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https://www.readbyqxmd.com/read/28732219/perioperative-systemic-corticosteroids-in-orthognathic-surgery-a-systematic-review-and-meta-analysis
#1
REVIEW
Simon Jean, Pierre-Luc Dionne, Carl Bouchard, Luc Giasson, Alexis F Turgeon
PURPOSE: Perioperative systemic corticosteroids are broadly used in orthognathic surgery to prevent postoperative complications, but it is unclear whether this practice is beneficial and concerns about potential side effects have been raised. The purpose of this systematic review and meta-analysis was to assess the effects of perioperative systemic corticosteroids on clinically important outcomes in patients undergoing orthognathic surgery. MATERIALS AND METHODS: The authors conducted a systematic review of randomized controlled trials evaluating the effect of systemic corticosteroids in orthognathic surgery compared with placebo or any other intervention...
June 24, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28731912/assessing-infant-and-maternal-readiness-for-newborn-discharge
#2
Ling Jing, Casidhe-Nicole Bethancourt, Thomas McDonagh
PURPOSE OF REVIEW: The review highlights the shift from prescribed length of stay (LOS) to mother-infant dyad readiness as the basis for making discharge decisions for healthy term newborns. We describe the components of readiness that should be considered in making the decision, focusing on infant clinical readiness, and maternal and familial readiness. RECENT FINDINGS: Although the Newborns' and Mothers' Health Protection Act of 1996 aimed to protect infants and mothers by establishing a minimum LOS, the American Academy of Pediatrics 2015 policy on newborn discharge acknowledges the shift from LOS-based to readiness-based discharge decision-making...
July 20, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28731843/telemedicine-use-decreases-rural-emergency-department-length-of-stay-for-transferred-north-dakota-trauma-patients
#3
Nicholas M Mohr, J Priyanka Vakkalanka, Karisa K Harland, Amanda Bell, Brian Skow, Dan M Shane, Marcia M Ward
BACKGROUND: Telemedicine has been proposed as one strategy to improve local trauma care and decrease disparities between rural and urban trauma outcomes. OBJECTIVES: This study was conducted to describe the effect of telemedicine on management and clinical outcomes for trauma patients in North Dakota. METHODS: Cohort study of adult (age ≥18 years) trauma patients treated in North Dakota Critical Access Hospital (CAH) Emergency Departments (EDs) from 2008 to 2014...
July 21, 2017: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/28731404/jackson-pratt-drainage-in-pediatric-craniofacial-reconstructive-surgery-is-it-helping-or-hurting
#4
Kumar Vasudevan, Ahyuda Oh, R Shane Tubbs, David Garcia, Andrew Reisner, Joshua J Chern
OBJECTIVE Jackson-Pratt drains (JPDs) are commonly employed in pediatric craniofacial reconstructive surgery (CRFS) to reduce postoperative wound complications, but their risk profile remains unknown. Perioperative blood loss and volume shifts are major risks of CFRS. The goal of this study was to evaluate the risks of JPD usage in CFRS, particularly with regard to perioperative blood loss, hyponatremia, intensive care unit (ICU) length of stay, and postoperative wound complications. METHODS The authors performed a retrospective review of data obtained in pediatric patients who underwent CFRS at a single institution, as performed by multiple surgeons between January 2010 and December 2014...
July 21, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28730986/long-term-use-of-left-ventricular-assist-devices-a-report-on-clinical-outcomes
#5
Sneha Raju, Jane MacIver, Farid Foroutan, Carolina Alba, Filio Billia, Vivek Rao
BACKGROUND: The literature examining clinical outcomes and readmissions during extended (> 1 yr) left ventricular assist device (LVAD) support is scarce, particularly in the era of continuous-flow LVADs. METHODS: We completed a retrospective cohort study on consecutive LVAD patients from June 2006 to March 2015, focusing on those who received more than 1 year of total LVAD support time. Demographic characteristics, clinical outcomes and readmissions were analyzed using standard statistical methods...
