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Emergency Medicin

Sundas Khan, Safiya Richardson, Andrew Liu, Vinodh Mechery, Lauren McCullagh, Andy Schachter, Salvatore Pardo, Thomas McGinn
BACKGROUND: Successful clinical decision support (CDS) tools can help use evidence-based medicine to effectively improve patient outcomes. However, the impact of these tools has been limited by low provider adoption due to overtriggering, leading to alert fatigue. We developed a tracking mechanism for monitoring trigger (percent of total visits for which the tool triggers) and adoption (percent of completed tools) rates of a complex CDS tool based on the Wells criteria for pulmonary embolism (PE)...
February 20, 2019: JMIR Human Factors
Min Gao, Hao Ou, Yu Jiang, Kangkai Wang, Yue Peng, Huali Zhang, Mingshi Yang, Xianzhong Xiao
BACKGROUND: The importance of sepsis-induced immunosuppression and its contribution to mortality has recently emerged. In this study we examined the effects of Tanshinone II-A (TSN), a widely used traditional Chinese medicine, on immunosuppression in experimental peritonitis induced septic mice. MATERIALS AND METHODS: Sepsis was achieved by means of cecal ligation and puncture (CLP). TSN at different doses (5, 15 and 45 mg/kg, i.p.) were used at different time-points (0, 3, 6 and 12 h) after CLP to evaluate its effect on the survival of septic mice...
February 19, 2019: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
Susana Junqueira-Neto, Inês A Batista, José Luís Costa, Sónia A Melo
Liquid biopsy represents the analysis of tumor-derived material in the blood and other body fluids of cancer patients. This portrays a minimally invasive detection tool for molecular biomarkers. Liquid biopsy has emerged as a complementary or alternative method to surgical biopsy. This non-invasive detection tool overcomes the recurrent problems in the clinical assessment of tumors that stem from the lack of accessibility to the tumor tissue and its clonal heterogeneity. Moreover, body fluid-derived components have shown to reflect the genetic profile of both primary and metastatic lesions and provide a real-time monitoring of tumor dynamics, representing a great promise for personalized medicine...
February 15, 2019: Acta Cytologica
Deogratius Bintabara, Alex Ernest, Bonaventura Mpondo
OBJECTIVE: This study used a nationally representative sample from Tanzania as an example of low-resource setting with a high burden of maternal and newborn deaths, to assess the availability and readiness of health facilities to provide basic emergency obstetric and newborn care (BEmONC) and its associated factors. DESIGN: Health facility-based cross-sectional survey. SETTING: We analysed data for obstetric and newborn care services obtained from the 2014-2015 Tanzania Service Provision Assessment survey, using WHO-Service Availability and Readiness Assessment tool...
February 19, 2019: BMJ Open
Amity E Quinn, Alun Edwards, Peter Senior, Kerry A McBrien, Brenda R Hemmelgarn, Marcello Tonelli, Flora Au, Zhihai Ma, Robert G Weaver, Braden J Manns
BACKGROUND: As the number of people with chronic diseases increases, understanding the impact of payment model on the types of patients seen by specialists has implications for improving the quality and value of care. We sought to determine if there is an association between specialist physician payment model and the types of patients seen. METHODS: In this descriptive study, we used administrative data to compare demographic characteristics, illness severity and visit indication of patients with diabetes seen by fee-for-service and salary-based internal medicine and diabetes specialists in Calgary and Edmonton between April 2011 and September 2014...
January 2019: CMAJ Open
Jai N Darvall, Sabine Braat, David A Story, Kate Greentree, Tony Bose, Joel Loth, Wen K Lim
INTRODUCTION: Frailty is of increasing importance to perioperative and critical care medicine, as the proportion of older patients increases globally. Evidence continues to emerge of the considerable impact frailty has on adverse outcomes from both surgery and critical care, which has led to a proliferation of different frailty measurement tools in recent years. Despite this, there remains a lack of easily implemented, comprehensive frailty assessment tools specific to these complex populations...
January 9, 2019: BMJ Open
Yuri T Jadotte, Heather B Leisy, Kimberly Noel, Dorothy S Lane
No abstract text is available yet for this article.
