Medicine by Alexandros G.Sfakianakis,Anapafseos 5 Agios Nikolaos,Crete 72100,Greece,tel :00302841026: 04/18/16

Δευτέρα 18 Απριλίου 2016

Single-level versus multiple-level lumbar disc arthroplasty: a prospective study with 24-months follow-up

BACKGROUND CONTEXT: Low back pain is one of the most prevalent spinal problems in the Western world and is only set to increase as the population ages. Degenerative disc disease is a significant contributor. Lumbar disc replacement (LDR) aims to preserve motion and avoid fusion-related complications.

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Flowcytometric evaluation of intraoperative salvaged blood filtered with leucocyte depletion filter in metastatic spine tumour surgery

BACKGROUND CONTEXT: Intra-operative cell salvage (IOCS) has not been widely adopted in oncological surgery due to hypothetical concerns of reinfusing malignant cells.

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High-grade anal intraepithelial neoplasia: Progression to invasive cancer is not a certainty

The incidences of high-grade anal intraepithelial neoplasia (HSIL) and superficially invasive squamous cell carcinomas (SISCCA) related to human papillomavirus (HPV) have increased. These lesions can progress to invasive anal cancer. The aim of the study was to assess the clinical outcome with a special focus on the healing rate.

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Computed tomography in evaluating gastroesophageal varices in patients with portal hypertension: A meta-analysis

Gastroesophageal varices (GOV) is a common complication in patients with portal hypertension. We conducted a meta-analysis in attempt to evaluate the diagnostic accuracy of computed tomography (CT) as a noninvasive imaging tool for identifying GOV in reference to esophagogastroduodenoscopy (EGD).

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Defining and improving the genome-wide specificities of CRISPR–Cas9 nucleases

Nature Reviews Genetics 17, 300 (2016). doi:10.1038/nrg.2016.28

Authors: Shengdar Q. Tsai & J. Keith Joung

CRISPR–Cas9 RNA-guided nucleases are a transformative technology for biology, genetics and medicine owing to the simplicity with which they can be programmed to cleave specific DNA target sites in living cells and organisms. However, to translate these powerful molecular tools into safe, effective clinical applications,

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Development: A colourful map of cell fate

Nature Reviews Genetics 17, 252 (2016). doi:10.1038/nrg.2016.48

Author: Denise Waldron

Researchers have engineered a multicoloured zebrafish that produces skin cells in over 70 distinguishable colours, enabling tracking of the behavioural dynamics of hundreds of individual epithelial cells during skin regeneration in vivo.The transgenic zebrafish system called skinbow is based on a previously published

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Endogenous microRNA sponges: evidence and controversy

Nature Reviews Genetics 17, 272 (2016). doi:10.1038/nrg.2016.20

Authors: Daniel W. Thomson & Marcel E. Dinger

The competitive endogenous RNA (ceRNA) hypothesis proposes that transcripts with shared microRNA (miRNA) binding sites compete for post-transcriptional control. This hypothesis has gained substantial attention as a unifying function for long non-coding RNAs, pseudogene transcripts and circular RNAs, as well as an alternative function for

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Gene regulation: Optical control of epigenetics

Nature Reviews Genetics 17, 254 (2016). doi:10.1038/nrg.2016.40

Author: Ross Cloney

Reis et al. present chemo-optical modulation of epigenetically regulated transcription (COMET), a new conceptual approach that harnesses the strengths of small-molecule inhibitors and optogenetic techniques to control the epigenome using light.Pharmacological small molecules and optogenetics are powerful tools to interrogate the epigenetic regulatory

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Technique: Transcript tracking by CRISPR

Nature Reviews Genetics 17, 254 (2016). doi:10.1038/nrg.2016.41

Author: Darren J. Burgess

RNA transcription, processing and trafficking are key steps in gene expression, hence tracking particular RNAs in living cells can provide valuable biological insights. A new study adapts the CRISPR–Cas9 genome-editing system to act as a programmable real-time transcript probe.The most common method for characterizing

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Resource: A comprehensive catalogue of human RNA-binding protein reagents

