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Defensive Medicine

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61. In Patients With Acute Myocardial Infarction and No Hypoxemia, Does Oxygen Therapy Improve Outcomes Compared With No Supplemental Oxygen? Full Text available with Trip Pro

In Patients With Acute Myocardial Infarction and No Hypoxemia, Does Oxygen Therapy Improve Outcomes Compared With No Supplemental Oxygen? In Patients With Acute Myocardial Infarction and No Hypoxemia, Does Oxygen Therapy Improve Outcomes Compared With No Supplemental Oxygen? - Annals of Emergency Medicine Email/Username: Password: Remember me Search Terms Search within Search Share this page Access provided by Volume 73, Issue 4, Pages 403–405 In Patients With Acute Myocardial Infarction (...) and No Hypoxemia, Does Oxygen Therapy Improve Outcomes Compared With No Supplemental Oxygen? x Brit Long , MD (EBEM Commentator) , x Michael D. April , MD, DPhil (EBEM Commentator) Department of Emergency Medicine, San Antonio Uniformed Services Health Education Consortium, Fort Sam Houston, TX DOI: | Publication History Published online: May 09, 2018 Expand all Collapse all Article Outline Take-Home Message Oxygen therapy does not reduce the risk of all-cause mortality, recurrent ischemia or myocardial

2019 Annals of Emergency Medicine Systematic Review Snapshots

62. Defensive medicine: It is time to finally slow down an epidemic Full Text available with Trip Pro

who seek compensation for presumed medical errors. However, in our view the growth of defensive medicine should be seen in the context of larger changes in the conception of medicine that have taken place in the last few decades, undermining the patient-physician trust, which has traditionally been the main source of professional satisfaction for physicians. These changes include the following: time directly spent with patients has been overtaken by time devoted to electronic health records (...) and desk work; family doctors have played a progressively less central role; clinical reasoning is being replaced by guidelines and algorithms; the public at large and a number of young physicians tend to believe that medicine is a perfect science rather than an imperfect art, as it continues to be; and modern societies do not tolerate the inevitable morbidity and mortality. To finally reduce the increasing defensive behavior of doctors around the world, the decriminalization of medical errors

2018 World journal of clinical cases

63. The attitudes towards defensive medicine among physicians of obstetrics and gynaecology in China: a questionnaire survey in a national congress. Full Text available with Trip Pro

%) participants had witnessed their colleagues exposed to medical disputes, lawsuits or loss of a lawsuit. Generally, 62.9% of the participants strongly agreed or agreed with defensive medicine. Gender, administration duty, employment hospital, education status, subspecialty, exposure to any medical disputes, lawsuits or loss of a lawsuit, and colleagues' experiences were independent risk factors relevant to participants' preferences about defensive medicine in a multivariate model. Participants were more (...) prone to accept or endorse defensive medicine if they were female physicians; without administrative duties; working in non-tertiary hospitals; with an undergraduate degree; with any exposure to medical disputes, lawsuits or loss of a lawsuit; or having witnessed colleagues' similar experiences.About two-thirds of Chinese physicians practising obstetrics and gynaecology in our survey agreed with the practice of defensive medicine, but they had diverse preferences and understanding of specific

2018 BMJ open

64. Defensive medicine among antibiotic stewards: the international ESCMID AntibioLegalMap survey. Full Text available with Trip Pro

Defensive medicine among antibiotic stewards: the international ESCMID AntibioLegalMap survey. To investigate fear of legal claims and defensive behaviours among specialists in infectious diseases (ID) and clinical microbiology (CM) and to identify associated demographic and professional characteristics.AntibioLegalMap was an international cross-sectional internet-based survey targeting specialists in ID and CM. Three variables were explored: fear of legal liability in antibiotic prescribing (...) liability. Similarly, 76.4% (505/661) reported defensive behaviours in advising. These behaviours were associated with being sometimes or often worried about liability. The preferred measures to reduce fear and defensive behaviours were having local guidelines and sharing decisions through teamwork.A significant proportion of specialists in ID and CM reported some form of defensive behaviour in prescribing or advising to prescribe antibiotics. Defensive medicine should be considered when implementing

