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https://www.readbyqxmd.com/read/29122832/fifteen-minute-consultation-a-child-with-a-suspected-drug-allergy
#1
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
https://www.readbyqxmd.com/read/29113637/nurses-knowledge-perception-and-self-confidence-regarding-evidence-based-antibiotic-use-in-the-long-term-care-setting
#2
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
https://www.readbyqxmd.com/read/29102998/development-of-a-clinical-pharmacy-model-within-an-australian-home-nursing-service-using-co-creation-and-participatory-action-research-the-visiting-pharmacist-vip-study
#3
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
https://www.readbyqxmd.com/read/29081857/analysis-of-a-paediatric-orthopaedic-network-a-six-year-experience-in-the-south-west-of-the-united-kingdom
#4
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
https://www.readbyqxmd.com/read/28986982/eeg-for-children-with-complex-febrile-seizures
#5
REVIEW
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
https://www.readbyqxmd.com/read/28981223/-child-behavior-disorder-clinical-reasoning-in-general-practice
#6
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
https://www.readbyqxmd.com/read/28936391/evaluation-of-a-multi-year-policy-focused-intervention-to-increase-physical-activity-and-related-behaviors-in-lower-resourced-early-care-and-education-settings-active-early-2-0
#7
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
https://www.readbyqxmd.com/read/28806470/efficacy-and-safety-of-sugammadex-versus-neostigmine-in-reversing-neuromuscular-blockade-in-adults
#8
REVIEW
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
https://www.readbyqxmd.com/read/28689526/tension-free-vaginal-taping-in-pakistani-women-with-stress-urinary-incontinence
#9
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
https://www.readbyqxmd.com/read/28585722/the-association-between-question-type-and-the-outcomes-of-a-dermatology-econsult-service
#10
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
https://www.readbyqxmd.com/read/28521082/training-doctors-briefly-and-in-situ-to-involve-their-patients-in-making-medical-decisions-preliminary-testing-of-a-newly-developed-module
#11
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
https://www.readbyqxmd.com/read/28503269/an-assessment-of-patient-waiting-and-consultation-time-in-a-primary-healthcare-clinic
#12
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
https://www.readbyqxmd.com/read/28470015/econsultations-to-infectious-disease-specialists-questions-asked-and-impact-on-primary-care-providers-behavior
#13
Ruchi Murthy, Gregory Rose, Clare Liddy, Amir Afkham, Erin Keely
BACKGROUND: Since 2010, the Champlain BASE (Building Access to Specialist Advice through eConsultation) has allowed primary care providers (PCPs) to submit clinical questions to specialists through a secure web service. The study objectives are to describe questions asked to Infectious Diseases specialists through eConsultation and assess impact on physician behaviors. METHODS: eConsults completed through the Champlain BASE service from April 15, 2013 to January 29, 2015 were characterized by the type of question asked and infectious disease content...
2017: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/28418599/use-of-the-harmonic-scalpel-for-delorme-s-procedure
#14
David Parés, Ioanna Drami, Katie Adams, Ugo Grossi, Ibnauf Suliman, Charles H Knowles
AIM: There are many surgical techniques to deal with external rectal prolapse but perineal procedures have the advantage of reduced invasiveness. Therefore, despite concerns regarding high recurrence rates, the technique is still used by many surgeons. METHOD: This manuscript and video describe our early clinical experience using the harmonic scalpel in eleven consecutive patients who underwent a Delorme's procedure for external rectal prolapse. RESULTS: The median age of patients was 76 years (range 30-94)...
April 18, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28407258/a-cardiovascular-prescreening-protocol-for-unmonitored-in-office-laryngology-procedures
#15
MULTICENTER STUDY
Lyndsay L Madden, John Ward, Anne Ward, VyVy N Young, Libby J Smith, David G Lott, Paul C Bryson, Matthew S Clary, Phillip A Weissbrod, Jonathan M Bock, Joel H Blumin, Clark A Rosen
OBJECTIVES: Currently, there are no cardiovascular (CV) preprocedure screening parameters for patients undergoing in-office laryngeal procedures (IOLP). Studies have shown significant changes in CV measures for IOLP. The aim was to develop and evaluate a pre-IOLP CV screening protocol. METHODS: Review of IOLP literature and consultation with an anesthesiologist and cardiologist led to the development of CV parameters and questions related to four metabolic equivalents (METS) of work as a patient-screening tool before IOLP...
