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https://www.readbyqxmd.com/read/29240884/a-proposal-for-a-comprehensive-risk-scoring-system-for-predicting-postoperative-complications-in-octogenarian-patients-with-medically-operable-lung-cancer-jacs1303
#1
Hisashi Saji, Takahiko Ueno, Hiroshige Nakamura, Norihito Okumura, Masanori Tsuchida, Makoto Sonobe, Takuro Miyazaki, Keiju Aokage, Masayuki Nakao, Tomohiro Haruki, Hiroyuki Ito, Kazuhiko Kataoka, Kazunori Okabe, Kenji Tomizawa, Kentaro Yoshimoto, Hirotoshi Horio, Kenji Sugio, Yasuhisa Ode, Motoshi Takao, Morihito Okada, Masayuki Chida
OBJECTIVES: Although some retrospective studies have reported clinicopathological scoring systems for predicting postoperative complications and survival outcomes for elderly lung cancer patients, optimized scoring systems remain controversial. METHODS: The Japanese Association for Chest Surgery (JACS) conducted a nationwide multicentre prospective cohort and enrolled a total of 1019 octogenarians with medically operable lung cancer. Details of the clinical factors, comorbidities and comprehensive geriatric assessment were recorded for 895 patients to develop a comprehensive risk scoring (RS) system capable of predicting severe complications...
December 11, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29240850/hospitalist-and-internal-medicine-leaders-perspectives-of-early-discharge-challenges-at-academic-medical-centers
#2
Hemali Patel, Margaret C Fang, Michelle Mourad, Adrienne Green, Robert M Wachter, Ryan D Murphy, James D Harrison
Improving early discharges may improve patient flow and increase hospital capacity. We conducted a national survey of academic medical centers addressing the prevalence, importance, and effectiveness of early-discharge initiatives. We assembled a list of hospitalist and general internal medicine leaders at 115 US-based academic medical centers. We emailed each institutional representative a 30-item online survey regarding early-discharge initiatives. The survey included questions on discharge prioritization, the prevalence and effectiveness of early-discharge initiatives, and barriers to implementation...
December 6, 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29240007/alternative-fistula-risk-score-for-pancreatoduodenectomy-a-frs-design-and-international-external-validation
#3
Timothy H Mungroop, L Bengt van Rijssen, David van Klaveren, F Jasmijn Smits, Victor van Woerden, Ralph J Linnemann, Matteo de Pastena, Sjors Klompmaker, Giovanni Marchegiani, Brett L Ecker, Susan van Dieren, Bert Bonsing, Olivier R Busch, Ronald M van Dam, Joris Erdmann, Casper H van Eijck, Michael F Gerhards, Harry van Goor, Erwin van der Harst, Ignace H de Hingh, Koert P de Jong, Geert Kazemier, Misha Luyer, Awad Shamali, Salvatore Barbaro, Thomas Armstrong, Arjun Takhar, Zaed Hamady, Joost Klaase, Daan J Lips, I Quintus Molenaar, Vincent B Nieuwenhuijs, Coen Rupert, Hjalmar C van Santvoort, Joris J Scheepers, George P van der Schelling, Claudio Bassi, Charles M Vollmer, Ewout W Steyerberg, Mohammed Abu Hilal, Bas Groot Koerkamp, Marc G Besselink
OBJECTIVE: The aim of this study was to develop an alternative fistula risk score (a-FRS) for postoperative pancreatic fistula (POPF) after pancreatoduodenectomy, without blood loss as a predictor. BACKGROUND: Blood loss, one of the predictors of the original-FRS, was not a significant factor during 2 recent external validations. METHODS: The a-FRS was developed in 2 databases: the Dutch Pancreatic Cancer Audit (18 centers) and the University Hospital Southampton NHS...
December 12, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/29238186/severe-copd-cases-from-korea-poland-and-usa-have-substantial-differences-in-respiratory-symptoms-and-other-respiratory-illnesses
#4
Woo Jin Kim, Jae-Joon Yim, Deog Kyeom Kim, Myung Goo Lee, Anne L Fuhlbrigge, Pawel Sliwinski, Iwona Hawrylkiewicz, Emily S Wan, Michael H Cho, Edwin K Silverman
Purpose: Chronic obstructive pulmonary disease (COPD), characterized by irreversible airflow obstruction, is a major cause of morbidity and mortality worldwide. However, geographic differences in the clinical characteristics of severe COPD patients have not been widely studied. Methods: We recruited a total of 828 severe COPD cases from three continents. Subjects in Poland were enrolled by the Institute of Tuberculosis and Lung Diseases in Warsaw; subjects in Korea participated at several university hospitals in Korea; and subjects in USA were enrolled at two clinics affiliated with academic medical centers...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/29236876/the-process-of-implementation-of-emergency-care-units-in-brazil
#5
Gisele O'Dwyer, Mariana Teixeira Konder, Luciano Pereira Reciputti, Mônica Guimarães Macau Lopes, Danielle Fernandes Agostinho, Gabriel Farias Alves
OBJECTIVE: To analyze the process of implementation of emergency care units in Brazil. METHODS: We have carried out a documentary analysis, with interviews with twenty-four state urgency coordinators and a panel of experts. We have analyzed issues related to policy background and trajectory, players involved in the implementation, expansion process, advances, limits, and implementation difficulties, and state coordination capacity. We have used the theoretical framework of the analysis of the strategic conduct of the Giddens theory of structuration...
