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https://www.readbyqxmd.com/read/28813728/-amputation-of-the-lower-limb-treatment-and-management
#1
Tim Ramczykowski, Thomas A Schildhauer
Despite modern conservative and surgical procedures, the number of amputations of the lower limb remains at a consistently high level. With the demographic changes and the consequent prevalence of atherosclerosis and diabetes mellitus, there is a steady increase of the risk factors that can lead to an amputation. The cause, which ultimately leads to the loss of the affected limb is therefore a symptom of the underlying disease. Primarily, the purpose of any medical treatment is the prevention of any amputation...
August 2017: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/28813557/facial-erosive-pustular-dermatosis-after-cosmetic-resurfacing
#2
Julie E Mervak, Stephanie D Gan, Emily H Smith, Frank Wang
Importance: Erosive pustular dermatosis (EPD) is a rare condition that typically affects actinically damaged skin of the scalp. Characterized by sterile pustules, erosions, and crusts, EPD is difficult to treat and heals slowly. The exact cause of EPD is unknown, although trauma is an inciting factor. Objective: To describe 3 women who presented with prolonged facial erosions after cosmetic resurfacing procedures, specifically fully ablative carbon dioxide laser or medium-depth chemical peel...
August 16, 2017: JAMA Dermatology
https://www.readbyqxmd.com/read/28813173/development-of-a-dermatology-diagnostic-techniques-teaching-session-a-nine-step-approach
#3
Robin M Farrell, Linda G Shell
Creating effective learning experiences for veterinary clinical skills and procedures can be a challenging task. Drawing from both medical and veterinary education literature and personal experiences as practicing veterinarians and educators, the authors share nine key steps that describe the development process of a pre-clinical veterinary clinical skills teaching session. Relevant research and pedagogical principles supporting the effectiveness of the proposed nine-step process were identified and discussed...
August 16, 2017: Journal of Veterinary Medical Education
https://www.readbyqxmd.com/read/28812845/a-qualitative-assessment-of-the-evidence-utilization-for-health-policy-making-on-the-basis-of-support-tools-in-a-developing-country
#4
Mohammad Hasan Imani-Nasab, Hesam Seyedin, Bahareh Yazdizadeh, Reza Majdzadeh
BACKGROUND: SUPPORT tools consist of 18 articles addressing the health policy-makers so that they can learn how to make evidence-informed health policies. These tools have been particularly recommended for developing countries. The present study tries to explain the process of evidence utilization for developing policy documents in the Iranian Ministry of Health and Medical Education (MoHME) and to compare the findings with those of SUPPORT tools. METHODS: A qualitative research was conducted, using the framework analysis approach...
January 8, 2017: International Journal of Health Policy and Management
https://www.readbyqxmd.com/read/28812247/towards-robot-assisted-echocardiographic-monitoring-in-catheterization-laboratories-usability-centered-manipulator-for-transesophageal-echocardiography
#5
Christina Pahl, Henning Ebelt, Mostafa Sayahkaraji, Eko Supriyanto, Amiliana Soesanto
This paper proposes a robotic Transesophageal Echocardiography (TOE) system concept for Catheterization Laboratories. Cardiovascular disease causes one third of all global mortality. TOE is utilized to assess cardiovascular structures and monitor cardiac function during diagnostic procedures and catheter-based structural interventions. However, the operation of TOE underlies various conditions that may cause a negative impact on performance, the health of the cardiac sonographer and patient safety. These factors have been conflated and evince the potential of robot-assisted TOE...
August 15, 2017: Journal of Medical Systems
https://www.readbyqxmd.com/read/28812121/-teaching-in-orthopaedic-and-trauma-surgery
#6
T Renkawitz, A Benditz, M Rüsseler, U Obertacke, J Grifka, M Weber
The scramble for available places to study medicine in Germany continues. One of the core points within the "Master Plan 2020", which has been recently adopted, is the reform of teaching concepts at German medical faculties. In the future, students of human medicine are to be trained primarily based upon competence-oriented, integrated curricula. The present paper is intended to present modern teaching concepts and methods, as well as current examination formats, which play a special role in student training in orthopaedics and traumatology...