2018 Journal of Antimicrobial Chemotherapy

65. Defensive medicine: a systematic review of qualitative studies

Defensive medicine: a systematic review of qualitative studies Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility or liability for the content of this registration record, any associated files or external websites. Email salutation (e.g. "Dr (...) . No control group 5. Combination therapy or contamination 6. Not about analgesics used in the clinic Full text-screening: As above, with the addition of: 7. No relevant outcome measure reported ">Prioritise the exclusion criteria Example: Two reviewers will independently extract data from each article. We first try to extract numerical data from tables, text or figures. If these are not reported, we will extract data from graphs using digital ruler software. In case data are not reported or unclear, we

2020 PROSPERO

66. From Defensive Medicine to Quaternary Prevention: The Transition That Pakistan Needs Full Text available with Trip Pro

From Defensive Medicine to Quaternary Prevention: The Transition That Pakistan Needs The issue of overprescribing laboratory investigations is an old one in the world of medical practice and it has unfortunately seen a tremendous increase with the digitalisation of medicine, in more recent times. Phrased usually as 'defensive medicine,' this kind of overmedicalisation steers medical practice away from the ethical, skill-refining fronts on the part of doctors and imposes an unnecessary financial (...) burden on the patients' pockets, adding to their suffering. Pakistan has not been able to save itself either, from the impropriety that roots out of what is now almost a norm in medical practice. The existent low literacy and awareness rates in the masses of the country, coupled with the cultural respect for doctors and lack of financial resources amongst the poor patients to stand up to doctors or the hospitals, have all made it even easier for physicians to get away with ordering whatever

2018 Cureus

67. Patenting of Medical Procedures, Gene Coding and Surgical Devices

definition of the exemption of medical procedures for patent purposes. The Patents Act 2013 says… Human beings, and biological processes for their generation, are not patentable inventions. An invention of a method of treatment of human beings by surgery or therapy is not a patentable invention. An invention of a method of diagnosis practised on human beings is not a patentable invention.”” 2 In Australia medical procedures can be patented. In Australia the right to patent medical procedures was upheld (...) … “The health of my patient will be my first consideration” 4 Accordingly an economic imperative is not essential to the development of medical knowledge by medical practitioners. In addition to the ethical imperative, other non-economic incentives motivate in this field. Medical research is undertaken to raise credibility with others (peers, employers, clients, 1 Law Ethics and Medicine O Mitnovetski and D Nicol Journal of Medical Ethics 2004 2 Patents Act 2013 Section 16 Other exclusions. 3 Rescare 1994

2013 ASERNIP-S

68. Coping With the Stress of Medical Professional Liability Litigation

professional mental health resources ( ). Claims managers and defense attorneys often advise physicians not to speak to anyone regarding any aspect of a medical liability case. Nevertheless, physicians need to express their emotional responses to being sued. Literal adherence to the advice to speak to no one can result in isolation, increased stress, and dysfunctional behavior. Such behavior may jeopardize family and work relationships. The ability to function professionally and to represent oneself (...) Coping With the Stress of Medical Professional Liability Litigation Coping With the Stress of Medical Professional Liability Litigation - ACOG Menu ▼ Coping With the Stress of Medical Professional Liability Litigation Page Navigation ▼ Number 551, January 2013 (Reaffirmed 2016. Replaces Committee Opinion Number 497, August 2011) Committee on Professional Liability This document provides risk management information that is current as of the date issued and is subject to change. This document

2013 American College of Obstetricians and Gynecologists

69. Device Closure Versus Medical Therapy for Cryptogenic Stroke Patients With High-Risk Patent Foramen Ovale (DEFENSE-PFO)

Model: Parallel Assignment Masking: Single (Participant) Primary Purpose: Prevention Official Title: Device Closure Versus Medical Therapy for Secondary Prevention in Cryptogenic Stroke Patients With High-Risk Patent Foramen Ovale : DEFENSE-PFO Study Start Date : February 2012 Estimated Primary Completion Date : February 2020 Estimated Study Completion Date : February 2020 Arms and Interventions Go to Arm Intervention/treatment Placebo Comparator: Medication Anticoagulation, Antiplatelet agent Drug (...) Device Closure Versus Medical Therapy for Cryptogenic Stroke Patients With High-Risk Patent Foramen Ovale (DEFENSE-PFO) Device Closure Versus Medical Therapy for Cryptogenic Stroke Patients With High-Risk Patent Foramen Ovale (DEFENSE-PFO) - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum

