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https://www.readbyqxmd.com/read/29155848/an-electronic-health-record-based-model-predicts-statin-adherence-ldl-cholesterol-and-cardiovascular-disease-in-the-united-states-military-health-system
#1
Joseph E Lucas, Taylor C Bazemore, Celan Alo, Patrick B Monahan, Deepak Voora
HMG-CoA reductase inhibitors (or "statins") are important and commonly used medications to lower cholesterol and prevent cardiovascular disease. Nearly half of patients stop taking statin medications one year after they are prescribed leading to higher cholesterol, increased cardiovascular risk, and costs due to excess hospitalizations. Identifying which patients are at highest risk for not adhering to long-term statin therapy is an important step towards individualizing interventions to improve adherence. Electronic health records (EHR) are an increasingly common source of data that are challenging to analyze but have potential for generating more accurate predictions of disease risk...
2017: PloS One
https://www.readbyqxmd.com/read/29154064/living-with-chronic-pain-evaluating-patient-experiences-with-a-medical-group-visit-focused-on-mindfulness-and-non-pharmacological-strategies
#2
Anna Sophia Lestoquoy, Lance D Laird, Suzanne Mitchell, Katherine Gergen-Barnett, N Lily Negash, Kelly McCue, Racquel Enad, Paula Gardiner
OBJECTIVES: Little is known about the acceptance of non-pharmacological group strategies delivered to low income racially diverse patients with chronic pain and depression. This paper examines how the Integrative Medical Group Visit (IMGV) addresses many of the deficits identified with usual care. DESIGN AND SETTING: Six IMGVs cohorts were held at a safety net hospital and two federally funded community health centres. Data was gathered through focus groups. Transcripts were analysed using both a priori codes and inductive coding...
December 2017: Complementary Therapies in Medicine
https://www.readbyqxmd.com/read/29152290/promyelocytic-sarcoma-of-the-right-humerus-an-unusual-clinical-presentation-with-unique-diagnostic-and-treatment-considerations
#3
Sameer Sawhney, Noa G Holtzman, Derik L Davis, Hannah Kaizer, Victoria Giffi, Ashkan Emadi, Rima Koka
Promyelocytic leukemia is a known medical emergency and requires rapid diagnosis and expedient therapy with differentiating agents. We present an unusual case in which the diagnosis is based on a fine needle aspirate of a humeral mass. Despite lack of systemic involvement, the sarcoma responded to traditional differentiation agents.
November 2017: Clinical Case Reports
https://www.readbyqxmd.com/read/29151309/evaluation-of-the-general-characteristics-of-patients-aged-85-years-and-above-admitted-to-a-university-hospital-emergency-department
#4
Ahmet Demircan, Ş. Gülbin Aygencel Bıkmaz, Gültekin Kadı, Ayfer Keleş, Fikret Bildik, Begüm Öktem, Onur Çakmak
Background/aim: The number of elderly people (≥65 years old) is increasing both in Turkey and internationally due to improved living conditions and decreased mortality rates. Knowing the characteristics of elderly patients admitted to emergency departments can provide guidance for diagnosis and treatment approaches. In this study, we analyzed the characteristics of very old patients (4≥85 years old) admitted to the emergency department and put together data for use in forward planning in healthcare services...
November 13, 2017: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/29151053/protocol-of-the-sepsivit-study-a-prospective-observational-study-to-determine-whether-continuous-heart-rate-variability-measurement-during-the-first-48-hours-of-hospitalisation-provides-an-early-warning-for-deterioration-in-patients-presenting-with-infection
#5
Vincent M Quinten, Matijs van Meurs, Maurits H Renes, Jack J M Ligtenberg, Jan C Ter Maaten
INTRODUCTION: One in five patients with sepsis deteriorates within 48 hours after hospital admission. Regrettably, a clear tool for the early detection of deterioration is still lacking. The SepsiVit study aims to determine whether continuous heart rate variability (HRV) measurement can provide an early warning for deterioration in patients presenting with suspected infection or sepsis to the emergency department (ED). METHODS AND ANALYSIS: The protocol of a prospective observational study in the ED...
