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https://www.readbyqxmd.com/read/28820896/a-strategy-for-scaling-up-access-to-comprehensive-care-in-adults-with-chagas-disease-in-endemic-countries-the-bolivian-chagas-platform
#1
Maria-Jesus Pinazo, Jimy Pinto, Lourdes Ortiz, Jareth Sánchez, Wilson García, Ruth Saravia, Mirko-R Cortez, Silvia Moriana, Enric Grau, Daniel Lozano, Joaquim Gascon, Faustino Torrico
BACKGROUND: Bolivia has the highest prevalence of Chagas disease (CD) in the world (6.1%), with more than 607,186 people with Trypanosoma cruzi infection, most of them adults. In Bolivia CD has been declared a national priority. In 2009, the Chagas National Program (ChNP) had neither a protocol nor a clear directive for diagnosis and treatment of adults. Although programs had been implemented for congenital transmission and for acute cases, adults remained uncovered. Moreover, health professionals were not aware of treatment recommendations aimed at this population, and research on CD was limited; it was difficult to increase awareness of the disease, understand the challenges it presented, and adapt strategies to cope with it...
August 18, 2017: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/28818305/treatment-of-the-ventral-intermediate-nucleus-for-medically-refractory-tremor-a-cost-analysis-of-stereotactic-radiosurgery-versus-deep-brain-stimulation
#2
Shearwood McClelland, Jerry J Jaboin
INTRODUCTION: Medically refractory tremor treatment has evolved over the past half-century from intraoperative thalamotomy to deep brain stimulation (DBS) of the thalamic ventral intermediate nucleus (VIM). Within the past 15years, unilateral radiosurgical VIM thalamotomy has emerged as a comparably efficacious treatment modality. METHODS: An extensive literature search of VIM DBS series was performed; the total cost of VIM DBS was calculated from hospitals geographically representative of the entire United States using current procedural terminology and work relative value unit (RVU) codes...
August 14, 2017: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
https://www.readbyqxmd.com/read/28817750/the-surgeon-on-service-model-for-timely-economically-viable-inpatient-care-of-tracheostomy-patients-in-academic-pediatric-otolaryngology
#3
Jennifer M Lavin, James W Schroeder, Dana M Thompson
Importance: The traditional practice model for pediatric otolaryngologists at high-volume academic centers is to simultaneously balance outpatient care responsibilities with those of the inpatient service, emergency department, and ambulatory care clinics. This model leads to challenges with care coordination, timeliness of nonemergency operative care, and consistent participation in care and consultation at the attending surgeon level. The "surgeon on service" (SOS) model-where faculty members rotate to manage the inpatient service in lieu of outpatient responsibilities-has been described as one method to address this conundrum...
August 17, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28816211/a-study-of-events-between-the-onset-of-symptoms-and-hospital-admission-in-patients-with-acute-abdomen
#4
Shubhada Khanapure, Sanjay Nagral, Aditya J Nanavati
BACKGROUND: Acute abdomen is a common surgical emergency. Prompt investigation and treatment, including surgical intervention, is critical in reducing morbidity and mortality. METHODS: We carried out a prospective observational study at a large urban secondary healthcare centre in India. Patients with surgical acute abdomen were consecutively enrolled in the study over a period of 2 years. Data were collected regarding the onset of symptoms, time of presentation to the hospital and events in the intervening period...
March 2017: National Medical Journal of India
https://www.readbyqxmd.com/read/28816031/do-you-see-what-i-see-a-mother-s-plea
#5
Kees Nydam, Rebecca Soole
There is sometimes dissonance between the medical services that the general public expects an ED to provide and the acute critical care that emergency clinicians hope to provide. One explanation for this is that the ED is both a territory and a meeting place for a cornucopia of clinicians, some of whom are not ED clinicians themselves. Roles are sometimes ambiguous and location-specific. Recently, one Queensland mother believed that her son's suicide could have been prevented had emergency staff been better educated...
