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https://www.readbyqxmd.com/read/28092282/neonatal-palliative-care
#1
Elvira Parravicini
PURPOSE OF REVIEW: A significant number of newborns are affected by life-limiting or life-threatening conditions. When prolongation of survival is no longer a goal, or prognosis is uncertain, a plan of care focused on the infant's comfort is essential. The aim of this article is to review the most recent and relevant literature regarding neonatal palliative care (NPC). RECENT FINDINGS: A variety of perinatal and NPC programs are described, but most programs focus exclusively on end-of-life care...
January 13, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28092280/challenges-and-opportunities-to-enhance-global-drug-development-in-neonates
#2
Alexandra M Smith, Jonathan M Davis
PURPOSE OF REVIEW: This study reviews the history of neonatal drug development, recent legislative efforts designed to facilitate the study of therapeutic agents in neonates, and future steps necessary to advance drug development. RECENT FINDINGS: Although many federal regulations have been introduced over the past 15 years to encourage pediatric and neonatal drug development, the majority of medications that are used in the Neonatal Intensive Care Unit are not approved by the Food and Drug Administration (FDA) for use in neonates...
January 13, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28089415/antimicrobial-stewardship-in-the-federal-bureau-of-prisons-approaches-from-the-national-and-local-levels
#3
Michael J Long, Brian N LaPlant, Justin C McCormick
OBJECTIVES: To determine the impact of national and local antimicrobial stewardship measures on overall antibiotic prescribing in the Federal Bureau of Prisons (BOP). SETTING: Care was delivered to more than 160,000 inmates in 122 BOP facilities in the United States and Puerto Rico. PRACTICE DESCRIPTION: Medical centers and health services clinics staffed by in-house medical staff, consultants, and specialists. Staffs include a variety of disciplines, including physicians, pharmacists, dentists, nurses, infection control personnel, therapists, health services administrators, and institution executive staff...
January 12, 2017: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/28089230/metastatic-fractures-of-long-limb-bones
#4
REVIEW
P Anract, D Biau, P Boudou-Rouquette
The diagnosis of pathological fracture should be considered routinely in patients with long limb-bone fractures. Investigations must be performed to establish the diagnosis of pathological fracture then to determine that the bone lesion is a metastasis. In over 85% of cases, the clinical evaluation combined with a detailed analysis of the radiographs is sufficient to determine that the fracture occurred at a tumour site. Aetiological investigations establish that the tumour is a metastasis. In some patients, the diagnosis of metastatic cancer antedates the fracture...
January 11, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28087958/the-teaching-of-trauma-management-in-undergraduate-medical-education
#5
S K Lum, T Subramaniam
BACKGROUND: The teaching of trauma in medical schools faces many educational and logistic challenges. Issues on what to teach, how to teach, when to teach, who will teach and whether medical students with insufficient exposure to clinical medicine can benefit from a trauma course are unclear. MATERIALS AND METHODS: A well-designed one day intensive trauma course concentrating on the primary survey was taught to semester seven and semester eight students by a multi-disciplinary team comprising of surgeons, anaesthetists, emergency physicians and trained medical officers...
December 2016: Medical Journal of Malaysia
https://www.readbyqxmd.com/read/28087554/how-prepared-are-uk-medical-graduates-for-practice-a-rapid-review-of-the-literature-2009-2014
#6
Lynn V Monrouxe, Lisa Grundy, Mala Mann, Zoe John, Eleni Panagoulas, Alison Bullock, Karen Mattick
OBJECTIVE: To understand how prepared UK medical graduates are for practice and the effectiveness of workplace transition interventions. DESIGN: A rapid review of the literature (registration #CRD42013005305). DATA SOURCES: Nine major databases (and key websites) were searched in two timeframes (July-September 2013; updated May-June 2014): CINAHL, Embase, Educational Resources Information Centre, Health Management Information Consortium, MEDLINE, MEDLINE in Process, PsycINFO, Scopus and Web of Knowledge...
January 13, 2017: BMJ Open
https://www.readbyqxmd.com/read/28087145/-computerised-sepsis-protocol-management-description-of-an-early-warning-system
#7
Begoña de Dios, Marcio Borges, Timothy D Smith, Alberto Del Castillo, Antonia Socias, Leticia Gutiérrez, Jordi Nicolás, Bartolomé Lladó, Jose A Roche, Maria P Díaz, Yolanda Lladó
INTRODUCTION: New strategies need to be developed for the early recognition and rapid response for the management of sepsis. To achieve this purpose, the Multidisciplinary Sepsis Team (MST) developed the Computerised Sepsis Protocol Management (PIMIS). The aim of this study was to evaluate the convenience of using PIMIS, as well as the activity of the MST. METHODS: An analysis was performed on the data collected from solicited MST consultations (direct activation of PIMIS by attending physician or telephone request) and unsolicited ones (by referral from the microbiology laboratory or an automatic referral via the hospital vital signs recording software [SIDCV]), as well as the hospital department, source of infection, treatment recommendation, and acceptance of this...
