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https://www.readbyqxmd.com/read/29935126/what-is-resilience-and-how-can-it-be-nurtured-a-systematic-review-of-empirical-literature-on-organizational-resilience
#1
Edwine Barasa, Rahab Mbau, Lucy Gilson
BACKGROUND: Recent health system shocks such as the Ebola outbreak of 2014-2016 and the global financial crisis of 2008 have generated global health interest in the concept of resilience. The concept is however not new, and has been applied to other sectors for a longer period of time. We conducted a review of empirical literature from both the health and other sectors to synthesize evidence on organizational resilience. METHODS: We systematically searched for literature in PubMed, Econlit, EBSCOHOST databases, google, and Google Scholar and manually searched the reference lists of selected papers...
February 6, 2018: International Journal of Health Policy and Management
https://www.readbyqxmd.com/read/29934370/young-man-presenting-with-out-of-hospital-cardiac-arrest
#2
Hans David Huang, William L Lombardi, Zachary Louis Steinberg
CLINICAL INTRODUCTION: A man in his early 30s with remote history of a febrile rash as a toddler presented to the emergency room following an out-of-hospital cardiac arrest while riding his bicycle. He received bystander cardiopulmonary resuscitation and one shock from an automatic external defibrillator, successfully restoring sinus rhythm. On arrival, he was haemodynamically stable without ECG evidence of ST segment changes to suggest active ischaemia, and an initial troponin I was mildly elevated at 0...
June 22, 2018: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29933894/optimal-sequence-of-surgical-procedures-for-hemodynamically-unstable-patients-with-pelvic-fracture-a-network-meta-analysis
#3
Jingli Tang, Zhanying Shi, Juzheng Hu, Hao Wu, Chengzhi Yang, Guoping Le, Jinmin Zhao
BACKGROUND: The mortality rate of patients with hemodynamic instability due to severe pelvic fracture remains substantial and massive transfusion happens frequently. Angio-embolization, external fixation and preperitoneal pelvic packing of the pelvis are the main managements used to control bleeding in these patients. In this paper, we aimed at characterizing the rationale of these surgical managements, and placed them in optimal management algorithm to compose a new guideline. METHODS: We selected controlled trials, assessing safety of management for the intervention of hemorrhagic shock from mortality data, and assessing efficacy from volume of first 24 h blood transfusion following hospitalization...
June 19, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29933141/let-sleeping-bats-lie-analyzing-institutional-adaptation-to-environmental-regulatory-change-through-adaptive-management-theory
#4
Evan M Mistur, Gordon Kingsley, Daniel C Matisoff, Yehyun An
Employing a case of a state transportation agency, we examine how complex institutions which integrate outsourcing within a bureaucratic process adapt to environmental regulatory changes. In 2012, two endangered species of bats were located outside of their established ranges in northern Georgia. These discoveries required the Georgia Department of Transportation (GDOT) to comply with a new set of federal regulations relating to those species when developing its projects. This article examines how GDOT adapted to new and unforeseen regulations in the face of environmental uncertainty...
June 19, 2018: Journal of Environmental Management
https://www.readbyqxmd.com/read/29930433/-cornual-pregnancy-in-2-cases
#5
S Wang, Y Zhang, Y Y Zhao, S Lu
Cornual pregnancy is one of the diseases caused by embryo embedment at abnormal site. Since few women with cornual pregnancy continue to a middle or late gestation are at a relatively increased risk of uterus rupture,placenta accrete,postpartum hemorrhage and some other severe obstetric complications. We reported two cases of cornual pregnancy at the third trimester, including their clinical symptoms, diagnoses, treatments and obstetric outcomes. Patient 1 had regular prenatal examination. The ultrasound scan at the second trimester showed that the placenta was located at the right fundus of uterus and the myometrium was thin...
