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https://www.readbyqxmd.com/read/28650946/the-hyperextension-tibial-plateau-fracture-pattern-a-predictor-of-poor-outcome
#1
Leah J Gonzalez, Ariana Lott, Sanjit Konda, Kenneth A Egol
OBJECTIVES: To assess the outcome of patients with hyperextension bicondylar tibial plateau fractures (HEBTP) to those with other complex tibial plateau fractures DESIGN:: Retrospective cohort design SETTING:: Academic Medical Center PATIENTS:: A total of 84 patients were included in the study. There were 69 patients with 69 knees (82%) that had sustained non-hyperextension bicondylar tibial plateau fractures and 15 patients with 15 knees (18%) that had hyperextension bicondylar tibial plateau fractures (HEBTP) INTERVENTION:: Surgical repair of bicondylar tibial plateau fracture MAIN OUTCOME MEASURES:: Clinical and functional outcomes included knee range of motion, post-operative alignment, NRS pain scores and Short Musculoskeletal Functional Assessment (SMFA) scores at long-term follow-up...
June 15, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28650904/pediatric-procedural-sedation-using-the-combination-of-ketamine-and-propofol-outside-of-the-emergency-department-a-report-from-the-pediatric-sedation-research-consortium
#2
Jocelyn R Grunwell, Curtis Travers, Anne G Stormorken, Patricia D Scherrer, Corrie E Chumpitazi, Jana A Stockwell, Mark G Roback, Joseph Cravero, Pradip P Kamat
OBJECTIVES: Outcomes associated with a sedative regimen comprised ketamine + propofol for pediatric procedural sedation outside of both the pediatric emergency department and operating room are underreported. We used the Pediatric Sedation Research Consortium database to describe a multicenter experience with ketamine + propofol by pediatric sedation providers. DESIGN: Prospective observational study of children receiving IV ketamine + propofol for procedural sedation outside of the operating room and emergency department using data abstracted from the Pediatric Sedation Research Consortium during 2007-2015...
June 23, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28650884/can-surgeon-demographic-factors-predict-postoperative-complication-rates-after-elective-spinal-fusion
#3
Danielle S Chun, Ralph W Cook, Joseph A Weiner, Michael S Schallmo, Kathryn A Barth, Sameer K Singh, Ryan D Freshman, Alpesh A Patel, Wellington K Hsu
STUDY DESIGN: Retrospective cohort. OBJECTIVE: Determine whether surgeon demographic factors influence postoperative complication rates after elective spine fusion procedures. BACKGROUND: Surgeon demographic factors have been shown to impact decision making in the management of degenerative disease of the lumbar spine. Complication rates are frequently reported outcome measurements used to evaluate surgical treatments, quality-of-care, and determine health care reimbursements...
June 23, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28650357/defining-the-role-of-minimally-invasive-proctectomy-for-locally-advanced-rectal-adenocarcinoma
#4
Sarath Sujatha-Bhaskar, Mehraneh D Jafari, John V Gahagan, Colette S Inaba, Christina Y Koh, Steven D Mills, Joseph C Carmichael, Michael J Stamos, Alessio Pigazzi
OBJECTIVE: National examination of open proctectomy (OP), laparoscopic proctectomy (LP), and robotic proctectomy (RP) in pathological outcomes and overall survival (OS). BACKGROUND: Surgical management for rectal adenocarcinoma is evolving towards utilization of LP and RP. However, the oncological impacts of a minimally invasive approach to rectal cancer have yet to be defined. METHODS: Retrospective review of the National Cancer Database identified patients with nonmetastatic locally advanced rectal adenocarcinoma from 2010 to 2014, who underwent neoadjuvant chemoradiation, surgical resection, and adjuvant therapy...
July 22, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28650248/health-services-utilization-among-fee-for-service-medicare-and-medicaid-patients-under-age-65-with-behavioral-health-illness-at-an-urban-safety-net-hospital
#5
Ramon S Cancino, Brian W Jack, John Jarvis, Alice Kate Cummings, Ellie Cooper, Pierre-Yves Cremieux, James F Burgess
BACKGROUND: In 2011, fee-for-service patients with both Medicare and Medicaid (dual eligible) sustained $319.5 billion in health care costs. OBJECTIVE: To describe the emergency department (ED) use and hospital admissions of adult dual eligible patients aged under 65 years who used an urban safety net hospital. METHODS: This was a retrospective database analysis of patients aged between 18 and 65 years with Medicare and Medicaid, who used an urban safety net academic health center between January 1, 2011, and December 31, 2011...
