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https://www.readbyqxmd.com/read/29677063/the-anesthesia-perioperative-call-for-help-experience-at-a-quaternary-pediatric-medical-center-analysis-of-67-564-anesthesia-encounters
#1
Bistra G Vlassakova, Sean M Sinnott, Nissa Askins, Matthew X Callahan, Izabela C Leahy, David Zurakowski, Paul R Hickey, Joseph P Cravero
BACKGROUND: During the past several decades, anesthesia has become increasingly safe. Truly major adverse events are rare, and anesthesia quality researchers have instituted programs to evaluate "near miss" or less critical adverse events to evaluate the safety of anesthesia delivery. In this study, we aimed to evaluate calls for emergency help in our institution as a surrogate for pending critical events. We hypothesized that calls would be more common in patients with high American Society of Anesthesiologists (ASA) physical status, history of prematurity, and children with recent respiratory illness compared to those without these characteristics...
April 17, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29670992/promotion-of-hand-hygiene-the-experience-of-the-orthopaedic-hospital-gaetano-pini-cto-milan-italy
#2
M Nobile, C Conti, A Bastianelli, A Piscitelli, G M Calori, P Navone
BACKGROUND: Hand hygiene is the primary preventive measure against health care-associated infections in terms of cost-effectiveness. In 2005, the WHO proposed the "Global Patient Safety Challenge" campaign, with the aim of reducing the overall incidence of such infections, through multimodal programs and strategies, interactive training tools and standardised methods for monitoring compliance. STUDY DESIGN: On the basis of project "Rimani", sponsored by the Health and Social Care Authority of Emilia-Romagna, the Istituto Ortopedico Gaetano Pini has implemented a project which seeks to increase healthcare staff's compliance with hand hygiene...
May 2018: Annali di Igiene: Medicina Preventiva e di Comunità
https://www.readbyqxmd.com/read/29656593/review-article-investigations-and-the-pregnant-woman-in-the-emergency-department-part-1-laboratory-investigations
#3
REVIEW
Adam Morton, Stephanie Teasdale
Accurate assessment of the pregnant patient in the ED depends on knowledge of physiological changes in pregnancy, and how these changes may impact on pathology tests, appearance on point-of-care ultrasound and electrocardiography. In addition the emergency physician needs to be cognisant of disorders that are unique to or more common in pregnancy. Part 1 of this review addresses potential deviations in laboratory investigation reference intervals resulting from physiological alterations in pregnancy, and the important causes of abnormal laboratory results in pregnancy...
April 15, 2018: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29628616/updates-on-uterine-artery-embolization
#4
REVIEW
Maureen P Kohi, James B Spies
Uterine fibroids (leiomyomas) are the most common benign neoplasm of the female pelvis and have a lifetime prevalence exceeding 80% among African American women and approaching 70% among Caucasian women. Approximately 50% of women with fibroids experience symptoms which may include menorrhagia that may result in anemia, bulk symptoms with bladder and bowel dysfunction and abdominal protrusion, dysmenorrhea, and infertility. Hysterectomy remains the most common treatment option for fibroids and concerns have been raised about the overuse of this procedure...
March 2018: Seminars in Interventional Radiology
https://www.readbyqxmd.com/read/29628299/effectiveness-and-safety-of-sclerotherapy-for-treatment-of-low-flow-vascular-malformations-of-the-oropharyngeal-region
#5
Patrick Bourgouin, Frédéric Thomas-Chaussé, Patrick Gilbert, Marie-France Giroux, Sébastien Périgny, Louis Guertin, Josée Dubois, Gilles Soulez
PURPOSE: To evaluate the efficacy and safety of sclerotherapy with sodium tetradecyl sulfate (STS) and bleomycin for treatment of venous malformations (VMs) of the oropharyngeal region. MATERIALS AND METHODS: A retrospective study of 33 patients with 46 VMs of the buccal and pharyngolaryngeal cavity associated with impairment of eating, respiration, or elocution was performed. Individual lesions were divided based on their anterior or posterior location, using the base of the tongue as an anatomic landmark...
April 6, 2018: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/29619627/new-advances-in-acute-postoperative-pain-management
#6
REVIEW
Sukanya Mitra, Daniel Carlyle, Gopal Kodumudi, Vijay Kodumudi, Nalini Vadivelu
PURPOSE OF REVIEW: Postoperative pain remains one of the most common challenges following inpatient and outpatient surgeries. With our advances in modern medicine, pain following surgical procedures still remains a challenge, though significant accomplishments have been made over the past few decades. This article highlights some of the promising new advances and approaches in postoperative pain management. RECENT FINDINGS: Over the last decade, Enhanced Recovery after Surgery (ERAS) pathways and protocols are becoming the benchmark standards for enhancing postoperative recovery...