August 2017: Laryngoscope
https://www.readbyqxmd.com/read/28402085/decision-aids-for-people-facing-health-treatment-or-screening-decisions
#16
REVIEW
Dawn Stacey, France Légaré, Krystina Lewis, Michael J Barry, Carol L Bennett, Karen B Eden, Margaret Holmes-Rovner, Hilary Llewellyn-Thomas, Anne Lyddiatt, Richard Thomson, Lyndal Trevena
BACKGROUND: Decision aids are interventions that support patients by making their decisions explicit, providing information about options and associated benefits/harms, and helping clarify congruence between decisions and personal values. OBJECTIVES: To assess the effects of decision aids in people facing treatment or screening decisions. SEARCH METHODS: Updated search (2012 to April 2015) in CENTRAL; MEDLINE; Embase; PsycINFO; and grey literature; includes CINAHL to September 2008...
April 12, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28319519/process-improvement-initiative-for-the-perioperative-management-of-patients-with-a-cardiovascular-implantable-electronic-device
#17
Margaret K Menzel Ellis, Miriam M Treggiari, Jamie M Robertson, Marc A Rozner, Peter F Graven, Michael F Aziz, Matthias J Merkel, Edward A Kahl, Norman A Cohen, Eric C Stecker, Peter M Schulman
BACKGROUND: Economic, personnel, and procedural challenges often complicate and interfere with efficient and safe perioperative care of patients with cardiovascular implantable electronic devices (CIEDs). In the context of a process improvement initiative, we created and implemented a comprehensive anesthesiologist-run perioperative CIED service to respond to all routine requests for perioperative CIED consultations at a large academic medical center. This study was designed to determine whether this new care model was associated with improved operating room efficiency, reduced institutional cost, and adequate patient safety...
July 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28316625/microbiological-study-of-cast-posts-before-cementation
#18
Maricela Vallejo-Labrada, Juan Carlos Ojeda-Garces
This study identifies the most common microorganisms present in type III gold cast posts related to pulpal disease and evaluates the sterilization/disinfection method before cementation in the root canal. Forty-five type III gold cast posts were aseptically collected in sterile sealed plastic bags and taken to the microbiology laboratory to carry out the study: fifteen cast posts had no treatment, fifteen were disinfected (immersion in 70% alcohol during 15 minutes), and fifteen were autoclaved at 121°C for 15 minutes by using saturated steam under 15 psi pressure...
2017: International Journal of Dentistry
https://www.readbyqxmd.com/read/28196076/patient-safety-incidents-are-common-in-primary-care-a-national-prospective-active-incident-reporting-survey
#19
RANDOMIZED CONTROLLED TRIAL
Philippe Michel, Jean Brami, Marc Chanelière, Marion Kret, Anne Mosnier, Isabelle Dupie, Anouk Haeringer-Cholet, Maud Keriel-Gascou, Claire Maradan, Frédéric Villebrun, Meredith Makeham, Jean-Luc Quenon
BACKGROUND: The study objectives were to describe the incidence and the nature of patient safety incidents (PSIs) in primary care general practice settings, and to explore the association between these incidents and practice or organizational characteristics. METHODS: GPs, randomly selected from a national influenza surveillance network (n = 800) across France, prospectively reported any incidents observed each day over a one-week period between May and July 2013...
2017: PloS One
https://www.readbyqxmd.com/read/28156601/what-s-in-the-special-sauce-of-protocol-driven-outpatient-palliative-care-consultations
#20
Marie Bakitas, J Nicholas Dionne-Odom, Jennifer Frost, Margaret Plunkett, Lisa A Lisa A Stephens, Peggy Bishop
139 Background: Initial outpatient palliative care consultations (OPCC) in clinics are usually requested for uncontrolled symptoms. The purpose of this substudy was to determine the nature of recommendations made in early PC (EPC) protocol-driven OPCC. METHODS: Using a standardized tool, we conducted a content analysis on the assessment and plan components of protocol-driven OPCCs. OPCCs were conducted as a component of the ENABLE [Educate, Nurture, Advise, Before Life Ends] RCT (10/2010-9/2013) consisting of an OPCC and 6 structured weekly telephone coaching sessions and monthly follow up either at study entry (early) or 12 weeks later (delayed)...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
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