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Emergency Management

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https://www.readbyqxmd.com/read/27926663/the-impact-of-value-based-healthcare-for-inflammatory-bowel-diseases-on-healthcare-utilization-a-pilot-study
#1
Welmoed K van Deen, Arlen Spiro, A Burak Ozbay, Martha Skup, Adriana Centeno, Natalie E Duran, Precious N Lacey, Darius Jatulis, Eric Esrailian, Martijn G H van Oijen, Daniel W Hommes
BACKGROUND AND OBJECTIVES: Value-based healthcare (VBHC) is considered to be the solution that will improve quality and decrease costs in healthcare. Many hospitals are implementing programs on the basis of this strategy, but rigorous scientific reports are still lacking. In this pilot study, we present the first-year outcomes of a VBHC program for inflammatory bowel disease (IBD) management that focuses on highly coordinated care, task differentiation of providers, and continuous home monitoring...
December 6, 2016: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/27926621/accountable-care-organization-implementation-experiences-and-rural-participation-considerations-for-nurses
#2
Matt Thomas Bagwell, Angeline Bushy, Judith Ortiz
BACKGROUND: Little is known about how accountable care organizations (ACOs) participate with rural health providers. This pilot study examines ACO participation with rural health clinics (RHCs). METHODS: Telephone interviews with 8 ACO administrators were conducted to determine the early implementation experiences of these organizations, and their participation with rural health providers, such as RHCs, using qualitative content analysis, ACO characteristics, and emerging themes from the ACO executive responses was identified...
January 2017: Journal of Nursing Administration
https://www.readbyqxmd.com/read/27926614/clinical-coordination-in-accountable-care-organizations-a-qualitative-study
#3
Valerie A Lewis, Karen Schoenherr, Taressa Fraze, Aleen Cunningham
BACKGROUND: Accountable care organizations (ACOs) are becoming a common payment and delivery model. Despite widespread interest, little empirical research has examined what efforts or strategies ACOs are using to change care and reduce costs. Knowledge of ACOs' clinical efforts can provide important context for understanding ACO performance, particularly to distinguish arenas where ACOs have and have not attempted care transformation. PURPOSE: The aim of the study was to understand ACOs' efforts to change clinical care during the first 18 months of ACO contracts...
December 6, 2016: Health Care Management Review
https://www.readbyqxmd.com/read/27926537/lactate-arterial-and-venous-agreement-in-sepsis-a-prospective-observational-study
#4
Deepankar Datta, Julia Grahamslaw, Alasdair J Gray, Catriona Graham, Craig A Walker
BACKGROUND: Sepsis is a common condition in the emergency department (ED). Lactate measurement is an important part of management: arterial lactate (A-LACT) measurement is the gold standard. There is increasing use of peripheral venous lactate (PV-LACT); however, there is little research supporting the interchangeability of the two measures.If PV-LACT has good agreement with A-LACT, it would significantly reduce patient discomfort and the risks of arterial sampling for a large group of acutely unwell patients, while allowing faster and wider screening, with potential reduced costs to the healthcare system...
December 6, 2016: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/27926430/insights-in-waste-management-bioprocesses-using-genomic-tools
#5
H J Purohit, A Kapley, A Khardenavis, A Qureshi, N A Dafale
Microbial capacities drive waste stabilization and resource recovery in environmental friendly processes. Depending on the composition of waste, a stress-mediated selection process ensures a scenario that generates a specific enrichment of microbial community. These communities dynamically change over a period of time while keeping the performance through the required utilization capacities. Depending on the environmental conditions, these communities select the appropriate partners so as to maintain the desired functional capacities...
