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Preventative care

Yoo-Sol An, Yinji Jin, Taixian Jin, Eun Young Hur, Sun-Mi Lee
AIMS AND OBJECTIVES: The purpose of this study was to analyze the operation, anesthesia, and recovery related factors affecting the occurrence of delirium in the intensive care unit. BACKGROUND: The occurrence rate of postoperative delirium is high in surgical patients. Postoperative delirium most frequently occurs usually within 3 days after an operation. DESIGN: This study used a secondary data analysis based on a case-control study. METHODS: This study analyzed data extracted from the electronic health records at a university hospital from October 2009 to July 2015...
December 16, 2018: Journal of Clinical Nursing
E Alagna, O E Santangelo, D D Raia, V Gianfredi, S Provenzano, A Firenze
INTRODUCTION: In Italy, as in the rest of the world, the number of homeless people is increasing considerably. Many of them suffer from chronic conditions, mental health problems and addiction to alcohol, drugs or smoking, and need complex medical care. Their health status is often exacerbated by greater difficulty in accessing primary care. The aim of the present study was to assess health conditions of homeless people living in Palermo, Southern Italy, and to find ways to limit the spread of common infectious diseases that can be prevented by vaccination...
January 2019: Annali di Igiene: Medicina Preventiva e di Comunità
M L Ciofi Degli Atti, C D'Amore, C Gagliotti, C Zotti, E Ricchizzi, M L Moro, M Raponi
BACKGROUND: Antimicrobial stewardship programs and comprehensive infection control programs represent the main strategies to limit the emergence and transmission of multi-drug resistant bacteria in hospital settings. The purpose of this study was to describe strategies implemented in Italian children's hospitals for controlling antibiotic resistance. STUDY DESIGN: Cross sectional multicenter study. METHODS: Four tertiary care Italian children's hospitals were invited to participate in a survey aimed at collecting information on activities implemented as of December 2015 using a self-administered online questionnaire...
January 2019: Annali di Igiene: Medicina Preventiva e di Comunità
Carla Assaf-Balut, Nuria García de la Torre, Alejandra Duran, Manuel Fuentes, Elena Bordiú, Laura Del Valle, Cristina Familiar, Johanna Valerio, Inés Jiménez, Miguel A Herraiz, Nuria Izquierdo, María J Torrejon, Maria Ángeles Cuadrado, Isabel Ortega, Francisco J Illana, Isabelle Runkle, Paz de Miguel, Inmaculada Moraga, Carmen Montañez, Ana Barabash, Martín Cuesta, Miguel A Rubio, Alfonso L Calle-Pascual
AIMS: The aim of the study was to evaluate the effect of a Mediterranean diet (MedDiet), enhanced with extra virgin olive oil (EVOO) and nuts, on a composite of adverse maternofoetal outcomes of women with normoglycemia during pregnancy. METHODS: This was a sub-analysis of the St Carlos gestational diabetes mellitus Prevention Study. Only normoglycemic women were analysed (697). They were randomized (at 8-12th gestational weeks) to: standard-care control group (337), where fat consumption was limited to 30% of total caloric intake; or intervention group (360), where a MedDiet, enhanced with EVOO and pistachios (40-42% fats of total caloric intake) was recommended...
December 14, 2018: Annals of Nutrition & Metabolism
Laura Cottey, S Jefferys, T Woolley, J E Smith
INTRODUCTION: Supplemental oxygen is a key element of emergency treatment algorithms. However, in the operational environment, oxygen supply poses a challenge. The lack of high-quality evidence alongside emerging technologies provides the opportunity to challenge current guidelines. The aim of this review was to appraise the evidence for the administration of oxygen in emergency patients and give recommendations for its use in clinical practice. METHODS: A critical review of the literature was undertaken to determine the evidence for emergency supplemental oxygen use...
December 15, 2018: Journal of the Royal Army Medical Corps
É Batassini, M G Beghetto
OBJECTIVE: To assess the incidence and factors associated with constipation in adult critical care patients. DESIGN: Prospective cohort study. SETTING: Intensive care unit (ICU) of a high-complexity hospital from November 2015 to October 2016. PATIENTS: Adults who were hospitalized for at least 72h in the ICU were followed from their admission to the ICU until their departure. INTERVENTIONS: None...
December 12, 2018: Enfermería Intensiva
Brian Yim, Renata E Howland, Gretchen M Culp, Anna Zhilkova, Oxiris Barbot, Tsu-Yu Tsao
INTRODUCTION: This study assesses preventable hospitalization rates among New York City residents living in public housing developments compared with all New York City residents and residents in low-income areas. Additionally, preventable hospitalization rates by development (one or multiple buildings in close proximity and served by the same management office) were determined. METHODS: The 2010-2014 New York City hospital discharge data were geocoded and linked with New York City Housing Authority records using building-level identifiers...
December 12, 2018: American Journal of Preventive Medicine
Christian J Dameff, Jordan A Selzer, Jonathan Fisher, James P Killeen, Jeffrey L Tully
BACKGROUND: Cybersecurity risks in health care systems have traditionally been measured in data breaches of protected health information, but compromised medical devices and critical medical infrastructure present risks of disruptions to patient care. The ubiquitous prevalence of connected medical devices and systems may be associated with an increase in these risks. OBJECTIVE: This article details the development and execution of three novel high-fidelity clinical simulations designed to teach clinicians to recognize, treat, and prevent patient harm from vulnerable medical devices...