July 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28649450/the-northwest-participant-and-clinical-interactions-network-increasing-opportunities-for-patients-to-participate-in-research-across-the-northwestern-united-states
#6
Laura-Mae Baldwin, Laurie Hassell, Cindi Laukes, Michelle Doyle, Anne Reedy, Brenda Mollis, Sandra Albritton, Elizabeth Ciemins, Robert Coker, Jeannine Brant, Katherine R Tuttle, Laura Baker, Bonnie Ramsey
INTRODUCTION: The Institute of Translational Health Sciences (ITHS) promotes and supports translational research collaboration between clinicians, communities, and investigators across the five-state Washington, Wyoming, Alaska, Montana, and Idaho (WWAMI) region. The ITHS has developed a collaborative regional clinical research network, the Northwest Participant & Clinical Interactions Network (NW PCI), involving 12 diverse clinical health systems and academic institutions. METHODS: This descriptive article details NW PCI's development, infrastructure and governance, tools, characteristics, and initial outcomes...
April 2017: Journal of clinical and translational science
https://www.readbyqxmd.com/read/28648330/experience-with-patient-referrals-for-upper-extremity-transplantation-at-a-u-s-academic-medical-center
#7
Harriet Kiwanuka, Mario A Aycart, Ericka M Bueno, Bohdan Pomahac, Simon G Talbot
PURPOSE: To date, there have been over 100 upper extremity transplantations (UET) performed worldwide. However, little data are available regarding institutional screening practices or description of the population of patients that seek transplantation as a treatment modality for their upper extremity disabilities. We performed a review of our institutional experience in an attempt to better understand our referral patterns and identify factors that may be associated with successful screening...
June 22, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28647784/replacing-single-frozen-thawed-euploid-embryos-in-a-natural-cycle-in-ovulatory-women-may-increase-live-birth-rates-compared-to-medicated-cycles-in-anovulatory-women
#8
Alexis P Melnick, Robert Setton, Logan D Stone, Nigel Pereira, Kangpu Xu, Zev Rosenwaks, Steven D Spandorfer
PURPOSE: The goal of this study was to compare pregnancy outcomes between natural frozen embryo transfer (FET) cycles in ovulatory women and programmed FET cycles in anovulatory women after undergoing in vitro fertilization with preimplantation genetic screening (IVF-PGS). METHODS: This was a retrospective cohort study performed at an academic medical center. Patients undergoing single FET IVF-PGS cycles between October 2011 and December 2014 were included. Patients were stratified by type of endometrial replacement: programmed cycles with estrogen/progesterone replacement and natural cycles...
June 24, 2017: Journal of Assisted Reproduction and Genetics
https://www.readbyqxmd.com/read/28647679/factors-impacting-on-psychological-wellbeing-of-international-students-in-the-health-professions-a-scoping-review
#9
REVIEW
Lisa McKenna, Eddie Robinson, Joy Penman, Danny Hills
BACKGROUND: There are increasing numbers of international students undertaking health professional courses, particularly in Western countries. These courses not only expose students to the usual stresses and strains of academic learning, but also require students to undertake clinical placements and practice-based learning. While much is known about general issues facing international students, less is known about factors that impact on those studying in the health professions. OBJECTIVES: To explore what is known about factors that influence the psychological wellbeing of international students in the health professions...
June 17, 2017: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/28647465/french-registry-on-acute-st-elevation-and-non-st-elevation-myocardial-infarction-2015-fast-mi-2015-design-and-baseline-data
#10
Loïc Belle, Guillaume Cayla, Yves Cottin, Pierre Coste, Khalife Khalife, Jean-Noël Labèque, Bruno Farah, Thibaut Perret, Patrick Goldstein, Pierre-Yves Gueugniaud, François Braun, Jacques Gauthier, Martine Gilard, Jean-Yves Le Heuzey, Nicolas Naccache, Elodie Drouet, Vincent Bataille, Jean Ferrières, Etienne Puymirat, François Schiele, Tabassome Simon, Nicolas Danchin
BACKGROUND: The FAST-MI programme, consisting of 1-month surveys of patients admitted to hospital for acute myocardial infarction (AMI) in France, has run since 2005. AIM: To gather data on the characteristics, management and outcomes of patients hospitalized for AMI at the end of 2015 in France and to provide comparisons with the previous surveys. METHODS: Consecutive adults with ST-segment elevation myocardial infarction (STEMI) or non-ST-segment-elevation myocardial infarction (NSTEMI) with symptom onset≤48hours were included over a 1-month period, with a possible extension of recruitment for 1 additional month...
