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https://www.readbyqxmd.com/read/28937571/practice-bulletin-no-183-postpartum-hemorrhage
#1
(no author information available yet)
Maternal hemorrhage, defined as a cumulative blood loss of greater than or equal to 1,000 mL or blood loss accompanied by signs or symptoms of hypovolemia within 24 hours after the birth process, remains the leading cause of maternal mortality worldwide (1). Additional important secondary sequelae from hemorrhage exist and include adult respiratory distress syndrome, shock, disseminated intravascular coagulation, acute renal failure, loss of fertility, and pituitary necrosis (Sheehan syndrome).Hemorrhage that leads to blood transfusion is the leading cause of severe maternal morbidity in the United States closely followed by disseminated intravascular coagulation (2)...
October 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28937566/practice-bulletin-no-183-summary-postpartum-hemorrhage
#2
(no author information available yet)
Maternal hemorrhage, defined as a cumulative blood loss of greater than or equal to 1,000 mL or blood loss accompanied by signs or symptoms of hypovolemia within 24 hours after the birth process, remains the leading cause of maternal mortality worldwide (1). Additional important secondary sequelae from hemorrhage exist and include adult respiratory distress syndrome, shock, disseminated intravascular coagulation, acute renal failure, loss of fertility, and pituitary necrosis (Sheehan syndrome).Hemorrhage that leads to blood transfusion is the leading cause of severe maternal morbidity in the United States closely followed by disseminated intravascular coagulation (2)...
October 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28934554/improvements-in-clinical-practice-for-fertility-preservation-among-young-cancer-patients-results-from-bundled-interventions
#3
Natalie K Bradford, Roderick Walker, Roslyn Henney, Po Inglis, Raymond J Chan
AIMS: The consequences of cancer and treatment on fertility can be a continuing source of distress for adolescents and young adults. The study aims were to assess the effects of bundled interventions on clinical practice concerning fertility in young people aged 14-25 years with cancer. METHODS: Bundled interventions, including development of quality indicators, resources, and targeted education, were introduced during 2015 across five cancer centers. Data before interventions (2012-2014) were compared with data prospectively collected during 2015-2016...
September 21, 2017: Journal of Adolescent and Young Adult Oncology
https://www.readbyqxmd.com/read/28930760/medical-education-and-health-care-delivery-a-call-to-better-align-goals-and-purposes
#4
David P Sklar, Paul A Hemmer, Steven J Durning
The transformation of the U.S. health care system is under way, driven by the needs of an aging population, rising health care spending, and the availability of health information. However, the speed and effectiveness of the transformation of health care delivery will depend, in large part, upon engagement of the health professions community and changes in clinicians' practice behaviors. Current efforts to influence practice behaviors emphasize changes in the health payment system with incentives to move from fee-for-service to alternative payment models...
September 14, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28927566/low-rates-of-adverse-events-following-ambulatory-outpatient-total-hip-arthroplasty-at-a-free-standing-surgery-center
#5
Patrick C Toy, Matthew N Fournier, Thomas W Throckmorton, William M Mihalko
BACKGROUND: We proposed to determine the complication and hospital admission rates for patients with total hip arthroplasty (THA) done by a single surgeon in a stand-alone ambulatory surgical center with same-day discharge. Given the recent emphasis on bundled payments for a 90-day episode of care, this same time frame after surgery was chosen to determine patient outcomes. METHODS: The records of patients with THAs done through a direct anterior approach by a single surgeon at 2 separate ambulatory surgery centers were reviewed...
August 26, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28927439/barriers-and-facilitators-towards-implementing-the-sepsis-six-care-bundle-bliss-1-a-mixed-methods-investigation-using-the-theoretical-domains-framework
#6
Neil Roberts, Guy Hooper, Fabiana Lorencatto, Wendell Storr, Michael Spivey
BACKGROUND: The 'Sepsis 6', a care bundle of basic, but vital, measures (e.g. intravenous fluid, antibiotics) has been implemented to improve sepsis treatment. However, uptake has been variable. Tools from behavioral sciences, such as the Theoretical Domains Framework (TDF) may be used to understand and address such implementation issues. This study used a behavioral science approach to identify barriers and facilitators towards Sepsis Six implementation at a case study hospital. METHODS: Semi-structured interviews based on the TDF were conducted with a sample group of consultants, junior doctors and nurses from Emergency Department, Medical and Surgical Admissions, to explore barriers/facilitators to Sepsis Six performance...
September 19, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28920658/value-based-health-care-how-to-succeed-in-a-bundled-care-apm
#7
Daniel T Engelman
No abstract text is available yet for this article.
March 2017: Bulletin of the American College of Surgeons
https://www.readbyqxmd.com/read/28918911/mortality-of-severe-septic-patients-between-physician-s-high-and-low-care-volumes
#8
Chun-Yao Lin, Jo-Chi Tseng, Chih-Yu Huang, Chien-Ming Chu, Huang-Pin Wu
BACKGROUND: Patients with severe sepsis frequently require intensive care unit (ICU) admission and different ICU care models may influence their outcomes. The mortality of severe septic patients between physician's high and low care volume remains unclear. METHODS: We analyzed the data from a three-year prospective observation study, which was performed in an adult medical ICU of Chung Gung Memorial Hospital, Keelung. The data included initial bundle therapies based on the Surviving Sepsis Campaign (SSC) guidelines for patients with severe sepsis...
