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https://www.readbyqxmd.com/read/28505059/creation-of-an-adult-observation-unit-improving-outcomes
#1
Joy M Plamann, Judith Zedreck-Gonzalez, Laura Fennimore
A growing segment of patients in hospitals are considered outpatients, classified as observation. These patients neither have the severity of illness nor the intensity of service to qualify as inpatients, yet are not well enough to be discharged. Hospitals have created observation units to address the clinical needs of this growing patient type to provide care in the right setting by managing emergency department throughput and utilizing the most efficient staffing resources. This article describes the change processes and improvements in quality, length of stay, and patient satisfaction, which occurred following the implementation of an adult observation unit...
May 12, 2017: Journal of Nursing Care Quality
https://www.readbyqxmd.com/read/28501667/update-and-new-insights-in-encephalitis
#2
REVIEW
Alexandra Mailles, Jean-Paul Stahl, Karen C Bloch
BACKGROUND: Encephalitis is a medical condition possibly caused by an unlimited number of infectious agents. AIMS: Our review aims at giving an overview of the recent discoveries and advances in encephalitis presentation, diagnosis and management, including in the field of emerging diseases. SOURCES: We search the literature using Pubmed and Embase to identify the most relevant new data published over the last years in the field of infectious encephalitis...
May 10, 2017: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/28497047/association-study-of-gut-flora-in-coronary-heart-disease-through-high-throughput-sequencing
#3
Li Cui, Tingting Zhao, Haibing Hu, Wen Zhang, Xiuguo Hua
Objectives. We aimed to explore the impact of gut microbiota in coronary heart disease (CHD) patients through high-throughput sequencing. Methods. A total of 29 CHD in-hospital patients and 35 healthy volunteers as controls were included. Nucleic acids were extracted from fecal samples, followed by α diversity and principal coordinate analysis (PCoA). Based on unweighted UniFrac distance matrices, unweighted-pair group method with arithmetic mean (UPGMA) trees were created. Results. After data optimization, an average of 121312 ± 19293 reads in CHD patients and 234372 ± 108725 reads in controls was obtained...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28487459/patient-flow-within-uk-emergency-departments-a-systematic-review-of-the-use-of-computer-simulation-modelling-methods
#4
Syed Mohiuddin, John Busby, Jelena Savović, Alison Richards, Kate Northstone, William Hollingworth, Jenny L Donovan, Christos Vasilakis
OBJECTIVES: Overcrowding in the emergency department (ED) is common in the UK as in other countries worldwide. Computer simulation is one approach used for understanding the causes of ED overcrowding and assessing the likely impact of changes to the delivery of emergency care. However, little is known about the usefulness of computer simulation for analysis of ED patient flow. We undertook a systematic review to investigate the different computer simulation methods and their contribution for analysis of patient flow within EDs in the UK...
May 9, 2017: BMJ Open
https://www.readbyqxmd.com/read/28483033/process-to-establish-11-primary-contact-allied-health-pathways-in-a-public-health-service
#5
Michelle Stute, Nicole Moretto, Maree Raymer, Merrilyn Banks, Peter Buttrum, Sonia Sam, Marita Bhagwat, Tracy Comans
Objective Faced with longstanding and increasing demand for specialist out-patient appointments that was unable to be met through usual medical consultant led care, Metro North Hospital and Health Service in 2014-15 established 11 allied health primary contact out-patient models of care.Methods The models involved six different allied health professions and nine specialist out-patient departments.Results All the allied health models have been endorsed for continuation following demonstration of their contribution to managing demand on specialist out-patient services...
