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Patient security

Brian Shiner, Christine Leonard Westgate, Vanessa Simiola, Richard Thompson, Paula P Schnurr, Joan M Cook
Objective: Available studies on implementation of evidence-based psychotherapy (EBP) for patients attending Department of Veterans Affairs (VA) residential post-traumatic stress disorder (PTSD) programs rely on therapist self-report of EBP delivery. Patient-level data on receipt of EBP are needed both to corroborate therapist self-report and to understand patient factors that predict receipt of EBPs for PTSD. Materials and Methods: We identified 159 therapists from 38 VA residential PTSD programs who responded to a survey about EBP implementation during the 2015 fiscal year (FY15)...
March 14, 2018: Military Medicine
Tim Doran
The creation of the National Health Service (NHS) marked a radical break with the past, making health care universally available on the basis of need rather than means. The NHS was conceived during wartime emergency and has had to survive further regular crises to reach its 70th year, but it now faces challenges that are unprecedented in scale and there are doubts about its ability to continue in its present form. Resources have not increased with need, and the NHS can no longer function as a comprehensive service during periods of peak demand...
March 16, 2018: Health Economics, Policy, and Law
Ryan P Donahue, Andrew W Stamm, Robert P Gibbons, Christopher R Porter, Kathleen C Kobashi, John M Corman, Una J Lee
INTRODUCTION: The ureteral stent is engrained in the fabric of urologic practice. Virginia Mason Medical Center had a unique role in its development through the pioneering work of Dr. Robert Gibbons. Here, we review his contribution to the evolution of the modern ureteral stent. METHODS: We reviewed Dr. Gibbons' extensive work through primary sources, including interviews, projector slides, radiology images, stent prototypes, his personal writings and archived documents...
March 12, 2018: Urology
Chengshuai Yang, Shunyao Shen, Jingyang Wu, Shilei Zhang
Mandibular reconstruction after partial or subtotal resection is considered a challenging procedure that is crucial for facial contour and function. Many reports regarding the reconstruction of mandibular defects have been published over the years. The fibula free flap has become a popular option for mandibular reconstruction since its introduction by Hidalgo in 1989. However, the locations of the reconstructed mandibular angle and the condyle of the fibular bone segments play a crucial role in facial symmetry and function...
February 20, 2018: Journal of Oral and Maxillofacial Surgery
Stephen Noblett, Jane Beenstock, James Noblett, Joanne Ireland, Sarah Ormiston
Aims and method The increased rates of smoking in people with mental illness is well documented, and establishing smoke-free mental health environments has been emphasised over recent years. This article examines the financial costs of implementing smoke free guidance and assesses the cost associated with patients who were prescribed clozapine and who committed to stopping smoking cigarettes for the duration of the study period. RESULTS: Patients (38) who were prescribed clozapine were included in the study...
April 2018: BJPsych Bulletin
Annette Haywood, Sarah Barnes, Hazel Marsh, Stuart G Parker
BACKGROUND: Older people with an acute illness, many of whom are also frail, form a significant proportion of the acute hospital inpatient population. Attention is focusing on ways of improving the physical environment to optimize health outcomes and staff efficiency. PURPOSE: This article explores the effects of the physical environment in three acute care settings: acute hospital site, in-patient rehabilitation hospital, and intermediate care provision (a nursing home with some beds dedicated to intermediate care) chosen to represent different steps on the acute care pathway for older people and gain the perspectives of patients, family carers, and staff...
January 1, 2018: HERD
Lisa Blom, Lucie Laflamme, Helle Mölsted Alvesson
BACKGROUND: Image-based teleconsultation between medical experts and healthcare staff at remote emergency centres can improve the diagnosis of conditions which are challenging to assess. One such condition is burns. Knowledge is scarce regarding how medical experts perceive the influence of such teleconsultation on their roles and relations to colleagues at point of care. METHODS: In this qualitative study, semi-structured interviews were conducted with 15 medical experts to explore their expectations of a newly developed App for burns diagnostics and care prior to its implementation...
2018: PloS One
Msj Wilson, P Maniam, A Ibrahim, N Makaram, S R Knight, P Patil
Introduction The use of polymeric clips in securing the appendiceal stump has been increasingly reported as a viable alternative to current methods in emergency laparoscopic appendicectomy. We evaluated the operative outcomes following the use of polymeric clips versus endoscopic ligatures. The primary endpoint was operative time, with secondary outcomes including complications, inpatient stay, and cost analysis. Materials and methods Operative records were retrospectively analysed to identify patients undergoing laparoscopic appendicectomy between January 2014 and June 2015...
