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https://www.readbyqxmd.com/read/28108436/novel-approach-for-independent-control-of-brain-hypothermia-and-systemic-normothermia-cerebral-selective-deep-hypothermia-for-refractory-cardiac-arrest
#1
Chih-Hsien Wang, Yu-Ting Lin, Heng-Wen Chou, Yi-Chih Wang, Joey-Jen Hwang, John R Gilbert, Yih-Sharng Chen
A 38-year-old man was found unconscious, alone in the driver's seat of his car. The emergency medical team identified his condition as pulseless ventricular tachycardia. Defibrillation was attempted but failed. Extracorporeal membrane oxygenation (ECMO) was started in the emergency room 52 min after the estimated arrest following the extracorporeal cardiopulmonary resuscitation (ECPR) protocol in our center. The initial prognosis under the standard protocol was <25% chance of survival. A novel adjunctive to our ECPR protocol, cerebral selective deep (<30°C) hypothermia (CSDH), was applied...
January 20, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28108319/how-the-changes-in-the-system-affect-trauma-care-provision-the-assessment-of-and-implications-for-lithuanian-trauma-service-performance-in-2007-2012
#2
Žilvinas Dambrauskas, Vytautas Aukštakalnis, Aurika Karbonskienė, Dmitrijus Kačiurinas, Jolanta Vokietienė, Robertas Lapka, Algimantas Pamerneckas, Narūnas Porvaneckas, Kęstutis Stašaitis, Nedas Jasinskas, Paulius Dobožinskas, Dinas Vaitkaitis, Raimundas Lunevičius
OBJECTIVE: The aim of this study was to identify and assess the effects of changes in the Lithuanian trauma service from 2007 to 2012. We postulate that the implications derived from this study will be of importance to trauma policy planners and makers in Lithuania and throughout other countries of Eastern and Central Europe. MATERIALS AND METHODS: Out of 10,390 trauma admissions to four trauma centers in 2007, 294 patients (2.8%) were randomly selected for the first arm of a representative study sample...
January 6, 2017: Medicina
https://www.readbyqxmd.com/read/28107703/how-universal-is-coverage-and-access-to-diagnosis-and-treatment-for-chagas-disease-in-colombia-a-health-systems-analysis
#3
Zulma M Cucunubá, Jennifer M Manne-Goehler, Diana Díaz, Pierre Nouvellet, Oscar Bernal, Andrea Marchiol, María-Gloria Basáñez, Lesong Conteh
Limited access to Chagas disease diagnosis and treatment is a major obstacle to reaching the 2020 World Health Organization milestones of delivering care to all infected and ill patients. Colombia has been identified as a health system in transition, reporting one of the highest levels of health insurance coverage in Latin America. We explore if and how this high level of coverage extends to those with Chagas disease, a traditionally marginalised population. Using a mixed methods approach, we calculate coverage for screening, diagnosis and treatment of Chagas...
January 4, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28106820/current-and-emerging-technology-for-continuous-glucose-monitoring
#4
REVIEW
Cheng Chen, Xue-Ling Zhao, Zhan-Hong Li, Zhi-Gang Zhu, Shao-Hong Qian, Andrew J Flewitt
Diabetes has become a leading cause of death worldwide. Although there is no cure for diabetes, blood glucose monitoring combined with appropriate medication can enhance treatment efficiency, alleviate the symptoms, as well as diminish the complications. For point-of-care purposes, continuous glucose monitoring (CGM) devices are considered to be the best candidates for diabetes therapy. This review focuses on current growth areas of CGM technologies, specifically focusing on subcutaneous implantable electrochemical glucose sensors...
January 19, 2017: Sensors
https://www.readbyqxmd.com/read/28106744/oligonucleotide-therapy-for-obstructive-and-restrictive-respiratory-diseases
#5
REVIEW
Wupeng Liao, Jinrui Dong, Hong Yong Peh, Lay Hong Tan, Kah Suan Lim, Li Li, Wai-Shiu Fred Wong
Inhaled oligonucleotide is an emerging therapeutic modality for various common respiratory diseases, including obstructive airway diseases like asthma and chronic obstructive pulmonary disease (COPD) and restrictive airway diseases like idiopathic pulmonary fibrosis (IPF). The advantage of direct accessibility for oligonucleotide molecules to the lung target sites, bypassing systemic administration, makes this therapeutic approach promising with minimized potential systemic side effects. Asthma, COPD, and IPF are common chronic respiratory diseases, characterized by persistent airway inflammation and dysregulated tissue repair and remodeling, although each individual disease has its unique etiology...