August 16, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28815690/treatment-of-individuals-who-cannot-receive-blood-products-for-religious-or-other-reasons
#6
REVIEW
Carlton D Scharman, Joseph J Shatzel, Edward Kim, Thomas G DeLoughery
By virtue of their religious principles, Jehovah's Witnesses (JWs) generally object to receiving blood products, raising numerous ethical, legal, and medical challenges for providers who care for these patients, especially in the emergent setting. In this review, we discuss several areas relevant to the care of JWs, including the current literature on "bloodless" medical care in the setting of peri- and intra-operative management, acute blood loss, trauma, pregnancy, and malignancy. We have found that medical and administrative efforts in the form of bloodless medicine and surgery programs can be instrumental in helping to reduce risks of morbidity and mortality in these patients...
August 17, 2017: American Journal of Hematology
https://www.readbyqxmd.com/read/28814285/quality-of-midwife-provided-intrapartum-care-in-amhara-regional-state-ethiopia
#7
Tegbar Yigzaw, Fantu Abebe, Lalem Belay, Yewulsew Assaye, Equlinet Misganaw, Ashebir Kidane, Desalegn Ademie, Jos van Roosmalen, Jelle Stekelenburg, Young-Mi Kim
BACKGROUND: Despite much progress recently, Ethiopia remains one of the largest contributors to the global burden of maternal and newborn deaths and stillbirths. Ethiopia's plan to meet the sustainable development goals for maternal and child health includes unprecedented emphasis on improving quality of care. The purpose of this study was to assess the quality of midwifery care during labor, delivery and immediate postpartum period. METHODS: A cross-sectional study using multiple data collection methods and a 2-stage cluster sampling technique was conducted from January 25 to February 14, 2015 in government health facilities of the Amhara National Regional State of Ethiopia...
August 16, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28814276/treatment-outcomes-of-patients-with-multidrug-resistant-and-extensively-drug-resistant-tuberculosis-in-hunan-province-china
#8
Kefyalew Addis Alene, Hengzhong Yi, Kerri Viney, Emma S McBryde, Kunyun Yang, Liqiong Bai, Darren J Gray, Archie C A Clements, Zuhui Xu
BACKGROUND: The worldwide emergence of multidrug-resistant tuberculosis (MDR-TB) and extensively drug-resistant tuberculosis (XDR-TB) has posed additional challenges for global tuberculosis (TB) control efforts, as limited treatment options are available and treatment outcomes are often sub-optimal. This study determined treatment outcomes among a cohort of MDR-TB and XDR-TB patients in Hunan Province, China, and identified factors associated with poor treatment outcomes. METHODS: We conducted a retrospective study using data obtained from medical records of TB patients in Hunan Chest Hospital, and from the internet-based TB management information system managed by the Tuberculosis Control Institute of Hunan Province, for the period 2011 to 2014...
August 16, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28813774/pulmonary-embolism-caused-by-popliteal-vein-aneurysm-a-case-report
#9
Kevin Marquez, Kalyan Chakravarthy Potu, Chad Laurich, Randall Lamfers
In this case report, we describe an unusual episode of bilateral submassive pulmonary embolism (PE) caused by a popliteal vein aneurysm (PVA). The development of PE stems from many risk factors including obesity (BMI³ 30 kg/m2), hypertension, cigarette smoking (greater than 25 cigarettes per day), increasing age, surgery, immobility, malignancy, and inherited thrombophilia. A PVA is a rare but significant cause of PE. A 28-year-old male presented to the emergency department with progressive shortness of breath...
March 2017: South Dakota Medicine: the Journal of the South Dakota State Medical Association
https://www.readbyqxmd.com/read/28813541/reflections-on-medical-tourism-from-the-2016-global-healthcare-policy-and-management-forum
#10
Valorie A Crooks, Meghann Ormond, Ki Nam Jin
In October 2016, the Global Healthcare Policy and Management Forum was held at Yonsei University, Seoul, South Korea. The goal of the forum was to discuss the role of the state in regulating and supporting the development of medical tourism. Forum attendees came from 10 countries. In this short report article, we identify key lessons from the forum that can inform the direction of future scholarly engagement with medical tourism. In so doing, we reference on-going scholarly debates about this global health services practice that have appeared in multiple venues, including this very journal...
