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https://www.readbyqxmd.com/read/28436211/primary-hpv-testing-verification-a-retrospective-ad-hoc-analysis-of-screening-algorithms-on-women-doubly-tested-for-cytology-and-hpv
#1
Jessica Tracht, Allison Wrenn, Isam-Eldin Eltoum
BACKGROUND: To evaluate human papillomavirus (HPV) testing as a primary screening tool, we retrospectively analyzed data comparing (1) HPV testing to the algorithms of the ATHENA Study: (2) cytology alone, (3) cytology with ASCUS triage in women 25-29 and (4) cotesting ≥ 30 or (5) cotesting ≥ 25. METHODS: We retrospectively analyzed data from women tested with both cytology and HPV testing from 2010 to 2013. Cumulative risk (CR) for CIN3+ was calculated...
April 23, 2017: Diagnostic Cytopathology
https://www.readbyqxmd.com/read/28424459/development-and-outcomes-of-a-primary-care-based-sleep-assessment-service-in-canterbury-new-zealand
#2
Michael J Epton, Paul T Kelly, Brett I Shand, Sallyanne V Powell, Judith N Jones, Graham R B McGeoch, Michael C Hlavac
Prior to 2007, increasing demand for sleep services, plus inability to adequately triage severity, led to long delays in sleep assessment and accessing continuous positive airway pressure. We established a community sleep assessment service carried out by trained general practices using a standardised tool and overnight oximetry. All cases were discussed at a multi-disciplinary meeting, with four outcomes: severe obstructive sleep apnoea treated with continuous positive airway pressure; investigation with more complex studies; sleep physician appointment; no or non-severe sleep disorder for general practitioner management...
April 19, 2017: NPJ Primary Care Respiratory Medicine
https://www.readbyqxmd.com/read/28422844/ultrasound-is-helpful-to-differentiate-bethesda-class-iii-thyroid-nodules-a-prisma-compliant-systematic-review-and-meta-analysis
#3
Lu-Ying Gao, Ying Wang, Yu-Xin Jiang, Xiao Yang, Ru-Yu Liu, Xue-Hua Xi, Shen-Ling Zhu, Rui-Na Zhao, Xing-Jian Lai, Xiao-Yan Zhang, Bo Zhang
BACKGROUND: Fine-needle aspiration (FNA) is the most dependable tool to triage thyroid nodules for medical or surgical management. However, Bethesda class III cytology, namely "follicular lesion of undetermined significance" (FLUS) or "atypia of undetermined significance" (AUS), is a major limitation of the US-FNA in assessing thyroid nodules. As the most important imaging method, ultrasound (US) has a high efficacy in diagnosing thyroid nodules. This meta-analysis aimed to assess the role of US in evaluating Bethesda class III thyroid nodules...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28418867/early-detection-of-gastric-cancer-using-global-genome-wide-and-irf4-elmo1-clip4-and-msc-dna-methylation-in-endoscopic-biopsies
#4
Francesca Pirini, Sassan Noazin, Martha H Jahuira-Arias, Sebastian Rodriguez-Torres, Leah Friess, Christina Michailidi, Jaime Cok, Juan Combe, Gloria Vargas, William Prado, Ethan Soudry, Jimena Pérez, Tikki Yudin, Andrea Mancinelli, Helen Unger, Carmen Ili-Gangas, Priscilla Brebi-Mieville, Douglas E Berg, Masamichi Hayashi, David Sidransky, Robert H Gilman, Rafael Guerrero-Preston
Clinically useful molecular tools to triage gastric cancer patients are not currently available. We aimed to develop a molecular tool to predict gastric cancer risk in endoscopy-driven biopsies obtained from high-risk gastric cancer clinics in low resource settings.We discovered and validated a DNA methylation biomarker panel in endoscopic samples obtained from 362 patients seen between 2004 and 2009 in three high-risk gastric cancer clinics in Lima, Perú, and validated it in 306 samples from the Cancer Genome Atlas project ("TCGA")...
