement lasting changes in communities it operates by providing effective and efficient mobile healthcare. After months of development, the MHC solution was operationalised in February 2015, aiming to provide integrated primary healthcare services to address the medical and psychosocial needs of Ebola virus (EBOV) survivors living in areas with low medical coverage. A total of 910 medical consultations for 246 EBOV survivors were performed between 7 February 2015 and 10 June 2016...
July 10, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28695249/first-study-on-iron-complexes-in-blood-and-organ-samples-from-thalassaemic-and-normal-laboratory-mice-using-m%C3%A3-ssbauer-spectroscopy
#17
George Charitou, Vlassis Petousis, Charalambos Tsertos, Yannis Parpottas, Marina Kleanthous, Marios Phylactides, Soteroula Christou
Measurements of iron complexes and iron stores in the body are crucial for evaluation and management of chelation therapy targeted against iron accumulation or overload in blood and organs. In this work, blood and tissue samples from one normal and one thalassaemic laboratory mouse were studied using (57)Fe Mössbauer spectroscopy at 78 K for the first time. In contrast to human patients, these laboratory mice did not receive any medical treatment, thus the iron components present in the samples are not altered from their natural state...
July 10, 2017: European Biophysics Journal: EBJ
https://www.readbyqxmd.com/read/28694393/turkish-assessment-of-surf-survey-of-risk-factor-management-study-control-rates-of-cardiovascular-risk-factors-derived-from-databases-of-15-different-levels-of-health-centers-in-turkey
#18
Lale Tokgözoğlu, Aytekin Oğuz, Mustafa Kemal Balcı, Ahmet Temizhan, Esma Güldal Altunoğlu, Osman Bektaş, Güler Aslan, Özgün Iyigün, Ahmet Kara, Handan Tanrıverdi Pınar, Saffet Yavuz, Murat Tekin, Saffet Ercan, Selda Çelik, Özlem Sezgin Meriçliler, İrem Bozkurt Çakır
OBJECTIVE: The aim of this study was to evaluate the adherence to recommendations for secondary prevention and the achievement of treatment targets for the control of risk factors in patients with established coronary heart disease (CHD) who were followed-up at various healthcare facilities in Turkey. METHODS: According to the protocol of the international Survey of Risk Factor Management study, questionnaire forms were completed and demographic, anthropometric, and laboratory data of CHD patients who were followed-up at a total of 15 selected primary, secondary, and tertiary healthcare centers were recorded...
July 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/28693489/inducible-clindamycin-and-methicillin-resistant-staphylococcus-aureus-in-a-tertiary-care-hospital-kathmandu-nepal
#19
R P Adhikari, S Shrestha, A Barakoti, R Amatya
BACKGROUND: Staphylococcus aureus, an important nosocomial pathogen, is frequently associated with infections in human. The management of the infections by it especially methicillin resistant ones is often difficult because methicillin resistant S. aureus is usually resistant to multiple antibiotics. Macrolide-lincosamide streptogramin B family of antibiotics is commonly used to treat such infections as an alternative to vancomycin. METHODS: This study was conducted over the period of one and half year from November 2013-April 2015 in Microbiology laboratory of Nepal Medical College and Teaching Hospital, Kathmandu, Nepal to find the incidence of different phenotypes of MLSB resistance among S...
July 11, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28692718/physician-reimbursement-in-medicare-advantage-compared-with-traditional-medicare-and-commercial-health-insurance
#20
Erin Trish, Paul Ginsburg, Laura Gascue, Geoffrey Joyce
Importance: Nearly one-third of Medicare beneficiaries are enrolled in a Medicare Advantage (MA) plan, yet little is known about the prices that MA plans pay for physician services. Medicare Advantage insurers typically also sell commercial plans, and the extent to which MA physician reimbursement reflects traditional Medicare (TM) rates vs negotiated commercial prices is unclear. Objective: To compare prices paid for physician and other health care services in MA, traditional Medicare, and commercial plans...
July 10, 2017: JAMA Internal Medicine
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