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1
Femtodynamics: A guide to laser settings and procedure techniques to optimize outcomes with femtosecond lasers. Thorofare, NJ: SLACK Inc., 2009.
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Lancellotti, Patrizio, and Bernard Cosyns. Examination. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780198713623.003.0001.
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Echocardiography is a diagnostic imaging technique by which ultrasound is used to display anatomic and physiologic characteristics of the cardiovascular system. Echocardiography consists of several different imaging modalities that require appropriate settings. In this chapter the most important system settings are discussed in the context of the basic physics of ultrasound image formation. Setting-up the echo machine to optimize patient examination is discussed in detail. All controls are covered. Continuous-wave, pulsed-wave, and colour flow Doppler are explained, as well as more advanced techniques including myocardial velocity imaging and speckle tracking and 3D imaging. Understanding these basic principles will allow optimizing image quality for each individual patient.
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Machtinger, Edward L., and Peter A. Nigrovic. Spanish for Pediatric Medicine. Edited by Janice A. Lowe. 2nd ed. American Academy of Pediatrics, 2005. http://dx.doi.org/10.1542/9781581104554.
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Enhance patient and parent encounters with this newly expanded and enhanced pocket guide! Here's the easy-to-use manual you need to communicate with Spanish-speaking patients and parents more efficiently and effectively. Spanish for Pediatric Medicine features a quick-reference design that enables you to rapidly identify and explore common medical problems. English and Spanish equivalents are shown side-by-side for instant, precise use. This handy resource fits right in your pocket as you travel between well-child, sick visit, and emergency department settings. Optimized for use with Bright Futures--visit-specific translations from prenatal to 18- to 21-year visits reflect the organization of the AAP Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, 3rd Edition. All-new audio program--electronic access to downloadable audio clips of translations from a native Spanish speaker helps you improve comprehension and pronunciation. The new 2nd edition includes general visit translations--medical history, family history, description of pain, examination instructions, immunization screening, and discharge instructions; Bright Futures stage visit translations--spanning issues addressed in prenatal and newborn through late adolescent visits; emergency department (ED) visit translations--ED history, description of pain, examination instructions, and discharge instructions; system-specific translations--hematology/oncology, skin, respiratory, cardiovascular, gastrointestinal, genitourinary, and musculoskeletal; special issues translations--abuse screening, developmental milestones, lead toxicity screening, and obesity prevention and treatment; and translations for commonly used expressions/greetings--terms of endearment for children.
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Kapoor, Reena, and Ezra E. H. Griffith. Cultural competence. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199360574.003.0060.
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Disparities exist in the rate of incarceration of minorities, with substantial elevations occurring in African American, Latino, and Native populations. Cultural competence is an essential aspect of providing mental health care in any setting. An understanding of culture is even more important in correctional settings, as several unique factors may lead to conflict and misunderstanding if not adequately addressed. First, minority ethnic groups are vastly overrepresented in prisons and jails, so a familiarity with the predominant culture of those groups is necessary to engage inmates in treatment and diagnose them accurately. Second, mental health clinicians may be unfamiliar with law enforcement culture, which heavily influences the practices of corrections officers and differs significantly from health care culture. Third, many correctional psychiatrists grow up and train outside the United States, bringing their own cultural beliefs about crime and punishment into the American health care system. As the field of cultural psychiatry has developed, scholars have attempted to apply its principles to the correctional setting to deliver competent care in prisons and jails. These papers have provided guidance to correctional mental health clinicians on matters such as immigrant populations, language barriers, validity of psychological testing in different ethnic groups, stigma of mental illness in prison, religion’s role in coping with the stress of incarceration, and many others. This chapter reviews the evolution of cultural competence skills in correctional settings and current best practices in jails and prisons to optimize effective treatment outcomes.
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Bannister, Susan, ed. Pediatric Collections: Enriching Pediatric Learning: A Guidebook for Preceptors. American Academy of Pediatrics, 2021. http://dx.doi.org/10.1542/9781610025836.
