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https://www.readbyqxmd.com/read/28818338/spinal-anesthesia-for-pediatric-urological-surgery-reducing-the-theoretic-neurotoxic-effects-of-general-anesthesia
#1
Emmett E Whitaker, Brianne Z Wiemann, Daniel G DaJusta, Seth A Alpert, Christina B Ching, Daryl J McLeod, Joseph D Tobias, Venkata R Jayanthi
BACKGROUND: Spinal anesthesia (SA) is an effective technique that has been used in children for years. With growing concern with regard to the risks of general anesthesia (GA), we developed a SA program to provide an alternative option. We present our initial experience with this program. OBJECTIVE: To implement a SA program at a large tertiary care pediatric center and assess the safety and efficacy of the technique as an alternative to GA for urologic surgery...
July 14, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28817738/compliance-with-supportive-periodontal-treatment-in-patients-with-dental-implants
#2
Kai-Fang Hu, Ying-Chu Lin, Kun-Yen Ho, Yu-Hsiang Chou
PURPOSE: The need for dental implants is increasing, and supportive periodontal treatment can achieve long-term success and prevent peri-implantitis. Contributing factors to noncompliance with long-term scheduled supportive periodontal treatment remain unclear. To investigate whether demographic and clinical characteristics are associated with noncompliance, the authors analyzed data for patients who had received dental implants. MATERIALS AND METHODS: The authors recruited patients participating in a supportive periodontal treatment program after receiving permanent prostheses on implants placed from 2005 to 2013...
August 17, 2017: International Journal of Oral & Maxillofacial Implants
https://www.readbyqxmd.com/read/28817138/influence-of-abutment-height-on-maintenance-of-peri-implant-crestal-bone-at-bone-level-implants-a-3-year-follow-up-study
#3
Lourdes Nóvoa, Pilar Batalla, Leticia Caneiro, Alexandre Pico, Antonio Liñares, Juan Blanco
In this 3-year follow-up study, peri-implant bone loss at bone-level implants was evaluated with two definitive abutment heights: 1 mm and 2.5 mm. Peri-implant bone loss was defined as the distance between the implant shoulder and the first bone-to-implant contact from the time of loading to the 36-month follow-up, estimated using periapical radiographs. The bone loss was increased at the time of follow-up, to 1.30 mm (95% confidence interval [CI]: 0.70-1.89 mm; SD = 1.89) and 0.33 mm (95% CI: 0.11-0.55; SD = 0...
September 2017: International Journal of Periodontics & Restorative Dentistry
https://www.readbyqxmd.com/read/28802868/development-and-implementation-of-an-ultrasound-guided-peripheral-intravenous-catheter-program-for-emergency-nurses
#4
Courtney Edwards, Jodi Jones
PROBLEM: Emergency medical care often necessitates placement of peripheral intravenous (PIV) catheters. When traditional methods for obtaining PIV access are not successful, ultrasound guidance is a rescue technique for peripheral vascular placement that improves the quality of patient care. METHODS: The aim of this training program was to develop a process where emergency nurses would be competent to perform ultrasound guided PIV to improve the quality of patient care delivered while reducing throughput time...
August 9, 2017: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
https://www.readbyqxmd.com/read/28801218/urology-residents-experience-and-attitude-towards-surgical-simulation-presenting-our-four-year-experience-with-a-multi-institutional-multi-modality-simulation-model
#5
Alexander Chow, B Sherer, E Yura, S Kielb, E Kocjancic, S Eggener, T Turk, S Park, S Psutka, M Abern, K Latchamsetty, C Coogan
OBJECTIVE: To evaluate the Urological resident's attitude and experience with surgical simulation in residency education using a multi-institutional, multi-modality model. MATERIALS AND METHODS: Residents from six area urology training programs rotated through simulation stations in four consecutive sessions from 2014 to 2017. Workshops included GreenLight photovaporization of the prostate(PVP), ureteroscopic stone extraction, laparoscopic peg transfer, 3-dimensional laparoscopy rope pass, transobturator sling placement, intravesical injection, high definition video system trainer (VITOM), vasectomy, and Urolift...
