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https://www.readbyqxmd.com/read/27920243/between-the-flags-implementing-a-safety-net-system-at-scale-to-recognise-and-manage-deteriorating-patients-in-the-new-south-wales-public-health-system
#1
Charles Pain, Malcolm Green, Colette Duff, Deborah Hyland, Annette Pantle, Kimberley Fitzpatrick, Cliff Hughes
QUALITY PROBLEM: In 2005, the Clinical Excellence Commission (CEC) found that unrecognised patient deterioration remained an important problem in New South Wales (NSW) public hospitals. INITIAL ASSESSMENT: The challenge was to design and implement an effective and sustainable safety-net system in all 225 NSW public hospitals. DESIGNING A SOLUTION: The CEC's system was designed in collaboration with a broad coalition of partners, including clinicians, managers, system administrators and collaborating agencies...
December 4, 2016: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/27919063/predictors-of-low-back-pain-in-nursing-home-workers-after-implementation-of-a-safe-resident-handling-programme
#2
Judith E Gold, Laura Punnett, Rebecca J Gore
OBJECTIVES: Healthcare workers have high rates of low back pain (LBP) related to handling patients. A large chain of nursing homes experienced reduced biomechanical load, compensation claims and costs following implementation of a safe resident handling programme (SRHP). The aim of this study was to examine whether LBP similarly declined and whether it was associated with relevant self-reported occupational exposures or personal health factors. METHODS: Worker surveys were conducted on multiple occasions beginning with the week of first SRHP introduction (baseline)...
November 10, 2016: Occupational and Environmental Medicine
https://www.readbyqxmd.com/read/27914655/crohn-s-disease
#3
REVIEW
Joana Torres, Saurabh Mehandru, Jean-Frédéric Colombel, Laurent Peyrin-Biroulet
Crohn's disease is a chronic inflammatory disease of the gastrointestinal tract, with increasing incidence worldwide. Crohn's disease might result from a complex interplay between genetic susceptibility, environmental factors, and altered gut microbiota, leading to dysregulated innate and adaptive immune responses. The typical clinical scenario is a young patient presenting with abdominal pain, chronic diarrhoea, weight loss, and fatigue. Assessment of disease extent and of prognostic factors for complications is paramount to guide therapeutic decisions...
November 30, 2016: Lancet
https://www.readbyqxmd.com/read/27914507/psychiatric-psychological-injury-and-law-introduction
#4
EDITORIAL
Gerald Young
This special issue on psychiatric/psychological injury and law covers major developments in the field, and illustrates the complexities for mental health professionals in dealing with psychiatric/psychological injuries in court. The articles vary in the range of topics covered, and include ones on posttraumatic stress disorder, other trauma reactions, dissociation, disability, pain, and traumatic brain injury, in particular but also new areas, such as the effects of early penile injury. Work in the area of psychiatric/psychological injury and law needs to be scientifically-informed, comprehensive, and impartial, and the series of articles to follow will help workers in the area meet this standard...
November 2016: International Journal of Law and Psychiatry
https://www.readbyqxmd.com/read/27908277/comparison-of-unilateral-and-bilateral-percutaneous-vertebroplasty-for-osteoporotic-vertebral-compression-fractures-a-systematic-review-and-meta-analysis
#5
Haolin Sun, Chunde Li
BACKGROUND: The aim of this meta-analysis is to examine the safety and effectiveness of unilateral percutaneous vertebroplasty (PVP) for treatment of osteoporotic vertebral compression fractures (OVCFs) compared with that of bilateral treatment. METHODS: The multiple databases including PubMed, Springer, EMBASE, OVID, and China Journal Full-text Database were adopted to search for relevant studies in English or Chinese, and full-text articles involving comparison of unilateral and bilateral PVP surgery were reviewed...
December 1, 2016: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/27900869/-evaluation-of-five-years-of-treatment-of-erdheim-chester-disease-with-anakinra-case-report-and-overview-of-literature
#6
Zdeněk Adam, Hana Petrášová, Zdeněk Řehák, Renata Koukalová, Marta Krejčí, Luděk Pour, Eva Vetešníková, Aleš Čermák, Sabina Ševčíková, Petr Szturz, Zdeněk Král, Jiří Mayer
: Erdheim-Chester disease is a histiocytic neoplasm of diseases from the group of non-Langerhans-cell histiocytoses, formed by infiltrates of foamy histiocytes. These pathological histiocytes produce pro-inflammatory cytokines. Therefore Erdheim-Chester disease is called inflammatory histiocytary neoplasm. The disease is accompanied by clinical symptoms of systemic inflammatory response, i.e. B symptoms. Imaging examinations detect typical osteosclerotic changes affecting diaphyses and metaphyses of the lower long bones and fibrotic changes which affect the aorta wall and the vessels leading from it...
