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https://www.readbyqxmd.com/read/29779231/specialist-perioperative-allergy-clinic-services-in-the-uk-2018-results-from-the-royal-college-of-anaesthetists-sixth-national-audit-project-nap6-investigation-of-perioperative-anaphylaxis
#1
W Egner, T M Cook, T Garcez, S Marinho, H Kemp, D N Lucas, K Floss, S Farooque, H Torevell, M Thomas, K Ferguson, S Nasser, S Karanam, K-L Kong, N McGuire, M Bellamy, A Warner, J Hitchman, L Farmer, N J N Harper
BACKGROUND: The Royal College of Anaesthetists 6th National Audit Project examined Grade 3-5 perioperative anaphylaxis for one year in the UK. OBJECTIVE: To describe the causes and investigation of anaphylaxis in the NAP6 cohort, in relation to published guidance and previous baseline survey results. METHODS: We used a secure registry to gather details of Grade 3-5 perioperative anaphylaxis. Anonymous reports were aggregated for analysis and reviewed in detail...
May 19, 2018: Clinical and Experimental Allergy: Journal of the British Society for Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/29778325/tranexamic-acid-for-hyperacute-primary-intracerebral-haemorrhage-tich-2-an-international-randomised-placebo-controlled-phase-3-superiority-trial
#2
Nikola Sprigg, Katie Flaherty, Jason P Appleton, Rustam Al-Shahi Salman, Daniel Bereczki, Maia Beridze, Hanne Christensen, Alfonso Ciccone, Ronan Collins, Anna Czlonkowska, Robert A Dineen, Lelia Duley, Juan Jose Egea-Guerrero, Timothy J England, Kailash Krishnan, Ann Charlotte Laska, Zhe Kang Law, Serefnur Ozturk, Stuart J Pocock, Ian Roberts, Thompson G Robinson, Christine Roffe, David Seiffge, Polly Scutt, Jegan Thanabalan, David Werring, David Whynes, Philip M Bath
BACKGROUND: Tranexamic acid can prevent death due to bleeding after trauma and post-partum haemorrhage. We aimed to assess whether tranexamic acid reduces haematoma expansion and improves outcome in adults with stroke due to intracerebral haemorrhage. METHODS: We did an international, randomised placebo-controlled trial in adults with intracerebral haemorrhage from acute stroke units at 124 hospital sites in 12 countries. Participants were randomly assigned (1:1) to receive 1 g intravenous tranexamic acid bolus followed by an 8 h infusion of 1 g tranexamic acid or a matching placebo, within 8 h of symptom onset...
May 15, 2018: Lancet
https://www.readbyqxmd.com/read/29776767/-visual-outcomes-5-years-after-small-incision-lenticule-extraction-smile-surgery-on-spherocylindrical-myopia-eyes-from-616-eyes
#3
J Burazovitch, H Ferguene, D Naguszewski
OBJECTIVE: Determine if the visual criteria of the technique of surgery refractive by Femtosecond Laser-assisted duckweed Extraction - Small Lenticule Extraction (FLEx-Smile® ), realized in the laser femtosecond VisuMax® (Carl Zeiss Meditec, Jena, Germany), are stable, secure, effective and predictable in the long term, to the nearsighted and astigmatic. MODEL OF THE STUDY: Retrospective study, monocentric with data collected between March 2012 and March 2017...
May 15, 2018: Journal Français D'ophtalmologie
https://www.readbyqxmd.com/read/29773938/correlations-between-a1c-and-diabetes-knowledge-diabetes-numeracy-and-food-security-in-a-vulnerable-type-2-diabetes-population
#4
Clipper F Young, Kenneth Yun, Edward Kang, Jay H Shubrook, Joy A Dugan
Type 2 diabetes is over-represented in vulnerable populations. Vulnerable patients managing diabetes are challenged with less-than-optimal processes and outcomes of care; thus, Healthy People 2020 and the American Diabetes Association have renewed the focus on social determinants of health with regard to the management of chronic diseases such as diabetes. This study explored the correlations between A1C and social and personal factors, including diabetes knowledge, diabetes numeracy, and food security. The Diabetes Numeracy Test-15, the Spoken Knowledge in Low Literacy Diabetes Scale, and the U...