June 18, 2018: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/29928313/-combat-approach-to-cardiogenic-shock
#6
REVIEW
Alexander G Truesdell, Behnam Tehrani, Ramesh Singh, Shashank Desai, Patricia Saulino, Scott Barnett, Stephen Lavanier, Charles Murphy
The incidence of cardiogenic shock is rising, patient complexity is increasing and patient survival has plateaued. Mirroring organisational innovations of elite military units, our multidisciplinary medical specialists at the INOVA Heart and Vascular Institute aim to combine the adaptability, agility and cohesion of small teams across our large healthcare system. We advocate for widespread adoption of our 'combat' methodology focused on: increased disease awareness, early multidisciplinary shock team activation, group decision-making, rapid initiation of mechanical circulatory support (as appropriate), haemodynamic-guided management, strict protocol adherence, complete data capture and regular after action reviews, with a goal of ending preventable death from cardiogenic shock...
May 2018: Interventional cardiology
https://www.readbyqxmd.com/read/29926792/a-paradigm-shift-in-the-provision-of-improved-critical-care-in-the-emergency-department
#7
K M Yim, H F Ko, M Lc Yang, T Y Li, S Ip, J Tsui
With Hong Kong's ageing population, advancement of medical technologies and hospital congestion, it is not uncommon for emergency physicians to encounter complicated critically ill patients in daily practice. It becomes a fundamental role of emergency physicians to initiate timely diagnostic and therapeutic interventions to save a patient's life and improve their prognosis. It is the reason a critical care service has been developed in emergency departments worldwide over the last decade. This article shares how emergency department intensivists can contribute to this novel model of care with some illustrative cases...
June 2018: Hong Kong Medical Journal, Xianggang Yi Xue za Zhi
https://www.readbyqxmd.com/read/29923896/part-iii-minimum-quality-threshold-in-pre-clinical-sepsis-studies-mqtipss-for-fluid-resuscitation-and-antimicrobial-therapy-endpoints
#8
Judith Hellman, Soheyl Bahrami, Mihaly Boros, Irshad Chaudry, Gerhard Fritsch, Waldemar Gozdzik, Shigeaki Inoue, Peter Radermacher, Mervyn Singer, Marcin F Osuchowski, Markus Huber-Lang
As outlined in the "International Guidelines for Management of Sepsis and Septic Shock: 2016", initial fluid resuscitation and administration of antibiotics are key steps in the early management of sepsis and septic shock. However, such clear guidelines do not exist for pre-clinical sepsis models. To address these shortcomings, the Wiggers-Bernard conference on pre-clinical sepsis models was held in Vienna in May, 2017. The participants reviewed 260 of the most highly cited papers between 2003 and 2012 that used sepsis models...
June 19, 2018: Shock
https://www.readbyqxmd.com/read/29922895/benefits-of-the-tranexamic-acid-in-head-trauma-with-no-extracranial-bleeding-a-prospective-follow-up-of-180-patients
#9
Olfa Chakroun-Walha, Amal Samet, Mouna Jerbi, Abdennour Nasri, Aziza Talbi, Hassen Kanoun, Basma Souissi, Kamilia Chtara, Mounir Bouaziz, Hichem Ksibi, Noureddine Rekik
INTRODUCTION: Tranexamic acid (TXA) is one of the debated therapies in the management of traumatic brain injury (TBI). We conducted this study to evaluate the benefits of TXA in TBI on the mortality and its safety in these patients. METHODS: This was a prospective randomized open-label trial including all patients, aged at 18 years or older, hospitalized in the emergency room during a 13-month period, for TBI. After the realization of the body CT scan, the patients were included if they had intracranial bleeding, and were then randomized according to their medical file number to receive or not the TXA...
June 19, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29921471/rethinking-the-concept-of-sepsis-and-septic-shock
#10
REVIEW
Joana A Cabrita, Isabel Pinheiro, L Menezes Falcão
Sepsis is a major global health problem and represents a challenge for physicians all over the world. The knowledge of sepsis and septic shock is a topic of interest among the scientific community and society in general. New guidelines for management of sepsis and septic shock were developed in 2016, providing an update on this area. In Sepsis-3 new definitions for sepsis and septic shock were published. The purpose of this narrative review is to discuss and compare the new criteria of 2016 with the old criteria, purposing at the same time an alternative approach for this topic...
