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https://www.readbyqxmd.com/read/28424823/-coma-in-the-emergency-room
#1
M Braun, C J Ploner, T Lindner, M Möckel, W U Schmidt
Coma of unknown origin (CUO) is a frequent unspecific emergency symptom associated with a high mortality. A fast diagnostic work-up is essential given the wide spectrum of underlying diagnoses that are made up of approximately 50% primary central nervous system (CNS) pathologies and approximately 50% extracerebral, almost exclusively internal medical causes. Despite the high mortality associated with this symptom, there are currently no generally accepted management guidelines for adult patients presenting with CUO...
April 19, 2017: Der Nervenarzt
https://www.readbyqxmd.com/read/28424063/clinical-and-cost-effectiveness-analysis-of-early-detection-of-patients-at-nutrition-risk-during-their-hospital-stay-through-the-new-screening-method-cipa-a-study-protocol
#2
José Pablo Suárez-Llanos, Néstor Benítez-Brito, Laura Vallejo-Torres, Irina Delgado-Brito, Adriá Rosat-Rodrigo, Carolina Hernández-Carballo, Yolanda Ramallo-Fariña, Francisca Pereyra-García-Castro, Juan Carlos-Romero, Nieves Felipe-Pérez, Jennifer García-Niebla, Eduardo Mauricio Calderón-Ledezma, Teresa de Jesús González-Melián, Ignacio Llorente-Gómez de Segura, Manuel Ángel Barrera-Gómez
BACKGROUND: Malnutrition is highly prevalent in hospitalized patients and results in a worsened clinical course as well as an increased length of stay, mortality, and costs. Therefore, simple nutrition screening systems, such as CIPA (control of food intake, protein, anthropometry), may be implemented to facilitate the patient's recovery process. The aim of this study is to evaluate the effectiveness and cost-effectiveness of implementing such screening tool in a tertiary hospital, consistent with the lack of similar, published studies on any hospital nutrition screening system...
April 20, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28420603/the-coags-uncomplicated-app-fulfilling-educational-gaps-around-diagnosis-and-laboratory-testing-of-coagulation-disorders
#3
Craig Kessler, Ellinor I Peerschke, Meera B Chitlur, Roshni Kulkarni, Natalia Holot, David L Cooper
BACKGROUND: Patients with coagulation disorders may present to a variety of physician specialties; however, accurate and efficient diagnosis can be challenging for physicians not specialized in hematology, due to identified gaps in knowledge around appropriate laboratory assays and interpretation of test results. Coags Uncomplicated was developed to fill this unmet educational need by increasing practical knowledge of coagulation disorders among nonexpert physicians and other health care professionals (HCPs) in a point-of-care (POC) setting...
April 18, 2017: JMIR Medical Education
https://www.readbyqxmd.com/read/28420381/operations-research-in-global-health-a-scoping-review-with-a-focus-on-the-themes-of-health-equity-and-impact
#4
REVIEW
Beverly D Bradley, Tiffany Jung, Ananya Tandon-Verma, Bassem Khoury, Timothy C Y Chan, Yu-Ling Cheng
BACKGROUND: Operations research (OR) is a discipline that uses advanced analytical methods (e.g. simulation, optimisation, decision analysis) to better understand complex systems and aid in decision-making. Herein, we present a scoping review of the use of OR to analyse issues in global health, with an emphasis on health equity and research impact. A systematic search of five databases was designed to identify relevant published literature. A global overview of 1099 studies highlights the geographic distribution of OR and common OR methods used...
April 18, 2017: Health Research Policy and Systems
https://www.readbyqxmd.com/read/28406489/consensus-recommendation-for-a-diagnostic-guideline-for-acid-sphingomyelinase-deficiency
#5
Margaret M McGovern, Carlo Dionisi-Vici, Roberto Giugliani, Paul Hwu, Olivier Lidove, Zoltan Lukacs, Karl Eugen Mengel, Pramod K Mistry, Edward H Schuchman, Melissa P Wasserstein
Disclaimer:This diagnostic guideline is intended as an educational resource and represents the opinions of the authors, and is not representative of recommendations or policy of the American College of Medical Genetics and Genomics (ACMG). The information should be considered a consensus based on expert opinion, as more comprehensive levels of evidence were not available in the literature in all cases. BACKGROUND: Acid sphingomyelinase deficiency (ASMD) is a rare, progressive, and often fatal lysosomal storage disease...
