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https://www.readbyqxmd.com/read/28195686/diagnosis-of-anaplastic-lymphoma-kinase-rearrangement-in-cytological-samples-through-a-fluorescence-in-situ-hybridization-based-assay-cytological-smears-versus-cell-blocks
#1
Federica Zito Marino, Giulio Rossi, Matteo Brunelli, Maria Gabriella Malzone, Giuseppina Liguori, Giuseppe Bogina, Alessandro Morabito, Gaetano Rocco, Renato Franco, Gerardo Botti
Anaplastic lymphoma kinase (ALK) status analysis of lung cytological specimens should be successfully encouraged in routine practice because biopsy specimens are not always available. To date, the US Food and Drug Administration has approved both fluorescence in situ hybridization (FISH) and immunohistochemistry (IHC) as diagnostic tests for identifying ALK-positive patients eligible for treatment with crizotinib. Although ALK IHC is an optimal diagnostic tool, FISH becomes mandatory in equivocal cases. ALK FISH of paraffin-embedded tissue material is still the gold standard, whereas the cytological specimen assay has not yet been completely standardized...
February 14, 2017: Cancer
https://www.readbyqxmd.com/read/28156460/developing-and-piloting-an-electronic-telephone-triage-application
#2
Christine Carlisle, Colleen F Ford, Jan Hartman, Peggy Nikolajski, Carol Reidmiller, Justin S Rushford, Leslie Stewart, Amanda Barry, Melinda Krebs
: 68 Background: Telephone triage is a vital part of today's oncology practice and is often not standardized and measured to allow for quality improvement. UPMC CancerCenter (UPMC) has 31 outpatient clinics and is in need of a tool to streamline the current telephone triage process. UPMC and Via Oncology collaborated to develop and pilot a prototype of an electronic telephone triage application. The key components of the prototype were defined as decision support, EHR integration, reporting and workflow management...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28089112/predictive-utility-of-the-total-glasgow-coma-scale-versus-the-motor-component-of-the-glasgow-coma-scale-for-identification-of-patients-with-serious-traumatic-injuries
#3
REVIEW
Roger Chou, Annette M Totten, Nancy Carney, Spencer Dandy, Rongwei Fu, Sara Grusing, Miranda Pappas, Ngoc Wasson, Craig D Newgard
STUDY OBJECTIVE: The motor component of the Glasgow Coma Scale (mGCS) has been proposed as an easier-to-use alternative to the total GCS (tGCS) for field assessment of trauma patients by emergency medical services. We perform a systematic review and meta-analysis to compare the predictive utility of the tGCS versus the mGCS or Simplified Motor Scale in field triage of trauma for identifying patients with adverse outcomes (inhospital mortality or severe brain injury) or who underwent procedures (neurosurgical intervention or emergency intubation) indicating need for high-level trauma care...
January 11, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28055239/the-evolving-role-of-pathology-in-new-developments-classification-terminology-and-diagnosis-of-pancreatobiliary-neoplasms
#4
Michelle D Reid, Melinda M Lewis, Field F Willingham, Volkan Adsay
Pancreatobiliary tract lesions are increasingly being discovered because of more sensitive imaging modalities. Magnetic resonance imaging has identified incidental pancreatic cysts in 13.5% of patients of progressively increasing age. Pancreatobiliary tissue is more accessible through endoscopic ultrasound and magnetic resonance imaging-guided biopsy procedures, and is now an integral part of pathologists' routine practice. Accordingly, several new tumor categories have been recently recognized, including intraductal tubulopapillary neoplasm, a new addition to tumoral intraepithelial neoplasms...
January 5, 2017: Archives of Pathology & Laboratory Medicine
https://www.readbyqxmd.com/read/28041758/emergency-medical-services-ems-versus-non-ems-transport-among-injured-children-in-the-united-states
#5
Michelle M Corrado, Junxin Shi, Krista K Wheeler, Jin Peng, Brian Kenney, Sarah Johnson, Huiyun Xiang
OBJECTIVES: This study aimed to assess the proportions of injured children transported to trauma centers by different transportation modes and evaluate the effect of transportation mode on inter-facility transfer rates using the US national trauma registry. METHODS: We analyzed data from the 2007-2012 National Trauma Data Bank (NTDB) to study trends of EMS versus non-EMS transport. Multivariable logistic regression was used to evaluate the association between transport mode and inter-facility transfer...