March 16, 2017: Oncotarget
https://www.readbyqxmd.com/read/28416251/initial-asthma-severity-assessment-tools-as-predictors-of-hospitalization
#5
Natalia Paniagua, Amaia Elosegi, Isabel Duo, Ana Fernandez, Elisa Mojica, Lorea Martinez-Indart, Santiago Mintegi, Javier Benito
BACKGROUND: Assessment tools to classify and prioritize patients, such as systems of triage, and indicators of severity, such as clinical respiratory scores, are helpful in guiding the flow of asthmatic patients in the emergency department. OBJECTIVE: Our aim was to assess the performance of the Pediatric Assessment Triangle (PAT), triage level (TL), Pulmonary Score (PS), and initial O2 saturation (O2 sat), in predicting hospitalization in pediatric acute asthma exacerbations...
April 14, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28412995/development-and-validation-of-prediction-models-for-risks-of-complications-in-early-onset-pre-eclampsia-prep-a-prospective-cohort-study
#6
Shakila Thangaratinam, John Allotey, Nadine Marlin, Ben W Mol, Peter Von Dadelszen, Wessel Ganzevoort, Joost Akkermans, Asif Ahmed, Jane Daniels, Jon Deeks, Khaled Ismail, Ann Marie Barnard, Julie Dodds, Sally Kerry, Carl Moons, Richard D Riley, Khalid S Khan
BACKGROUND: The prognosis of early-onset pre-eclampsia (before 34 weeks' gestation) is variable. Accurate prediction of complications is required to plan appropriate management in high-risk women. OBJECTIVE: To develop and validate prediction models for outcomes in early-onset pre-eclampsia. DESIGN: Prospective cohort for model development, with validation in two external data sets. SETTING: Model development: 53 obstetric units in the UK...
April 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28411260/the-fast-ed-app-a-smartphone-platform-for-the-field-triage-of-patients-with-stroke
#7
Raul G Nogueira, Gisele S Silva, Fabricio O Lima, Yu-Chih Yeh, Carol Fleming, Daniel Branco, Arthur H Yancey, Jonathan J Ratcliff, Robert Keith Wages, Earnest Doss, Mehdi Bouslama, Jonathan A Grossberg, Diogo C Haussen, Teppei Sakano, Michael R Frankel
BACKGROUND AND PURPOSE: The Emergency Medical Services field triage to stroke centers has gained considerable complexity with the recent demonstration of clinical benefit of endovascular treatment for acute ischemic stroke. We sought to describe a new smartphone freeware application designed to assist Emergency Medical Services professionals with the field assessment and destination triage of patients with acute ischemic stroke. METHODS: Review of the application's platform and its development as well as the different variables, assessments, algorithms, and assumptions involved...
April 14, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28383332/improving-triage-accuracy-a-staff-development-approach
#8
Carmen M Brosinski, Autumn J Riddell, Sherwin Valdez
PURPOSE: The purpose of the process improvement initiative was to improve the percentage of undertriaged patients to less than 10% (benchmark) using the Emergency Severity Index tool. Undertriaged patients have an increased potential for poor outcomes due to a lengthier waiting room stay, which results in delay of care. DESCRIPTION OF THE PROJECT: An evidence-based project designed for staff development was conducted for a 7-month period. Project procedures consisted of triage chart reviews for a 3-month period during pre- and post-Emergency Severity Index training...
May 2017: Clinical Nurse Specialist CNS
https://www.readbyqxmd.com/read/28380196/an-agent-based-simulation-combined-with-group-decision-making-technique-for-improving-the-performance-of-an-emergency-department
#9
M Yousefi, R P M Ferreira
This study presents an agent-based simulation modeling in an emergency department. In a traditional approach, a supervisor (or a manager) allocates the resources (receptionist, nurses, doctors, etc.) to different sections based on personal experience or by using decision-support tools. In this study, each staff agent took part in the process of allocating resources based on their observation in their respective sections, which gave the system the advantage of utilizing all the available human resources during the workday by being allocated to a different section...
