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https://www.readbyqxmd.com/read/28431008/diabetes-mellitus-as-the-major-risk-factor-for-mucormycosis-in-mexico-epidemiology-diagnosis-and-outcomes-of-reported-cases
#1
Dora E Corzo-León, Luis D Chora-Hernández, Ana P Rodríguez-Zulueta, Thomas J Walsh
Mucormycosis is an emerging infectious disease with high rates of associated mortality and morbidity. Little is known about the characteristics of mucormycosis or entomophthoromycosis occurring in Mexico. A search strategy was performed of literature published in journals found in available databases and theses published online at Universidad Nacional Autónoma de México (UNAM) library website reporting clinical cases or clinical case series of mucormycosis and entomophthoromycosis occurring in Mexico between 1982 and 2016...
April 20, 2017: Medical Mycology: Official Publication of the International Society for Human and Animal Mycology
https://www.readbyqxmd.com/read/28430850/trends-in-hospitalization-for-hypertensive-emergency-and-relationship-of-end-organ-damage-with-in-hospital-mortality
#2
Mahek Shah, Shantanu Patil, Brijesh Patel, Shilpkumar Arora, Nilay Patel, Lohit Garg, Sahil Agrawal, Larry Jacobs, Susan P Steigerwalt, Matthew W Martinez
BACKGROUND: There are no comprehensive guidelines on management of hypertensive emergency (HTNE) and complications. Despite advances in antihypertensive medications HTNE is accompanied with significant morbidity and mortality. METHODS: We queried the 2002-2012 nationwide inpatient sample database to identify patients with HTNE. Trends in incidence of HTNE and in-hospital mortality were analyzed. Logistic regression analysis was used to assess the relationship between end-organ complications and in-hospital mortality...
April 20, 2017: American Journal of Hypertension
https://www.readbyqxmd.com/read/28429527/balancing-health-care-education-and-patient-care-in-the-uk-workplace-a-realist-synthesis
#3
Sarah Sholl, Rola Ajjawi, Helen Allbutt, Jane Butler, Divya Jindal-Snape, Jill Morrison, Charlotte Rees
CONTEXT: Patient care activity has recently increased without a proportionate rise in workforce numbers, impacting negatively on health care workplace learning. Health care professionals are prepared in part by spending time in clinical practice, and for medical staff this constitutes a contribution to service. Although stakeholders have identified the balance between health care professional education and patient care as a key priority for medical education research, there have been very few reviews to date on this important topic...
April 20, 2017: Medical Education
https://www.readbyqxmd.com/read/28429248/time-in-therapeutic-range-as-a-marker-for-thrombotic-and-bleeding-outcomes-in-fontan-patients
#4
Jenna M Faircloth, Kristin M Miner, Tarek Alsaied, Nicole Nelson, Julie Ciambarella, Tomoyuki Mizuno, Joseph S Palumbo, Alexander A Vinks, Gruschen R Veldtman
Fontan patients managed with warfarin are at risk not only for thrombotic events, but also for bleeding episodes as a consequence of anticoagulation treatment. The aim of this study was to determine whether time spent in patient specified therapeutic range (TTR), when managed in a cardiology-based pharmacist managed anticoagulation clinic (PMAC), is a useful target metric for monitoring, as well as improving outcomes. A single center retrospective review was conducted evaluating TTR of all Fontan patients (n = 45) on warfarin managed in our outpatient cardiology pharmacist managed anticoagulation clinic (PMAC) during a 19 month time frame...
April 20, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28429198/managing-the-perioperative-patient-on-direct-oral-anticoagulants
#5
Jordan Leitch, Janet van Vlymen
PURPOSE: Patients are increasingly treated with direct oral anticoagulants (DOACs) for the prevention of stroke due to non-valvular atrial fibrillation and for the treatment of venous thromboembolism. When these patients present for urgent or emergent surgical procedures, they present a challenge to the anesthesiologist who must manage perioperative risk due to anticoagulation. The purpose of this module is to review the literature surrounding the perioperative management of DOACs. Timing, laboratory monitoring, and availability of reversal agents are important considerations to optimize patients being treated with DOACs who require emergent surgery...
April 20, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28429117/a-comparison-of-mcgrath-mac%C3%A2-and-standard-direct-laryngoscopy-in-simulated-immobilized-cervical-spine-pediatric-intubation-a-manikin-study
#6
Marcin Madziala, Jacek Smereka, Marek Dabrowski, Steve Leung, Kurt Ruetzler, Lukasz Szarpak
Emergency airway management in children is generally considered to be challenging, and endotracheal intubation requires a high level of personal skills and experience. Immobilization of the cervical spine is indicated in all patients with the risk of any cervical spine injury but significantly aggravates endotracheal intubation. The best airway device in this setting has not been established yet, although the use of videolaryngoscopes is generally promising. Seventy-five moderately experienced paramedics of the Emergency Medical Service of Poland performed endotracheal intubations in a pediatric manikin in three airway scenarios: (A) normal airway, (B) manual in-line cervical immobilization, and (C) cervical immobilization using a Patriot cervical extrication collar and using two airway techniques: (1) McGrath videolaryngoscope and (2) Macintosh blade in a randomized sequence...