2017: BMC Proceedings
https://www.readbyqxmd.com/read/28812053/emergency-medical-service-personnel-recognize-pediatric-concussions
#11
Joshua N Speirs, Matthew I Lyons, Bert E Johansson
Concussions are a major cause of morbidity in pediatrics. Many concussions occur during activities with emergency medical service (EMS) providers present to determine if a higher level of care is needed. Data are limited on how capable these providers are. We assessed the ability of EMS providers to recognize pediatric concussions. Fifty-six total responses were included, 38 from EMS and 18 from our MD/RN (medical doctor/registered nurse) group. No statistical differences were found between the 2 groups when adjusted for age, gender, number of years in practice, and number of pediatric concussions managed...
2017: Global Pediatric Health
https://www.readbyqxmd.com/read/28811394/overview-and-current-management-of-computerized-adaptive-testing-in-licensing-certification-examinations
#12
Dong Gi Seo
Computerized adaptive testing (CAT) has been implemented in the high stakes examinations such as National Council Licensure Examination-Registered Nurses (NCLEX-RN) in the United States since 1994. After that, The National Registry Emergency Medical Technician (NREMT) in the United States adopted a CAT to certify an Emergency Medical Technician (EMT) in 2007. It aimed at introducing CAT for the implementation in the medical health licensing examinations. Most CATs are based on the item response theory (IRT) which hypothesizes that both examinee and item has own characteristics that does not change...
July 26, 2017: Journal of Educational Evaluation for Health Professions
https://www.readbyqxmd.com/read/28811137/influence-of-guidelines-on-management-of-paediatric-mild-traumatic-brain-injury-ct-assessment-and-admission-policy
#13
J J Lenstra, A R A Pikstra, J M Fock, Z Metting, J van der Naalt
BACKGROUND: The annual number of paediatric injury-related emergency visits and application of computed tomography (CT) has substantially increased, with associated higher risk of malignancies. In 2010, a guideline for CT-assessment based on risk factors for patients with mild traumatic brain injury (mTBI) became effective in all Emergency Departments (ED) in the Netherlands. This study evaluated the influence of this guideline on the frequency of CT-assessments, hospital admissions and factors that are related to guideline adherence...
August 3, 2017: European Journal of Paediatric Neurology: EJPN
https://www.readbyqxmd.com/read/28811051/patient-blood-management-in-the-intensive-care-unit
#14
REVIEW
Aryeh Shander, Mazyar Javidroozi, Gregg Lobel
Patient Blood Management underscores a fundamental shift from a product-centered approach to a patient-centric approach through timely application of evidence-based medical and surgical concepts designed to maintain hemoglobin concentration, optimize hemostasis, and minimize blood loss in an effort to improve patient outcome. In this concept, allogeneic blood transfusion is not viewed as the treatment of default for anemic patients, but one among many treatment modalities that should be weighed based on its merits-potentials risks and benefits-for the individual patient in the context of other alternatives...
July 31, 2017: Transfusion Medicine Reviews
https://www.readbyqxmd.com/read/28811014/assessing-need-for-pharmacist-involvement-to-improve-care-coordination-for-patients-on-lai-antipsychotics-transitioning-from-hospital-to-home-a-work-system-approach
#15
Olufunmilola Abraham, Michelle N Myers, Amanda L Brothers, Jamie Montgomery, Bryan A Norman, Tanya Fabian
BACKGROUND: The use of Long-Acting Injectable (LAI) antipsychotic medications has increased for patients with Serious Mental Illness (SMI). Care coordination for this population is complex, and pharmacist involvement may improve and support long-term medication adherence and patient outcomes. OBJECTIVES: (1) Examine pharmacists' role in addressing care coordination and adherence challenges for patients taking Long-Acting Injectable (LAI) antipsychotics; and (2) explore patients' medication use experiences with LAI antipsychotics and educational needs...
