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https://www.readbyqxmd.com/read/27936189/impact-of-attending-physicians-comments-on-residents-workloads-in-the-emergency-department-results-from-two-j-o-pan-randomized-controlled-trials
#1
Akira Kuriyama, Noriyuki Umakoshi, Jun Fujinaga, Toshie Kaihara, Seigo Urushidani, Naoki Kuninaga, Motohiro Ichikawa, Shinichiro Ienaga, Akira Sasaki, Tetsunori Ikegami
OBJECTIVE: To examine whether peppy comments from attending physicians increased the workload of residents working in the emergency department (ED). METHODS: We conducted two parallel-group, assessor-blinded, randomized trials at the ED in a tertiary care hospital in western Japan. Twenty-five residents who examined either ambulatory (J(^o^)PAN-1 Trial) or transferred patients (J(^o^)PAN-2 Trial) in the ED on weekdays. Participants were randomly assigned to groups that either received a peppy message such as "Hope you have a quiet day!" (intervention group) or did not (control group) from the attending physicians...
2016: PloS One
https://www.readbyqxmd.com/read/27935182/pain-management-intervention-targeting-nursing-staff-and-general-practitioners-pain-intensity-consequences-and-clinical-relevance-for-nursing-home-residents
#2
Dagmar Dräger, Andrea Budnick, Ronny Kuhnert, Sonja Kalinowski, Franziska Könner, Reinhold Kreutz
AIM: Although chronic pain is common in older adults, its treatment is frequently inappropriate. This problem is particularly prevalent in nursing home residents. We therefore developed an intervention to optimize pain management and evaluated its effects on pain intensity and pain interference with function in nursing home residents in Germany. METHODS: In a cluster-randomized controlled intervention, 195 residents of 12 Berlin nursing homes who were affected by pain were surveyed at three points of measurement...
December 9, 2016: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/27933151/improving-asthma-care-in-a-pediatric-resident-clinic
#3
Julia Lee, Albina Gogo, Daniel Tancredi, Erik Fernandez Y Garcia, Ulfat Shaikh
There is variation in pediatric asthma management in the outpatient setting. Adherence to national asthma guidelines provides a systematic standardized approach to asthma management. There is a gap between usual and guideline-consistent asthma care in resident clinics. Practice improvement modules aimed at improving resident physician adherence to asthma care guidelines have not been consistently utilized and have not yet been studied. Our aim was to increase guideline consistent care in our pediatric resident clinic in a twelve-month period via increasing performance on the following measures to 75%: spirometry testing; influenza immunization recommendation; level of control assessed through the use of a standardized questionnaire; appropriate medications per national guideline; and use of written asthma action plans...
2016: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/27931906/burnout-in-japanese-residents-and-its-associations-with-temperament-and-character
#4
Ryoei Miyoshi, Hisae Matsuo, Ryuichiro Takeda, Hiroyuki Komatsu, Hiroshi Abe, Yasushi Ishida
AIM: High risk of burnout in healthcare workers has long been recognized. However, there are no methods to predict vulnerability to burnout. METHODS: We examined whether temperament and character are associated with burnout and depressive state in residents by using the Temperament and Character Inventory (TCI). The TCI was used for residents at the beginning of clinical training and then the Maslach Burnout Inventory-General Survey (MBI-GS) and the Self-Rating Depression Scale (SDS) were administered at the beginning of clinical training and after four and ten months...
December 2016: Asian Journal of Psychiatry
https://www.readbyqxmd.com/read/27931234/patterns-and-determinants-of-malaria-risk-in-urban-and-peri-urban-areas-of-blantyre-malawi
#5
Don P Mathanga, Atupele Kapito Tembo, Themba Mzilahowa, Andy Bauleni, Kondwani Mtimaukenena, Terrie E Taylor, Clarissa Valim, Edward D Walker, Mark L Wilson
BACKGROUND: Although malaria disease in urban and peri-urban areas of sub-Saharan Africa is a growing concern, the epidemiologic patterns and drivers of transmission in these settings remain poorly understood. Factors associated with variation in malaria risk in urban and peri-urban areas were evaluated in this study. METHODS: A health facility-based, age and location-matched, case-control study of children 6-59 months of age was conducted in four urban and two peri-urban health facilities (HF) of Blantyre city, Malawi...
