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https://www.readbyqxmd.com/read/28749037/transfusion-for-sickle-cell-disease-in-pregnancy-a-single-centre-survey
#1
J Sharif, L Byrd, K Stevenson, J Raddats, E Morsman, K Ryan
INTRODUCTION: Sickle cell disease in pregnancy carries a high risk of maternal and fetal adverse outcomes. The use of prophylactic transfusions to reduce the risk of sickle complications is controversial. Current UK standards do not recommend the routine use of transfusion for sickle pregnancy. We examined transfusion episodes during sickle pregnancies in a single centre over an 11-year period. METHODS: We conducted a retrospective observational study of all pregnancies in patients with sickle cell disease who attended the joint obstetric/haematology clinic over an 11-year period...
July 27, 2017: Transfusion Medicine
https://www.readbyqxmd.com/read/28743315/tight-intra-operative-blood-pressure-control-versus-standard-care-for-patients-undergoing-hip-fracture-repair-hip-fracture-intervention-study-for-prevention-of-hypotension-hip-hop-trial-study-protocol-for-a-randomised-controlled-trial
#2
Iain Keith Moppett, Stuart White, Richard Griffiths, Donal Buggy
BACKGROUND: Hypotension during anaesthesia for hip fracture surgery is common. Recent data suggest that there is an association between the lowest intra-operative blood pressure and mortality, even when adjusted for co-morbidities. This is consistent with data derived from the wider surgical population, where magnitude and duration of hypotension are associated with mortality and peri-operative complications. However, there are no trial to data to support more aggressive blood pressure control...
July 25, 2017: Trials
https://www.readbyqxmd.com/read/28743257/longer-travel-time-to-district-hospital-worsens-neonatal-outcomes-a-retrospective-cross-sectional-study-of-the-effect-of-delays-in-receiving-emergency-cesarean-section-in-rwanda
#3
Joseph Niyitegeka, Georges Nshimirimana, Allison Silverstein, Jackline Odhiambo, Yihan Lin, Theoneste Nkurunziza, Robert Riviello, Stephen Rulisa, Paulin Banguti, Hema Magge, Martin Macharia, Regis Habimana, Bethany Hedt-Gauthier
BACKGROUND: In low-resource settings, access to emergency cesarean section is associated with various delays leading to poor neonatal outcomes. In this study, we described the delays a mother faces when needing emergency cesarean delivery and assessed the effect of these delays on neonatal outcomes in Rwanda. METHODS: This retrospective study included 441 neonates and their mothers who underwent emergency cesarean section in 2015 at three district hospitals in Rwanda...
July 25, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28742643/sensitive-troponin-i-and-stress-testing-in-the-emergency-department-for-the-early-management-of-chest-pain-using-2-hour-protocol
#4
Shahriar Dadkhah, Zakaria Almuwaqqat, Samian Sulaiman, Husein Husein, Quang Nguyen, Saad Ali, Tuncay Taskesen
BACKGROUND: Despite improvements in identifying high-risk patients with non-ST segment ACS (acute coronary syndrome), low risk patients presenting with atypical chest pain and non-diagnostic Electrocardiogram (ECG) continued to undergo unnecessary admissions and testing. Since 1992, our chest pain protocol included using 4-hour serial biomarkers from ED admission in combination with stress testing to evaluate these patients. Our study aimed at determining whether a new accelerated diagnostic protocol using sensitive cardiac troponin I (cTnI) 2 hours after admission to the ED followed by stress testing is safe and effective in emergency settings, allowing for appropriate triage, earlier discharge and reducing costs...
September 2017: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/28737073/bleeding-pelvic-fracture-patients-evolution-of-resuscitation-protocols
#5
T Söderlund, T Ketonen, L Handolin
BACKGROUND AND AIMS: Massive transfusion protocol seems to improve outcome in massively bleeding trauma patients, but not pelvic fracture patients. The aim of this study was to evaluate the effect of massive transfusion protocol on the mortality and fluid resuscitation of shocked pelvic fracture patients. MATERIAL AND METHODS: This is a trauma register study from a single hospital. From the trauma registry patients with pelvic fracture, injury severity score >15, admission base excess below -5, age >15 years, blunt trauma, and primary admission from the scene were identified...