January 17, 2017: Molecules: a Journal of Synthetic Chemistry and Natural Product Chemistry
https://www.readbyqxmd.com/read/28106020/renin-angiotensin-aldosterone-system-blockers-and-cardiovascular-outcomes-a-meta-analysis-of-randomized-clinical-trials
#6
Pınar Kızılırmak, Yağız Üresin, Oktay Özdemir, Burçak Kılıçkıran Avcı, Lale Tokgözoğlu, Zeki Öngen
OBJECTIVE: Hypertension is the most prevalent modifiable risk factor for cardiovascular (CV) and cerebrovascular morbidity and mortality. This study aimed to assess the effects of renin-angiotensin-aldosterone system (RAAS) blockade on CV outcomes. METHODS: This study was designed according to the Preferred Reporting Items for Systemic reviews and Meta-Analyses statement. Databases were searched for articles published as of December 2014. Two sets of studies were selected...
January 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/28104427/novel-cpr-system-that-predicts-return-of-spontaneous-circulation-from-amplitude-spectral-area-before-electric-shock-in-ventricular-fibrillation
#7
Yoshihide Nakagawa, Mari Amino, Sadaki Inokuchi, Satoshi Hayashi, Tsutomu Wakabayashi, Tatsuya Noda
AIM: Amplitude spectral area (AMSA), an index for analysing ventricular fibrillation (VF) waveforms, is thought to predict the return of spontaneous circulation (ROSC) after electric shocks, but its validity is unconfirmed. We developed an equation to predict ROSC, where the change in AMSA (ΔAMSA) is added to AMSA measured immediately before the first shock (AMSA1). We examine the validity of this equation by comparing it with the conventional AMSA1-only equation. METHOD: We retrospectively investigated 285 VF patients given prehospital electric shocks by emergency medical services...
January 16, 2017: Resuscitation
https://www.readbyqxmd.com/read/28103925/protocol-for-a-realist-review-of-workplace-learning-in-postgraduate-medical-education-and-training
#8
Anel Wiese, Caroline Kilty, Colm Bergin, Patrick Flood, Na Fu, Mary Horgan, Agnes Higgins, Bridget Maher, Grainne O'Kane, Lucia Prihodova, Dubhfeasa Slattery, Deirdre Bennett
BACKGROUND: Postgraduate medical education and training (PGMET) is a complex social process which happens predominantly during the delivery of patient care. The clinical learning environment (CLE), the context for PGMET, shapes the development of the doctors who learn and work within it, ultimately impacting the quality and safety of patient care. Clinical workplaces are complex, dynamic systems in which learning emerges from non-linear interactions within a network of related factors and activities...
January 19, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/28103732/evaluation-of-antivenom-therapy-for-vipera-palaestinae-bites-in-children-experience-of-two-large-tertiary-care-pediatric-hospitals
#9
Dikla Pivko-Levy, Itamar Munchnak, Ayelet Rimon, Uri Balla, Dennis Scolnik, Christopher Hoyte, Yair Voliovitch, Miguel Glatstein
BACKGROUND: Antivenom has been successfully used to treat systemic and progressive, local manifestations of envenomation inflicted by Vipera (V.) palaestinae, the most common venomous snake in Israel. The objective of this study was to evaluate the fixed dose V. palaestinae monovalent (equine) immunoglobulin G antivenom used in two pediatric emergency departments. In particular, we wanted to assess the need for repeated antivenom administration and the rate of adverse antivenom effects in children...
January 20, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28103718/peer-review-improves-psychometric-characteristics-of-multiple-choice-questions
#10
Hani Abozaid, Yoon Soo Park, Ara Tekian
PURPOSE: For new and emerging medical schools, developing a system to peer-review and evaluate the assessment processes through faculty development programs can be a challenge. This study evaluates the impact of peer-review practices on item analysis, reliability, and the standard error of measurement of multiple-choice questions for summative final examinations. METHODS: This study used a retrospective cohort design of two consecutive academic years in 2012 and in 2013...
