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Evidence based emergency medicine

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https://www.readbyqxmd.com/read/29136247/behavioral-mental-health-an-emerging-field-of-service-or-an-oxymoron
#1
Christopher G Hudson
Proliferation in the use of the terminology around behavioral mental health suggests, on one hand, an emerging field of service that integrates psychiatric, substance abuse, and related services. On the other hand, this development also raises questions about the coherence of this approach. This review explores the history, definitional issues, current trends, and available data on the impact of this field. It considers a variety of critiques of behavioral mental health, such as possibility that the field attempts to integrate fundamentally incompatible domains, that the term "behavioral mental health" is thus an oxymoron, and that it represents a co-optation by the insurance industry of traditional ideals of mental health and of behavioral medicine or as code for the implementation of a medical model that emphasizes short-term, behavioral, and psychopharmacological treatments at the expense of a truly biopsychosocial orientation...
November 9, 2017: Social Work
https://www.readbyqxmd.com/read/29127600/a-review-of-current-and-emerging-approaches-to-pain-management-in-the-emergency-department
#2
REVIEW
Knox H Todd
INTRODUCTION: Pain is the most common symptom prompting an emergency department visit and emergency physicians are responsible for managing both acute pain and acute exacerbations of chronic pain resulting from a broad range of illnesses and injuries. The responsibility to treat must be balanced by the duty to limit harm resulting from analgesics. In recent years, opioid-related adverse effects, including overdose and deaths, have increased dramatically in the USA. In response to the US opioid crisis, emergency physicians have broadened their analgesic armamentarium to include a variety of non-opioid approaches...
November 10, 2017: Pain and Therapy
https://www.readbyqxmd.com/read/29124374/complications-and-treatment-strategy-after-breast-augmentation-by-polyacrylamide-hydrogel-injection-summary-of-10-year-clinical-experience
#3
Rui Jin, Xusong Luo, Xiaoke Wang, Jie Ma, Fei Liu, Qun Yang, Jun Yang, Xi Wang
From 1997 to 2006, polyacrylamide hydrogel (PAAG) was approved for use in China as a permanent filler for breast augmentation, and it is estimated that 200,000 women have undergone PAAG injection since then. After injection, complications such as pain, mass, hematoma, asymmetry, migration, infection, and even cancer continue to emerge. Because of the potential toxicity and unstable nature of the material and the nonstandardized injection layers, complications after PAAG injection breast augmentation are often complex and difficult to treat...
November 9, 2017: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/29123350/evaluation-of-community-based-palliative-care-services-perspectives-from-various-stakeholders
#4
Venugopal Vinayagamoorthy, Elayaperumal Suguna, Amol R Dongre
Background: As a part of Memorandum of Understanding with Tamil Nadu Institute of Palliative Medicine, community-based palliative care services have been initiated 2 years back in our urban field practice areas. Aim: The aim of this study was to evaluate the home care service, a major component of our community-based palliative care, with a view to identify the unmet needs of the services rendered for decision-making about the program. Materials and Methods: It was a descriptive qualitative design carried out by the authors trained in qualitative research methods...
October 2017: Indian Journal of Palliative Care
https://www.readbyqxmd.com/read/29121042/polish-translation-of-the-anatomical-quality-assurance-aqua-checklist-new-guidelines-for-reporting-in-original-anatomical-studies
#5
Brandon Michael Henry, Agata Marcinów, Przemysław Pękala, Dominik Taterra, Marios Loukas, R Shane Tubss, Jerzy A Walocha, Krzysztof A Tomaszewski
Recently, an improvement of the quality of reporting and methodology in original research has been observed. Major fields in research have introduced checklists aimed at promoting clear and univocal reporting of methods and results. The basis of evidence-based medicine (EBM) lies in transparent reporting of primary studies. Although clinical research progressed rapidly into evidence-based guidelines, the basic sciences, including anatomy, just recently started to use the rules of EBM. No anatomy-specific standardized research checklist has been introduced so far...
2017: Folia Medica Cracoviensia
https://www.readbyqxmd.com/read/29120333/evaluation-and-validation-of-a-model-for-identifying-serious-bacterial-infections-among-children-presenting-to-the-emergency-evidence-based-medicine-viewpoint
#6
https://www.readbyqxmd.com/read/29116361/intermediate-care-units-recommendations-on-facilities-and-structure
#7
REVIEW
C Waydhas, E Herting, S Kluge, A Markewitz, G Marx, E Muhl, T Nicolai, K Notz, V Parvu, M Quintel, E Rickels, D Schneider, K R Steinmeyer-Bauer, G Sybrecht, T Welte
A growing number of patients with increasingly complex or specialized diseases are being treated in hospitals worldwide. The treatment requirements of some of these patients are exceeding the capacity of standard nursing units. However, the severity of these diseases or the treatment requirements for these specific clinical pictures do not always justify admission to an intensive care unit. For this reason, an increasing number of special units (intermediate care units) are being set up to offer highly specialized treatment and close monitoring, in order to fulfil an intermediate role between the standard care unit and the intensive care unit...
