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X W Xu, R C Zhang, Y P Mou, Z Y Qian, C J Huang, Q C Zhu, W W Jin, Y C Zhou
Objective: To evaluate the safety and feasibility of laparoscopic radical antegrade modular pancreatosplenectomy(Lap-RAMPS) for left-sided pancreatic adenocarcinoma. Methods: Clinical data of total 12 patients underwent Lap-RAMPS for left-sided pancreatic adenocarcinoma at Department of Gastrointestinal and Pancreatic Surgery, Zhejiang Provincial People's Hospital from March 2016 to August 2017 were reviewed retrospectively.There were 7 male patients and 5 female patients, with median age of 60.5 years old(47-68 years old)...
March 1, 2018: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
Margaret E Kruk, Anna D Gage, Godfrey M Mbaruku, Hannah H Leslie
OBJECTIVE: Describe content of clinical care for sick children in low-resource settings. DATA SOURCES: Nationally representative health facility surveys in Haiti, Kenya, Malawi, Namibia, Nepal, Rwanda, Senegal, Tanzania, and Uganda from 2007 to 2015. STUDY DESIGN: Clinical visits by sick children under 5 years were observed and caregivers interviewed. We describe duration and content of the care in the visit and estimate associations between increased content and caregiver knowledge and satisfaction...
March 7, 2018: Health Services Research
Kevin P McCutcheon, Wanda L Whittet, Julie L Kirsten, John L Fuchs
BACKGROUND: Challenges for bedside placement of small-bore feeding tube (SBFT) include iatrogenic injury, multiple exposures to x-rays, and prolonged placement times. In 2011, the study facility began a feeding tube placement team (FTPT) using the CORTRAK system (CS) in the adult intensive care unit (ICU) and medical-surgical populations. In 2013, a protocol was implemented using the CS to determine final SBFT location. METHODS: Serial retrospective reviews were done of patients with SBFT placement by the FTPT during July 2011-December 2012 and 2015...
January 2018: JPEN. Journal of Parenteral and Enteral Nutrition
H Tafazal, P Spreadborough, D Zakai, N Shastri-Hurst, S Ayaani, M Hanif
Introduction There is an increasing trend towards day case surgery for uncomplicated gallstone disease. The challenges of maximising training opportunities are well recognised by surgical trainees and the need to demonstrate timely progression of competencies is essential. Laparoscopic cholecystectomy provides the potential for excellent trainee learning opportunities. Our study builds upon previous work by assessing whether measures of outcome are still affected when cases are stratified based on procedural difficulty...
March 2018: Annals of the Royal College of Surgeons of England
Mélanie Sustersic, Aurélie Gauchet, Anaïs Kernou, Charlotte Gibert, Alison Foote, Céline Vermorel, Jean-Luc Bosson
BACKGROUND: There is no validated generic tool to measure Doctor-Patient-Communication (DPC) in a context of acute conditions. OBJECTIVE: To create and validate such a scale in a real population. MATERIALS AND METHOD: We performed a systematic review of validated DPC scales available in English. From these, using a theoretical model based on a multidisciplinary approach, we selected pertinent items that met the inclusion criteria and included them in a simple questionnaire...
2018: PloS One
Leandro Pereira Garcia, Camila Mariano Fernandes, Jefferson Traebert
OBJECTIVES: To analyze the risk factors for neonatal death in Florianópolis, the Brazilian city capital with the lowest infant mortality rate. METHOD: Data were extracted from a historical cohort with 15,879 live births. A model was used that included socioeconomic, behavioral, and health service use risk factors, as well as the Apgar score and biological factors. Risk factors were analyzed by hierarchical logistic regression. RESULTS: Based on the multivariate analysis, socioeconomic factors showed no association with death...
February 11, 2018: Jornal de Pediatria
Emilie Bessède, Julien Asselineau, Paul Perez, Guillaume Valdenaire, Olivier Richer, Philippe Lehours, Francis Mégraud
The detection of campylobacters in stools is performed essentially by culture, but this technique has a low sensitivity. New detection methods are now available. Among them, immunochromatography tests (ICTs) are very attractive in that they offer a result within 15 minutes. However, previous studies suggest that these tests have a relatively low specificity. The objective of this study was to evaluate the performance of these tests.During the study period, all patients who consulted the emergency units and had a stool culture were included...