August 15, 2017: Der Orthopäde
https://www.readbyqxmd.com/read/28812056/initiating-a-standardized-regional-referral-and-counter-referral-system-in-guatemala-a-mixed-methods-study
#7
Rupa Kapoor, Leslie Avendaño, Maria Antonieta Sandoval, Andrea T Cruz, Esther M Sampayo, Miguel A Soto, Elizabeth A Camp, Heather L Crouse
Background:Few data exist for referral processes in resource-limited settings. We utilized mixed-methods to evaluate the impact of a standardized algorithm and training module developed for locally identified needs in referral/counter-referral procedures between primary health centers (PHCs) and a Guatemalan referral hospital. Methods: PHC personnel and hospital physicians participated in surveys and focus groups pre-implementation and 3, 6, and 12 months post-implementation to evaluate providers' experience with the system...
2017: Global Pediatric Health
https://www.readbyqxmd.com/read/28812052/the-superior-labial-frenulum-in-newborns-what-is-normal
#8
Chloe Santa Maria, Janelle Aby, Mai Thy Trong, Yogita Thakur, Sharon Rea, Anna Messner
Introduction and Objectives: There has been an emergence of procedures to release the superior labial frenula in infants, yet little is known about the normal appearance or incidence of severe attachment, or "lip-tie." The objective of this article was to develop a classification system for superior labial frenula and to estimate the incidence of different degrees of attachment. Methods: A prospective cross-sectional study. Newborns were examined and had photographs taken of their upper frenula. Relevant medical professionals rated the appearance of the labial frenula using a previously described Kotlow classification system...
2017: Global Pediatric Health
https://www.readbyqxmd.com/read/28811987/early-complications-and-outcomes-in-adult-spinal-deformity-surgery-an-nsqip-study-based-on-5803-patients
#9
Nathan J Lee, Parth Kothari, Jun S Kim, John I Shin, Kevin Phan, John Di Capua, Sulaiman Somani, Dante M Leven, Javier Z Guzman, Samuel K Cho
STUDY DESIGN: Retrospective analysis. OBJECTIVE: The purpose of this study is to determine the incidence, impact, and risk factors for short-term postoperative complications following elective adult spinal deformity (ASD) surgery. METHODS: Current Procedural Terminology codes were used to query the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) for adults who underwent spinal deformity surgery from 2010 to 2014...
August 2017: Global Spine Journal
https://www.readbyqxmd.com/read/28811394/overview-and-current-management-of-computerized-adaptive-testing-in-licensing-certification-examinations
#10
Dong Gi Seo
Computerized adaptive testing (CAT) has been implemented in the high stakes examinations such as National Council Licensure Examination-Registered Nurses (NCLEX-RN) in the United States since 1994. After that, The National Registry Emergency Medical Technician (NREMT) in the United States adopted a CAT to certify an Emergency Medical Technician (EMT) in 2007. It aimed at introducing CAT for the implementation in the medical health licensing examinations. Most CATs are based on the item response theory (IRT) which hypothesizes that both examinee and item has own characteristics that does not change...
July 26, 2017: Journal of Educational Evaluation for Health Professions
https://www.readbyqxmd.com/read/28811136/determination-of-ghb-and-ghb-%C3%AE-o-glucuronide-in-hair-of-three-narcoleptic-patients-comparison-between-single-and-chronic-ghb-exposure
#11
Lena-Maria Mehling, Xin Wang, Sys-Stybe Johansen, Annika Spottke, Anna Heidbreder, Peter Young, Burkhard Madea, Cornelius Hess
Gamma-hydroxybutyric acid (GHB) can be used as a knock-out drug in drug facilitated crime (DFC). Due to its rapid metabolism and resulting narrow detection window, uncovering GHB use in DFC still constitutes a problem. In this experiment we determined the GHB and GHB-β-O-glucuronide (GHB-Gluc) concentrations in hair samples after single and chronic GHB exposures. Hair samples of three narcoleptic patients therapeutically taking sodium oxybate (GHB-sodium-salt) were collected. Patients 1 (P1) and 2 (P2) took the medication for nine and six years, respectively...
