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Blood cultures: when do they make a meaningful impact on clinical care? - emdocs

emDocs post containing very useful emergency medicine information  
emdocs.net
over 4 years ago
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Same-Day Discharge in PCI: 'Next Step' in Evolution of PCI

There are opportunities for same-day discharge in every modern cath-lab practice or interventional practice, researchers say. "What it requires is a change in the culture."  
medscape.com
over 4 years ago
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Fever with seizure and confusion

A 41 year old previously healthy man presented with a six day history of fever, headache, and vomiting, followed by two episodes of staring spells and unresponsiveness and secondarily generalised tonic-clonic seizures. In the emergency department he was restless, inattentive, and not oriented to time, place, and person (Glasgow coma score 10/15; best eye opening response (E): 3; best motor response (M): 5 and best verbal response (V):2). He had neck stiffness; Kernig’s sign was positive and his ocular fundi were normal. He had no limb weakness or ataxia and deep tendon reflexes and plantar reflexes were normal. He tested negative for HIV1/2 antigen and antibody. His blood coagulation profile and platelet count were normal. An initial unenhanced computed tomogram of the brain found no contraindications for lumbar puncture. Analysis of cerebral spinal fluid (CSF) showed glucose 3.4 mmol/L (reference range 2.2-3.9 mmol/L; corresponding blood glucose was 5.8 mmol/L), protein 2.59 g/L (0.15-0.45 g/L), 450×106 white blood cells/L (100% lymphocytes; 0-5×106), and 40×106 red blood cells/L. Gram staining of the CSF was negative and bacterial culture was sterile. A confirmatory microbiological test was performed on his CSF and computed tomography of the brain repeated the second week after the onset of symptoms (fig 1⇓).  
feeds.bmj.com
over 4 years ago
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Fever with seizure and confusion

A 41 year old previously healthy man presented with a six day history of fever, headache, and vomiting, followed by two episodes of staring spells and unresponsiveness and secondarily generalised tonic-clonic seizures. In the emergency department he was restless, inattentive, and not oriented to time, place, and person (Glasgow coma score 10/15; best eye opening response (E): 3; best motor response (M): 5 and best verbal response (V):2). He had neck stiffness; Kernig’s sign was positive and his ocular fundi were normal. He had no limb weakness or ataxia and deep tendon reflexes and plantar reflexes were normal. He tested negative for HIV1/2 antigen and antibody. His blood coagulation profile and platelet count were normal. An initial unenhanced computed tomogram of the brain found no contraindications for lumbar puncture. Analysis of cerebral spinal fluid (CSF) showed glucose 3.4 mmol/L (reference range 2.2-3.9 mmol/L; corresponding blood glucose was 5.8 mmol/L), protein 2.59 g/L (0.15-0.45 g/L), 450×106 white blood cells/L (100% lymphocytes; 0-5×106), and 40×106 red blood cells/L. Gram staining of the CSF was negative and bacterial culture was sterile. A confirmatory microbiological test was performed on his CSF and computed tomography of the brain repeated the second week after the onset of symptoms (fig 1⇓).  
feeds.bmj.com
over 4 years ago
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Radiology-Guided Cultures Provide Less Invasive Osteomyelitis Diagnosis

Interventional radiology-guided cultures are a less invasive alternative to operative cultures for diagnosing acute hematogenous osteomyelitis (AHO) in children, according to a retrospective review.  
medscape.com
over 4 years ago
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Medical Students: False Beliefs About Blacks' Biology Common

Believing false biological differences between black and white patients led students to perceive a lower pain experience in blacks and issue less appropriate medical recommendations to them.  
medscape.com
over 4 years ago
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James, William | Internet Encyclopedia of Philosophy