Nature Reviews Genetics 17, 255 (2016). doi:10.1038/nrg.2016.42

Author: Linda Koch

A new resource of validated antibodies and short hairpin RNA (shRNA) constructs that recognize and target human RNA-binding proteins (RBPs) promises to help foster our understanding of RBP function. Sundararaman et al. tested the efficiency and specificity of 700 commercially available antibodies for 535

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Bioinformatics: Taking the epigenome to another dimension

Nature Reviews Genetics 17, 255 (2016). doi:10.1038/nrg.2016.44

Author: Linda Koch

A new algorithm called EpiTensor can infer 3D genomic contacts from 1D maps of epigenomic data. The team analysed 16 histone modifications, DNase I sequencing and RNA sequencing data in five cell types to identify spatial patterns within topologically associating domains (TADs) at a resolution

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Genetic variation: New tool to map genetic modifiers of transcription factor–gene target connections

Nature Reviews Genetics 17, 255 (2016). doi:10.1038/nrg.2016.43

Author: Linda Koch

Fazlollahi et al. have developed a computational approach to determine genetic variants that affect the functional interactions of gene regulatory networks. Using this algorithm, the team were able to map so-called connectivity quantitative trait loci (cQTLs). These cQTLs are natural genetic variants that influence

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Technique: Unwanted sequences DASH off

Nature Reviews Genetics 17, 252 (2016). doi:10.1038/nrg.2016.37

Author: Linda Koch

A new method called DASH (Depletion of Abundant Sequences by Hybridization) exploits the unique properties of the endonuclease Cas9 to target and prevent the amplification of unwanted sequences during next-generation sequencing (NGS) protocols, enabling enrichment of rare and less abundant non-targeted sequences in NGS libraries

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Genetic testing: Whole-exome sequencing for clinical diagnostics

Nature Reviews Genetics 17, 252 (2016). doi:10.1038/nrg.2016.38

Author: Linda Koch

A prospective study has found that singleton whole-exome sequencing (WES) as a first-tier test in infants with suspected monogenic genetic disorders outperforms standard care. The team compared the rate of diagnosis, clinical utility and impact on management of singleton WES with that of standard investigations,

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Reprogramming: Your contacts reveal your past

Nature Reviews Genetics 17, 253 (2016). doi:10.1038/nrg.2016.35

Author: Darren J. Burgess

Reprogramming differentiated cells into induced pluripotent stem cells (iPSCs) holds promise for generating patient-specific cells for regenerative medicine. However, transcriptomics and DNA-methylation analyses have revealed that iPSCs typically retain a subtle molecular 'memory' of their cell-type of origin, which then favours subsequent differentiation towards the

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Genetic testing: Clinical sequencing right on target

Nature Reviews Genetics 17, 253 (2016). doi:10.1038/nrg.2016.34

Author: Denise Waldron

As genome sequencing moves from the research laboratory to the clinic, the accuracy of variant calls used in diagnoses is increasingly important. In a new study published in Genome Medicine, Goldfeder et al. reveal that many disease-associated genes and variants lie within areas

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High-grade anal intraepithelial neoplasia: Progression to invasive cancer is not a certainty

Computed tomography in evaluating gastroesophageal varices in patients with portal hypertension: A meta-analysis

Colonic small cell neuroendocrine carcinoma in a patient with long-standing ulcerative colitis treated with azathioprine

We report the case of a patient with long-standing ulcerative colitis (UC) treated with Azathioprine (AZA) who developed a neuroendocrine small cell carcinoma arising from the sigmoid colon.

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Translating RNA sequencing into clinical diagnostics: opportunities and challenges

Nature Reviews Genetics 17, 257 (2016). doi:10.1038/nrg.2016.10

Authors: Sara A. Byron, Kendall R. Van Keuren-Jensen, David M. Engelthaler, John D. Carpten & David W. Craig

With the emergence of RNA sequencing (RNA-seq) technologies, RNA-based biomolecules hold expanded promise for their diagnostic, prognostic and therapeutic applicability in various diseases, including cancers and infectious diseases. Detection of gene fusions and differential expression of known disease-causing transcripts by RNA-seq represent some of the