August 8, 2017: Urology
https://www.readbyqxmd.com/read/28797716/radiology-trainee-vs-faculty-radiologist-fluoroscopy-time-for-imaging-guided-procedures-a-retrospective-study-of-17-966-reports-over-a-5-5-year-period
#6
REVIEW
Ariadne K DeSimone, Andrew Post, Richard Duszak, Phuong-Anh T Duong
To evaluate differences in fluoroscopy time (FT) for common vascular access and gastrointestinal procedures performed by radiology trainees vs faculty radiologists. Report information was extracted for all 17,966 index fluoroscopy services performed by trainees or faculty, or both from 2 university hospitals over 66 months. Various vascular access procedures (eg, peripherally inserted central catheters [PICCs] and ports) and gastrointestinal fluoroscopy procedures (eg, upper gastrointestinal and contrast enema studies) were specifically targeted...
July 8, 2017: Current Problems in Diagnostic Radiology
https://www.readbyqxmd.com/read/28797214/provider-perspectives-on-employment-for-people-with-serious-mental-illness
#7
Mark Costa, Michaella Baker, Larry Davidson, Julienne Giard, Linda Guillorn, Angels González Ibáñez, Dawn Weitz, Maria O'Connell
BACKGROUND: Persons with serious mental illnesses (SMI) can lead productive lives, and the majority want to work. Mental health providers can play an important role in helping their clients gain and maintain employment. AIMS: The Provider Survey was developed to shed additional light on providers' views toward employment and recovery, and the utilization of Individual Placement and Support (IPS) supported employment (SE) services for people with SMI. METHODS: A total of 1,306 providers of the State of Connecticut participated in the survey...
August 1, 2017: International Journal of Social Psychiatry
https://www.readbyqxmd.com/read/28793916/a-manual-based-vocational-rehabilitation-program-for-patients-with-an-acquired-brain-injury-study-protocol-of-a-pragmatic-randomized-controlled-trial-rct
#8
Louise K Hoeffding, Maria Haahr Nielsen, Morten A Rasmussen, Anne Norup, Juan Carlos Arango-Lasprilla, Ulrikka K Kjær, Kristoffer Sølvsten Burgdorf, Trine Schow
BACKGROUND: An acquired brain injury (ABI) is a complex injury often followed by a broad range of cognitive, physical, emotional, and behavioral disabilities. Because of these disabilities, vocational rehabilitation (VR) is a challenging task, however, of great importance, since approximately 75% of the patients with ABI are of working age. Thus, standardized clinically effective and cost-effective methodologies regarding VR for patients with ABI are highly needed. Therefore, the aim of this study is to evaluate the effect of an individually targeted manual-based VR for patient with ABI compared to conventional VR (usual care)...
August 10, 2017: Trials
https://www.readbyqxmd.com/read/28792293/the-opioid-epidemic-challenges-of-sustained-remission
#9
Nitin Chopra, Lauren H Marasa
Opioid use disorder is a growing epidemic, with an alarming number of associated deaths. In 2014, in the United States, 18,893 lethal overdoses were related to prescription opioids and 10,574 due to heroin. Despite the growing number of treatment options for substance use disorders, which are chronic, relapsing-remitting conditions, relapse rates remain as high as 91%. In the United States, 7.5 million children reside with at least one patient who abuses drugs or alcohol. Mothers are twice as likely to lose custody of their children...
March 2017: International Journal of Psychiatry in Medicine
https://www.readbyqxmd.com/read/28765679/placement-instability-among-young-people-removed-from-their-original-family-and-the-likely-mental-health-implications
#10
Simon Rice, Sue Cotton, Kristen Moeller-Saxone, Cathrine Mihalopoulos, Anne Magnus, Carol Harvey, Cathy Humphreys, Stephen Halperin, Angela Scheppokat, Patrick McGorry, Helen Herrman
BACKGROUND: Young people in out-of-home care are more likely to experience poorer mental and physical health outcomes related to their peers. Stable care environments are essential for ameliorating impacts of disruptive early childhood experiences, including exposure to psychological trauma, abuse and neglect. At present there are very few high quality data regarding the placement stability history of young people in out-of-home care in Australia or other countries. OBJECTIVES: To undertake the first systematic census of background, care type and placement stability characteristics of young people living in the out-of-home care sector in Australia...
April 25, 2017: Shanghai Archives of Psychiatry
https://www.readbyqxmd.com/read/28743217/identifying-content-for-simulation-based-curricula-in-urology-a-national-needs-assessment
#11
Leizl Joy Nayahangan, Rikke Bølling Hansen, Karen Gilboe Lindorff-Larsen, Charlotte Paltved, Bjørn Ulrik Nielsen, Lars Konge
OBJECTIVE: Simulation-based training is well recognized in the transforming field of urological surgery; however, integration into the curriculum is often unstructured. Development of simulation-based curricula should follow a stepwise approach starting with a needs assessment. This study aimed to identify technical procedures in urology that should be included in a simulation-based curriculum for residency training. MATERIALS AND METHODS: A national needs assessment was performed using the Delphi method involving 56 experts with significant roles in the education of urologists...
