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Emergency centre

Natasha McDonald, Peter J Eddowes, James Hodson, Scott I K Semple, Nigel P Davies, Catherine J Kelly, Stella Kin, Miranda Phillips, Amy H Herlihy, Timothy J Kendall, Rachel M Brown, Desley A H Neil, Stefan G Hübscher, Gideon M Hirschfield, Jonathan A Fallowfield
LiverMultiScan is an emerging diagnostic tool using multiparametric MRI to quantify liver disease. In a two-centre prospective validation study, 161 consecutive adult patients who had clinically-indicated liver biopsies underwent contemporaneous non-contrast multiparametric MRI at 3.0 tesla (proton density fat fraction (PDFF), T1 and T2* mapping), transient elastography (TE) and Enhanced Liver Fibrosis (ELF) test. Non-invasive liver tests were correlated with gold standard histothological measures. Reproducibility of LiverMultiScan was investigated in 22 healthy volunteers...
June 15, 2018: Scientific Reports
M E Kelly, F Patterson, S O'Flynn, J Mulligan, A W Murphy
BACKGROUND: The purpose of this paper is to systematically review the literature with respect to stakeholder views of selection methods for medical school admissions. METHODS: An electronic search of nine databases was conducted between January 2000-July 2014. Two reviewers independently assessed all titles (n = 1017) and retained abstracts (n = 233) for relevance. Methodological quality of quantitative papers was assessed using the MERSQI instrument. The overall quality of evidence in this field was low...
June 15, 2018: BMC Medical Education
Yi-Tsung Lin, Yi-Hsiang Cheng, Chih-Han Juan, Ping-Feng Wu, Yi-Wei Huang, Sheng-Hua Chou, Tsuey-Ching Yang, Fu-Der Wang
Capsular type K1 Klebsiella pneumoniae, highly virulent strains which are common in Asian countries, can cause pyogenic infections. These hypervirulent strains are usually susceptible to most antimicrobials, except for ampicillin. Little is known regarding the clinical and molecular characteristics of antimicrobial-resistant K1 K. pneumoniae strains. This retrospective study evaluated patients infected with capsular type K1 K. pneumoniae strains in a Taiwanese medical centre between April 2013 and March 2016...
June 12, 2018: International Journal of Antimicrobial Agents
Louise Thomson, Marcus Barker, Catherine Kaylor-Hughes, Anne Garland, Rajini Ramana, Richard Morriss, Emily Hammond, Gail Hopkins, Sandra Simpson
BACKGROUND: A specialist depression service (SDS) offering collaborative pharmacological and cognitive behaviour therapy treatment for persistent depressive disorder showed effectiveness against depression symptoms versus usual community based multidisciplinary care in a randomised controlled trial (RCT) in specialist mental health services in England. However, there is uncertainty concerning how specialist depression services effect such change. The current study aimed to evaluate the factors which may explain the greater effectiveness of SDS compared to Treatment as Usual (TAU) by exploring the experience of the RCT participants...
June 15, 2018: BMC Psychiatry
Mary Kensington, Jean Rankin, Andrea Gilkison, Rea Daellenbach, Susan Crowther, Ruth Deery, Lorna Davies
Rural practice presents unique challenges and skill requirements for midwives. New Zealand and Scotland face similar challenges in sustaining a rural midwifery workforce. This paper draws from an international multi-centre study exploring rural midwifery to focus on the education needs of student midwives within pre-registration midwifery programmes in order to determine appropriate preparation for rural practice. The mixed-methods study was conducted with 222 midwives working in rural areas in New Zealand (n = 145) and Scotland (n = 77)...
June 5, 2018: Nurse Education in Practice
Serge Molliex, Sylvie Passot, Jerome Morel, Emmanuel Futier, Jean Yves Lefrant, Jean Michel Constantin, Yannick Le Manach, Bruno Pereira
INTRODUCTION: in elderly patients, goal directed haemodynamic therapy (GDHT), depth of anaesthesia monitoring and lung-protective ventilation have been shown to improve postoperative outcomes. The aim of this study was to evaluate current practices concerning strategies of anaesthesia optimisation in patients aged ≥ 75 years. PATIENTS AND METHODS: a multicentre observational study was performed from February to May 2015 in 23 French academic centres. On 30 consecutive days in each centre, patients ≥ 75 years with at least one major co-morbidity undergoing elective or emergency procedures (femoral-neck fractures surgery, intraperitoneal abdominal surgery or vascular surgery) were included...