April 13, 2017: Genetics in Medicine: Official Journal of the American College of Medical Genetics
https://www.readbyqxmd.com/read/28399929/xanthogranulomatous-pyelonephritis-presenting-as-acute-pleuritic-chest-pain-a-case-report
#6
Justin Chow, Rameez Kabani, Kirstie Lithgow, Magdalena A Sarna
BACKGROUND: Xanthogranulomatous pyelonephritis is a rare and serious manifestation of chronic kidney inflammation that can be life-threatening if not recognized and treated appropriately, often with antibiotics and surgery. Affected patients are most commonly females in their fifth or sixth decade of life with a background of obstructive uropathy, nephrolithiasis, or recurrent urinary tract infections who present with vague nonspecific symptoms. CASE PRESENTATION: A 43-year-old woman of Russian ethnicity with a history of nephrolithiasis presented to our emergency department with new left-sided pleuritic chest pain amid a 6-week history of constitutional symptoms including fevers, night sweats, and 7 kg of weight loss...
April 12, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28396131/effectiveness-of-a-simple-intervention-on-management-of-acute-exacerbations-of-chronic-obstructive-pulmonary-disease-and-its-cardiovascular-comorbidities-corepoc-study
#7
Jesús Díez-Manglano, Jesús Recio Iglesias, José Manuel Varela Aguilar, Pere Almagro Mena, Gabriel Zubillaga Garmendia
BACKGROUND AND OBJECTIVE: To determine the effectiveness of a simple educational intervention to improve the management of cardiovascular comorbidities in patients hospitalized with an acute exacerbation of chronic obstructive pulmonary disease (COPD). MATERIAL AND METHODS: Multicenter study participated in by 26 hospital centers. A panel of experts elaborated a set of recommendations about diagnostic and therapeutic management of acute exacerbation of COPD and cardiovascular comorbidities (coronary artery disease, atrial fibrillation, heart failure and diabetes)...
April 7, 2017: Medicina Clínica
https://www.readbyqxmd.com/read/28385463/clinical-and-social-barriers-to-antimicrobial-stewardship-in-pulmonary-medicine-a-qualitative-study
#8
Jennifer K Broom, Alex F Broom, Emma R Kirby, Alexandra F Gibson, Jeffrey J Post
BACKGROUND: The treatment of pulmonary infections is one of the largest indications for antibiotics in human health care, offering significant potential for antibiotic optimization internationally. This study explores the perspectives of pulmonary clinicians on antibiotic use in hospital pulmonary infections. METHODS: Twenty-eight pulmonary doctors and nurses from 2 hospitals participated in semi-structured interviews focusing on their experiences of antibiotic use...
April 3, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28384684/an-international-collaborative-standardizing-a-comprehensive-patient-centered-outcomes-measurement-set-for-colorectal-cancer
#9
Jessica A Zerillo, Maartje G Schouwenburg, Annelotte C M van Bommel, Caleb Stowell, Jacob Lippa, Donna Bauer, Ann M Berger, Gilles Boland, Josep M Borras, Mary K Buss, Robert Cima, Eric Van Cutsem, Eino B van Duyn, Samuel R G Finlayson, Skye Hung-Chun Cheng, Corinna Langelotz, John Lloyd, Andrew C Lynch, Harvey J Mamon, Pamela K McAllister, Bruce D Minsky, Joanne Ngeow, Muhammad R Abu Hassan, Kim Ryan, Veena Shankaran, Melissa P Upton, John Zalcberg, Cornelis J van de Velde, Rob Tollenaar
Importance: Global health systems are shifting toward value-based care in an effort to drive better outcomes in the setting of rising health care costs. This shift requires a common definition of value, starting with the outcomes that matter most to patients. Objective: The International Consortium for Health Outcomes Measurement (ICHOM), a nonprofit initiative, was formed to define standard sets of outcomes by medical condition. In this article, we report the efforts of ICHOM's working group in colorectal cancer...
April 6, 2017: JAMA Oncology
https://www.readbyqxmd.com/read/28379619/blood-pressure-lowering-efficacy-of-renin-inhibitors-for-primary-hypertension
#10
REVIEW
Vijaya M Musini, Kendra Ak Lawrence, Patricia M Fortin, Ken Bassett, James M Wright
BACKGROUND: Hypertension is a chronic condition associated with an increased risk of mortality and morbidity. Renin is the enzyme responsible for converting angiotensinogen to angiotensin I, which is then converted to angiotensin II. Renin inhibitors are a new class of drugs that decrease blood pressure (BP) by preventing the formation of both angiotensin I and angiotensin II. OBJECTIVES: To quantify the dose-related BP lowering efficacy of renin inhibitors compared to placebo in the treatment of primary hypertension...