May 9, 2017: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/28451447/dynamic-changes-of-serum-microrna-122-5p-through-therapeutic-courses-indicates-amelioration-of-acute-liver-injury-accompanied-by-acute-cardiac-decompensation
#6
Satoshi Koyama, Takashi Kuragaichi, Yukihito Sato, Yasuhide Kuwabara, Shunsuke Usami, Takahiro Horie, Osamu Baba, Daihiko Hakuno, Yasuhiro Nakashima, Tomohiro Nishino, Masataka Nishiga, Tetsushi Nakao, Hidenori Arai, Takeshi Kimura, Koh Ono
AIMS: Recent studies have shown that serum microRNA (miR) abundance is informative for the diagnosis or prognosis of heart failure. However, the dynamics and kinetics of miRs in acute heart failure are largely unknown. Serial measurement and analysis of serum miRs changes in individuals along their therapeutic course could reduce inter-individual variation and should detect potentially important serum miRs related to disease mechanisms. Based on this concept, we profiled serum miR signatures of blood samples that were obtained sequentially on the day of admission and on hospital Day 7...
May 2017: ESC Heart Failure
https://www.readbyqxmd.com/read/28438193/pathos-a-decision-support-system-for-reporting-high-throughput-sequencing-of-cancers-in-clinical-diagnostic-laboratories
#7
Kenneth D Doig, Andrew Fellowes, Anthony H Bell, Andrei Seleznev, David Ma, Jason Ellul, Jason Li, Maria A Doyle, Ella R Thompson, Amit Kumar, Luis Lara, Ravikiran Vedururu, Gareth Reid, Thomas Conway, Anthony T Papenfuss, Stephen B Fox
BACKGROUND: The increasing affordability of DNA sequencing has allowed it to be widely deployed in pathology laboratories. However, this has exposed many issues with the analysis and reporting of variants for clinical diagnostic use. Implementing a high-throughput sequencing (NGS) clinical reporting system requires a diverse combination of capabilities, statistical methods to identify variants, global variant databases, a validated bioinformatics pipeline, an auditable laboratory workflow, reproducible clinical assays and quality control monitoring throughout...
April 24, 2017: Genome Medicine
https://www.readbyqxmd.com/read/28438104/impact-of-a-scribe-program-on-patient-throughput-physician-productivity-and-patient-satisfaction-in-a-community-based-emergency-department
#8
Waqas Shuaib, John Hilmi, Joshua Caballero, Ijaz Rashid, Hashim Stanazai, Kerolos Tawfeek, Ahmed Amari, Alan Ajanovic, Alex Moshtaghi, Anjit Khurana, Hesham Hasabo, Abdulrehman Baqais, Arthur J Szczerba, Theodore J Gaeta
Previous literature on the impact of scribe programs varies and has mostly been reported from academic institutions or other clinics. We report the implementation of the scribe program in the emergency room of a community hospital and its impact on patient throughput, physician productivity, and patient satisfaction. We performed a quasi-experimental, before-and-after study measuring patient throughput metrics, physician productivity, and patient satisfaction. The intervention measuring the scribe implementation was divided into pre- and post-implementation periods...
April 1, 2017: Health Informatics Journal
https://www.readbyqxmd.com/read/28435492/applying-systems-engineering-reduces-radiology-transport-cycle-times-in-the-emergency-department
#9
Benjamin A White, Brian J Yun, Michael H Lev, Ali S Raja
INTRODUCTION: Emergency department (ED) crowding is widespread, and can result in care delays, medical errors, increased costs, and decreased patient satisfaction. Simultaneously, while capacity constraints on EDs are worsening, contributing factors such as patient volume and inpatient bed capacity are often outside the influence of ED administrators. Therefore, systems engineering approaches that improve throughput and reduce waste may hold the most readily available gains. Decreasing radiology turnaround times improves ED patient throughput and decreases patient waiting time...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28420531/high-throughput-determination-of-vancomycin-in-human-plasma-by-a-cost-effective-system-of-two-dimensional-liquid-chromatography
#10
Yanghao Sheng, Boting Zhou
Therapeutic drug monitoring (TDM) is one of the most important services of clinical laboratories. Two main techniques are commonly used: the immunoassay and chromatography method. We have developed a cost-effective system of two-dimensional liquid chromatography with ultraviolet detection (2D-LC-UV) for high-throughput determination of vancomycin in human plasma that combines the automation and low start-up costs of the immunoassay with the high selectivity and sensitivity of the liquid chromatography coupled with mass spectrometric detection without incurring their disadvantages, achieving high cost-effectiveness...