December 11, 2017: Revista de Saúde Pública
https://www.readbyqxmd.com/read/29235159/the-effect-of-green-tea-ointment-on-episiotomy-pain-and-wound-healing-in-primiparous-women-a-randomized-double-blind-placebo-controlled-clinical-trial
#6
Hadis Shahrahmani, Nourossadat Kariman, Sharareh Jannesari, Mahmoud Rafieian-Kopaei, Moghadameh Mirzaei, Sahar Ghalandari, Nasim Shahrahmani, Gashtasb Mardani
The delayed healing of episiotomy wound and its associated pain is a major problem in obstetrics. Because green tea has analgesic and wound-healing properties, the present study was conducted to determine the effect of green tea ointment on episiotomy pain and wound-healing. The green tea extract was also standardized by measuring its Phenolic and flavonoid compounds, antioxidant activity, and one of its active components, that is, Epigallocatechin gallate. The present clinical trial was conducted on 99 primiparous women visiting Afzalipour Hospital in Kerman in 2015...
December 13, 2017: Phytotherapy Research: PTR
https://www.readbyqxmd.com/read/29233607/the-concept-of-frailty-in-intensive-care
#7
Fakhri Athari, Ken M Hillman, Steven A Frost
Our population is ageing and this is also reflected in the ageing of the hospital and intensive care population. Along with ageing, there is also an increase in age-related chronic health conditions or co-morbidities, which in turn affects the patient's functional state. There is an increasing need to describe a patient's clinical condition in terms of their functional capacity, such as frailty. Frailty is an age-related syndrome which reduces physiological and cognitive reserves. As a result, frailty increases people's vulnerability to insults such as infection and trauma...
December 9, 2017: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/29233028/therapeutic-effects-of-oral-liothyronine-on-aluminum-phosphide-poisoning-as-an-adjuvant-therapy-a-clinical-trial
#8
M H Goharbari, F Taghaddosinejad, M Arefi, M Sharifzadeh, M Mojtahedzadeh, S Nikfar, M Baeeri, M Rahimifard, M Abdollahi
BACKGROUND: In aluminum phosphide (AlP) poisoning, death is mainly due to cardiovascular failure and refractory acute heart failure. There is a lot of evidence showing thyroid hormones have cardioprotective effects. OBJECTIVE: The purpose of this study was to evaluate the effect of oral liothyronine in the treatment of AlP poisoning. METHODS: Twenty-four patients from intensive care unit of Baharloo Hospital, Tehran, Iran, were included based on the inclusion and exclusion criteria...
January 1, 2017: Human & Experimental Toxicology
https://www.readbyqxmd.com/read/29232680/is-outpatient-control-of-long-term-non-invasive-ventilation-feasible-in-chronic-obstructive-pulmonary-disease-patients
#9
Sarah Bettina Schwarz, Jens Callegari, Christine Hamm, Wolfram Windisch, Friederike Sophie Magnet
BACKGROUND: Long-term non-invasive ventilation (NIV) is an established and increasingly used treatment option for patients with chronic hypercapnic chronic obstructive pulmonary disease (COPD). Following inpatient NIV establishment, inpatient control visits regularly occur thereafter. However, it remains unclear whether such control visits can also be performed in an outpatient setting, which, in turn, would reduce costs, patient burden and the complications related to hospitalization...