December 8, 2016: Malaria Journal
https://www.readbyqxmd.com/read/27931212/pdgf-aa-mediates-mesenchymal-stromal-cell-chemotaxis-to-the-head-and-neck-squamous-cell-carcinoma-tumor-microenvironment
#6
Tammara L Watts, Ruwen Cui, Peter Szaniszlo, Vicente A Resto, Don W Powell, Irina V Pinchuk
BACKGROUND: The robust desmoplasia associated with head and neck squamous cell carcinoma (HNSCC) suggests that the tumor microenvironment may be an important component in the pathophysiology of this cancer. Moreover, the high recurrence rate and poor clinical response to chemotherapy and radiation treatment further underscores that the non-cancerous cells of the microenvironment, such as mesenchymal stromal cells (MSCs), cancer associated fibroblasts (CAFs), and pericytes, may be important in the pathophysiology of HNSCC...
December 8, 2016: Journal of Translational Medicine
https://www.readbyqxmd.com/read/27929753/generation-and-characterization-of-abbv642-a-dual-variable-domain-immunoglobulin-molecule-dvd-ig-that-potently-neutralizes-vegf-and-pdgf-bb-and-is-designed-for-the-treatment-of-exudative-age-related-macular-degeneration
#7
Kun Ding, Lucia Eaton, Diana Bowley, Matthew Rieser, Qing Chang, Maria C Harris, Anca Clabbers, Feng Dong, Jikui Shen, Sean F Hackett, Debra S Touw, Jacqueline Bixby, Suju Zhong, Lorenzo Benatuil, Sahana Bose, Christine Grinnell, Gregory M Preston, Ramesh Iyer, Ramkrishna Sadhukhan, Susan Marchie, Gary Overmeyer, Tariq Ghayur, Deborah A van Riet, Shibo Tang, Peter A Campochario, Jijie Gu
Exudative age-related macular degeneration (AMD) is the most common cause of moderate and severe vision loss in developed countries. Intraocular injections of vascular endothelial growth factor (VEGF or VEGF-A)-neutralizing proteins provide substantial benefit, but frequent, long-term injections are needed. In addition, many patients experience initial visual gains that are ultimately lost due to subretinal fibrosis. Preclinical studies and early phase clinical trials suggest that combined suppression of VEGF and platelet-derived growth factor-BB (PDGF-BB) provides better outcomes than suppression of VEGF alone, due to more frequent regression of neovascularization (NV) and suppression of subretinal fibrosis...
December 8, 2016: MAbs
https://www.readbyqxmd.com/read/27929699/elucidating-trainee-effect-on-outcomes-for-general-gynecologic-and-urologic-oncology-procedures
#8
Megan Sippey, Konstantinos Spaniolas, Kevin R Kasten
BACKGROUND AND OBJECTIVES: Surgical complications delay adjuvant therapy in oncology patients. Current literature remains unclear regarding resident effect on postoperative outcomes, with inappropriate coverage possibly endangering patients in spite of attending oversight. We assessed resident postgraduate year (PGY) effect on 30-day overall morbidity in cancer patients undergoing major intra-abdominal and non-abdominal surgery. METHODS: Patients undergoing non-emergent major intra- and extra-abdominal operations from 2005-2012 were queried using the American College of Surgeons' National Surgical Quality Improvement Program...
December 8, 2016: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
https://www.readbyqxmd.com/read/27928011/high-prevalence-of-infectious-adeno-associated-virus-aav-in-human-peripheral-blood-mononuclear-cells-indicative-of-t-lymphocytes-as-sites-of-aav-persistence
#9
Daniela Hüser, Dina Khalid, Timo Lutter, Eva-Maria Hammer, Stefan Weger, Melanie Heßler, Ulrich Kalus, Yvonne Tauchmann, Karin Hensel-Wiegel, Dirk Lassner, Regine Heilbronn
: Seroepidemiology shows that infections with adeno-associated virus (AAV) are widespread, but diverse AAV serotypes isolated from man or non-human primates have so far not been proven as causes of human disease. In view of the increasing success of AAV-derived vectors in human gene therapy, the definition of the in vivo sites of wild-type AAV persistence and clinical consequences of its reactivation are becoming increasingly urgent.Here, we identified the presumed cell-type for AAV persistence in the human host, by highly sensitive AAV PCRs developed for the full spectrum of human AAV serotypes...