June 11, 2018: Anaesthesia, Critical Care & Pain Medicine
Rajan Atwal, Charles Stewart
We describe the unique case of a child with pneumonia presenting with acute scoliosis and abdominal pain, without any typical features of the disease.A 10-year-old girl presented to the emergency department on 3 consecutive days with right-sided abdominal pain. There were no associated features, in particular, no fevers or respiratory symptoms. On the first 2 presentations, observation,examination, and blood test findings were unremarkable. Chest x-ray and abdominal ultrasound were also normal. On the third presentation a marked scoliosis was noted and abdominal examination revealed right-sided tenderness with rebound...
June 2018: Medicine (Baltimore)
(no author information available yet)
AIM: Previous studies reported conflicting evidence on the effects of obesity on outcomes after gastrointestinal surgery. The aims of this study were to explore the relationship of obesity with major post-operative complications in an international cohort and to present a meta-analysis of all available prospective data. METHODS: This prospective, multi-centre study included adults undergoing both elective and emergency gastrointestinal resection, reversal of stoma, or formation of stoma...
June 13, 2018: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
Gheorghe-Andrei Dan, Konstantinos Iliodromitis, Daniel Scherr, Francisco Marín, Radoslaw Lenarczyk, Heidi L Estner, Marcin Kostkiewicz, Nikolaos Dagres, Gregory Y H Lip
Despite the huge progress made in the both understanding the mechanisms and the management of atrial fibrillation (AF) this arrhythmia still represents an important health and social burden. Atrial fibrillation is increasing in frequency and is a major cause of death, stroke, heart failure, cognitive decline, and hospitalizations. New data have emerged emphasizing the multidisciplinary approach to better management of this common arrhythmia. Despite the availability of AF management guidelines, practice among European centres may differ from the current guideline recommendations...
June 8, 2018: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Therese Avallin, Åsa Muntlin Athlin, Erik Elgaard Sorensen, Alison Kitson, Martin Björck, Eva Jangland
AIMS: To explore and describe the impact of the organizational culture on and the patient-practitioner patterns of actions that contribute to or detract from successful pain management for the patient with acute abdominal pain across the acute care pathway. BACKGROUND: Although pain management is a recognised human right, unmanaged pain continues to cause suffering and prolong hospital care. Unanswered questions about how to successfully manage pain relate to both organizational culture and individual practitioners' performance...
June 12, 2018: Journal of Advanced Nursing
Emer Joyce, Erik H Howell, Alpana Senapati, Randall C Starling, Eiran Z Gorodeski
AIMS: The utility of combined assessment of both frailty and cognitive impairment in hospitalized heart failure (HF) patients for incremental post-discharge risk stratification, using handgrip strength and Mini-Cog as feasible representative parameters, was investigated. METHODS AND RESULTS: A prospective, single-centre cohort study of older adults (age ≥65) hospitalized for HF being discharged to home was performed. Pre-discharge, grip strength was assessed using a dynamometer (Jamar hydrolic hand dynamometer, Lafayette Instruments, Lafayette, IN, USA) and was defined as weak if the maximal value was below the gender-derived and body mass index-derived cut-offs according to Fried criteria...
June 12, 2018: ESC Heart Failure
Jeroen Meulemans, Jacqueline Bijnens, Pierre Delaere, Vincent Vander Poorten
Introduction/aim: Transoral laser microsurgery (TLM) is a minimally invasive surgical alternative for radiotherapy (RT) in the primary management of early glottic cancer. More recently, TLM emerged also as a possible salvage treatment for selected radiorecurrent cancers. We reviewed outcomes of primary and salvage TLM performed in a Belgian tertiary referral center. Patients and methods: A retrospective review of records from 142 consecutive patients who underwent TLM was performed...
2018: Frontiers in Oncology
András Folyovich, Anna Béres-Molnár K, Judit Gimesi-Országh, Lajos Katona, Dávid Biczó, Károly Vörös, Gábor Gőbl, András Ajtay, Dániel Bereczki
Background and purpose: The therapeutic time window of acute stroke is short. Decision on the use of intravenous thrombolysis is based on well-defined criteria. Any delay in the transport to a designated stroke centre decreases the odds of therapeutic success. In Hungary, the admission rate of stroke patients peaks on Monday, the number gradually decreasing by the end of the week. This phenomenon has long been suggested to be due to the lack of emergency care approach. According to the literature, however, returning to work following a holiday is a risk factor for acute stroke...