August 2017: Biomedical Journal
https://www.readbyqxmd.com/read/28916216/coronary-artery-bypass-grafting-bundled-payment-proposal-will-have-significant-financial-impact-on-hospitals
#9
Robert B Hawkins, J Hunter Mehaffey, Kenan W Yount, Leora T Yarboro, Clifford Fonner, Irving L Kron, Mohammed Quader, Alan Speir, Jeffrey Rich, Gorav Ailawadi
OBJECTIVES: The Centers for Medicare and Medicaid Services plans to institute a 5-year trial of bundled payments for coronary artery bypass grafting through 90 days after discharge. To investigate the impact, we reviewed actual inpatient costs for patients undergoing bypass surgery relative to the target price. METHODS: A total of 13,276 Medicare patients with estimated cost data underwent isolated coronary artery bypass grafting from 2008 to 2015 in 18 hospitals over 8 Medicare-defined regions within the Commonwealth of Virginia...
July 29, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28914622/ce-assessing-patients-during-septic-shock-resuscitation
#10
Elizabeth Bridges
How to integrate capillary refill time and skin mottling score into the six-hour bundle. ABSTRACT: In 2015, the Surviving Sepsis Campaign six-hour bundle was updated. The revised version now recommends documenting the reassessment of volume status and tissue perfusion after initial fluid resuscitation through a repeated focused examination. This article addresses the practice and interpretation of two components of this examination in adults: capillary refill time and skin mottling score...
September 13, 2017: American Journal of Nursing
https://www.readbyqxmd.com/read/28913711/emergency-neurological-life-support-resuscitation-following-cardiac-arrest
#11
Jonathan Elmer, Kees H Polderman
Cardiac arrest is the most common cause of death in North America. An organized bundle of neurocritical care interventions can improve chances of survival and neurological recovery in patients who are successfully resuscitated from cardiac arrest. Therefore, resuscitation following cardiac arrest was chosen as an Emergency Neurological Life Support protocol. Key aspects of successful early post-arrest management include: prevention of secondary brain injury; identification of treatable causes of arrest in need of emergent intervention; and, delayed neurological prognostication...
September 14, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28913501/acute-poisoning-due-to-ingestion-of-datura-stramonium-a-case-report
#12
Sebastian Daniel Trancă, Robert Szabo, Mihaela Cociş
Datura stramonium (DS) is a widespread annual plant, containing atropine, hyoscyamine, and scopolamine, which can produce poisoning with a severe anticholinergic syndrome. Teenagers ingest the roots, seeds or the entire plant to obtain its hallucinogenic and euphoric effects. We presented the case of a 22 year old male who was admitted to the Emergency Room in a coma after consuming Datura stramonium, 2 hours earlier. The patient presented with fever, tachycardia with right bundle branch block, and urinary retention...
April 2017: Rom J Anaesth Intensive Care
https://www.readbyqxmd.com/read/28912948/outbreak-of-fusarium-oxysporum-infections-in-children-with-cancer-an-experience-with-7-episodes-of-catheter-related-fungemia
#13
Fabianne Carlesse, Anna-Paula C Amaral, Sarah S Gonçalves, Hemilio Xafranski, Maria-Lucia M Lee, Victor Zecchin, Antonio S Petrilli, Abdullah M Al-Hatmi, Ferry Hagen, Jacques F Meis, Arnaldo L Colombo
BACKGROUND: Fusarium species are widely spread in nature as plant pathogens but are also able to cause opportunistic fungal infections in humans. We report a cluster of Fusarium oxysporum bloodstream infections in a single pediatric cancer center. METHODS: All clinical and epidemiological data related to an outbreak involving seven cases of fungemia by Fusarium oxysporum during October 2013 and February 2014 were analysed. All cultured isolates (n = 14) were identified to species level by sequencing of the TEF1 and RPB2 genes...
2017: Antimicrobial Resistance and Infection Control
https://www.readbyqxmd.com/read/28912056/revisiting-unplanned-extubation-in-the-pediatric-intensive-care-unit-what-s-new
#14
REVIEW
Paulo Sérgio Lucas da Silva, Daniela Farah, Marcelo Cunio Machado Fonseca
In 2010, recommendations for preventing unplanned extubations (UEs) in pediatric patients were published based on a literature review. Since then, there have been an increasing number of publications related to UE focusing on children. If the introduction of care bundles and larger body of evidence on UE had impact on UE occurrence, this would have important implications on clinical practice. We searched for relevant publications published between Jan 1, 2010 and Jun 30, 2016 in the MEDLINE, EMBASE, and Cochrane systems...
