检索结果-南通市图书馆

World Journal of emergency medicine 2020年第4期11卷 255-257页

作者： Jenshen Cheng Susmita Roy Chowdhury Aliviya Dutta R Ponampalam singhealth emergency medicine residency programme Singapore Health ServicesSingapore Department of emergency medicine Singapore General HospitalSingapore

Dear editor,The coronavirus disease 2019(COVID-19)pandemic has enveloped the globe with ferocious pace,prompting lockdowns of countries and ***,up to one-third of the world’s population is living in some forms of coronavirus mass quarantine,which brings new and unprecedented challenges to healthcare systems *** of these is the potentially deleterious effects of physical inactivity due to enacted restrictions.

关键词： consequence prompt editor

Mobile technology:Usage and perspective of patients and caregivers presenting to a tertiary care emergency department

在线全文

学校读者我要写书评

暂无评论

World Journal of emergency medicine 2020年第1期11卷 5-11页

作者： Zhenghong Liu Mingwei Ng Dinesh V.Gunasekeran Huihua Li Kishanti Ponampalam R Ponampalam singhealth emergency medicine residency programme Singapore Health ServicesSingapore Ministry of Health Holdings Singapore Health Services Research Unit Singapore General HospitalSingapore University of Newcastle Australia Department of emergency medicine Singapore General HospitalSingapore

BACKGROUND:Developments in information technology(IT)have driven a push in healthcare innovation in the emergency department(ED).Many of these applications rely on mobile technology(MT)such as smartphones but not everyone is comfortable with MT *** study aims to characterize the technology usage behavior of users in the ED so as to guide the implementation of IT interventions in the ***:A cross-sectional survey was conducted in the emergency department of a tertiary *** and their caregivers aged 21 and above were *** survey collected demographic information,technology usage patterns,and participant reported comfort level in the usage of *** performed descriptive statistics and multivariate logistic regression to identify factors differentially associated with comfort in usage of ***:A total of 498 participants were recruited,and 299(60%)were *** was the most commonly written and read language(66.9%)and 64.2%reported a comfort level of 3/5 or more in using *** that were associated with being comfortable in using MT include having a tertiary education,being able to read and write English,as well as being a frequent user of *** were more likely to display these ***:A large proportion of ED patients are not comfortable in the usage of *** that predicted comfort level in the usage of MT were common amongst *** interventions should take this into consideration in the design of MT interventions.

关键词： Mobile health technology Information technology emergency department

Association between the elderly frequent attender to the emergency department and 30-day mortality： A retrospective study over 10 years

在线全文

学校读者我要写书评

暂无评论

World Journal of emergency medicine 2018年第1期9卷 20-25页

作者： Yuzeng Shen Yee Chien Tay Edward Wee Kwan Too Nan Liu Shao Wei Lam Marcus Eng Hock Ong Department of emergency medicine Singapore General Hospital Singapore Department of emergency medicine Sengkang Health Singapore Business Analytics program National University of Singapore Singapore singhealth Health Selvices Research Centre Singapore

BACKGROUND: To determine if elderly frequent attenders are associated with increased 30-day mortality, assess resource utilization by the elderly frequent attenders and identify associated characteristics that contribute to mortality. METHODS: Retrospective observational study of electronic clinical records of all emergency department(ED) visits over a 10-year period to an urban tertiary general hospital in Singapore. Patients aged 65 years and older, with 3 or more visits within a calendar year were identified. Outcomes measured include 30-day mortality, admission rate, admission diagnosis and duration spent at ED. Chi-square-tests were used to assess categorical factors and Student t-test was used to assess continuous variables on their association with being a frequent attender. Univariate and multivariate logistic regressions were conducted on all significant independent factors on to the outcome variable(30-day mortality), to determine factor independent odds ratios of being a frequent ***: 1.381 million attendance records were analyzed. Elderly patients accounted for 25.5% of all attendances, of which 31.3% are frequent attenders. Their 30-day mortality rate increased from 4.0% in the first visit, to 8.8% in the third visit, peaking at 10.2% in the sixth visit. Factors associated with mortality include patients with neoplasms, ambulance utilization, male gender and having attended the ED the previous ***: Elderly attenders have a higher 30-day mortality risk compared to the overall ED population, with mortality risk more marked for frequent attenders. This study illustrates the importance and need for interventions to address frequent ED visits by the elderly, especially in an aging society.

