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Pre-Hospital Care

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https://www.readbyqxmd.com/read/28086822/assessment-of-quality-of-care-among-in-patients-with-postpartum-haemorrhage-and-severe-pre-eclampsia-at-st-francis-hospital-nsambya-a-criteria-based-audit
#1
Alfred Lumala, Peter Sekweyama, Andrew Abaasa, Humphrey Lwanga, Romano Byaruhanga
BACKGROUND: The maternal mortality ratio of Uganda is still high and the leading causes of maternal mortality are postpartum haemorrhage (PPH), severe pre-eclampsia and eclampsia. Criteria-based audit (CBA) is a way of improving quality of care that has not been commonly used in low income countries. This study aimed at finding out the quality of care provided to patients with these conditions and to find out if the implementation of recommendations from the audit cycle resulted in improvement in quality of care...
January 13, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28086784/health-related-quality-of-life-assessment-in-acute-coronary-syndrome-patients-the-effectiveness-of-early-phase-i-cardiac-rehabilitation
#2
Lawrence Anchah, Mohamed Azmi Hassali, Melissa Siaw Han Lim, Mohamed Izham Mohamed Ibrahim, Kui Hian Sim, Tiong Kiam Ong
BACKGROUND: Acute Coronary Syndrome (ACS) is one of the most burdensome cardiovascular diseases in terms of the cost of interventions. The Cardiac Rehabilitation Programme (CRP) is well-established in improving clinical outcomes but the assessment of actual clinical improvement is challenging, especially when considering pharmaceutical care (PC) values in phase I CRP during admission and upon discharge from hospital and phase II outpatient interventions. This study explores the impact of pharmacists' interventions in the early stages of CRP on humanistic outcomes and follow-up at a referral hospital in Malaysia...
January 13, 2017: Health and Quality of Life Outcomes
https://www.readbyqxmd.com/read/28080157/detection-of-recurrence-in-early-stage-endometrial-cancer-the-role-of-symptoms-and-routine-follow-up
#3
Mette Moustgaard Jeppesen, Ole Mogensen, Dorte Gilså Hansen, Maria Iachina, Malene Korsholm, Pernille Tine Jensen
BACKGROUND: Considerable controversy remains as to the optimal organization of endometrial cancer follow-up. AIM: To evaluate the relationship between the way recurrence was detected and survival after treatment for endometrial cancer. Further, to identify characteristics associated with a pre-scheduled examination in women with symptomatic recurrence. MATERIAL AND METHODS: All women with early stage endometrial cancer during 2005-2009 were included in a population-based historical cohort derived from the Danish Gynecological Cancer Database...
January 12, 2017: Acta Oncologica
https://www.readbyqxmd.com/read/28077058/imaging-investigations-before-referral-to-a-sarcoma-center-delay-the-final-diagnosis-of-musculoskeletal-sarcoma
#4
Heidi Buvarp Dyrop, Peter Vedsted, Mathias Rædkjær, Akmal Safwat, Johnny Keller
Background and purpose - The use of point-of-care or local investigations before referral to specialist sarcoma centers as part of a fast-track diagnostic pathway varies, and may affect the time to diagnosis. We wanted to investigate differences in time intervals and proportion of malignancy in patients who were referred after initial diagnostic investigations were performed locally and in patients who were referred without these investigations. Patients and methods - We included 545 consecutive patients who were referred to Aarhus Sarcoma Center for suspected musculoskeletal sarcoma...
January 12, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28074472/cost-evaluation-of-irinotecan-related-toxicities-associated-with-the-ugt1a1-28-patient-genotype
#5
R Roncato, E Cecchin, M Montico, E De Mattia, L Giodini, A Buonadonna, V Solfrini, F Innocenti, G Toffoli
The adoption of a pre-emptive UGT1A1*28 genotyping to increase irinotecan safety in clinical practice is still limited. This is the first actual study of costs associated to the management of irinotecan-related toxicity, and their association with UGT1A1*28 genotype. A retrospective analysis of the cost of toxicity management was conducted on 243 metastatic colorectal cancer patients enrolled in a clinical trial and treated with standard of care FOLFIRI. The mean predicted cost per patient was higher for *28/*28 (4,886€), versus *1/*1 (812€), (regression coefficient 1...