January 20, 2017: Medical Teacher
https://www.readbyqxmd.com/read/28103121/comparison-of-helicopter-emergency-medical-services-transport-types-and-delays-on-patient-outcomes-at-two-level-i-trauma-centers
#11
Brodie Nolan, Homer Tien, Bruce Sawadsky, Sandro Rizoli, Amanda McFarlan, Andrea Phillips, Alun Ackery
BACKGROUND: Helicopter emergency medical services (HEMS) have become an engrained component of trauma systems. In Ontario, transportation for trauma patients is through one of three ways: scene call, modified scene call, or interfacility transfer. We hypothesize that differences exist between these types of transports in both patient demographics and patient outcomes. This study compares the characteristics of patients transported by each of these methods to two level 1 trauma centers and assesses for any impact on morbidity or mortality...
January 19, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28102533/hospital-incident-command-first-responders-or-receiving-centers
#12
Brian Fletcher, Amanda Knight, Brandy Pockrus, Matthew J Wain, Kathy Lehman-Huskamp
OBJECTIVES: (1) Propose a conceptual model of an alternative hospital incident management system (HIMS) that integrates concepts used by emergency operations centers (EOCs). (2) Compare HIMS to the standard hospital incident command system (HICS) model. DESIGN: A quasi-experimental study was performed. Two identical tabletop incident scenarios were presented, one utilizing HICS and one using HIMS. Participants completed postexercise surveys for each tabletop. Surveys contained both knowledge and satisfaction questions...
April 2016: American Journal of Disaster Medicine
https://www.readbyqxmd.com/read/28102532/time-to-epinephrine-in-out-of-hospital-cardiac-arrest-a-retrospective-analysis-of-intraosseous-versus-intravenous-access
#13
Elliot M Ross, Julian Mapp, Chetan Kharod, David A Wampler, Christopher Velasquez, David A Miramontes
INTRODUCTION: The 2015 advanced cardiac life support update continues to advocate administering epinephrine during cardiac arrest. The goal of our study is to determine if prehospital intraosseous (IO) access results in shorter time to epinephrine than prehospital peripheral intravenous (PIV) access. METHODS: The out-of-hospital cardiac arrest (OHCA) database of a large, urban, fire-based emergency medical services system was searched for consecutive cases of OHCA between January 2013 and December 2015...
April 2016: American Journal of Disaster Medicine
https://www.readbyqxmd.com/read/28101563/world-health-organisation-global-disability-action-plan-2014-2021-challenges-and-perspectives-for-physical-medicine-and-rehabilitation-in-pakistan
#14
Fary Khan, Bhasker Amatya, Tahir M Sayed, Aamir W Butt, Khalid Jamil, Waseem Iqbal, Alaeldin Elmalik, Farooq A Rathore, Geoff Abbott
OBJECTIVE: To provide an update on disability and outline potential barriers and facilitators for implementation of the World Health Organization Global Disability Action Plan (GDAP) in Pakistan. METHODS: A 6-day workshop at the Armed Forces Institute of Rehabilitation Medicine, Islamabad facilitated by rehabilitation staff from Royal Melbourne Hospital, Australia. Local healthcare professionals (n = 33) from medical rehabilitation facilities identified challenges in service provision, education and attitudes/approaches to people with disabilities, using consensus agreement for objectives listed in the GDAP...
January 19, 2017: Journal of Rehabilitation Medicine
https://www.readbyqxmd.com/read/28100277/stress-echo-2020-the-international-stress-echo-study-in-ischemic-and-non-ischemic-heart-disease
#15
Eugenio Picano, Quirino Ciampi, Rodolfo Citro, Antonello D'Andrea, Maria Chiara Scali, Lauro Cortigiani, Iacopo Olivotto, Fabio Mori, Maurizio Galderisi, Marco Fabio Costantino, Lorenza Pratali, Giovanni Di Salvo, Eduardo Bossone, Francesco Ferrara, Luna Gargani, Fausto Rigo, Nicola Gaibazzi, Giuseppe Limongelli, Giuseppe Pacileo, Maria Grazia Andreassi, Bruno Pinamonti, Laura Massa, Marco A R Torres, Marcelo H Miglioranza, Clarissa Borguezan Daros, José Luis de Castro E Silva Pretto, Branko Beleslin, Ana Djordjevic-Dikic, Albert Varga, Attila Palinkas, Gergely Agoston, Dario Gregori, Paolo Trambaiolo, Sergio Severino, Ayana Arystan, Marco Paterni, Clara Carpeggiani, Paolo Colonna
BACKGROUND: Stress echocardiography (SE) has an established role in evidence-based guidelines, but recently its breadth and variety of applications have extended well beyond coronary artery disease (CAD). We lack a prospective research study of SE applications, in and beyond CAD, also considering a variety of signs in addition to regional wall motion abnormalities. METHODS: In a prospective, multicenter, international, observational study design, > 100 certified high-volume SE labs (initially from Italy, Brazil, Hungary, and Serbia) will be networked with an organized system of clinical, laboratory and imaging data collection at the time of physical or pharmacological SE, with structured follow-up information...