2016: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/27900227/urachal-cyst-causing-small-bowel-obstruction-in-an-adult-with-a-virgin-abdomen
#7
Michael P O'Leary, Zane W Ashman, David S Plurad, Dennis Y Kim
Introduction. A patent urachus is a rare congenital or acquired pathology, which can lead to complications later in life. We describe a case of urachal cystitis as the etiology of small bowel obstruction in an adult without prior intra-abdominal surgery. Case Report. A 64-year-old male presented to the acute care surgery team with a 5-day history of right lower quadrant abdominal pain, distention, nausea, and vomiting. He had a two-month history of urinary retention and his past medical history was significant for benign prostate hyperplasia...
2016: Case Reports in Surgery
https://www.readbyqxmd.com/read/27896530/maxillary-sinus-mucocele-predisposing-factors-clinical-presentations-and-treatment
#8
Mosaad Abdel-Aziz, Hassan El-Hoshy, Khaled Azooz, Nader Naguib, Ahmed Hussein
PURPOSE: Maxillary sinus mucocele (MSM) is uncommon lesion and has many presenting features. The aim of this study was to detect the possible predisposing factors, clinical characteristics, and to assess the efficacy of trans-nasal endoscopic treatment of this lesion. METHODS: This retrospective multicenter study was conducted on 36 patients with MSM, the diagnosis of the disease was based on computed tomographic criteria. The patients' history, presenting features, and surgical management were reviewed...
November 28, 2016: Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/27893661/acute-coronary-vasospasm-in-a-patient-with-eosinophilic-granulomatosis-with-polyangiitis-following-nsaid-administration-a-case-report
#9
Naïl Benallegue, Pierre Lozach, Cristina Belizna, Christian Lavigne, Geoffrey Urbanski
Eosinophilic with polyangiitis (EGPA, formerly known as Churg-Strauss syndrome) is a rare systemic disease characterized by a small-vessel necrotizing vasculitis. Cardiac manifestations are broad-ranging and are associated with a poor prognosis. Coronary vasospasm is uncommon.Here, we report a case of an acute coronary vasospasm in a patient with EGPA after corticosteroids withdrawal and nonsteroidal antiinflammatory drug (NSAID) introduction. This patient was initially misdiagnosed as bradykinin-mediated angioedema...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27891054/patellofemoral-joint-arthroplasty-our-experience-in-isolated-patellofemoral-and-bicompartmental-arthritic-knees
#10
L Sabatini, M Schirò, F Atzori, G Ferrero, A Massè
INTRODUCTION: Isolated patellofemoral (PF) arthritis is rare, and there is no complete agreement about the best surgical treatment. The operative treatments are total knee arthroplasty and patellofemoral replacement (PFR). The incidence of many early complications of PF arthroplasty has decreased with the introduction of newer designs. Nowadays, the main cause of revision surgery is the progression of tibiofemoral osteoarthritis. In the past, PF arthroplasty was contraindicated in patients with evidence of osteoarthritis or pain in medial or lateral tibiofemoral compartments...
2016: Clinical Medicine Insights. Arthritis and Musculoskeletal Disorders
https://www.readbyqxmd.com/read/27890246/treatment-of-dynamic-scapholunate-instability-dissociation-contribution-of-arthroscopy
#11
C Mathoulin
Scapholunate (SL) ligament injuries generally result from trauma to an extended, supinated wrist, leading to chronic instability that progresses toward osteoarthritis. They can occur together with distal radius fracture. These injuries can be difficult to diagnose, especially early on. Treating chronic SL ligament injuries before the onset of osteoarthritis is still a challenge for surgeons. Until recently, the recommended treatments consisted of open SL ligament reconstruction or repair procedures that reduce pain and improve pinch strength but also lead to wrist stiffness...
December 2016: Hand Surgery and Rehabilitation
https://www.readbyqxmd.com/read/27878805/pancreatic-enzyme-replacement-therapy-for-people-with-cystic-fibrosis
#12
REVIEW
Usha Rani Somaraju, Arturo Solis-Moya
BACKGROUND: Most people with cystic fibrosis (80% to 90%) need pancreatic enzyme replacement therapy to prevent malnutrition. Enzyme preparations need to be taken whenever food is taken, and the dose needs to be adjusted according to the food consumed. A systematic review on the efficacy and safety of pancreatic enzyme replacement therapy is needed to guide clinical practice, as there is variability between centres with respect to assessment of pancreatic function, time of commencing treatment, dose and choice of supplements...
November 23, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27878715/prescription-drug-coverage-and-chronic-pain
#13
Padmaja Ayyagari
Chronic pain is one of the most common chronic conditions affecting more than 50 % of older adults. While pain management can be quite complex, prescription drugs are the most commonly used treatment modality. In this study, I examine whether increased access to prescription drugs due to the introduction of the Medicare Part D program in 2006 led to better management of pain among the elderly. While prior work has identified increases in the utilization of analgesics due to the introduction of Medicare Part D, the extent to which this increase in drug use actually improved the well-being of older adults is not known...
