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https://www.readbyqxmd.com/read/28905212/hub-and-spoke-stroke-network-in-the-veneto-region-a-retrospective-study-investigating-the-effectiveness-of-the-stroke-pathway-and-trends-over-time
#1
L Nardetto, B Giometto, G Moretto, D Mantoan, M Saia
After recognizing the pivotal role played by stroke unit (SU) admission in reducing mortality and dependency in stroke patients, the need to organize and monitor stroke networks has become an increasingly essential aspect of stroke care. We conducted a retrospective study of stroke patients admitted to hospitals in the Veneto region from 2007 to 2015 in order to evaluate the effectiveness of the stroke pathway and trends over time. Between 2007 and 2015, 61,062 stroke patients were discharged from Veneto hospitals: they were more frequently female, females were older than males, and had higher intrahospital mortality and a lower probability of undergoing systemic thrombolysis...
September 13, 2017: Neurological Sciences
https://www.readbyqxmd.com/read/28900664/-prehospital-care-for-stroke-patients
#2
REVIEW
C H Nolte, H J Audebert
The effectiveness of thrombolysis or mechanical recanalization for acute stroke is higher, the sooner these therapies are started. Therefore, acute stroke patients need to be evaluated by qualified staff for these therapies as soon as possible. Lay persons need to identify the typical symptoms of stroke as an emergency and act accordingly by calling the emergency medical system (EMS). The EMS team reassesses the symptoms and prompts cerebral imaging. Cerebral imaging is performed ideally in hospitals with a stroke unit where subsequent (stroke) treatments occur...
September 12, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28892306/effect-of-locally-tailored-labour-management-guidelines-on-intrahospital-stillbirths-and-birth-asphyxia-at-the-referral-hospital-of-zanzibar-a-quasi-experimental-pre-post-study-the-partoma-study
#3
Nanna Maaløe, Natasha Housseine, Tarek Meguid, Birgitte Bruun Nielsen, Aksel Karl Georg Jensen, Rashid Saleh Khamis, Ali Gharib Mohamed, Mbweni Makame Ali, Said Mzee Said, Jos van Roosmalen, Ib Christian Bygbjerg
OBJECTIVE: To evaluate effect of locally-tailored labour management guidelines (PartoMa guidelines) on intrahospital stillbirths and birth asphyxia. DESIGN: Quasi-experimental pre-post-study investigating the causal pathway through changes in clinical practice. SETTING: Tanzanian low-resource referral hospital, Mnazi Mmoja Hospital. POPULATION: Facility deliveries during baseline (1(st) October 2014 till 31(st) January 2015) and the ninth till twelfth intervention month (1(st) October 2015 till 31(st) January 2016)...
September 11, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28869634/the-effects-of-an-early-intrahospital-rehabilitation-on-weight-bearing-during-lower-extremity-lengthening-with-ilizarov-method
#4
Grzegorz Konieczny, Piotr Morasiewicz, Natalia Kuciel
PURPOSE: Exerting axial pressure on the affected lower limb remains one of the most crucial elements of Ilizarov method. The objective was to determine the effects of an early intrahospital rehabilitation on weight bearing during lower extremity lengthening with Ilizarov method. METHODS: The study included 15 patients who underwent lower limb lengthening. The patients were tested on the third day after surgery using the pedobarographic platform. The tests were performed four times in the standing position: twice with the support of forearm crutches and twice without crutches...
2017: Acta of Bioengineering and Biomechanics
https://www.readbyqxmd.com/read/28839885/emergency-general-surgery-hot-clinics-reduce-admission-rates-and-duration-of-inpatient-stay
#5
Francesca Th'ng, Christos Skouras, Alice Paterson-Brown, Rajan Ravindran, Peter Lamb, Andrew de Beaux, Simon Paterson-Brown, Damian J Mole
OBJECTIVE: To determine the impact of a 'Hot Clinic' (HC) on emergency general surgery patient flow-through. DESIGN: Prospective service evaluation study. SETTING: HC is a four-bedded area coordinated by a specialist nurse. The HC consultant sees emergency patients referred from the emergency department, general practitioners or those in preceding 24 h considered suitable for interim discharge while awaiting investigations and HC reassessment...