March 15, 2018: Annals of the Royal College of Surgeons of England
Christiana R Dallas, Curtis H Harris, Cham E Dallas
In the U.S., migration has been documented to affect the prevalence of infectious disease. As a mitigation entity, border security has been recorded by numerous scholarly works as being essential to the support of the health of the U.S. POPULATION: Consequently, the lack of current health care monitoring of the permeable U.S. border places the U.S. population at risk in the broad sectors of infectious disease and interpersonal violence. Visualizing border security in the context of public health mitigation has significant potential to protect migrant health as well as that of all populations on both sides of the border...
March 15, 2018: Disaster Medicine and Public Health Preparedness
Mohammed Firdouse, Karen Devon, Ahmed Kayssi, Jeremy Goldfarb, Peter Rossos, Tulin D Cil
BACKGROUND: Text messaging has become ubiquitous and is being increasingly used within the health care system. The purpose of this study was to understand texting practices for clinical communication among staff surgeons at a large academic institution. METHODS: Staff surgeons in 4 subspecialties (vascular, plastics, urology, and general surgery) were surveyed electronically. RESULTS: A total of 62 surgeons from general surgery (n = 33), vascular surgery (n = 6), plastic surgery (n = 13), and urology (n = 10) completed the study (response rate 30%)...
March 1, 2018: Surgical Innovation
Fernando González-Magaña, Héctor Omar Malagón-Hidalgo, Eugenio García-Cano, Roberto Vilchis-López, Adriana Fentanes-Vera, Fernan-Alejandra Ayala-Ugalde
Objectives: Airway management in patients with panfacial trauma is complicated. In addition to involving facial lesions, such trauma compromises the airway, and the use of intermaxillary fixation makes it difficult to secure ventilation by usual approaches (nasotracheal or endotracheal intubation). Submental airway derivation is an alternative to tracheostomy and nasotracheal intubation, allowing a permeable airway with minimal complications in complex patients. Materials and Methods: This is a descriptive, retrospective study based on a review of medical records of all patients with facial trauma from January 2003 to May 2015...
February 2018: Journal of the Korean Association of Oral and Maxillofacial Surgeons
Ersilia M DeFilippis, Avinainder Singh, Sanjay Divakaran, Ankur Gupta, Bradley L Collins, David Biery, Arman Qamar, Amber Fatima, Mattheus Ramsis, Daniel Pipilas, Roxanna Rajabi, Monica Eng, Jon Hainer, Josh Klein, James L Januzzi, Khurram Nasir, Marcelo F Di Carli, Deepak L Bhatt, Ron Blankstein
BACKGROUND: Substance abuse is increasingly prevalent among young adults but data on cardiovascular outcomes remain limited. OBJECTIVES: Our objective was to assess the prevalence of cocaine and marijuana use in adults with their first myocardial infarction (MI) at ≤50 years and determine its association with long-term outcomes. METHODS: We retrospectively analyzed records of patients presenting with a Type 1 MI at ≤50 years at two academic hospitals from 2000-2016...
March 5, 2018: Journal of the American College of Cardiology
H W Guo, W S Kong, Y Q Lai, F Kuang, J W Zhuang, Z G Shan
Objective: To explore the diagnosis, therapy and prevention method of chronic sternal osteomyelitis with sinus tract after cardiovascular surgery. Methods: A total of 53 patients with chronic sternal sinus tract after cardiovascular surgery between January 2000 and January 2016. After definite diagnosis by contrast fistulography and CT scanning, all the patients received combined modality therapy including debridement, musculocutaneous flap transplantation and intermediate thickness free skin graft transplantation if necessary...
February 27, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
David A Paz, Karin E Thomas, Denis G Primakov
In support of Operation Enduring Freedom, American, North American Treaty Organization (NATO) Coalition, and Afghan forces worked together in training exercises and counterinsurgency operations. While serving at the NATO Role 3 Multinational Medical Unit, Kandahar, Afghanistan, numerous patients with explosive blast injuries (Coalition and Afghan security forces, and insurgents) were treated. A disparity was noted between the ocular injury patterns of US and Coalition forces in comparison with their Afghan counterparts, which were overwhelmingly influenced by the use, or lack thereof, of eye protection...