July 26, 2017: Scandinavian Journal of Urology
https://www.readbyqxmd.com/read/28732525/effectiveness-and-cost-effectiveness-of-embedded-simulation-in-occupational-therapy-clinical-practice-education-study-protocol-for-a-randomised-controlled-trial
#12
Christine Imms, Eli Mang Yee Chu, Stephen Guinea, Loretta Sheppard, Elspeth Froude, Rob Carter, Susan Darzins, Samantha Ashby, Susan Gilbert-Hunt, Nigel Gribble, Kelli Nicola-Richmond, Merrolee Penman, Elena Gospodarevskaya, Erin Mathieu, Mark Symmons
BACKGROUND: Clinical placements are a critical component of the training for health professionals such as occupational therapists. However, with growing student enrolments in professional education courses and workload pressures on practitioners, it is increasingly difficult to find sufficient, suitable placements that satisfy program accreditation requirements. The professional accrediting body for occupational therapy in Australia allows up to 200 of the mandatory 1000 clinical placement hours to be completed via simulation activities, but evidence of effectiveness and efficiency for student learning outcomes is lacking...
July 21, 2017: Trials
https://www.readbyqxmd.com/read/28709415/assessing-anesthesiology-residents-out-of-the-operating-room-ooor-emergent-airway-management
#13
Lauryn R Rochlen, Michelle Housey, Ian Gannon, Shannon Mitchell, Deborah M Rooney, Alan R Tait, Milo Engoren
BACKGROUND: At many academic institutions, anesthesiology residents are responsible for managing emergent intubations outside of the operating room (OOOR), with complications estimated to be as high as 39%. In order to create an OOOR training curriculum, we evaluated residents' familiarity with the content and correct adherence to the American Society of Anesthesiologists' Difficult Airway Algorithm (ASA DAA). METHODS: Residents completed a pre-simulation multiple-choice survey measuring their understanding and use of the DAA...
July 15, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28700450/comparison-of-thirty-day-complications-between-navigated-and-conventional-single-level-instrumented-posterior-lumbar-fusion-a-propensity-score-matched-analysis
#14
Patawut Bovonratwet, Stephen J Nelson, Nathaniel T Ondeck, Benjamin J Geddes, Jonathan N Grauer
STUDY DESIGN: cohort comparison study. OBJECTIVE: To compare perioperative outcomes between navigated and conventional single-level instrumented posterior lumbar fusions in the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database. SUMMARY OF BACKGROUND DATA: Although multiple studies have investigated the accuracy of pedicle screw placement and radiation exposure with navigation, no study has compared perioperative complications between navigated and conventional posterior lumbar fusion...
July 11, 2017: Spine
https://www.readbyqxmd.com/read/28697017/risk-factors-for-deep-vein-thrombosis-and-pulmonary-embolism-after-traumatic-injury-a-competing-risks-analysis
#15
Jan-Michael Van Gent, Richard Y Calvo, Ashley L Zander, Erik J Olson, C Beth Sise, Michael J Sise, Steven R Shackford
BACKGROUND: Venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE), is typically reported as a composite measure of the quality of trauma center care. Given recent data suggesting post-injury DVT and PE are distinct clinical processes, a better understanding may result from analyzing them as independent, competing events. Using competing risks analysis, we evaluated our hypothesis that the risk factors and timing of post-injury DVT and PE are different...
July 8, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28690941/a-simulation-based-quality-improvement-approach-to-improve-pediatric-resident-competency-with-required-procedures
#16
Michelle Starr, Taylor Sawyer, Maya Jones, Maneesh Batra, Heather McPhillips
INTRODUCTION: Pediatric residents report a lack of confidence and competence with procedural skills at graduation. Training programs could benefit from improved approaches to target these needs. Using the Institute for Healthcare Improvement (IHI) Model for Improvement and three Plan-Do-Study-Act (PDSA) cycles, we examined the impact of a procedure simulation boot camp on self-reported procedural confidence and competence as well as the longitudinal impacts of these sequential interventions on Accreditation Council for Graduate Medical Education (ACGME) Graduating Resident Survey (GRS) results...