January 18, 2017: Cardiovascular Ultrasound
https://www.readbyqxmd.com/read/28100247/the-evolution-of-the-medical-workforce-in-cape-verde-since-independence-in-1975
#16
A P Delgado, A C Tolentino, P Ferrinho
BACKGROUND: Cape Verdean doctors have always graduated abroad. The first experience of pre-graduate medical education in Cape Verde begun in October 2015. Counting how many doctors Cape Verde has, knowing who they are, and knowing how they are distributed are very important to help fine-tune the medical training. The aim of this study is to analyze the evolution of the medical workforce in Cape Verde to support medical education implementation. METHODS: Secondary data on doctors, from July 1975 until December 2014, collected from the Ministry of Health, were entered into an SPSS 20 database and studied by a simple descriptive statistical analysis...
January 18, 2017: Human Resources for Health
https://www.readbyqxmd.com/read/28100143/end-of-life-in-high-security-prisons-in-switzerland
#17
Irene Marti, Ueli Hostettler, Marina Richter
Similar to other institutions, the Swiss prison system faces a growing number of elderly prisoners, trends toward securitization, and, in consequence, more prisoners who will spend the end-of-life (EOL) period of time in prison. By law, prisoners should have the same access to care as the rest of the population. However, custody makes meeting the demands of medical and palliative care difficult. This article focuses on the organizational challenges related to EOL care. Based on ethnographic and documentary research, it examines the institutional logic of the prison and the competing "new" logic emerging with EOL care...
January 2017: Journal of Correctional Health Care
https://www.readbyqxmd.com/read/28100142/reduction-in-jail-emergency-department-visits-and-closure-after-implementation-of-on-site-urgent-care
#18
Erick Eiting, Carrie S Korn, Erin Wilkes, Glenn Ault, Sean O Henderson
This descriptive study evaluates the impact of implementation of full service on-site urgent care services at the Los Angeles County Jail (LACJ) by examining the number of patients seen at the referral hospital, Los Angeles County + University of Southern California Medical Center (LAC+USC), and the number of hours that the referral hospital was closed to transfers in the periods before and after the development of the LACJ Urgent Care. The appropriate utilization of public resources is a critical priority for an overburdened county medical health care system...
January 2017: Journal of Correctional Health Care
https://www.readbyqxmd.com/read/28099639/failure-to-activate-the-in-hospital-emergency-team-causes-and-outcomes
#19
Vera Barbosa, Ernestina Gomes, Senio Vaz, Gustavo Azevedo, Gonçalo Fernandes, Amélia Ferreira, Rui Araujo
Objective: To determine the incidence of afferent limb failure of the in-hospital Medical Emergency Team, characterizing it and comparing the mortality between the population experiencing afferent limb failure and the population not experiencing afferent limb failure. Methods: A total of 478 activations of the Medical Emergency Team of Hospital Pedro Hispano occurred from January 2013 to July 2015. A sample of 285 activations was obtained after excluding incomplete records and activations for patients with less than 6 hours of hospitalization...
October 2016: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/28098631/after-the-fall-the-tapestry-of-disturbance-and-recovery
#20
Nalini M Nadkarni
On July 3, 2015, Nalini Nadkarni, a world-renowned ecologist who had been studying the biologic processes of ecosystem disturbance and recovery, sustained a catastrophic 50-foot free-fall from the top of the rainforest canopy to the forest floor at her remote field research site. She lost consciousness in shock and sustained life-threatening injuries. Her accompanying students hiked out, radio-called 911, and the Harborview Medical Center (Seattle) Medivac team arrived 4 hours later to rescue her. Her prognosis was extremely grim; her family gathered in anticipation of her death as she underwent four operations during her 10 days in the ICU...
February 2017: Critical Care Medicine
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