December 7, 2016: Journal of Virology
https://www.readbyqxmd.com/read/27927872/mumps-outbreak-among-a-highly-vaccinated-university-community-new-york-city-ny-january-april-2014
#10
Leena N Patel, Robert Arciuolo, Jie Fu, Francesca R Giancotti, Jane R Zucker, Jennifer Rakeman, Jennifer B Rosen
BACKGROUND: On January 14, 2014, a vaccinated student presented with parotitis. Mumps IgM testing was negative and reverse-transcription polymerase chain reaction (RT-PCR) testing was not performed, resulting in a missed diagnosis and the start of an outbreak at a New York City (NYC) university. METHODS: Mumps case investigations included patient interviews, medical records review, and laboratory testing including mumps serology and RT-PCR. Cases were considered linked to the outbreak if they attended or had epidemiologic linkage to the university...
December 7, 2016: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/27927860/prediction-of-outcome-from-adult-bacterial-meningitis-in-a-high-hiv-seroprevalence-resource-poor-setting-using-the-malawi-adult-meningitis-score-mams
#11
Emma C Wall, Mavuto Mukaka, Matthew Scarborough, Katherine Ma Ajdukiewicz, Katharine E Cartwright, Mulinda Nyirenda, Brigitte Denis, Theresa J Allain, Brian Faragher, David G Lalloo, Robert S Heyderman
: Acute bacterial meningitis (ABM) in adults residing in resource-poor countries is associated with mortality rates in excess of 50%. To improve outcome, interventional trials and standardised clinical algorithms are urgently required. To optimise these processes we developed and validated an outcome prediction tool to identify ABM patients at greatest risk of death. METHODS: We derived a nomogram using mortality predictors derived from a logistic regression model of a discovery database of adult Malawian ABM patients (n=523, 65% CSF culture positive)...
December 7, 2016: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/27927646/bcr-abl-specific-t-cell-therapy-in-ph-all-patients-on-tyrosine-kinase-inhibitors
#12
Patrizia Comoli, Sabrina Basso, Giovanni Riva, Patrizia Barozzi, Ilaria Guido, Antonella Gurrado, Giuseppe Quartuccio, Laura Rubert, Ivana Lagreca, Daniela Vallerini, Fabio Forghieri, Monica Morselli, Paola Bresciani, Angela Cuoghi, Ambra Paolini, Elisabetta Colaci, Roberto Marasca, Antonio Cuneo, Lorenzo Iughetti, Tommaso Trenti, Franco Narni, Robin Foà, Marco Zecca, Mario Luppi, Leonardo Potenza
While the emergence of bone marrow-resident (p190)BCR-ABL-specific T lymphocytes has been correlated with hematologic and cytogenetic remissions in patients with Philadelphia chromosome positive, acute lymphoblastic leukemia (Ph+ ALL) undergoing maintenance tyrosine-kinase inhibitor treatment, little is known about the possibility of culturing these cells ex vivo and employing them in T-cell therapy strategies. We investigated the feasibility of expanding/priming (p190)BCR-ABL-specific T cells in vitro by stimulation with dendritic cells pulsed with (p190)BCR-ABL peptides derived from the BCR-ABL junctional region and alternative splicing, and of adoptively administering them to patients with relapsed disease...
December 7, 2016: Blood
https://www.readbyqxmd.com/read/27927185/epidemiology-of-visceral-leishmaniasis-among-children-in-gadarif-hospital-eastern-sudan
#13
Mohammed Ahmed A Ahmed, Ahmed A Ahmed, Saeed M Omar, Gamal K Adam, Tajeldin M Abdallah, AbdelAziem A Ali
BACKGROUND: Since 1900s, visceral leishmaniasis (VL) has been among the most important health problems in Sudan, particularly in the endemic areas such as eastern and central regions. METHODS: This was a cross sectional, hospital-based study conducted from 1(st) January 2015 to 31(st) December 2015 to investigate the epidemiological factors of VL in Gadarif hospital, eastern Sudan. RESULTS: During the study period there were 47 identified children with VL among 145 suspected cases...
December 7, 2016: BMC Public Health
https://www.readbyqxmd.com/read/27926687/an-initiative-to-standardize-the-identification-of-and-acute-response-to-postoperative-lower-extremity-neurological-deficits-effects-on-provider-knowledge-confidence-and-communication-skills
#14
Peter B Derman, Sravisht Iyer, Matthew Garner, Steven Orr, Karla J Felix, Allison Goldberg, Titilayo Ologhobo, Minlun Wu, Laura Robbins, Charles Cornell
BACKGROUND: Although relatively uncommon, neurological deficits following hip and knee arthroplasty can have permanent and debilitating consequences. This study was conducted to quantify the effectiveness of an educational curriculum aimed at standardizing the identification of and acute response to postoperative neurological deficits in the inpatient setting, specifically with respect to improvements in clinician knowledge, confidence levels, and communication skills. METHODS: A multidisciplinary committee at a single, high-volume academic institution created an algorithm delineating the appropriate clinical actions and escalation procedures in the setting of a postoperative neurological deficit for each clinical practitioner involved in care for patients who undergo arthroplasty...