February 27, 2017: Journal of Chromatography. A
https://www.readbyqxmd.com/read/28404952/high-throughput-detection-of-clinically-targetable-alterations-using-next-generation-sequencing
#11
Julie A Vendrell, David Grand, Isabelle Rouquette, Valérie Costes, Samira Icher, Janick Selves, Marion Larrieux, Aurore Barbe, Pierre Brousset, Jérôme Solassol
Next-generation sequencing (NGS) has revolutionized the therapeutic care of patients by allowing high-throughput and parallel sequencing of large numbers of genes in a single run. However, most of available commercialized cancer panels target a large number of mutations that do not have direct therapeutic implications and that are not fully adapted to low quality formalin-fixed, paraffin-embedded (FFPE) samples. Here, we designed an amplicon-based NGS panel assay of 16 currently actionable genes according to the most recent recommendations of the French National Cancer Institute (NCI)...
March 3, 2017: Oncotarget
https://www.readbyqxmd.com/read/28398746/sensitive-immunoassay-for-detection-and-quantification-of-the-neurotoxin-tetramethylenedisulfotetramine
#12
Natalia Vasylieva, Bogdan Barnych, Amy Rand, Bora Inceoglu, Shirley J Gee, Bruce D Hammock
Tetramethylenedisulfotetramine (TETS, tetramine) is a formerly used and highly neurotoxic rodenticide. Its lethality, recent history of intentional use for mass poisoning, and the absence of a known antidote raise public health concerns. Therefore, rapid, high throughput, and sensitive methods for detection and quantification of TETS are critical. Instrumental analysis method such as GC/MS is sensitive but not rapid or high throughput. Therefore, an immunoassay selective to TETS was developed. The assay shows an IC50 of 4...
April 24, 2017: Analytical Chemistry
https://www.readbyqxmd.com/read/28376563/the-effect-of-access-to-electronic-health-records-on-throughput-efficiency-and-imaging-utilization-in-the-emergency-department
#13
Matthew M Knepper, Edward M Castillo, Theodore C Chan, David A Guss
STUDY OBJECTIVE: To evaluate whether the availability of Electronic Health Records (EHRs) reduces throughput time and utilization of advanced imaging for patients in an academic ED. DATA SOURCES: All patients arriving at an academic Emergency Department (ED) via ambulance between June 1, 2011, and June 4, 2012, were included in the study. This accounted for 9,970 unique ambulance patient visits. STUDY DESIGN: Retrospective noninterventional analysis of patients in an academic ED...
April 4, 2017: Health Services Research
https://www.readbyqxmd.com/read/28346095/identification-by-high-throughput-screening-of-pseudomonas-acyl-coenzyme-a-synthetase-inhibitors
#14
Lorenzo Turcano, Daniela Visaggio, Emanuela Frangipani, Antonino Missineo, Matteo Andreini, Sergio Altamura, Paolo Visca, Alberto Bresciani
Pseudomonas infections are common among hospitalized, immunocompromised, and chronic lung disease patients. These infections are recalcitrant to common antibacterial therapies due to inherent antibiotic resistance. To meet the need of new anti- Pseudomonas drugs, a sensitive, homogenous, and robust assay was developed with the aim of identifying inhibitors of acyl-coenzyme A synthetases (ACSs) from Pseudomonas. Given the importance of fatty acids for in vivo nutrition of Pseudomonas, such inhibitors might have the potential to reduce the bacterial fitness during infection...
January 1, 2017: SLAS Discovery
https://www.readbyqxmd.com/read/28334556/impact-of-a-hospitalwide-quality-improvement-initiative-on-emergency-department-throughput-and-crowding-measures
#15
James D Melton, Fred Blind, A Brad Hall, Maureen Leckie, April Novotny
BACKGROUND: This pre- and postintervention analysis evaluates the impact of a systemwide, comprehensive, executively supported quality improvement (QI) project on emergency department (ED) throughput measures and crowding in a large nonacademic community hospital. METHODS: The two primary endpoints used to assess the impact of the project were (1) the percentage of all patients who were door-in to door-out in less than three hours and (2) the percentage of patients who left without being seen (LWBS)...