March 1, 2017: Scandinavian Journal of Surgery: SJS
https://www.readbyqxmd.com/read/28733686/comparison-of-the-proportion-and-healthcare-utilisation-of-adult-patients-with-uncontrolled-severe-asthma-versus-non-severe-asthma-seen-in-a-southeast-asian-hospital-based-respiratory-specialist-clinic
#6
Tunn Ren Tay, Hang Siang Wong, Rosna Ihsan, Hsiao Peng Toh, Xuening Choo, Augustine Kh Tee
INTRODUCTION: Understanding the burden of uncontrolled severe asthma is essential for disease-targeted healthcare planning. There is a scarcity of data regarding the proportion, healthcare utilisation and costs of patients with uncontrolled severe asthma in Asia. This study aimed to plug the knowledge gap in this area. MATERIALS AND METHODS: Consecutive patients with asthma managed in our respiratory specialist clinic were evaluated prospectively. Healthcare utilisation comprising unscheduled asthma-related primary care visits, emergency department (ED) visits and hospital admissions were obtained from the national health records system...
June 2017: Annals of the Academy of Medicine, Singapore
https://www.readbyqxmd.com/read/28729905/an69st-membranes-adsorb-nafamostat-mesylate-and-affect-the-management-of-anticoagulant-therapy-a-retrospective-study
#7
Takahiro Hirayama, Nobuyuki Nosaka, Yasumasa Okawa, Soichiro Ushio, Yoshihisa Kitamura, Toshiaki Sendo, Toyomu Ugawa, Atsunori Nakao
BACKGROUND: In Japan, nafamostat mesylate (NM) is frequently used as an anticoagulant during continuous renal replacement therapy (CRRT). The dialyzer membrane AN69ST has been reported to adsorb NM and affect the management of anticoagulant therapy. However, the adsorbed amount has not yet been quantitatively assessed. Therefore, in this study, we evaluated the pre- and post-hemofilter prolongation of the activated clotting time (ACT) in patients with AN69ST and PS membranes. We also measured the adsorption of NM in three types of CRRT membranes using an experimental model...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28728804/pharmacy-technician-self-efficacies-insight-to-aid-future-education-staff-development-and-workforce-planning
#8
Shane P Desselle, Ryan Hoh, Erin R Holmes, Amanpreet Gill, Lemuel Zamora
BACKGROUND: The roles of pharmacy technicians are increasingly prominent given pharmacy's transition to patient-centered activities and evolving scopes of practice in many U.S. states and throughout the world. OBJECTIVES: The aims of this study were to assess U.S. pharmacy technicians' self-efficacies for and attitudes toward performing current and emerging roles in hospital and in community pharmacy and to identify factors related to pharmacy technician self-efficacies in these roles...
July 15, 2017: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/28727183/a-randomised-controlled-trial-on-a-nurse-led-smartphone-based-self-management-programme-for-patients-with-poorly-controlled-type-2-diabetes-a-study-protocol
#9
Wenru Wang, Betsy Seah, Ying Jiang, Violeta Lopez, Cherry Tan, Suan Tee Lim, Hongliang Ren, Yin Hao Khoo
AIM: To develop and compare a nurse-led smartphone-based self-management programme with an existing nurse-led diabetes service on health-related outcomes for patients with poorly controlled type 2 diabetes in Singapore. BACKGROUND: Over the past decades, Asia has emerged as the 'diabetes epicentre' in the world due to rapid economic development, urbanisation and nutrition transition. There is an urgent need to develop more effective care management strategies in response to this rising diabetes epidemic...
July 20, 2017: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/28727180/why-was-a-local-anaesthetic-used-before-administering-intranasal-ketamine-for-paediatric-injuries
#10
Sabine Lemoine, Daniel Jost, Kilian Bertho, Jean Pierre Tourtier
We were very interested to read Scheier et al's brief report on the use of intranasal ketamine in their pediatric emergency department, specifically for pain and anxiety in children who had resisted venipuncture or intravenous placement (1). Intravenous access can be difficult for pre-hospital medical teams that are not specialised in paediatric care, namely when children complain of pain from, for example suspected fractures and burns. This article is protected by copyright. All rights reserved.