September 2017: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/28810133/floor-of-mouth-hematoma-following-dental-implant-placement-systematic-review-and-case-presentation
#16
REVIEW
Catherine Law, Peyman Alam, Farzad Borumandi
PURPOSE: The authors provide a structured review of reported cases of floor-of-mouth hematoma during or after dental implantation and frequent causes and management and present a related case. MATERIALS AND METHODS: An online search of the medical literature was conducted from 1990 through 2016. The following search terms were used: floor of mouth hematoma, sublingual hematoma, dental implant hematoma, implant in mandible, and complication of dental implant. Abstracts were screened for relevance to the aims of the review...
July 21, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28810127/medicaid-prior-authorization-and-opioid-medication-abuse-and-overdose
#17
Gerald Cochran, Adam J Gordon, Walid F Gellad, Chung-Chou H Chang, Wei-Hsuan Lo-Ciganic, Carroline Lobo, Evan Cole, Winfred Frazier, Ping Zheng, David Kelley, Julie M Donohue
OBJECTIVES: The US opioid medication epidemic has resulted in serious health consequences for patients. Formulary management tools adopted by payers, specifically prior authorization (PA) policies, may lower the rates of opioid medication abuse and overdose. We compared rates of opioid abuse and overdose among enrollees in plans that varied in their use of PA from "High PA" (ie, required PA for 17 to 74 opioids), with "Low PA" (ie, required PA for 1 opioid), and "No PA" policies for opioid medications...
May 1, 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/28808948/tiotropium-bromide-in-children-and-adolescents-with-asthma
#18
Hengameh H Raissy, H William Kelly
Evidence is emerging on the use of long-acting muscarinic antagonists (LAMAs) in the management of asthma. Tiotropium bromide (Spiriva(®) Respimat(®)) is the only LAMA approved in children and adolescents. As the use of tiotropium becomes more common in clinical practice, it is necessary to review the existing data to identify patients who may benefit from the addition of this medication to their daily asthma regimen. This review discusses recent evidence on the safety and efficacy of tiotropium bromide in the management of asthma in children and adolescents...
August 14, 2017: Paediatric Drugs
https://www.readbyqxmd.com/read/28808824/gasless-single-incision-laparoscopic-inguinal-hernia-repair-initial-experience
#19
M W V Ng, K C Ng
PURPOSE: Laparoscopic hernioplasty has been gaining its popularity in the past decade for its rapid recovery. Single-incision surgery, as its possible advancement, has also received more attention. Traditional laparoscopic surgery with carbon dioxide insufflation precluded patients with underlying cardiovascular or pulmonary disease from minimal invasive surgery. We report our early experience with gasless single-incision laparoscopic inguinal hernia repair via totally extraperitoneal (TEP) approach...
August 14, 2017: Hernia: the Journal of Hernias and Abdominal Wall Surgery
https://www.readbyqxmd.com/read/28808608/intrathecal-catheter-associated-inflammatory-mass-in-a-neurofibromatosis-type-1-patient-receiving-fentanyl-and-bupivacaine
#20
Derek G Southwell, Joseph A Osorio, Christopher S Liverman, Lauren M Friedman, Ramana K Naidu, Lawrence R Poree, Melanie M Henry, Line Jacques
BACKGROUND: Catheter-associated inflammatory masses (CIMs) are a rare but serious complication of intrathecal drug delivery devices. CIM formation is influenced by local medication concentration, which is determined in part by flow dynamics at the catheter tip. Underlying spinal pathologies, such as neoplasms, may alter flow at the catheter tip, thereby contributing to CIM formation. Moreover, they may also complicate the clinical and radiologic diagnosis of a CIM. CASE DESCRIPTION: A 36-year-old man with neurofibromatosis type 1 presented to our emergency department with complaints of increased back pain and leg weakness...
2017: Surgical Neurology International
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