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This collection is intended to optimize the medical education and practical teaching techniques to improve clinical observation, feedback, assessment, and evaluation. This collection is applicable to the busy preceptor in a variety of settings—rural or regional or urban practice, community hospital, or academic center. Available for purchase at https://shop.aap.org/pediatric-collections-enriching-pediatric-learning-a-guidebook-for-preceptors-paperback/
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Cobb, Benjamin, and Steven Lipman. Perimortem Cesarean Delivery for Maternal Cardiac Arrest. Edited by Matthew D. McEvoy and Cory M. Furse. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190226459.003.0042.
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In the absence of a return of spontaneous circulation during maternal cardiac arrest, a perimortem cesarean section should be strongly considered as an integral component of maternal resuscitation. Uterine compression of the great vessels in the second–third trimesters may contribute to ineffective resuscitative measures. In addition, in the setting of ongoing maternal compromise, fetal outcome may be optimized by delivery. The rarity of maternal cardiac arrest poses a multitude of challenges in the effective application of a perimortem cesarean delivery. Nevertheless, perimortem cesarean delivery remains an essential rescue maneuver for women with periviable fetuses who do not respond to initial resuscitative maneuvers.
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Mahmoud, Mohamed, Robert S. Holzman, and Keira P. Mason. Pediatric Anesthesia Outside of the Operating Room. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190495756.003.0027.
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This textbook provides an important tool to cover major aspects of anesthesia care in non–operating room anesthesia (NORA) locations. It outlines perioperative concerns for the most commonly performed procedures in NORA settings. An overview of various anesthesia delivery techniques and tools required to optimize the patient before endoscopy, cardiac, and neuroradiology procedures are provided. The text also covers specialized situations, including a pediatric update on anesthesia/sedation strategies for dental procedures, electroconvulsive therapy, cosmetic procedures, ophthalmologic surgery, procedures in the emergency department, and infertility treatment. Practical recommendations based on current literature and author experience are presented, and current practice guidelines are reviewed.
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Elbogen, Eric B., and Robert Graziano. Assessing Acute Risk of Violence in Military Veterans. Edited by Phillip M. Kleespies. Oxford University Press, 2015. http://dx.doi.org/10.1093/oxfordhb/9780199352722.013.15.
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Research has shown aggression toward others is a problem in a subset of military veterans. Predicting this kind of aggression would be immensily helpful in clinical settings. To our knowledge, there currently are no risk assessment tools or screens that have been validated to specifically evaluate acute violence among veterans. This chapter reviews what we do and do not know about violence in veterans so that clinicians who are making decisions about acute violence can be informed by the existing scientific knowledge base. Examining these empirically supported risk and protective factors using a systematic approach may optimize clinical decision making when assessing acute violence in veterans.
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Kappetein, Arie Pieter, and Stephan Windecker. The heart team in acute cardiac care. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199687039.003.0012.
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The complexity of acute cardiac care today makes it necessary that patients are looked after by more than one health care professional. Complex tasks require complex systems. Teamwork is essential for minimizing adverse events caused by miscommunication and misunderstanding about roles and responsibilities, and it can have an immediate and positive impact on the patient. The increasing complexity and specialization of care of the cardiac patient in the acute setting make it necessary to coordinate teams of doctors for each specialty area. Multidisciplinary decision making optimizes care and is mandatory in light of evolving options and improvement of quality of care and will lead to more efficiency.
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Kappetein, Arie Pieter, Christiaan Antonides, and Stephan Windecker. The heart team in acute cardiac care. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199687039.003.0012_update_001.
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The complexity of acute cardiac care today makes it necessary that patients are looked after by more than one health care professional. Complex tasks require complex systems. Teamwork is essential for minimizing adverse events caused by miscommunication and misunderstanding about roles and responsibilities, and it can have an immediate and positive impact on the patient. The increasing complexity and specialization of care of the cardiac patient in the acute setting, combined with an ever increasing number of therapeutic options, make it necessary to coordinate teams of doctors for each specialty area. Multidisciplinary decision making optimizes care and is mandatory in light of evolving options and improvement of quality of care and will lead to more efficiency.
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Evans, Charlotte, Anne Creaton, Marcus Kennedy, and Terry Martin, eds. Obstetrics and gynaecology. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780198722168.003.0013.
