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https://www.readbyqxmd.com/read/29244964/outpatient-negative-pressure-dressing-therapy-for-pretibial-lacerations-in-a-patient-with-high-anaesthetic-risk-a-case-study
#1
L Sutton, D Edwards, M McColl
Pretibial lacerations are a common cause of presentation to accident and emergency departments. The management of these wounds is contentious with a variation in practise between individual institutions. We present the case of a 49-year-old female with a background of pulmonary atresia and associated pulmonary hypertension, who underwent successful outpatient negative pressure wound therapy (NPWT) for three pretibial lacerations. We would propose that this therapy is an effective option for the management of these wounds in independently mobile patients who are at high-risk when under anaesthetic...
December 2, 2017: Journal of Wound Care
https://www.readbyqxmd.com/read/29244096/treatment-of-pulmonary-tuberculosis-past-and-present
#2
Dmitry Borisovich Giller, Boris Dmitrievich Giller, Galina Vitalievna Giller, Galina Vladimirovna Shcherbakova, Anuar Bahtibaevich Bizhanov, Inga Igorevna Enilenis, Aleksey Aleksandrovich Glotov
OBJECTIVES: Surgical interventional has been key in the treatment of tuberculosis (TB) for a long time. Its importance diminished after the emergence of chemotherapy. However, the spread of rapid multidrug-resistant (MDR) and extensively drug-resistant (XDR) TB has led us to return to surgery to treat TB. Today, every second patient in Russia with destructive TB has either MDR or XDR TB, which is the reason for the low efficacy of conservative treatment. In 2015, treatment with drugs resulted in clinical recovery in only 29...
December 12, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29243077/pulmonary-embolus-as-cause-of-death-in-an-adolescent-demonstration-on-postmortem-ct
#3
Mary P Harty, H Theodore Harcke, Sharon W Gould, Adrienne Sukula-Perlman
Computed tomography (CT) is widely accepted in adult forensic death investigations (determination of cause and manner of death) but is only beginning to play a larger role in the cause of death determination in infants and children. We present a case of an adolescent with nephrotic syndrome who sustained cardiac arrest and died in the emergency department. A postmortem CT was requested by the state Office of the Medical Examiner as part of the medicolegal death investigation. Postmortem CT showed a saddle pulmonary embolus that was confirmed on conventional autopsy, demonstrating a natural manner of death...
December 14, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/29242571/divergent-risk-factors-for-cerebellar-and-intraventricular-hemorrhage
#4
Zachary A Vesoulis, Maja Herco, Amit M Mathur
OBJECTIVE: To identify whether intraventricular hemorrhage (IVH) and cerebellar hemorrhage (CH) have common or divergent risk factors. STUDY DESIGN: This is a retrospective cross-sectional cohort of infants including all infants born <30 weeks from 2007 to 2016. Comprehensive perinatal and clinical factors were extracted from the medical record. Outborn infants, infants with major congenital anomaly, those transferred prior to discharge, and those with mixed or no brain injury were excluded...
December 15, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/29241516/factors-affecting-self-care-behavior-in-koreans-with-copd
#5
Soo Kyung Park
BACKGROUND: Despite the importance of self-care in people with COPD, little is known about the effect of symptoms and symptom clusters on self-care behavior in people with exacerbated COPD. This study was designed to describe their level of self-care and to examine factors associated with self-care behavior, including symptoms and symptom clusters. METHODS: For this cross-sectional descriptive study, the researcher recruited Koreans with exacerbated COPD (N=71) from three tertiary care hospitals...
December 2017: Applied Nursing Research: ANR
https://www.readbyqxmd.com/read/29240234/prospective-study-feasibility-screening-of-antenatal-total-abnormal-pulmonary-venous-return
#6
Christine Levêque, Louise Paret, Tiffany Cochet, Félicia Joinau-Zoulovits, E Chantalat, F Vidal, Christophe Vayssière, Nadine David
INTRODUCTION: Total Abnormal Pulmonary Venous Return (TAPVR) is a heart defect often missed prenatally, yet at birth it is a surgical emergency. Antenatal detection could be improved by sonographic visualization of the anastomosis of two pulmonary veins in a sinus into the left atrium. The objective of this study is to evaluate the feasibility of this screening method. METHOD: Prospective observational study. Five operators selected one representative image taken during morphological ultrasound screening...