关键词： Frequent attenders Elderly emergency department Mortality

A case of phenibut withdrawal and treatment with baclofen

在线全文

学校读者我要写书评

暂无评论

World Journal of emergency medicine 2023年第4期14卷 338-340页

作者： Michael Morris James Espinosa Alan Lucerna Robin Lahr Department of emergency medicine Rowan University SOM/Jefferson StratfordNJ 08084USA emergency medicine residency program Director Rowan University SOM/Jefferson StratfordNJ 08084USA

Phenibut(β-phenyl-γ-aminobutyric acid)is a psychoactive gamma-aminobutyric acid(GABA)analog marketed online as a nutritional and nootropic(cognition enhancing)*** consumption poses a high risk of potential *** from phenibut mimics benzodiazepine and alcohol withdrawal and can be dangerous.A number of approaches have been described for phenibut withdrawal,including protocols that include baclofen,but for inpatient and outpatient *** we describe a 30-year-old male who presented to an emergency department(ED)with insomnia,anxiety and palpitations after he stopped taking phenibut.

关键词： treatment withdrawal alcohol

Handheld bedside ultrasound in the diagnosis of myocarditis

在线全文

学校读者我要写书评

暂无评论

World Journal of emergency medicine 2024年第1期15卷 73-74页

作者： Frank Wheeler Robin Lahr James Espinosa Alan Lucerna Henry Schuitema Department of emergency medicine Rowan University School of Osteopathic MedicineStratford 08084USA emergency medicine residency program Jeff erson HealthStratford 08084USA Department of emergency medicine and Associate Chief Medical Offi cer Stratford 08084USA

Myocarditis is a disease process that every emergency physician fears *** severity can be mild to life-threatening,and many cases are likely undetected because they are subclinical with nonspecifi c signs.[1]Subtle cardiac signs may be overshadowed by systemic symptoms of the underlying infectious ***,myalgias,lethargy,symptoms commonly associated with viral syndrome,can mask the life-threatening myocarditis that may be *** fact,in the United States Myocarditis Treatment Trial,almost 90%of patients reported symptoms consistent with a viral prodrome.[2]Ammirati et al[3]reported that 27%of patients with myocarditis had either reduced left ventricular ejection fraction,ventricular arrhythmias,or low cardiac ***,we present a case report,in which handheld point-of-care ultrasound was utilized at the bedside to aid in the critical diagnosis of *** the additional information provided through this imaging modality,this patient was able to be transferred to the appropriate tertiary care facility in an expeditious manner and receive possible defi nitive treatment.

关键词： diagnosis myocarditis Fever

Ileal inflammatory fibroid polyp causing chronic ileocolic intussusception and mimicking cecal carcinoma

在线全文

学校读者我要写书评

暂无评论

World Journal of Gastrointestinal Oncology 2009年第1期1卷 89-92页

作者： Naveen Gara John S Falzarano Whitney ML Limm Thomas S Namiki Laurie KS Tom Uinversity of Hawaii Internal medicine residency program

Inflammatory fibroid polyp(IFP) is a rare,idiopathic pseudotumorous lesion of the gastrointestinal *** mostly reported as solitary gastric lesions,multiple cases of small bowel IFPs are also *** is a documented cause of intussusception in *** the case reports of ileal inflammatory fibroid polyps with intussusception,an emergent presentation with small bowel obstruction has been most often *** we depict a case of ileal inflammatory fibroid polyp presenting with chronic intermittent ileocolic intussusception,anemia and weight loss with an endoscopic appearance mimicking necrotic cecal carcinoma.