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Complex disease: A global view of regulatory networks

Nature Reviews Genetics 17, 252 (2016). doi:10.1038/nrg.2016.36

Author: Linda Koch

Marbach et al. have developed a novel resource of 394 human cell type- and tissue-specific gene regulatory networks, representing 146 different cell types, 111 tissues and 137 cell lines. Transcriptional regulatory circuits were inferred on the basis of expression profiles of enhancers and promoters,

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Memory for Allergies and Health Foods: How Younger and Older Adults Strategically Remember Critical Health Information

Objectives:

While older adults often display memory deficits, with practice, they can sometimes selectively remember valuable information at the expense of less value information. We examined age-related differences and similarities in memory for health-related information under conditions where some information was critical to remember.

Method:

In Experiment 1, participants studied 3 lists of allergens, ranging in severity from 0 (not a health risk) to 10 (potentially fatal), with the instruction that it was particularly important to remember items to which a fictional relative was most severely allergic. After each list, participants received feedback regarding their recall of the high-value allergens. Experiment 2 examined memory for health benefits, presenting foods that were potentially beneficial to the relative's immune system.

Results:

While younger adults exhibited better overall memory for the allergens, both age groups in Experiment 1 developed improved selectivity across the lists, with no evident age differences in severe allergen recall by List 2. Selectivity also developed in Experiment 2, although age differences for items of high health benefit were present.

Discussion:

The results have implications for models of selective memory in older age, and for how aging influences the ability to strategically remember important information within health-related contexts.

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Associations Between Perceived Support in Older Adult Marriages and Dyadic Covariations in Momentary Affect and Aches

Objectives:

Spousal support within marriage may be particularly important in old age when spouses become more likely to rely on each other's help. However, spousal support does not have to be unanimously positive. In fact, very little is known about covariations in spousal affect and aches as couples engage in their daily routines and environments.

Method:

Up to 27 simultaneous, momentary assessments from 49 older adult married couples (M age = 72 years [60–83]; M relationship duration = 42 years) were used taking into account the perspective of both partners.

Results:

This study shows that social support within marriage was associated with reduced overall levels of negative affect (NA) but unrelated to positive affect (PA). Interestingly, high spousal support was both associated with reduced overall NA means but also with an increased covariation in NA between partners. No similar covariations were observed for aches and PA.

Discussion:

Spousal support may be a double-edged sword; it is associated with reduced overall NA, but it may also lead to more permeable boundaries between spouses that seem to be specific to NA.

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Psychological

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Are Volunteer Satisfaction and Enjoyment Related to Cessation of Volunteering by Older Adults?

Objectives:

Previous research indicates that volunteer satisfaction and enjoyment do not exert direct effects on the cessation of volunteering by older adults. This study examined whether satisfaction with and enjoyment of volunteering indirectly affect volunteer cessation via hours volunteered.

Method:

Our sample consisted of participants in the Americans' Changing Lives study (N = 380) who were 65 years old and older and who volunteered at Wave 1. Volunteer satisfaction, volunteer enjoyment, hours volunteered, and several covariates were assessed at Wave 1, and volunteer cessation was assessed 3 years later at Wave 2.

Results:

Volunteer satisfaction and volunteer enjoyment were positively associated with hours volunteered, and more hours volunteered was associated with decreased likelihood of volunteer cessation. The indirect effects of volunteer satisfaction and volunteer enjoyment on volunteer cessation via hours volunteered were –.023 (p = .059) and –.036 (p = .015), respectively.

Discussion:

The dynamics of volunteer cessation are important because a volunteer shortage is forecasted and because the benefits of volunteering may attenuate when volunteering stops. Future research should test the proposed causal sequence using longitudinal data with at least 3 waves.

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Social

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Association of Hearing Impairment and Emotional Vitality in Older Adults

Objectives:

To better understand the potential impact of hearing impairment (HI) and hearing aid use on emotional vitality and mental health in older adults.