2016: Advances in Applied Microbiology
https://www.readbyqxmd.com/read/27925670/limited-abdominal-sonography-for-evaluation-of-children-with-right-lower-quadrant-pain
#6
Martha M Munden, Shannon Wai, Michael C DiStefano, Wei Zhang
OBJECTIVES: To determine whether a complete abdominal sonographic examination is necessary in the evaluation of children with right lower quadrant pain that is suspicious for appendicitis in the emergency department and whether performing a limited, more-focused study would miss clinically important disease. METHODS: With Institutional Review Board approval, a retrospective study was performed of 704 patients, from ages 5-19 years, presenting to the emergency department with right lower quadrant pain that was suspicious for appendicitis who underwent a complete abdominal sonographic examination...
November 30, 2016: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/27924759/sudden-cardiac-death-in-south-india-incidence-risk-factors-and-pathology
#7
Uma N Srivatsa, K Swaminathan, K Sithy Athiya Munavarah, Ezra Amsterdam, K Shantaraman
BACKGROUND: Sudden cardiac death (SCD) is a major cause of mortality secondary to coronary artery disease (CAD) in the industrialized societies. Although South Asians have a high prevalence of CAD, the frequency and underlying pathology of SCD among this population are unknown. METHODS: Medical records of consecutive patients presenting with unexplained sudden death (USD) in a tertiary care center were reviewed. Patients with trauma, violent deaths, positive toxicology and non-cardiac pathology were excluded to determine sudden cardiac death (SCD)...
July 2016: Indian Pacing and Electrophysiology Journal
https://www.readbyqxmd.com/read/27924661/sleep-disordered-breathing-in-pregnancy-the-maternal-and-fetal-implications
#8
Shanthi Carnelio, Adam Morton, H David McIntyre
Sleep disordered breathing (SDB) which includes obstructive sleep apnoea (OSA) and upper airway resistance syndrome (UARS), has emerged as a risk factor for adverse maternal-foetal outcomes in pregnancy. Physiological changes of pregnancy predispose a woman 'at risk' towards developing SDB. The increasing incidence of OSA in pregnancy closely correlates with the population trends of obesity. Common screening tools validated in non-pregnant subjects including Epworth Sleepiness Scale (ESS) and Berlin Questionnaire (BQ) are poor predictors of SDB in pregnancy...
December 7, 2016: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/27924392/colonic-stenting-as-a-bridge-to-surgery-versus-emergency-surgery-for-malignant-colonic-obstruction-results-of-a-multicentre-randomised-controlled-trial-esco-trial
#9
Alberto Arezzo, Carmen Balague, Eduardo Targarona, Felice Borghi, Giorgio Giraudo, Luigi Ghezzo, Antonio Arroyo, Javier Sola-Vera, Paolo De Paolis, Maurizio Bossotti, Elisa Bannone, Edoardo Forcignanò, Marco Augusto Bonino, Roberto Passera, Mario Morino
BACKGROUND: The aim of colonic stenting with self-expandable metallic stents in neoplastic colon obstruction is to avoid emergency surgery and thus potentially reduce morbidity, mortality, and need for a stoma. Concern has been raised, however, about the effect of colonic stenting on short-term complications and long-term survival. We compared morbidity rates after colonic stenting as a bridge to surgery (SBTS) versus emergency surgery (ES) in the management of left-sided malignant large-bowel obstruction...
December 6, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/27924186/treatment-of-chronic-hepatitis-c-infection-with-sofosbuvir-based-regimens-in-a-commercially-insured-patient-population
#10
John Barron, Yiqiong Xie, Sze-Jung Wu, Jeff White, Joseph Singer, Bernard Tulsi, Alan Rosenberg
BACKGROUND: The response to treatment with direct-acting antiviral agents in patients with chronic hepatitis C virus (HCV) is not well-characterized in the real-world setting. OBJECTIVE: To describe patients' response to 3 sofosbuvir-based treatment regimens among commercially insured patients with chronic HCV. METHODS: In this observational study, we identified patients with HCV who started sofosbuvir treatment with 1 of 3 sofosbuvir-based regimens between December 1, 2013, and April 30, 2014, in the HealthCore Integrated Research Database, a large managed care repository...