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High acuity and critical care presentations in obstetrics and gynaecology are not uncommon, and when seen in the retrieval setting they present pathophysiology and risk avoidance challenges for the retrieval physician, coordinator, and system. The particular risks in obstetric retrieval which are associated with the consideration of infant risk, and the emotive implications of perinatal death, create additional pressure. The wellbeing of the mother is in all circumstances the priority, and it is important that this drives decision-making and planning. Careful consideration and consultation with specialist retrieval coordinators with obstetric experience and qualifications is important to optimize plans. These plans often revolve around the wisdom of intervention or delivery pre, post, or instead of high-risk transfer. Experience, perspective, and understanding of practitioner and system capability will inform best decisions and outcomes.
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Reich, David L., Stephan A. Mayer, and Suzan Uysal, eds. Neuroprotection in Critical Care and Perioperative Medicine. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190280253.001.0001.
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Clinicians caring for patients are challenged by the task of protecting the brain and spinal cord in high-risk situations. These include following cardiac arrest, in critical care settings, and during complex procedural and surgical care. This book provides a comprehensive overview of various types of neural injury commonly encountered in critical care and perioperative contexts and the neuroprotective strategies used to optimize clinical outcomes. In addition to introductory chapters on the physiologic modulators of neural injury and pharmacologic neuroprotectants, the topics covered include: imaging assessment; tissue biomarker identification; monitoring; assessment of functional outcomes and postoperative cognitive decline; traumatic brain injury; cardiac arrest and heart-related issues such as valvular and coronary artery bypass surgery, aortic surgery and stenting, and vascular and endovascular surgery; stroke; intracerebral hemorrhage; mechanical circulatory support; sepsis and acute respiratory distress syndrome; neonatal issues; spinal cord injury and spinal surgery; and issues related to general, orthopedic, peripheral vascular, and ear, nose and throat surgeries.
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Patterson, Caroline, and Derek Bell. Causes and diagnosis of chest pain. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0144.
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Differentiating life-threatening from benign causes of chest pain in the critical care setting is a challenge when the symptoms and signs overlap, and patients are unable to communicate fully. A high index of suspicion is required for occult disease. Once the clinician has ensured the patient is haemodynamically stable, it is imperative to rule out myocardial infarction in the first instance. Where possible, a thorough history and a full examination should be undertaken. Electrocardiogram, chest X-ray, and routine observations are often diagnostic. Targeted investigation such as computed tomography, or transthoracic or transoesophageal ultrasonography may be required to confirm these diagnoses. Timely intervention optimizes survival benefit. Treatment may be necessary prior to confirmation of diagnosis, based on high clinical suspicion and risk scoring. Other causes of chest pain should be considered once the immediately life-threatening conditions are excluded.
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Martin, Colin J., and Dr David G. Sutton. Diagnostic radiology—patient dosimetry. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199655212.003.0014.
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A knowledge of the doses that patients receive is important to optimize radiation protection in diagnostic radiology. This chapter covers the methodology involved in assessment and management of patient dose for radiography and fluoroscopy. The dose quantities are described and ones to use for different applications are discussed. The instruments and measurement techniques used are described, including passive techniques such as TLD and radiochromic film. The need to consider scattering of X-rays from surfaces is explained. Factors to be taken into account include whether the assessment is for practical evaluation of technique or to provide an indication of risk. The appropriate dose to assess could be that to the whole body, the skin surface, or a particular organ such as the breast in mammography. These factors all feed into the patient dose audit process, which is explained together with the setting of diagnostic references levels to aid optimization.
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Wouters, Patrick F., Fabio Guarracino, and Manfred Seeberger. Perioperative echocardiography. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780198726012.003.0066.
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Perioperative echocardiography is one of the fastest growing areas of echocardiography. Transthoracic imaging is increasingly being used in postoperative patients, in critical care settings, and in emergency medicine. Intraoperative imaging remains the exclusive domain of transoesophageal echocardiography (TOE) where cardiac surgery is the primary field of application. However, the use of intraoperative TOE is gradually expanding towards non-cardiac surgery. The indications for perioperative echo have recently been re-evaluated, resulting in recognition of the ubiquitous benefit in patients undergoing surgery. Although TOE is safe, there may be a greater risk of traumatic damage to the soft tissues in anaesthetized patients who cannot complain of pain nor resist during probe insertion. Perioperative imaging in cardiac surgery should be used to confirm and refine the preoperative diagnosis, detect new or unsuspected pathology, adjust the anaesthetic and surgical plan, and assess the results of surgical intervention. Using imaging to optimize myocardial function is a constantly developing technique to ensure that patients leave the operating room in the best possible condition.