November 7, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/29113461/regenerative-medicine-shedding-light-on-the-link-between-aging-and-cancer
#8
Fabio Marongiu, Maria Paola Serra, Maura Fanti, Erika Cadoni, Monica Serra, Ezio Laconi
The evidence linking aging and cancer is overwhelming. Findings emerging from the field of regenerative medicine reinforce the notion that aging and cancer are profoundly interrelated in their pathogenetic pathways. We discuss evidence to indicate that age-associated alterations in the tissue microenvironment contribute to the emergence of a neoplastic-prone tissue landscape, which is able to support the selective growth of preneoplastic cell populations. Interestingly, tissue contexts that are able to select for the growth of preneoplastic cells, including the aged liver microenvironment, are also supportive for the clonal expansion of normal, homotypic, transplanted cells...
September 2017: Cell Transplantation
https://www.readbyqxmd.com/read/29113010/comparison-of-four-methods-of-endotracheal-tube-passage-in-simulated-airways-there-is-room-for-improved-techniques
#9
Kirsten Kingma, Ross Hofmeyr, Irene Suilan Zeng, Christin Coomarasamy, Andrew Brainard
OBJECTIVE: Endotracheal intubation requires laryngoscopy followed by passage of the endotracheal tube (ETT). Tube passage can be difficult, but there is little evidence to support which adjunct for tube passage is most effective. METHODS: The four tube passage adjuncts tested were the naked ETT, stylet ETT, railroaded bougie and preloaded bougie. Participants completed pre- and post-test surveys identifying demographics, experience and method preference. After instruction, participants completed eight intubations on manikins with 'easy' and 'difficult' airways...
November 7, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29110668/measuring-the-bias-against-low-income-country-research-an-implicit-association-test
#10
Matthew Harris, James Macinko, Geronimo Jimenez, Pricila Mullachery
BACKGROUND: With an increasing array of innovations and research emerging from low-income countries there is a growing recognition that even high-income countries could learn from these contexts. It is well known that the source of a product influences perception of that product, but little research has examined whether this applies also in evidence-based medicine and decision-making. In order to examine likely barriers to learning from low-income countries, this study uses established methods in cognitive psychology to explore whether healthcare professionals and researchers implicitly associate good research with rich countries more so than with poor countries...
November 6, 2017: Globalization and Health
https://www.readbyqxmd.com/read/29109195/sleep-apnea-and-cardiovascular-disease-lessons-from-recent-trials-and-need-for-team-science
#11
REVIEW
Luciano F Drager, R Doug McEvoy, Ferran Barbe, Geraldo Lorenzi-Filho, Susan Redline
Emerging research highlights the complex interrelationships between sleep-disordered breathing and cardiovascular disease, presenting clinical and research opportunities as well as challenges. Patients presenting to cardiology clinics have a high prevalence of obstructive and central sleep apnea associated with Cheyne-Stokes respiration. Multiple mechanisms have been identified by which sleep disturbances adversely affect cardiovascular structure and function. Epidemiological research indicates that obstructive sleep apnea is associated with increases in the incidence and progression of coronary heart disease, heart failure, stroke, and atrial fibrillation...
November 7, 2017: Circulation
https://www.readbyqxmd.com/read/29107469/diseases-of-the-retina-and-the-optic-nerve-associated-with-obstructive-sleep-apnea
#12
REVIEW
Marielle Mentek, Florent Aptel, Diane Godin-Ribuot, Renaud Tamisier, Jean-Louis Pepin, Christophe Chiquet
Many associations between ocular disorders and obstructive sleep apnea (OSA) have been studied, such as nonarteritic anterior ischemic optic neuropathy, glaucoma, papilledema, retinal vein occlusion, eyelid hyperlaxity, lower-eyelid ectropion and recurrent corneal erosions. The objective of this review is to synthetize the possible vascular disorders of the retina and the optic nerve associated with sleep apnea patients and to discuss the underlying pathophysiological hypotheses. Main mechanisms involved in the ocular complications of OSA are related to intermittent hypoxia, sympathetic system activation, oxidant stress, and deleterious effects of endothelin 1...
May 29, 2017: Sleep Medicine Reviews
https://www.readbyqxmd.com/read/29105321/evidence-based-medicine-the-significance-of-research-literacy-in-emergency-medicine-training
#13
Lisa Brichko, Jessica Forbes, Kimberly Humphrey
No abstract text is available yet for this article.
November 3, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29068643/diagnosis-and-management-of-acute-exacerbation-of-chronic-obstructive-pulmonary-disease-digest
#14
Van Holden, Donald Slack Iii, Michael T McCurdy, Nirav G Shah, Nachi Gupta, Jeffrey Nusbaum
Acute exacerbation of chronic obstructive pulmonary disease (COPD) is a clinical diagnosis that is based on changes in dyspnea, cough, and/or sputum production in a COPD patient; however, patients presenting with an acute exacerbation may be undiagnosed or have a variety of comorbid conditions that can complicate diagnosis. This issue presents strategies and algorithms for the early use of evidence-based interventions, including appropriate use of antibiotics, bronchodilators, and corticosteroids, along with noninvasive ventilation with capnography, to minimize morbidity and mortality associated with this disease...