April 4, 2018: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/29615125/in-office-laryngeal-procedures-iolp-in-canada-current-safety-practices-and-procedural-care
#7
Yael Bensoussan, Jennifer Anderson
BACKGROUND: The advent of chip tip technology combined with advanced endoscopy has revolutionized the field of laryngology in the past decade. Procedures such as transnasal esophagoscopy, site-specific steroid injections, injection laryngoplasty and laryngeal laser treatment can now be performed in the office setting under local anaesthesia. Although In-Office Laryngeal Procedures (IOLPs) have become standard-of-care in many American and several Canadian centers, there are no guidelines regulating the practice of these procedures...
April 3, 2018: Journal of Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/29601462/incident-reporting-to-improve-patient-safety-the-effects-of-process-variance-on-pediatric-patient-safety-in-the-emergency-department
#8
Karen J OʼConnell, Kathy N Shaw, Richard M Ruddy, Prashant V Mahajan, Richard Lichenstein, Cody S Olsen, Tomohiko Funai, Stephen Blumberg, James M Chamberlain
OBJECTIVE: Medical errors threaten patient safety, especially in the pediatric emergency department (ED) where overcrowding, multiple handoffs, and workflow interruptions are common. Errors related to process variance involve situations that are not consistent with standard ED operations or routine patient care. SETTING/PARTICIPANTS: We performed a planned subanalysis of the Pediatric Emergency Care Applied Research Network incident reporting data classified as process variance events...
April 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29594184/photoacoustic-based-catheter-tracking-simulation-phantom-and-in-vivo-studies
#9
Alexis Cheng, Younsu Kim, Yuttana Itsarachaiyot, Haichong K Zhang, Clifford R Weiss, Russell H Taylor, Emad M Boctor
Catheters are commonly used in many procedures and tracking and localizing them is critical to patient safety and surgical success. The standard of care for catheter tracking is with the use of fluoroscopy. Alternatives using conventional tracking technologies such as electromagnetic trackers have been previously explored. This work explores the use of an emerging imaging modality, photoacoustics, as a means for tracking. A piezoelectric (PZT) sensor is placed at the tip of the catheter, allowing it to receive the acoustic signals generated from photoacoustic markers due to the photoacoustic effect...
April 2018: Journal of Medical Imaging
https://www.readbyqxmd.com/read/29577627/review-article-investigations-and-the-pregnant-woman-in-the-emergency-department-part-2-point-of-care-ultrasound-electrocardiography-respiratory-function-tests-and-radiology
#10
REVIEW
Adam Morton, Stephanie Teasdale
Accurate assessment of the pregnant patient in the ED depends on knowledge of physiological changes in pregnancy, and how these changes may impact on pathology tests, appearance on point-of-care ultrasound, electrocardiography and respiratory function tests. In addition, the emergency physician needs to be cognisant of disorders that are unique to or more common during pregnancy. Part 2 of this review addresses the role of point-of-care ultrasound in pregnancy, physiological changes that may affect interpretation of point-of-care ultrasound, changes in electrocardiography and respiratory function tests, and the safety of radiological procedures in the pregnant patient...
March 25, 2018: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29574567/two-port-robotic-hysterectomy-a-novel-approach
#11
Gaby N Moawad, Paul Tyan, Elias D Abi Khalil
The objective of the study was to demonstrate a novel technique for two-port robotic hysterectomy with a particular focus on the challenging portions of the procedure. The study is designed as a technical video, showing step-by-step a two-port robotic hysterectomy approach (Canadian Task Force classification level III). IRB approval was not required for this study. The benefits of minimally invasive surgery for gynecological pathology have been clearly documented in multiple studies. Patients had fewer medical and surgical complications postoperatively, better cosmesis and quality of life...
March 24, 2018: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/29559781/novel-treatment-options-in-depression-and-psychosis
#12
REVIEW
Eva Ceskova, Petr Silhan
In spite of tremendous development in central nervous system research, current treatment is suboptimal, especially in severe mental disorders. In medicine, there are two main methods of improving the health care provided: seeking new treatment procedures and perfecting (optimizing) the existing ones. Optimization of treatment includes not only practical tools such as therapeutic drug monitoring but also implementation of general trends in the clinical practice. New pharmacological options include new more sophisticated forms of monoaminergic drugs, old drugs rediscovered on the base of a better understanding of pathophysiology of mental illnesses, and drugs aimed at new treatment targets...
2018: Neuropsychiatric Disease and Treatment
https://www.readbyqxmd.com/read/29547428/global-surgery-system-strengthening-it-is-all-about-the-right-metrics
#13
David A Watters, Glenn D Guest, Viliami Tangi, Mark G Shrime, John G Meara
Progress in achieving "universal access to safe, affordable surgery, and anesthesia care when needed" is dependent on consensus not only about the key messages but also on what metrics should be used to set goals and measure progress. The Lancet Commission on Global Surgery not only achieved consensus on key messages but also recommended 6 key metrics to inform national surgical plans and monitor scale-up toward 2030. These metrics measure access to surgery, as well as its timeliness, safety, and affordability: (1) Two-hour access to the 3 Bellwether procedures (cesarean delivery, emergency laparotomy, and management of an open fracture); (2) Surgeon, Anesthetist, and Obstetrician workforce >20/100,000; (3) Surgical volume of 5000 procedures/100,000; (4) Reporting of perioperative mortality rate; and (5 and 6) Risk rates of catastrophic expenditure and impoverishment when requiring surgery...