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Diamond, Pamela M. Traumatic brain injury. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199360574.003.0053.
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During the past decade, traumatic brain injury (TBI) has become a frequent topic in the media. It has been a decade of expanding awareness, increased research, and growing concern about TBI of all severity levels. Consistent with this increased attention, researchers and policymakers have made strides toward greater understanding of the risks of TBI, the scope and complexity of the symptom profiles seen after TBI, and the types of treatments that optimize recovery. Recent studies have confirmed a 50 to 60% prevalence of TBI among prisoners. Most have experienced multiple injuries and experienced their first TBI in their mid-teens. Routine screening for TBI is rarely done in these settings in spite of there being a number of tested instruments available. The cognitive deficits associated with mild to moderate TBI are often indistinguishable from those associated with many mental illnesses and substance abuse. Etiology is difficult to establish; nevertheless, the common symptom patterns often make adjustment to jail or prison difficult. Educational interventions designed to improve staff knowledge of the prevalence of TBI and frequent symptom patterns are important first steps. Training staff how to modify their behavior and facilitate communication with inmates expressing these symptoms may reduce episodes of misunderstanding and potential aggression. Similarly, current programming may be modified to accommodate the cognitive deficits suffered by inmates with TBI as well as other disorders. This chapter reviews the prevalence of TBI in correctional settings, its impact on co-occurring mental illness and substance use, and opportunities to recognize, intervene, and treat patients with TBI.
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Klein, Kelly R., and Paul E. Pepe. Pre- and inter-hospital transport of the critically ill and injured. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0005.
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Pre- and inter-hospital transport medicine has become a highly specialized branch of critical care and emergency medicine practices, and is an integral part of modern health care. It can have a significant impact on mortality and morbidity when used appropriately. However, it also poses very unique challenges involving extension of hospital resources into often unfamiliar and sometimes austere and hostile arenas in the out-of-hospital setting. The very nature of critical care also means that the patient is profoundly ill or injured, and needs intensive monitoring and treatment with limited secondary support and personnel in the limited space of an ambulance, helicopter, or fixed wing aircraft. Accordingly, to optimize safety and patient care under these circumstances, specific guidelines and strict regulations regarding critical care transport have been implemented. Protocols and policies need to be in place to ensure optimal care, and safety for both patients and transport crews with contingencies for unanticipated weather and altitude challenges, and should also address key issues.
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Harder, Louise, and Atul Malhotra. Pathophysiology and therapeutic strategy for sleep disturbance in the ICU. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0225.
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Robust data have shown that sleep disruption and inadequate sleep duration in the general population impact neurocognitive function and produce cardiometabolic sequelae. Despite widespread recognition of the importance of sleep as an essential homeostatic function, there are relatively few data regarding the importance of sleep in critically-ill patients. Obstructive sleep apnoea is a common respiratory condition that is prevalent in the ICU and can be particularly problematic pre-intubation, post-extubation, and in the peri-operative setting. Considerable discussion regarding the impact of sleep versus sedation has occurred, with some insights emerging from improvements in our understanding of basic neurobiology. Sleep disturbance may also have an impact in critically-ill mechanically-ventilated patients by contributing to the development of delirium, which is associated with poor outcomes. However, further data are required to determine the ideal strategy to optimize sleep in the ICU and whether such strategies will in turn improve hard outcomes of critically-ill patients.
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Brand, Caroline A., and Ilana N. Ackerman. Delivery (organization and outcome). Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199668847.003.0036.