关键词： Ileal polyp Colon cancer Endoscopy Intussusception Intussusception in elderly

Nanocarrier-mediated siRNA delivery:a new approach for the treatment of traumatic brain injury-related Alzheimer's disease

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Neural Regeneration Research 2025年第9期20卷 2538-2555页

作者： Jie Jin Huajing Zhang Qianying Lu Linqiang Tian Sanqiao Yao Feng Lai Yangfan Liang Chuanchuan Liu Yujia Lu Sijia Tian Yanmei Zhao Wenjie Ren Institute of Disaster and emergency medicine Tianjin UniversityTianjinChina Key Laboratory for Disaster medicine Technology TianjinChina Henan Medical Key Laboratory for Research of Trauma and Orthopedics The Third Affiliated Hospital of Xinxiang Medical UniversityXinxiangHenan ProvinceChina Clinical Medical Center of Tissue Engineering and Regeneration Xinxiang Medical UniversityXinxiangHenan ProvinceChina Institutes of Health Central Plain Xinxiang Medical UniversityXinxiangHenan ProvinceChina School of Public Health Xinxiang Medical UniversityXinxiangHenan ProvinceChina

Traumatic brain injury and Alzheimer's disease share pathological similarities,including neuronal loss,amyloid-βdeposition,tau hyperphosphorylation,blood-brain barrier dysfunction,neuroinflammation,and cognitive ***,traumatic brain injury can exacerbate Alzheimer's disease-like pathologies,potentially leading to the development of Alzheimer's *** offer a potential solution by facilitating the delive ry of small interfering RNAs across the blood-brain barrier for the targeted silencing of key pathological genes implicated in traumatic brain injury and Alzheimer's disease.U nlike traditional approaches to neuro regeneration,this is a molecula r-targeted strategy,thus avoiding non-specific drug *** review focuses on the use of nanocarrier systems for the efficient and precise delive ry of siRNAs,discussing the advantages,challenges,and future *** principle,siRNAs have the potential to target all genes and non-targetable protein s,holding significant promise for treating various *** the various therapeutic approaches currently available for neurological diseases,siRNA gene silencing can precisely"turn off"the expression of any gene at the genetic level,thus radically inhibiting disease progression;however,a significant challenge lies in delivering siRNAs across the blood-brain *** have received increasing attention as an innovative drug delive ry tool fo r the treatment of brain *** are considered a potential therapeutic strategy with the advantages of being able to cross the blood-brain barrier,targeted drug delivery,enhanced drug stability,and multifunctional *** use of nanoparticles to deliver specific modified siRNAs to the injured brain is gradually being recognized as a feasible and effective *** this strategy is still in the preclinical exploration stage,it is expected to achieve clinical translation in the future,creating a new field of molecular tar

关键词： blood-brain barrier cognitive dysfunction exosomes gene silencing immunotherapy inorganic nanomaterials liposome nanoparticles neuroinflammation polymer nanoparticles stem cells

A cadaveric model for transesophageal echocardiography transducer placement training: A pilot study

在线全文

学校读者我要写书评

暂无评论

World Journal of emergency medicine 2022年第1期13卷 18-22页

作者： Ryan W.Horton Kian R.Niknam Viveta Lobo Kathryn H.Pade Drew Jones Kenton L.Anderson Department of emergency medicine Stanford University School of MedicinePalo Alto 94304USA emergency medicine residency program University of Texas at Austin Dell Medical SchoolAustin 78756USA University of California San Francisco School of medicine San Francisco 94143USA Department of emergency medicine Rady Children’s HospitalSan Diego 92123USA Department of emergency medicine University of Central Florida/HCA Ocala RegionalOcala 34471USA