July 31, 2017: Forensic Science International
https://www.readbyqxmd.com/read/28811061/surgical-demographics-of-carpal-tunnel-syndrome-and-cubital-tunnel-syndrome-over-5-years-at-a-single-institution
#12
Dafang Zhang, Jamie E Collins, Brandon E Earp, Philip Blazar
PURPOSE: Carpal tunnel and cubital tunnel syndrome are the 2 most common upper-limb compressive neuropathies. However, whether the characteristics of patient populations undergoing surgery for these conditions are similar is unclear in terms of demographics and concomitant pathologies. Our null hypothesis was that there are no identifiable differences between these patient populations. METHODS: A retrospective cohort study was performed by billing system query using Common Procedural Terminology (CPT) codes for all patients who underwent open carpal tunnel release (CTR) (CPT code 64721) and/or open cubital tunnel surgery (CPT code 64718) by 1 of 4 hand surgeons from August 2008 to July 2013...
August 12, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28810280/-dual-antiplatelet-therapy-in-the-perioperative-period-to%C3%A2-continue-or-discontinue-treatment
#13
Jürgen Koscielny, Christian von Heymann, Uwe Zeymer, Jochen Cremer, Michael Spannagl, Joachim Labenz, Evangelos Giannitsis, Franz Goss
Background For secondary prevention of acute coronary syndrome, guidelines recommend dual antiplatelet therapy (DAPT) with acetylsalicylic acid and a P2Y12 receptor antagonist such as clopidogrel, prasugrel or ticagrelor for a period of 12 months. Often, uncertainty exists with respect to surgical or diagnostic procedures in these high-risk patients: can the DAPT be continued without interruption? If not, what is the recommended withdrawal strategy? What should be considered for the perioperative management? Methods An interdisciplinary group of experienced experts in the fields of cardiology, cardiac surgery, gastroenterology, anaesthesiology, intensive care and haemostaseology developed recommendations relevant to daily clinical practice based on the current scientific evidence...
August 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28810270/the-personal-antipsychotic-choice-index
#14
Floor van Dijk, Iris de Wit, Matthijs Blankers, Iris Sommer, Lieuwe de Haan
Introduction We present an online decision aid to involve patients with a psychotic disorder in shared decision-making concerning the selection of antipsychotic medication. Method Patients selected effectiveness and adverse effects criteria from the Subject's Response to Antipsychotics-34 questionnaire. Numerical data from meta-analyses, clinical trial data, receptor affinities and expert opinions were used to rank antipsychotics on each criterion. When using the the tool, patients indicate on a 5-point Likert scale how they value each (adverse) effect...
August 15, 2017: Pharmacopsychiatry
https://www.readbyqxmd.com/read/28810184/design-and-evaluation-of-a-parametric-model-for-cardiac-sounds
#15
Roilhi F Ibarra-Hernández, Miguel A Alonso-Arévalo, Alejandro Cruz-Gutiérrez, Ana L Licona-Chávez, Salvador Villarreal-Reyes
Heart sound analysis plays an important role in the auscultative diagnosis process to detect the presence of cardiovascular diseases. In this paper we propose a novel parametric heart sound model that accurately represents normal and pathological cardiac audio signals, also known as phonocardiograms (PCG). The proposed model considers that the PCG signal is formed by the sum of two parts: one of them is deterministic and the other one is stochastic. The first part contains most of the acoustic energy. This part is modeled by the Matching Pursuit (MP) algorithm, which performs an analysis-synthesis procedure to represent the PCG signal as a linear combination of elementary waveforms...
