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https://www.readbyqxmd.com/read/27913981/the-challenges-of-anaesthesia-and-pain-relief-in-hip-fracture-care
#1
Rachel Cowan, Jun Hao Lim, Terence Ong, Ashok Kumar, Opinder Sahota
The care of the older person with hip fracture is complicated by their comorbid condition, limited physiological reserve, cognitive impairment and frailty. Two aspects of hip fracture management that have received considerable attention are how best to manage the pain associated with it and the ideal mode of anaesthesia. Existing literature has reported on the suboptimal treatment of pain in this orthogeriatric cohort. With recent advancements in medical care, a number of options have emerged as alternatives to conservative systemic analgesia...
December 3, 2016: Drugs & Aging
https://www.readbyqxmd.com/read/27913657/cost-benefit-analysis-of-telehealth-in-pre-hospital-care
#2
James R Langabeer, Tiffany Champagne-Langabeer, Diaa Alqusairi, Junghyun Kim, Adria Jackson, David Persse, Michael Gonzalez
OBJECTIVE: There has been very little use of telehealth in pre-hospital emergency medical services (EMS), yet the potential exists for this technology to transform the current delivery model. In this study, we explore the costs and benefits of one large telehealth EMS initiative. METHODS: Using a case-control study design and both micro- and gross-costing data from the Houston Fire Department EMS electronic patient care record system, we conducted a cost-benefit analysis (CBA) comparing costs with potential savings associated with patients treated through a telehealth-enabled intervention...
December 2, 2016: Journal of Telemedicine and Telecare
https://www.readbyqxmd.com/read/27913565/a-24-year-old-male-with-a-painful-and-cold-lower-extremity
#3
Eric A Robinson, Zain I Khalpey, Rajesh Janardhanan
CLINICAL INTRODUCTION: A 24-year-old male presented to the emergency department with intense pain in his right lower extremity. He has a medical history significant for systemic lupus erythematosus and antiphospholipid syndrome. He also had four prior episodes of deep venous thromboses on rivaroxaban. The patient stated that early in the morning, he started to feel intense pain that started from his knee and progressed to his calf, with associated numbness and paraesthesia. On physical examination, the limb felt cold with absent right popliteal and dorsalis pedis pulses...
December 2, 2016: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/27912214/common-cold-an-umbrella-term-for-acute-infections-of-nose-throat-larynx-and-bronchi
#4
P Kardos, F A Malek
Acute respiratory tract infections, i. e. rhinitis, sinusitis, pharyngitis, laryngitis, bronchitis, belong to the most common medical conditions with a high economic burden. Nonetheless, there is little agreement concerning their differential diagnosis.This paper will discuss to what extent different anatomical sites of acute respiratory tract infections can be uniquely identified or whether the overlap and consecutive development in signs and symptoms renders these distinctions meaningless.Acute respiratory tract infections are variable but definition of diagnostic categories based on the anatomical sites of the dominant complaints shows that signs and symptoms both overlap to a great extent and/or emerge successively...
December 2, 2016: Pneumologie
https://www.readbyqxmd.com/read/27911959/barriers-to-timely-and-safe-blood-transfusion-for-pph-patients-evidence-from-a-qualitative-study-in-dhaka-bangladesh
#5
Sadika Akhter, Iqbal Anwar, Rashida Akter, Feroza Akhter Kumkum, Monjura Khatun Nisha, Fatema Ashraf, Ferdousi Islam, Nazneen Begum, Mahbub Elahi Chowdhury, Anne Austin, Syed Shariful Islam, Aminur Rahman
BACKGROUND AND OBJECTIVES: In Bangladesh, postpartum hemorrhage (PPH) is the leading cause of maternal mortality accounting for 31% of all blood transfusions in the country. Although safe blood transfusion is one of the 8 signal functions of Comprehensive Emergency Obstetric Care (CEmOC) strategy, most of the designated public sector CEmOC facilities do not have on-site blood storage system. Emergent blood is mainly available from external blood banks. As a result, emergent patients are to rely on an unregulated network of brokers for blood which may raise question about blood safety...
