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Procedures internal medicine

Michael J Peluso, Neo Tapela, John Langeveldt, Margaret E Williams, Kagiso Mochankana, Kebonye Motseosi, Brian Ricci, Adam Rodman, Cecil Haverkamp, Miriam Haverkamp, Rosa Maoto, Rebecca Luckett, Detlef Prozesky, Oathokwa Nkomazana, Tomer Barak
BACKGROUND: Medical internship is the final year of training before independent practice for most doctors in Botswana. Internship training in Botswana faces challenges including variability in participants' level of knowledge and skill related to their completion of medical school in a variety of settings (both foreign and domestic), lack of planned curricular content, and limited time for structured educational activities. Data on trainees' opinions regarding the content and delivery of graduate medical education in settings like Botswana are limited, which makes it difficult to revise programs in a learner-centered way...
April 30, 2018: Annals of Global Health
Delecia K Wood-Thompson, Callistus O A Enyuma, Abdullah E Laher
Introduction: Procedural sedation and analgesia allows the clinician to safely and efficiently administer sedation, analgesia, anxiolysis and sometimes amnesia to facilitate the performance of various procedures in the emergency centre. The aim of this study is to determine current sedation practices, common indications and major obstacles in selected emergency centres across Southern Gauteng, South Africa, with a view to improving future standards and practices. Methods: This was a prospective, questionnaire based, cross-sectional interview of emergency centre managers or their designee of selected private-sector and public-sector hospitals in Southern Gauteng...
March 2019: African Journal of Emergency Medicine Revue
Grace Y Yi, Ying Yan, Xiaomei Liao, Donna Spiegelman
Measurement error and misclassification have long been a concern in many fields, including medicine, administrative health care data, epidemiology, and survey sampling. It is known that measurement error and misclassification may seriously degrade the quality of estimation and inference, and should be avoided whenever possible. However, in practice, it is inevitable that measurements contain error for a variety of reasons. It is thus necessary to develop statistical strategies to cope with this issue. Although many inference methods have been proposed in the literature to address mis-measurement effects, some important issues remain unexplored...
December 15, 2018: International Journal of Biostatistics
Ahmed A Aljohaney
Introduction: Simulation-based training is gradually replacing the classic "apprenticeship" training model. Predictors of better performance of virtual reality simulation bronchoscopy are not clear. Objective: We aim to explore the predictors of performance of simulation bronchoscopy among novice bronchoscopists. Materials and methods: This is a descriptive observational cohort study conducted at King Abdulaziz University Clinical Skills and Simulation Center, Jeddah, Saudi Arabia...
2019: Advances in Medical Education and Practice
Sören Kottner, Sarah Schaerli, Martin Fürst, Wolfgang Ptacek, Michael Thali, Dominic Gascho
Two-dimensional photographic documentation is a substantial part of post-mortem examinations for legal investigations. Additional three-dimensional surface documentation has been shown to assist in the visualization of findings and contribute to the reconstruction of the sequence of events. However, 2D photo documentation and, especially, 3D surface documentation, are time-consuming procedures that require specially trained personnel. In this study a 3D imaging system, called VirtoScan-on-Rails, was developed to automate and facilitate 3D surface documentation for photo documentation in autopsy suites...
March 9, 2019: Forensic Science, Medicine, and Pathology
Nikoletta K Pianou, Petros Z Stavrou, Evangelia Vlontzou, Phivi Rondogianni, Demetrios N Exarhos, Ioannis E Datseris
Prostate cancer (PCa) is the most common solid cancer affecting men worldwide. Serum prostate-specific antigen (PSA) is at present the most commonly used biomarker for PCa screening, as well as a reliable marker of disease recurrence after initial treatment. Bone metastases (BM) are present in advanced stages of the disease. Imaging of BM is important not only for localization and characterization, but also to evaluate their size and number, as well as to follow-up the disease during and after therapy. Bone metastases formation is triggered by cancer initiating cells in the bone marrow and is facilitated by the release of several growth factors...