BACKGROUND: Transesophageal echocardiography(TEE) is used in the emergency department to guide resuscitation during cardiac arrest. Insertion of a TEE transducer requires manual skill and experience, yet in some residency programs cardiac arrest is uncommon, so some physicians may lack the means to acquire the manual skills to perform TEE in clinical practice. For other infrequently performed procedural skills, simulation models are used. However, there is currently no model that adequately simulates TEE transducer insertion. The aim of this study is to evaluate the feasibility and efficacy of using a cadaveric model to teach TEE transducer placement among novice ***: A convenience sample of emergency medicine residents was enrolled during a procedure education session using cadavers as tissue models. A pre-session assessment was used to determine prior knowledge and confidence regarding TEE manipulation. Participants subsequently attended a didactic and hands-on education session on TEE placement. All participants practised placing the TEE transducer until they were able to pass a standardized assessment of technical skill(SATS). After the educational session, participants completed a post-session assessment. RESULTS: Twenty-five residents participated in the training session. Mean assessment of knowledge improved from 6.2/10 to 8.7/10(95% confidence interval [CI] of knowledge difference 1.6–3.2, P<0.001) and confidence improved from 1.6/5 to 3.1/5(95% CI of confidence difference 1.1–2.0, P<0.001). There was no relationship between training level and the delta in knowledge or ***: In this pilot study, the use of a cadaveric model to teach TEE transducer placement methods among novice users is feasible and improves both TEE manipulation knowledge and confidence levels.

关键词： Cardiopulmonary resuscitation Echocardiography Education Simulation

Advocacy inquiry and circular questioning to maintain psychological safety in training,feedback,and conversations with residents

在线全文

学校读者我要写书评

暂无评论

emergency and Critical Care medicine 2024年第1期4卷 35-38页

作者： Fatimah Lateef Department of emergency medicine Singapore General HospitalSingaporeEmergency Medicine ResidencySingHealthSingaporeDuke-NUS Graduate Medical SchoolYong Loo Lin School of MedicineNational University of Singapore and Lee Kong Chian Medical SchoolNanyang Technological UniversitySingHealth Duke NUS Institute of Medical Simulation(SIMS)SingaporeDuke NUS Global Health InstituteSingapore.

Training of emergency physicians through an emergency medicine residency program takes 5 years,that is,3 years in junior residency and 2 years in senior *** this period,residents will be exposed to a variety of educational methodologies and meet a spectrum of faculty,supervisors,and teachers,who will have different personalities,styles,and approaches to teaching and nurturing *** is important to ensure the maintenance of psychological safety for these residents throughout their training journey and into the future years of practice s an emergency ***,interactions(which involve questioning),and presentations will be an important part of this training *** article looks at two modes of questioning:advocacy inquiry and circular questioning,which can be applied as *** two methods are examples in which faculty may consider adopting in their many interactions,follow-up,feedback,tutorials,facilitation,partnerships,and counseling sessions with *** two techniques offer options to maintain psychological safety,which can facilitate learners sharing and opening *** can be included in the faculty’s armamentarium of questioning techniques and applied where applicable.

关键词： Advocacy Circular questions emergency medicine Inquiry Residents

Hepatocellular carcinoma surveillance:An evidence-based approach

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastroenterology 2019年第13期25卷 1550-1559页

作者： Patrick S Harris Ross M Hansen Meagan E Gray Omar I Massoud Brendan M McGuire Mohamed G Shoreibah Tinsley Harrison Internal medicine residency program Department of Medicine University of Alabama at Birmingham Division of Gastroenterology and Hepatology Department of Medicine University of Alabama at Birmingham

Hepatocellular carcinoma(HCC) makes up 75%-85% of all primary liver cancers and is the fourth most common cause of cancer related death worldwide. Chronic liver disease is the most significant risk factor for HCC with 80%-90% of new cases occurring in the background of cirrhosis. Studies have shown that early diagnosis of HCC through surveillance programs improve prognosis and availability of curative therapies. All patients with cirrhosis and high-risk hepatitis B patients are at risk for HCC and should undergo surveillance. The recommended surveillance modality is abdominal ultrasound(US) given that it is cost effective and noninvasive with good sensitivity. However, US is limited in obese patients and those with non-alcoholic fatty liver disease(NAFLD). With the current obesity epidemic and rise in the prevalence of NAFLD, abdominal computed tomography or magnetic resonance imaging may be indicated as the primary screening modality in these patients. The addition of alpha-fetoprotein to a surveillance regimen is thought to improve the sensitivity of HCC *** investigation of serum biomarkers is needed. Semiannual screening is the suggested surveillance interval. Surveillance for HCC is underutilized and low adherence disproportionately affects certain demographics such as nonCaucasian race and low socioeconomic status.

关键词： Liver cancer Hepatocellular carcinoma Surveillance