December 12, 2017: Respiration; International Review of Thoracic Diseases
https://www.readbyqxmd.com/read/29231234/feasibility-acceptability-and-effectiveness-of-integrated-care-for-copd-patients-a-mixed-methods-evaluation-of-a-pilot-community-based-programme
#10
Tania Carron, Pierre-Olivier Bridevaux, Karin Lörvall, Rachel Parmentier, Jean-Bernard Moix, Vincent Beytrison, Raymond Pernet, Constance Rey, Pierre-Yves Roberfroid, Prashant N Chhajed, Thomas Dieterle, Ladina Joos Zellweger, Malcolm Kohler, Sabrina Maier, David Miedinger, Robert Thurnheer, Pascal Urwyler, Jean-Marie Tschopp, Emilie Zuercher, Jörg Daniel Leuppi, Bernard Burnand, Isabelle Peytremann-Bridevaux
QUESTION UNDER STUDY: The aim of this study was to assess the feasibility, acceptability and effectiveness of a pilot COPD integrated care programme implemented in Valais, Switzerland. METHODS: The programme was adapted from the self-management programme Living Well with COPD, and included the following elements: self-management patient-education group sessions, telephone and medical follow-ups, multidisciplinary teams, training of healthcare professionals, and evidence-based COPD care...
December 12, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/29230596/distribution-of-potential-eye-and-tissue-donors-within-an-australian-teaching-hospital
#11
Martin J Dutch, Anthony F Denahy
Eye and Tissue donation has the capacity to transform lives, yet the vast majority of potential in-hospital donors are not recognised. Studies which describe the relative importance of specific units or wards in determining the size of the donor pool are limited. The aim of this study was to map the distribution of potential Eye and Tissue donors within the study hospital. A 12-month retrospective analysis of all patient deaths at the study hospital was undertaken. The ability to donate corneal, heart valve, bone and skin tissue was investigated...
December 11, 2017: Cell and Tissue Banking
https://www.readbyqxmd.com/read/29229259/effects-of-positive-airway-pressure-and-mechanical-ventilation-of-the-lungs-during-cardiopulmonary-bypass-on-pulmonary-adverse-events-after-cardiac-surgery-a-systematic-review-and-meta-analysis
#12
Yi-Chia Wang, Chi-Hsiang Huang, Yu-Kang Tu
OBJECTIVE: To investigate whether different ventilation strategies during cardiopulmonary bypass (CPB) can improve outcomes in adult cardiac surgery patients. DESIGN: Systematic review of randomized controlled trials with meta-analyses. SETTING: Clinical trials for human studies up to July 2016 were obtained from electronic databases (Medline, Embase, PubMed, and the Cochrane Central Register of Controlled Trials) and reference lists of relevant randomized trials and review articles...
September 14, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29228933/pulmonary-exacerbations-and-clinical-outcomes-in-a-longitudinal-cohort-of-infants-and-preschool-children-with-cystic-fibrosis
#13
Jordana E Hoppe, Brandie D Wagner, Scott D Sagel, Frank J Accurso, Edith T Zemanick
BACKGROUND: Pulmonary exacerbations (PEx) in school aged children and adults with cystic fibrosis (CF) lead to increased morbidity and lung function decline. However, the effect of exacerbations in young children with CF is not fully understood. We sought to characterize the frequency and clinical impact of PEx in a pilot study of infants and pre-school aged children with CF. METHODS: Thirty young children with CF [median (range) 1.5 years (0.2-4.9)] were prospectively followed for 2 years...
December 11, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/29226811/evidence-based-therapy-and-its-association-with-workforce-detachment-after-first-hospitalization-for-heart-failure
#14
Rasmus Rørth, Emil L Fosbøl, Ulrik M Mogensen, Kristian Kragholm, Pardeep S Jhund, Mark C Petrie, Morten Schou, Gunnar H Gislason, John J V McMurray, Christian Torp-Pedersen, Lars Køber, Søren L Kristensen
OBJECTIVES: This study investigated the association between the use of evidence-based medicine (EBM) for heart failure (HF) and risk of workforce detachment. BACKGROUND: The ability to work can be a marker of functional capacity and quality of life. METHODS: We examined a nationwide cohort of patients in the workforce 1 year after first hospitalization for HF. EBM was defined as treatment with β-blockers and renin angiotensin system inhibitors...
November 27, 2017: JACC. Heart Failure
https://www.readbyqxmd.com/read/29225958/overcoming-challenges-in-implementing-the-who-surgical-safety-checklist-lessons-learnt-from-using-a-checklist-training-course-to-facilitate-rapid-scale-up-in-madagascar
#15
REVIEW
Kristin L Close, Linden S Baxter, Vaonandianina A Ravelojaona, Hasiniaina N Rakotoarison, Emily Bruno, Alison Herbert, Vanessa Andean, James Callahan, Hery H Andriamanjato, Michelle C White
The WHO Surgical Safety Checklist was launched in 2009, and appropriate use reduces mortality, surgical site infections and complications after surgery by up to 50%. Implementation across low-income and middle-income countries has been slow; published evidence is restricted to reports from a few single institutions, and significant challenges to successful implementation have been identified and presented. The Mercy Ships Medical Capacity Building team developed a multidisciplinary 3-day Surgical Safety Checklist training programme designed for rapid wide-scale implementation in all regional referral hospitals in Madagascar...