February 16, 2019: American Journal of Preventive Medicine
Jae-Uk Sul, Myung Kwan Kim, Jungtae Leem, Hee-Geun Jo, Sang-Hoon Yoon, Jeeyong Kim, Eun-Jung Lee, Jeong-Eun Yoo, So Jung Park, Young Il Kim, Eunseok Kim, In Chul Jung, Ju-Hyun Jeon, Yang-Chun Park
BACKGROUND: Degenerative knee osteoarthritis is a leading cause of disability in the elderly. If patients do not respond to pharmacological or nonpharmacological intervention, total knee replacement surgery is recommended. However, owing to the contraindications and adverse effects of surgery, the need for a new treatment strategy is emerging. Traditional herbal medicine is a widely used intervention in east Asia to treat knee osteoarthritis. Gyejigachulbutang is one of the frequently prescribed herbal formulae...
February 19, 2019: Trials
C Dawes, D T W Wong
The objective of this article was to provide an account of some of the developments related to saliva over the first 100 years of the Journal of Dental Research and to outline some of the many biomarkers identified in saliva in the last few years. The first section covers findings in salivary physiology, biochemistry, calcium phosphate chemistry related to saliva, microbiology, and the role of saliva in maintaining oral health. The second section highlights salivary diagnostics, salivaomics, and saliva exosomics in the context of the emerging theme of personalized and precision medicine...
February 2019: Journal of Dental Research
Maria Olenick, Monica Flowers, Teresa Muñecas, Tatayana Maltseva
Background: This study explored the positive and negative factors that influence interprofessional education (IPE) implementation in health care education programs across the United States. Methods: The study sample consisted of 439 (response rate 8.4%) health care faculties from seven health care professions (nursing, medicine, pharmacy, physical therapy, occupational therapy, physician assistant, and social work) who were asked what the positive and negative factors are that influence their decisions to engage in IPE...
February 16, 2019: Healthcare (Basel, Switzerland)
Tsu-Hsiang Kuo, Yueh-Hsiung Kuo, Chun-Yu Cho, Chih-Jung Yao, Gi-Ming Lai, Shuang-En Chuang
Radiotherapy for treatment of hepatocellular carcinoma causes severe side effects, including acute hepatitis and chronic fibrosis. Complementary and alternative medicine (CAM) has emerged as an important part of integrative medicine in the management of diseases. Antrodia cinnamomea (AC), a valuable medicinal fungus originally found only in Taiwan, has been shown to possess anti-oxidation, vaso-relaxtation, anti-inflammation, anti-hepatitis, and anti-cancer effects. In this paper we evaluate the protective effects of ethanol extract of Antrodia cinnamomea (ACE) against radiotoxicity both in normal liver cell line CL48 and in tumor-bearing mice...
February 15, 2019: International Journal of Molecular Sciences
Victoria S S Wong, Matthew Stevenson, Jared Mott, Kinshuk Sahaya
PURPOSE: The prevalence and characteristics of seizure and epilepsy research published in nonneurology journals are unknown. Characterizing this published research allows for insight into the relevance of seizures and epilepsy in other specialties and may increase opportunity for cross-specialty collaboration. METHODS: In this observational study, we reviewed the top five highly cited clinical journals within eleven specialties in the InCites Journal Citation Reports (JCR) database (2016)...
February 16, 2019: Epilepsy & Behavior: E&B
Paul M Lu, Elizabeth E Park, Tracy L Rabin, Jeremy I Schwartz, Lee S Shearer, Eugenia L Siegler, Robert N Peck
BACKGROUND: The prevalence of global health in graduate medical education in the United States (US) has soared over the past two decades. The majority of US internal medicine and pediatric residency programs now offer global health electives abroad. Despite the prevalence of global health electives among US graduate medical programs today, challenges exist that may impact the experience for visiting trainees and/or host institutions. Previous reviews have predominately focused on experiences of undergraduate medical students and have primarily described positive outcomes...
November 5, 2018: Annals of Global Health
Anne M Libby, Kerryann B Broderick, Richard D Zane
No abstract text is available yet for this article.