June 16, 2018: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/29920412/unusual-site-for-primary-arterio-enteric-fistula-resulting-in-massive-upper-gastrointestinal-bleeding-a-case-report-on-presentation-and-management
#11
Anthony Pio Dimech, Matthew Sammut, Kelvin Cortis, Nebosja Petrovic
INTRODUCTION: Communications between an artery and the bowel are termed arterio-enteric fistulae. These are uncommon and mainly involve the aorta and duodenum. They can cause fatal haemorrhage. A primary aorto-enteric fistula has several aetiologies, one of which is post-radiotherapy. CASE REPORT: 75-year old gentleman presented with acute upper gastrointestinal bleeding and haemorrhagic shock. He had a past history of right colonic cancer treated by resection and radiotherapy...
June 4, 2018: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29916971/cervicofacial-necrotizing-fasciitis-and-drugs
#12
Laís Sara Egas, Erik Neiva Ribeiro de Carvalho Reis, Leonardo Freitas da Silva, João Paulo Bonardi, Valthierre Nunes de Lima, Pedro Henrique Silva Gomes Ferreira, Ciro Borges Duailibe de Deus, Idelmo Rangel Garcia Júnior
Necrotizing fasciitis (NF) is a devastating disease that typically affects immunocompromised patients, chronically debilitated patients or drug users, but can also affect healthy patients. Necrotizing fasciitis can rapidly produce septic shock and requires immediate surgical management of the necrotic tissue. It is a bacterial infection that progresses rapidly and has a high mortality generally caused by aerobic and anaerobic bacteria. The patient was immunocompromised and drug user. During treatment, a combination of broad-spectrum antibiotic therapy with Ciprofloxacin and Metronidazole, besides the use of activated charcoal dressing composed of carbonized fabric and impregnated with 0...
June 18, 2018: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/29916835/the-modern-cardiovascular-care-unit-the-cardiologist-managing-multiorgan-dysfunction
#13
Thomas Bochaton, Eric Bonnefoy-Cudraz, Nadia Aissaoui
PURPOSE OF REVIEW: Despite many advances in the management of critically ill patients, cardiogenic shock remains a challenge because it is associated with high mortality. Even if there is no universally accepted definition of cardiogenic shock, end-perfusion organ dysfunction is an obligatory and major criterion of its definition.Organ dysfunction is an indicator that cardiogenic shock is already at an advanced stage and is undergoing a rapid self-aggravating evolution. The aim of the review is to highlight the importance to diagnose and to manage the organ dysfunction occurring in the cardiogenic shock patients by providing the best literature published this year...
June 16, 2018: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/29915654/a-dramatic-recovery-in-a-patient-initially-expected-to-die-of-ttp-its-complications
#14
Jennifer Ogilvie, Jaskeerat Singh
Thrombotic thrombocytopenic purpura (TTP) has a high fatality rate if not caught early and treated with plasmapheresis. When TTP patients present late in their sequelae with neuro symptoms, an elevated lactate dehydrogenase and systemic symptoms, there is a high mortality rate. This report describes the case of a young female who had no significant medical problems and presented to our hospital after several days of hematuria, new onset blurry vision and dizziness. She was found to have thrombocytopenia and microangiopathic hemolytic anemia consistent with TTP and was thus started on plasmapheresis...
2018: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/29915141/dido-harding-nhs-improvement-i-m-shocked-at-the-lack-of-basic-people-management-skills-in-the-nhs
#15
Tom Moberly
No abstract text is available yet for this article.