December 2016: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28333338/drug-discovery-for-male-subfertility-using-high-throughput-screening-a-new-approach-to-an-unsolved-problem
#16
Sarah J Martins da Silva, Sean G Brown, Keith Sutton, Louise V King, Halil Ruso, David W Gray, Paul G Wyatt, Mark C Kelly, Christopher L R Barratt, Anthony G Hope
STUDY QUESTION: Can pharma drug discovery approaches be utilized to transform investigation into novel therapeutics for male infertility? SUMMARY ANSWER: High-throughput screening (HTS) is a viable approach to much-needed drug discovery for male factor infertility. WHAT IS KNOWN ALREADY: There is both huge demand and a genuine clinical need for new treatment options for infertile men. However, the time, effort and resources required for drug discovery are currently exorbitant, due to the unique challenges of the cellular, physical and functional properties of human spermatozoa and a lack of appropriate assay platform...
May 1, 2017: Human Reproduction
https://www.readbyqxmd.com/read/28325207/using-a-systematic-framework-of-interventions-to-improve-early-discharges
#17
Hemali Patel, Sasha Morduchowicz, Michelle Mourad
BACKGROUND: Late-afternoon hospital discharges can lead to admission bottlenecks and negatively affect the flow of patients needing hospital admission. Delays in discharge are a prevalent health care problem and have been linked to increased length of stay, lower patient satisfaction scores, and adverse outcomes. As a result, hospitals are placing a renewed emphasis on early discharge as a way to reduce admission delays and achieve optimal patient flow. This study shows that the Model for Improvement (MFI) is an effective approach for complex improvement efforts...
April 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28317854/sets-of-serum-exosomal-micrornas-as-candidate-diagnostic-biomarkers-for-kawasaki-disease
#18
Hong-Ling Jia, Chao-Wu Liu, Li Zhang, Wei-Jun Xu, Xue-Juan Gao, Jun Bai, Yu-Fen Xu, Ming-Guo Xu, Gong Zhang
Although Kawasaki disease is the main cause of acquired heart disease in children, no diagnostic biomarkers are available. We aimed to identify candidate biomarkers for diagnosing Kawasaki disease using serum exosomal microRNAs (miRNAs). Using frozen serum samples from a biobank, high-throughput microarray technologies, two-stage real-time quantitative PCR, and a self-referencing strategy for data normalization, we narrowed down the list of biomarker candidates to a set of 4 miRNAs. We further validated the diagnostic capabilities of the identified miRNAs (namely, CT(miR-1246)-CT(miR-4436b-5p) and CT(miR-197-3p)-CT(miR-671-5p)) in 79 samples from two hospitals...
March 20, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28304241/wireless-teleophthalmology-a-novel-low-cost-flexible-network-architecture-and-its-performance-evaluation-for-remote-eye-care-solutions
#19
Shashwat Pathak, Basant Kumar
INTRODUCTION: This article proposes a novel, cost-effective, flexible, and easy-to-deploy wireless teleophthalmology network architecture and performance evaluation for its potential use in remote areas. This study has used practical telecommunication standards, which is widely deployed throughout India. METHODS: In the proposed scenario, patient's eye images are obtained using a specified imaging modality, and then sent to a server at the primary eye care centre (PECC) using ZigBee a short-range wireless network...
March 17, 2017: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/28279543/emergency-department-holding-orders
#20
Stephen J Traub, M'Hamed Temkit, Soroush Saghafian
BACKGROUND: Holding orders help transition admitted emergency department (ED) patients to hospital beds. OBJECTIVE: To describe the effect of ED holding orders. METHODS: We conducted a single-site retrospective study of ward admissions from the ED to the hospital internal medicine (HIM) service over 2 years. Patients were classified based on whether the ED did (group 1) or did not (group 2) write holding orders; group 1 was subdivided into patients sent to the floor with only ED holding orders (group 1A) vs...
March 6, 2017: Journal of Emergency Medicine
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