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https://www.readbyqxmd.com/read/28743152/-prevention-of-perioperative-hypothermia-guidelines-for-daily-clinical-practice
#1
Timo Iden, Jan Höcker
Inadvertent perioperative hypothermia (body core temperature < 36 °C) is a serious complication leading to increased rates of wound infection, higher blood loss associated with increased transfusion requirements as well as patient dissatisfaction among others. Body core temperature is a vital parameter and needs constant monitoring just like heart rate, blood pressure and arterial oxygen saturation. Patient-, anesthesia-, surgery- and environment-related risk factors were identified for occurring perioperative hypothermia...
July 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/28742801/tracking-the-return-of-aedes-aegypti-to-brazil-the-major-vector-of-the-dengue-chikungunya-and-zika-viruses
#2
Panayiota Kotsakiozi, Andrea Gloria-Soria, Adalgisa Caccone, Benjamin Evans, Renata Schama, Ademir Jesus Martins, Jeffrey R Powell
BACKGROUND: Aedes aegypti, commonly known as "the yellow fever mosquito", is of great medical concern today primarily as the major vector of dengue, chikungunya and Zika viruses, although yellow fever remains a serious health concern in some regions. The history of Ae. aegypti in Brazil is of particular interest because the country was subjected to a well-documented eradication program during 1940s-1950s. After cessation of the campaign, the mosquito quickly re-established in the early 1970s with several dengue outbreaks reported during the last 30 years...
July 2017: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/28742676/committee-opinion-no-711-opioid-use-and-opioid-use-disorder-in-pregnancy
#3
(no author information available yet)
Opioid use in pregnancy has escalated dramatically in recent years, paralleling the epidemic observed in the general population. To combat the opioid epidemic, all health care providers need to take an active role. Pregnancy provides an important opportunity to identify and treat women with substance use disorders. Substance use disorders affect women across all racial and ethnic groups and all socioeconomic groups, and affect women in rural, urban, and suburban populations. Therefore, it is essential that screening be universal...
August 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28742670/committee-opinion-no-711-summary-opioid-use-and-opioid-use-disorder-in-pregnancy
#4
(no author information available yet)
Opioid use in pregnancy has escalated dramatically in recent years, paralleling the epidemic observed in the general population. To combat the opioid epidemic, all health care providers need to take an active role. Pregnancy provides an important opportunity to identify and treat women with substance use disorders. Substance use disorders affect women across all racial and ethnic groups and all socioeconomic groups, and affect women in rural, urban, and suburban populations. Therefore, it is essential that screening be universal...
August 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28742544/the-marginal-costs-of-adverse-drug-events-associated-with-exposures-to-anticoagulants-and-hypoglycemic-agents-during-hospitalization
#5
William D Spector, Rhona Limcangco, Michael F Furukawa, William E Encinosa
BACKGROUND: Anticoagulants and hypoglycemic agents are 2 of the most challenging drug classes for medical management in the hospital resulting in many adverse drug events (ADE). OBJECTIVE: Estimating the marginal cost (MC) of ADEs associated with anticoagulants and hypoglycemic agents for adults in 5 patient groups during their hospital stay and the total annual ADE costs for all patients exposed to these drugs during their stay. RESEARCH DESIGN AND SUBJECT: Data are from 2010 to 2013 Healthcare Cost and Utilization Project (HCUP) State Inpatient Databases and Medicare Patient Safety Monitoring System (MPSMS)...
July 24, 2017: Medical Care
https://www.readbyqxmd.com/read/28742468/single-ct-scan-prolongs-survival-by-extending-cancer-latency-in-trp53-heterozygous-mice
#6
Jennifer A Lemon, Nghi Phan, Douglas R Boreham
There is growing concern over the effects of medical diagnostic procedures on cancer risk. Although numerous studies have demonstrated that low doses of ionizing radiation can have protective effects including reduced cancer risk and increasing lifespan, the hypothesis that any radiation exposure increases cancer risk still predominates. In this study, we investigated cancer development and longevity of cancer-prone Trp53(+/-) mice exposed at 7-8 weeks of age to a single 10 mGy dose from either a diagnostic CT scan or gamma radiation...