May 2018: Diabetes Spectrum: a Publication of the American Diabetes Association
https://www.readbyqxmd.com/read/29773529/development-of-a-just-in-time-adaptive-mhealth-intervention-for-insomnia-usability-study
#5
I Wayan Pulantara, Bambang Parmanto, Anne Germain
BACKGROUND: Healthy sleep is a fundamental component of physical and brain health. Insomnia, however, is a prevalent sleep disorder that compromises functioning, productivity, and health. Therefore, developing efficient treatment delivery methods for insomnia can have significant societal and personal health impacts. Cognitive behavioral therapy for insomnia (CBTI) is the recommended first-line treatment of insomnia but access is currently limited for patients, since treatment must occur in specialty sleep clinics, which suffer from an insufficient number of trained clinicians...
May 17, 2018: JMIR Human Factors
https://www.readbyqxmd.com/read/29773480/must-i-respond-if-my-health-is-at-risk
#6
Kenneth V Iserson
BACKGROUND: Widespread epidemics, pandemics, and other risk-prone disasters occur with disturbing regularity. When such events occur, how should, and will, clinicians respond? The moral backbone of medical professionals-a duty to put the needs of patients first-may be sorely tested. DISCUSSION: It is incumbent on health care professionals to ask what we must do and what we should do if a dangerous health care situation threatens both ourselves and our community...
May 14, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29772759/human-babesiosis-caused-by-babesia-duncani-has-widespread-distribution-across-canada
#7
John D Scott, Catherine M Scott
Human babesiosis caused by Babesia duncani is an emerging infectious disease in Canada. This malaria-like illness is brought about by a protozoan parasite infecting red blood cells. Currently, controversy surrounds which tick species are vectors of B. duncani. Since the availability of a serological or molecular test in Canada for B. duncani has been limited, we conducted a seven-year surveillance study (2011⁻2017) to ascertain the occurrence and geographic distribution of B. duncani infection country-wide...
May 17, 2018: Healthcare (Basel, Switzerland)
https://www.readbyqxmd.com/read/29771772/nasogastric-tube-syndrome-a-diagnostic-dilemma
#8
Gyanaranjan Nayak, Ramandeep S Virk, Manvi Singh, Meenu Singh
BACKGROUND: Nasogastric tubes have been used in the pediatric age group to supplement nutrition in cases of malignancy and failure to thrive due to a variety of causes. Breathing difficulty may occur after the insertion of a nasogastric tube and it can have multiple causes. Here we discuss 2 patients of acute lymphoblastic leukemia (ALL) who developed a rare condition called the Sofferman syndrome (nasogastric tube syndrome). We will also briefly outline a diagnostic algorithm to facilitate its fast and correct diagnosis...
May 16, 2018: Journal of Bronchology & Interventional Pulmonology
https://www.readbyqxmd.com/read/29770179/biomechanical-comparison-between-titanium-and-cobalt-chromium-rods-used-in-a-pedicle-subtraction-osteotomy-model
#9
Kalpit N Shah, Gregory Walker, Sarath C Koruprolu, Alan H Daniels
Instrumentation failure is a common complication following complex spinal reconstruction and deformity correction. Rod fracture is the most frequent mode of hardware failure and often occurs at or near a 3-column osteotomy site. Titanium (Ti) rods are commonly utilized for spinal fixations, however, theoretically stiffer materials, such as cobalt-chrome (CoCr) rods are also available. Despite ongoing use in clinical practice, there is little biomechanical evidence that compares the construct ability to withstand fatigue stress for Ti and Co-Cr rods...
March 29, 2018: Orthopedic Reviews
https://www.readbyqxmd.com/read/29769776/root-coverage-with-buccal-fat-pad-placed-on-restored-cervical-abrasion-case-report-with-three-year-follow-up
#10
Harpreet Singh Grover, Sagrika Shukla, Ashi Chug, Kuldeep Singh
A patient was reported with Class II gingival recession (GR) of 5 mm. After restoring abrasion with glass ionomer cement, a full-thickness flap was raised and using blunt dissection through the buccinator and loose surrounding fascia buccal fat pad (BFP) was exposed into the mouth. It was easily spread over the maxillary roots of 14, 15, and 16. It was secured and immobilized using sutures. Postoperatively, the patient did not report swelling or trismus. At 3-year postoperative, gingival margin was at cementoenamel junction, stable and healthy and did not show any recession...