January 11, 2017: Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/28073292/health-care-utilization-after-hospice-enrollment-in-patients-with-heart-failure-and-cancer
#6
Meredith A MacKenzie, Alexandra Hanlon
This study aimed to examine the role of diagnosis in health-care utilization patterns after hospice enrollment. Using 2007 National Home and Hospice Care Survey data from hospice patients with heart failure (n = 311) and cancer (n = 946), we analyzed emergency service use and discharge to hospital via logistic regression pre- and postpropensity score matching. Prematching, patients with heart failure had twice the odds of emergency services use than patients with cancer ( P < .001) and twice the odds of discharge to hospital ( P = ...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28070670/the-impact-of-pneumococcal-conjugate-vaccine-on-community-acquired-pneumonia-hospitalizations-in-children-with-comorbidity
#7
Ellinor Sterky, Rutger Bennet, Ann Lindstrand, Margareta Eriksson, Anna Nilsson
: The burden of community-acquired pneumonia (CAP) in high-income countries is still significant. The introduction of pneumococcal conjugate vaccines (PCV) has reduced the overall need for hospitalization for CAP. However, it is not clear whether children with underlying disease also have benefitted from the PCV immunization programme. Children 0 to <5 years of age hospitalized with CAP and discharged with an ICD-10 code of J13-J18.9 between November 1, 2005, and April 30, 2007 (pre-vaccination period), and November 1, 2010, and April 30, 2012 (post-vaccination period), were eligible for this study...
January 9, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28070149/outcome-analysis-of-hip-or-knee-arthroplasty-in-patients-with-cirrhotic-liver-disease
#8
Young-Jun Seol, Taek-Rim Yoon, Dong-Hyun Lee, Sun-Ho Lee, Kyung-Soon Park
OBJECTIVE: Present helpful measures to prevent expected complications that occur in patients with liver cirrhosis undergoing arthroplasty. METHODS: 218 patients who underwent hip or knee arthroplasty were included in this study. Prognoses of patients with underlying disease of liver cirrhosis and those without are compared with measures. RESULTS: Patients with liver cirrhosis show an increase in amount of bleeding, hospital stay and infection rate compared to those who do not...
March 2017: Journal of Orthopaedics
https://www.readbyqxmd.com/read/28070029/the-relationship-between-scores-and-outcomes-for-polytrauma-patients-in-the-emergency-department-a-case-study
#9
Maria Gioffre-Florio, Letizia Maria Murabito, Carmela Visalli, Alessandra Villari, Floriana Lauritano, Carla Bramanti, Fausto Fama
AIM: Traumas are one of the most relevant pathological events in health care, because of clinical and prognostic relevance. Morbidity and mortality rates are strongly affected by the timely and correct approach to the patient (golden hour). The objective of this study was to investigate the possible influence of the diagnostic time and of the Injury Severity Score (ISS) on outcomes in trauma patients. MATERIAL OF STUDY: Out of a total of 240,833 emergency patients, we observed, 447 polytrauma...
December 29, 2016: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/28068945/why-women-bleed-and-how-they-are-saved-a-cross-sectional-study-of-caesarean-section-near-miss-morbidity
#10
S Maswime, E J Buchmann
BACKGROUND: Maternal deaths from 'bleeding during and after caesarean section' (BDACS) have increased in South Africa, and have now become the largest sub-cause of deaths from obstetric haemorrhage. The aim of this study was to describe risk factors and causes of near-miss related to BDACS and interventions used to arrest haemorrhage and treat its effects. METHODS: Cross-sectional prospective study in 13 urban public hospitals in South Africa, from July to December 2014...