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This chapter considers the organization and delivery of care for osteoarthritis (OA) within the broader context of chronic condition management, and with a specific focus on the current OA literature. It describes factors that have influenced healthcare reforms for people with chronic conditions such as OA, and the development and characteristics of chronic condition models of care. The chapter also examines existing models of care for OA, which are commonly multidisciplinary in nature and situated within primary care, community care, or secondary/tertiary care settings. It summarizes current evidence for the effectiveness and cost-effectiveness of OA models of care, acknowledging that limited data are available regarding access and efficiency outcomes. Barriers to the successful development, implementation, and sustainability of OA models of care are discussed, as well as enablers that could facilitate the success of models of care. The chapter also presents points to consider when planning the implementation and evaluation of models of care, such as the development of a program logic, use of theoretical models or frameworks, and careful selection of appropriate research designs (including mixed-methods approaches). Finally, it considers future challenges for OA models of care, particularly the rise of multi-morbidity among patient populations that will necessitate integrated chronic condition management rather than stand-alone OA services. Future models of care may require the design of specific OA modules that can be integrated with generic chronic condition models that address risk behaviour modification and optimize self-management and mental health outcomes.
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Kreitzer, Mary Jo, Mary Koithan, and Andrew Weil, eds. Integrative Nursing. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190851040.001.0001.
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Fully updated and revised, the second edition of Integrative Nursing is a complete roadmap to holistic patient care, providing a step-by-step guide to assess and clinically treat conditions through a variety of combined methodologies including traditional and alternative therapies with all aspects of lifestyle. This text identifies both the skills and theoretical frameworks for interprofessional systems leaders to consider and implement integrative healthcare strategies within institutions, including several case studies involving practical nursing-led initiatives. This volume covers the foundations of the field; the most effective ways to optimize wellbeing; principles of symptom management for many common disorders like sleep, anxiety, pain, and cognitive impairment; the application of integrative nursing techniques in a variety of clinical settings and among a diverse patient population; and integrative practices around the world and how they impact planetary health. The academic rigor of the text is balanced by practical and relevant content that can be readily implemented into practice for both established professionals as well as students enrolled in undergraduate or graduate nursing programs. Integrative health and medicine is defined as healing-oriented care that takes account of the whole person (body, mind, and spirit) as well as all aspects of lifestyle; it emphasizes the therapeutic relationship and makes use of appropriate therapies, both conventional and alternative. Series editor Andrew Weil, MD, is Professor and Director of the Arizona Center for Integrative Medicine at the University of Arizona. Dr. Weil’s program was the first such academic program in the U.S., and its stated goal is “to combine the best ideas and practices of conventional and alternative medicine into cost effective treatments without embracing alternative practices uncritically.”
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Kuypers, Dirk R. J., and Maarten Naesens. Immunosuppression. Edited by Jeremy R. Chapman. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199592548.003.0281_update_001.
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Combination immunosuppressive therapy produces excellent short-term results after kidney transplantation. Long-term graft survival has improved, but less dramatically. Death with a functioning graft remains the primary cause of graft loss. Dosing of current immunosuppressive therapy balances between careful clinical interpretation of time-driven immunological risk assessments and drug-related toxicity on the one hand, and the use of simple surrogate drug exposure indicators like blood/plasma concentrations on the other. The combined use of calcineurin-inhibitors (CNIs) with mycophenolic acids and corticosteroids has been fine-tuned over the last decade, based on empirically derived observations as well as on the results of large multicentre randomized clinical studies. Corticosteroid withdrawal and avoidance are feasible, at least in patients with a low immunological risk, but CNI-free protocols have had few long-term successes. Some minimization strategies have increased risk of developing acute rejection or (donor-specific) anti-HLA antibodies, with deleterious effects on the graft. Mammalian target of rapamycin inhibitors (mTORi) have shown limited benefit in early CNI replacement regimens and their long-term use as primary drug is hampered by intolerance. In the setting of particular malignant disease occurring after transplantation, such as squamous cell carcinoma of the skin and Kaposi’s sarcoma, mTORi seem promising. Induction agents (anti-interleukin 2 receptor monoclonal antibodies, antithymocyte globulins) effectively diminish the risk of early immunological graft loss in recipients with moderate to high immunological risk but at the price of more infectious or malignant complications. While personalized transplantation medicine is only in its early stages of development, attempts are made to quantitatively measure the clinical degree of immunosuppression, to tailor immunosuppressive therapy more specifically to the patient’s individual profile, and to monitor graft status by use of invasive (e.g. surveillance renal biopsies) and non-invasive biomarkers. These scientific endeavours are a necessity to further optimize the current immunosuppressive therapy which will remain for some time to come.