July 25, 2017: Radiation Research
https://www.readbyqxmd.com/read/28742328/attachable-pulse-sensors-integrated-with-inorganic-optoelectronic-devices-for-monitoring-heart-rates-at-various-body-locations
#7
Juho Kim, Namyun Kim, Minjeong Kwon, Jongho Lee
Monitoring cardiovascular signals such as heart rate and blood flow provides critically important healthcare information about patients under medical care. However, when the sensors are worn for extended times, the sensors sometimes require higher mechanical compatibility with soft deformable tissues. In this paper, we report an attachable and flexible pulse sensor (bending radius: 2.4 mm), integrated with micro-inorganic photodetectors (thickness: 4.1 μm, photocurrent: 8.99 μA under 1.5 mW/cm(2)) and a red light emitting diode (620 nm), to monitor vital signals for extended times...
July 25, 2017: ACS Applied Materials & Interfaces
https://www.readbyqxmd.com/read/28742291/evaluating-the-effect-of-the-changes-in-fda-guidelines-for-clozapine-monitoring
#8
Ryan S Sultan, Mark Olfson, Christoph U Correll, Erica J Duncan
BACKGROUND: Concerns exist that clozapine is underutilized in the management of treatment-resistant schizophrenia. Although a 2015 change in the US Food and Drug Administration (FDA) monitoring recommendations lowered the threshold of the absolute neutrophil count for treatment interruption from 1,500/μL to 1,000/μL and removed white blood cell count thresholds from the monitoring algorithm, the implications of this policy change on clozapine interruptions remain unknown. METHODS: We analyzed outpatient prescribing records for antipsychotic medications in the Veterans Integrated Service Network 7 (VISN 7) database between 1999 and 2012 to assess the potential impact of the recent changes in FDA neutropenia monitoring recommendations on clozapine treatment discontinuation...
July 18, 2017: Journal of Clinical Psychiatry
https://www.readbyqxmd.com/read/28742243/data-privacy-management-and-data-quality-monitoring-in-the-german-centre-for-cardiovascular-research-s-multicentre-translational-registry-for-cardiomyopathies-dzhk-torch
#9
Thea Schwaneberg, Kerstin Weitmann, Andreas Dösch, Claudia Seyler, Thomas Bahls, Lars Geidel, Dana Stahl, Mahsa Lee, Monika Kraus, Hugo A Katus, Wolfgang Hoffmann
AIMS: The multicentric TranslatiOnal Registry for CardiomyopatHies (TORCH) of the German Centre for Cardiovascular Research aims to recruit 2300 patients with non-ischemic cardiomyopthies. METHODS AND RESULTS: The investigations were performed after standard operating procedures. The data are collected in standardized electronic case report forms provided by the data holding of the central data management of the German Centre for Cardiovascular Research using secuTrial (interActive Systems GmbH, Berlin, Germany)...
July 18, 2017: ESC Heart Failure
https://www.readbyqxmd.com/read/28741583/elderly-patients-with-an-atypical-presentation-of-illness-in-the-emergency-department
#10
M R Hofman, F van den Hanenberg, I N Sierevelt, C R Tulner
BACKGROUND: Very little information is available on the prevalence and clinical outcome of elderly patients with atypical presentations of illness in the emergency department. The objective was to determine the prevalence and clinical outcome of elderly patients seen in the emergency department with an atypical presentation. METHODS: A monocentric retrospective observational study on 355 elderly patients presenting to the emergency department. Patients of 80 years and older were included...