December 14, 2017: Prenatal Diagnosis
https://www.readbyqxmd.com/read/29239751/feasibility-of-single-vs-two-physician-procedural-sedation-in-a-small-community-emergency-department
#7
Clayton P Josephy, David R Vinson
OBJECTIVE: Sedation is commonly required for painful procedures in the emergency department (ED). Some facilities mandate two physicians be present for deep sedation cases. Evidence is lacking, however, that a two-physician approach improves safety outcomes. We report our experience on the feasibility of replacing a two-physician ED procedural sedation policy with a single-physician policy in a small, single-coverage community ED. METHODS: This is a retrospective, before/after, single-center observational study of prospectively collected data from January 2013 through December 2016...
November 3, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29238640/high-risk-subgroup-membership-is-a-predictor-of-30-day-morbidity-following-anterior-lumbar-fusion
#8
Rachel S Bronheim, Jun S Kim, John Di Capua, Nathan J Lee, Parth Kothari, Sulaiman Somani, Kevin Phan, Samuel K Cho
Study Design: Retrospective cohort study. Objective: To determine if membership in a high-risk subgroup is predictive of morbidity and mortality following anterior lumbar fusion (ALF). Methods: The American College of Surgeons National Surgical Quality Improvement Program database was utilized to identify patients undergoing ALF between 2010 and 2014. Multivariate analysis was utilized to identify high-risk subgroup membership as an independent predictor of postoperative complications...
December 2017: Global Spine Journal
https://www.readbyqxmd.com/read/29238493/correlation-of-gerkin-queen-s-college-george-and-jackson-methods-in-estimating-maximal-oxygen-consumption
#9
Payam Heydari, Sakineh Varmazyar, Ali Safari Variani, Fariba Hashemi, Seyed Sajad Ataei
Background and aim: Test of maximal oxygen consumption is the gold standard for measuring cardio-pulmonary fitness. This study aimed to determine correlation of Gerkin, Queen's College, George, and Jackson methods in estimating maximal oxygen consumption, and demographic factors affecting maximal oxygen consumption. Methods: This descriptive cross-sectional study was conducted in a census of medical emergency students (n=57) in Qazvin University of Medical Sciences in 2016...
October 2017: Electronic Physician
https://www.readbyqxmd.com/read/29238021/-granulomatosis-with-polyangiitis-complicated-with-gastrointestinal-perforation-a-case-report-and-review-of-literature
#10
Takao Kiboshi, Kentaro Isoda, Koichi Furukawa, Tomoyuki Wakahara, Kenichiro Otani, Kayo Ueda, Junichi Konma, Kazuhiro Teramura, Nozomi Ueno, Hiroshi Fujiwara, Takeshi Shoda
  A 51-year-old man was detected nasal bleeding, multiple pulmonary nodule and mass, urinalysis abnormality, renal involvement and high titer of proteinase 3-anti-neutrophil cytoplasmic antibody (PR3-ANCA), and was suspected of granulomatosis with polyangiitis and initiated with steroid pulse therapy. On the day after the start of steroid pulse therapy, generalized peritonitis due to ileal perforation occurred, and emergency ileectomy and peritonitis surgery were performed. Induction therapy with steroid pulse therapy, plasma exchange and intravenous cyclophosphamide therapy (IVCY) and maintenance therapy with glucocorticoid and azathioprine led to good therapeutic outcomes...