November 17, 2017: BMJ Open
https://www.readbyqxmd.com/read/29148174/prehospital-transfusion-of-red-cell-concentrates-in-a-paramedic-staffed-helicopter-emergency-medical-service
#6
Stefan Heschl, Emily Andrew, Anthony de Wit, Stephen Bernard, Marcus Kennedy, Karen Smith
OBJECTIVE: The optimal volume and type of intravenous fluid for the treatment of blood loss in the prehospital setting is controversial. The use of red cell concentrates (RCCs) may be associated with improved outcomes; however, the administration of blood products is limited to physicians in many jurisdictions. We sought to describe the characteristics of RCC transfusions in a paramedic-staffed helicopter emergency medical system in Victoria, Australia. METHODS: We performed a retrospective analysis of all cases where paramedics consulted the responsible physician for approval of RCC transfusion between July 2011 and December 2015 in Victoria, Australia...
November 17, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29148155/identifying-biomechanical-gait-parameters-in-adolescent-boys-with-haemophilia-using-principal-component-analysis
#7
L B Suckling, D Stephensen, M C Cramp, R Mahaffey, W I Drechsler
INTRODUCTION: Improvements in the medical management for those with haemophilia have resulted in improved clinical outcomes. However, current treatment regimens do not alleviate all joint haemarthroses with the potential for long-term joint deterioration remaining. The evaluation of functional activities such as gait, using standardized tools to monitor children with haemophilia is emerging. AIM: This study explored differences in sagittal plane biomechanics of walking in adolescent boys aged 11-18 years with haemophilia and an age-matched group of typically developing boys...
November 17, 2017: Haemophilia: the Official Journal of the World Federation of Hemophilia
https://www.readbyqxmd.com/read/29146489/exploring-the-barriers-to-and-facilitators-of-using-evidence-based-drugs-in-the-secondary-prevention-of-cardiovascular-diseases-findings-from-a-multistakeholder-qualitative-analysis
#8
Victoria Miller, Lavanya Nambiar, Malvika Saxena, Darryl Leong, Amitava Banerjee, José Pablo Werba, Jose Rocha Faria Neto, Katherine Curi Quinto, Mohammed Moniruzzaman, Shweta Khandelwal
BACKGROUND: Health-system barriers and facilitators associated with cardiovascular medication adherence have seldom been studied, particularly in low- and middle-income countries where uptake rates are poorest. OBJECTIVES: This study sought to explore the major obstacles and facilitators to the use of evidence-supported medications for secondary prevention of cardiovascular disease using qualitative analysis in 2 diverse countries across multiple levels of their health care systems...
November 13, 2017: Global Heart
https://www.readbyqxmd.com/read/29146123/planetary-health-protecting-human-health-on-a-rapidly-changing-planet
#9
Samuel S Myers
The impact of human activities on our planet's natural systems has been intensifying rapidly in the past several decades, leading to disruption and transformation of most natural systems. These disruptions in the atmosphere, oceans, and across the terrestrial land surface are not only driving species to extinction, they pose serious threats to human health and wellbeing. Characterising and addressing these threats requires a paradigm shift. In a lecture delivered to the Academy of Medical Sciences on Nov 13, 2017, I describe the scale of human impacts on natural systems and the extensive associated health effects across nearly every dimension of human health...
November 10, 2017: Lancet
https://www.readbyqxmd.com/read/29146122/health-and-wellbeing-of-indigenous-adolescents-in-australia-a-systematic-synthesis-of-population-data
#10
Peter S Azzopardi, Susan M Sawyer, John B Carlin, Louisa Degenhardt, Ngiare Brown, Alex D Brown, George C Patton
BACKGROUND: Indigenous populations have high rates of disease and premature mortality. Most Indigenous communities are young, and adolescence (age 10-24 years) provides great opportunities for population health gain. However, the absence of a comprehensive account of Indigenous adolescents' health has been a barrier to effective policy. We aimed to report a national health profile for Indigenous adolescents in Australia. METHODS: We undertook a systematic synthesis of population data to report the health and wellbeing of Indigenous adolescents in Australia...