June 2016: Int J Health Econ Manag
https://www.readbyqxmd.com/read/27875630/eosinophilic-fasciitis-with-subjacent-myositis
#14
Julia B Whitlock, Elliot L Dimberg, Duygu Selcen, Devon I Rubin
Introduction Eosinophilic fasciitis (EF) is a rare disorder that can present with muscle symptoms that mimic other neuromuscular diseases. Methods We report a 43-year-old woman with chronic muscle aches, tightness, and stiffness with hypertrophied, well-defined muscles despite physical inactivity, and thickened skin with reduced elasticity and discoloration. Results Except for mild peripheral eosinophilia, laboratory studies, including blood count, electrolytes, paraneoplastic panel, muscle enzymes, thyroid function, and serum protein electrophoresis were normal...
November 22, 2016: Muscle & Nerve
https://www.readbyqxmd.com/read/27875096/paraesophageal-hernia-repair-techniques-for-success
#15
Tyler D Cohn, Nathaniel J Soper
With the introduction of laparoscopy, the outcomes of patients undergoing paraesophageal hernia repair have improved dramatically. When the fundamentals of a proper repair are followed, patients can expect to have improvement in gastroesophageal reflux symptoms, including heartburn, regurgitation, chest pain, dysphagia, and dyspnea. Adhering to these principles will alleviate patients' symptoms and avoid reoperation. This article describes the approach to paraesophageal hernia repair, including patient evaluation, operative technique, and postoperative management...
November 22, 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/27871590/does-nitrous-oxide-labor-analgesia-influence-the-pattern-of-neuraxial-analgesia-usage-an-impact-study-at-an-academic-medical-center
#16
Lesley E Bobb, Michaela K Farber, Catherine McGovern, William Camann
STUDY OBJECTIVE: To compare the rate of epidural use before and after the implementation of nitrous oxide (N2O). DESIGN: Data were obtained from a nursing database of N2O usage and our obstetric anesthesia database. We compared 8 months before and 8 months after the introduction of N2O. It was available 24 h/d, 7 d/wk, consistent with neuraxial analgesia availability. Epidural utilization before and after introduction of N2O was compared using χ(2) analysis. SETTING: Labor and delivery floor...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27869488/a-randomised-controlled-trial-assessing-the-efficacy-of-co-phenylcaine-nasal-spray-in-flexible-transnasal-pharyngolaryngoscopy
#17
F Javed, A Parmar, A Hussain, D Hajioff, D Pinder
INTRODUCTION The aim of this study was to assess whether using co-phenylcaine nasal spray before flexible transnasal pharyngolaryngoscopy results in reduced pain and discomfort during the procedure. METHODS This was a randomised controlled trial. Eighty-four patients were randomised to receive either co-phenylcaine nasal spray or placebo nasal spray before performing transnasal flexible pharyngolaryngoscopy. Patient reported outcome measures included pain, discomfort, unpleasantness and willingness to repeat the procedure while clinician reported outcome measures comprised ease of examination and quality of view obtained during the procedure...
November 21, 2016: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/27865087/-pain-management-in-patients-of-a-swiss-institute-of-oncology-and-the-role-of-nurses-from-programs-to-reality
#18
Dario Valcarengi, Carla Pedrazzani, Paola Di Giulio, Laura Moser, Monica Bianchi
INTRODUCTION: In 2004, the Oncology Institute of Southern Switzerland (IOSI) started a program to improve cancer pain treatment, through training of health professionals and the introduction of monitoring tools . AIM: The aim is to evaluate patient relief from pain (effective pain control), with attention to nursing role (pain assessment, monitoring and documentation). METHOD: Retrospective study. The health records of patients admitted in the last three months of 2010 were consulted to evaluate how pain was assessed and managed...
June 2016: Professioni Infermieristiche
https://www.readbyqxmd.com/read/27862689/applying-lean-six-sigma-methodology-to-reduce-cesarean-section-rate
#19
Ze-Ying Chai, Hua-Min Hu, Xiu-Ling Ren, Bao-Jin Zeng, Ling-Zhi Zheng, Feng Qi
OBJECTIVES: This study aims to reduce cesarean section rate and increase rate of vaginal delivery. METHODS: By using Lean Six Sigma (LSS) methodology, the cesarean section rate was investigated and analyzed through a 5-phase roadmap consisting of Define, Measure, Analyze, Improve, and Control. The principal causes of cesarean section were identified, improvement measures were implemented, and the rate of cesarean section before and after intervention was compared...
November 14, 2016: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/27861787/tropical-fish-community-does-not-recover-45-years-after-predator-introduction
#20
D M T Sharpe, L F De León, R Gonzalez, M E Torchin
Predation is considered an important factor structuring natural communities. However, it is often difficult to determine how it may influence long-term, broad-scale diversity patterns, particularly in diverse tropical systems. Biological introductions can provide powerful insight to test the sustained consequences of predation in natural communities, if pre-introduction data are available. Half a century ago, Zaret and Paine (1973) demonstrated strong and immediate community-level effects following the introduction of a novel apex predator (peacock bass, Cichla monoculus) into Lake Gatun, Panama...
November 11, 2016: Ecology
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