January 2017: Frontline Gastroenterology
https://www.readbyqxmd.com/read/28831517/-terrorist-attack-trauma-an-individual-entity-of-polytrauma-a-10-year-update
#6
REVIEW
C Güsgen, A Franke, S Hentsch, E Kollig, R Schwab
The incidence of terrorist attacks is increasing worldwide, and they have also become a permanent threat in European cities. Due to its complexity, terrorist attack trauma places high demands on the strategy of surgical treatment. The combination of various mechanisms, explosions and gunshot injuries, with the characteristic pressure (blast) damage and a high proportion of penetrating trauma with simultaneous burns are characteristic features. Unlike in military conflicts, injuries to people of all ages and without ballistic body protection (body armor) are to be expected...
August 22, 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/28807696/a-tailored-intervention-to-improving-the-quality-of-intrahospital-nursing-handover
#7
Jochen Bergs, Frank Lambrechts, Ines Mulleneers, Kim Lenaerts, Caroline Hauquier, Geert Proesmans, Sarah Creemers, Dominique Vandijck
INTRODUCTION: Nursing handover is a process central to the delivery of high-quality and safe care. We aimed to improve the quality of nursing handover from the emergency department to ward and intensive care unit (ICU). METHODS: A quasi-experimental non-equivalent control group pre-test - post-test design was applied. Handover quality was measured using the Handover Evaluation Scale (HES). A tailored intervention, inspired by appreciative inquiry, was designed to improve the implementation of an existing handover form and procedure...
August 11, 2017: International Emergency Nursing
https://www.readbyqxmd.com/read/28719478/a-review-of-nonfatal-drowning-in-the-pediatric-age-group-a-10-year-experience-at-a-university-hospital-in-saudi-arabia
#8
Faisal O Al-Qurashi, Abdullah A Yousef, Abdullah Aljoudi, Saleh M Alzahrani, Nasser Y Al-Jawder, Abdulrahman K Al-Ahmar, Mosab S Al-Majed, Hussam M Abouollo
OBJECTIVE: The aim of this study was to evaluate the nonfatal drowning experience, risk factors, intrahospital assessment and postincidental outcomes for children admitted to King Fahd Hospital of the University, AlKhobar, Saudi Arabia, over a 10-year period. METHODS: Children up to the age of 14 years who were admitted with the diagnosis of nonfatal drowning from July 2005 to June 2015 were included. Data regarding demographics, timing, season and location of drowning, presence of an assigned lifeguard, duration of submersion and transport to hospital, cardiopulmonary resuscitation, initial Glasgow Coma Scale, temperature, pH, blood sugar level, total hospital stay, and discharge status were extrapolated, and their effects on the patient's outcome analyzed...
July 17, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28694343/non-withdrawal-of-beta-blockers-in-acute-decompensated-chronic-and-de-novo-heart-failure-with-reduced-ejection-fraction-in-a-prospective-multicentre-study-of-patients-with-acute-heart-failure-in-the-middle-east
#9
Charbel Abi Khalil, Kadhim Sulaiman, Ziyad Mahfoud, Rajvir Singh, Nidal Asaad, Khalid F AlHabib, Alawi Alsheikh-Ali, Mohammed Al-Jarallah, Bassam Bulbanat, Wael AlMahmeed, Mustafa Ridha, Nooshin Bazargani, Haitham Amin, Ahmed Al-Motarreb, Husam Al Faleh, Abdelfatah Elasfar, Prashanth Panduranga, Jassim Al Suwaidi
OBJECTIVES: Beta blockers reduce mortality in heart failure (HF). However, it is not clear whether they should be temporarily withdrawn during acute HF. DESIGN: Analysis of prospectively collected data. SETTING: The Gulf aCute heArt failuRe rEgistry is a prospective multicentre study of patients hospitalised with acute HF in seven Middle Eastern countries. PARTICIPANTS: 5005 patients with acute HF. OUTCOME MEASURES: We studied the effect of beta blockers non-withdrawal on intrahospital, 3-month and 12-month mortality and rehospitalisation for HF in patients with acute decompensated chronic heart failure (ADCHF) and acute de novo heart failure (ADNHF) and a left ventricular ejection fraction (LVEF) <40%...
July 9, 2017: BMJ Open
https://www.readbyqxmd.com/read/28660768/comparison-of-peri-and-post-procedural-complications-in-patients-undergoing-revascularisation-of-coronary-artery-multivessel-disease-by-coronary-artery-bypass-grafting-or-protected-percutaneous-coronary-intervention-with-the-impella-2-5-device
#10
Tobias Becher, Stefan Baumann, Frederik Eder, Simon Perschka, Dirk Loßnitzer, Christian Fastner, Michael Behnes, Christina Doesch, Martin Borggrefe, Ibrahim Akin
BACKGROUND: While coronary artery bypass grafting remains the standard treatment of complex multivessel coronary artery disease, the advent of peripheral ventricular assist devices has enhanced the safety of percutaneous coronary intervention. We therefore evaluated the safety in terms of inhospital outcome comparing protected high-risk percutaneous coronary intervention with the Impella 2.5 device and coronary artery bypass grafting in patients with complex multivessel coronary artery disease...
