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https://www.readbyqxmd.com/read/29914871/secondary-peritonitis-principles-of-diagnosis-and-intervention
#1
REVIEW
James T Ross, Michael A Matthay, Hobart W Harris
Secondary peritonitis accounts for 1% of urgent or emergent hospital admissions and is the second leading cause of sepsis in patients in intensive care units globally. Overall mortality is 6%, but mortality rises to 35% in patients who develop severe sepsis. Despite the dramatic growth in the availability and use of imaging and laboratory tests, the rapid diagnosis and early management of peritonitis remains a challenge for physicians in emergency medicine, surgery, and critical care. In this article, we review the pathophysiology of peritonitis and its potential progression to sepsis, discuss the utility and limitations of the physical examination and laboratory and radiographic tests, and present a paradigm for the management of secondary peritonitis...
June 18, 2018: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/29907267/critical-care-airway-management
#2
REVIEW
Etieno U Umobong, Paul H Mayo
Critical care airway management is associated with a variety of complications, including severe oxygen desaturation, life-threatening hypotension, and death. This article reviews aspects of airway management that are relevant to intensivists and emergency medicine clinicians tasked with improving the quality of urgent endotracheal intubation in the critically ill patient.
July 2018: Critical Care Clinics
https://www.readbyqxmd.com/read/29902259/the-economic-burden-of-inpatient-care-of-depression-in-poznan-poland-and-kiel-germany-in-2016
#3
Tomasz Zaprutko, Robert Göder, Krzysztof Kus, Wiktor Pałys, Filip Rybakowski, Elżbieta Nowakowska
Depression is a global health problem associated with a significant public health burden and costs. Although studies on costs of diseases are being considered as an increasingly important factor for health policies, information concerning costs of inpatient care of depression is still insufficient. Thus, the main aim of this study was to evaluate costs of hospitalization of patients treated in 2016 in psychiatric clinics in Poznan (Poland) and in Kiel (Germany) and to analyze treatment used in these centers...
2018: PloS One
https://www.readbyqxmd.com/read/29867596/a-european-research-agenda-for-somatic-symptom-disorders-bodily-distress-disorders-and-functional-disorders-results-of-an-estimate-talk-estimate-delphi-expert-study
#4
Christina M van der Feltz-Cornelis, Iman Elfeddali, Ursula Werneke, Ulrik F Malt, Omer Van den Bergh, Rainer Schaefert, Willem J Kop, Antonio Lobo, Michael Sharpe, Wolfgang Söllner, Bernd Löwe
Background: Somatic Symptom Disorders (SSD), Bodily Distress Disorders (BDD) and functional disorders (FD) are associated with high medical and societal costs and pose a substantial challenge to the population and health policy of Europe. To meet this challenge, a specific research agenda is needed as one of the cornerstones of sustainable mental health research and health policy for SSD, BDD, and FD in Europe. Aim: To identify the main challenges and research priorities concerning SSD, BDD, and FD from a European perspective...
2018: Frontiers in Psychiatry
https://www.readbyqxmd.com/read/29858529/what-do-stakeholders-expect-from-patient-engagement-are-these-expectations-being-met
#5
Mathieu Boudes, Paul Robinson, Neil Bertelsen, Nicholas Brooke, Anton Hoos, Marc Boutin, Jan Geissler, Ify Sargeant
BACKGROUND: Meaningful patient engagement (PE) in medicines development and during the life cycle of a product requires all stakeholders have a clear understanding of respective expectations. OBJECTIVE: A qualitative survey was undertaken to understand stakeholder expectations. DESIGN: The survey explored 4 themes from the perspective of each stakeholder group: meaning, views, expectations and priorities for PE. Participants were grouped into 7 categories: policymakers/regulators; health-care professionals (HCPs); research funders; payers/purchasers/HTA; patients/patient representatives; pharmaceutical/life sciences industry; and academic researchers...
