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Emergency protocols

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https://www.readbyqxmd.com/read/27922870/quality-and-safety-in-health-care-part-xx-goal-directed-fluid-therapy-and-the-universal-protocol
#1
Jay A Harolds
There have been numerous initiatives to improve quality and safety in surgery. Goal-directed fluid therapy and a quality bundle for emergency laparotomy surgery are two of them. The establishment of a Universal Protocol to prevent the wrong procedure, the wrong patient having a procedure, or the wrong site for a procedure is an important safeguard for patients.
December 3, 2016: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/27920894/recent-advances-in-the-preparation-and-application-of-multifunctional-iron-oxide-and-liposome-based-nanosystems-for-multimodal-diagnosis-and-therapy
#2
REVIEW
Marzia Marciello, Juan Pellico, Irene Fernandez-Barahona, Fernando Herranz, Jesus Ruiz-Cabello, Marco Filice
Nowadays, thanks to the successful discoveries in the biomedical field achieved in the last two decades, a deeper understanding about the complexity of mechanistic aspects of different pathological processes has been obtained. As a consequence, even the standard therapeutic protocols have undergone a vast redesign. In fact, the awareness about the necessity to progress towards a combined multitherapy in order to potentially increase the final healing chances has become a reality. One of the crucial elements of this novel approach is that large amounts of detailed information are highly needed and in vivo imaging techniques represent one of the most powerful tools to visualize and monitor the pathological state of the patient...
December 6, 2016: Interface Focus
https://www.readbyqxmd.com/read/27920846/three-dimensional-computed-tomography-rendering-of-pedunculated-colon-polyp-new-clapper-bell-sign-pedunculated-polyp-at-3d-computed-tomography
#3
Marco Di Serafino, Rosa Severino, Fabia Laviani, Domenico Maroscia
The incidental detection of a tubulovillous adenoma at a contrast-enhanced computed tomography (CECT) with nondedicated protocol, performed in emergency conditions, is an uncommon finding. We report a case of a woman presenting with a subocclusive episode. A CECT scan was performed, and a pedunculated polyp could be appreciated at 3D-reconstruction images. A particular depiction of pedunculus of the polypoid lesion, resemble a clapper-bell, could help to define the vegetating lesion at the volume-rendering reconstruction images...
December 2016: Radiology case reports
https://www.readbyqxmd.com/read/27920728/connecting-sarcomere-protein-mutations-to-pathogenesis-in-cardiomyopathies-the-development-of-disease-in-a-dish-models
#4
Rebecca Zaunbrecher, Michael Regnier
Recent technological and protocol developments have greatly increased the ability to utilize stem cells transformed into cardiomyocytes as models to study human heart muscle development and how this is affected by disease associated mutations in a variety of sarcomere proteins. In this perspective we provide an overview of these emerging technologies and how they are being used to create better models of "disease in a dish" for both research and screening assays. We also consider the value of these assays as models to explore the seminal processes in initiation of the disease development and the possibility of early interventions...
2016: Frontiers in Physiology
https://www.readbyqxmd.com/read/27920704/autoimmune-hemolytic-anemia-as-a-complication-of-nivolumab-therapy
#5
Amruth R Palla, Devin Kennedy, Hossain Mosharraf, Donald Doll
Recently, immunotherapeutic drugs, including PD-1 inhibitors (nivolumab, pembrolizumab), PD-L1 inhibitors (atezolizumab, avelumab), and CTLA4 inhibitors (ipiliumumab), have emerged as important additions to the armamentarium against certain malignancies and have been incorporated into therapeutic protocols for first-, second-, or third-line agents for these metastatic cancers. Immune checkpoint inhibitor nivolumab is currently FDA approved for the treatment of patients with metastatic malignant melanoma [Redman et al...