August 2017: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/28730896/cannabinoid-hyperemesis-syndrome-potential-mechanisms-for-the-benefit-of-capsaicin-and-hot-water-hydrotherapy-in-treatment
#6
John R Richards, Jeff M Lapoint, Guillermo Burillo-Putze
INTRODUCTION: Cannabinoid hyperemesis syndrome is a clinical disorder that has become more prevalent with increasing use of cannabis and synthetic cannabinoids, and which is difficult to treat. Standard antiemetics commonly fail to alleviate the severe nausea and vomiting characteristic of the syndrome. Curiously, cannabinoid hyperemesis syndrome patients often report dramatic relief of symptoms with hot showers and baths, and topical capsaicin. OBJECTIVES: In this review, we detail the pharmacokinetics and pharmacodynamics of capsaicin and explore possible mechanisms for its beneficial effect, including activation of transient receptor potential vanilloid 1 and neurohumoral regulation...
July 21, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28730691/effect-of-abrupt-discontinuation-of-antidepressants-in-critically-ill-hospitalized-adults
#7
Taryn B Bainum, David S Fike, Diana Mechelay, Krystal K Haase
OBJECTIVES: To determine whether discontinuation of chronic antidepressant therapy is associated with a higher risk of antidepressant discontinuation syndrome (ADS) symptoms in patients admitted to the intensive care unit (ICU) when compared with those who were continued on therapy and to identify factors associated with increased risk of ADS in this population. DESIGN: Single-center retrospective observational cohort study. SETTING: ICUs in a tertiary care hospital...
July 21, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28730555/intermittent-versus-continuous-renal-replacement-therapy-in-acute-methanol-poisoning-comparison-of-clinical-effectiveness-in-mass-poisoning-outbreaks
#8
Sergey Zakharov, Jan Rulisek, Olga Nurieva, Katerina Kotikova, Tomas Navratil, Martin Komarc, Daniela Pelclova, Knut Erik Hovda
BACKGROUND: Intermittent hemodialysis (IHD) is the modality of choice in the extracorporeal treatment (ECTR) of acute methanol poisoning. However, the comparative clinical effectiveness of intermittent versus continuous modalities (CRRT) is unknown. During an outbreak of mass methanol poisoning, we therefore studied the effect of IHD versus CRRT on mortality and the prevalence of visual/central nervous system (CNS) sequelae in survivors. METHODS: The study was designed as prospective observational cohort study...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28730536/effectiveness-and-feasibility-of-robotic-gastric-neurostimulator-placement-in-patients-with-refractory-gastroparesis
#9
Mia Mowzoon, Francisco Igor B Macedo, Jaskiran Kaur, Ramachandra Kolachalam
Gastric neurostimulation (GNS) with Enterra(®) therapy device (Medtronic, Minneapolis, MN) appears as the last resort for patients with refractory gastroparesis. Currently, the device has Humanitarian Use status by Food and Drug Administration, thereby requiring further investigation. We aim to describe its feasibility and clinical outcomes using robotic technique. From June 2014 to September 2016, 15 consecutive patients underwent robotic insertion of Enterra(®) device. Patient demographics, comorbidities, and clinical outcomes including mortality, length of stay, readmission rates, reoperation and complications were retrospectively collected...
July 20, 2017: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/28730398/prevalence-and-correlates-of-psychological-distress-and-psychiatric-disorders-in-asylum-seekers-and-refugees-resettled-in-an-italian-catchment-area
#10
Michela Nosè, Giulia Turrini, Maria Imoli, Francesca Ballette, Giovanni Ostuzzi, Francesca Cucchi, Chiara Padoan, Mirella Ruggeri, Corrado Barbui
In recent years there has been a progressive rise in the number of asylum seekers and refugees displaced from their country of origin, with significant social, economic, humanitarian and public health implications. The aim of this study is to describe the frequency and correlates of psychological distress and psychiatric disorders in asylum seekers and refugees resettled in an Italian catchment area. In the catchment area of Verona, all male asylum seekers and refugees aged 18 or above included in the Italian protection system for asylum seekers and refugees during a period of 1 year were screened for psychological distress and psychiatric disorders using validated questionnaires...