February 19, 2019: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Lucas F Garcia, Marcia S Fernandes, Jonathan D Moreno, Jose R Goldim
OBJECTIVE: To present a narrative review of the history of bioethics in Latin America and of scientific output in this interdisciplinary field. METHODS: This was a mixed-methods study. RESULTS: A total of 1458 records were retrieved, of which 1167 met the inclusion criteria. According to the Web of Science classification, the predominant topics of study were medical ethics (n= 488), social sciences and medicine (n= 354), and environmental and public health topics (n= 279)...
February 18, 2019: Journal of Bioethical Inquiry
Jessica Pflipsen, Cian McDermott, Eva Mary Doherty, Niamh Humphries
BACKGROUND: In recent years, attrition from Emergency Medicine (EM) training in Ireland has increased. Australian data illustrates that increasing numbers of Irish-trained doctors are embarking on EM training in Australia. This has implications for EM in Ireland, particularly for Emergency Departments already under strain. An adequate supply of qualified specialist EM doctors is essential to provide high-quality patient care. AIMS: The aim of this study is to gain insights into the reasons for attrition from EM training in Ireland...
February 18, 2019: Irish Journal of Medical Science
Chun-Chuan Shih, Chun-Chieh Yeh, Jen-Lin Yang, Hsin-Long Lane, Chien-Jung Huang, Jaung-Geng Lin, Ta-Liang Chen, Chien-Chang Liao
BACKGROUND: The effect of traditional Chinese medicine (TCM) on the outcomes of dementia remains unclear. Our purpose is to compare the use of emergency care and hospitalization in patients with post-stroke cognitive impairment (PSCI) with or without treatment of TCM. METHODS: In a stroke cohort of 67521 patients with PSCI aged over 40 years obtained from the 23 million people in Taiwan's national health insurance between 2000 and 2007, we identified 6661 newly diagnosed PSCI patients who were treated with TCM and 6661 propensity score-matched PSCI patients who were not treated with TCM...
February 18, 2019: QJM: Monthly Journal of the Association of Physicians
Freda DeKeyser Ganz, Ilana Margalith, Julie Benbenishty, Miriam Hirschfeld, Nurit Wagner, Orly Toren
PURPOSE: The purpose of this study was to determine the willingness of Israeli registered nurses to work under threatening conditions, their perceived level of threat, and perceptions of peer willingness to report to work. DESIGN: This descriptive study was based on a convenience sample of registered nurses working in four hospitals throughout Israel from internal medicine, surgical, emergency, and intensive care units. METHODS: A questionnaire designed by the investigators was administered to registered nurses while on duty...
February 18, 2019: Journal of Nursing Scholarship
Francis T Delaney, Emma L Gray, Joseph C Lee
We present a case of lung cancer incidentally detected as a pulmonary nodule on computed tomography attenuation correction (CTAC) images during myocardial perfusion scintigraphy (MPS). Unfortunately, the incidental lesion was not fully investigated following MPS report and had developed into metastatic lung carcinoma when diagnosed over 1 year later, with failure of subsequent emergent chemotherapy. The disease appeared to be localized when initially detected during MPS. This case highlights the importance and potential clinical value of routine review of CTAC images in MPS with appropriate reporting and further investigation of suspicious incidental findings...
January 2019: World Journal of Nuclear Medicine
Lehe Yang, Jifa Li, Lingyuan Xu, Shichong Lin, Youqun Xiang, Xuanxuan Dai, Guang Liang, Xiaoying Huang, Jiandong Zhu, Chengguang Zhao
Background: Non-small-cell lung cancer (NSCLC) comprises about 85% of all lung cancers and is usually diagnosed at an advanced stage with poor prognosis. The IL-6/STAT3 signaling pathway plays a pivotal role in NSCLC biology. Rhein is a lipophilic anthraquinone extensively found in medicinal herbs. Emerging evidence suggests that Rhein has significant antitumor effects, supporting the potential uses of Rhein as an antitumor agent. Methods: Cell viability and colony formation were performed to examine Rhein's potent anti-proliferative effect in human NSCLC cell lines PC-9, H460 and A549...
2019: Cancer Management and Research
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