May 30, 2018: Ideggyógyászati Szemle
Lambert M Felix, Seamus Grundy, Stephen J Milan, Ross Armstrong, Haley Harrison, Dave Lynes, Sally Spencer
BACKGROUND: Bronchiectasis is a chronic respiratory disease characterised by abnormal and irreversible dilatation of the smaller airways and associated with a mortality rate greater than twice that of the general population. Antibiotics serve as front-line therapy for managing bacterial load, but their use is weighed against the development of antibiotic resistance. Dual antibiotic therapy has the potential to suppress infection from multiple strains of bacteria, leading to more successful treatment of exacerbations, reduced symptoms, and improved quality of life...
June 11, 2018: Cochrane Database of Systematic Reviews
Ian Ferguson, Hatem Alkhouri, Toby Fogg, Anders Aneman
OBJECTIVE: This study aimed to quantify the proportion of patients undergoing rapid sequence intubation using ketamine in Australian and New Zealand EDs between 2010 and 2015. METHODS: The Australian and New Zealand Emergency Department Airway Registry is a multicentre airway registry prospectively capturing data from 43 sites. Data on demographics and physiology, the attending staff and indication for intubation were recorded. The primary outcome was the annual percentage of patients intubated with ketamine...
June 11, 2018: Emergency Medicine Australasia: EMA
Ehsanollah Ghaznavi-Rad, Alireza Ekrami
Objectives: Incidence of methicillin-resistant Staphylococcus aureus (MRSA) is increasing every year, especially in burn patients with a high rate of morbidity and mortality. Molecular and epidemiologic studies are useful practices for understanding the relatedness of isolates in a single patient or a hospital. This study aimed at determining molecular characterizations of isolates collected in 2006 and 2014 using S. aureus -specific staphylococcal protein A (Spa) typing and Multilocus Sequence Typing (MLST) methods...
2018: International Journal of Microbiology
Ângela Melo, Renata Veríssimo, Margarida Farinha, Nuno Nogueira Martins, Francisco Nogueira Martins
The major purpose of this article was to compare the discriminative value of different algorithms and serum biomarkers in the differential diagnosis of adnexal masses. We performed a retrospective study with 247 women with adnexal neoplasia, submitted to surgical treatment and with a histological diagnosis. The evaluation of the area under the curve (AUC) for isolated CA-125 and HE4, and for ROMA and RMI-II, showed a better specificity of HE4 and RMI-II in premenopausal women. In the postmenopausal group, ROMA and RMI-II were the algorithms with a better performance...
June 8, 2018: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
Ming Ann Sim, Weiling Liu, Sophia T H Chew, Lian Kah Ti
INTRODUCTION: Postoperative atrial fibrillation (POAF) is a common complication following cardiac surgery associated with increased morbidity and mortality. Although sustained hyperglycemia is a known risk factor of AF and poor ICU outcomes, emerging in-vitro studies reveal acute glycemic fluctuations to be an additional independent predictor of AF. The effect of acute glycemic fluctuations on the incidence of POAF in the clinical setting remains unclear. We aim to investigate the effect of the magnitude of acute perioperative glycemic fluctuations on the incidence of POAF in a multi-ethnic Southeast-Asian population...
2018: PloS One
V Hodgetts Morton, A Wilson, C Hewitt, A Weckesser, N Farmer, D Lissauer, P Hardy, R K Morris
Background: Worldwide caesarean section (CS) delivery is the most common major operation. Approximately 25% of pregnant women undergo a CS in the UK for delivery of their babies. Sepsis and post-natal infection constitute significant maternal mortality and morbidity. Infection following a CS has a number of primary sources including endometritis occurring in 7-17% of women. Sepsis reduction and reduction in antibiotic use have been identified as a national and international priority. The overarching aim of this research is to reduce infectious morbidity from caesarean sections...
2018: Pilot and Feasibility Studies
Claudio Vernieri, Alessia Mennitto, Michele Prisciandaro, Veronica Huber, Monica Milano, Lucia Rinaldi, Maria Silvia Cona, Claudia Maggi, Benvenuto Ferrari, Siranoush Manoukian, Gabriella Mariani, Giulia Bianchi, Giuseppe Capri, Licia Rivoltini, Filippo de Braud
Platinum salts are active against metastatic triple negative breast cancer (mTNBC), and biomarkers to predict their effectiveness are urgently needed. In recent years, the neutrophil-to-lymphocyte ratio (NLR) and the platelet-to-lymphocyte ratio (PLR) have emerged as prognostic biomarkers in many malignancies, but their predictive role in platinum-treated mTNBC patients remains unexplored. We performed a retrospective, single centre study to evaluate the association between baseline NLR or PLR and progression free survival (PFS) of mTNBC patients treated with platinum-based chemotherapy...
June 7, 2018: Scientific Reports
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