Method:

We investigated the cross-sectional association of HI with emotional vitality in 1,903 adults aged 76–85 years in the Health ABC study adjusted for demographic and cardiovascular risk factors. Hearing was defined by the speech frequency pure tone average (no impairment < 25 dB, mild impairment 25–40 dB, and moderate or greater impairment > 40 dB). Emotional vitality was defined as having a high sense of personal mastery, happiness, low depressive symptomatology, and low anxiety.

Results:

Compared with individuals with no HI, participants with moderate or greater HI had a 23% lower odds of emotional vitality (odds ratio [OR] = 0.77; 95% confidence interval [CI]: 0.59–0.99). Hearing aid use was not associated with better emotional vitality (OR = 0.98; 95% CI: 0.81–1.20).

Discussion:

HI is associated with lower odds of emotional vitality in older adults. Further studies are needed to examine the longitudinal impact of HI on mental health and well-being.

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Social Sciences Table of Content

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Subjective Age and Health in Later Life: The Role of Posttraumatic Symptoms

Objectives:

We examined: (a) long-term effects of war-related trauma and captivity on posttraumatic stress symptoms (PTSS), physical health, and subjective age; and (b) the moderation effect of PTSS and health on subjective age among ex-prisoners of war (ex-POWs) and war veterans.

Method:

Israeli veterans of the 1973 Yom Kippur War (mean age 57 years), including 111 ex-POWs and 167 matched veterans were assessed for subjective age, war-related PTSS, and health-related measures (physical symptoms, somatization, health-risk behaviors, and self-rated health).

Results:

Controlling for age, ex-POWs endorsed higher subjective age than controls, and ex-POWs with posttraumatic stress disorder (PTSD) endorsed higher subjective age than ex-POWs and controls without PTSD. PTSS and health measures besides health-risk behaviors predicted subjective age. Significant interactions were found between PTSS and each health measure, suggesting that health only predicts subjective age for those reporting high PTSS.

Discussion:

PTSS appear to be implicated in the link between health measures and subjective age in later life, pointing to the long-term effect of captivity and war-induced traumatic distress on aging.

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Subscriptions

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Find Telrepco at booth #14 at the CT Conference of Municipalities Emergency Management Symposium on April 28

We hope to see you next week at CT Conference of Municipalities Emergency Management Symposium on April 28th at the Radisson Hotel in Cromwell, CT! We will be at Booth # 14 displaying new and refurbished Panasonic Toughbooks and related accessories, the new Panasonic Arbitrator Body Worn Camera, as well as new Getac ruggedized laptops and tablets. We will also be holding a table raffle for a $100 Visa ...

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Changes in Sleep Predict Changes in Affect in Older Caregivers of Individuals with Alzheimers Dementia: A Multilevel Model Approach

Objectives:

Understanding predictors of older dementia caregivers' mood could provide insight into potential treatments which may delay institutionalization of their care recipient. Research with older noncaregivers has shown that nights characterized by better subjective sleep were associated with days characterized by higher positive and lower negative affect, and vice versa. Examining daily relationships is important, as sleep and affect are state-like behaviors that fluctuate within individuals, across time. This study was a preliminary examination of whether a sample with a greater proportion of older dementia caregivers exhibits similar daily sleep/affect associations.

Methods:

Sleep diaries, actigraphy, and affect data were collected concurrently for 7 days in 55 community-dwelling, dementia caregivers (M = 62.80 years, SD = 12.21; 77.8% female). Sleep and affect were examined within- (day-to-day level) and between-persons (mean level).

Results:

Findings for older noncaregivers were replicated for negative affect only. Specifically, nights characterized by better subjective sleep were characterized by lower negative affect, and vice versa.

Discussion:

Examining older caregivers' daily sleep/affect association is important, because caregiving-related awakenings are unavoidable, often unpredictable, and can impact mood. Future research is needed to examine whether regularization in awakenings and/or negative affect represent important secondary, or even target, treatment outcomes for this vulnerable population.

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Cardiorespiratory Fitness Is Associated With Cognitive Performance in Older But Not Younger Adults

Objectives:

Aging is associated with declines in executive function and episodic memory. Cardiorespiratory fitness (CRF) has been associated with enhanced executive function in older adults (OA), but the relationship with episodic memory remains unclear. The purpose of the study was to examine the relationship between CRF and cognition in young and OA and whether CRF mitigates age-related cognitive decline.