March 2018: Journal of Indian Society of Periodontology
https://www.readbyqxmd.com/read/29769151/real-time-automated-detection-of-ventilator-associated-events-avoiding-missed-detections-misclassifications-and-false-detections-due-to-human-error
#11
Erica S Shenoy, Eric S Rosenthal, Yu-Ping Shao, Siddharth Biswal, Manohar Ghanta, Erin E Ryan, Dolores Suslak, Nancy Swanson, Valdery Moura Junior, David C Hooper, M Brandon Westover
OBJECTIVETo validate a system to detect ventilator associated events (VAEs) autonomously and in real time.DESIGNRetrospective review of ventilated patients using a secure informatics platform to identify VAEs (ie, automated surveillance) compared to surveillance by infection control (IC) staff (ie, manual surveillance), including development and validation cohorts.SETTINGThe Massachusetts General Hospital, a tertiary-care academic health center, during January-March 2015 (development cohort) and January-March 2016 (validation cohort)...
May 17, 2018: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/29764322/biting-the-hands-that-feed-the-alligators-a-case-study-in-morbid-obesity-extremes-end-of-life-care-and-prohibitions-on-harming-and-accelerating-the-end-of-life
#12
Michael J Malinowski
Obesity, recognized as a disease in the U.S. and at times as a terminal illness due to associated medical complications, is an American epidemic according to the Centers for Disease Control and Prevention ("CDC"), American Heart Association ("AHA"), and other authorities. More than one third of Americans (39.8% of adults and 18.5% of children) are medically obese. This article focuses on cases of "extreme morbid obesity" ("EMO")-situations in which death is imminent without aggressive medical interventions, and bariatric surgery is the only treatment option with a realistic possibility of success...
March 2018: American Journal of Law & Medicine
https://www.readbyqxmd.com/read/29760941/hip-fracture-in-the-elderly-multidisciplinary-rehabilitation-femur-feasibility-study-testing-the-use-of-routinely-collected-data-for-future-health-economic-evaluations
#13
Nefyn H Williams, Kevin Mawdesley, Jessica L Roberts, Nafees Ud Din, Nicola Totton, Joanna M Charles, Zoe Hoare, Rhiannon T Edwards
Background: Health economic evaluations rely on the accurate measurement of health service resource use in order to calculate costs. These are usually measured with patient completed questionnaires using instruments such as the Client Service Receipt Inventory (CSRI). These rely on participants' recall and can be burdensome to complete. Health service activity data are routinely captured by electronic databases.The aim was to test methods for obtaining these data and compare with those data collected using the CSRI, within a feasibility study of an enhanced rehabilitation intervention following hip fracture (Fracture in the Elderly Multidisciplinary Rehabilitation: FEMuR)...
2018: Pilot and Feasibility Studies
https://www.readbyqxmd.com/read/29760027/case-management-in-primary-care-for-frequent-users-of-health-care-services-a-mixed-methods-study
#14
Catherine Hudon, Maud-Christine Chouinard, Marie-France Dubois, Pasquale Roberge, Christine Loignon, Éric Tchouaket, Mireille Lambert, Émilie Hudon, Fatoumata Diadiou, Danielle Bouliane
PURPOSE: This study aimed to evaluate the effects of the V1SAGES case management intervention (Vulnerable Patients in Primary Care: Nurse Case Management and Self-management Support) for frequent users of health care services with chronic disease and complex care needs on psychological distress and patient activation. METHODS: We used a 2-phase sequential mixed methods design. The first phase was a pragmatic randomized controlled trial with intention-to-treat analysis that measured the effects of the intervention compared with usual care on psychological distress and patient activation before and after 6 months...
May 2018: Annals of Family Medicine
https://www.readbyqxmd.com/read/29759261/deriving-a-framework-for-a-systems-approach-to-agitated-patient-care-in-the-emergency-department
#15
Ambrose H Wong, Halley Ruppel, Lauren J Crispino, Alana Rosenberg, Joanne D Iennaco, Federico E Vaca
BACKGROUND: The rising agitated patient population presenting to the emergency department (ED) has caused increasing safety threats for health care workers and patients. Development of evidence-based strategies has been limited by the lack of a structured framework to examine agitated patient care in the ED. In this study, a systems approach from the patient safety literature was used to derive a comprehensive theoretical framework for addressing ED patient agitation. METHODS: A mixed-methods approach was used with ED staff members at an academic site and a community site of a regional health care network...