September 2016: Case Reports in Oncology
https://www.readbyqxmd.com/read/27919393/business-analysis-for-a-sustainable-multi-stakeholder-ecosystem-for-leveraging-the-electronic-health-records-for-clinical-research-ehr4cr-platform-in-europe
#6
Danielle Dupont, Ariel Beresniak, Mats Sundgren, Andreas Schmidt, John Ainsworth, Pascal Coorevits, Dipak Kalra, Marc Dewispelaere, Georges De Moor
INTRODUCTION: The Electronic Health Records for Clinical Research (EHR4CR) technological platform has been developed to enable the trustworthy reuse of hospital electronic health records data for clinical research. The EHR4CR platform can enhance and speed up clinical research scenarios: protocol feasibility assessment, patient identification for recruitment in clinical trials, and clinical data exchange, including for reporting serious adverse events. Our objective was to seed a multi-stakeholder ecosystem to enable the scalable exploitation of the EHR4CR platform in Europe, and to assess its economic sustainability...
January 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/27919376/usability-evaluation-of-the-smart-application-for-youth-with-mtbi
#7
Judith W Dexheimer, Brad G Kurowski, Shilo H Anders, Nicole McClanahan, Shari L Wade, Lynn Babcock
OBJECTIVE: There is a dearth of evidence-based treatments available to address the significant morbidity associated with mild traumatic brain injury (mTBI). To address this gap, we designed a novel user-friendly, web-based application. We describe the preliminary evaluation of feasibility and usability of the application to promote recovery following mTBI in youth, the Self-Monitoring Activity-Restriction and Relaxation Treatment (SMART). SMART incorporates real-time recommendations for individualized symptom management and activity restriction along with training in cognitive-behavioral coping strategies...
January 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/27919281/incidence-causes-and-consequences-of-preventable-adverse-drug-events-protocol-for-an-overview-of-reviews
#8
Brian Hutton, Salmaan Kanji, Erika McDonald, Fatemeh Yazdi, Dianna Wolfe, Kednapa Thavorn, Sally Pepper, Laurie Chapman, Becky Skidmore, David Moher
BACKGROUND: Medication errors represent a noteworthy source of harm to patients. In recent years, several systematic reviews have assessed the frequency and causes of these events, as well as other factors such as commonly associated drugs, their incidence in different specialties, and their consequences to patients. Despite this past literature, there remains a need to study discrepancies between these reviews and establish the current state of the evidence. The planned review will bring together, compare, and contract existing evidence related to the occurrence of medication errors in acute and continuing/long-term care settings...
December 5, 2016: Systematic Reviews
https://www.readbyqxmd.com/read/27918864/comparison-of-emergency-medical-services-and-trauma-care-systems-among-pan-asian-countries-an-international-multicenter-population-based-survey
#9
Kyong Min Sun, Kyoung Jun Song, Sang Do Shin, Hideharu Tanaka, Goh E Shaun, Wen-Chu Chiang, Kentaro Kajino, Sabariah Faizah Jamaluddin, Akio Kimura, Young Sun Ro, Dae Han Wi, Ju Ok Park, Sung Woo Moon, Young Hee Jung, Min Jung Kim, James F Holmes
OBJECTIVE: Knowledge on the current trauma systems in Asian countries is limited. The objective of this study was to describe the emergency medical services (EMS) and trauma care systems among countries participating in the Pan-Asian Trauma Outcomes Study (PATOS) Clinical Research Network. METHODS: The PATOS network consists of 33 participating sites from 14 countries. Standardized data was collected from each site using an EMS survey form and included general information (population, population density, urbanization, EMS service fee, etc...
December 5, 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27918858/d10-in-the-treatment-of-prehospital-hypoglycemia-a-24-month-observational-cohort-study
#10
H Gene Hern, Matthew Kiefer, Derex Louie, Joseph Barger, Harrison J Alter
INTRODUCTION: Prehospital first responders historically have used an IV bolus of 50 mL of 50% dextrose solution (D50) for the treatment of hypoglycemia in the field. A local Emergency Medical Services (EMS) system recently approved a hypoglycemia treatment protocol of IV 10% dextrose solution (D10) due to occasional shortages and higher cost of D50. We use the experience of this EMS system to report the feasibility, safety, and efficacy of this approach. METHODS: Over the course of 104 weeks, paramedics treated 1,323 hypoglycemic patients with D10 and recorded patient demographics and clinical outcomes...