January 9, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28066904/implementing-point-of-care-ultrasonography-of-the-heart-and-lungs-in-an-anesthesia-department
#11
M T Bøtker, M L Vang, T Grøfte, H Kirkegaard, C A Frederiksen, E Sloth
BACKGROUND: Implementation of point-of-care ultrasonography (POCUS) of the heart and lungs requires image acquisition skills among providers. We aimed to determine the effect of POCUS implementation using a systematic education program on image acquisition skills and subsequent use and barriers in a department of anesthesiology. METHODS: Twenty-five anesthesiologists underwent a systematic education program in POCUS during the fall of 2012. A POCUS expert evaluated images from baseline and evaluation examinations performed on two healthy individuals as useful or not useful for clinical interpretation...
February 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28066851/analysis-of-smartphone-interruptions-on-academic-general-internal-medicine-wards-frequent-interruptions-may-cause-a-crisis-mode-work-climate
#12
Alon Vaisman, Robert C Wu
INTRODUCTION: Hospital-based medical services are increasingly utilizing team-based pagers and smartphones to streamline communications. However, an unintended consequence may be higher volumes of interruptions potentially leading to medical error. There is likely a level at which interruptions are excessive and cause a 'crisis mode' climate. METHODS: We retrospectively collected phone, text messaging, and email interruptions directed to hospital-assigned smartphones on eight General Internal Medicine (GIM) teams at two tertiary care centres in Toronto, Ontario from April 2013 to September 2014...
January 4, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28065700/integrating-supportive-care-principles-into-dialysis-decision-making-a-primer-for-palliative-medicine-providers
#13
Alvin H Moss
Despite advances in pre-dialysis care and dialysis technology, patients with advanced chronic kidney disease and end-stage renal disease continue to experience multiple comorbidities, a high symptom burden, a shortened life expectancy and substantial physical, emotional, and spiritual suffering. Patients with acute kidney injury and end-stage renal disease, especially if they are older, often undergo prolonged hospitalizations, greater use of intensive medical treatment, and limited survival. Unfortunately, most nephrologists are not trained to conduct shared decision-making conversations to elicit patients' values, preferences, and goals for treatment and address their patients' multifactorial suffering...
January 5, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28065689/virtual-teach-to-goal%C3%A2-adaptive-learning-of-inhaler-technique-for-inpatients-with-asthma-or-copd
#14
Valerie G Press, Colleen A Kelly, John J Kim, Steven R White, David O Meltzer, Vineet M Arora
BACKGROUND: Asthma and chronic obstructive pulmonary disease (COPD) result in more than 1 million hospitalizations annually. Most hospitalized patients misuse respiratory inhalers. This misuse can be corrected with in-person education; however, this strategy is resource intensive and skills wane quickly after discharge. OBJECTIVE: The objective of this study was to develop and pilot a virtual teach-to-goal™ (V-TTG™) inhaler skill training module, using innovative adaptive learning technology...
January 5, 2017: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/28063822/-hospital-discharge-criteria-for-very-low-birth-weight-newborns
#15
Isabel Benavente Fernández, María Dolores Sánchez Redondo, Jose Luis Leante Castellanos, Alejandro Pérez Muñuzuri, Segundo Rite Gracia, Cèsar W Ruiz Campillo, Ester Sanz López, Manuel Sánchez Luna
Hospital discharge criteria for the pre-term newborn are mainly based on physiological competences (thermoregulation, respiratory stability, and feeding skills), although family support and ability to care for the baby, as well as a well-planned discharge are also cornerstones to ensure a successful discharge. In this article, the Committee of Standards of the Spanish Society of Neonatology reviews the current hospital discharge criteria in order for it to be useful as a clinical guide in Spanish neonatal units...