July 20, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28726526/integrated-care-coordination-by-an-interprofessional-team-reduces-emergency-department-visits-and-hospitalisations-at-an-academic-health-centre
#11
Anne H Gaglioti, Patrick Barlow, Kate DuChene Thoma, George R Bergus
People with chronic behavioural and physical health conditions have higher healthcare costs and mortality rates than patients with chronic physical conditions alone. As a result, there has been promotion of integrated care for this group. It is important to train primary care residents to practice in integrated models of care with interprofessional teams and to evaluate the effectiveness of integrated care models to promote high-quality care for this at-risk group. We implemented an integrated, interprofessional care management programme for adults with chronic mental and physical health needs as part of a curriculum for family medicine and family medicine psychiatry residents...
July 20, 2017: Journal of Interprofessional Care
https://www.readbyqxmd.com/read/28721570/task-shifting-the-use-of-laypersons-for-acquisition-of-vital-signs-data-for-clinical-decision-making-in-the-emergency-room-following-traumatic-injury
#12
Bryce E Haac, Jared R Gallaher, Charles Mabedi, Andrew J Geyer, Anthony G Charles
IMPORTANCE: In resource-limited settings, identification of successful and sustainable task-shifting interventions is important for improving care. OBJECTIVE: To determine whether the training of lay people to take vital signs as trauma clerks is an effective and sustainable method to increase availability of vital signs in the initial evaluation of trauma patients. DESIGN: We conducted a quasi-experimental study of patients presenting with traumatic injury pre- and post-intervention...
July 18, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28721327/two-catastrophes-in-one-patient-drug-reaction-with-eosinophilia-and-systemic-symptoms-and-toxic-shock-syndrome
#13
Moayed Ibrahim, Diana L Nunley
A 70-year-old, immunocompromised patient presented to the emergency room (ER) five weeks after she was started on clopidogrel. She complained of skin eruption, mouth ulcers, fatigue, and myalgia over the past two weeks. Labs showed severe hyponatremia, acute kidney injury, rhabdomyolysis, hyperkalemia, and elevated liver enzymes. She was treated with steroids and discharged after her condition improved. However, a month later, she returned to the ER, complaining of nausea, vomiting, diarrhea, dizziness, chills, and shortness of breath over the past two days...
June 15, 2017: Curēus
https://www.readbyqxmd.com/read/28721026/a-community-virtual-ward-model-to-support-older-persons-with-complex-health-care-and-social-care-needs
#14
C Lewis, Z Moore, F Doyle, A Martin, D Patton, L E Nugent
BACKGROUND: Globally the older population is increasing rapidly. As a result there is an increase in frail older persons living within the community, with increased risks of a hospital admission and higher mortality and morbidity rates. Due to complexity of care, health care professionals face challenges in providing effective case management and avoiding unplanned admissions to hospital. A community virtual ward (CVW) model was developed to assist health care professionals to support older persons at home during periods of illness and/or functional decline...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/28719229/experiences-using-pre-exposure-prophylaxis-for-safer-conception-among-hiv-serodiscordant-heterosexual-couples-in-the-united-states
#15
Angela R Bazzi, Ashley A Leech, Dea L Biancarelli, Meg Sullivan, Mari-Lynn Drainoni
Antiretroviral pre-exposure prophylaxis (PrEP) is a promising HIV prevention strategy for HIV serodiscordant couples (HIV-infected male, uninfected female) seeking safer conception. However, most research on PrEP for safer conception has focused on couples in sub-Saharan Africa; little is known about the perspectives or experiences of heterosexual couples in the United States. We conducted qualitative interviews with six couples (six women and five of their male partners) receiving PrEP for conception services at an urban safety net hospital in the US Northeast...
July 18, 2017: AIDS Patient Care and STDs
https://www.readbyqxmd.com/read/28717904/a-description-of-deaths-following-emergency-abdominal-surgery
#16
Henrik Wolsted, Ann Merete Møller, Mai-Britt Tolstrup, Morten Vester-Andersen
OBJECTIVE: Emergency major abdominal surgery carries a high mortality rate. The aim of this present study was to characterize a population of deceased abdominal surgical patients, to examine how many died unexpectedly and how many were subject to treatment limitations. MATERIALS AND METHODS: We included adult emergency abdominal surgical patients who died within 30 days postoperatively. We collected data from January 1, 2013, to December 31, 2014, in a Danish tertiary care hospital (Herlev)...