November 10, 2017: Lancet
https://www.readbyqxmd.com/read/29145728/understanding-how-emergency-medicine-physicians-survive-and-thrive-in-rural-practice-a-theoretical-model
#11
Ashra Kolhatkar, Andrea Keesey, Bob Bluman, Brenna Lynn, Tandi Wilkinson
INTRODUCTION: The challenges facing emergency medicine (EM) services in Canada reflect the limitations of the entire healthcare system. The emergency department (ED) is uniquely situated in the healthcare system such that shortcomings in hospital- and community-based services are often first revealed there. This is especially true in rural settings, where there are additional site-specific barriers to the provision of EM care. Existing studies look at the factors that influence rural EM physicians in isolation...
November 2017: Rural and Remote Health
https://www.readbyqxmd.com/read/29144719/real-world-health-plan-claims-analysis-of-differences-in-healthcare-utilization-and-total-cost-in-patients-suffering-from-cluster-headaches-and-those-without-headache-related-conditions
#12
Michael Polson, Todd C Lord, Themmi M Evangelatos, Maria Lopes, Briana L Santaniello
BACKGROUND: According to the World Health Organization, headache disorders are underappreciated by many health systems. These disorders have a substantial impact on quality of life, yet the true correlation between headache conditions and increased total healthcare utilization is not well understood. This study further explores the impact of headache conditions on healthcare utilization. OBJECTIVES: To assess differences in healthcare utilization and total cost in patients suffering from cluster headaches (CH) compared with patients without headache-related conditions...
November 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/29144565/rethinking-status-dystonicus
#13
REVIEW
Marta Ruiz-Lopez, Alfonso Fasano
Status dystonicus is a movement disorder emergency that has been a source of controversy in terms of terminology, phenomenology, and management since it was first described in 1982. Here we argue that the current use of the term status dystonicus falls well short of the precision needed for either clinical or academic use. We performed a critical review on this topic, describing possible pathophysiological mechanisms and areas of uncertainties. This review also addresses the problems derived by the extreme clinical heterogeneity of this condition, as the lack of an objective criterion useful for the definition, or the fact that status dystonicus may present not only in the context of a known dystonic syndrome...
November 16, 2017: Movement Disorders: Official Journal of the Movement Disorder Society
https://www.readbyqxmd.com/read/29144411/nucleic-acid-aptamers-emerging-applications-in-medical-imaging-nanotechnology-neurosciences-and-drug-delivery
#14
REVIEW
Pascal Röthlisberger, Cécile Gasse, Marcel Hollenstein
Recent progresses in organic chemistry and molecular biology have allowed the emergence of numerous new applications of nucleic acids that markedly deviate from their natural functions. Particularly, DNA and RNA molecules-coined aptamers-can be brought to bind to specific targets with high affinity and selectivity. While aptamers are mainly applied as biosensors, diagnostic agents, tools in proteomics and biotechnology, and as targeted therapeutics, these chemical antibodies slowly begin to be used in other fields...
November 16, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/29143331/implicit-review-instrument-to-evaluate-quality-of-care-delivered-by-physicians-to-children-in-emergency-departments
#15
James P Marcin, Patrick S Romano, Madan Dharmar, James M Chamberlain, Nanette Dudley, Charles G Macias, Lise E Nigrovic, Elizabeth C Powell, Alexander J Rogers, Meridith Sonnett, Leah Tzimenatos, Elizabeth R Alpern, Rebecca Andrews-Dickert, Dominic A Borgialli, Erika Sidney, Charlie Casper, Jonathan Michael Dean, Nathan Kuppermann
OBJECTIVE: To evaluate the consistency, reliability, and validity of an implicit review instrument that measures the quality of care provided to children in the emergency department (ED). DATA SOURCES/STUDY SETTING: Medical records of randomly selected children from 12 EDs in the Pediatric Emergency Care Applied Research Network (PECARN). STUDY DESIGN: Eight pediatric emergency medicine physicians applied the instrument to 620 medical records...