December 7, 2016: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/27924665/behind-closed-doors
#15
Kevin Duan, Leslie Sheu
This Personal View about feedback culture is based on our personal experiences as internal medicine chief residents with attendings, residents, and interns who came into our office to discuss concerns about team members. Our unique perspective as chief residents revealed a tendency amongst physicians at all levels of training to first raise these concerns behind closed doors, instead of with the learner directly. We highlight the need to shift feedback culture in medical training away from this practice towards a clinical "micro-coaching" approach...
December 7, 2016: Medical Teacher
https://www.readbyqxmd.com/read/27923396/how-we-read-fch-pet-ct-for-prostate-cancer
#16
REVIEW
Jean-Mathieu Beauregard, Alexis Beaulieu
Over the last decade, (18)F-fluorocholine positron emission tomography/computed tomography (FCH-PET/CT) has gained in popularity for the staging and restaging of patients with prostate cancer (PCa). However, despite abundant literature on the topic, there is a lack of publications on how to actually interpret FCH-PET/CT in a clinical setting. Here we propose a practical, TNM-oriented approach to read FCH-PET/CT, with notes on procedure technique, image display, review sequence and report structure. The purpose of this article is to provide guidance to radiologists, nuclear medicine physicians and residents who are new to FCH-PET/CT, as well as to propose an alternate approach to more experienced physicians...
December 6, 2016: Cancer Imaging: the Official Publication of the International Cancer Imaging Society
https://www.readbyqxmd.com/read/27923267/sleep-and-processing-of-trauma-memories
#17
Ihori Kobayashi, Thomas A Mellman, Duaa Altaee, Mary Katherine Howell, Joseph Lavela
Sleep has been implicated in learning processes that appear to underlie recovery from posttraumatic stress disorder (PTSD). The importance of quality and timing of sleep following exposure-based therapies has been suggested. The present study evaluated relationships between sleep and adaptive emotional processing following written narrative exposure (WNE) to memories of traumatic events experienced by participants with clinically significant PTSD symptoms. Participants included 21 urban-residing nontreatment-seeking adults with full or subthreshold symptoms of PTSD who completed 4 sessions of 30-min WNE with the first session either in the evening or the morning...
December 2016: Journal of Traumatic Stress
https://www.readbyqxmd.com/read/27922718/costly-and-unnecessary
#18
Kate Harrington
Many U.S. medical students, residents, and physicians want to see the elimination of the U.S. Medical Licensing Exam Step 2 Clinical Skills exam, saying it has a high price tag and an even higher first-attempt pass rate.
December 1, 2016: Texas Medicine
https://www.readbyqxmd.com/read/27919498/association-between-exposure-to-farm-animals-and-pets-and-risk-of-multiple-sclerosis
#19
Dylan Siejka, Bruce Taylor, Anne-Louise Ponsonby, Terence Dwyer, Ingrid van der Mei
PURPOSE: There exists inconsistent evidence regarding animals including pets as risk factors for the development of Multiple Sclerosis (MS). We investigated the association between farm animals and pets as possible environmental factors in MS development. METHODS: Population based case-control study with 136 clinically definite MS cases and 272 controls randomly chosen from the community matched on sex and age. Data was collected from both questionnaire and a lifetime calendar detailing residence, occupation and pet/animal exposure over the course of participant's lives...
November 2016: Multiple Sclerosis and related Disorders
https://www.readbyqxmd.com/read/27919374/the-m-health-revolution-exploring-perceived-benefits-of-whatsapp-use-in-clinical-practice
#20
Kurubaran Ganasegeran, Pukunan Renganathan, Abdul Rashid, Sami Abdo Radman Al-Dubai
BACKGROUND: The dawn of m-Health facilitates new horizons of professional communication through WhatsApp, allowing health professionals to interact fast and efficiently for effective patient management. This preliminary study aimed to investigate perceived benefits, if any, of WhatsApp use across general medical and emergency teams during clinical practice in Malaysia. METHODS: A cross-sectional study was conducted in a universal sample of 307 health professionals comprising of nurses, medical assistants, medical residents, medical officers and physicians across medical and casualty departments in a Malaysian public hospital...
January 2017: International Journal of Medical Informatics
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