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https://www.readbyqxmd.com/read/28351066/bringing-rounds-back-to-the-patient-a-one-year-evaluation-of-the-chiefs-service-model-for-inpatient-teaching
#1
Nadia L Bennett, Judd D Flesch, Peter Cronholm, James B Reilly, Jack Ende
PURPOSE: The Chiefs' Service (CS), a structured approach to inpatient teaching rounds, focuses on resident education and patient-centered care without disrupting patient census sizes or admitting cycles. It has five key elements: morning huddles; bedside rounds; diagnostic "time-outs"; day-of-discharge rounds; and postdischarge follow-up rounds. The authors hypothesized the CS model would be well received by residents and considered more effective than more-traditional rounds. METHOD: The CS was implemented on Penn Presbyterian Medical Center's general medicine inpatient service using a quasi-experimental design...
April 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28350942/prevention-of-surgical-site-infection-in-spine-surgery
#2
Paul A Anderson, Jason W Savage, Alexander R Vaccaro, Kristen Radcliff, Paul M Arnold, Brandon D Lawrence, Mohammed F Shamji
BACKGROUND: Spine surgery is complicated by an incidence of 1% to 9% of surgical site infection (SSI). The most common organisms are gram-positive bacteria and are endogenous, that is are brought to the hospital by the patient. Efforts to improve safety have been focused on reducing SSI using a bundle approach. The bundle approach applies many quality improvement efforts and has been shown to reduce SSI in other surgical procedures. OBJECTIVE: To provide a narrative review of practical solutions to reduce SSI in spine surgery...
March 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28346604/blended-learning-educational-format-for-third-year-pediatrics-clinical-rotation
#3
Erik E Langenau, Robert Lee, Marci Fults
CONTEXT: Traditional medical education is shifting to incorporate learning technologies and online educational activities with traditional face-to-face clinical instruction to engage students, especially at remote clinical training sites. OBJECTIVE: To describe and evaluate the effectiveness of the blended learning format (combining online and face-to-face instruction) for third-year osteopathic medical students during their pediatric rotation. METHODS: Third-year medical students who completed the 4-week clerkship in pediatrics during the 2014-2015 academic year were divided into a standard learning group and a blended learning group with online activities (discussion boards, blogs, virtual patient encounters, narrated video presentations, and online training modules)...
April 1, 2017: Journal of the American Osteopathic Association
https://www.readbyqxmd.com/read/28346010/non-healing-perianal-ulcers-in-a-healthy-elderly-male
#4
Alia Cloutier-Bosworth, Karen Naert, Carly Kirshen
BACKGROUND: Perforating dermatoses are a rare group of dermatologic conditions characterized by transepidermal elimination of dermal material that can be primary or acquired secondary to systemic disease. OBJECTIVE: We present an atypical case of perforating dermatosis resembling elastosis perforans serpiginosa (EPS) presenting with perianal ulcers in an elderly male with no systemic disease or medications and outline his successful treatment course. CONCLUSIONS: Perianal ulcers in an otherwise healthy individual is an unusual presentation for perforating disorders but should be considered in cases not responding to traditional treatment options...
March 1, 2017: Journal of Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/28345683/-workplace-health-promotion-in-poland-in-2015-diagnosis-based-on-a-representative-survey-of-companies-employing-more-than-50-employees
#5
Krzysztof Puchalski, Elżbieta Korzeniowska
BACKGROUND: The workplace health promotion (WHP) activity of enterprises in Poland was examined. The findings referred to how many companies implemented non-obligatory actions for health and what actions were taken, what were the reasons and obstacles in the implementation, whether companies evaluated their activity, how they motivated staff to WHP, and whether the size and economic standing differentiated their activity. MATERIAL AND METHODS: Representative survey, consisted of computer assisted telephone interviews with delegates of the boards of 1000 companies employing > 50 employees, held in November-December 2015...
March 24, 2017: Medycyna Pracy
https://www.readbyqxmd.com/read/28344717/a-digital-peer-to-peer-learning-platform-for-clinical-skills-development
#6
Jesse Basnak, Jennifer Ortynski, Meghan Chow, Emeka Nzekwu
BACKGROUND: Due to constraints in time and resources, medical curricula may not provide adequate opportunities for pre-clerkship students to practice clinical skills. To address this, medical students at the University of Alberta developed a digital peer-to-peer learning initiative. The initiative assessed if students can learn clinical skills from their peers in co-curricular practice objective structured clinical exams (OSCEs). METHODS: A total of 144 first-year medical students participated...