2018: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
Phillip M Mitchell, Cory A Collinge, David E O'Neill, Jesse E Bible, Hassan R Mir
OBJECTIVES: To determine whether sarcopenia is an independent predictor of mortality in geriatric acetabular fractures. DESIGN: Retrospective cohort. SETTING: ACS Level I trauma center. PATIENTS/PARTICIPANTS: One hundred and forty-six patients over the age 60 with acetabular fractures treated at our institution over a 12-year period. MAIN OUTCOME MEASUREMENTS: The primary outcome was 1-year mortality, collected using the Social Security Death Index...
March 5, 2018: Journal of Orthopaedic Trauma
Takahiro Tadokoro, Manabu Kakinohana, Michael Navarro, Motoaki Goya, Yuichiro Odo
BACKGROUND: Insufficient fixation of an epidural catheter may result in migration of the catheter and eventual catheter failure. However, the best fixation method remains to be established. Aron Alpha A (2-ethyl cyanoacrylate) adhesive is approved for clinical use and can be used for surgical adhesion to both skin and blood vessels. We hypothesized that the addition of Aron Alpha A adhesive to film dressing would result in consistent and dependable catheter fixation. METHODS: In this study, 58 women who were scheduled for cesarean delivery under spinal and epidural anesthesia were recruited...
March 12, 2018: Anesthesia and Analgesia
Valerie S Marmolejo, Jonathan F Arnold
Heel ulcerations are a significant burden of care in both hospital and long-term care settings. The presence of peripheral arterial disease as a contributing factor to delayed healing is often not recognized, resulting in prolonged healing and high patient morbidity and mortality. Formal vascular evaluation and intervention is often not performed as these patients can have palpable pedal pulses while having localized ischemia of the heel. As routine noninvasive vascular studies can be affected by medial calcinosis and collateralization and do not specifically assess tissue perfusion to the heel, a false sense of security of adequate perfusion for healing can result...
March 1, 2018: Foot & Ankle Specialist
Takumi Matsumoto, Christopher E Gross, Selene G Parekh
Distal Chevron osteotomy is a well-established surgical procedure for mild to moderate hallux valgus deformity. Many methods have been described for fixation of osteotomy site; secure fixation, enabling large displacement of the metatarsal head, is one of the essentials of this procedure. The purpose of the present study was to evaluate the short-term radiographic outcome of a distal Chevron osteotomy using an intramedullary plate for the correction of hallux valgus deformity. The present study evaluated 37 patients (40 feet) who underwent distal Chevron osteotomy using an intramedullary plate by periodic radiographs obtained preoperatively and at 4 weeks, 8 weeks, 3 months, and 6 months postoperatively...
March 1, 2018: Foot & Ankle Specialist
Taressa Bull, Amanda Corley, Danielle J Smyth, David J McMillan, Kimble R Dunster, John F Fraser
BACKGROUND: Extracorporeal membrane oxygenation (ECMO) delivers cardiac and/or respiratory support to critically ill patients who have failed conventional medical therapies. If the large-bore cannulas used to deliver ECMO become infected or dislodged, the patient consequences can be catastrophic. ECMO cannula-related infection has been reported to be double the rate of other vascular devices (7.1 vs 3.4 episodes/1000 ECMO days respectively). The aim of this study was to assess the ability of cyanoacrylate tissue adhesive (TA) to inhibit bacterial growth at the ECMO cannulation site, and the effectiveness of TA and securement devices in securing ECMO cannulas and tubing...
March 12, 2018: Intensive Care Medicine Experimental
Stephanie K Mansell, Steven Cutts, Isobel Hackney, Martin J Wood, Kevin Hawksworth, Dean D Creer, Cherry Kilbride, Swapna Mandal
Introduction: Ventilation parameter data from patients receiving home mechanical ventilation can be collected via secure data cards and modem technology. This can then be reviewed by clinicians and ventilator prescriptions adjusted. Typically available measures include tidal volume (VT ), leak, respiratory rate, minute ventilation, patient triggered breaths, achieved pressures and patient compliance. This study aimed to assess the potential impact of ventilator data downloads on management of patients requiring home non-invasive ventilation (NIV)...
2018: BMJ Open Respiratory Research
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