Methods:

Participants completed exercise testing to evaluate CRF (peak VO₂) and neuropsychological testing to assess cognition.

Results:

In OA, peak VO₂ was positively related to executive function, as well as to accuracy on an experimental face–name memory task and visual episodic memory. In young adults (YA), a relationship between peak VO₂ and cognition was not evident. High-fit OA performed as well as YA on executive function measures. On episodic memory measures, YA performed better than high-fit OA, who in turn performed better than low-fit OA.

Conclusions:

CRF is positively associated with executive function and episodic memory in OA and attenuates age-related cognitive decline. We provide preliminary support for the age-dependence hypothesis, which posits that cognition and CRF relationships may be most readily observed during lifetime periods of significant neurocognitive development.

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Social Disadvantage and Social Isolation Are Associated With a Higher Resting Heart Rate: Evidence From The Irish Longitudinal Study on Ageing

Objectives:

A high resting heart rate (RHR) represents a major risk factor for cardiovascular disease and individuals from poorer backgrounds have a higher RHR compared with their more advantaged peers. This study investigates the pathways through which low socioeconomic status (SES) contributes to a higher RHR.

Method:

The sample involved data for 4,888 respondents who were participating in the first wave of The Irish Longitudinal Study on Ageing. Respondents completed a detailed interview at home and underwent a 5-min baseline electrocardiograph recording as part of a clinic-based health assessment. SES was indexed using household income.

Results:

The mean difference in RHR between those at polarized ends of the income distribution was 2.80 beats per minute (bpm) (95% CI = 1.54, 4.06; p < .001), with the magnitude of the socioeconomic differential being greater for men (4.15 bpm; 95% CI = 2.18, 6.12; p < .001) compared with women (1.57 bpm; 95% CI = 0.04, 3.10; p < .05). Psychosocial factors including social network size and loneliness accounted for a sizeable proportion of the socioeconomic differential in RHR, particularly among men.

Discussion:

The finding that poorer people have a higher RHR reinforces the need for additional research exploring the pathways through which social inequalities are translated into biological inequalities.

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Authors Reply to Letter to the Editor From Dr. Bliwise (re: "Sleep Architecture and Mental Health Among Community-dwelling Older Men")

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Wisdom at the End of Life: An Analysis of Mediating and Moderating Relations Between Wisdom and Subjective Well-Being

Objectives:

Several studies have shown that wisdom, measured as an integration of cognitive, reflective, and compassionate dimensions, is positively related to subjective well-being in old age. This study investigated whether wisdom might be particularly beneficial for people at the end of life, when extrinsic means to increase well-being largely disappear, and whether the association between wisdom and well-being is mediated by mastery and purpose in life.

Methods:

Samples of 156 older community residents (M = 71 years) and 41 older hospice patients and nursing home residents (M = 77 years) were analyzed, using a moderated and mediated path model.

Results:

(a) Wisdom was positively related to subjective well-being in the later years, even after controlling for physical health, socioeconomic status, financial situation, social involvement, age, gender, race, and marital status. (b) The association between wisdom and well-being was significantly stronger in the nursing home and hospice sample than the community sample. (c) The relation between wisdom and well-being was partially mediated by purpose in life, both directly and via a sense of mastery.

Conclusion:

Aging well at the end of life might depend to a larger extent on psychosocial growth across the life course than on present circumstances.

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Remember 2 Things: Improving stroke recognition and response by EMS providers

Stroke recognition is one of the most important roles of paramedics and EMTs. This episode of Remember Two Things reviews the importance of using the Cincinnati Prehospital Stroke Scale to identify stroke. Show host Steve Whitehead also discusses early notification of the hospital of a suspected stroke. Alerting the hospital early makes a remarkable difference to the speed of patient care. After watching share your experience with stroke scales in the comments and read more about stroke scales.