2017: BMJ Global Health
https://www.readbyqxmd.com/read/29225957/limited-sterile-processing-capabilities-for-safe-surgery-in-low-income-and-middle-income-countries-experience-in-the-republic-of-congo-madagascar-and-benin
#16
REVIEW
Olive Fast, Christina Fast, Dan Fast, Suzanne Veltjens, Zouliha Salami, Michelle C White
It is highly difficult to perform safe surgery without sterile instruments, yet the capacity to adequately clean, disinfect and sterilise surgical instruments in low-income and middle-income countries is largely unknown. Sterile Processing Education Charitable Trust developed an assessment tool and, in partnership with Mercy Ships, evaluated the sterile processing capacity in 59 facilities in Madagascar, Benin and the Republic of Congo. This data-driven analysis paper illustrates how lack of sterile processing capacity acts as a barrier to safe surgical care...
2017: BMJ Global Health
https://www.readbyqxmd.com/read/29224789/pediatric-surgical-capacity-building-a-pathway-to-improving-access-to-pediatric-surgical-care-in-haiti
#17
Neema Kaseje, Hillary Jenny, Andre Patrick Jeudy, Jean Louis MacLee, John G Meara, Henri R Ford
PURPOSE: Lack of human resources is a major barrier to accessing pediatric surgical care globally. Our aim was to establish a model for pediatric surgical training of general surgery residents in a resource constrained region. MATERIALS/METHODS: A pediatric surgical program with a pediatric surgical rotation for general surgery residents in a tertiary hospital in Haiti in 2015 was established. We conducted twice daily patient rounds, ran an outpatient clinic, and provided emergent and elective pediatric surgical care, with tasks progressively given to residents until they could run clinic and perform the most common elective and emergent procedures...
November 16, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29223401/palliative-care-need-and-availability-in-four-referral-hospitals-in-senegal-results-from-a-multi-component-assessment
#18
Hana Hamdi, Oumar Ba, Serigne Niang, Christian Ntizimira, Mouhadou Mbengue, Aminata Sophie Coulbary, Rokhaya Niang, Matthew Parsons, Joseph J Amon, Diederik Lohman
CONTEXT: With prevalence of non-communicable diseases and life expectancy rising in Senegal, the need for palliative care is likely growing. No national palliative care needs assessments have been carried out. OBJECTIVES: To assess the capacity and need for palliative care in Senegal. METHODS: A multi-component assessment of availability and demand for palliative care was conducted in two tertiary and two regional hospitals in Senegal in 2015 with approval from Senegal's National Ethics Committee for Health Research...
December 6, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29221643/respiratory-and-cardiovascular-responses-to-walking-down-a-traffic-polluted-road-compared-with-walking-in-a-traffic-free-area-in-participants-aged-60-years-and-older-with-chronic-lung-or-heart-disease-and-age-matched-healthy-controls-a-randomised-crossover
#19
Rudy Sinharay, Jicheng Gong, Benjamin Barratt, Pamela Ohman-Strickland, Sabine Ernst, Frank Kelly, Junfeng Jim Zhang, Peter Collins, Paul Cullinan, Kian Fan Chung
BACKGROUND: Long-term exposure to pollution can lead to an increase in the rate of decline of lung function, especially in older individuals and in those with chronic obstructive pulmonary disease (COPD), whereas shorter-term exposure at higher pollution levels has been implicated in causing excess deaths from ischaemic heart disease and exacerbations of COPD. We aimed to assess the effects on respiratory and cardiovascular responses of walking down a busy street with high levels of pollution compared with walking in a traffic-free area with lower pollution levels in older adults...
December 5, 2017: Lancet
https://www.readbyqxmd.com/read/29221606/-medical-information-system-pmsi-does-not-adequately-identify-severe-trauma
#20
A Perozziello, T Gauss, A Diop, M Frank-Soltysiak, P Rufat, M Raux, S Hamada, B Riou
BACKGROUND: Resource allocation to hospitals is highly dependent on appropriate case coding. For trauma victims, the major diagnosis-coding category (DCC) is multiple trauma (DCC26), which triggers higher funding. We hypothesized that DCC26 has limited capacity for appropriate identification of severe trauma victims. METHODS: We studied Injury Severity Score (ISS), Trauma Related Injury Severity Score (TRISS) and in-hospital mortality using data recorded in three level 1 trauma centers over a 2-year period...
December 5, 2017: Revue D'épidémiologie et de Santé Publique
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