March 5, 2019: Hellenic Journal of Nuclear Medicine
Joshua D Hutcheson, Craig J Goergen, Frederick J Schoen, Masanori Aikawa, Peter Zilla, Elena Aikawa, Glenn R Gaudette
The first successful heart transplant 50 years ago by Dr.Christiaan Barnard in Cape Town, South Africa revolutionized cardiovascular medicine and research. Following this procedure, numerous other advances have reduced many contributors to cardiovascular morbidity and mortality; yet, cardiovascular disease remains the leading cause of death globally. Various unmet needs in cardiovascular medicine affect developing and underserved communities, where access to state-of-the-art advances remain out of reach. Addressing the remaining challenges in cardiovascular medicine in both developed and developing nations will require collaborative efforts from basic science researchers, engineers, industry, and clinicians...
2019: Frontiers in Cardiovascular Medicine
Nancy Denizard-Thompson, Kirsten B Feiereisel, Carolyn F Pedley, Cynthia Burns, Claudia Campos
Introduction: Although musculoskeletal (MSK) complaints are very common in ambulatory clinics, internal medicine residents report low confidence in performing MSK examinations and intra-articular steroid injections. Our goal is to strengthen residents' MSK competence by using visual, auditory, and kinesthetic educational modalities during an academic half-day session. Methods: Our intervention was a workshop/academic half-day session that included multimodal educational materials on common shoulder and knee MSK complaints...
September 15, 2018: MedEdPORTAL Publications
Dana Sall, Gregory W Wigger, Benjamin Kinnear, Matthew Kelleher, Eric Warm, Jennifer K O'Toole
Introduction: Structured procedural education and assessment of competency are growing needs for residency and fellowship programs. Simulation is a useful way to learn, experience, and practice procedural skills with competence. Paracentesis is a common procedure encountered in internal medicine. This educational resource for paracentesis education includes didactics, cases, and assessments to address cognitive skills, a simulation experience to address psychomotor procedural skills, and an entrustment-based assessment tool...
August 30, 2018: MedEdPORTAL Publications
Molly Rideout, William Raszka
Introduction: Volume depletion is a common problem in pediatrics. Interns need to be able to recognize critical illness such as hypovolemic shock, obtain access, and manage complications. This simulation case involves a child with hypovolemic shock who requires intraosseous (IO) needle placement. While designed for subinterns in pediatrics, it is relevant for clerkship students and interns in family medicine and emergency medicine. Methods: In this case, a 3-year-old child presents with vomiting, diarrhea, and lethargy, and is in hypovolemic shock...
March 16, 2018: MedEdPORTAL Publications
Peter C Rockers, Richard O Laing, Paul G Ashigbie, Monica A Onyango, Carol K Mukiira, Veronika J Wirtz
BACKGROUND: Novartis Access is a Novartis programme that offers a portfolio of non-communicable disease medicines at a wholesale price of US$1 per treatment per month in low-income and middle-income countries. We evaluated the effect of Novartis Access in Kenya, the first country to receive the programme. METHODS: We did a cluster-randomised controlled trial in eight counties in Kenya. Counties (clusters) were randomly assigned to the intervention or the control group with a covariate-constrained randomisation procedure that maximised balance on a set of demographic and health variables...
February 21, 2019: Lancet Global Health
Abdulaziz H Alathel, Linda Nott, Jennifer Bjazevic, Ben H Chew, Kenneth T Pace, Hassan Razvi
INTRODUCTION: Although general guidelines exist directing the management of new/novel oral anticoagulants (NOACs) in the perioperative period for open/endoscopic procedures, no consensus exists for those patients being considered for shock wave lithotripsy (SWL). In order to gauge current practice, we administered a survey to the international endourological community. METHODS: A web-based survey was sent to current Endourological Society members. Respondents were asked whether they would consider SWL in patients receiving NOACs; and if they used SWL how these agents were managed perioperatively...
February 22, 2019: Journal of Endourology
J Alasdair Millar
AIMS: Teriflunomide, used globally to treat multiple sclerosis (MS) and widely subsidised for this indication including in Australia and New Zealand, is the main metabolite of leflunomide, an older immune-modulating drug. Leflunomide therefore represents a potential alternative therapy for MS. Teriflunomide is about 50-500 times more expensive than leflunomide, depending on prices in each jurisdiction. I wished to study how this situation arose. METHODS: Web search to obtain the publicly available minutes of eight international regulatory bodies that have approved teriflunomide for the governments of the US, Canada, Europe, England, Scotland, Australia (TGA and PBS) and New Zealand, and examination of the processes and minuted discussions concerning the metabolic, efficacy, toxicity and cost relationship between teriflunomide and leflunomide...
