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Hospital throughput

Weiran Li, Yu Zhu, Yiyuan Li, Min Shu, Yang Wen, Xiaolin Gao, Chaomin Wan
AIM: This study explored the gut microbiota of children with hand, foot and mouth disease (HFMD). METHODS: We enrolled 15 cases with HFMD admitted to the West China Second Hospital, Sichuan University, China, from July to September 2016 at a median age of three years. The controls were 15 healthy children of a similar age who underwent routine health examinations at the hospital during the same period. Gut microbiota was analysed using high throughput 16S ribosomal deoxyribonucleic acid sequencing...
November 14, 2018: Acta Paediatrica
Michelle P Lin, Shaw Natsui, Corine Sinnette, Alexis Ball, Joel S Weissman, Jeremiah D Schuur
BACKGROUND: Chest pain of possible cardiac etiology is a leading reason for emergency department (ED) visits and hospitalizations nationwide. Evidence suggests outpatient management is safe and effective for low-risk patients; however, ED admission rates for chest pain vary widely. To identify barriers and facilitators to outpatient management after ED visits, we performed a multicenter qualitative study of key stakeholders. METHODS AND RESULTS: We identified Massachusetts hospitals with below-average admission rates for adult ED chest pain visits from 2010 to 2011...
December 2018: Critical Pathways in Cardiology
Tristan Struja, Andreas Eckart, Alexander Kutz, Andreas Huber, Peter Neyer, Marius Kraenzlin, Beat Mueller, Christian Meier, Luca Bernasconi, Philipp Schuetz
Background: There is a lack of biochemical markers for early prediction of relapse in patients with Graves' disease [GD], which may help to direct treatment decisions. We assessed the prognostic ability of a high-throughput proton NMR metabolomic profile to predict relapse in a well characterized cohort of GD patients. Methods: Observational study investigating patients presenting with GD at a Swiss hospital endocrine referral center and an associated endocrine outpatient clinic. We measured 227 metabolic markers in the blood of patients before treatment initiation...
2018: Frontiers in Endocrinology
Lawrence O Lin, Rachel A McKenna, Rosaline S Zhang, Ian C Hoppe, Jordan W Swanson, Scott P Bartlett, Jesse A Taylor
BACKGROUND: Hospital resource overutilization can significantly disrupt patient treatment such as cancelling surgical patients due to a lack of intensive care unit (ICU) space. The authors describe a clinical pathway (CP) designed to reduce ICU length of stay (LOS) for nonsyndromic single-suture craniosynostosis (nsSSC) patients undergoing cranial vault reconstruction (CVR) in order to minimize surgical disruptions and improve patient outcomes. METHODS: A multidisciplinary team implemented a perioperative CP including scheduled laboratory testing to decrease ICU LOS...
October 29, 2018: Journal of Craniofacial Surgery
Franziska Singer, Anja Irmisch, Nora C Toussaint, Linda Grob, Jochen Singer, Thomas Thurnherr, Niko Beerenwinkel, Mitchell P Levesque, Reinhard Dummer, Luca Quagliata, Sacha I Rothschild, Andreas Wicki, Christian Beisel, Daniel J Stekhoven
BACKGROUND: Molecular precision oncology is an emerging practice to improve cancer therapy by decreasing the risk of choosing treatments that lack efficacy or cause adverse events. However, the challenges of integrating molecular profiling into routine clinical care are manifold. From a computational perspective these include the importance of a short analysis turnaround time, the interpretation of complex drug-gene and gene-gene interactions, and the necessity of standardized high-quality workflows...
October 29, 2018: BMC Medical Informatics and Decision Making
Lidia S van Huizen, Pieter U Dijkstra, Bernard F A M van der Laan, Harry Reintsema, Kees T B Ahaus, Hendrik P Bijl, Jan L N Roodenburg
BACKGROUND: Head and neck cancers are fast growing tumours that are complex to diagnose and treat. Multidisciplinary input into organization and logistics is critical to start treatment without delay. A multidisciplinary first-day consultation (MFDC) was introduced to reduce throughput times for patients suffering from head and neck cancer in the care pathway. In this mixed method study we evaluated the effects of introducing the MFDC on throughput times, number of patient hospital visits and compliance to the Dutch standard to start treatment within 30 calendar-days...
October 29, 2018: BMC Health Services Research
Hans Ackerman, Climent Casals-Pascual
This opinion article deals with the diagnostic clinical challenges faced by clinicians or health care workers in malaria-endemic areas when a severely sick child presents to the clinic with fever, coma or respiratory distress. Indeed, the coexistence of malaria with other severe infections like meningitis, invasive bacterial infection or pneumonia makes appropriate treatment allocation a matter of life and death. The use of biomarkers has been proposed as a potential solution to this problem. The arrival of high-throughput technologies allowed thousands of molecules (transcripts, proteins and metabolites) to be been screened in clinical samples from large cohorts of well/characterised patients...