2016: PloS One
https://www.readbyqxmd.com/read/27911071/severe-brain-injury-in-massachusetts-assessing-the-continuum-of-care
#6
Laura Lorenz, Gabrielle Katz
Acquired brain injury (ABI) is a major public health problem in Massachusetts (Hackman et al, 2014) and includes traumatic brain injury (TBI), stroke, ABI-related infectious diseases, metabolic disorders affecting the central nervous system (brain and spinal cord), and brain tumor. Advances in emergency medical care and neurosurgery mean that more people are surviving severe traumatic brain injury (Trexler et al, 2014). Yet many patients with severe TBI in particular, are not receiving inpatient services after initial treatment (Hackman et al, 2014; CDC, 2014) or later that are known to be effective (Malec & Kean, 2015; Lewis & Horn, 2015; BI Commission, 2011; Kolakowsky-Hayner et al, 2000; Interviews)...
December 10, 2015: Issue Brief
https://www.readbyqxmd.com/read/27909958/using-group-medical-visits-with-those-who-have-diabetes-examining-the-evidence
#7
REVIEW
Laura M Housden, Sabrina T Wong
The number of people with diabetes is expected to rise to over 592 million by the year 2035. Past work provides evidence that the conventional method of primary care delivery may not meet many patients' needs. An alternative to the conventional one-on-one appointment is care offered to a group of patients through group medical visits (GMVs). Group medical visits for diabetes have a positive impact on physiologic and self-care outcomes including improved HbA1c, blood pressure control and self-management skills...
December 2016: Current Diabetes Reports
https://www.readbyqxmd.com/read/27909594/knowledge-of-the-research-assistants-regarding-local-anaesthetics-and-toxicity
#8
Derya Karasu, Canan Yılmaz, Şeyda Efsun Özgünay, Mürüvvet Dayıoğlu, Çağdaş Baytar, Gülsen Korfalı
OBJECTIVE: Cardiovascular system depression, respiratory arrest, coma, convulsions, loss of consciousness, muscle twitching, blurred vision, vertigo, dizziness and numbness of the tongue can be seen in local anaesthetic toxicity. Treatment includes 20% lipid solutions, airway control, symptomatic treatment for arrhythmia and convulsions. The aim of this study is to present the knowledge of research assistants, who used local anaesthetics in daily practice, regarding these medications and toxicity treatment and to raise awareness...
August 2016: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/27908846/the-effectiveness-of-web-based-asthma-self-management-system-my-asthma-portal-map-a-pilot-randomized-controlled-trial
#9
Sara Ahmed, Pierre Ernst, Susan J Bartlett, Marie-France Valois, Tasneem Zaihra, Guy Paré, Roland Grad, Owis Eilayyan, Robert Perreault, Robyn Tamblyn
BACKGROUND: Whether Web-based technologies can improve disease self-management is uncertain. My Asthma Portal (MAP) is a Web-based self-management support system that couples evidence-based behavioral change components (self-monitoring of symptoms, physical activity, and medication adherence) with real-time monitoring, feedback, and support from a nurse case manager. OBJECTIVE: The aim of this study was to compare the impact of access to a Web-based asthma self-management patient portal linked to a case-management system (MAP) over 6 months compared with usual care on asthma control and quality of life...
December 1, 2016: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/27908332/prehospital-sepsis-care
#10
REVIEW
Jerrilyn Jones, Benjamin J Lawner
Prehospital care providers are tasked with the delivery of time-sensitive care, and emergency medical services (EMS) systems must match patients to appropriate clinical resources. Modern systems are uniquely positioned to recognize and treat patients with sepsis. Interventions such as administration of intravenous fluid and transporting patients to the appropriate level of definitive care are linked to improved patient outcomes. As EMS systems refine their protocols for the recognition and stabilization of patients with suspected or presumed sepsis, EMS providers need to be educated about the spectrum of sepsis-related presentations and treatment strategies need to be standardized...
