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https://www.readbyqxmd.com/read/29791584/risk-factors-for-early-onset-ventilator-associated-pneumonia-in-aneurysmal-subarachnoid-hemorrhage-patients
#1
J B Cui, Q Q Chen, T T Liu, S J Li
This study aimed to investigate the risk factors related to ventilator-acquired pneumonia (VAP) in aneurysmal subarachnoid hemorrhage (SAH) patients. From January 2011 to December 2015, a single-center retrospective study including 200 SAH patients requiring mechanical ventilation (MV) ≥48 h was performed. The clinical data of these patients were collected and analyzed. The age range of the patients were 41-63 and 72 (36%) were male. The Glasgow coma scale score range was 5-15 and the Simplified Acute Physiology Score II range was 31-52...
2018: Brazilian Journal of Medical and Biological Research, Revista Brasileira de Pesquisas Médicas e Biológicas
https://www.readbyqxmd.com/read/29781145/core-outcome-set-for-gene-therapy-in-haemophilia-results-of-the-corehem-multistakeholder-project
#2
A Iorio, M W Skinner, E Clearfield, D Messner, G F Pierce, M Witkop, S Tunis
BACKGROUND: Gene therapy trial results show potential to cure haemophilia A and haemophilia B. Securing broad access to a cure for a lifelong chronic disease is anticipated to face barriers at the individual and healthcare system levels, which can be partly mitigated by harmonized planning of clinical research studies. The aim of the coreHEM project was to determine the set of outcome measures required to evaluate efficacy, safety, comparative effectiveness and value of gene therapy for haemophilia...
May 20, 2018: Haemophilia: the Official Journal of the World Federation of Hemophilia
https://www.readbyqxmd.com/read/29779231/specialist-perioperative-allergy-clinic-services-in-the-uk-2018-results-from-the-royal-college-of-anaesthetists-sixth-national-audit-project-nap6-investigation-of-perioperative-anaphylaxis
#3
W Egner, T M Cook, T Garcez, S Marinho, H Kemp, D N Lucas, K Floss, S Farooque, H Torevell, M Thomas, K Ferguson, S Nasser, S Karanam, K-L Kong, N McGuire, M Bellamy, A Warner, J Hitchman, L Farmer, N J N Harper
BACKGROUND: The Royal College of Anaesthetists 6th National Audit Project examined Grade 3-5 perioperative anaphylaxis for one year in the UK. OBJECTIVE: To describe the causes and investigation of anaphylaxis in the NAP6 cohort, in relation to published guidance and previous baseline survey results. METHODS: We used a secure registry to gather details of Grade 3-5 perioperative anaphylaxis. Anonymous reports were aggregated for analysis and reviewed in detail...
May 19, 2018: Clinical and Experimental Allergy: Journal of the British Society for Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/29773938/correlations-between-a1c-and-diabetes-knowledge-diabetes-numeracy-and-food-security-in-a-vulnerable-type-2-diabetes-population
#4
Clipper F Young, Kenneth Yun, Edward Kang, Jay H Shubrook, Joy A Dugan
Type 2 diabetes is over-represented in vulnerable populations. Vulnerable patients managing diabetes are challenged with less-than-optimal processes and outcomes of care; thus, Healthy People 2020 and the American Diabetes Association have renewed the focus on social determinants of health with regard to the management of chronic diseases such as diabetes. This study explored the correlations between A1C and social and personal factors, including diabetes knowledge, diabetes numeracy, and food security. The Diabetes Numeracy Test-15, the Spoken Knowledge in Low Literacy Diabetes Scale, and the U...
May 2018: Diabetes Spectrum: a Publication of the American Diabetes Association
https://www.readbyqxmd.com/read/29771772/nasogastric-tube-syndrome-a-diagnostic-dilemma
#5
Gyanaranjan Nayak, Ramandeep S Virk, Manvi Singh, Meenu Singh
BACKGROUND: Nasogastric tubes have been used in the pediatric age group to supplement nutrition in cases of malignancy and failure to thrive due to a variety of causes. Breathing difficulty may occur after the insertion of a nasogastric tube and it can have multiple causes. Here we discuss 2 patients of acute lymphoblastic leukemia (ALL) who developed a rare condition called the Sofferman syndrome (nasogastric tube syndrome). We will also briefly outline a diagnostic algorithm to facilitate its fast and correct diagnosis...