April 5, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28379080/interprofessional-collaborative-reasoning-by-residents-and-nurses-in-internal-medicine-evidence-from-a-simulation-study
#11
K S Blondon, F Maître, V Muller-Juge, N Bochatay, S Cullati, P Hudelson, N V Vu, G L Savoldelli, M R Nendaz
Clinical reasoning has been studied in residents or nurses, using interviews or patient-provider encounters. Despite a growing interest in interprofessional collaboration, the notion of collaborative reasoning has not been well studied in clinical settings. Our study aims at exploring resident-nurse collaborative reasoning in a simulation setting. We enrolled 14 resident-nurse teams from a general internal medicine division in a mixed methods study. Teams each managed one of four acute case scenarios, followed by a stimulated-recall session...
April 2017: Medical Teacher
https://www.readbyqxmd.com/read/28373258/european-prospective-cohort-study-on-enterobacteriaceae-showing-resistance-to-carbapenems-eureca-a-protocol-of-a-european-multicentre-observational-study
#12
Belén Gutiérrez-Gutiérrez, Jesús Sojo-Dorado, José Bravo-Ferrer, Nienke Cuperus, Marlieke de Kraker, Tomislav Kostyanev, Lul Raka, George Daikos, Jan Feifel, Laura Folgori, Alvaro Pascual, Herman Goossens, Seamus O'Brien, Marc J M Bonten, Jesús Rodríguez-Baño
INTRODUCTION: The rapid worldwide spread of carbapenem-resistant Enterobacteriaceae (CRE) constitutes a major challenge. The aim of the EUropean prospective cohort study on Enterobacteriaceae showing REsistance to CArbapenems (EURECA), which is part of the Innovative Medicines Initiative Joint Undertaking (IMI JU) funded COMBACTE-CARE project, is to investigate risk factors for and outcome determinants of CRE infections to inform randomised clinical trial designs and to provide a historical cohort that could eventually be used for future comparisons with new drugs targeting CRE...
April 3, 2017: BMJ Open
https://www.readbyqxmd.com/read/28372942/human-biomonitoring-reference-values-derived-for-persistent-organic-pollutants-in-blood-plasma-from-the-canadian-health-measures-survey-2007-2011
#13
Douglas A Haines, Cheryl Khoury, Gurusankar Saravanabhavan, Kate Werry, Mike Walker, Morie Malowany
Nationally representative human biomonitoring data on persistent organic pollutants (POPs) including organochlorine pesticides (OCs), polychlorinated biphenyls (PCBs) brominated flame retardants (BFRs) and perfluoroalkyl substances (PFASs) are available through the Canadian Health Measures Survey (CHMS). We have used a systematic approach building on the reference interval concept proposed by the International Federation of Clinical Chemistry and Laboratory Medicine and the International Union of Pure and Applied Chemistry to derive human biomonitoring reference values (RV95s) for selected POPs in blood plasma in the general Canadian population...
March 18, 2017: International Journal of Hygiene and Environmental Health
https://www.readbyqxmd.com/read/28372529/panel-4-report-of-the-microbiology-panel
#14
Stephen J Barenkamp, Tasnee Chonmaitree, Anders P Hakansson, Terho Heikkinen, Samantha King, Johanna Nokso-Koivisto, Laura A Novotny, Janak A Patel, Melinda Pettigrew, W Edward Swords
Objective To perform a comprehensive review of the literature from July 2011 until June 2015 on the virology and bacteriology of otitis media in children. Data Sources PubMed database of the National Library of Medicine. Review Methods Two subpanels comprising experts in the virology and bacteriology of otitis media were created. Each panel reviewed the relevant literature in the fields of virology and bacteriology and generated draft reviews. These initial reviews were distributed to all panel members prior to meeting together at the Post-symposium Research Conference of the 18th International Symposium on Recent Advances in Otitis Media, National Harbor, Maryland, in June 2015...
April 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28363610/unnecessary-overuse-study-of-inadvisable-practices-for-patients-with-atrial-fibrillation
#15
M M Ortiz, P Llamas, M Sanmartín, J A Egido, J Del Toro, M I Egocheaga, M S Estévez, I M Navarro, J J Mira
OBJECTIVE: To identify overuse (diagnostic, therapeutic and self-care practices that represent risks that outweigh the potential benefits) in patients with atrial fibrillation. METHOD: The study was based on qualitative research techniques. Using the "Metaplan" technique, we identified and ordered potentially inappropriate, ineffective and inefficient practices. By means of a consensus conference, we then established a number of "inadvisable practice" measures (relatively common practices that should be eliminated based on the scientific evidence or clinical experience)...