February 2017: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/27908330/sepsis-in-special-populations
#11
REVIEW
Matthew P Borloz, Khalief E Hamden
Sepsis is recognized by the presence of physiologic and laboratory changes that reflect the inflammatory response to infection on cellular and systemic levels. Comorbid conditions, such as cirrhosis, end-stage renal disease, and obesity, alter patients' susceptibility to infection and their response to it once present. Baseline changes in vital signs and chronic medications often mask clues to the severity of illness. The physiologic, hematologic, and biochemical adjustments that accompany pregnancy and the puerperium introduce similar challenges...
February 2017: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/27906086/massive-adrenal-vein-aneurysm-mimicking-an-adrenal-tumor-in-a-patient-with-hemophilia-a-a-case-report-and-review-of-the-literature
#12
Richard Sleightholm, Steven Wahlmeier, Jeffrey S Carson, Andjela Drincic, Audrey Lazenby, Jason M Foster
BACKGROUND: Visceral venous aneurysms are exceedingly rare, and until now, there have been no reports of this phenomenon in the adrenal vasculature. This report details the first adrenal venous aneurysm reported in the literature. The aneurysm presented as an 18-cm mass that was initially suspected to be a hematoma or tumor on the basis of the complex medical history of the patient, which included hemophilia A and testicular cancer. After surgical excision, pathologic examination confirmed this mass to be a 15...
December 1, 2016: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/27900653/a-survey-of-authentication-schemes-in-telecare-medicine-information-systems
#13
Muhammad Umair Aslam, Abdelouahid Derhab, Kashif Saleem, Haider Abbas, Mehmet Orgun, Waseem Iqbal, Baber Aslam
E-Healthcare is an emerging field that provides mobility to its users. The protected health information of the users are stored at a remote server (Telecare Medical Information System) and can be accessed by the users at anytime. Many authentication protocols have been proposed to ensure the secure authenticated access to the Telecare Medical Information System. These protocols are designed to provide certain properties such as: anonymity, untraceability, unlinkability, privacy, confidentiality, availability and integrity...
January 2017: Journal of Medical Systems
https://www.readbyqxmd.com/read/27900235/technical-challenges-in-mass-spectrometry-based-metabolomics
#14
Fumio Matsuda
Metabolomics is a strategy for analysis, and quantification of the complete collection of metabolites present in biological samples. Metabolomics is an emerging area of scientific research because there are many application areas including clinical, agricultural, and medical researches for the biomarker discovery and the metabolic system analysis by employing widely targeted analysis of a few hundred preselected metabolites from 10-100 biological samples. Further improvement in technologies of mass spectrometry in terms of experimental design for larger scale analysis, computational methods for tandem mass spectrometry-based elucidation of metabolites, and specific instrumentation for advanced bioanalysis will enable more comprehensive metabolome analysis for exploring the hidden secrets of metabolism...
2016: Mass Spectrometry
https://www.readbyqxmd.com/read/27900156/sports-injuries-and-ill-health-episodes-in-the-cali-2013-world-games
#15
Paulo José Llinás, Rafael Fernando Serrano, Laureano Quintero Barrera, Juan Carlos Quiceno Noguera, Juan Pablo Martinez Cano
BACKGROUND: The World Games is a multisport event, second in importance only to the Olympic Games. Systematic surveillance of injuries and ill-health episodes is an essential part of modern integral healthcare given to athletes. AIM: To describe and analyse injuries and ill-health episodes affecting competitors during the Cali World Games 2013. METHODS: This is a cross-sectional study of injuries and ill-health episodes suffered by competing athletes...