March 30, 2017: Brazilian Journal of Medical and Biological Research, Revista Brasileira de Pesquisas Médicas e Biológicas
https://www.readbyqxmd.com/read/28375009/sustainable-practices-in-medicinal-chemistry-part-2-green-by-design
#10
Ignacio Aliagas, Raphaelle Berger, Kristin Goldberg, Rachel T Nishimura, John Reilly, Paul F Richardson, Daniel Tyler Richter, Edward C Sherer, Brian Andrew Sparling, Marian C Bryan
With the development of ever-expanding synthetic methodologies, a medicinal chemist's toolkit continues to swell. However, with finite time and resources as well as a growing understanding of our field's environment impact, it is critical to refine what can be made to what should be made. This Perspective seeks to highlight multiple cheminformatic approaches in drug discovery that can influence and triage design and execution impacting the likelihood of rapidly generating high-value molecules in a more sustainable manner...
April 4, 2017: Journal of Medicinal Chemistry
https://www.readbyqxmd.com/read/28366284/comment-on-lentz-ba-et-al-validity-of-emergency-department-triage-tools-addressing-heterogeneous-definitions-of-over-triage-and-under-triage-american-journal-of-emergency-medicine-2017-http-dx-doi-org-10-1016-j-ajem-2017-02-012
#11
https://www.readbyqxmd.com/read/28363626/validating-signs-and-symptoms-from-an-actual-mass-casualty-incident-to-characterize-an-irritant-gas-syndrome-agent-igsa-exposure-a-first-step-in-the-development-of-a-novel-igsa-triage-algorithm
#12
Joan M Culley, Jane Richter, Sara Donevant, Abbas Tavakoli, Jean Craig, Salvatore DiNardi
INTRODUCTION: Chemical exposures can pose a significant threat to life. Rapid assessment by first responders/emergency nurses is required to reduce death and disability. Currently, no informatics tools for irritant gas syndrome agents (IGSA) exposures exist to process victims efficiently, continuously monitor for latent signs/symptoms, or make triage recommendations. This study describes the first step in developing ED informatics tools for chemical incidents: validation of signs/symptoms that characterize an IGSA syndrome...
March 28, 2017: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
https://www.readbyqxmd.com/read/28363470/time-driven-activity-based-costing-a-dynamic-value-assessment-model-in-pediatric-appendicitis
#13
Yangyang R Yu, Paulette I Abbas, Carolyn M Smith, Kathleen E Carberry, Hui Ren, Binita Patel, Jed G Nuchtern, Monica E Lopez
OBJECTIVES: Healthcare reform policies are emphasizing value-based healthcare delivery. We hypothesize that time-driven activity-based costing (TDABC) can be used to appraise healthcare interventions in pediatric appendicitis. METHODS: Triage-based standing delegation orders, surgical advanced practice providers, and a same-day discharge protocol were implemented to target deficiencies identified in our initial TDABC model. Post-intervention process maps for a hospital episode were created using electronic time stamp data for simple appendicitis cases during February to March 2016...
March 18, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28362647/validity-of-the-pediatric-canadian-triage-acuity-scale-in-a-tertiary-children-s-hospital-in-israel
#14
Raviv Allon, Oren Feldman, Anna Karminsky, Carmit Steinberg, Ronit Leiba, Itai Shavit
OBJECTIVE: In 2015, the Israeli Ministry of Health issued national guidelines demanding the use of a five-level triage system in pediatric emergency departments (EDs). The present study aimed to evaluate the validity of the Pediatric Canadian Triage Acuity Scale (PedCTAS) in the ED of a tertiary children's hospital in Israel. METHODS: A retrospective cohort study of all patients admitted between January 2011 and December 2015 was carried out. The proportion of hospitalization was the primary outcome measure...
March 30, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28353184/high-pneumococcal-dna-load-procalcitonin-and-supar-levels-correlate-to-severe-disease-development-in-patients-with-pneumococcal-pneumonia
#15
A J M Loonen, C Kesarsing, R Kusters, M Hilbink, P C Wever, A J C van den Brule
Community-acquired pneumonia (CAP) is mostly caused by Streptococcus pneumoniae. Identification of the pathogen causing CAP can be achieved by conventional culture techniques of sputum and/or blood, antigen detection from urine or molecular analysis. However, it remains difficult to determine patients who are at risk of severe disease development (intensive care unit [ICU] admittance and/or death). In this retrospective study, 121 patients admitted to the emergency department with pneumonia symptoms were included...