2012 Clinical Trials

70. Study of Medical Students' Malpractice Fear and Defensive Medicine: A “Hidden Curriculum?” Full Text available with Trip Pro

Study of Medical Students' Malpractice Fear and Defensive Medicine: A “Hidden Curriculum?” Defensive medicine is a medical practice in which health care providers' primary intent is to avoid criticism and lawsuits, rather than providing for patients' medical needs. The purpose of this study was to characterize medical students' exposure to defensive medicine during medical school rotations.We performed a cross-sectional survey study of medical students at the beginning of their third year (...) . We gave students Likert scale questionnaires, and their responses were tabulated as a percent with 95% confidence interval (CI).Of the 124 eligible third-year students, 102 (82%) responded. Most stated they rarely worried about being sued (85.3% [95% CI=77.1% to 90.9%]). A majority felt that faculty were concerned about malpractice (55.9% [95% CI=46.2% to 65.1%]), and a smaller percentage stated that faculty taught defensive medicine (32.4% [95% CI=24.1% to 41.9%]). Many students believed

2013 Western Journal of Emergency Medicine

71. Are Corticosteroids Beneficial in the Treatment of Community-Acquired Pneumonia? (SRS Therapy)

, MD Department of Emergency Medicine Rush University Medical Center Chicago, IL Results Comparison of corticosteroids with control for community-acquired pneumonia. Outcome No. of Studies (No. of Participants) Relative Risk (95% CI) I 2 ,% Mortality (adults with severe CAP) 9 (995) 0.58 (0.40–0.84) 12 Mortality (adults with nonsevere CAP) 4 (868) 0.95 (0.45–2.00) 0 Early clinical failure (adults with severe CAP) 5 (419) 0.32 (0.15–0.70) 74 Early clinical failure (adults with nonsevere CAP) 2 (905 (...) Are Corticosteroids Beneficial in the Treatment of Community-Acquired Pneumonia? (SRS Therapy) TAKE-HOME MESSAGE For adult patients with severe community-acquired pneumonia, corticosteroids reduce morbidity and mortality. For pediatric patients and adults with nonsevere community-acquired pneumonia, corticosteroids appear to reduce morbidity, but not mortality. Are Corticosteroids Bene?cial in the Treatment of Community-Acquired Pneumonia? EBEM Commentators Thomas Seagraves, MD Michael Gottlieb

2018 Annals of Emergency Medicine Systematic Review Snapshots

72. Does Bed Rest or Fluid Supplementation Prevent Post?Dural Puncture Headache? (SRS therapy)

Does Bed Rest or Fluid Supplementation Prevent Post?Dural Puncture Headache? (SRS therapy) TAKE-HOME MESSAGE Neither bed rest nor ?uid supplementation decreases the incidence of headache after dural puncture. Does Bed Rest or Fluid Supplementation Prevent Post–Dural Puncture Headache? EBEM Commentators Michael D. April, MD, DPhil Brit Long, MD Department of Emergency Medicine San Antonio Uniformed Services Health Education Consortium Fort Sam Houston, TX Results The review included 24 trials (...) M, Brandt T, Muller A. Incidence of post-lumbarpuncture syndrome reducedby reinserting the stylet: a randomized prospective studyof 600 patients.J Neurol. 1998;24:589-592. The view(s) expressed herein are those of the author(s) and do not re?ect the of?cial policy or position of Brooke Army Medical Center, the US Army Medical Department, the US Army Of?ce of the Surgeon General, the Department of the Army, the Department of the Air Force and Department of Defense, or the US government. Michael