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Norwegian doc. for MSF survived,-talks about Ebola:

Don`t know what could be more frightening then seeing more and more people die -in a not so nice way, and then be a patient, far away from home. She was ( and AFAIK is ) a doc. att Ullevål hospital - Oslo, Norway. Glad she made it :-), brave comes to mind. Tip my hat. http://ift.tt/1vO4VCb ExEMTNor

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Remember 2 Things: Improving stroke recognition and response by EMS providers

Norwegian doc. for MSF survived,-talks about Ebola:

Entry Level Firefighter/EMT - City of Cocoa

COCOA, CITY OF 65 STONE STREET COCOA, FLORIDA 32922 Updated: April 18, 2016 Job Classification: Entry-Level Firefighter/EMT The City of Cocoa is hiring for Entry-Level Firefighter/EMT. All testing through National Testing Network (NTN) must be completed by April 29, 2016. Salary Information: Base Salary of $34,544.00 based on a 50-hour work week at $13.29 hourly with annual increases for the next two ...

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Remember 2 Things: Ultrasound use by paramedics

Prehospital ultrasound, increasingly available to EMS providers, has known application to find occult bleeding. In this episode of Remember Two Things, host Steve Whitehead, describes two additional uses for ultrasound. Whitehead discusses use of ultrasound for detecting cardiac activity and obtaining vascular access. After watching share your experience with ultrasound in the comments, read this article on prehospital ultrasound and listen to an Inside EMS podcast discussion of ultrasound.

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Remember 2 Things: Improving stroke recognition and response by EMS providers

Norwegian doc. for MSF survived,-talks about Ebola

Don`t know what could be more frightening then seeing more and more people die -in a not so nice way, and then be a patient, far away from home. She was ( and AFAIK is ) a doc. att Ullevål hospital - Oslo, Norway. Glad she made it, brave comes to mind. Tip my hat. http://ift.tt/1vO4VCb ExEMTNor

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Remember 2 Things: Ultrasound use by paramedics

Rapid Response: Resident shoots at responders, killing a paramedic and injuring a firefighter

What happened: Firefighter-paramedic John Ulmschneider and firefighter Kevin Swain were shot Friday evening after forcing entry in a home for a welfare check. Ulmschneider died from his injuries and Swain, 19, is now recovering.

Ulmschneider, Prince George's County Fire Department, and Swain, Morningside Volunteer Fire Department, were at the home at the request of the occupant's brother who reported the occupant had a history of diabetes.

Swain and Ulmschneider, as well as other firefighters, were told by the man's brother he was concerned about his brother's safety after his brother's phone was not answered and his car was parked in the driveway. The brother who made the 911 call was also shot and injured. Neither of their names have been released.

Police said a decision was made to force entry. As that was happening, the man inside fired several rounds. Once police officers got into the home, the gunfire stopped.

The occupant and shooter was released from custody Saturday evening and it is unknown if charges will be filed. Meanwhile we offer our condolences to the family, colleagues and friends of Ulmschneider, as well as our best wishes to Swain for a fast recovery.

Why it's significant: In January, firefighter Jason Adams, responding to a medical call, was shot and killed by the homeowner. The homeowner alleged he thought the firefighter was an intruder.

Paramedics, EMTs, firefighters and police officers frequently respond to calls to check on the welfare of a resident. Those calls run the gamut from a passerby report of a man down in a public park to concerned family, unable to reach an aging relative, calling from a thousand miles away. In some cases, like this incident, a relative or neighbor may attempt to contact or access the patient before calling 911.

Top takeaways: These takeaways are a call for reflection and conversation about the scenes you will respond to today and in the days and weeks ahead. Join us in honoring Ulmschneider's service while also discussing these points with your partner or company today or at your next station or department training.

1. There are no routine calls
This tragic incident is another reminder that danger potentially lurks behind every door or corner. The safety or danger of a scene is dynamic and risk assessment needs to be continuous.

2. Review welfare check protocols
It's not clear from available news if police were part of the initial response and on scene when the shooting started or only responded after shots were fire. Regardless, welfare check protocols and response configurations likely vary widely from community to community. Response is based on information provided to and gathered by dispatchers, previous experience with a caller, subject or location, and available resources at the time of the call.

3. Decision to force entry
Force entry is an option when there is no response from a home or vehicle occupant. The decision to force entry, much like the decision to use an offensive interior attack at a fire, significantly expands the potential risks to responders.