May 2018: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/29759054/successfully-navigating-multiple-electronic-health-records-when-using-telepsychiatry-the-nc-step-experience
#16
Sy Atezaz Saeed
Telepsychiatry is a viable option for providing psychiatric care to those who are currently underserved or who lack access to services, but barriers to its widespread utilization remain. Use of different electronic health record systems (EHRs) by various health care systems is one such barrier. Utilization of different EHRs makes it difficult for providers to review patient data and to document clinical encounters. This column describes a Web portal developed by the North Carolina Statewide Telepsychiatry Program that connects participating hospital emergency departments and remote psychiatric providers, allowing them to share secure electronic health information regarding patient encounters across different EHRs...
May 15, 2018: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/29758124/use-of-electronic-patient-portals-in-pregnancy-an-overview
#17
Erinma P Ukoha, Lynn M Yee
Electronic patient portals are increasingly utilized in contemporary health care systems. Patient portal use has been found to be beneficial in multiple specialties, particularly in management of chronic diseases. However, there are disparities within portal use. For example, individuals who are racial and ethnic minorities and persons from lower socioeconomic status are less likely to enroll and use patient portals than non-Hispanic white persons and persons with higher socioeconomic status. Because portal use and, specifically, patient-provider secure messaging has been associated with favorable health outcomes, disparities in use of these portals could affect health outcomes...
May 14, 2018: Journal of Midwifery & Women's Health
https://www.readbyqxmd.com/read/29756556/mapping-the-scope-of-occupational-therapy-practice-in-palliative-care-a-european-association-for-palliative-care-cross-sectional-survey
#18
Gail Eva, Deidre Morgan
BACKGROUND: Occupational therapists play an integral role in the care of people with life-limiting illnesses. However, little is known about the scope of occupational therapy service provision in palliative care across Europe and factors influencing service delivery. AIM: This study aimed to map the scope of occupational therapy palliative care interventions across Europe and to explore occupational therapists' perceptions of opportunities and challenges when delivering and developing palliative care services...
May 2018: Palliative Medicine
https://www.readbyqxmd.com/read/29753624/a-critical-review-and-analysis-of-ethical-issues-associated-with-the-artificial-pancreas
#19
REVIEW
A Quintal, V Messier, R Rabasa-Lhoret, E Racine
The artificial pancreas combines a hormone infusion pump with a continuous glucose ontinuous glucose monitoring, supported by a dosing algorithm currently installed on the pump. It allows for dynamic infusions of insulin (and possibly other hormones such as glucagon) tailored to patient needs. For patients with type 1 diabetes the artificial pancreas has been shown to prevent more effectively hypoglycaemic events and hyperglycaemia than insulin pump therapy and has the potential to simplify care. However, the potential ethical issues associated with the upcoming integration of the artificial pancreas into clinical practice have not yet been discussed...
April 25, 2018: Diabetes & Metabolism
https://www.readbyqxmd.com/read/29753563/critical-appraisal-of-the-2018-acc-scientific-sessions-late-breaking-trials-from-a-statistician-s-perspective
#20
REVIEW
Stuart J Pocock, Tim J Collier
The late-breaking clinical trials presentations at the American College of Cardiology Scientific Sessions in March 2018 are an important contribution to the field of cardiology. This paper presents a constructive critical appraisal of 7 key studies: ODYSSEY OUTCOMES (Evaluation of Cardiovascular Outcomes After an Acute Coronary Syndrome During Treatment With Alirocumab), VEST (Vest Prevention of Early Sudden Death Trial), SECURE-PCI (Statins Evaluation in Coronary Procedures and Revascularization), TREAT (Ticagrelor in Patients with ST-Elevation Myocardial Infarction treated with Pharmacological Thrombolysis), POISE (PeriOperative ISchemic Evaluation), SMART-DATE (Safety of 6-Month Duration of Dual Antiplatelet Therapy After Percutaneous Coronary Intervention in Patients With Acute Coronary Syndrome), and CVD-REAL 2 (Comparative Effectiveness of Cardiovascular Outcomes in New Users of SGLT-2 Inhibitors)...
May 7, 2018: Journal of the American College of Cardiology
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