May 16, 2018: Journal of Bronchology & Interventional Pulmonology
https://www.readbyqxmd.com/read/29769151/real-time-automated-detection-of-ventilator-associated-events-avoiding-missed-detections-misclassifications-and-false-detections-due-to-human-error
#6
Erica S Shenoy, Eric S Rosenthal, Yu-Ping Shao, Siddharth Biswal, Manohar Ghanta, Erin E Ryan, Dolores Suslak, Nancy Swanson, Valdery Moura Junior, David C Hooper, M Brandon Westover
OBJECTIVETo validate a system to detect ventilator associated events (VAEs) autonomously and in real time.DESIGNRetrospective review of ventilated patients using a secure informatics platform to identify VAEs (ie, automated surveillance) compared to surveillance by infection control (IC) staff (ie, manual surveillance), including development and validation cohorts.SETTINGThe Massachusetts General Hospital, a tertiary-care academic health center, during January-March 2015 (development cohort) and January-March 2016 (validation cohort)...
May 17, 2018: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/29764322/biting-the-hands-that-feed-the-alligators-a-case-study-in-morbid-obesity-extremes-end-of-life-care-and-prohibitions-on-harming-and-accelerating-the-end-of-life
#7
Michael J Malinowski
Obesity, recognized as a disease in the U.S. and at times as a terminal illness due to associated medical complications, is an American epidemic according to the Centers for Disease Control and Prevention ("CDC"), American Heart Association ("AHA"), and other authorities. More than one third of Americans (39.8% of adults and 18.5% of children) are medically obese. This article focuses on cases of "extreme morbid obesity" ("EMO")-situations in which death is imminent without aggressive medical interventions, and bariatric surgery is the only treatment option with a realistic possibility of success...
March 2018: American Journal of Law & Medicine
https://www.readbyqxmd.com/read/29723120/transabdominal-versus-subcuticular-sutures-to-secure-a-laparoscopic-gastrostomy
#8
Ashwini S Poola, Katrina L Weaver, Richard Sola, Shiva Reddy, Angela Mundakkal, Fedra Fallahian, Harmeet Bawa, Rebecca M Rentea, Richard J Hendrickson, Shawn D St Peter
PURPOSE: Traditional methods for securing a laparoscopic gastrostomy (LG) involve the placement of two monofilament transabdominal (TA) sutures to be removed after a short interval of 5 days. A modified technique employing an absorbable suture tunneled subcutaneously has been adopted by many surgeons. The aim of this study was to compare wound complications between these techniques. METHODS: A retrospective review of patients who underwent LG placement between 2010 and 2016 was conducted, dividing patients into two cohorts by securing stitch type, TA and subcutaneous (SC), and evaluating for complications...
May 3, 2018: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/29690533/snakebite-when-the-human-touch-becomes-a-bad-touch
#9
REVIEW
Bryan G Fry
Many issues and complications in treating snakebite are a result of poor human social, economic and clinical intervention and management. As such, there is scope for significant improvements for reducing incidence and increasing patient outcomes. Snakes do not target humans as prey, but as our dwellings and farms expand ever farther and climate change increases snake activity periods, accidental encounters with snakes seeking water and prey increase drastically. Despite its long history, the snakebite crisis is neglected, ignored, underestimated and fundamentally misunderstood...
April 21, 2018: Toxins
https://www.readbyqxmd.com/read/29688555/a-pilot-study-on-posterior-polyethylene-tethers-to-prevent-proximal-junctional-kyphosis-after-multilevel-spinal-instrumentation-for-adult-spinal-deformity
#10
Thomas J Buell, Avery L Buchholz, John C Quinn, Shay Bess, Breton G Line, Christopher P Ames, Frank J Schwab, Virginie Lafage, Christopher I Shaffrey, Justin S Smith
BACKGROUND: Proximal junctional kyphosis (PJK) is a common problem after multilevel spine instrumentation. OBJECTIVE: To determine if junctional tethers reduce PJK after multilevel instrumented surgery for adult spinal deformity (ASD). METHODS: ASD patients who underwent posterior instrumented fusion were divided into 3 groups: no tether (NT), polyethylene tether-only (TO; tied securely through the spinous processes of the uppermost instrumented vertebra [UIV] + 1 and UIV-1), and tether with crosslink (TC; passed through the spinous process of UIV+1 and tied to a crosslink between UIV-1 and UIV-2)...