November 30, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27992953/age-related-disparities-in-trauma-center-access-for-severe-head-injuries-following-the-release-of-the-updated-field-triage-guidelines
#6
Thomas J Flottemesch, Susan Raetzman, Kevin C Heslin, Katie Fingar, Rosanna Coffey, Marguerite Barrett, Ernest Moy
OBJECTIVE: In 2006, the American College of Surgeons' Committee on Trauma and the Center for Disease Control released field triage guidelines with special consideration for older adults. Additional considerations for direct transport to a Level I or II trauma center (TC) were added in 2011, reflecting perceived undertriage to TCs for older adults. We examined whether age-based disparities in TC care for severe head injury decreased following introduction of the 2011 revisions. METHODS: A pre-post design analyzing the 2009 and 2012 Healthcare Cost and Utilization Project State Emergency Department Databases (SEDD) and State Inpatient Databases (SID) with multivariable logistic regressions considered changes in (1) the trauma designation of the emergency department where treatment was initiated and (2) transfer to a TC following initial treatment at a non-TC...
December 19, 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/27982665/building-health-it-capacity-to-improve-hiv-infection-health-outcomes
#7
Hannah Rettler, Monina Klevens, Gillian Haney, Liisa Randall, Alfred DeMaria, Johanna Goderre
Eighty-six percent of those engaged in HIV medical care in Massachusetts achieved viral suppression, making Massachusetts's long-term goal of eliminating new infections of HIV a real possibility. In order to achieve this goal, Massachusetts is working to engage all individuals living with HIV/AIDS in HIV medical care, keep them retained in care, and render their viral load non-detectable. Currently, in Massachusetts, the data elements necessary to monitor the HIV care continuum are documented in siloed health information systems that do not communicate with each other...
December 2016: American Journal of Managed Care
https://www.readbyqxmd.com/read/27965331/understanding-attention-deficit-hyperactivity-disorder-as-a-continuum
#8
REVIEW
John D McLennan
OBJECTIVE: To review research findings that consider whether attention deficit hyperactivity disorder (ADHD) is a discrete entity or whether it is more consistent with an extreme end-of-trait distribution in the population and to then grapple with the potential clinical implications. QUALITY OF EVIDENCE: Peer-reviewed publications in the past 5 years, drawing from diverse fields (taxonomy, epidemiology, genetics, neurobiology, and neuropsychology), were identified through searches in MEDLINE and PsycINFO...
December 2016: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/27941470/simbu-ptosis-an-outreach-approach-to-myogenic-ptosis-in-eastern-highlands-of-papua-new-guinea-experience-and-results-from-a-high-volume-oculoplastic-surgical-camp
#9
Anna G Gushchin, Alison V Crum, Ben B Limbu, Edward P Quigley, Michael S Seward, Geoffrey C Tabin
PURPOSE: To present the results of a high-volume oculoplastic surgical outreach in a remote region of Simbu Province in the Eastern Highlands of Papua New Guinea. The authors describe the clinical features and evaluation and treatment of a novel ptosis syndrome found in this area. DESIGN: A team of 4 international ophthalmologists and 3 local doctors and 3 local nurses involved in a high-volume field intervention for all patients presenting with a bilateral ptosis to Mingende Rural Hospital...
December 9, 2016: Ophthalmic Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/27928226/achieving-timely-percutaneous-reperfusion-for-rural-st-elevation-myocardial-infarction-patients-by-direct-transport-to-an-urban-pci-hospital
#10
Charles-Lwanga K Bennin, Saif Ibrahim, Farah Al-Saffar, Lyndon C Box, Joel A Strom
BACKGROUNDS: ST-elevation myocardial infarction (STEMI) guidelines recommend reperfusion by primary percutaneous coronary intervention (PCI) ≤ 90 min from time of first medical contact (FMC). This strategy is challenging in rural areas lacking a nearby PCI-capable hospital. Recommended reperfusion times can be achieved for STEMI patients presenting in rural areas without a nearby PCI-capable hospital by ground transportation to a central PCI-capable hospital by use of protocol-driven emergency medical service (EMS) STEMI field triage protocol...