December 5, 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27918258/prolonged-excretion-of-type-2-poliovirus-from-a-primary-immune-deficient-patient-during-the-transition-to-a-type-2-poliovirus-free-world-israel-2016
#11
Merav Weil, Lester M Shulman, Sophia Heiman, Tali Stauber, Jacqueline Alfandari, Leah Weiss, Ilana Silberstein, Viki Indenbaum, Ella Mendelson, Danit Sofer
Wild poliovirus type-2 has been eradicated, use of live type-2 vaccine has been terminated globally, and all type-2 polioviruses are under strict laboratory containment protocols. Re-emergence may arise from prolonged asymptomatic excretion of poliovirus by hospitalised primary immune deficient (PID) patients, as described here, through repeated exposure of close contacts to high titres of infected material. At this transition time, PID patients should be screened and hospital containment protocols updated in parallel with laboratory containment...
November 24, 2016: Euro Surveillance: Bulletin Européen sur les Maladies Transmissibles, European Communicable Disease Bulletin
https://www.readbyqxmd.com/read/27917967/innovations-and-diverse-livelihood-pathways-alternative-livelihoods-livelihood-diversification-and-societal-transformation-in-pastoral-communities
#12
I Köhler-Rollefson
Pastoralists have a rich tradition of 'innovation', as continuous adaptation to new ecological and economic scenarios has been a prerequisite for their survival through the millennia. One of their greatest assets is the large number of locally adapted livestock breeds they have developed, which represent a major resource for climate change adaptation as well as mitigation. Pastoralists are beginning to position themselves as providers of ecological services as well as of livestock products that represent a healthy and eco-friendly alternative to the products from industrial production systems...
November 2016: Revue Scientifique et Technique
https://www.readbyqxmd.com/read/27917769/risk-factors-for-unsuccessful-lumbar-puncture-in-children
#13
C Procter, H Buys, H Carrara, J Thomas
BACKGROUND: This descriptive study provides the first information on an association between the use of sedation and a reduction in the prevalence of unsuccessful lumbar puncture (LP) in African children of all races. OBJECTIVE: Our hypothesis was that children who do not receive any procedural sedation are more likely to have unsuccessful LPs. METHODS: A cross-sectional observational study examined LPs performed from February to April 2013, including details of the procedure, sedation or analgesia used, and techniques...
December 1, 2016: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/27917402/academic-institution-pilot-study-shows-far-fewer-diagnoses-of-sinusitis-than-reported-nationally
#14
Sarah R Akkina, Sarah J Novis, Nahid R Keshavarzi, Melissa A Pynnonen
OBJECTIVE: To compare the prevalence of acute sinusitis (AS) and chronic sinusitis (CS) diagnosed by primary care and emergency medicine physicians in our academic institution to national data. STUDY DESIGN: Cross-sectional pilot study of institutional census data and a population-based national sample. The setting was primary care and emergency departments at an academic healthcare institution and community healthcare practices nationally. MATERIALS AND METHODS: We determined the proportion of adults visits at our institution for AS and CS from January 1, 2005, to December 31, 2010...
October 2016: Laryngoscope Investigative Otolaryngology
https://www.readbyqxmd.com/read/27916917/a-routing-protocol-for-multisink-wireless-sensor-networks-in-underground-coalmine-tunnels
#15
Xu Xia, Zhigang Chen, Hui Liu, Huihui Wang, Feng Zeng
Traditional underground coalmine monitoring systems are mainly based on the use of wired transmission. However, when cables are damaged during an accident, it is difficult to obtain relevant data on environmental parameters and the emergency situation underground. To address this problem, the use of wireless sensor networks (WSNs) has been proposed. However, the shape of coalmine tunnels is not conducive to the deployment of WSNs as they are long and narrow. Therefore, issues with the network arise, such as extremely large energy consumption, very weak connectivity, long time delays, and a short lifetime...