June 3, 2017: Curēus
https://www.readbyqxmd.com/read/28690015/causes-of-failure-of-pallidal-deep-brain-stimulation-in-cases-with-pre-operative-diagnosis-of-isolated-dystonia
#17
K Amande M Pauls, Joachim K Krauss, Constanze E Kämpfer, Andrea A Kühn, Christoph Schrader, Martin Südmeyer, Niels Allert, Rainer Benecke, Christian Blahak, Jana K Boller, Gereon R Fink, Wolfgang Fogel, Thomas Liebig, Faycal El Majdoub, Philipp Mahlknecht, Josef Kessler, Joerg Mueller, Juergen Voges, Matthias Wittstock, Alexander Wolters, Mohammad Maarouf, Elena Moro, Jens Volkmann, Kailash P Bhatia, Lars Timmermann
INTRODUCTION: Pallidal deep brain stimulation (GPi-DBS) is an effective therapy for isolated dystonia, but 10-20% of patients show improvement below 25-30%. We here investigated causes of insufficient response to GPi-DBS in isolated dystonia in a cross-sectional study. METHODS: Patients with isolated dystonia at time of surgery, and <30% improvement on the Burke-Fahn-Marsden dystonia-rating-scale (BFMDRS) after ≥6 months of continuous GPi-DBS were videotaped ON and OFF stimulation, and history, preoperative videos, brain MRI, medical records, stimulation settings, stimulation system integrity, lead location, and genetic information were obtained and reviewed by an expert panel...
June 28, 2017: Parkinsonism & related Disorders
https://www.readbyqxmd.com/read/28689047/major-regional-differences-in-automated-external-defibrillator-placement-and-basic-life-support-training-in-france-further-needs-for-coordinated-implementation
#18
Nicole Karam, Kumar Narayanan, Wulfran Bougouin, Nordine Benameur, Frankie Beganton, Daniel Jost, Lionel Lamhaut, Marie-Cécile Perier, Alain Cariou, David S Celermajer, Eloi Marijon, Xavier Jouven
BACKGROUND: Public Access Defibrillation (PAD) programs have emerged since mid-1990s with the aim of improving survival from Out-of-Hospital Cardiac Arrest (OHCA). The extent to which their implementation in the community differs among different areas has not been evaluated. METHODS: We carried out a 5-year prospective national evaluation of PAD programs in 51 French districts (29.3 million inhabitants), through the cumulative density of Automated External Defibrillator (AEDs) and the proportion of persons educated in Basic Life Support (BLS)...
September 2017: Resuscitation
https://www.readbyqxmd.com/read/28688550/a-quality-study-of-family-centered-care-coordination-to-improve-care-for-children-undergoing-tracheostomy-and-the-quality-of-life-for-their-caregivers
#19
Christopher Hartnick, Gillian Diercks, Vanessa De Guzman, Elizabeth Hartnick, Jeanne Van Cleave, Kevin Callans
IMPORTANCE: Approximately 4000 U.S. children undergo tracheostomy yearly [1], and these surgeries often result in hospital re-admissions that have definite cost and caregiver burdens due to complications that are avoidable with proper training and support. OBJECTIVE: To assess the impact of a Family-Centered Care Coordination (FCCC) program on the quality of care received by children undergoing tracheostomy and their caregivers. DESIGN: Caregivers of children undergoing tracheostomies from January 2012 to January 2013 and then a different set of caregivers of children undergoing tracheostomies from January 2015 to January 2016 completed both the Pediatric Tracheostomy Health Status Instrument (PTHSI) 1 month after discharge and the Medical Complications Associated with Pediatric Tracheostomy (MCAT) questionnaire 6 months after initial tracheostomy...
August 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28687709/the-effects-of-public-access-defibrillation-on-survival-after-out-of-hospital-cardiac-arrest-a-systematic-review-of-observational-studies
#20
Josefine Bækgaard, Søren Viereck, Thea Møller, Annette Ersbøll, Freddy Lippert, Fredrik Folke
Background -Despite recent advances, the average survival after out-of-hospital cardiac arrest (OHCA) remains below 10%. Early defibrillation by an automated external defibrillator (AED) is the most important intervention for OHCA patients, showing survival proportions above 50%. Accordingly, placement of AEDs in the community as part of a public access defibrillation program (PAD) is recommended by international guidelines. However, different strategies have been proposed on how exactly to increase and make use of public available AEDs...
July 7, 2017: Circulation
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