February 7, 2018: Journal of Clinical Microbiology
Erin Keely, Jennifer Li, Peter Magner, Amir Afkham, Clare Liddy
Background: The Champlain BASE™ (Building Access to Specialists through eConsultation) eConsult service allows primary care providers (PCPs) to submit patient-specific clinical questions to specialists via a secure web service. Objective: Our objective was to describe the types of nephrology questions asked through an eConsult service based in eastern Ontario and assess the service's impact on the need for face-to-face consultations. Design: Cross-sectional study using descriptive statistics was conducted using nephrology cases submitted between May 2011 and January 2015...
2018: Canadian Journal of Kidney Health and Disease
Peishan Wu, Katherine Longbottom, Rosemary Hague, Gillian Vance
Adverse drug reactions are common in children, but true drug allergy is rare. It can be difficult to determine whether signs such as skin rashes are caused by the underlying illness or medications prescribed. Accurate diagnosis is important for patient safety and optimal treatment. We review the presentation of drug allergy and discuss current management options for children.
November 9, 2017: Archives of Disease in Childhood. Education and Practice Edition
LaDonna S Hale, Lindsey L Votaw, Janell E Mayer, Kristen F Sobota
OBJECTIVE: Describe knowledge, perceptions, and self-confidence of nurses in the long-term care setting before and after online antibiotic stewardship education, and assess effectiveness and satisfaction with the education. DESIGN: Pre-/postsurvey. SETTING: Three long-term care facilities, Topeka, Kansas. PARTICIPANTS: Convenience sample of 140 licensed practical and registered nurses. INTERVENTIONS: Nurses viewed a 12-minute online module developed by long-term care consultant pharmacists...
November 1, 2017: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
Rohan A Elliott, Cik Yin Lee, Christine Beanland, Dianne P Goeman, Neil Petrie, Barbara Petrie, Felicity Vise, June Gray
OBJECTIVE: To develop a collaborative, person-centred model of clinical pharmacy support for community nurses and their medication management clients. DESIGN: Co-creation and participatory action research, based on reflection, data collection, interaction and feedback from participants and other stakeholders. SETTING: A large, non-profit home nursing service in Melbourne, Australia. PARTICIPANTS: Older people referred to the home nursing service for medication management, their carers, community nurses, general practitioners (GPs) and pharmacists, a multidisciplinary stakeholder reference group (including consumer representation) and the project team...
November 3, 2017: BMJ Open
D Bruce, C Kocialkowski, F Bintcliffe, F Monsell, J Barnes, R Brown
PURPOSE: We report our experience of a paediatric orthopaedic network, based on a 'hub and spoke' model, covering the South West of the United Kingdom. We identify the areas of most clinical concern, the effect of the network on stream-lining patient management and the benefits of the network to the clinician. METHODS: Prospective data were collected from the minutes of the bi-annual meetings of the South West Paediatric Network (UK) between November 2006 and May 2012...
October 1, 2017: Journal of Children's Orthopaedics
Pankaj B Shah, Saji James, S Elayaraja
BACKGROUND: Febrile seizures can be classified as simple or complex. Complex febrile seizures are associated with fever that lasts longer than 15 minutes, occur more than once within 24 hours, and are confined to one side of the child's body. It is common in some countries for doctors to recommend an electroencephalograph (EEG) for children with complex febrile seizures. A limited evidence base is available to support the use of EEG and its timing after complex febrile seizures among children...
October 7, 2017: Cochrane Database of Systematic Reviews
N Kacenelenbogen
CONTEXT: in Belgium 70 % of the children aged 0 - 14 years have at least one annual contact with their family doctor, while for the same period, only 6 - 12 % of them will see a neuropaediatrician and/or a child psychiatrist, despite the fact that a diagnostic of Externalizing behavior before the age of 6 to 7 years, such as various ways of aggressiveness, of anger or of stealing will very often alert the family, the staff of creches or nursery as well as the teachers. Other children are showing signs of Internalizing behavior, very often together with depression or other forms of anxiety...