2018 Annals of Emergency Medicine Systematic Review Snapshots

73. Do Corticosteroids Improve Mortality or Shock Reversal in Patients With Septic Shock? (SRS therapy)

comparisons between interventions when possible within a single trial and indirect Systematic Review Snapshot Volume 71, no. 1 : January 2018 Annals of Emergency Medicine 35such as hyperglycemia, superinfec- tion, and gastrointestinal bleeding. This review does not re?ect the views or opinions of the US government, Department of Defense, US Army, US Air Force, or SAUSHEC EM Residency Program. Editor’s Note: This is a clinical synopsis, a regular feature of the Annals’ Systematic Review Snapshot (SRS (...) adult patients: consensus statements from an international task force by the American College of Critical Care Medicine. Crit Care Med. 2008;36: 1937-1949. 9. Veterans Administration Systemic Sepsis Cooperative Study Group. Effect of high-dose glucocorticoid therapy on mortality in patients with clinical signs of systemic sepsis.NEnglJMed. 1987;317:659-665. 10. Bone RC, Fisher CJ, Clemmer TP, et al. A controlled clinical trial of high-dose methylprednisolone in the treatment of severe sepsis

2018 Annals of Emergency Medicine Systematic Review Snapshots

74. Does Lidocaine Gel Decrease Procedural Pain for Pediatric Urethral Catheterization? (SRS therapy)

: November 2018 Annals of Emergency Medicine 589review and recommendations. J Endourol. 2009;23:821-826. 10. ChenYT,HsiaoPJ,WongWY,etal. Randomized double-blind comparison of lidocaine gel and plain lubricating gel in relieving pain during ?exible cystoscopy.JEndourol. 2005;19: 163-166. This review does not re?ect the views or opinions of the US government, Department of Defense, US Army, US Air Force, or SAUSHEC EM Residency Program. Michael Brown, MD, MSc, Jestin N. Carlson, MD, MS, and Alan Jones, MD (...) Does Lidocaine Gel Decrease Procedural Pain for Pediatric Urethral Catheterization? (SRS therapy) TAKE-HOME MESSAGE Lidocaine gel does not reduce the pain of transurethral bladder catheterization in children younger than 4 years compared with nonanesthetic gel. Further study evaluating lidocaine gel in patients older than 4 years is required. Does Lidocaine Gel Decrease Procedural Pain for Pediatric Urethral Catheterization? EBEM Commentators Brit Long, MD Michael D. April, MD, DPhil Department

2018 Annals of Emergency Medicine Systematic Review Snapshots

75. In Patients With Acute Myocardial Infarction and No Hypoxemia, Does Oxygen Therapy Improve Outcomes Compared With No Supplemental Oxygen?

Outcomes Compared With No Supplemental Oxygen? EBEM Commentators Brit Long, MD Michael D. April, MD, DPhil Department of Emergency Medicine San Antonio Uniformed Services Health Education Consortium Fort Sam Houston, TX Results Authors included 7 randomized controlled trials with 3,842 pa- tients receiving oxygen therapy and 3,860 patients not receiving supplemental oxygen. Time frames for outcome measure- ments ranged from index admis- sion up to 12 months. Most included patients were men (...) on individual study). Investigators included studies only if authors reported outcomes for patients in both the oxygen therapy arm and no oxygen therapy arm. DATA EXTRACTION AND SYNTHESIS Two investigators independently extracted data from included studies. Primary outcomes included all-cause mortality, recurrent ischemia or myocardial infarction, CARDIOLOGY/SYSTEMATIC REVIEW SNAPSHOT Volume 73, no. 4 : April 2019 Annals of Emergency Medicine 403Commentary Acute myocardial infarction is a major cause

2018 Annals of Emergency Medicine Systematic Review Snapshots

76. Medical Preparedness: Information Regarding the Correlated Activities of the Council of National Defense and the Advisory Commission, the Medical Departments of Government and the Committee of American Physicians for Medical Prepardedness Full Text available with Trip Pro