February 22, 2019: New Zealand Medical Journal
Shangfei Yang, Kailai Nie, Hui Jiang, Liwen Feng, Wei Fan
PURPOSE: To compare the efficacy and safety of intraocular lens (IOL) repositioning and IOL exchange for the treatment of patients with IOL dislocation. METHODS: We systematically searched for relevant publications in English or Chinese in MEDLINE, Embase, the Cochrane Central Register of Controlled Trials, WHO International Clinical Trial Registration Platform, Clinical, China Biology Medicine Database, China National Knowledge Infrastructure Database and grey literature sources...
2019: PloS One
Tobias Brummaier, Basirudeen Syed Ahamed Kabeer, Stephen Lindow, Justin C Konje, Sasithon Pukrittayaamee, Juerg Utzinger, Mohammed Toufiq, Antonios Antoniou, Alexandra K Marr, Sangrawee Suriyakan, Tomoshige Kino, Souhaila Al Khodor, Annalisa Terranegra, François Nosten, Daniel H Paris, Rose McGready, Damien Chaussabel
INTRODUCTION: Preterm birth (PTB) results from heterogeneous influences and is a major contributor to neonatal mortality and morbidity that continues to have adverse effects on infants beyond the neonatal period. This protocol describes the procedures to determine molecular signatures predictive of PTB through high-frequency sampling during pregnancy, at delivery and the postpartum period. METHODS AND ANALYSIS: Four hundred first trimester pregnant women from either Myanmar or Thailand of either Karen or Burman ethnicity, with a viable, singleton pregnancy will be enrolled in this non-interventional, prospective pregnancy birth cohort study and will be followed through to the postpartum period...
January 15, 2019: BMJ Open
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
Barbara Sgorbini, Cecilia Cagliero, Stefano Acquadro, Arianna Marengo, Chiara Cordero, Erica Liberto, Carlo Bicchi, Patrizia Rubiolo
A correct botanical identification and analytical quality control of volatile key-markers responsible for aroma and biological activities is necessary to monitor volatile compounds transferred from a plant to the related herbal tea and human intake to guarantee their safe use. This is mainly true for markers limited by regulations or by a recommended maximum amount of consumption per day. GC-MS is the elective technique to analyze volatiles, provided that for aqueous samples (herbal teas) an appropriate sample preparation procedure, and/or a water-compatible GC stationary phases are applied...
February 6, 2019: Journal of Chromatography. A
Wolf Armbruster, Rüdiger Eichholz, Thomas Notheisen
Lung ultrasound is an underrated tool in preclinical emergency situations, intensive care units, ORs and emergency rooms. For certain clinical questions, there is a drastically higher sensitivity in comparison to chest X-ray examinations (sensitivity in pneumothorax diagnostics 86 vs. 28%, specificity 97 vs. 100%. A standardized examination improves the quality of the ultrasound examination and thus the diagnostic value. The article provides basic information on pulmonary ultrasound and aims to highlight the superiority of ultrasound over x-ray procedures for anesthesia, intensive care and emergency medicine in accordance to the international evidence-based recommendations for point of care ultrasound...
February 2019: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
Ruth Kleinpell, Curtis N Sessler, Clareen Wiencek, Marc Moss
OBJECTIVES: Over-utilization of tests, treatments, and procedures is common for hospitalized patients in ICU settings. American Board of Internal Medicine Foundation's Choosing Wisely campaign tasked professional societies to identify sources of overuse in specialty care practice. The purpose of this study was to assess how critical care clinicians were implementing the Critical Care Societies Collaborative Choosing Wisely recommendations in clinical practice. DESIGN: Descriptive survey methodology with use of Research Electronic Data Capture (https://projectredcap...
March 2019: Critical Care Medicine
Alexandre Lafleur, Gabriel Demchuk, Marie-Laurence Tremblay, Caroline Simard, Étienne Rivière
BACKGROUND: In self-regulated procedural simulation, learners practise on many simulators (e.g. paracentesis), self-regulating their choice of simulators, time and goals. Current needs assessments cannot predict the number of simulators needed to plan cost-effective self-regulated simulation. Knowing the ratios of simulators and participants would allow for better-informed purchase decisions to be made. METHODS: We designed 90-minute sessions of self-regulated procedural simulation for internal medicine residents...
February 13, 2019: Clinical Teacher
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