William James is considered by many to be the most insightful and stimulating of American philosophers, as well as the second of the three great pragmatists (the middle link between Charles Sanders Peirce and John Dewey).  As a professor of psychology and of philosophy at Harvard University, he became the most famous living American psychologist and later the most famous living American philosopher of his time.  Avoiding the logically tight systems typical of European rationalists, such as the German idealists, he cobbled together a psychology rich in philosophical implications and a philosophy enriched by his psychological expertise.  More specifically, his theory of the self and his view of human belief as oriented towards conscious action raised issues that required him to turn to philosophy.  There he developed his pragmatic epistemology, which considers the meaning of ideas and the truth of beliefs not abstractly, but in terms of the practical difference they can make in people’s lives.  He explored the implications of this theory in areas of religious belief, metaphysics, human freedom and moral values, and social philosophy. His contributions in these areas included critiques of long-standing philosophical positions on such issues as freedom vs. determinism, correspondence vs. coherence, and dualism vs. materialism, as well as a thorough analysis of a phenomenological understanding of the self and consciousness, a “forward-looking” conception of truth (based on validation and revisable experience), a thorough-going metaphysical pluralism, and a commitment to a full view of agency in connection with communal and social concerns. Thus he created one of the last great philosophical systems in Western thought, even if he did not live quite long enough to complete every aspect of it. The combination of his provocative ideas and his engaging writing style has contributed to the enduring impact of his work.  
iep.utm.edu
over 4 years ago
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Does Hospital Workplace Culture Affect Surgical Outcomes?

Commentary on a study on whether the culture of safety within a hospital affects the risk for postoperative infections, published in the Journal of the American College of Surgeons.  
medscape.com
over 4 years ago
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Lever systems in the human body

After watching this video session, it is expected that you will be able to Define levers. Enumerate the main uses of levers Identify the three classes of lev...  
youtube.com
over 4 years ago
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KeyLIME Ep# 104: Power, Culture and Patient Safety

KeyLIME Session 104 – Article under review: Appelbaum NP, Dow A, Mazmanian PE, Jundt DK, Appelbaum EN. The effect of power, leadership, and psychological safety on resident event reporting. Medical Education. 2016;[ePub ahead of print] Reviewer: Jason R. Frank   Background [This paper is the next in our series of reviews of upcoming publications in the…  
icenetblog.royalcollege.ca
over 4 years ago
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Moral Foundations Theory Homepage

Where does morality come from and why does it vary across cultures and political ideologies?  
yourmorals.org
over 4 years ago
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Culture of bullying at Birmingham hospital prevented staff from reporting high cardiac death rates

An NHS hospital under investigation for its high mortality rates from cardiac surgery saw a culture of bullying develop that prevented staff from speaking out against poor care, a damning report has found.  
feeds.bmj.com
over 4 years ago
Www.bmj
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Culture of bullying at Birmingham hospital prevented staff from reporting high cardiac death rates

An NHS hospital under investigation for its high mortality rates from cardiac surgery saw a culture of bullying develop that prevented staff from speaking out against poor care, a damning report has found.  
feeds.bmj.com
over 4 years ago
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Culture of bullying at Birmingham hospital prevented staff from reporting high cardiac death rates

An NHS hospital under investigation for its high mortality rates from cardiac surgery saw a culture of bullying develop that prevented staff from speaking out against poor care, a damning report has found.  
feeds.bmj.com
over 4 years ago
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Birmingham's QE Hospital: 'Bullying culture stopped speaking out' - BBC News

A culture of bullying at an NHS trust prevented staff from speaking out about the number of heart surgery patients who were dying, a report finds.  
bbc.co.uk
over 4 years ago
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Fever in an intravenous drug user

A 29 year old intravenous drug user presented to the acute medical unit feeling generally unwell. On clinical examination he was found to be in septic shock with a fever of 39.2°C. A septic screen was performed and broad spectrum antibiotics started empirically. Staphylococcus aureus was grown in both blood culture bottles after one day. An echocardiogram showed a large irregular mass on …  
feeds.bmj.com
over 4 years ago
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Fever in an intravenous drug user

A 29 year old intravenous drug user presented to the acute medical unit feeling generally unwell. On clinical examination he was found to be in septic shock with a fever of 39.2°C. A septic screen was performed and broad spectrum antibiotics started empirically. Staphylococcus aureus was grown in both blood culture bottles after one day. An echocardiogram showed a large irregular mass on …  
feeds.bmj.com
over 4 years ago
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'How my mental health issues helped me help others' - BBC News

Tom McAlpine set-up the MoodSwings charity in 1999 with a belief that it is possible for those suffering even severe mental health issues to make a good recovery.  
bbc.co.uk
over 4 years ago
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What is the oldest civilization known to man?

Civilizations do not typically have discreet start dates, but tend to emerge gradually over the course of many centuries. This makes it a matter of interpretation whether Egypt, Mesopotamia or India...  
ask.com
over 4 years ago