Medical Preparedness: Information Regarding the Correlated Activities of the Council of National Defense and the Advisory Commission, the Medical Departments of Government and the Committee of American Physicians for Medical Prepardedness 18737302 2008 08 29 2008 11 20 0093-402X 15 5 1917 May California state journal of medicine Cal State J Med Medical Preparedness: Information Regarding the Correlated Activities of the Council of National Defense and the Advisory Commission, the Medical (...) Departments of Government and the Committee of American Physicians for Medical Prepardedness. 136-9 eng Journal Article United States Cal State J Med 0414327 0093-402X 1917 5 1 0 0 1917 5 1 0 1 1917 5 1 0 0 ppublish 18737302 PMC1593041

1917 California state journal of medicine

77. Documentation of Medical Records in Hospitals of Mazandaran University of Medical Sciences in 2014: a Quantitative Study Full Text available with Trip Pro

Documentation of Medical Records in Hospitals of Mazandaran University of Medical Sciences in 2014: a Quantitative Study Documentation of patient care in medical record formats is always emphasized. These documents are used as a means to go on treating the patients, staff in their own defense, assessment, care, any legal proceedings and medical science education. Therefore, in this study, each of the data elements available in patients' records are important and filling them indicates (...) the importance put by the documenting teams, so it has been dealt with the documentation the patient records in the hospitals of Mazandaran province.This cross-sectional study aimed to review medical records in 16 hospitals of Mazandaran University of Medical Sciences (MazUMS). In order to collection data, a check list was prepared based on the data elements including four forms of the admission, summary, patients' medical history and progress note. The data recording was defined as "Yes" with the value of 1

2016 Acta Informatica Medica

78. Defining Optimal Length of Opioid Pain Medication Prescription After Common Surgical Procedures. Full Text available with Trip Pro

Defining Optimal Length of Opioid Pain Medication Prescription After Common Surgical Procedures. The overprescription of pain medications has been implicated as a driver of the burgeoning opioid epidemic; however, few guidelines exist regarding the appropriateness of opioid pain medication prescriptions after surgery.To describe patterns of opioid pain medication prescriptions after common surgical procedures and determine the appropriateness of the prescription as indicated by the rate (...) of refills.The Department of Defense Military Health System Data Repository was used to identify opioid-naive individuals 18 to 64 years of age who had undergone 1 of 8 common surgical procedures between January 1, 2005, and September 30, 2014. The adjusted risk of refilling an opioid prescription based on the number of days of initial prescription was modeled using a generalized additive model with spline smoothing.Length of initial prescription for opioid pain medication.Need for an additional subsequent

2017 JAMA surgery

79. Association between the antioxidant uric acid and depression and antidepressant medication use in 96 989 individuals. (Abstract)

Association between the antioxidant uric acid and depression and antidepressant medication use in 96 989 individuals. In the last decade, several studies have suggested that depression is accompanied by increased oxidative stress and decreased antioxidant defenses. We tested the hypothesis that high levels of the antioxidant uric acid are associated with lower risk of hospitalization with depression and use of prescription antidepressant medication.We examined plasma levels of the antioxidant (...) as in-patient or out-patient with depression and antidepressant medication use. A doubling in uric acid was associated with an effect estimate of 0.57 (95% CI 0.49-0.65) and 0.77 (0.73-0.81) for hospitalization with depression and antidepressant medication use. The association was consistent across strata of all covariates. Results were attenuated in Cox regression analyses with less statistical power.High plasma levels of uric acid were associated with low risk of depression hospitalization

2017 Acta Psychiatrica Scandinavica

80. Data mining and medical world: breast cancers’ diagnosis, treatment, prognosis and challenges Full Text available with Trip Pro

are published about applications of data mining in various fields of sciences such as defense, banking, insurances, education, telecommunications, medicine and etc. This investigation attempts to provide a comprehensive survey about applications of data mining techniques in breast cancer diagnosis, treatment & prognosis till now. Further, the main challenges in these area is presented in this investigation. Since several research studies currently are going on in this issues, therefore, it is necessary (...) Data mining and medical world: breast cancers’ diagnosis, treatment, prognosis and challenges The amount of data in electronic and real world is constantly on the rise. Therefore, extracting useful knowledge from the total available data is very important and time consuming task. Data mining has various techniques for extracting valuable information or knowledge from data. These techniques are applicable for all data that are collected inall fields of science. Several research investigations

2017 American journal of cancer research

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