March 29, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28351447/near-infrared-spectroscopy-a-promising-prehospital-tool-for-management-of-traumatic-brain-injury
#16
Joost Peters, Bas Van Wageningen, Nico Hoogerwerf, Edward Tan
Introduction Early identification of traumatic brain injury (TBI) is essential. Near-infrared spectroscopy (NIRS) can be used in prehospital settings for non-invasive monitoring and the diagnosis of patients who may require surgical intervention. METHODS: The handheld NIRS Infrascanner (InfraScan Inc.; Philadelphia, Pennsylvania USA) uses eight symmetrical scan points to detect intracranial bleeding. A scanner was tested in a physician-staffed helicopter Emergency Medical Service (HEMS)...
March 29, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28351153/gas-chromatography-mass-spectrometry-metabolomics-of-urine-and-serum-from-nonhuman-primates-exposed-to-ionizing-radiation-impacts-on-the-tricarboxylic-acid-cycle-and-protein-metabolism
#17
Evan L Pannkuk, Evagelia C Laiakis, Simon Authier, Karen Wong, Albert J Fornace
Ionizing radiation (IR) directly damages cells and tissues or indirectly through reactive free radicals that may lead to longer term adverse sequelae such as cancers, persistent inflammation, or possible death. Potential exposures include nuclear reactor accidents, improper disposal of equipment containing radioactive materials or medical errors, and terrorist attacks. Metabolomics (comprehensive analysis of compounds <1 kDa) by mass spectrometry (MS) has been proposed as a tool for high-throughput biodosimetry and rapid assessment of exposed dose and triage needed...
March 29, 2017: Journal of Proteome Research
https://www.readbyqxmd.com/read/28341682/the-royal-college-of-emergency-medicine-composite-pain-scale-for-children-level-of-inter-rater-agreement
#18
Ffion James, Rosie Edwards, Nirmal James, Rhian Dyer, Victoria Goodwin
OBJECTIVE: To assess the inter-rater agreement of the Royal College of Emergency Medicine (RCEM) Composite Pain Scale. METHODS: A prospective, observational study of 117 children who presented to the ED with pain due to a limb injury. Pain severity was assessed by the triage nurse, doctor and child (depending on their age) using indicators of the RCEM Composite Pain Scale. This pain scale comprises a modified Wong-Baker FACES Pain Rating Scale (FACES Scale), a Behaviour scale and a numerical rating scale (Ladder)...
March 24, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28339735/triage-quality-control-is-missing-tools-a-new-observation-technique-for-ed-quality-improvement
#19
Tomi Malmström, Veli-Pekka Harjola, Paulus Torkki, Salla Kumpulainen, Raija Malmström
Objective: Correct assessment of patient urgency is critical to ensuring patient safety in emergency departments (EDs). Although significant time and effort have been devoted to developing triage systems, less attention has been paid to the development of quality control. The aim of this study is to introduce and test observation technique, which enables identifying of patient groups at risk of erroneous assessment in triage. The introduced technique is aimed to be less laborious to use than existing triage quality control methods...
February 23, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28338866/the-growing-challenge-of-major-trauma-in-older-people-a-role-for-comprehensive-geriatric-assessment
#20
James Michael Fisher, Charlotte Bates, Jay Banerjee
In this commentary article, we describe the impact that an ageing population is having on the nature of major trauma seen in emergency departments. The proportion of major trauma victims who are older people is rapidly increasing and a fall from standing is now the most common mechanism of injury in major trauma. Potential barriers to effective care of this patient group are highlighted, including: a lack of consensus regarding triage criteria; potentially misleading physiological parameters within triage criteria; non-linear patient presentations and diagnostic nihilism...
March 10, 2017: Age and Ageing
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