Use this incident to initiate conversations in your department about forcing entry for a medical call. How many personnel need to be on scene" Is the decision made at the field provider level or by a company officer or chief" What resources need to be on scene" Should the two-in, two-out rule apply to forcing entry for a medical call" What operational intelligence, such as 360-degree size-up and reverse 911 calls to the resident, needs to be gathered before forcing entry"

4. Body armor for every response
EMS agencies are increasingly purchasing or considering body armor for their personnel. Because there is no such thing as a routine call and even the seemingly benign or high frequency calls can unpredictably and quickly escalate, it makes sense that any PPE purchased by an employer be used on every call. As information is gathered and the scene changes, from roadside to ambulance compartment or front door to patient on a cot, paramedics and EMTs can adjust the PPE necessary.

What's next: The man turned himself into police after the shooting. He was later released and has yet to be charged.

On Saturday, a Pennsylvania man suspected to have overdosed received Narcan. He became responsive and attacked an EMT. This assailant is facing charges for aggravated assault and being held in jail on a $20,000 bail.

EMS providers are regularly injured in violent encounters with patients who have an altered level of consciousness. When a patient is under the influence of drugs or alcohol it is easy to say their actions are inexcusable and demand accountability for attacking medical personnel. For other causes of altered mental status or reduced level of consciousness, such as mental illness, hypoglycemia and post-ictal, it is less easy to connect the violent outburst to a level of civil or criminal responsibility.

Should the killer of Ulmschneider be charged with a crime" If yes, what crime"

Further reading: Learn more about violent encounters and body armor for EMS personnel with this collection of news and expert-written articles.

Violence and body armor:

Accountability for violent attacks on EMS personnel:

Body armor purchased for EMS personnel

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Paramedic - Falck Rocky Mountain

Position Summary: The primary responsibility of the Paramedic is to respond to emergency and non-emergency requests, provide advanced and basic life support as needed, and transports sick or injured persons to the appropriate medical facility. Qualifications: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are ...

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Sepsis 3.0: Implications for paramedics and prehospital care

Understand the origins of sepsis criteria and what the new sepsis definitions mean for EMS assessment and treatment of septic patients

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Emergency Medical Technicians (EMT’S) (Seasonal) - Mizkan America, Inc.

Description We are actively recruiting for First Aid Technicians (EMT's). The EMT's will provide support to our First Aid Department located at our factory in Stockton, California. These positions are seasonal, or, on an as needed basis. Job Requirements Basic Qualifications: · High School Diploma or GED equivalent. · Previous work experience in First Aid. · Current ...

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Emotion regulation during threat: Parsing the time course and consequences of safety signal processing

Abstract

Improved understanding of fear inhibition processes can inform the etiology and treatment of anxiety disorders. Safety signals can reduce fear to threat, but precise mechanisms remain unclear. Safety signals may acquire attentional salience and affective properties (e.g., relief) independent of the threat; alternatively, safety signals may only hold affective value in the presence of simultaneous threat. To clarify such mechanisms, an experimental paradigm assessed independent processing of threat and safety cues. Participants viewed a series of red and green words from two semantic categories. Shocks were administered following red words (cue+). No shocks followed green words (cue-). Words from one category were defined as safety signals (SS); no shocks were administered on cue+ trials. Words from the other (control) category did not provide information regarding shock administration. Threat (cue+ vs. cue-) and safety (SS+ vs. SS-) were fully crossed. Startle response and ERPs were recorded. Startle response was increased during cue+ versus cue-. Safety signals reduced startle response during cue+, but had no effect on startle response during cue-. ERP analyses (PD130 and P3) suggested that participants parsed threat and safety signal information in parallel. Motivated attention was not associated with safety signals in the absence of threat. Overall, these results confirm that fear can be reduced by safety signals. Furthermore, safety signals do not appear to hold inherent hedonic salience independent of their effect during threat. Instead, safety signals appear to enable participants to engage in effective top-down emotion regulatory processes.