June 21, 2017: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/28647046/assessment-of-emergency-general-surgery-care-based-on-formally-developed-quality-indicators
#11
Angela Ingraham, Avery Nathens, Andrew Peitzman, Allison Bode, Gina Dorlac, Warren Dorlac, Preston Miller, Mahsa Sadeghi, Deena D Wasserman, Karl Bilimoria
BACKGROUND: Emergency general surgery outcomes vary widely across the United States. The utilization of quality indicators can reduce variation and assist providers in administering care aligned with established recommendations. Previous quality indicators have not focused on emergency general surgery patients. We identified indicators of high-quality emergency general surgery care and assessed patient- and hospital-level compliance with these indicators. METHODS: We utilized a modified Delphi technique (RAND Appropriateness Methodology) to develop quality indicators...
June 21, 2017: Surgery
https://www.readbyqxmd.com/read/28646976/promoting-parent-academic-expectations-predicts-improved-school-outcomes-for-low-income-children-entering-kindergarten
#12
John E Loughlin-Presnal, Karen L Bierman
This study explored patterns of change in the REDI (Research-based Developmentally Informed) Parent program (REDI-P), designed to help parents support child learning at the transition into kindergarten. Participants were 200 prekindergarten children attending Head Start (55% European-American, 26% African American, 19% Latino, 56% male, Mage=4.45years, SD=0.29) and their primary caregivers, who were randomized to a 16-session home-visiting intervention (REDI-P) or a control group. Extending beyond a prior study documenting intervention effects on parenting behaviors and child kindergarten outcomes, this study assessed the impact of REDI-P on parent academic expectations, and then explored the degree to which intervention gains in three areas of parenting (parent-child interactive reading, parent-child conversations, parent academic expectations) predicted child outcomes in kindergarten (controlling for baseline values and a set of child and family characteristics)...
June 2017: Journal of School Psychology
https://www.readbyqxmd.com/read/28646811/alternative-therapy-for-patients-with-obstructive-sleep-apnea-hypopnea-syndrome-a-1-year-single-blind-randomized-trial-of-tui-na
#13
Cheng-Nan Lu, Michael Friedman, Hsin-Ching Lin, Kuo-Wei Bi, Tun-Pin Hsueh, Hsueh-Wen Chang, Mao-Chang Su, Meng-Chih Lin
Context • Obstructive sleep apnea/hypopnea syndrome (OSAHS) is among the most prevalent of sleep-related breathing disorders. No long-term follow-up studies have documented the continued success of lifestyle changes in treatment; oral appliances have an approximate 50% success rate; compliance with continuous positive airway pressure is poor, ranging from 50% to 89%; and the success rate of upper-airway surgery is only 66.4%. Therefore, some OSAHS patients seek alternative treatments. Objectives • The study intended to examine the efficacy of traditional Chinese therapeutic massage (tui na) for patients with OSAHS...
July 2017: Alternative Therapies in Health and Medicine
https://www.readbyqxmd.com/read/28646524/risk-factors-for-severe-respiratory-depression-from-prescription-opioid-overdose
#14
Lindsay M Fox, Robert S Hoffman, David Vlahov, Alex F Manini
BACKGROUND AND AIMS: Prescription opioid overdose is a leading cause of injury-related morbidity and mortality in the US. We aimed to identify characteristics associated with clinical severity in emergency department patients with prescription opioid overdose. DESIGN: This was a secondary data analysis of adult prescription opioid overdoses from a large prospective cohort of acute overdoses. We examined elements of a typical emergency department evaluation using a multivariable model to determine which characteristics were associated with clinical severity, specifically severe respiratory depression (SRD)...
June 23, 2017: Addiction
https://www.readbyqxmd.com/read/28645986/feasibility-study-of-a-randomised-controlled-trial-to-investigate-the-effectiveness-of-using-a-humanoid-robot-to-improve-the-social-skills-of-children-with-autism-spectrum-disorder-kaspar-rct-a-study-protocol
#15
Silvana E Mengoni, Karen Irvine, Deepshikha Thakur, Garry Barton, Kerstin Dautenhahn, Karen Guldberg, Ben Robins, David Wellsted, Shivani Sharma
INTRODUCTION: Interventions using robot-assisted therapy may be beneficial for the social skills development of children with autism spectrum disorder (ASD); however, randomised controlled trials (RCTs) are lacking. The present research aims to assess the feasibility of conducting an RCT evaluating the effectiveness of a social skills intervention using Kinesics and Synchronisation in Personal Assistant Robotics (Kaspar) with children with ASD. METHODS AND ANALYSIS: Forty children will be recruited...