September 2016: American Health & Drug Benefits
https://www.readbyqxmd.com/read/27923970/an-exploratory-study-of-the-impact-of-gender-on-health-behavior-among-african-american-and-latino-men-with-type-2-diabetes
#11
Jaclynn Hawkins, Daphne C Watkins, Edith Kieffer, Michael Spencer, Gretchen Piatt, Emily J Nicklett, Alana Lebron, Nicolaus Espitia, Gloria Palmisano
This study explores gender values and beliefs among Latino and African American men with diabetes and examines how these values and beliefs may influence their health behaviors. Participants were recruited from individuals who participated in one of three Racial and Ethnic Approaches to Community Health Detroit Partnership diabetes self-management interventions. One focus group was conducted with African American men (n = 10) and two focus groups were conducted with Latino men (n = 12) over a 3-month period...
December 5, 2016: American Journal of Men's Health
https://www.readbyqxmd.com/read/27923754/successful-coil-embolization-of-pediatric-carotid-cavernous-fistula-due-to-ruptured-post-traumatic-giant-internal-carotid-artery-aneurysm
#12
Daisuke Wajima, Ichiro Nakagawa, Hun Soo Park, Shohei Yokoyama, Takeshi Wada, Kimihiko Kichikawa, Hiroyuki Nakase
BACKGROUND: The goal of the treatment of direct carotid cavernous fistula (CCF) is to occlude the arteriovenous shunt and to preserve the patency of the concerned internal carotid artery (ICA). However, for the ipsilateral post-traumatic fragile cerebrum, coil embolization plus parent artery occlusion for the high flow direct CCF would be better for the prevention of hyper-perfusion syndrome and the intracranial hemorrhage. We experienced such a case and managed it successfully. CASE DESCRIPTION: A 6-year-old boy was suffered from severe head trauma caused by being hit by a car...
December 3, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27923680/the-100-most-cited-manuscripts-in-emergency-abdominal-surgery-a-bibliometric-analysis
#13
Thomas Ellul, Nicholas Bullock, Tarig Abdelrahman, Arfon G M T Powell, Jolene Witherspoon, Wyn G Lewis
BACKGROUND: The number of citations a scientific article receives provides a good indication of its impact within any given field. This bibliometric analysis aimed to identify the 100 most cited articles in Emergency Abdominal Surgery (EAS), to highlight key areas of interest and identify those that have most significantly shaped contemporary clinical practice in this newly evolving surgical specialty. This is of increasing relevance as concerns grow regarding the variable and suboptimal outcomes in Emergency General Surgery...
December 3, 2016: International Journal of Surgery
https://www.readbyqxmd.com/read/27923540/fetal-cytomegalovirus-infection
#14
REVIEW
Marianne Leruez-Ville, Yves Ville
Cytomegalovirus (CMV) congenital infection affects 0.7% of live births worldwide and is the leading cause of congenital neurological handicap of infectious origin. However, systematic screening for this infection has not been implemented in pregnancy or at birth in any country. This apparent paradox had been justified by persisting gaps in the knowledge of this congenital infection: uncertain epidemiological data, difficulty in the diagnosis of maternal infection, absence of validated prenatal prognostic markers, unavailability of an efficient vaccine and scarcity of data available on the treatment...
October 20, 2016: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/27923314/value-of-early-warning-scores-in-emergency-departments
#15
(no author information available yet)
Developed in the belief that early identification and intervention of deteriorating patients would reduce the number of deaths, early warning scores (EWS) have become a routine feature of work in UK emergency departments (EDs) and are becoming increasingly common in paediatric emergency care. They are popular with managers, commissioners and clinicians, yet the authors of this report state that there is little evidence of this reduction in the literature.