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Hearing loss in patients with inflammatory bowel disease

Digestive Diseases and Sciences

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Frequent detection of HCV RNA and HCVcoreAg in stool of patients with chronic hepatitis C

Journal of Clinical Virology

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Magnitude of health problems among late adolescents: a cross sectional study

2016-04-18T02-29-31Z
Source: International Journal of Community Medicine and Public Health
Vivek Baliram Waghachavare, Manohar Shankarrao Chavan, Alka Dilip Gore, Jitesh Hanmantrao Kadam, Vishwajeet Manohar Chavan, Girish Bhimrao Dhumale.
Background: Adolescence is a very important phase of growth and maturity, but is often related with mental and behavioural problems. However, very few attempts are made to understand the magnitude of adolescent health problems; hence the current study was planned. Methods: It is a cross-sectional study conducted among arts, commerce and science college students from Sangli, (Maharashtra) India; by using cluster random sampling. Due ethical considerations and written consent were undertaken. The study tool was self-administered questionnaire with inventories like SPIN, DASS-21 and PSST-A. Analysis was done using percentages and chi-square test. Microsoft Excel 2007 and SPSS-22 were used for analysis. Results: Eight hundred one (67.5%) students had psychological problems with anxiety being the commonest. Menstrual problems were reported by 413 (58.4%) female students. Psychological problems were associated with menstrual problems. Conclusions: Majority of students had some psychological problem. Menstrual problems were present in more than 50% female students. There is unmet need for proper guidance and help regarding health.

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Clinical features and outcomes of complementary and alternative medicine induced acute liver failure and injury

The American Journal of Gastroenterology

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Poor performance status is associated with increased mortality in patients with cirrhosis

Clinical Gastroenterology and Hepatology

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Randomized, multicenter study: on-demand versus continuous maintenance treatment with esomeprazole in patients with non-erosive gastroesophageal reflux disease

BMC Gastroenterology

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Preliminary analysis of clinical situations involved in quantification of contrast-enhanced ultrasound in Crohn's disease

Ultrasound in Medicine and Biology

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Transmission of Hepatitis B core Antibody and Galactomannan Enzyme Immunoassay positivity via immunoglobulin products: a comprehensive analysis

Clinical Infectious Diseases

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Linkage to care for suburban heroin users with hepatitis C virus infection, New Jersey, USA

Emerging Infectious Diseases

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Safety and efficacy of endoscopic mucosal resection for sporadic, nonampullary duodenal adenomas: a single U.S. center experience

Gastrointestinal Endoscopy

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Efficacy and safety profile of anti–tumor necrosis factor-α versus anti-integrin agents for the treatment of crohn's disease: a network meta-analysis of indirect comparisons

Clinical Therapeutics

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Loss of peristaltic reserve, determined by multiple rapid swallows is the most frequent esophageal motility abnormality in patients with systemic sclerosis

Clinical Gastroenterology and Hepatology

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Metagenomics reveals dysbiosis and a potentially pathogenic n. flavescens strain in duodenum of adult celiac patients

The American Journal of Gastroenterology

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Norwegian doc. for MSF survived talks about Ebola

Don`t know what could be more frightening then seeing more and more people die, and then be a patient, far away from home. She was ( and AFAIK is ) a doc. att Ullevål hospital - Oslo, Norway. Glad she made it. Tip my hat. ExEMTNor

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Study of cutaneous manifestations in geriatrics

2016-04-18T00-48-32Z
Source: International Journal of Research in Medical Sciences
Shashikant B. Dhumale, Rajesh Khyalappa.
Background: Cutaneous signs and symptoms increases as the age advances. These are physiological as well as pathological changes. They can be due to systemic diseases present in old age. Methods: All the 200 geriatric patients have cutaneous manifestations. Results: Pruritus, eczema, stasis eczema, fungal infections were common. Diabetes was found in large incidence i.e. 27.5%, which show certain skin manifestations like pruritus, skin tag etc. Conclusions: Poor hygiene and systemic medical related senile skin dermatoses are observed. A significant no. of diabetics an emerging disease in India, presented with skin manifestations, which cannot be neglected.

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Πληροφορίες

Δευτέρα 18 Απριλίου 2016

Abstract