August 9, 2017: Computers in Biology and Medicine
https://www.readbyqxmd.com/read/28810130/the-cost-of-adherence-mismeasurement-in-serious-mental-illness-a-claims-based-analysis
#16
Jason Shafrin, Felicia Forma, Ethan Scherer, Ainslie Hatch, Edward Vytlacil, Darius Lakdawalla
OBJECTIVES: To quantify how adherence mismeasurement affects the estimated impact of adherence on inpatient costs among patients with serious mental illness (SMI). STUDY DESIGN: Proportion of days covered (PDC) is a common claims-based measure of medication adherence. Because PDC does not measure medication ingestion, however, it may inaccurately measure adherence. We derived a formula to correct the bias that occurs in adherence-utilization studies resulting from errors in claims-based measures of adherence...
May 1, 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/28809861/high-frequency-measurement-of-depressive-severity-in-a-patient-treated-for-severe-treatment-resistant-depression-with-deep-brain-stimulation
#17
S Sani, J Busnello, R Kochanski, Y Cohen, R D Gibbons
Although there have been previous studies of deep-brain stimulation (DBS), we present, to our knowledge, the first example of high-frequency depressive severity measurement-based DBS treatment in particular and psychiatric treatment in general. Daily post-surgical e-mail prompts for a period of 6 months resulted in 93 administrations of a computerized adaptive test (CAT) of depression severity (CAT-Depression Inventory or CAT-DI) via the internet. There was an average of 3.37 weekly measurements with an average separation of 2...
August 15, 2017: Translational Psychiatry
https://www.readbyqxmd.com/read/28809725/clinical-characteristics-and-complications-of-pediatric-liver-biopsy-a-single-centre-experience
#18
Patricia Almeida, Richard A Schreiber, Jennifer Liang, Quais Mujawar, Orlee R Guttman
INTRODUCTION: Percutaneous liver biopsy (LB) is the gold standard method for evaluation and management of patients with liver disease. The purpose of this study was to characterize pediatric patients undergoing LB at British Columbia Children's Hospital, and to determine the rate and timing of complications following the procedure. MATERIAL AND METHODS: The medical records of all pediatric patients who underwent LB during a six-year retrospective study were reviewed to collect demographic and procedure-related data...
August 8, 2017: Annals of Hepatology
https://www.readbyqxmd.com/read/28809724/comparison-of-hemostasis-times-with-a-kaolin-based-hemostatic-pad-quikclot-radial-vs-mechanical-compression-tr-band-following-transradial-access-a-pilot-prospective-study
#19
Jonathan S Roberts, Jianli Niu, Juan A Pastor-Cervantes
BACKGROUND: Hemostasis following transradial access (TRA) is usually achieved by mechanical compression. We investigated use of the QuikClot Radial hemostasis pad (Z-Medica) compared with the TR Band (Terumo Medical) to shorten hemostasis after TRA. METHODS: Thirty patients undergoing TRA coronary angiography and/or percutaneous coronary intervention were randomized into three cohorts post TRA: 10 patients received mechanical compression with the TR Band, 10 patients received 30 min of compression with the QuikClot Radial pad, and 10 patients received 60 min of compression with the QuikClot Radial pad...
August 15, 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28809585/patient-autonomy-and-doctor-s-concern-a-case-of-intravenous-drug-abuser
#20
Alok Atreya, Tanuj Kanchan, Rajeev K Shah
Intravenous substance abuse is often associated with physical and psychological harm, and often requires urgent medical attention. We report a case of a young male who presented with life-threatening complications of intravenous drug abuse, but refused to give details or agree to the proposed treatment, raising concerns for the team of doctors. A compos mentis patient has a right to decide what should be done to his body. Medical management or surgical interventions cannot be initiated without the patient's consent even if these are lifesaving procedures, or a procedure meant to benefit the patient...
January 1, 2017: Medico-legal Journal
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