June 1, 2018: Health Expectations: An International Journal of Public Participation in Health Care and Health Policy
https://www.readbyqxmd.com/read/29848478/traditional-chinese-medicine-for-acute-myocardial-infarction-in-western-medicine-hospitals-in-china
#6
Erica S Spatz, Yongfei Wang, Adam L Beckman, Xuekun Wu, Yuan Lu, Xue Du, Jing Li, Xiao Xu, Patricia M Davidson, Frederick A Masoudi, John A Spertus, Harlan M Krumholz, Lixin Jiang
BACKGROUND: Amid national efforts to improve the quality of care for people with cardiovascular disease in China, the use of traditional Chinese medicine (TCM) is increasing, yet little is known about its use in the early management of acute myocardial infarction (AMI). METHODS AND RESULTS: We aimed to examine intravenous use of TCM within the first 24 hours of hospitalization (early IV TCM) for AMI. Data come from the China Patient-centered Evaluative Assessment of Cardiac Events Retrospective Study of Acute Myocardial Infarction, restricted to a large, representative sample of Western medicine hospitals throughout China (n=162)...
March 2018: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/29781222/quality-use-of-medicines-in-aged-care-facilities-a-need-for-new-models-of-care
#7
S Kosari, N McDerby, J Thomas, M Naunton
WHAT IS KNOWN AND OBJECTIVE: Despite all the advancement in aged care, medication adverse events are still reported to occur frequently in aged care residents and to be a major contributor to hospitalization and reduced quality of life in older adults. Thus, there is an urgent need for interventions and developing new models of care to address medication safety. COMMENT: Interdisciplinary collaboration, as well as accessibility to health professionals, is amongst the factors affecting medication safety in aged care...
May 20, 2018: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/29750550/knowledge-of-hiv-testing-guidelines-among-us-internal-medicine-residents-a-decade-after-the-centers-for-disease-control-and-prevention-s-routine-hiv-testing-recommendations
#8
Dima Dandachi, Bich N Dang, Rita Wilson Dib, Harvey Friedman, Thomas Giordano
Ten years after the Centers for Disease Control and Prevention recommended universal HIV screening, rates remain low. Internal medicine residents are the front-line medical providers for large groups of patients. We evaluated the knowledge of internal medicine residents about HIV testing guidelines and examined adherence to universal HIV testing in an outpatient setting. A cross-sectional survey of internal medicine residents at four residency programs in Chicago was conducted from January to March 2016. Aggregate data on HIV screening were collected from 35 federally qualified community health centers in the Chicago area after inclusion of an HIV testing best practice alert in patients' electronic medical records...
May 2018: AIDS Patient Care and STDs
https://www.readbyqxmd.com/read/29686787/pattern-duration-of-stay-and-outcomes-of-medical-admissions-a-report-from-teaching-community-hospital-in-assir-region-saudi-arabia
#9
Mushabab A Al-Ghamdi, Aref A Bin Abdulhak
Background : Population-based studies are the gold standard to understand the burden of different diseases, plan health care policy and resource allocation, and provide an accurate estimate of disease several disease indices including mortality. However, population-based studies are difficult to undertake in a resource-limited situation where no robust data bases and disease registries are available. Therefore, hospital-based cohorts may be used to inform about the community health. Objectives: We sought to study the pattern of disease causing admission, hospital stay, and outcomes of medical admissions to King Abdullah Hospital in Bisha in order to inform clinicians, public health professionals, and policymakers about the current status of diseases within the community in Bisha...
2018: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/29674796/prescriber-and-dispenser-perceptions-about-antibiotic-use-in-acute-uncomplicated-childhood-diarrhea-and-upper-respiratory-tract-infection-in-new-delhi-qualitative-study
#10
Anita Kotwani, P C Joshi, Urmila Jhamb, Kathleen Holloway
OBJECTIVE: The objective of the study was to explore the prescribing practices, knowledge, and attitudes of primary care doctors and community pharmacists, regarding antibiotic use in acute upper respiratory tract infections (URTI) and diarrhea in children to better understand causes of misuse and identify provider suggestions to change such behavior. MATERIALS AND METHODS: Two focus group discussions (FGDs) each were conducted with primary care government doctors (GDs), private general practitioners (GPs), pediatricians, and community pharmacists in Delhi...