December 7, 2016: Emergency Nurse: the Journal of the RCN Accident and Emergency Nursing Association
https://www.readbyqxmd.com/read/27923294/recognition-and-nursing-management-of-diabetes-in-children
#16
Polly Teuten, Sharon Holt, Sujata Edate, Siba Prosad Paul
Diabetes mellitus is a common condition in children, characterised by chronic hyperglycaemia resulting from an absolute insulin deficiency. It can present in various ways, and hospital admission may result from complications related to previously diagnosed diabetes, or from a new diagnosis. To raise awareness of the condition, Diabetes UK has launched the 4Ts campaign, which highlights the four most common symptoms of diabetes. This article discusses the different clinical presentations, diagnosis and management of children with diabetes, and includes two case studies to illustrate some of the challenges faced by emergency department nurses...
December 7, 2016: Emergency Nurse: the Journal of the RCN Accident and Emergency Nursing Association
https://www.readbyqxmd.com/read/27923204/case-report-of-the-surgical-management-of-small-bowel-and-colonic-ischaemia-associated-with-anorexia-nervosa-binge-purge-subtype
#17
Ann T Foran, Cillian Clancy, Tom F Gorey
INTRODUCTION: Anorexia Nervosa affects up to 1% of the population and can present with binge/purge episodes. A paucity of literature exists regarding small bowel and colonic ischaemia relating to this common condition. We report our own experience and management of a patient with anorexia nervosa binge/purge subtype with small bowel and colon ischaemia and review existing cases in the literature. PRESENTATION OF CASE: A 32year old female self-presented to the emergency department complaining of abdominal pain, abdominal distension and vomiting on a background history of binge/purge subtype eating disorder, following consumption of a large amount of carbohydrates...
August 25, 2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27922966/local-coverage-for-acute-severely-herniated-brain-using-scalp-and-forehead-flaps-in-a-pediatric-patient-with-head-trauma
#18
Matthew Brown, Navid Pourtaheri, Kristopher Katira, Sunil Manjila, Ali S Totonchi
A 4-year-old-boy required emergent craniectomy and drainage of a large right-sided acute subdural hematoma after head trauma, during which massive sinus hemorrhage with brain swelling occurred. Acute intraoperative management entailed dural cover using synthetic dural membrane substitute and scalp coverage over the herniated brain using acellular dermal matrix. After intensive monitoring and control of raised intracranial pressure over the next few days, the exposed brain was then covered by scalp and forehead flaps with cadaveric skin grafting to the donor site...
December 5, 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/27922570/developing-a-simulation-based-training-program-for-the-prehospital-professionals-and-students-on-the-management-of-middle-east-respiratory-syndrome
#19
Melih Elcin, Arif Onan, Orhan Odabasi, Melahat Saylam, Handan Ilhan, Pinar Daylan Kockaya, Ilker Gurcuoglu, Yavuz Uckuyu, Duygu Cengiz, Osman Arikan Nacar
INTRODUCTION: Middle East Respiratory Syndrome (MERS) is a major global health threat. Prehospital professionals face the risk of infection as they work to save lives. They should be made aware of the disease and be prepared to handle such cases. The aims of our study are to develop a training program about the prehospital management of a MERS case using standardized patient (SP) scenarios, to evaluate the awareness and preparedness of the participants about MERS, and to evaluate the effectiveness of this training...
December 2016: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
https://www.readbyqxmd.com/read/27922569/mode-of-information-delivery-does-not-effect-anesthesia-trainee-performance-during-simulated-perioperative-pediatric-critical-events-a-trial-of-paper-versus-electronic-cognitive-aids
#20
Scott C Watkins, Shilo Anders, Anna Clebone, Elisabeth Hughes, Vikram Patel, Laura Zeigler, Yaping Shi, Matthew S Shotwell, Matthew D McEvoy, Matthew B Weinger
INTRODUCTION: Cognitive aids (CAs), including emergency manuals and checklists, have been recommended as a means to address the failure of healthcare providers to adhere to evidence-based standards of treatment during crisis situations. Unfortunately, users of CAs still commit errors, omit critical steps, fail to achieve perfect adherence to guidelines, and frequently choose to not use CA during both simulated and real crisis events. We sought to evaluate whether the mode in which a CA presents information (ie, paper vs...
December 2016: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
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