January 10, 2017: Enfermedades Infecciosas y Microbiología Clínica
https://www.readbyqxmd.com/read/28086879/validity-evidence-for-two-objective-structured-clinical-examination-stations-to-evaluate-core-skills-of-the-shoulder-and-knee-assessment
#8
Michael J Battistone, Andrea M Barker, J Peter Beck, Robert Z Tashjian, Grant W Cannon
BACKGROUND: We developed two objective structured clinical examinations (OSCEs) to educate and evaluate trainees in the evaluation and management of shoulder and knee pain. Our objective was to examine the evidence for validity of these OSCEs. METHODS: A multidisciplinary team of content experts developed checklists of exam maneuvers and criteria to guide rater observations. Content was proposed by faculty, supplemented by literature review, and finalized using a Delphi process...
January 13, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/28086871/the-integrated-care-pathway-for-post-stroke-patients-icapps-a-shared-care-approach-between-stakeholders-in-areas-with-limited-access-to-specialist-stroke-care-services
#9
Aznida Firzah Abdul Aziz, Nor Azlin Mohd Nordin, Mohd Fairuz Ali, Noor Azah Abd Aziz, Saperi Sulong, Syed Mohamed Aljunid
BACKGROUND: Lack of intersectoral collaboration within public health sectors compound efforts to promote effective multidisciplinary post stroke care after discharge following acute phase. A coordinated, primary care-led care pathway to manage post stroke patients residing at home in the community was designed by an expert panel of specialist stroke care providers to help overcome fragmented post stroke care in areas where access is limited or lacking. METHODS: Expert panel discussions comprising Family Medicine Specialists, Neurologists, Rehabilitation Physicians and Therapists, and Nurse Managers from Ministry of Health and acadaemia were conducted...
January 13, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28078644/eight-or-12-week-treatment-of-hepatitis-c-with-ledipasvir-sofosbuvir-real-world-experience-in-a-large-integrated-health-system
#10
Jennifer B Lai, Maxwell A Witt, Mary Patricia Pauly, Joanna Ready, Michael Allerton, Suk Seo, David J Witt
BACKGROUND: Second-generation direct-acting antiviral agents are integral to treatment of hepatitis C (HCV) infection. Eight-week courses of ledipasvir/sofosbuvir (LDV/SOF) have been supported in some studies, but data are limited on efficacy in real-world use. Controversy exists regarding applicability of clinical trials to real-world effectiveness. We report virologic responses of patients with HCV genotype 1 infection receiving LDV/SOF for 8 or 12 weeks in a large integrated healthcare system...
January 11, 2017: Drugs
https://www.readbyqxmd.com/read/28078377/advances-in-imaging-and-management-trends-of-traumatic-aortic-injuries
#11
Prashant Nagpal, Brian F Mullan, Indrani Sen, Sachin S Saboo, Ashish Khandelwal
Acute traumatic aortic injury (ATAI) is a life-threatening injury. CT is the imaging tool of choice, and the knowledge of direct and indirect signs of injury, grading system, and current management protocol helps the emergency radiologist to better identify and classify the injury and provide additional details that can impact management options. Newer dual-source CT technology with ultrafast acquisition speed has also influenced the appropriate protocol for imaging in patients with suspected ATAI. This review highlights the imaging protocol in patients with blunt trauma, CT appearance and grading systems of ATAI, management options, and the role of the multidisciplinary team in the management of these patients...
January 11, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28076638/the-future-of-psychiatric-research
#12
Marco Antonio Caldieraro
Psychiatric disorders place considerable burden on individuals and on public health. Funding for research in psychiatry is less than ideal, but even so high quality research is being conducted at many centers. However, these studies have not impacted clinical practice as much as expected. The complexity of psychiatric disorders is one of the reasons why we face difficulties in translating research results to patient care. New technologies and improved methodologies are now available and must be incorporated to deal with this complexity and to accelerate the translational process...
October 2016: Trends in Psychiatry and Psychotherapy
https://www.readbyqxmd.com/read/28076546/pharmacist-s-contribution-to-the-promotion-of-access-and-rational-use-of-essential-medicines-in-sus
#13
Daniela Oliveira de Melo, Lia Lusitana Cardozo de Castro
Objective: to describe the pharmaceutical inclusion process in a Basic Health Unit multidisciplinary team and evaluate results related to rational use and promotion of access to essential medicines. Methods: This is a descriptive, cross-sectional study conducted in a primary care health unit in the city of São Paulo. Pharmacist's activities were evaluated regarding the service structure and organization and prescribing quality improvement, guidance method creation, and implementation of clinical pharmacy service...
January 2017: Ciência & Saúde Coletiva
https://www.readbyqxmd.com/read/28076003/reducing-functional-mr-imaging-acquisition-times-by-optimizing-workflow
#14
Wilson B Chwang, Michael Iv, Jason Smith, Aleksandrs Kalnins, Jake Mickelsen, Roland Bammer, Dominik Fleischmann, David B Larson, Max Wintermark, Michael Zeineh
Functional magnetic resonance (MR) imaging is a complex, specialized examination that is able to noninvasively measure information critical to patient care such as hemispheric language lateralization ( 1 ). Diagnostic functional MR imaging requires extensive patient interaction as well as the coordinated efforts of the entire health care team. We observed in our practice at an academic center that the times to perform functional MR imaging examinations were excessively lengthy, making scheduling of the examination difficult...