October 20, 2017: Emergency Medicine Practice
https://www.readbyqxmd.com/read/29068641/pediatric-wound-care-and-management-in-the-emergency-department-digest
#15
Jennifer E Sanders, Kathryn H Pade
Traumatic wounds and lacerations are common pediatric presenting complaints to emergency departments. Although there is a large body of literature on wound care, many emergency clinicians base management of wounds on theories and techniques that have been passed down over time. Therefore, controversial, conflicting, and unfounded recommendations are prevalent. This issue reviews evidence-based recommendations for wound care and management, including wound cleansing and irrigation, anxiolysis/sedation techniques, closure methods, and post-repair wound care...
October 23, 2017: Pediatric Emergency Medicine Practice
https://www.readbyqxmd.com/read/29068247/australian-elapid-snake-envenomation-in-cats-clinical-priorities-and-approach
#16
Trudi J Mcalees, Linda A Abraham
Practical relevance: No fewer than 140 species of terrestrial snakes reside in Australia, 92 of which possess venom glands. With the exception of the brown tree snake, the venom-producing snakes belong to the family Elapidae. The venom of a number of elapid species is more toxic than that of the Indian cobra and eastern diamondback rattle snake, which has earned Australia its reputation for being home to the world's most venomous snakes. Clinical challenges: The diagnosis of elapid snake envenomation is not always easy...
November 2017: Journal of Feline Medicine and Surgery
https://www.readbyqxmd.com/read/29061498/effect-of-a-red-blood-cell-transfusion-on-biological-markers-used-to-determine-the-cause-of-anemia-a-prospective-study
#17
Antoine Froissart, Benjamin Rossi, Brigitte Ranque, Irène Jarrin, Jean-François Bergmann, Sébastien Beaune, Sandrine Dautheville, Nicole Breau, Agnès Dauvergne, Lauréline Deluche, Tiphaine Robert, Nathalie Gault, Carine Roy, Virginie Zarrouk, Olivier Steichen, Bruno Fantin
BACKGROUND: Blood test results required for the evaluation of anemia are considered difficult to interpret after red blood cell transfusion. However, this hypothesis is neither supported by a strong physiological rationale nor is it evidence based. METHODS: We conducted a prospective multicenter study to compare the values of key assays before and after a course of red blood cell transfusion in the emergency or internal medicine units in four university hospitals...
October 20, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/29061113/the-emerging-roles-of-ngs-based-liquid-biopsy-in-non-small-cell-lung-cancer
#18
REVIEW
Yi-Chen Zhang, Qing Zhou, Yi-Long Wu
The treatment paradigm of non-small cell lung cancer (NSCLC) has evolved into oncogene-directed precision medicine. Identifying actionable genomic alterations is the initial step towards precision medicine. An important scientific progress in molecular profiling of NSCLC over the past decade is the shift from the traditional piecemeal fashion to massively parallel sequencing with the use of next-generation sequencing (NGS). Another technical advance is the development of liquid biopsy with great potential in providing a dynamic and comprehensive genomic profiling of NSCLC in a minimally invasive manner...
October 23, 2017: Journal of Hematology & Oncology
https://www.readbyqxmd.com/read/29048340/helping-health-services-to-meet-the-needs-of-young-people-with-chronic-conditions-towards-a-developmental-model-for-transition
#19
REVIEW
Albert Farre, Janet E McDonagh
The transition to adult healthcare has been the subject of increased research and policy attention over many years. However, unmet needs of adolescent and young adults (AYAs) and their families continue to be documented, and universal implementation has yet to be realised. Therefore, it is pertinent to re-examine health transition in light of the principles of adolescent medicine from which it emerged, and consider this particular life transition in terms of a developmental milestone rather than a negotiation of structural boundaries between child and adult services...
October 19, 2017: Healthcare (Basel, Switzerland)
https://www.readbyqxmd.com/read/29037256/effects-of-timing-on-intracoronary-autologous-bone-marrow-derived-cell-transplantation-in-acute-myocardial-infarction-a-meta-analysis-of-randomized-controlled-trials
#20
Jia-Ying Xu, Dai Liu, Yang Zhong, Rong-Chong Huang
BACKGROUND: Several cell-based therapies for adjunctive treatment of acute myocardial infarction have been investigated in multiple clinical trials, but the timing of transplantation remains controversial. We conducted a meta-analysis of randomized controlled trials to investigate the effects of timing on bone marrow-derived cell (BMC) therapy in acute myocardial infarction (AMI). METHODS: A systematic literature search of PubMed, MEDLINE, and Cochrane Evidence-Based Medicine databases from January 2000 to June 2017 was performed on randomized controlled trials with at least a 3-month follow-up for patients with AMI undergoing emergency percutaneous coronary intervention (PCI) and receiving intracoronary BMC transfer thereafter...
October 16, 2017: Stem Cell Research & Therapy
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