November 30, 2016: Sensors
https://www.readbyqxmd.com/read/27914822/effects-of-sodium-thiosulfate-versus-observation-on-development-of-cisplatin-induced-hearing-loss-in-children-with-cancer-accl0431-a-multicentre-randomised-controlled-open-label-phase-3-trial
#16
David R Freyer, Lu Chen, Mark D Krailo, Kristin Knight, Doojduen Villaluna, Bonnie Bliss, Brad H Pollock, Jagadeesh Ramdas, Beverly Lange, David Van Hoff, Michele L VanSoelen, John Wiernikowski, Edward A Neuwelt, Lillian Sung
BACKGROUND: Sodium thiosulfate is an antioxidant shown in preclinical studies in animals to prevent cisplatin-induced hearing loss with timed administration after cisplatin without compromising the antitumour efficacy of cisplatin. The primary aim of this study was to assess sodium thiosulfate for prevention of cisplatin-induced hearing loss in children and adolescents. METHODS: ACCL0431 was a multicentre, randomised, open-label, phase 3 trial that enrolled participants at 38 participating Children's Oncology Group hospitals in the USA and Canada...
November 30, 2016: Lancet Oncology
https://www.readbyqxmd.com/read/27913561/hospitals-and-patients-working-in-unity-how-r-u-protocol-for-a-prospective-feasibility-study-of-telephone-peer-support-to-improve-older-patients-quality-of-life-after-emergency-department-discharge
#17
Judy A Lowthian, Alyse Lennox, Andrea Curtis, Jeremy Dale, Colette Browning, De Villiers Smit, Gillian Wilson, Debra O'Brien, Cate Rosewarne, Lee Boyd, Cath Garner, Peter Cameron
INTRODUCTION: Older people presenting to an emergency department (ED) have a higher likelihood of social isolation, loneliness and depression; which are all associated with negative health outcomes and increased health service use, including higher rates of ED attendance. The HOW R U? study aims to ascertain the feasibility and acceptability of a postdischarge telephone support programme for older ED patients following discharge. The intervention, which aims to improve quality of life, will be delivered by hospital-based volunteers...
December 2, 2016: BMJ Open
https://www.readbyqxmd.com/read/27912778/medical-priority-dispatch-codes-comparison-with-national-early-warning-score
#18
Marko Hoikka, Sami Länkimäki, Tom Silfvast, Tero I Ala-Kokko
BACKGROUND: In Finland, calls for emergency medical services are prioritized by educated non-medical personnel into four categories-from A (highest risk) to D (lowest risk)-following a criteria-based national dispatch protocol. Discrepancies in triage may result in risk overestimation, leading to inappropriate use of emergency medical services units and to risk underestimation that can negatively impact patient outcome. To evaluate dispatch protocol accuracy, we assessed association between priority assigned at dispatch and the patient's condition assessed by emergency medical services on the scene using an early warning risk assessment tool...
December 3, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/27912071/classical-and-alternative-macrophages-have-impaired-function-during-acute-and-chronic-hiv-1-infection
#19
Leonardo J Galvão-Lima, Milena S Espíndola, Luana S Soares, Fabiana A Zambuzi, Maira Cacemiro, Caroline Fontanari, Valdes R Bollela, Fabiani G Frantz
OBJECTIVES: Three decades after HIV recognition and its association with AIDS development, many advances have emerged - especially related to prevention and treatment. Undoubtedly, the development of Highly Active Antiretroviral Therapy (HAART) dramatically changed the future of the syndrome that we know today. In the present study, we evaluate the impact of HAART on macrophage function and its relevance to HIV pathogenesis. METHODS: PBMCs were isolated from blood samples and monocytes (CD14+ cells) were purified...
November 29, 2016: Brazilian Journal of Infectious Diseases
https://www.readbyqxmd.com/read/27911667/barriers-and-benefits-in-telemedicine-arising-between-a-high-technology-hospital-service-provider-and-remote-public-healthcare-units-a-qualitative-study-in-brazil
#20
Carlos Henrique Amaral de Souza, Renata Albaladejo Morbeck, Milton Steinman, Cora Pereira Hors, Mario Maia Bracco, Elisa H Kozasa, Eliseth Ribeiro Leão
BACKGROUND: In Brazil, the Program for Institutional Development of the Unified Healthcare System (PROADI-SUS) has implemented a telemedicine service for urgent situations and emergencies. It is delivered by a high-technology (HT) hospital to 15 remote healthcare units (RUs) in 11 different Brazilian states. The aim of this study was to investigate possible barriers and benefits in telemedicine service among these units. MATERIALS AND METHODS: We performed a qualitative study on the perceptions of physicians involved in telemedicine service in their role as providers and consultants...
December 2, 2016: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
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