July 20, 2017: Journal of Immigrant and Minority Health
https://www.readbyqxmd.com/read/28730275/comparative-analysis-of-open-and-robotic-transversus-abdominis-release-for-ventral-hernia-repair
#11
James G Bittner, Sameer Alrefai, Michelle Vy, Micah Mabe, Paul A R Del Prado, Natasha L Clingempeel
BACKGROUND: Transversus abdominis release (TAR) is a safe, effective strategy to repair complex ventral incisional hernia (VIH); however, open TAR (o-TAR) often necessitates prolonged hospitalization. Robot-assisted TAR (r-TAR) may benefit short-term outcomes and shorten convalescence. This study compares 90-day outcomes of o-TAR and r-TAR for VIH repair. METHODS: A single-center, retrospective review of patients who underwent o-TAR or r-TAR for VIH from 2015 to 2016 was conducted...
July 20, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28729904/impact-of-a-sepsis-bundle-in-wards-of-a-tertiary-hospital
#12
F Teles, W G Rodrigues, M G T C Alves, C F T Albuquerque, S M O Bastos, M F A Mota, E S Mota, F J L Silva
BACKGROUND: Sepsis is a prevalent disease worldwide and still exhibits high rates of mortality. In the last years, many interventions aiming a positive impact on sepsis evolution have been studied. One of the main is the use of managed care protocols (sepsis bundles), which consist in systematization of diagnosis and treatment, such as standardization of antibiotics, collection of specific tests (cultures, lactate), and fluid replacement. Some studies have shown a reduction in hospital costs and lower mortality with the use of these tools...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28729473/automatic-versus-manual-oxygen-administration-in-the-emergency-department
#13
Erwan L'Her, Patricia Dias, Maelenn Gouillou, Anne Riou, Luc Souquiere, Nicolas Paleiron, Patrick Archambault, Pierre-Alexandre Bouchard, François Lellouche
Oxygen is commonly administered in hospitals, with poor adherence to treatment recommendations.We conducted a multicentre randomised controlled study in patients admitted to the emergency department requiring O2 ≥3 L·min(-1) Patients were randomised to automated closed-loop or manual O2 titration during 3 h. Patients were stratified according to arterial carbon dioxide tension (PaCO2 ) (hypoxaemic PaCO2 ≤45 mmHg; or hypercapnic PaCO2 >45-≤55 mmHg) and study centre. Arterial oxygen saturation measured by pulse oximetry (SpO2 ) goals were 92-96% for hypoxaemic, or 88-92% for hypercapnic patients...
July 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/28729411/recognized-obstructive-sleep-apnea-is-associated-with-improved-in-hospital-outcomes-after-st-elevation-myocardial-infarction
#14
Divyanshu Mohananey, Pedro A Villablanca, Tanush Gupta, Sahil Agrawal, Michael Faulx, Venugopal Menon, Samir R Kapadia, Brian P Griffin, Stephen G Ellis, Milind Y Desai
BACKGROUND: Obstructive sleep apnea (OSA) is an independent risk factor for many cardiovascular conditions such as coronary artery disease, myocardial infarction, systemic hypertension, pulmonary hypertension, and stroke. However, the association of OSA with outcomes in patients hospitalized for ST-elevation myocardial infarction remains controversial. METHODS AND RESULTS: We used the nation-wide inpatient sample between 2003 and 2011 to identify patients with a primary discharge diagnosis of ST-elevation myocardial infarction and then used the International Classification of Diseases, Clinical Modification code 327...
July 20, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28729329/fluids-in-sepsis-and-septic-shock-fissh-protocol-for-a-pilot-randomised-controlled-trial
#15
Bram Rochwerg, Tina Millen, Peggy Austin, Michelle Zeller, Frédérick D'Aragon, Roman Jaeschke, Marie-Hélène Masse, Sangeeta Mehta, Francois Lamontagne, Maureen Meade, Gordon Guyatt, Deborah J Cook
INTRODUCTION: Observational evidence suggests physiological benefits and lower mortality with lower chloride solutions; however, 0.9% saline remains the most widely used fluid worldwide. Given uncertainty regarding the association of lower chloride on mortality, it is unlikely that practice will change without direct randomised clinical trial (RCT) evidence. This pilot RCT will investigate the feasibility of a large-scale trial directly comparing low chloride with high chloride fluids in patients with septic shock...