March 28, 2017: Revista Clínica Española
https://www.readbyqxmd.com/read/28355984/hydroxychloroquine-induced-hyperpigmentation-in-systemic-diseases-prevalence-clinical-features-and-risk-factors-a-cross-sectional-study-of-41-cases
#16
E Bahloul, M Jallouli, S Garbaa, S Marzouk, A Masmoudi, H Turki, Z Bahloul
Introduction Hydroxychloroquine is an antimalarial agent widely prescribed in internal medicine, rheumatology and dermatology. Its use can be complicated by various side effects including skin pigmentation. Objectives The aim of the study is to review epidemiological, clinical features and risk factors of hydroxychloroquine-induced pigmentation. Materials and methods We performed a cross-sectional study conducted over a period of 5 months. During this period, patients who had been treated with hydroxychloroquine for over 6 months, in the internal medicine department, underwent a complete dermatological examination...
January 1, 2017: Lupus
https://www.readbyqxmd.com/read/28347451/the-role-of-computerized-diagnostic-proposals-in-the-interpretation-of-the-12-lead-electrocardiogram-by-cardiology-and-non-cardiology-fellows
#17
Tomas Novotny, Raymond Bond, Irena Andrsova, Lumir Koc, Martina Sisakova, Dewar Finlay, Daniel Guldenring, Jindrich Spinar, Marek Malik
INTRODUCTION: Most contemporary 12-lead electrocardiogram (ECG) devices offer computerized diagnostic proposals. The reliability of these automated diagnoses is limited. It has been suggested that incorrect computer advice can influence physician decision-making. This study analyzed the role of diagnostic proposals in the decision process by a group of fellows of cardiology and other internal medicine subspecialties. MATERIALS AND METHODS: A set of 100 clinical 12-lead ECG tracings was selected covering both normal cases and common abnormalities...
May 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/28341581/the-graham-jackson-memorial-lecture-issm-2016-the-man-who-knew-too-much-time-to-recognize-erectile-dysfunction-and-low-testosterone-as-independent-risk-factors-for-cardiovascular-disease
#18
REVIEW
Geoffrey Hackett
INTRODUCTION: Graham Jackson introduced the concept that erectile dysfunction (ED) is a marker for undiagnosed cardiovascular (CV) disease and future events. In the Princeton 3 guidelines, he recognized the important impact of testosterone deficiency (TD) on all-cause and CV mortality. Recent evidence suggests that testosterone therapy to target levels and for sufficient duration decreases CV events. Unfortunately, this had a modest impact on CV disease management because ED is not incorporated into current risk calculators...
March 21, 2017: Sexual Medicine Reviews
https://www.readbyqxmd.com/read/28330460/sepsis-recognition-in-the-emergency-department-impact-on-quality-of-care-and-outcome
#19
Marius Morr, Alexander Lukasz, Eva Rübig, Hermann Pavenstädt, Philipp Kümpers
BACKGROUND: Appropriate and timely recognition of sepsis is a prerequisite for starting goal-directed therapy bundles. We analyzed the appropriateness of sepsis recognition and documentation with regard to adequacy of therapy and outcome in an internal medicine emergency department (ED). METHODS: This study included 487 consecutive patients ≥18 years of age who presented to a university hospital ED during a 4-week period. Clinical, laboratory, and follow-up data were acquired independently from documentation by ED physicians...
March 23, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/28321908/reduced-field-of-view-single-shot-spiral-perfusion-imaging
#20
Yang Yang, Li Zhao, Xiao Chen, Peter W Shaw, Jorge A Gonzalez, Frederick H Epstein, Craig H Meyer, Christopher M Kramer, Michael Salerno
PURPOSE: To develop a single-shot spiral perfusion pulse sequence with outer-volume suppression (OVS) to achieve whole-heart coverage with a short temporal footprint of 10 ms per slice location. METHODS: A highly accelerated single-shot variable density spiral pulse sequence with an integrated OVS module for reduced field of view (rFOV) perfusion imaging with 2 mm spatial resolution was developed and evaluated in simulations, phantom experiments and in clinical patients with (n = 8) or without (n = 8) OVS...
March 20, 2017: Magnetic Resonance in Medicine: Official Journal of the Society of Magnetic Resonance in Medicine
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