2017: Nihon Rinshō Men'eki Gakkai Kaishi, Japanese Journal of Clinical Immunology
https://www.readbyqxmd.com/read/29237706/patient-characteristics-resource-use-and-outcomes-associated-with-general-internal-medicine-hospital-care-the-general-medicine-inpatient-initiative-gemini-retrospective-cohort-study
#11
Amol A Verma, Yishan Guo, Janice L Kwan, Lauren Lapointe-Shaw, Shail Rawal, Terence Tang, Adina Weinerman, Peter Cram, Irfan A Dhalla, Stephen W Hwang, Andreas Laupacis, Muhammad M Mamdani, Steven Shadowitz, Ross Upshur, Robert J Reid, Fahad Razak
BACKGROUND: The precise scope of hospital care delivered under general internal medicine services remains poorly quantified. The purpose of this study was to describe the demographic characteristics, medical conditions, health outcomes and resource use of patients admitted to general internal medicine at 7 hospital sites in the Greater Toronto Area. METHODS: This was a retrospective cohort study involving all patients who were admitted to or discharged from general internal medicine at the study sites between Apr...
December 11, 2017: CMAJ Open
https://www.readbyqxmd.com/read/29235658/baseline-characteristics-and-outcomes-of-older-adults-seeking-care-in-ambulatory-urgent-care-clinics
#12
Bernardo J Reyes, Javier M Lopez, Diana J Galindo, Maria Briceno, Joseph G Ouslander
OBJECTIVES: To determine the most common clinical conditions associated with older adults visiting Urgent care centers (UCCs) and the potential need for further resource use. DESIGN: Cross-sectional retrospective study. SETTING: Nonprofit academic medical center with campuses and multiple satellite offices in Ohio and Florida. PARTICIPANTS: Individuals aged 55 and older who visited UCCs between August 2014 and March 2015 (N = 9,445; average age 63...
December 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29234619/delayed-pulmonary-artery-rupture-after-using-bioglue-in-cardiac-surgery
#13
Wongi Woo, Soonchang Hong, Tae-Hoon Kim, Min-Young Baek, Suk-Won Song
A 56-year-old woman, who underwent cardiac surgery 3 months previously, presented to the emergency room with pulmonary artery rupture due to the cytotoxic effects of BioGlue (CryoLife Inc., Kennesaw, GA, USA). She was successfully treated with surgical management. Although surgical glue can be effectively used for hemostasis, it can induce delayed vascular complications. Therefore, surgical glue should be used cautiously.
December 2017: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29233835/right-atrial-deformation-in-predicting-outcomes-in-pediatric-pulmonary-hypertension
#14
Pei-Ni Jone, Michal Schäfer, Ling Li, Mary Craft, D Dunbar Ivy, Shelby Kutty
BACKGROUND: Elevated right atrial (RA) pressure is a risk factor for mortality, and RA size is prognostic of adverse outcomes in pulmonary hypertension (PH). There is limited data on phasic RA function (reservoir, conduit, and pump) in pediatric PH. We sought to evaluate (1) the RA function in pediatric PH patients compared with controls, (2) compare the RA deformation indices with Doppler indices of diastolic dysfunction, functional capacity, biomarkers, invasive hemodynamics, and right ventricular functional indices, and (3) evaluate the potential of RA deformation indices to predict clinical outcomes...
December 2017: Circulation. Cardiovascular Imaging
https://www.readbyqxmd.com/read/29230286/asthma-mimic-case-report-and-literature-review-of-vocal-cord-nodule-associated-with-wheezing
#15
Muhammad Kashif, Tushi Singh, Ahsan Aslam, Misbahuddin Khaja
Asthma is a heterogeneous disease, usually characterized by chronic airway inflammation. Various clinical conditions can mimic asthma, such as foreign body aspiration, subglottic stenosis, congestive heart failure, diffuse panbronchiolitis, aortic arch anomalies, reactive airway dysfunction syndrome, chronic obstructive pulmonary disease, retrosternal goiter, vocal cord tumors, other airway tumors, and vocal cord dysfunction. Upper airway obstruction can be a life-threatening emergency. Here, we present the case of a 58-year-old female with recurrent hospital visits for wheezing and exacerbations of asthma, who was later found to have a vocal cord nodule confirmed to be squamous cell carcinoma, which was mimicking like asthma...