February 2017: Canadian Medical Education Journal
https://www.readbyqxmd.com/read/28344554/cannabis-in-chinese-medicine-are-some-traditional-indications-referenced-in-ancient-literature-related-to-cannabinoids
#7
REVIEW
E Joseph Brand, Zhongzhen Zhao
Cannabis sativa L. (Cannabaceae) has a long history of utilization as a fiber and seed crop in China, and its achenes ("seeds") as well as other plant parts have been recorded in Chinese medical texts for nearly 2000 years. While the primary applications of cannabis in Chinese medicine center around the use of the achenes, ancient indications for the female inflorescence, and other plant parts include conditions such as pain and mental illness that are the subject of current research into cannabinoids such as cannabidiol (CBD) and Δ(9)-tetrahydrocannabinol (THC)...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/28344422/impaired-left-ventricular-diastolic-functions-and-thickened-epicardial-adipose-tissue-in-rheumatoid-arthritis-patients-is-correlated-with-das-28-score
#8
Sertac Alpaydın, Zafer Buyukterzi, Halil Ekrem Akkurt, Halim Yılmaz
BACKGROUND: Rheumatoid arthritis (RA) is a chronic inflammatory disease that is known to be associated with high cardiovascular (CV) morbidity and mortality. In this study, we aimed to demonstrate whether RA disease activity reflected with disease activity score-28 (DAS-28) had an impact on left ventricular diastolic functions and epicardial adipose tissue (EAT) thickness in RA patients with no traditional CV risk factors. METHODS: In this retrospective study, 41 patients newly diagnosed with RA were included...
March 2017: Acta Cardiologica Sinica
https://www.readbyqxmd.com/read/28344031/culture-bound-syndromes-of-a-brazilian-amazon-riverine-population-tentative-correspondence-between-traditional-and-western-medicine-terms-and-possible-ethnopharmacological-implications
#9
E Pagani, J de F L Santos, E Rodrigues
ETHNOPHARMACOLOGICAL RELEVANCE: It is not always possible to correlate the "emic" terms to the "etic" ones during ethnopharmacological surveys, especially regarding those related to Culture-Bound Syndromes (CBS). Nevertheless, it is the role of ethnopharmacology to address these correlations, since they are the basis for the understanding of potential bioactives. AIM AND OBJECTIVES: This study reports the clinical manifestations and therapeutic resources used for the treatment of CBS among some riverine inhabitants of Brazilian Amazonia...
March 23, 2017: Journal of Ethnopharmacology
https://www.readbyqxmd.com/read/28344030/antibacterial-activity-of-medicinal-plants-from-the-physicians-of-myddvai-a-13-th-century-welsh-medical-manuscript
#10
Charles Wagner, Jillian De Gezelle, Maureen Robertson, Keith Robertson, Mickey Wilson, Slavko Komarnytsky
ETHNOPHARMACOLOGICAL RELEVANCE: Antimicrobial drug resistance is a growing threat to global public health. Historical records and herbal texts relating to traditional Celtic medicine indicate an extensive pharmacopeia of plants for treating infections likely caused by microbes. However, a major barrier for successful integration of these remedies into mainstream practice is the current lack of accurate interpretation and scientific validation. MATERIALS AND METHODS: We applied Mobile Discovery approach to the Isle of Arran, Scotland, for in situ targeted screening of 83 out of 138 plants identified in Meddygion Myddvai (a 13(th) century Welsh manuscript) to treat conditions related to microbial infections, and an additional 18 plants from modern ethnobotanical knowledge on the island...