January 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/28075611/what-the-radiologist-should-know-about-treatment-of-peritoneal-malignancy
#15
Emily A Aherne, Helen M Fenlon, Conor J Shields, Jurgen J Mulsow, Carmel G Cronin
OBJECTIVE: The purpose of this article is to discuss the role of the radiologist in the treatment of peritoneal cancer, with focus placed on advanced treatment options and selection of patients with resectable disease for whom complete cytoreduction can be achieved. CONCLUSION: Peritoneal cancers traditionally have been associated with significant morbidity and universal mortality; however, the management of such cancers has evolved substantially. Advanced treatment options, including cytoreductive surgery and intraperitoneal chemotherapy, are associated with significantly improved long-term patient survival...
January 11, 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28074724/-tasty-food-for-cancer-patients-the-impact-of-smell-and-taste-alterations-on-eating-behaviour
#16
E M Postma, Y C de Vries, S Boesveldt
- This article provides an overview of smell and taste changes in cancer patients and the influence of these changes on eating behaviour and food preferences.- Taste changes seem to be more common than alterations in the sense of smell.- The changes in taste and smell are often temporary; smell and taste functions mostly return to their previous level after treatment cessation.- The type of cancer and its treatment influence changes in the sense of smell and taste, making it challenging to give general advice...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28074578/managing-conflicts-between-physicians-and-surrogates
#17
Carol Bayley
Two articles in this issue of the Hastings Center Report explore two sides of the same problematic coin. In "The Limits of Surrogates' Moral Authority and Physician Professionalism," Jeffrey Berger discusses the moral problem of a surrogate refusing a treatment, palliative sedation, on behalf of a patient whose suffering is refractory to intensive palliative efforts provided by a multidisciplinary team. In "After the DNR: Surrogates Who Persist in Requesting Cardiopulmonary Resuscitation," Ellen Robinson and her colleagues analyze data from a study of cases in which physicians wished not to perform cardiopulmonary resuscitation on patients whom they thought it would harm...
January 2017: Hastings Center Report
https://www.readbyqxmd.com/read/28074311/improving-maternal-and-infant-child-health-outcomes-with-community-based-pregnancy-support-groups-outcomes-from-moms2b-ohio
#18
Patricia Temple Gabbe, Rebecca Reno, Carmen Clutter, T F Schottke, Tanikka Price, Katherine Calhoun, Jamie Sager, Courtney D Lynch
Objectives To describe temporal changes in maternal and child health outcomes in an impoverished urban community after the implementation of an innovative community-based pregnancy support program, named Moms2B. Methods Beginning in 2011, pregnant women in an urban impoverished community were recruited for participation in a community-based pregnancy support program focused on improving nutrition coupled with increasing social and medical support. The comprehensive program targeting pregnancy through the infants' first year of life was developed and staffed by a multidisciplinary team from an academic health system...
January 10, 2017: Maternal and Child Health Journal
https://www.readbyqxmd.com/read/28073201/azoospermic-patient-s-treatment-an-experience-of-a-pma-hospital-unit-and-role-of-ultrasonography
#19
Paolo Panella, Pietro Pepe, Placido Borzì, Maria Elena Vento, Michele Pennisi, Paolo Scollo
INTRODUCTION: Azoospermia causes about 10% of male infertility and the best therapeutic option is the retrieval of sperm from testis or epididymis. MATERIAL AND METHODS: From Juanary 2008 to June 2016, 92 men (median 36 years; range: 25-54 years) were submitted in 47 cases to TESE (testicular sperm extraction) and in 45 cases to PESA (percutaneous epididymal sperm aspiration) for secretory and obstructive azoospermia, respectively; moreover, all the patients previously underwent color Doppler ultrasound of the testis and transrectal ultrasound of the prostate...
December 30, 2016: Archivio Italiano di Urologia, Andrologia
https://www.readbyqxmd.com/read/28072804/multidisciplinary-care-of-unruptured-brain-arteriovenous-malformations-to-improve-symptomatic-headache-and-the-onset-progression-and-outcomes-of-unruptured-brain-arteriovenous-malformations
#20
Ling-Feng Lai, Min Chen, Jia-Xiang Chen, Kuang Zheng, Xu-Ying He, Xi-Feng Li, Xin Zhang, Jian Yin, Qiu-Jing Wang, Tuan-Ming Zou, Chuan-Zhi Duan
BACKGROUND: Symptomatic headaches attributed to unruptured brain arteriovenous malformations (ubAVMs) are very common and affect patients' quality life, but multidisciplinary care of ubAVMs to improve symptomatic headache remains unclear. OBJECTIVE: The objective is to identify the features of symptomatic headaches, and to obtain headache outcomes following multidisciplinary care of ubAVMs, as well as provide background on the natural history of ubAVMs. STUDY DESIGN: The features of symptomatic headaches and headache outcomes were analyzed in a large cohort of cases after multidisciplinary care of ubAVMs...
January 2017: Pain Physician
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