July 17, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28717775/impact-of-early-coronary-angiography-on-the-survival-to-discharge-after-out-of-hospital-cardiac-arrest
#17
Jikyoung Shin, Eunsil Ko, Won Chul Cha, Tae Rim Lee, Hee Yoon, Sung Yeon Hwang, Tae Gun Shin, Min Seob Sim, Ik Joon Jo, Keun Jeong Song, Joong Eui Rhee, Yeon Kwon Jeong, Jin-Ho Choi
OBJECTIVE: Acute myocardial infarction is a major cause of out-of-hospital cardiac arrest (OHCA). Coronary angiography (CAG) enables diagnostic confirmation of coronary artery disease and subsequent revascularization, which might improve the prognosis of OHCA survivors. Non-randomized data has shown a favorable impact of CAG on prognosis for this population. However, the optimal timing of CAG has been debated. METHODS: The clinical outcomes of 607 OHCA patients registered in CAPTURES (Cardiac Arrest Pursuit Trial with Unique Registration and Epidemiologic Surveillance), a nationwide multicenter registry performed in 27 hospitals, were analyzed...
June 2017: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/28716784/protocol-for-a-prospective-observational-study-to-improve-prehospital-notification-of-injured-patients-presenting-to-trauma-centres-in-india
#18
Biswadev Mitra, Joseph Mathew, Amit Gupta, Peter Cameron, Gerard O'Reilly, Kapil Dev Soni, Gaurav Kaushik, Teresa Howard, Madonna Fahey, Michael Stephenson, Vineet Kumar, Sharad Vyas, Satish Dharap, Pankaj Patel, Advait Thakor, Naveen Sharma, Tony Walker, Mahesh Chandra Misra, Russell Gruen, Mark Fitzgerald
INTRODUCTION: Prehospital notification of injured patients enables prompt and timely care in hospital through adequate preparation of trauma teams, space, equipment and consumables necessary for resuscitation, and may improve outcomes. In India, anecdotal reports suggest that prehospital notification, in those few places where it occurs, is unstructured and not linked to a well-defined hospital response. The aim of this manuscript is to describe, in detail, a study protocol for the evaluation of a formalised approach to prehospital notification...
July 17, 2017: BMJ Open
https://www.readbyqxmd.com/read/28716643/reduced-risk-of-acute-exacerbation-of-chronic-obstructive-pulmonary-disease-after-bariatric-surgery-a-self-controlled-case-series-study
#19
Tadahiro Goto, Yusuke Tsugawa, Mohammad Kamal Faridi, Carlos A Camargo, Kohei Hasegawa
BACKGROUND: Obesity is common among individuals with chronic obstructive pulmonary disease (COPD) and associated with increased COPD morbidities. However, little is known about the impact of weight reduction on COPD-related outcomes in obese patients. METHODS: Using the population-based emergency department (ED) and inpatient sample in three U.S. states (California, Florida, and Nebraska), we performed a self-controlled case series study of 481 obese adults (aged 40-65 years) with COPD who underwent bariatric surgery...
July 14, 2017: Chest
https://www.readbyqxmd.com/read/28713660/a-cross-sectional-pharmacoepidemiological-study-of-the-utilization-pattern-of-pre-anesthetic-medications-in-major-surgical-procedures-in-a-tertiary-care-hospital
#20
Madhuri Kulkarni, Anant Patil
OBJECTIVE : A study of the utilization pattern of pre-anesthetic medications in major surgical procedures. MATERIAL AND METHODS : A cross-sectional, pharmacoepidemiological study was conducted among patients undergoing surgical procedures in routine or emergency conditions under general anesthesia. The utilization of pre-anesthetic medicines in all patients was reported. RESULTS: A total of 110 patients (mean age - 42.36 years; 57.27% males) were enrolled...
June 13, 2017: Curēus
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