April 24, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29680581/middle-east-respiratory-syndrome-coronavirus-risk-factors-and-determinants-of-primary-household-and-nosocomial-transmission
#11
REVIEW
David S Hui, Esam I Azhar, Yae-Jean Kim, Ziad A Memish, Myoung-Don Oh, Alimuddin Zumla
Middle East respiratory syndrome coronavirus (MERS-CoV) is a lethal zoonosis that causes death in 35·7% of cases. As of Feb 28, 2018, 2182 cases of MERS-CoV infection (with 779 deaths) in 27 countries were reported to WHO worldwide, with most being reported in Saudi Arabia (1807 cases with 705 deaths). MERS-CoV features prominently in the WHO blueprint list of priority pathogens that threaten global health security. Although primary transmission of MERS-CoV to human beings is linked to exposure to dromedary camels (Camelus dromedarius), the exact mode by which MERS-CoV infection is acquired remains undefined...
April 18, 2018: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/29678945/ers-ecdc-statement-european-union-standards-for-tuberculosis-care-2017-update
#12
G B Migliori, G Sotgiu, S Rosales-Klintz, R Centis, L D'Ambrosio, I Abubakar, G Bothamley, J A Caminero, D M Cirillo, M Dara, G de Vries, S Aliberti, A T Dinh-Xuan, R Duarte, F Midulla, I Solovic, D Subotic, M Amicosante, A M Correira, A Cirule, G Gualano, H Kunst, F Palmieri, V Riekstina, S Tiberi, R Verduin, M J van der Werf
The International Standards for Tuberculosis (TB) Care define the essential level of care for managing patients who have or are presumed to have TB, or are at increased risk of developing the disease. The resources and capacity in the European Union and the European Economic Area (EU/EEA) permit higher standards of care to secure quality and timely TB diagnosis, prevention and treatment. On this basis, the European Union Standards for Tuberculosis Care (ESTC) were published in 2012 as standards specifically tailored to the EU-setting...
April 20, 2018: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/29678002/midlevel-maternity-providers-preferences-of-a-childbirth-monitoring-tool-in-low-income-health-units-in-uganda
#13
Michael S Balikuddembe, Peter K Wakholi, Nazarius M Tumwesigye, Thorkild Tylleskär
A third of women in childbirth are inadequately monitored, partly due to the tools used. Some stakeholders assert that the current labour monitoring tools are not efficient and need improvement to become more relevant to childbirth attendants. The study objective was to explore the expectations of maternity service providers for a mobile childbirth monitoring tool in maternity facilities in a low-income country like Uganda. Semi-structured interviews of purposively selected midwives and doctors in rural-urban childbirth facilities in Uganda were conducted before thematic data analysis...
2018: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/29676258/-multiple-uses-of-skeletal-anchorages-taking-advantage-of-mini-screws-to-improve-aesthetics-with-active-and-passive-appliances
#14
Stéphane Renger, Mélanie Gremeret, Sarah Gebeile-Chauty
INTRODUCTION: The main causes of failures in canine traction are anchorage defects, incorrect direction of force, uncontrolled forces. An adolescent female (10 years, 9 months) presents with two included canines on the maxillary arch, in a palatal position and her lateral incisors (12 and 22) are microdontic. Two mini-screws are inserted on the palate, in a mesial position to 16 and 26 to secure the traction of 13 and 23; in general, braces are bonded after this first step. After debonding, mini-screws remain to help stabilize the palatal plate during the retention period and to avoid unaesthetic metallic wires and hooks which sometimes cause occlusal interferences...
March 2018: L' Orthodontie Française
https://www.readbyqxmd.com/read/29673147/the-effects-of-health-coverage-schemes-on-length-of-stay-and-preventable-hospitalization-in-seoul
#15
Jungah Kim, Changwoo Shon
The Medical Aid program is government’s medical benefit program to secure the minimum livelihood and medical services for low-income Korean households. In Seoul, the number of Medical Aid beneficiaries has grown, driving an increases in the length of stay (LOS) and healthcare cost. Until now, studies have focused on quantity indicators, such as LOS, but only a few studies have been conducted on the service quality. We investigated both LOS and the preventable hospitalization (PH) rate as proxy indicators for the quantity and quality of services provided to Medical Aid beneficiaries in Seoul...