June 22, 2017: BMJ Open
https://www.readbyqxmd.com/read/28645963/effectiveness-and-safety-of-moxibustion-treatment-for-non-specific-lower-back-pain-protocol-for-a-systematic-review
#16
Jungtae Leem, Seunghoon Lee, Yeoncheol Park, Byung-Kwan Seo, Yeeun Cho, Jung Won Kang, Yoon Jae Lee, In-Hyuk Ha, Hyun-Jong Lee, Eun-Jung Kim, Sanghoon Lee, Dongwoo Nam
INTRODUCTION: Many patients experience acute lower back pain that becomes chronic pain. The proportion of patients using complementary and alternative medicine to treat lower back is increasing. Even though several moxibustion clinical trials for lower back pain have been conducted, the effectiveness and safety of moxibustion intervention is controversial. The purpose of this study protocol for a systematic review is to evaluate the effectiveness and safety of moxibustion treatment for non-specific lower back pain patients...
June 23, 2017: BMJ Open
https://www.readbyqxmd.com/read/28645479/impact-of-the-nap-1-strain-on-disease-severity-mortality-and-recurrence-of-healthcare-associated-clostridium-difficile-infection
#17
Karri A Bauer, Jessica E W Johnston, Eric Wenzler, Debra A Goff, Charles H Cook, Joan-Miquel Balada-Llasat, Preeti Pancholi, Julie E Mangino
OBJECTIVES: Studies are conflicting regarding the association of the North American pulsed-field gel electrophoresis type 1 (NAP1) strain in Clostridium difficile infection (CDI) and outcomes. We evaluated the association of NAP1 with healthcare-associated CDI disease severity, mortality, and recurrence at our academic medical center. METHODS: Healthcare-associated CDI cases were identified from November 1, 2011 through January 31, 2013. Multivariable regression models were used to evaluate the associations of NAP1 with severe disease (based on the Hines VA severity score index), mortality, and recurrence...
June 20, 2017: Anaerobe
https://www.readbyqxmd.com/read/28645462/analgosedation-practices-and-the-impact-of-sedation-depth-on-clinical-outcomes-among-patients-requiring-mechanical-ventilation-in-the-emergency-department-a-cohort-study
#18
Robert J Stephens, Enyo Ablordeppey, Anne M Drewry, Christopher Palmer, Brian T Wessman, Nicholas M Mohr, Brian W Roberts, Stephen Y Liang, Marin H Kollef, Brian M Fuller
BACKGROUND: Analgesia and sedation are cornerstone therapies for mechanically ventilated patients. Despite data showing that early deep sedation in the intensive care unit influences outcome, this has not been investigated in the emergency department (ED). Therefore, ED-based sedation practices, and their influence on outcome, remain incompletely defined. This study's objectives were to describe ED sedation practices in mechanically ventilated patients, and to test the hypothesis that ED sedation depth is associated with worse outcomes METHODS: This was a cohort study on a prospectively compiled ED registry of adult, mechanically ventilated patients at a single academic medical center...
June 20, 2017: Chest
https://www.readbyqxmd.com/read/28644931/quadrigia-and-productivity
#19
John Ingraham
Financial productivity in academic surgery is important and deserves great emphasis, yet it is but one of many vital elements of a healthy practice. Productivity must be carefully balanced with many other vital goals such as maximizing patient safety, maintaining excellent outcomes, optimizing resident and medical student education, and earning outstanding patient feedback. The following editorial explores this elusive balance and the importance of not swaying too far in the direction of revenue.
July 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28644823/eeg-characteristics-in-cooled-and-rewarmed-periods-in-post-cardiac-arrest-therapeutic-hypothermia-patients
#20
K Kim, Kimberly L Pargeon, Amy S Labar, Oren Friedman, Padmaja N Kandula, Douglas R Labar
PURPOSE: Continuous video EEG is a tool to assess brain function in injuries, including cardiac arrest (CA). In post-CA therapeutic hypothermia (TH) studies, some EEG features are linked to poor prognosis, but the evolvement of EEG characteristics during two temperature phases and its significance is unclear. We systematically analyzed EEG characteristics in cooled and rewarmed phases of post-CA therapeutic hypothermia patients and investigated their correlation to patient outcome. METHODS: This is a retrospective study of EEG analyses, from a single academic center, of 20 patients who underwent CA and therapeutic hypothermia...
July 2017: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
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