2017: SAGE Open Medical Case Reports
https://www.readbyqxmd.com/read/29229104/heart-rate-and-risk-of-death-among-patients-with-pulmonary-hypertension-a-12-lead-ecg-analysis
#16
Helene Bouchery-Bardet, Christian Creveuil, Fabrice Bauer, Farzin Beygui, Laure Champ-Rigot, Eric Saloux, Fabien Labombarda, Vincent Roule, Rémi Sabatier, Damien Legallois, Gérard Zalcman, Emmanuel Bergot, Paul Milliez
BACKGROUND: Despite the emergence of new therapies, Pulmonary Hypertension (PH) still has a high mortality. Several clinical, echocardiographic, biological or hemodynamic prognostic factors have been identified but are of limited predictive value for survival. We aimed to assess whether heart rate (HR) and all ECG abnormalities measured on a 12-lead ECG may help to better identify patients at high risk of death in this population. METHODS AND RESULTS: 296 patients followed in a registry were included with all types of PH, except group 2 of the WHO clinical classification...
November 2017: Respiratory Medicine
https://www.readbyqxmd.com/read/29228935/dosimetrically-administered-nebulized-morphine-for-breathlessness-in-very-severe-chronic-obstructive-pulmonary-disease-a-randomized-controlled-trial
#17
Piotr Janowiak, Małgorzata Krajnik, Zygmunt Podolec, Tomasz Bandurski, Iwona Damps-Konstańska, Piotr Sobański, David C Currow, Ewa Jassem
BACKGROUND: Systemic morphine has evidence to support its use for reducing breathlessness in patients with severe chronic obstructive pulmonary disease (COPD). The effectiveness of the nebulized route, however, has not yet been confirmed. Recent studies have shown that opioid receptors are localized within epithelium of human trachea and large bronchi, a target site for a dosimetric nebulizer. The aim of this study was to compare any clinical or statistical differences in breathlessness intensity between nebulized 2...
December 11, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/29225775/fibromax-based-nonalcoholic-fatty-liver-disease-in-chronic-obstructive-pulmonary-disease-patients-with-obstructive-sleep-apnea-methodological-considerations
#18
Denis Monneret
The relationship between nonalcoholic fatty liver disease (NAFLD) and obstructive sleep apnea (OSA) has been well demonstrated, but remains to be evidenced in chronic obstructive pulmonary disease (COPD). Recently, Viglino et al. (Eur Respir J, 2017) attempted to determine the prevalence of liver fibrosis, steatosis and nonalcoholic steatohepatitis (NASH) in COPD patients, some of whom had OSA, basing the NAFLD diagnostic on three circulating biomarker-based liver scores: the FibroTest, SteatoTest and NashTest, from the Fibromax® panel...
2017: F1000Research
https://www.readbyqxmd.com/read/29225413/outbreak-of-hospital-infection-from-biofilm-embedded-pan-drug-resistant-pseudomonas-aeroginosa-due-to-a-contaminated-bronchoscope
#19
Nader Alipour, Alper Karagoz, Abbas Taner, Nasrin Gaeini, Nastaran Alipour, Hassan Zeytin, Fatih Yildiz, Riza Durmaz
Background: Colistin-resistant Pseudomonas aeruginosa (P. aeruginosa) has been defined as pandrug-resistant (PDR) strain. Outbreaks of PDR P. aeruginosa especially in pulmonary tract infections due to contaminated bronchoscopes have rarely been reported. The emergence of pandrug-resistant strains in both CF (Cystic Fibrosis) and non-CF clinical isolates over recent years remains of a great concern. Hospital wards contaminated with PDR P. aeruginosa infection, must be shot down until their eradication...
2017: Tap Chi y Hoc du Phong, Journal of Preventive Medicine / Hoi y Hoc du Phong Viet Nam
https://www.readbyqxmd.com/read/29224662/managing-venous-thromboembolic-disease-on-call
#20
Jason W Mitchell, William G O Connell, Charles A Gilliland, Irwin M Best
Managing venous thromboembolic disease on-call requires the interventional radiologist consider not only potential risk and benefit to the patient but also available resources in the IR suite as well as throughout the hospital, such as intensive care monitoring during treatment. We demonstrate how our practice manages these on-call cases ranging from deep venous thrombosis to acute pulmonary embolism and decide which patients need emergent treatment and which can undergo delayed intervention during working hours...
December 2017: Techniques in Vascular and Interventional Radiology
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