November 16, 2017: Health Services Research
https://www.readbyqxmd.com/read/29142581/an-unexpected-reason-for-isolated-foot-drop-acute-stroke
#16
Eylem Kuday Kaykisiz, Erden Erol Unluer
The differential diagnosis of acute weakness (AW) in emergency departments (ED) is broad and includes both neurological and medical reasons. We describe an 81-year-old female patient with cortical infarct presenting with sudden onset isolated foot drop, which to the best of our knowledge, was the third case in English literature. An 81-year-old female was admitted to our ED with a 12-hour history of left-sided foot drop. Her motor strength was normal throughout the upper and lower extremities, except for weakness in the left ankle and toe dorsiflexors...
September 2017: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/29141770/outcomes-following-changing-from-a-two-tiered-to-a-three-tiered-hospital-rapid-response-system
#17
Winston Cheung
Objectives The aim of the present study was to determine whether changing a hospital rapid response system (RRS) from a two-tiered to a three-tiered model can reduce disruption to normal hospital routines while maintaining the same overall patient outcomes.Methods Staff at an Australian teaching hospital attending medical emergency team and cardiac arrest (MET/CA) calls were interviewed after the RRS was changed from a two-tiered to three-tiered model, and the results were compared with a study using the same methods conducted before the change...
November 16, 2017: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/29140309/biosensors-to-diagnose-chagas-disease-a-brief-review
#18
REVIEW
María-Isabel Rocha-Gaso, Luis-Jesús Villarreal-Gómez, Denis Beyssen, Frédéric Sarry, Marco-Antonio Reyna, Carlos-Napoleón Ibarra-Cerdeña
Chagas disease (CD), which mostly affects those living in deprived areas, has become one of Latin America's main public health problems. Effective prevention of the disease requires early diagnosis, initiation of therapy, and regular blood monitoring of the infected individual. However, the majority of the Trypanosoma cruzi infections go undiagnosed because of mild symptoms, limited access to medical attention and to a high variability in the sensitivity and specificity of diagnostic tests. Consequently, more affordable and accessible detection technologies capable of providing early diagnosis and T...
November 15, 2017: Sensors
https://www.readbyqxmd.com/read/29139375/kitty-litter-dermatitis-from-bromo-2-nitropropane-1-3-diol
#19
John W Sullenbarger, Brooke Hensley, Jeffrey B Travers
70-year-old white man presented with a 6-week history of an acute pruritic eruption in the axillary vaults, inguinal folds, and central lumbar area. Due to the severity of the pruritus, the patient was evaluated in the emergency department. He was treated with intramuscular triamcinolone, oral fluconazole, clobetasol cream, and miconazole powder, which provided only minimal relief. The patient had presented with brightly erythematous patches in the axillary vaults and inguinal folds with numerous erythematous, scaly, coalescing papules and plaques agminated on the lumbar region (Figure)...
2017: Skinmed
https://www.readbyqxmd.com/read/29138849/elevated-serum-levels-of-lipoprotein%C3%A2-associated-phospholipase%C3%A2-a2-predict-mortality-rates-in-patients-with-sepsis
#20
Zhongwei Huang, Haiyan Jiang, Xiaohui Cui, Guiwen Liang, Yu Chen, Ting Wang, Zhichao Sun, Lei Qi
Sepsis remains one of the leading contributors to mortality rates in the intensive care unit (ICU) and emergency intensive care unit (EICU). Therefore, any treatments against the agents which produce sepsis in a medical emergency, are welcome. Elevated serum levels of lipoprotein‑associated phospholipase A2 (Lp‑PLA2) have been reported in a small cohort of patients with inflammation. The present study evaluated serum levels of Lp‑PLA2 in patients with sepsis and investigated the role of Lp‑PLA2 in sepsis...
November 13, 2017: Molecular Medicine Reports
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