April 21, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28427977/decompressive-craniectomy-in-spontaneous-intracerebral-hemorrhage-a-case-control-study
#7
Yu Tung Lo, Angela An Qi See, Nicolas Kon Kam King
BACKGROUND: Decompressive craniectomy is performed to relieve intracranial pressure as an emergency procedure. There is no large study to systematically evaluate the benefit of decompressive craniectomy versus best medical therapy. This study evaluates the survival and long-term functional outcomes of decompressive craniectomy for spontaneous intracranial hemorrhage. METHODS: A total of 54 eligible patients with spontaneous supratentorial hemorrhage (median age 55, IQR 47-64) who underwent decompressive craniectomy were retrospectively matched to 72 patients managed with best medical treatment (median age 58, IQR 32-74)...
April 17, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28424823/-coma-in-the-emergency-room
#8
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/28424564/new-developments-in-the-management-of-narcolepsy
#9
REVIEW
Vivien C Abad, Christian Guilleminault
Narcolepsy is a life-long, underrecognized sleep disorder that affects 0.02%-0.18% of the US and Western European populations. Genetic predisposition is suspected because of narcolepsy's strong association with HLA DQB1*06-02, and genome-wide association studies have identified polymorphisms in T-cell receptor loci. Narcolepsy pathophysiology is linked to loss of signaling by hypocretin-producing neurons; an autoimmune etiology possibly triggered by some environmental agent may precipitate hypocretin neuronal loss...
2017: Nature and Science of Sleep
https://www.readbyqxmd.com/read/28423982/from-data-to-improved-decisions-operations-research-in-healthcare-delivery
#10
Muge Capan, Anahita Khojandi, Brian T Denton, Kimberly D Williams, Turgay Ayer, Jagpreet Chhatwal, Murat Kurt, Jennifer Mason Lobo, Mark S Roberts, Greg Zaric, Shengfan Zhang, J Sanford Schwartz
BACKGROUND: The Operations Research Interest Group (ORIG) within the Society of Medical Decision Making (SMDM) is a multidisciplinary interest group of professionals that specializes in taking an analytical approach to medical decision making and healthcare delivery. ORIG is interested in leveraging mathematical methods associated with the field of Operations Research (OR) to obtain data-driven solutions to complex healthcare problems and encourage collaborations across disciplines. This paper introduces OR for the non-expert and draws attention to opportunities where OR can be utilized to facilitate solutions to healthcare problems...
April 1, 2017: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/28422779/the-utility-of-high-fidelity-simulation-for-training-critical-care-fellows-in-the-management-of-extracorporeal-membrane-oxygenation-emergencies-a-randomized-controlled-trial
#11
Bishoy M Zakhary, Lily M Kam, Brian S Kaufman, Kevin J Felner
OBJECTIVE: Although extracorporeal membrane oxygenation volume has increased, proficiency in the technology requires extensive training. We compared traditional water-drill-based extracorporeal membrane oxygenation training with simulation-based extracorporeal membrane oxygenation training with the hypothesis that simulation-based training is superior. DESIGN: Randomized controlled trial. SETTING: Academic medical center. SUBJECTS: Pulmonary/critical care fellows...
April 18, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28422296/keeping-out-and-getting-in-reframing-emergency-department-gatekeeping-as-structural-competence
#12
Mara Buchbinder
Sociologists have tended to frame medical gatekeeping as an exclusionary social practice, delineating how practitioners and clerical staff police the moral boundaries of medicine by keeping out patients who are categorised as 'bad', 'deviant', or otherwise problematic. Yet medical gatekeeping, understood more broadly, can include not only keeping patients out of particular clinical settings, but also redirecting them to alternative sources of care. In this article, I draw on qualitative analysis of audio-recorded patient-provider interactions in a United States emergency department (ED) to illustrate medical gatekeeping as a two-step process of, first, categorising certain patient complaints as unsuitable for treatment within a particular setting, and second, diverting patients to alternative sites for care...
April 19, 2017: Sociology of Health & Illness
https://www.readbyqxmd.com/read/28421912/a-survey-of-school-nurse-emergency-preparedness-2014-2015
#13
Margaret R Ugalde, Danielle Guffey, Charles G Minard, Angelo P Giardino, Gwendolyn A Johnson
Well-prepared school nurses are more likely to handle emergencies properly. Thus, assessing crisis management preparedness is important. In August 2014, a questionnaire was sent to 275 nurses in a large Texas school system to collect data about nurse and school characteristics, emergency frequency and management, and equipment availability. Completed surveys (201, 73%) were analyzed. Fisher's exact test was used to evaluate comparisons among nurses' confidence levels, school characteristics, emergencies, and medical emergency response plans (MERP)...