July 2017: Netherlands Journal of Medicine
https://www.readbyqxmd.com/read/28741391/clinical-implications-benefits-and-pitfalls-of-using-and-reversing-non-vitamin-k-antagonist-oral-anticoagulants
#11
Alexandra S Moss, Gerasimos Dimitropoulos, Gregory Y H Lip
The use of non-Vitamin K antagonist oral anticoagulant (NOAC) drugs is increasingly common in clinical practice. As compared to vitamin K antagonists they are more straightforward to initiate, require no hematological monitoring and offer potentially more stable therapeutic indices. Concern has been raised with regard to their safety profiles particularly in the context of acute reversal in major bleeding. Further issues pertain to patient concordance. Areas Covered: This review article aims to provide an overview of the current evidence relating to NOAC safety as well as the management of NOAC-related major bleeding with particular emphasis on reversal agents in use and in development following a selective literature review...
July 25, 2017: Expert Review of Hematology
https://www.readbyqxmd.com/read/28741242/the-weakening-effect-of-soluble-epoxide-hydrolase-inhibitor-auda-on-febrile-response-to-lipopolysaccharide-and-turpentine-in-rat
#12
Jakub Piotrowski, Tomasz Jędrzejewski, Małgorzata Pawlikowska, Agata Joanna Pacuła, Jacek Ścianowski, Wiesław Kozak
A still growing body of evidence suggests the importance of epoxyeicosatrienoic acids (EETs) in the regulation of inflammatory response; therefore, drugs that stabilize their levels by targeting the soluble epoxide hydrolase (sEH), an enzyme responsible for their metabolism, are currently under investigation. The effect of sEH inhibitors on molecular components of fever mechanism, i.e., on synthesis of pro-inflammatory cytokines or prostaglandins, has been repeatedly proven; however, the hypothesis that sEH inhibitors affect febrile response has never been tested...
July 24, 2017: Journal of Physiology and Biochemistry
https://www.readbyqxmd.com/read/28741008/the-national-resuscitation-council-singapore-and-34-years-of-resuscitation-training-1983-to-2017
#13
Venkataraman Anantharaman
Training in the modern form of cardiopulmonary resuscitation (CPR) started in Singapore in 1983. For the first 15 years, the expansion of training programmes was mainly owing to the interest of a few individuals. Public training in the skill was minimal. In an area of medical care where the greatest opportunity for benefit lies in employing core resuscitation skills in the prehospital environment, very little was being done to address such a need. In 1998, a group of physicians, working together with the Ministry of Health, set up the National Resuscitation Council (NRC)...
July 2017: Singapore Medical Journal
https://www.readbyqxmd.com/read/28739656/guiding-principles-for-team-based-pediatric-care
#14
Julie P Katkin, Susan J Kressly, Anne R Edwards, James M Perrin, Colleen A Kraft, Julia E Richerson, Joel S Tieder, Liz Wall
The American Academy of Pediatrics (AAP) recognizes that children's unique and ever-changing needs depend on a variety of support systems. Key components of effective support systems address the needs of the child and family in the context of their home and community and are dynamic so that they reflect, monitor, and respond to changes as the needs of the child and family change. The AAP believes that team-based care involving medical providers and community partners (eg, teachers and state agencies) is a crucial and necessary component of providing high-quality care to children and their families...
July 24, 2017: Pediatrics
https://www.readbyqxmd.com/read/28739655/critical-issues-in-food-allergy-a-national-academies-consensus-report
#15
Scott H Sicherer, Katrina Allen, Gideon Lack, Steve L Taylor, Sharon M Donovan, Maria Oria
The National Academies of Sciences, Engineering, and Medicine convened an expert, ad hoc committee to examine critical issues related to food allergy. The authors of the resulting report, "Finding a Path to Safety in Food Allergy: Assessment of the Global Burden, Causes, Prevention, Management, and Public Policy," evaluated the scientific evidence on the prevalence, diagnosis, prevention, and management of food allergy and made recommendations to bring about a safe environment for those affected. The committee recommended approaches to monitor prevalence, explore risk factors, improve diagnosis, and provide evidence-based health care...