June 18, 2018: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/29914833/favorable-impact-of-thoracic-endovascular-aortic-repair-on-survival-of-patients-with-acute-uncomplicated-type-b-aortic-dissection
#16
James C Iannuzzi, Sahael M Stapleton, Yanik J Bababekov, David Chang, Robert T Lancaster, Mark F Conrad, Richard P Cambria, Virendra I Patel
BACKGROUND: In uncomplicated type B aortic dissection (UTBAD), the "gold standard" has been nonoperative treatment with medical therapy, although this has been questioned by studies demonstrating improved outcomes in those treated with thoracic endovascular aortic repair (TEVAR). This study assessed long-term survival after acute UTBAD comparing medical therapy, open repair, and TEVAR. METHODS: The California Office of Statewide Hospital Planning Development database was analyzed from 2000 to 2010 for adult patients with acute UTBAD...
June 15, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29913711/some-practical-treatment-methods-of-dealing-with-pain-disabilities-in-rural-ghana
#17
Desmond Ayim-Aboagye, T Gordh
Background and aims The investigation was conducted among six practitioners and twenty-two patients in rural Ghana, where both practitioners and patients, were asked to unveil effective methods of treating pain and pain disabilities. Methods The investigation utilised strictly observational methods in acquiring data from two communities. Both patients and practitioners were later interviewed in a manner that elicited certain information needed to provide accurate understanding concerning these treatments methods they give to patients...
December 29, 2017: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/29912782/a-randomized-triple-blind-trial-of-cardiac-shock-wave-therapy-on-exercise-tolerance-and-symptoms-in-patients-with-stable-angina-pectoris
#18
Evgeny Shkolnik, Greta Burneikaite, Gabrielius Jakutis, Mikhail Scherbak, Gitana Zuoziene, Birute Petrauskiene, Ekaterina Trush, Yury Vasyuk, Aleksandras Laucevicius, Jelena Celutkiene
BACKGROUND: Despite major advances in managing coronary artery disease and continuous research on alternative techniques to enhance myocardial perfusion and reduce symptoms, coronary artery disease is still one of the leading causes of adult disability worldwide. Cardiac shock-wave therapy (CSWT) has shown promising results in the amelioration of myocardial ischemia in experimental studies; however, clinical results are limited to single-center, mostly uncontrolled and underpowered trials...
June 16, 2018: Coronary Artery Disease
https://www.readbyqxmd.com/read/29911144/emergence-of-dengue-in-nepal
#19
REVIEW
Birendra Prasad Gupta, Mahesh Lamsal, Sudhikshya Chaulagain, Ramanuj Rauniyar, Rajani Malla, Smita Shrestha, Roshan Kurmi, Krishna Das Manandhar
Dengue virus is a major health problem in Nepal. The endogenous dengue appeared in 2006 in the country with reported outbreaks in 2010, 2013 and 2016. Eleven years vertical data show there were sporadic cases in all the years and mostly adults between 25 and 40 years of age were infected with dengue virus. Compared with primary infections, secondary infections were observed in relatively larger numbers during the period of 2008-2016. Most of the cases had symptoms of dengue fever; while 7 and 19 cases demonstrated dengue hemorrhagic fever/dengue shock syndrome in 2010 and 2013 respectively...
June 2018: Virusdisease
https://www.readbyqxmd.com/read/29910582/management-of-hyperglycemia-during-and-in-the-immediate-follow-up-of-acute-coronary-syndrome
#20
REVIEW
Jamal El Ouazzani, Amine Ghalem, Ghizlane El Ouazzani, Nabila Ismaili, Noha El Ouafi
Diabetes is a serious, frequent, and insidious morbidity and mortality risk factor in patients with coronary artery disease. It has been shown that carbohydrate metabolism disorders are common in acute coronary syndromes (ACSs): 30-40% of patients have diabetes, 25-36% have an intolerance to carbohydrates, and only 30-40% have a normal carbohydrate profile. Hyperglycemia occurring either in diabetic or nondiabetic patients is strongly associated with a poor prognosis. It increases the extent of myocardial necrosis, and the risk of recurrence acute coronary syndrome and hemodynamic complications, particularly heart failure and cardiogenic shock, reflecting the importance of optimal management of glucose metabolism abnormalities...
April 2018: Journal of the Saudi Heart Association
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