November 2017: Indian Journal of Pharmacology
https://www.readbyqxmd.com/read/29662451/risk-assessment-and-risk-minimization-in-nanomedicine-a-need-for-predictive-alternative-and-3rs-strategies
#11
REVIEW
Lisa Accomasso, Caterina Cristallini, Claudia Giachino
The use of nanomaterials in medicine has grown very rapidly, leading to a concern about possible health risks. Surely, the application of nanotechnology in medicine has many significant potentialities as it can improve human health in at least three different ways: by contributing to early disease diagnosis, improved treatment outcomes and containment of health care costs. However, toxicology or safety assessment is an integral part of any new medical technology and the nanotechnologies are no exception. The principle aim of nanosafety studies in this frame is to enable safer design of nanomedicines...
2018: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/29651758/the-role-of-emergency-medicine-clerkship-e-portfolio-to-monitor-the-learning-experience-of-students-in-different-settings-a-prospective-cohort-study
#12
Arif Alper Cevik, Sami Shaban, Margret El Zubeir, Fikri M Abu-Zidan
BACKGROUND: Although emergency departments provide acute care learning opportunities for medical students, student exposure to recommended curriculum presentations and procedures are limited. In this perspective, clinical environments providing learning opportunities for students should be monitored as part of an ongoing quality improvement process. This study aims to analyze student exposures and their involvement levels in two different hospitals (Tawam and Al Ain) so as to improve the teaching and learning activities...
April 12, 2018: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29649399/a-rules-based-algorithm-to-prioritize-poor-prognosis-cancer-patients-in-need-of-advance-care-planning
#13
Christine M Bestvina, Kristen E Wroblewski, Bobby Daly, Brittany Beach, Selina Chow, Andrew Hantel, Monica Malec, Michael T Huber, Blase N Polite
BACKGROUND: Accurate understanding of the prognosis of an advanced cancer patient can lead to decreased aggressive care at the end of life and earlier hospice enrollment. OBJECTIVE: Our goal was to determine the association between high-risk clinical events identified by a simple, rules-based algorithm and decreased overall survival, to target poor prognosis cancer patients who would urgently benefit from advanced care planning. DESIGN: A retrospective analysis was performed on outpatient oncology patients with an index visit from April 1, 2015, through June 30, 2015...
March 13, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29629681/antibiotic-prescribing-practice-and-adherence-to-guidelines-in-primary-care-in-the-cape-town-metro-district-south-africa
#14
J Gasson, M Blockman, B Willems
BACKGROUND: Knowledge of antibiotic prescribing practice in primary care in South Africa is limited. As 80% of human antibiotic use is in primary care, this knowledge is important in view of the global problem of antibiotic resistance. OBJECTIVES: To assess antibiotic prescribing in primary care facilities in the Cape Town Metro District and compare it with current national guidelines, and to assess the reasons why prescriptions were not adherent to guidelines. METHODS: A retrospective medical record review was performed in April/May 2016...
March 28, 2018: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/29627355/atrial-fibrillation-in-the-icu
#15
REVIEW
Nicholas A Bosch, Jonathan Cimini, Allan J Walkey
Atrial fibrillation (AF) is the most common arrhythmia encountered in the ICU. Preexisting AF is highly prevalent among older patients with chronic conditions who are at risk for critical illness, whereas new-onset AF can be triggered by accelerated atrial remodeling and arrhythmogenic triggers encountered during critical illness. The acute loss of atrial systole and onset of rapid ventricular rates that characterize new-onset AF often lead to decreased cardiac output and hemodynamic compromise. Thus, new-onset AF is both a marker of disease severity as well as a likely contributor to poor outcomes, similar to other manifestations of organ dysfunction during critical illness...