2016: BMJ Open Sport & Exercise Medicine
https://www.readbyqxmd.com/read/27899112/a-comparison-of-intimate-partner-violence-and-associated-physical-injuries-between-cohabitating-and-married-women-a-5-year-medical-chart-review
#16
Janet Yuen-Ha Wong, Anna Wai-Man Choi, Daniel Yee-Tak Fong, Edmond Pui Hang Choi, John Kit-Shing Wong, Fung Ling So, Chu-Leung Lau, Chak-Wah Kam
BACKGROUND: Cohabitation, referring to a co-residential romantic relationship between two intimate partners without a marriage license, has become widely accepted in contemporary societies. It has been found that cohabitating women have a higher risk of experiencing intimate partner violence (IPV) than married women. However, as yet, no studies have investigated the level and pattern of IPV-associated physical injuries and its mental health impact on cohabitating women. Therefore, we aim to compare IPV-associated physical injuries between cohabitating and married women by conducting a review of 5-year medical records from the emergency departments of two major public hospitals in Hong Kong...
November 29, 2016: BMC Public Health
https://www.readbyqxmd.com/read/27894563/administration-of-crofab-antivenom-by-a-helicopter-emergency-medical-service-team
#17
Michael T Steuerwald, Season R K Gabbard, Gillian A Beauchamp, Matthew K Riddle, Edward J Otten
The case presented here highlights an unconventional use of a helicopter emergency medical service (HEMS) to provide a specialized medication to a critically ill patient when definitive transport was delayed. A 39-year-old man presented to a rural hospital 1 hour after sustaining a copperhead envenomation. He developed severe symptoms and was intubated. Arrangements were made for transfer to a tertiary referral center by HEMS, but because of incoming weather conditions, the team would not be able to make the return flight safely...
November 2016: Air Medical Journal
https://www.readbyqxmd.com/read/27894220/the-role-of-the-pharmacist-in-the-design-development-and-implementation-of-medication-prescription-support-systems
#18
Nuria Sola Bonada, Ana María Álvarez Díaz, Carlos Codina Jané
Clinical Decision Support Systems (CDSS) are computerized tools designed to help healthcare professionals to make clinical and therapeutic decisions, with the objective of improving patient care. Prescription-targeted CDSS have the highest impact in improving patient safety. Although there are different designs and functionalities, all these systems will combine clinical knowledge and patient information in a smart manner, in order to improve the prescription process. With the emergence of new technologies and advances in smart decision systems, the implementation of said systems can achieve an important improvement in terms of the prescription process and patient safety...
November 1, 2016: Farmacia Hospitalaria
https://www.readbyqxmd.com/read/27894030/fatigue-in-hospital-nurses-supernurse-culture-is-a-barrier-to-addressing-problems-a-qualitative-interview-study
#19
Linsey M Steege, Jessica G Rainbow
BACKGROUND: Fatigue in hospital nurses is associated with decreased nurse satisfaction, increased turnover and negative patient outcomes. Addressing fatigue in nurses has been identified as a priority by many organizations worldwide in an effort to promote both a culture of patient safety and a healthy nursing workforce. OBJECTIVES: The overall aim of this study was to explore barriers and facilitators within the hospital nurse work system to nurse coping and fatigue...
November 21, 2016: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/27893670/epidemiology-and-clinical-characteristics-of-traumatic-brain-injury-in-lebanon-a-systematic-review
#20
Hussein Abou-Abbass, Hisham Bahmad, Hiba Ghandour, Jawad Fares, Rayyan Wazzi-Mkahal, Basel Yacoub, Hala Darwish, Stefania Mondello, Hayat Harati, Mazen J El Sayed, Hani Tamim, Firas Kobeissy
BACKGROUND: Traumatic brain injury (TBI) is a debilitating medical and emerging public health problem that is affecting people worldwide due to a multitude of factors including both domestic and war-related acts. The objective of this paper is to systematically review the status of TBI in Lebanon - a Middle Eastern country with a weak health system that was chartered by several wars and intermittent outbursts of violence - in order to identify the present gaps in knowledge, direct future research initiatives and to assist policy makers in planning progressive and rehabilitative policies...
November 2016: Medicine (Baltimore)
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