October 2016: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/27918864/comparison-of-emergency-medical-services-and-trauma-care-systems-among-pan-asian-countries-an-international-multicenter-population-based-survey
#11
Kyong Min Sun, Kyoung Jun Song, Sang Do Shin, Hideharu Tanaka, Goh E Shaun, Wen-Chu Chiang, Kentaro Kajino, Sabariah Faizah Jamaluddin, Akio Kimura, Young Sun Ro, Dae Han Wi, Ju Ok Park, Sung Woo Moon, Young Hee Jung, Min Jung Kim, James F Holmes
OBJECTIVE: Knowledge on the current trauma systems in Asian countries is limited. The objective of this study was to describe the emergency medical services (EMS) and trauma care systems among countries participating in the Pan-Asian Trauma Outcomes Study (PATOS) Clinical Research Network. METHODS: The PATOS network consists of 33 participating sites from 14 countries. Standardized data was collected from each site using an EMS survey form and included general information (population, population density, urbanization, EMS service fee, etc...
December 5, 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27886997/using-stable-free-radicals-to-obtain-unique-and-clinically-useful-data-in-vivo-in-human-subjects
#12
Harold M Swartz
This paper attempts to: (1) provide a critical overview of the challenges and opportunities to extend electron paramagnetic resonance (EPR) into practical applications in human subjects, based on EPR measurements made in vivo; (2) summarize the clinical applications of EPR for improving treatments in cancer, wound healing and diabetic care, emphasizing EPR's unique capability to measure tissue oxygen repeatedly and with particular sensitivity to hypoxia and (3) summarize the capabilities of in vivo EPR to measure radiation dose for triage and medical guidance after a large-scale radiation exposure...
December 2016: Radiation Protection Dosimetry
https://www.readbyqxmd.com/read/27833674/alternative-destination-transport-the-role-of-paramedics-in-optimal-use-of-the-emergency-department
#13
Michael M Neeki, Fanglong Dong, Leigh Avera, Tan Than, Rodney Borger, Joe Powell, Reza Vaezazizi, Richard Pitts
INTRODUCTION: Alternative destination transportation by emergency medical services (EMS) is a subject of hot debate between those favoring all patients being evaluated by an emergency physician (EP) and those recognizing the need to reduce emergency department (ED) crowding. This study aimed to determine whether paramedics could accurately assess a patient's acuity level to determine the need to transport to an ED. METHODS: We performed a prospective double-blinded analysis of responses recorded by paramedics and EPs of arriving patients' acuity level in a large Level II trauma center between April 2015 and November 2015...
November 2016: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27797986/ambulance-smartphone-tool-for-field-triage-of-ruptured-aortic-aneurysms-filtr-study-protocol-for-a-prospective-observational-validation-of-diagnostic-accuracy
#14
Thomas L Lewis, Rachael T Fothergill, Alan Karthikesalingam
INTRODUCTION: Rupture of an abdominal aortic aneurysm (rAAA) carries a considerable mortality rate and is often fatal. rAAA can be treated through open or endovascular surgical intervention and it is possible that more rapid access to definitive intervention might be a key aspect of improving mortality for rAAA. Diagnosis is not always straightforward with up to 42% of rAAA initially misdiagnosed, introducing potentially harmful delay. There is a need for an effective clinical decision support tool for accurate prehospital diagnosis and triage to enable transfer to an appropriate centre...
24, 2016: BMJ Open
https://www.readbyqxmd.com/read/27793995/identifying-patients-at-risk-for-prehospital-sudden-cardiac-arrest-at-the-early-phase-of-myocardial-infarction-the-e-must-study-evaluation-en-m%C3%A3-decine-d-urgence-des-strat%C3%A3-gies-th%C3%A3-rapeutiques-des-infarctus-du-myocarde
#15
Nicole Karam, Sophie Bataille, Eloi Marijon, Olivier Giovannetti, Muriel Tafflet, Dominique Savary, Hakim Benamer, Christophe Caussin, Philippe Garot, Jean-Michel Juliard, Virginie Pires, Thévy Boche, François Dupas, Gaelle Le Bail, Lionel Lamhaut, François Laborne, Hugues Lefort, Mireille Mapouata, Frederic Lapostolle, Christian Spaulding, Jean-Philippe Empana, Xavier Jouven, Yves Lambert
BACKGROUND: In-hospital mortality of ST-segment-elevation myocardial infarction (STEMI) has decreased drastically. In contrast, prehospital mortality from sudden cardiac arrest (SCA) remains high and difficult to reduce. Identification of the patients with STEMI at higher risk for prehospital SCA could facilitate rapid triage and intervention in the field. METHODS: Using a prospective, population-based study evaluating all patients with STEMI managed by emergency medical services in the greater Paris area (11...