January 1, 2017: Journal of School Nursing: the Official Publication of the National Association of School Nurses
https://www.readbyqxmd.com/read/28421900/the-magnitude-and-factors-related-to-facility-based-maternal-mortality-in-mozambique
#14
Leonardo Chavane, Martinho Dgedge, Olivier Degomme, Osvaldo Loquiha, Marc Aerts, Marleen Temmerman
Facility-based maternal mortality remains an important public health problem in Mozambique. A number of factors associated with health system functioning can be described behind the occurrence of these deaths. This paper aimed to evaluate the magnitude of the health facility-based maternal mortality, its geographical distribution and to assess the health facility factors implicated in the occurrence of these deaths. A secondary analysis was done on data from the survey on maternal health needs performed by the Ministry of Health of Mozambique in 2008...
May 2017: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28421894/how-learning-analytics-can-early-predict-under-achieving-students-in-a-blended-medical-education-course
#15
Mohammed Saqr, Uno Fors, Matti Tedre
AIM: Learning analytics (LA) is an emerging discipline that aims at analyzing students' online data in order to improve the learning process and optimize learning environments. It has yet un-explored potential in the field of medical education, which can be particularly helpful in the early prediction and identification of under-achieving students. The aim of this study was to identify quantitative markers collected from students' online activities that may correlate with students' final performance and to investigate the possibility of predicting the potential risk of a student failing or dropping out of a course...
April 19, 2017: Medical Teacher
https://www.readbyqxmd.com/read/28421841/adolescent-with-prolonged-toxidrome
#16
Jami Johnson, Kristie Williams, William Banner
A 13-year-old female was presented to the emergency department following an intentional ingestion. The patient developed significant toxicity including multiple, discreet tonic-clonic seizures. Despite appropriate resuscitation and antidotal management, the patient's symptoms persisted for more than 36 hours post-ingestion. An upright abdominal radiograph was performed revealing a radiopacity suggesting a pharmacobezoar. An esophagogastroduodenoscopy was performed with successful removal of a tennis ball-sized pharmacobezoar...
June 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28421651/self-management-of-first-trimester-medical-termination-of-pregnancy-a-qualitative-study-of-women-s-experiences
#17
Carrie Purcell, Sharon Cameron, Julia Lawton, Anna Glasier, Jeni Harden
OBJECTIVE: To explore the experiences of women in Scotland who return home to complete medical termination of pregnancy (TOP) ≤63 days of gestation, after being administered with mifepristone and misoprostol at an NHS TOP clinic. DESIGN: Qualitative interview study. SETTING: One National Health Service health board (administrative) area in Scotland. POPULATION OR SAMPLE: Women in Scotland who had undergone medical TOP ≤63 days, and self-managed passing the pregnancy at home; recruited from three clinics in on NHS health board area between January and July 2014...
April 19, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28420367/rationale-and-methods-of-the-ifightdepression-study-a-double-blind-randomized-controlled-trial-evaluating-the-efficacy-of-an-internet-based-self-management-tool-for-moderate-to-mild-depression
#18
Azucena Justicia, Matilde Elices, Ana Isabel Cebria, Diego J Palao, Jesús Gorosabel, Dolors Puigdemont, Javier de Diego-Adeliño, Andrea Gabilondo, Alvaro Iruin, Ulrich Hegerl, Víctor Pérez
BACKGROUND: During the last decade online interventions have emerged as a promising approach for patients with mild/moderate depressive symptoms, reaching at large populations and representing cost-effective alternatives. The main objective of this double-blind, randomized controlled trial is to examine the efficacy of an internet-based self-management tool (iFightDepression) for mild to moderate depression as an add-on to treatment as usual (TAU) versus internet-based psychoeducation plus TAU...
April 19, 2017: BMC Psychiatry
https://www.readbyqxmd.com/read/28420358/healthcare-utilization-in-older-patients-using-personal-emergency-response-systems-an-analysis-of-electronic-health-records-and-medical-alert-data-brief-description-a-longitudinal-retrospective-analyses-of-healthcare-utilization-rates-in-older-patients-using
#19
Stephen Agboola, Sara Golas, Nils Fischer, Mariana Nikolova-Simons, Jorn Op den Buijs, Linda Schertzer, Joseph Kvedar, Kamal Jethwani
BACKGROUND: Personal Emergency Response Systems (PERS) are traditionally used as fall alert systems for older adults, a population that contributes an overwhelming proportion of healthcare costs in the United States. Previous studies focused mainly on qualitative evaluations of PERS without a longitudinal quantitative evaluation of healthcare utilization in users. To address this gap and better understand the needs of older patients on PERS, we analyzed longitudinal healthcare utilization trends in patients using PERS through the home care management service of a large healthcare organization...
April 18, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28420352/assessing-the-reliability-of-self-reported-weight-for-the-management-of-heart-failure-application-of-fraud-detection-methods-to-a-randomised-trial-of-telemonitoring
#20
Adam Steventon, Sarwat I Chaudhry, Zhenqiu Lin, Jennifer A Mattera, Harlan M Krumholz
BACKGROUND: Since clinical management of heart failure relies on weights that are self-reported by the patient, errors in reporting will negatively impact the ability of health care professionals to offer timely and effective preventive care. Errors might often result from rounding, or more generally from individual preferences for numbers ending in certain digits, such as 0 or 5. We apply fraud detection methods to assess preferences for numbers ending in these digits in order to inform medical decision making...
April 18, 2017: BMC Medical Informatics and Decision Making
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