April 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29531940/the-emerging-role-for-robotics-in-cholecystectomy-the-dawn-of-a-new-era
#14
REVIEW
Jessica A Zaman, Tejender Paul Singh
Though laparoscopic cholecystectomy (LC) was highly criticized in its early stages, it quickly grew to become a new standard of care and has revolutionized the field of general surgery. Now emerging robotic technology is making its way into the minimally invasive arena. Robotic cholecystectomy (RC) is often disparaged as a costly technology that can lead to increased operative times with outcomes that are quite similar to LC. However, this perspective is skewed as many existing studies were performed in the early phase of learning for this procedure...
February 2018: Hepatobiliary Surgery and Nutrition
https://www.readbyqxmd.com/read/29530691/evaluation-of-the-relevance-of-surgery-in-patients-with-multiple-myeloma-harboring-symptomatic-spinal-involvement-a-retrospective-case-series
#15
Mathilde Quidet, Fahed Zairi, Eileen Boyle, Thierry Facon, Marie-Hélène Vieillard, François Machuron, Jean-Paul Lejeune, Richard Assaker
INTRODUCTION: Multiple myeloma spinal involvement can lead to bone-fractures and neurological impairment that can severely alter quality of life. The role of surgery is controversial, given its high morbidity, and the lack of evidence. We hereby aim to evaluate efficacy and safety of surgery in the management of symptomatic spinal lesions in patients with multiple myeloma. METHODS: We included all patients operated on for a myeloma-related spinal lesion, in our institution between 2007 and 2015...
March 9, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29495935/responsibility-among-bachelor-degree-nursing-students-a-concept-analysis
#16
Saeed Ghasemi, Fazlollah Ahmadi, Anoshirvan Kazemnejad
BACKGROUND: Responsibility is an important component of the professional values and core competencies for bachelor degree nursing students and has relationships with nursing education and professionalization. It is important for providing safe and high-quality care to the clients for the present and future performance of student. But there is no clear and operational definition of this concept for bachelor degree nursing students; however, there are extensive contents and debates about the definitions, attributes, domains and boundaries of responsibility in nursing and non-nursing literature...
January 1, 2018: Nursing Ethics
https://www.readbyqxmd.com/read/29478204/transradial-pci-and-same-day-discharge
#17
REVIEW
Ali Elfandi, Jordan G Safirstein
PURPOSE OF REVIEW: The evolution of cardiac catheterization has led to the development of well-refined, more effective, and safer devices that allow cardiovascular interventionalists to deliver high-quality percutaneous interventions (PCI). Transradial PCI (TRI) has gained more popularity in the USA over the past 10 years, and as experience and volume of TRI grow, studies adopting same day radial PCI protocols have emerged and are showing promising results. We sought to review the current literature on TRI and same day discharge (SDD)...
February 24, 2018: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/29461368/safety-outcomes-in-endoscopic-versus-open-repair-of-metopic-craniosynostosis
#18
Tara L Braun, Bradley S Eisemann, Olushola Olorunnipa, Edward P Buchanan, Laura A Monson
BACKGROUND: Premature fusion of the metopic suture leads to a range of clinical presentations, with more severe patients presenting characteristically with trigonocephaly. Endoscopic-assisted correction of craniosynostosis is emerging as an alternative to the gold-standard open cranial vault remodeling. While there are several documented benefits of endoscopic correction, the management of craniosynostosis varies widely in the literature with little consensus as to the preferred timing and surgical technique for repair...
February 14, 2018: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/29459240/telehealth-for-remote-stroke-management
#19
REVIEW
Charlotte Zerna, Thomas Jeerakathil, Michael D Hill
Stroke is a leading cause of adult disability and the fourth leading cause of death in Canada. Most strokes are ischemic and functional outcome is highly time-dependent, making fast diagnosis and treatment initiation crucial. This poses a challenge in vast geographical areas where stroke neurology expertise is only available in urban centres. In this article we review the rationale for telestroke networks and their current implementation in Canada. Telestroke networks enable stroke-specific procedures to be performed by less experienced physicians under the guidance of stroke neurology experts...
December 27, 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/29438575/primary-care-professionals-providing-non-urgent-care-in-hospital-emergency-departments
#20
REVIEW
Daniela Gonçalves-Bradley, Jaspreet K Khangura, Gerd Flodgren, Rafael Perera, Brian H Rowe, Sasha Shepperd
BACKGROUND: In many countries emergency departments (EDs) are facing an increase in demand for services, long waits, and severe crowding. One response to mitigate overcrowding has been to provide primary care services alongside or within hospital EDs for patients with non-urgent problems. However, it is unknown how this impacts the quality of patient care and the utilisation of hospital resources, or if it is cost-effective. This is the first update of the original Cochrane Review published in 2012...
February 13, 2018: Cochrane Database of Systematic Reviews
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