December 20, 2016: Circulation
https://www.readbyqxmd.com/read/27789231/triage-damned-triage%C3%A2-and-statistics-sorting-out-redundancy-and-duplication-within-an-emergency-department-presenting-problem-code-set-to-enhance-research-capacity
#16
Saartje Berendsen Russell, Michael M Dinh, Nerida Bell
BACKGROUND: Having a robust Emergency Department Presenting Problem Code Set (EDPPCS) is important for collecting and analysing data around Emergency Department (ED) activity, funding, bio-surveillance and research. This paper analyses the clinical utilisation of the current EDPPCS using two years worth of ED data collected as part of the larger state-wide Demand for Emergency Services Trends in Years 2010-2014 (DESTINY) project. This project proposes potential improvements in the current EDPPCS including a reduction in duplication and redundant clinical terms...
October 24, 2016: Australasian Emergency Nursing Journal: AENJ
https://www.readbyqxmd.com/read/27786390/diagnosis-based-emergency-department-alcohol-harm-surveillance-what-can-it-tell-us-about-acute-alcohol-harms-at-the-population-level
#17
Genevieve Whitlam, Michael Dinh, Craig Rodgers, David J Muscatello, Rhydwyn McGuire, Therese Ryan, Sarah Thackway
INTRODUCTION AND AIMS: Acute harm from heavy drinking episodes is an increasing focus of public health policy, but capturing timely data on acute harms in the population is challenging. This study aimed to evaluate the precision of readily available administrative emergency department (ED) data in public health surveillance of acute alcohol harms. DESIGN AND METHODS: We selected a random sample of 1000 ED presentations assigned an ED diagnosis code for alcohol harms (the 'alcohol syndrome') in the New South Wales, Australia, automatic syndromic surveillance system...
November 2016: Drug and Alcohol Review
https://www.readbyqxmd.com/read/27757716/simedis-a-discrete-event-simulation-model-for-testing-responses-to-mass-casualty-incidents
#18
Michel Debacker, Filip Van Utterbeeck, Christophe Ullrich, Erwin Dhondt, Ives Hubloue
It is recognized that the study of the disaster medical response (DMR) is a relatively new field. To date, there is no evidence-based literature that clearly defines the best medical response principles, concepts, structures and processes in a disaster setting. Much of what is known about the DMR results from descriptive studies and expert opinion. No experimental studies regarding the effects of DMR interventions on the health outcomes of disaster survivors have been carried out. Traditional analytic methods cannot fully capture the flow of disaster victims through a complex disaster medical response system (DMRS)...
December 2016: Journal of Medical Systems
https://www.readbyqxmd.com/read/27733926/wearable-multimodal-vitals-acquisition-unit-for-intelligent-field-triage
#19
Christoph Beck, Julius Georgiou
In this Letter, the authors describe the characterisation design and development of the authors' wearable, multimodal vitals acquisition unit for intelligent field triage. The unit is able to record the standard electrocardiogram, blood oxygen and body temperature parameters and also has the unique capability to record up to eight custom designed acoustic streams for heart and lung sound auscultation. These acquisition channels are highly synchronised to fully maintain the time correlation of the signals. The unit is a key component enabling systematic and intelligent field triage to continuously acquire vital patient information...
September 2016: Healthcare Technology Letters
https://www.readbyqxmd.com/read/27732713/evaluation-of-rural-vs-urban-trauma-patients-served-by-9-1-1-emergency-medical-services
#20
Craig D Newgard, Rongwei Fu, Eileen Bulger, Jerris R Hedges, N Clay Mann, Dagan A Wright, David P Lehrfeld, Carol Shields, Gregory Hoskins, Craig Warden, Lynn Wittwer, Jennifer N B Cook, Michael Verkest, William Conway, Stephanie Somerville, Matthew Hansen
Importance: Despite a large rural US population, there are potential differences between rural and urban regions in the processes and outcomes following trauma. Objectives: To describe and evaluate rural vs urban processes of care, injury severity, and mortality among injured patients served by 9-1-1 emergency medical services (EMS). Design, Setting, and Participants: This was a preplanned secondary analysis of a prospective cohort enrolled from January 1 through December 31, 2011, and followed up through hospitalization...
January 1, 2017: JAMA Surgery
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