2017: Revue Médicale de Bruxelles
Emily J Tomayko, Ronald J Prince, Jill Hoiting, Abbe Braun, Tara L LaRowe, Alexandra K Adams
Physical activity is a critical component of obesity prevention, but few interventions targeting early childhood have been described. The Active Early guide was designed to increase physical activity in early care and education (ECE) settings. The purpose of Active Early 2.0 was to evaluate the effectiveness of Active Early along with provider training, microgrant support, and technical assistance over 2 years (2012-2014) to increase physical activity and related behaviors (e.g., nutrition) in settings serving a high proportion of children from underserved groups in recognition of significant disparities in obesity and challenges meeting physical activity recommendations in low-resource settings...
December 2017: Preventive Medicine Reports
Ana-Marija Hristovska, Patricia Duch, Mikkel Allingstrup, Arash Afshari
BACKGROUND: Acetylcholinesterase inhibitors, such as neostigmine, have traditionally been used for reversal of non-depolarizing neuromuscular blocking agents. However, these drugs have significant limitations, such as indirect mechanisms of reversal, limited and unpredictable efficacy, and undesirable autonomic responses. Sugammadex is a selective relaxant-binding agent specifically developed for rapid reversal of non-depolarizing neuromuscular blockade induced by rocuronium. Its potential clinical benefits include fast and predictable reversal of any degree of block, increased patient safety, reduced incidence of residual block on recovery, and more efficient use of healthcare resources...
August 14, 2017: Cochrane Database of Systematic Reviews
Ayesha Saleem
OBJECTIVE: To evaluate the effectiveness and determine the peroperative and postoperative complications of tension-free vaginal tape (TVT) sling for urinary stress incontinence (USI) and contributing factors to complications. STUDY DESIGN: Descriptive study. PLACE AND DURATION OF STUDY: Kidney Centre Postgraduate Institute, Karachi, from January 2009 to December 2010. METHODOLOGY: One hundred consecutive patients underwent TVT as per Ulmsten Technique for urinary stress incontinence and patients were followed for 3 years...
June 2017: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
Ashley O'Toole, Jiyeh Joo, Jean-Pierre DesGroseilliers, Clare Liddy, Steven Glassman, Amir Afkham, Erin Keely
BACKGROUND: eConsult is a web based service that facilitates communication between primary care providers (PCPs) and specialists, which can reduce the need for face-to-face consultations with specialists. One example is the Champlain BASE (Building Access to Specialist through eConsultation) service with dermatology being the largest specialty consulted. METHODS: Dermatology eConsults submitted from July 2011 to January 2015 were reviewed. Post eConsult surveys for PCPs were analyzed to determine the number of traditional consults avoided and perceived value of eConsults...
June 6, 2017: International Journal of Dermatology
Jürgen Kasper, Katrin Liethmann, Christoph Heesen, Daniel R Reissmann, Friedemann Geiger
OBJECTIVE: To carry out preliminary evaluation of a training module for doctors to enhance their ability to involve their patients in medical decision making. The training refers to the shared decision-making (SDM) communication concept. METHODS: The training module includes a comprehensive manual, a corresponding video tutorial with communication examples and a 15-minute face-to-face feedback session based on an SDM analysis of a consultation recording provided by the trainee...
December 2017: Health Expectations: An International Journal of Public Participation in Health Care and Health Policy
B A Ahmad, K Khairatul, A Farnaza
Waiting is a common phenomenon in the doctor's waiting room. The purpose of this audit is to assess patient waiting time and doctor consultation time in a primary healthcare clinic and to formulate strategies for improvement. This audit was conducted at a primary care clinic for 4 weeks using the universal sampling method. All patients who attended the clinic during this period was included in the study except for those who required more time to be seen such as those who were critically ill, aggressive or those who came for repeat medication or procedures only without needing to see the doctor...
2017: Malaysian Family Physician
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