July 20, 2017: BMJ Open
https://www.readbyqxmd.com/read/28729323/gait-outcomes-of-older-adults-receiving-subacute-hospital-rehabilitation-following-orthopaedic-trauma-a-longitudinal-cohort-study
#16
Saira A Mathew, Paul Varghese, Suzanne S Kuys, Kristiann C Heesch, Steven M McPhail
OBJECTIVES: This study aimed to describe gait speed at admission and discharge from inpatient hospital rehabilitation among older adults recovering from orthopaedic trauma and factors associated with gait speed performance and discharge destination. DESIGN: A longitudinal cohort study was conducted. SETTING: Australian tertiary hospital subacute rehabilitation wards. PARTICIPANTS: Patients aged ≥60 years recovering from orthopaedic trauma (n=746, 71% female) were eligible for inclusion...
July 20, 2017: BMJ Open
https://www.readbyqxmd.com/read/28729306/hospital-variation-in-allogeneic-transfusion-and-extended-length-of-stay-in-primary-elective-hip-and-knee-arthroplasty-a-cross-sectional-study
#17
Veronique M A Voorn, Perla J Marang-van de Mheen, Anja van der Hout, Cynthia So-Osman, M Elske van den Akker-van Marle, Ankie W M M Koopman-van Gemert, Albert Dahan, Thea P M Vliet Vlieland, Rob G H H Nelissen, Leti van Bodegom-Vos
OBJECTIVES: Outcomes in total hip and knee arthroplasty (THA and TKA), such as allogeneic transfusions or extended length of stay (LoS), can be used to compare the performance of hospitals. However, there is much variation in these outcomes. This study aims to rank hospitals and to assess hospital differences of two outcomes in THA and TKA: allogeneic transfusions and extended LoS, and to additionally identify factors associated with these differences. DESIGN: Cross-sectional medical record review study...
July 20, 2017: BMJ Open
https://www.readbyqxmd.com/read/28729305/biomechanical-reposition-techniques-in-anterior-shoulder-dislocation-a-randomised-multicentre-clinical-trial-the-brasd-trial-protocol
#18
David N Baden, Martijn H Roetman, Tom Boeije, Floris Roodheuvel, Nieke Mullaart-Jansen, Suzanne Peeters, Mike D Burg
INTRODUCTION: Glenohumeral (shoulder) dislocations are the most common large joint dislocations seen in the emergency department (ED). They cause pain, often severe, and require timely interventions to minimise discomfort and tissue damage. Commonly used reposition or relocation techniques often involve traction and/or leverage. These techniques have high success rates but may be painful and time consuming. They may also cause complications. Recently, other techniques-the biomechanical reposition techniques (BRTs)-have become more popular since they may cause less pain, require less time and cause fewer complications...
July 20, 2017: BMJ Open
https://www.readbyqxmd.com/read/28729005/influence-of-late-fluid-management-on-the-outcomes-of-severe-trauma-patients-a-retrospective-analysis-of-294-severely-injured-patients
#19
Mehdi Mezidi, Mehdi Ould-Chikh, Pauline Deras, Camille Maury, Orianne Martinez, Xavier Capdevila, Jonathan Charbit
BACKGROUND: Liberal late fluid management (LFM) is associated with higher morbi-mortality in critically ill populations. The aim of the study was to assess the association between LFM and duration of mechanical ventilation in a severe trauma population. METHODS: A retrospective analysis of consecutive patients with an ISS≥16 and a length of stay in the intensive care unit (ICU)≥7 days was performed. The conservative LFM group included patients with at least 2 consecutive days with a negative fluid balance between day 3 and day 7; other patients were allocated to the liberal LFM group...
June 15, 2017: Injury
https://www.readbyqxmd.com/read/28728984/operative-versus-non-operative-management-of-adhesive-small-bowel-obstruction-a-systematic-review-and-meta-analysis
#20
REVIEW
Shahab Hajibandeh, Shahin Hajibandeh, Nilanjan Panda, Asaf Khan, Samik Kumar Bandyopadhyay, Sanjay Dalmia, Sohail Malik, Zahirul Huq, Moustafa Mansour
OBJECTIVES: To investigate outcomes of operative and non-operative management of adhesive small bowel obstruction (SBO). METHODS: We performed a systematic review in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement standards. We conducted a search of electronic information sources to identify all randomised controlled trials (RCTs) and observational studies investigating outcomes of operative versus non-operative management of patients with adhesive SBO...
July 17, 2017: International Journal of Surgery
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