September 11, 2017: Heart & Lung: the Journal of Critical Care
https://www.readbyqxmd.com/read/28906260/effectiveness-of-a-post-emergency-department-discharge-multidisciplinary-bundle-in-reducing-acute-hospital-admissions-for-the-elderly
#15
Colin Ong, Marxengel Asinas-Tan, Lit-Sin Quek, Michael de Dios, Xue-Ting Cai, Beng-Leong Lim
OBJECTIVE: We evaluated the effectiveness of the Subacute Ambulatory care for the Functionally challenged and Elderly (SAFE) programme, a post-emergency department (ED) discharge intervention for elderly and functionally challenged patients, in reducing acute hospital admissions. METHODS: This study was a 32-month retrospective quasi-experimental study comparing patients with at least one of six diagnostic classifications who underwent SAFE intervention with those who were eligible but declined and received usual ED care (control)...
September 12, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28904897/peyronie-s-graft-surgery-tips-and-tricks-from-the-masters-in-andrologic-surgery
#16
Georgios Hatzichristodoulou, Peter Tsambarlis, Hubert Kübler, Laurence A Levine
BACKGROUND: Grafting techniques in the surgical management of Peyronie's disease (PD) are challenging, especially in inexperienced hands. In order to improve surgical outcomes the urologist should follow a standard surgical approach, preferably of an established and reliable grafting technique. The aim of this study is to provide tips and tricks for graft surgery for PD. METHODS: This report offers a step-by-step tutorial for grafting techniques in PD, especially for the Sealing technique and the partial plaque excision and grafting (PEG) procedure...
August 2017: Translational Andrology and Urology
https://www.readbyqxmd.com/read/28899901/do-the-stars-align-distribution-of-high-quality-ratings-of-healthcare-sectors-across-us-markets
#17
Jose Figueroa, Yevgeniy Feyman, Daniel Blumenthal, Ashish Jha
BACKGROUND: The US government created five-star rating systems to evaluate hospital, nursing homes, home health agency and dialysis centre quality. The degree to which quality is a property of organisations versus geographical markets is unclear. OBJECTIVES: To determine whether high-quality healthcare service sectors are clustered within US healthcare markets. DESIGN: Using data from the Centers for Medicare and Medicaid Services' Hospital, Dialysis, Nursing Home and Home Health Compare databases, we calculated the mean star ratings of four healthcare sectors in 304 US hospital referral regions (HRRs)...
September 12, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/28893630/engineered-axially-vascularized-osteogenic-grafts-from-human-adipose-derived-cells-to-treat-avascular-necrosis-of-bone-in-a-rat-model
#18
Tarek Ismail, Rik Osinga, Atanas Todorov, Alexander Haumer, Laurent A Tchang, Christian Epple, Nima Allafi, Nadia Menzi, René D Largo, Alexandre Kaempfen, Ivan Martin, Dirk J Schaefer, Arnaud Scherberich
BACKGROUND: Avascular necrosis of bone (AVN) leads to sclerosis and collapse of bone and joints. The standard of care, vascularized bone grafts, is limited by donor site morbidity and restricted availability. The aim of this study was to generate and test engineered, axially vascularized SVF cells-based bone substitutes in a rat model of AVN. METHODS: SVF cells were isolated from lipoaspirates and cultured onto porous hydroxyapatite scaffolds within a perfusion-based bioreactor system for 5 days...
September 8, 2017: Acta Biomaterialia
https://www.readbyqxmd.com/read/28888825/multimodal-interventions-for-bundle-implementation-to-decrease-central-line-associated-bloodstream-infections-in-adult-intensive-care-units-in-a-teaching-hospital-in-taiwan-2009-2013
#19
Wu-Pu Lin, Yu-Ching Chang, Un-In Wu, Mei-Chuan Hung, Pao-Yu Chuang, Jann-Tay Wang, Wang-Huei Sheng, Yee-Chun Chen, Shan-Chwen Chang
BACKGROUND: Central line (CL)-associated bloodstream infection (CLABSI) poses a major threat to patient safety and is associated with additional cost. This study investigated the sustained effect of multimodal interventions focusing on CL bundle improvement in the adult intensive care units (ICUs) of a teaching hospital in Taiwan. METHODS: A before-after prospective study was conducted in 17 adult ICUs of a medical center in northern Taiwan from January 2009 to December 2013...
August 26, 2017: Journal of Microbiology, Immunology, and Infection, Wei Mian Yu Gan Ran za Zhi
https://www.readbyqxmd.com/read/28886399/effectiveness-of-a-measure-program-to-prevent-admission-hypothermia-in-very-low-birth-weight-preterm-infants
#20
Jamil Pedro de Siqueira Caldas, Fernanda de Castro Millen, Juliana Fernandes de Camargo, Paula Almeida Cavalcanti Castro, Ana Letícia da Fonseca Camilo, Sérgio Tadeu Martins Marba
OBJECTIVE: To evaluate the effectiveness of a thermoregulation bundle for preventing admission hypothermia (AH) in very low-birth weight preterm infants. METHODS: Interventional study with retrospective evaluation of data undertaken in a tertiary neonatal unit including all very low-birth weight preterm infants (<1500g) born at and admitted to the unit. Two periods were compared: before intervention (PI; 01/01/2012 to 02/28/2014_ and after intervention (PII; 04/01/2014 to 11/30/2016)...
September 5, 2017: Jornal de Pediatria
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