March 24, 2017: Journal of Ethnopharmacology
https://www.readbyqxmd.com/read/28344011/the-epidemiology-pathogenesis-transmission-diagnosis-and-management-of-multidrug-resistant-extensively-drug-resistant-and-incurable-tuberculosis
#11
REVIEW
Keertan Dheda, Tawanda Gumbo, Gary Maartens, Kelly E Dooley, Ruth McNerney, Megan Murray, Jennifer Furin, Edward A Nardell, Leslie London, Erica Lessem, Grant Theron, Paul van Helden, Stefan Niemann, Matthias Merker, David Dowdy, Annelies Van Rie, Gilman K H Siu, Jotam G Pasipanodya, Camilla Rodrigues, Taane G Clark, Frik A Sirgel, Aliasgar Esmail, Hsien-Ho Lin, Sachin R Atre, H Simon Schaaf, Kwok Chiu Chang, Christoph Lange, Payam Nahid, Zarir F Udwadia, C Robert Horsburgh, Gavin J Churchyard, Dick Menzies, Anneke C Hesseling, Eric Nuermberger, Helen McIlleron, Kevin P Fennelly, Eric Goemaere, Ernesto Jaramillo, Marcus Low, Carolina Morán Jara, Nesri Padayatchi, Robin M Warren
Global tuberculosis incidence has declined marginally over the past decade, and tuberculosis remains out of control in several parts of the world including Africa and Asia. Although tuberculosis control has been effective in some regions of the world, these gains are threatened by the increasing burden of multidrug-resistant (MDR) and extensively drug-resistant (XDR) tuberculosis. XDR tuberculosis has evolved in several tuberculosis-endemic countries to drug-incurable or programmatically incurable tuberculosis (totally drug-resistant tuberculosis)...
March 15, 2017: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/28343763/identifying-high-risk-post-infarction-patients-by-autonomic-testing-below-the-tip-of-the-iceberg
#12
Axel Bauer
Despite major advances in medical therapies late mortality after myocardial infarction (MI) is still high. A substantial proportion of post-MI patients die from sudden cardiac death. Prophylactic implantable-cardioverter defibrillator (ICD) therapy has been established for post-MI patients with reduced left ventricular ejection fraction (LVEF ≤35%). However, most patients who die after MI have an LVEF >35%. For this large group of patients, no specific prophylactic strategies exist. There is strong evidence that measures of cardiac autonomic dysfunction after MI provide important prognostic information in post-MI patients with preserved LVEF...
March 18, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28343456/implementation-of-neurocritical-care-is-associated-with-improved-outcomes-in-traumatic-brain-injury
#13
Mypinder S Sekhon, Peter Gooderham, Brian Toyota, Navid Kherzi, Vivien Hu, Vinay K Dhingra, Morad S Hameed, Dean R Chittock, Donald E Griesdale
Background Traditionally, the delivery of dedicated neurocritical care (NCC) occurs in distinct NCC units and is associated with improved outcomes. Institution-specific logistical challenges pose barriers to the development of distinct NCC units; therefore, we developed a consultancy NCC service coupled with the implementation of invasive multimodal neuromonitoring, within a medical-surgical intensive care unit. Our objective was to evaluate the effect of a consultancy NCC program on neurologic outcomes in severe traumatic brain injury patients...
March 27, 2017: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
https://www.readbyqxmd.com/read/28343097/strait-razor-v2s-advancing-sequence-based-str-allele-reporting-and-beyond-to-other-marker-systems
#14
Jonathan L King, Frank R Wendt, Jie Sun, Bruce Budowle
STRait Razor has provided the forensic community a free-to-use, open-source tool for short tandem repeat (STR) analysis of massively parallel sequencing (MPS) data. STRait Razor v2s (SRv2s) allows users to capture physically phased haplotypes within the full amplicon of both commercial (ForenSeq) and "early access" panels (PowerSeq, Mixture ID). STRait Razor v2s may be run in batch mode to facilitate population-level analysis and is supported by all Unix distributions (including MAC OS). Data are reported in tables in string (haplotype), length-based (e...
March 12, 2017: Forensic Science International. Genetics
https://www.readbyqxmd.com/read/28342271/more-bark-than-bite-comparative-studies-are-needed-to-determine-the-importance-of-canine-zoonoses-in-aboriginal-communities-a-critical-review-of-published-research
#15
REVIEW
F Smout, L Schrieber, R Speare, L F Skerratt
The objective of this review was to identify and critique over forty years of peer-reviewed literature concerned with the transmission of canine zoonoses to Aboriginal people and determine the zoonotic organisms documented in dogs in Australian Aboriginal communities. A systematic literature search of public health, medical and veterinary databases identified 19 articles suitable for critical appraisal. Thirteen articles documented the occurrence of recognized zoonotic organisms in dogs in Aboriginal communities, including Toxocara canis, Dirofilaria immitis, Streptococcus dysgalactiae, Rickettsia felis, Sarcoptes scabiei and Giardia...