October 22, 2018: Malaria Journal
Viktor Gabriel, Areg Grigorian, Sebastian D Schubl, Marija Pejcinovska, Eugene Won, Michael Lekawa, Nicole Bernal, Jeffry Nahmias
BACKGROUND: Perforated peptic ulcer (PPU) surgery mortality ranges 1% to 24%. We hypothesized a decrease in length of stay (LOS) with laparoscopic surgical repair (LSR) compared with open surgical repair (OSR). METHODS: Patients undergoing PPU surgery 2005 to 2015 were identified in NSQIP. LSR was compared with OSR 2005 to 2015. LSR 2005 to 2010 was compared with 2011 to 2015. OSR 2005 to 2010 was compared with 2011 to 2015. The primary outcome was LOS. Secondary outcomes were mortality and morbidity...
October 11, 2018: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
B Lakshmi Dhevi, K S Vishvaksenan, K Senthamil Selvan, A Rajalakshmi
In this article, we ponder multi-user medical image transmission using Cognitive Multiple-input Multiple-output (MIMO) Multi-carrier Code-division-multiple-access (MC-CDMA) system to monitor patient information. We investigate the performance of such system in the communication layer and application layer of internet of things (IOT). Patient monitoring system plays vital role in the hospital particularly in the emergency ward to resolve certain problems such as maintaining glucose level in the body, maintaining minimum sugar levels under emergency conditions...
October 11, 2018: Journal of Medical Systems
Kaat De Pourcq, Paul Gemmel, Jeroen Trybou, Vibeke Kruse
This study was designed to focus on the patient perspective in a reorganisation of care processes at a cancer day care unit (CDU). The effects of dose banding and of taking blood samples one day (or more) before the day care treatment (on Day -1) are investigated in terms of throughput efficiency and perceived service quality. Data were collected by mapping patient processes in detail and surveying patients in two CDUs at a university hospital (n = 308). A univariate model was used to investigate the effect of these factors on patient throughput time, and perceived service quality was examined with multiple linear regression...
October 4, 2018: European Journal of Cancer Care
Elizabeth R Lusczek, Cole Myers, Kimberly Popovsky, Kristine Mulier, Greg Beilman, Robert Sawyer
INTRODUCTION: Age and sex affect outcomes from trauma. Older patients tend to be under-triaged, consume more healthcare resources, and experience worse outcomes relative to younger patients. Sex has also been associated with different outcomes, with women experiencing better outcomes than men. While baseline metabolism differs with both age and sex, no study has examined how these differences affect the response to trauma. We used high-throughput metabolomics to assess metabolic differences associated with blunt trauma according to age and sex...
September 17, 2018: Injury
Jing Ouyang, Fengjun Sun, Dongsheng Zhou, Jiao Feng, Zhe Zhan, Zhijian Xiong, Bo Yang, Zhirui Liu, Tingbo Li, Yigang Tong, Peiyuan Xia
Background: Plasmid-mediated multi-drug resistance (MDR) has been widely found in Citro-bacter freundii . C. freundii P10159 was isolated from a human case of postoperative urinary tract infection in a Chinese teaching hospital. Methods: The complete nucleotide sequences of five resistance plasmids pP10159-1, pP10159-2, pP10159-3, pP10159-4 and pP10159-5 from C. freundii P10159 were determined through high-throughput genome sequencing, and then compared with related plasmids sequences...
2018: Infection and Drug Resistance
T Ziprian, F Laue, N Ramadanov, U Nienaber, R Volland, R Lefering, G Matthes
BACKGROUND: Registries are becoming increasingly more important in clinical research. The TraumaRegister DGU® of the German Society for Trauma Surgery plays an excellent role with respect to the care of severely injured patients. AIM: Within the framework of this investigation the quality of data provided by this registry was to be verified. MATERIAL AND METHODS: Certified hospitals participating in the TraumaNetzwerk DGU® of the German Society for Trauma Surgery are obliged to submit data of treated severely injured patients to the TraumaRegister DGU®...