April 6, 2018: Chest
https://www.readbyqxmd.com/read/29575112/the-what-when-and-why-of-human-prostate-cancer-xenografts
#16
REVIEW
W Nathaniel Brennen, John T Isaacs
BACKGROUND: Presently, ∼85 serially transplantable human prostate cancer xenografts spanning the phenotypic, epigenetic, and genetic heterogeneity seen clinically are available in a variety of laboratories throughout the world. If distributed to the prostate cancer research community, these can provide an experimental platform for resolving the specificity versus generalizability of basic cancer biology principles (eg, credentialing of therapeutic molecular targets) and for validating translational approaches for prevention, diagnosis, and therapy...
June 2018: Prostate
https://www.readbyqxmd.com/read/29574586/precision-medicine-in-chronic-rhinosinusitis-with-nasal-polyps
#17
REVIEW
Klementina Avdeeva, Wytske Fokkens
PURPOSE OF REVIEW: Chronic rhinosinusitis is a disease with high prevalence, significant impact on health-related quality of life (HRQoL) and it is associated with substantial healthcare and productivity costs. We face an urgent need to improve the level of disease control and achieve higher patient satisfaction and disease prevention. Precision medicine is increasingly recognized as the way forward in optimal patient care. The combination of personalized care, prevention of disease, prediction of success of treatment, and participation of the patient in the elaboration of the treatment plan is expected to guarantee the best possible therapeutic approach for individuals suffering from a chronic disabling condition...
March 24, 2018: Current Allergy and Asthma Reports
https://www.readbyqxmd.com/read/29562541/patient-engagement-the-fundaci%C3%A3-ace-framework-for-improving-recruitment-and-retention-in-alzheimer-s-disease-research
#18
Mercè Boada, Miguel A Santos-Santos, Octavio Rodríguez-Gómez, Montserrat Alegret, Pilar Cañabate, Asunción Lafuente, Carla Abdelnour, Mar Buendía, Maria José de Dios, América Morera, Ángela Sanabria, Laura Campo, Agustín Ruiz, Lluís Tárraga
Alzheimer's disease (AD) research is at a critical time. The global society is increasingly aware of the frightening rate of growth of the human and financial burden caused by this condition and of the urgent need to halt its progression. Consequently, the scientific community holds great responsibility to quickly put in place and optimize the machinery necessary for testing new treatments or interventions. In this context demand for participants for AD research is at an all-time high. In this review, we will focus on a methodological factor that is increasingly recognized as a key factor that shapes trial populations and affects validity of results in clinical trials: patient engagement, recruitment, and retention...
2018: Journal of Alzheimer's Disease: JAD
https://www.readbyqxmd.com/read/29548923/precision-medicine-for-drug-resistant-tuberculosis-in-high-burden-countries-is-individualised-treatment-desirable-and-feasible
#19
REVIEW
Helen Cox, Jennifer Hughes, John Black, Mark P Nicol
Treatment for drug-resistant tuberculosis is largely delivered through standardised, empirical combination regimens in low-resource, high-burden settings. However, individualised treatment, guided by detailed drug susceptibility testing, probably results in improved individual outcomes and is the standard of care in well-resourced settings. Driven by the urgent need to scale up treatment provision, new tuberculosis drugs, incorporated into standardised regimens, are being tested. Although standardised regimens are expected to improve access to treatment in high-burden settings, they are also likely to contribute to the emergence of resistance, even with good clinical management...
March 13, 2018: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/29543146/-oral-drops-unsafe-or-unwieldy-method-of-administration
#20
D A van Riet-Nales, E D Nijholt-Faber, A de Boer
The Netherlands Medicines Evaluation Board (MEB) was recently informed about a serious pipamperone overdose in a 6-year-old boy, which happened because the boy was given the medication in streams rather than in drops. This article describes the use of drops in pharmaceutical patient care and explains why the MEB has maintained marketing authorization for the product on the basis of currently available information. The MEB urgently requests the healthcare professional groups to report all problems concerning drug use to the Netherlands Pharmacovigilance Centre Lareb, and the Portal for Patient Safety; this is the only way in which it can be verified whether incidental medication errors are actually, and continue to be, incidental...
2018: Nederlands Tijdschrift Voor Geneeskunde
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