April 17, 2018: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/29669399/the-impact-of-systemic-lupus-erythematosus-on-the-clinical-phenotype-of-antiphospholipid-antibody-positive-patients-results-from-antiphospholipid-syndrome-alliance-for-clinical-trials-and-international-networking-aps-action-clinical-database-and-repository
#16
Ozan Unlu, Doruk Erkan, Medha Barbhaiya, Danieli Andrade, Iana Nascimento, Renata Rosa, Alessandra Banzato, Vittorio Pengo, Amaia Ugarte, Maria Gerosa, Lanlan Ji, Maria Efthymiou, D Ware Branch, Guilherme Raires de Jesus, Angela Tincani, H Michael Belmont, Paul R Fortin, Michelle Petri, Esther Rodriguez, Guillermo J Pons-Estel, Jason S Knight, Tatsuya Atsumi, Rohan Willis, Stephane Zuily, Maria G Tektonidou
OBJECTIVE: Although systemic lupus erythematosus (SLE) is the most common autoimmune disease associated with antiphospholipid antibodies (aPL), limited data exist on the impact of SLE on the clinical phenotype of aPL-positive patients. The primary objective was to compare the clinical, laboratory, and treatment characteristics of aPL-positive patients with or without SLE. METHODS: A secure web-based data capture system stores patient demographics, and aPL-related clinical and laboratory characteristics...
April 18, 2018: Arthritis Care & Research
https://www.readbyqxmd.com/read/29665190/comparison-of-emergency-medicine-malpractice-cases-involving-residents-to-non-resident-cases
#17
Kiersten L Gurley, Shamai A Grossman, Margaret Janes, C Winnie Yu-Moe, Ellen Song, Carrie D Tibbles, Nathan I Shapiro, Carlo L Rosen
BACKGROUND: Data are lacking on how emergency medicine (EM) malpractice cases with resident involvement differs from cases that do not name a resident. OBJECTIVES: To compare malpractice case characteristics in cases where a resident is involved (resident case) to cases that do not involve a resident (non-resident case) and to determine factors that contribute to malpractice cases utilizing EM as a model for malpractice claims across other medical specialties. METHODS: We used data from the Controlled Risk Insurance Company (CRICO) Strategies' division Comparative Benchmarking System (CBS) to analyze open and closed EM cases asserted from 2009-2013...
April 17, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29623621/resources-and-costs-associated-with-the-treatment-of-advanced-and-metastatic-gastric-cancer-in-the-mexican-public-sector-a-patient-chart-review
#18
Miguel Quintana, José A Toriz, Diego Novick, Kyla Jones, Brenda S Botello, Juan Alejandro Silva
BACKGROUND: Little evidence is available on the management and cost of treating patients with advanced or metastatic gastric cancer (GC). This study evaluates patient characteristics, treatment patterns, and resource utilization for these patients in Mexico. METHODS: Data were collected from three centers of investigation (tertiary level). Patients were ≥18 years of age, diagnosed between 1 January 2009 and 1 January 2015, had advanced or metastatic GC, received first-line fluoropyrimidine/platinum, and had ≥3 months follow-up after discontinuing first-line treatment...
July 31, 2017: PharmacoEconomics Open
https://www.readbyqxmd.com/read/29606564/serum-concentrations-after-switching-from-originator-infliximab-to-the-biosimilar-ct-p13-in-patients-with-quiescent-inflammatory-bowel-disease-secure-an-open-label-multicentre-phase-4-non-inferiority-trial
#19
Anne S Strik, Wim van de Vrie, Joanne P J Bloemsaat-Minekus, Michael Nurmohamed, Peter J J Bossuyt, Alexander Bodelier, Theo Rispens, Yvonne J B van Megen, Geert R D'Haens
BACKGROUND: Biological treatment of chronic inflammatory diseases has improved patient outcomes but increased health-care costs. Switching patients from originator infliximab to a biosimilar can reduce costs, but prospective data about pharmacokinetics and potential immunogenicity are scarce. We aimed to show that infliximab serum concentrations with biosimilar CT-P13 are non-inferior to those with originator infliximab after switching from originator infliximab in patients with inflammatory bowel disease...
March 29, 2018: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29606074/use-of-security-officers-on-inpatient-psychiatry-units
#20
Ryan E Lawrence, Maria M Perez-Coste, Stan D Arkow, Paul S Appelbaum, Lisa B Dixon
OBJECTIVE: Violent and aggressive behaviors are common among psychiatric inpatients. Hospital security officers are sometimes used to address such behaviors. Research on the role of security in inpatient units is scant. This study examined when security is utilized and what happens when officers arrive. METHODS: The authors reviewed the security logbook and the medical records for all patients discharged from an inpatient psychiatry unit over a six-month period...
April 2, 2018: Psychiatric Services: a Journal of the American Psychiatric Association
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