September 21, 2018: Der Unfallchirurg
M Ambigavathi, D Sridharan
In recent days, intelligent biomedical sensors and wearable devices are changing the healthcare industry by providing various heterogeneous vital signs of patients to the hospitals, caregivers, and clinicals. This collective form of monitoring sensor devices forms a very short-range Wireless Body Area Network (WBAN) and plays a key role in the data gathering process. If any sensor node in the network detects abnormal values that should be transmitted promptly via wireless medium with less delay. A single medium allows one-way delivery of a data packet, and it may not be sufficient to satisfy the high volume of communication demand between the sensor nodes in the network...
September 20, 2018: Journal of Medical Systems
Jennifer L Dale, Kenneth B Beckman, Julia L E Willett, Jennifer L Nilson, Nagendra P Palani, Joshua A Baller, Adam Hauge, Daryl M Gohl, Raymond Erickson, Dawn A Manias, Michael J Sadowsky, Gary M Dunny
Enterococcus faecalis is a common commensal bacterium in animal gastrointestinal (GI) tracts and a leading cause of opportunistic infections of humans in the modern health care setting. E. faecalis OG1RF is a plasmid-free strain that contains few mobile elements yet retains the robust survival characteristics, intrinsic antibiotic resistance, and virulence traits characteristic of most E. faecalis genotypes. To facilitate interrogation of the core enterococcal genetic determinants for competitive fitness in the GI tract, biofilm formation, intrinsic antimicrobial resistance, and survival in the environment, we generated an arrayed, sequence-defined set of chromosomal transposon insertions in OG1RF...
September 2018: MSystems
Daniel J Lin, Christopher C McConkey, Paul Nankivell, Janet Dunn, Hisham Mehanna
OBJECTIVES: High institutional clinical trial recruitment and high hospital volume are reported to be independent indicators of better patient outcomes following cancer treatment. However, their relationship in head and neck cancers (HNC) remains less clear. METHODS: We aimed to assess the relationship between institutional clinical trial recruitment, hospital throughput of HNC cases, and survival of patients with advanced HNC treated with primary chemoradiotherapy at hospitals which recruited to the PET-NECK trial (2008-2012)...
October 2018: Oral Oncology
Charles J Sande, Martin Mutunga, Jacqueline Muteti, James A Berkley, D James Nokes, James Njunge
The upper airway - which consists mainly of the naso- and oro-pharynx - is the first point of contact between the respiratory system and microbial organisms that are ubiquitous in the environment. It has evolved highly specialised functions to address these constant threats whilst facilitating seamless respiratory exchange with the lower respiratory tract. Dysregulation of its critical homeostatic and defence functions can lead to ingress of pathogens into the lower respiratory tract, potentially leading to serious illness...
September 14, 2018: Scientific Reports
Joonhong Park, Hanwool Cho, Seung Jun Choi, Gun Dong Lee, Sang Hyun Sin, Ji Hyeong Ryu, Hye Sun Park, Hyeyoung Lee, Yonggoo Kim, Eun Jee Oh
The detection and quantification of hepatitis B virus (HBV) DNA plays an important role in diagnosing and monitoring HBV infection as well as in assessing the therapeutic response. We compared the analytical performance of a random access, fully automated HBV assay-DxN VERIS Molecular Diagnostics System (Beckman Coulter, Brea, CA, USA)-with that of Abbott RealTime HBV assay (Abbott Laboratories, Des Plaines, IL, USA). The between-day precision of the VERIS assay ranged from 0.92% (mean 4.68 log IU/mL) to 4...
January 2019: Annals of Laboratory Medicine
Joseph A Izzo, Jonathan Watson, Rahul Bhat, Matthew Wilson, Joseph Blumenthal, Christina Houser, Edward Descallar, Daniel Hoffman, Ethan Booker
OBJECTIVES: Emergency Department crowding is an increasing problem, leading to treatment delays and higher risk of mortality. Our institution recently implemented a telemedicine physician intake ("tele-intake") process as a mitigating front-end strategy. Previous studies have focused on ED throughput metrics such as door to disposition; our work aimed to specifically assess the tele-intake model for clinical accuracy. METHODS: We retrospectively reviewed ED visits at a high acuity, tertiary care academic hospital before and after tele-intake implementation...
August 7, 2018: American Journal of Emergency Medicine
Maggy Mitzkewich
INTRODUCTION: Identifying patients with sepsis at triage can lead to a decrease in door-to-antibiotic time. Our community hospital emergency department's mean door-to-antibiotic time was 105.3 minutes, falling short of the Surviving Sepsis Campaign guideline's benchmark goal of 60 minutes. One of the most common reasons for treatment delays was that patients with sepsis were not identified upon entrance to the emergency department. A solution to the delay was to implement a practice improvement project by having the triage nurse screen all patients for sepsis upon entrance to the emergency department...
September 5, 2018: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
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