June 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28618404/prevalence-of-hyponatremia-and-its-associated-morbimortality-in-hospitalized-patients-receiving-parenteral-nutrition
#11
Emilia Gómez-Hoyos, Martín Cuesta, Nayade Del Prado-González, Pilar Matía, Natalia Pérez-Ferre, Daniel Antonio De Luis, Alfonso Calle-Pascual, Miguel Ángel Rubio, Isabelle Runkle-De la Vega
BACKGROUND: The objective of the study was to determine the prevalence of hyponatremia (HN) and its associated morbimortality in hospitalized patients receiving parenteral nutrition (PN). METHODS: A retrospective study including 222 patients receiving total PN (parenteral nutrition group [PNG]) over a 7-month period in a tertiary hospital and 176 matched to 179 control subjects without PN (control subjects group [CSG]). Demographic data, Charlson Comorbidity Index (CCI), date of HN detection-(serum sodium or SNa <135 mmol/L)-intrahospital mortality, and hospital length-of-stay (LOS) were registered...
2017: Annals of Nutrition & Metabolism
https://www.readbyqxmd.com/read/28589019/provider-initiated-delivery-late-preterm-birth-and-perinatal-mortality-a-secondary-analysis-of-the-who-multicountry-survey-on-maternal-and-newborn-health
#12
Naho Morisaki, Xun Zhang, Togoobaatar Ganchimeg, Joshua P Vogel, Joo Paulo Dias Souza, Jose G Cecatti, Maria Regina Torloni, Erika Ota, Rintaro Mori, Suneeta Mittal, Suzanne Tough, Siobhan Dolan, Michael S Kramer
INTRODUCTION: In high-income countries, a reduced clinical threshold for obstetric interventions such as labour induction (LI) and prelabour caesarean delivery (PLCD) has played a substantial role in increasing rates of late preterm births. However, the association between provider-initiated delivery and perinatal outcomes have not been studied in a multicountry setting including low-income and middle-income countries. METHODS: 286 hospitals in 29 countries participated in the WHO Multi-Country Survey on Maternal and Newborn Health and yielded 2 52 198 singleton births of at least 34 weeks in 2010-2011...
March 2017: BMJ Global Health
https://www.readbyqxmd.com/read/28512170/deconstruction-of-interhospital-transfer-workflow-in-large-vessel-occlusion-real-world-data-in-the-thrombectomy-era
#13
Felix C Ng, Essie Low, Emily Andrew, Karen Smith, Bruce C V Campbell, Peter J Hand, Douglas E Crompton, Tissa Wijeratne, Helen M Dewey, Philip M Choi
BACKGROUND AND PURPOSE: Interhospital transfer is a critical component in the treatment of acute anterior circulation large vessel occlusive stroke transferred for mechanical thrombectomy. Real-world data for benchmarking and theoretical modeling are limited. We sought to characterize transfer workflow from primary stroke center (PSC) to comprehensive stroke center after the publication of positive thrombectomy trials. METHODS: Consecutive patients transferred from 3 high-volume PSCs to a single comprehensive stroke center between January 2015 and August 2016 were included in a retrospective study...
July 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28504982/characteristics-in-hospital-management-and-outcome-of-late-acute-st-elevation-myocardial-infarction-presenters
#14
Enrico Cerrato, Davide Forno, Silvia Ferro, Alessandra Chinaglia
BACKGROUND: Patients with delayed presentation of acute myocardial infarction with ST-segment elevation (STEMI) frequently have a poor prognosis but literature about acute complications in intensive cardiac care unit (ICCU) and in-hospital outcome are still limited. METHODS: All STEMI patients admitted to our institution between June 2007 and December 2013 were divided into patients presenting more than 12 h after symptom onset (lateSTEMI) and within 12 h (STEMI)...
August 2017: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/28461547/use-of-electromagnetic-device-to-insert-postpyloric-feeding-tubes-in-a-pediatric-intensive-care-unit
#15
Ann-Marie Brown, Christine Perebzak, Colleen Handwork, M David Gothard, Kristine Nagy
BACKGROUND: The preferred route for providing nutrition in the pediatric intensive care unit is enteral. Placement of postpyloric feeding tubes using an electromagnetic-tipped stylet that emits a signal detected by a device held over the patient's abdomen is effective in adult intensive care units, but has not been well studied in pediatric units. OBJECTIVES: To determine the effectiveness of the electromagnetic device in reducing the numbers of radiation exposures, intrahospital transports, tubes used, and tube placement attempts in the pediatric intensive care unit...