January 4, 2017: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/28062881/characteristics-and-risk-factors-for-mortality-in-paediatric-in-hospital-cardiac-events-in-singapore-retrospective-single-centre-experience
#16
Yee Hui Mok, Amanda Pt Loke, Tsee Foong Loh, Jan Hau Lee
Introduction: There is limited data on paediatric resuscitation outcomes in Asia. We aimed to describe outcomes of paediatric in-hospital cardiac arrests (IHCA) and peri-resuscitation factors associated with mortality in our institution. Materials and Methods: Using data from our hospital's code registry from 2009 to 2014, we analysed all patients younger than 18 years of age with IHCA who required cardiopulmonary resuscitation (CPR). Exposure variables were obtained from clinical demographics, CPR and post-resuscitation data...
December 2016: Annals of the Academy of Medicine, Singapore
https://www.readbyqxmd.com/read/28062529/a-mixed-reality-simulator-concept-for-future-medical-emergency-response-team-training
#17
Robert J Stone, R Guest, P Mahoney, D Lamb, C Gibson
The UK Defence Medical Service's Pre-Hospital Emergency Care (PHEC) capability includes rapid-deployment Medical Emergency Response Teams (MERTs) comprising tri-service trauma consultants, paramedics and specialised nurses, all of whom are qualified to administer emergency care under extreme conditions to improve the survival prospects of combat casualties. The pre-deployment training of MERT personnel is designed to foster individual knowledge, skills and abilities in PHEC and in small team performance and cohesion in 'mission-specific' contexts...
January 6, 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/28061841/supervised-neuromuscular-exercise-prior-to-hip-and-knee-replacement-12-month-clinical-effect-and-cost-utility-analysis-alongside-a-randomised-controlled-trial
#18
Linda Fernandes, Ewa M Roos, Søren Overgaard, Allan Villadsen, Rikke Søgaard
BACKGROUND: There are indications of beneficial short-term effect of pre-operative exercise in reducing pain and improving activity of daily living after total hip replacement (THR) and total knee replacement (TKR) surgery. Though, information from studies conducting longer follow-ups and economic evaluations of exercise prior to THR and TKR is needed. The aim of the study was to analyse 12-month clinical effect and cost-utility of supervised neuromuscular exercise prior to THR and TKR surgery...
January 6, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28060690/-peritoneal-dialysis-in-the-first-two-years-of-life-experience-of-a-nephrology-and-renal-transplantation-pediatric-unit
#19
Sofia Deuchande, Tânia Mano, Cristina Novais, Rute Machado, Rosário Stone, Margarida Almeida
INTRODUCTION: Peritoneal dialysis is the dialytic method of choice in chronic end-stage renal disease in children. This study main purpose was to characterize the long-term survival of a pediatric population who began peritoneal dialysis within the first two years of life. MATERIAL AND METHODS: A descriptive and retrospective study was performed in a portuguese nephrology and renal transplantation pediatric unit, between January 1991 and August 2014. End-stage renal disease etiology, mortality, comorbidities and complications of peritoneal dialysis and end-stage renal disease, growth and psychomotor development were evaluated...
September 2016: Acta Médica Portuguesa
https://www.readbyqxmd.com/read/28058496/-traumatology-in-the-elderly-multimodal-prevention-of-delirium-and-use-of-augmentation-techniques
#20
D Wähnert, A Roos, J Glasbrenner, K Ilting-Reuke, P Ohrmann, G Hempel, T Duning, N Roeder, M J Raschke
Recent data show that 20-80% of surgery patients are affected by delirium during inpatient clinical treatment. The medical consequences are often dramatic and include a 20 times higher mortality and treatment expenses of the medical unit increase considerably. At the University Hospital of Münster a multimodal and interdisciplinary concept for prevention and management of delirium was developed: all patients older than 65 years admitted for surgery are screened by a specialized team for the risk of developing delirium and treated by members of the team if there is a risk of delirium...
January 5, 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
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