July 24, 2017: Pediatrics
https://www.readbyqxmd.com/read/28739114/ethical-and-medical-management-of-a-pregnant-woman-with-brain-stem-death-resulting-in-delivery-of-a-healthy-child-and-organ-donation
#16
A Gopčević, B Rode, M Vučić, A Horvat, M Širanović, Ž Gavranović, V Košec, A Košec
Maternal brain death during pregnancy remains an exceedingly complex situation that requires not only a well-considered medical management plan, but also careful decision-making in a legally and ethically delicate situation. Management of brain dead pregnant patients needs to adhere to special strategies that support the mother in a way that she can deliver a viable and healthy child. Brain death in pregnant women is very rare, with only a few published cases. We present a case of a pregnant woman with previously diagnosed multiple brain cavernomas that led to intracranial hemorrhage and brain stem death during the 21st week of pregnancy...
June 24, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28738808/carotid-plaque-rather-than-intima-media-thickness-as-a-predictor-of-recurrent-vascular-events-in-patients-with-acute-ischemic-stroke
#17
Hyun Ju Yoon, Kye Hun Kim, Hyukjin Park, Jae Yeong Cho, Young Joon Hong, Hyung Wook Park, Ju Han Kim, Youngkeun Ahn, Myung Ho Jeong, Jeong Gwan Cho, Jong Chun Park
BACKGROUND: To investigate the impacts of carotid plaque and intima-media thickness (IMT) on future vascular events (VEs) in the patients with acute ischemic stroke. METHODS: A total of 479 consecutive Korean patients with acute ischemic stroke were divided into 2 groups according to development of VEs; VE group (65.4 ± 10.9 years) vs no VE group (62.8 ± 13.2 years). VEs were defined as the development of recurrent stroke, coronary events, peripheral arterial disease, and death...
July 24, 2017: Cardiovascular Ultrasound
https://www.readbyqxmd.com/read/28738800/benchmarked-performance-charts-using-principal-components-analysis-to-improve-the-effectiveness-of-feedback-for-audit-data-in-hiv-care
#18
Skevi Michael, Mark Gompels, Caroline Sabin, Hilary Curtis, Margaret T May
BACKGROUND: Feedback tools for clinical audit data that compare site-specific results to average performance over all sites can be useful for quality improvement. Proposed tools should be simple and clearly benchmark the site's performance, so that a relevant action plan can be directly implemented to improve patient care services. We aimed to develop such a tool in order to feedback data to UK HIV clinics participating in the 2015 British HIV Association (BHIVA) audit assessing compliance with the 2011 guidelines for routine investigation and monitoring of adult HIV-1- infected individuals...
July 24, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28737991/lowering-cost-share-may-improve-rates-of-home-glucose-monitoring-among-patients-with-diabetes-using-insulin
#19
Yiqiong Xie, Abiy Agiro, Kevin Bowman, Andrea DeVries
BACKGROUND: Not much is known about the extent to which lower cost share for blood glucose strips is associated with persistent filling. OBJECTIVE: To evaluate the relationship between cost sharing for blood glucose testing strips and continued use of testing strips. METHODS: This is a retrospective observational study using medical and pharmacy claims data integrated with laboratory hemoglobin A1c (A1c) values for patients using insulin and blood glucose testing strips...
August 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28737983/advancing-patient-care-through-specialty-pharmacy-services-in-an-academic-health-system
#20
Autumn Bagwell, Tara Kelley, Alicia Carver, Jennifer B Lee, Brandon Newman
BACKGROUND: With the rapid growth of specialty pharmacies, including those within academic health systems, pharmacists have the opportunity to improve patient care through the management of specialty medications. Specialty pharmacists within academic health systems are uniquely positioned to overcome restrictions to medication access, financial constraints, and provider burdens that often lead to obstacles for patients to start and maintain necessary treatments. The Vanderbilt Specialty Pharmacy (VSP) model at Vanderbilt University Medical Center (VUMC) provides an example of a patient-centered, collaborative care prototype that places pharmacists directly into specialty clinics to assist with comprehensive management of patients on specialty medications...
August 2017: Journal of Managed Care & Specialty Pharmacy
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