May 2017: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
https://www.readbyqxmd.com/read/28447107/-role-of-anesthesiology-in-pain-medicine-and-palliative-care-treatment-in-german-hospitals-survey-of-department-heads-of-anesthesiology-on-treatment-structures
#16
J Erlenwein, F Petzke, U Stamer, W Meißner, F Nauck, E Pogatzki-Zahn, W Koppert, C Maier
BACKGROUND: The aim of this analysis was to describe the role of anesthesiology departments in pain medicine and palliative care services in German hospitals. METHOD: In the year 2012, all heads of departments of anesthesiology registered with the German Society of Anesthesiology and Intensive Care Medicine were surveyed about structures of pain medicine and palliative care services in their hospitals using a standardized postal questionnaire. RESULTS: Out of 408 returned questionnaires (response rate 47%) 403 could be evaluated...
April 26, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28331988/point-of-care-testing-of-cardiac-autonomic-function-for-risk-assessment-in-patients-with-suspected-acute-coronary-syndromes
#17
C Eick, M Duckheim, P Groga-Bada, N Klumpp, S Mannes, C S Zuern, M Gawaz, K D Rizas, Axel Bauer
BACKGROUND: Impaired cardiac autonomic function has been linked to adverse outcomes in patients with acute coronary syndromes (ACS) but is not included in clinical risk models. This is the first study to investigate whether point-of-care testing of cardiac autonomic function by means of short-term deceleration capacity (DC) of heart rate improves risk assessment in patients with suspected ACS. METHODS: 1821 patients with suspected ACS were prospectively enrolled if they were older than 17 years and in sinus rhythm...
March 22, 2017: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/28314516/impact-of-an-intrahospital-mobile-thrombolysis-team-on-3-month-clinical-outcomes-in-patients-benefiting-from-intravenous-thrombolysis-for-acute-ischemic-stroke
#18
B Hebant, A Triquenot-Bagan, E Guegan-Massardier, O Ozkul-Wermester, L Grangeon, D Maltête
INTRODUCTION/OBJECTIVE: The benefits of thrombolysis in patients presenting with acute ischemic stroke (IS) are highly time-dependent. The aim of our study was to evaluate the clinical benefit, after 3 months, of an intrahospital mobile thrombolysis team (MTT) for thrombolysis in IS. PATIENTS AND METHODS: A total of 95 consecutive patients treated with IV tPA for acute IS at the neurology department of Rouen University Hospital between 1 January and 31 December 2015 were retrospectively identified...
March 2017: Revue Neurologique
https://www.readbyqxmd.com/read/28273224/emergency-cricothyrotomy-temporary-measure-or-definitive-airway-a-systematic-review
#19
Marina Barguil Macêdo, Ruggeri Bezerra Guimarães, Sahâmia Martins Ribeiro, Kátia Maria Marabuco DE Sousa
Being a fast and safe method in the hands of well trained professionals in both prehospital and intrahospital care, Cricothyrotomy has been broadly recommended as the initial surgical airway in the scenario "can't intubate, can't ventilate", and is particularly useful when the obstruction level is above or at the glottis. Its prolonged permanence, however, is an endless source of controversy. In this review we evaluate the complications of cricothyrotomy and the need of its routine conversion to tracheotomy through a search on PubMed, LILACS and SciELO electronic databases with no restriction to the year or language of the publication...
December 2016: Revista do Colégio Brasileiro de Cirurgiões
https://www.readbyqxmd.com/read/28270801/molecular-fingerprinting-studies-do-not-support-intrahospital-transmission-of-candida-albicans-among-candidemia-patients-in-kuwait
#20
Mohammad Asadzadeh, Suhail Ahmad, Noura Al-Sweih, Ziauddin Khan
Candida albicans, a constituent of normal microbial flora of human mucosal surfaces, is a major cause of candidemia in immunocompromised individuals and hospitalized patients with other debilitating diseases. Molecular fingerprinting studies have suggested nosocomial transmission of C. albicans based on the presence of clusters or endemic genotypes in some hospitals. However, intrahospital strain transmission or a common source of infection has not been firmly established. We performed multilocus sequence typing (MLST) on 102 C...
2017: Frontiers in Microbiology
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