March 25, 2017: Zoonoses and Public Health
https://www.readbyqxmd.com/read/28342151/cardiovascular-disease-in-rheumatoid-arthritis-medications-and-risk-factors-in-china
#16
Chun Li, X R Wang, H J Ji, X Y Zhang, X F Li, L Z Wang, C H Wang, Y F Wang, Rong Yang, G C Wang, Xin Lu, Ping Zhu, L N Chen, H T Jin, J T Liu, X Y Liu, Lin Sun, H Y Chen, Ping Wei, J X Wang, L F Cui, Rong Shu, B L Liu, Z L Zhang, G T Li, Z B Li, Jing Yang, J F Li, Bin Jia, F X Zhang, J M Tao, S L Han, J Y Lin, M Q Wei, X M Liu, Dan Ke, S X Hu, Cong Ye, X Y Yang, Hao Li, C B Huang, Ming Gao, Bei Lai, X F Li, L J Song, Yi Wang, X Y Wang, Y D Tang, Yin Su, Rong Mu, Z G Li
This study aims to assess the risk factors of cardiovascular disease (CVD) and to determine the association of traditional and biologic disease-modifying anti-rheumatic drugs (DMARDs) with risk for CVD in Chinese rheumatoid arthritis (RA) patients. A cross-sectional cohort of 2013 RA patients from 21 hospitals around China was established. Medical history of CVD was documented. The patients' social background, clinical manifestations, comorbidities, and medications were also collected. Of the 2013 patients, 256 had CVD with an incidence of 12...
March 24, 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/28342126/learning-curve-takes-65-repetitions-of-totally-extraperitoneal-laparoscopy-on-inguinal-hernias-for-reduction-of-operating-time-and-complications
#17
Fábio Yuji Suguita, Felipe Futema Essu, Lucas Torres Oliveira, Leandro Ryuchi Iuamoto, Juliana Mika Kato, Matheus Beloni Torsani, André Silva Franco, Alberto Meyer, Wellington Andraus
BACKGROUND: Inguinal hernia repair is one of the most frequently conducted surgical procedures worldwide. Totally extraperitoneal (TEP) hernioplasty has shown many advantages over traditional open surgery. However, because of increased surgical complexity, it requires more practice to achieve optimal results. OBJECTIVES: The aim of this study is to evaluate the learning curve for TEP hernioplasty, analysing parameters related to the mean operating time. The secondary objective is to assess the complications and early discharge rates related to this procedure...
March 24, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28342095/-advances-in-diagnostic-microbiology-opportunities-and-limitations
#18
F P Maurer, M Hentschke, H Rohde
In the light of ever increasing problems related to the emergence of multidrug-resistant bacteria, rapid microbiological diagnostics are of growing importance. Timely pathogen detection and availability of susceptibility data are essential for optimal treatment, but are even more crucial for de-escalation of broad spectrum empiric therapies. Medical microbiology is, thus, an integral part of antimicrobial stewardship programs. Traditional microbiological techniques for species identification and susceptibility testing rely on bacterial growth and are, thus, characterized by inherent slowness...
March 24, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28342016/severity-of-psoriasis-differs-between-men-and-women-a-study-of-the-clinical-outcome-measure-psoriasis-area-and-severity-index-pasi-in-5438-swedish-register-patients
#19
David Hägg, Anders Sundström, Marie Eriksson, Marcus Schmitt-Egenolf
BACKGROUND: Psoriasis is a common skin disease and moderate to severe psoriasis is associated with a dose-dependent risk for metabolic and cardiovascular morbidity. It has previously been speculated that women have less severe psoriasis, as men are overrepresented in psoriasis registers and consume more care. OBJECTIVE: The objective of this study was to investigate, for the first time, the sex differences in the severity of psoriasis using the gold standard of severity measurement, the Psoriasis Area and Severity Index (PASI), and the distinct elements of the PASI score...
March 24, 2017: American Journal of Clinical Dermatology
https://www.readbyqxmd.com/read/28341507/endovascular-aortic-repair-for-progressive-chronic-thoracoabdominal-aortic-dissections
#20
Vito Mantese, Shameem Kunhammed
BACKGROUND: Ascending and thoracic aortic dissections progress into thoracoabdominal aneurysms 20-40% of the time, due to the initial aortic injury with associated weakness of the aortic wall. The increased firmness of the intimal flap usually results in a collapsed true lumen that does not spontaneously re-expand even with progressive dilatation of the aorta. In an effort to identify a safe and effective treatment path for this complex disease process, we present 4 cases illustrating successful sequential thoracic endovascular aortic repair (TEVAR) and fenestrated endovascular aortic repair (FEVAR)...
March 21, 2017: Annals of Vascular Surgery
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