December 12, 2018: Journal of Emergency Medicine
Zoe Donnell, Roseanne Hoffman, Gaya Myers, Kelly Sarmiento
INTRODUCTION: The Centers for Disease Control and Prevention (CDC) Pediatric Mild Traumatic Brain Injury (mTBI) Guideline was created to help standardize diagnosis, prognosis, and management and treatment of pediatric mTBI. This paper describes the process CDC used to develop educational tools, and a dissemination and implementation strategy, in support of the CDC Pediatric mTBI Guideline. METHODS: Two qualitative data collection projects with healthcare providers who care for pediatric patients were conducted...
December 2018: Journal of Safety Research
Laura J Gardner, Jennifer L Strunck, Yelena P Wu, Douglas Grossman
In the first article in this continuing medical education series we review controversies and uncertainties relating to the epidemiology and initial diagnosis of localized cutaneous melanoma (ie, stage 0, I, or II). Many of these issues are unsettled because of conflicting evidence. Melanoma incidence appears to be increasing, yet its basis has not been fully explained. Despite the advantages of early detection, the US Preventive Services Task Force does not recommend skin screening for the general population...
January 2019: Journal of the American Academy of Dermatology
Alex Carignan, Robert Sabbagh, Vincent Masse, Nicolas Gagnon, Louis-Philippe Montpetit, Marc-Andre Smith, Mathieu Raymond, Catherine Allard, Cybèle Bergeron, Jacques Pépin
BACKGROUND: Rates of infection following ultrasound-guided transrectal prostate needle biopsy (TRUSPB) are increasing. We aimed to evaluate the effectiveness of fosfomycin tromethamine (FMT) prophylaxis in preventing post-TRUSPB infectious complications. METHODS: This nested case-control study included patients who underwent TRUSPB in a Canadian tertiary care hospital, and developed post-TRUSPB bacteremia or urinary tract infections. Four prophylaxis periods included: i) ciprofloxacin, low-resistance period (CIPRO-LOW), 2002-2009; ii) ciprofloxacin, high-resistance period (CIPRO-HIGH), 2010-October 2013; iii) oral FMT, one dose (FOSFO1), December 2013-September 2015; and iv) oral FMT, two doses (FOSFO2), October 2015-June 2016...
December 12, 2018: Journal of Global Antimicrobial Resistance
Sang Hun Lee, Jihwan Song, Byungrae Cho, SoonGweon Hong, Ori Hoxha, Taewook Kang, Dongchoul Kim, Luke P Lee
Microfluidic polymerase chain reaction (PCR) has been of great interest owing to its ability to perform rapid and specific nucleic acid amplification and analysis on small volumes of samples. One of the major drawbacks of microfluidic PCR is bubble generation and reagent evaporation, which can cause malfunctions. Here, through theoretical modeling and characterization of bubble behavior, we propose a bubble-free microfluidic PCR device via controlled fluid transfer. Our approach exploits a thin impermeable polyethylene (PE) top layer that minimizes the generation of bubbles by inhibiting mass transport along a vertical direction...
October 11, 2018: Biosensors & Bioelectronics
Daniella Gregoria Bomfim Prado da Silva, Flávia Jacqueline Almeida, Mariana Volpe Arnoni, Marco Aurélio Palazzi Sáfadi, Marcelo Jenne Mimica, Daniel Jarovsky, Gabriela Pereira de Almeida Rossetti, Mauricio Magalhães, Danielle Bruna Leal de Oliveira, Luciano Matsumiya Thomazelli, Thais Cristina Colmanetti, Edison Luiz Durigon, Eitan Naaman Berezin
OBJECTIVE: Respiratory syncytial virus is a pathogen frequently involved in nosocomial outbreaks. Although several studies have reported nosocomial outbreaks in neonatal intensive care units, molecular epidemiology data are scarce. Here, the authors describe two consecutive respiratory syncytial virus outbreaks caused by genotypes ON-1 and NA-2 in a neonatal intensive care unit in São Paulo, Brazil. METHODS: A prospective search for respiratory syncytial virus was performed after diagnosing the index case and four other symptomatic newborns in the neonatal intensive care unit...
December 12, 2018: Jornal de Pediatria
Megan Slocum, Sophie F Garcia, June M McKoy
Millions of individuals worldwide are living with cancer and have remained disease-free for more than 5 years. These individuals are considered to be cancer survivors. The advent of new targeted therapies and personalized treatment modalities have contributed to this increased survivorship. Additionally, earlier diagnosis and detection of cancer, greater access to preventive screenings, and greater focus on cancer pharmaceutical safety have all been contributed to increasing longevity. Of note, all cancer types have benefited in the survivorship arena...
2019: Cancer Treatment and Research
Renato Rocha Martins, Lunara Teles Silva, Flavio Marques Lopes
Background Drug-related problems are mostly preventable or predictable circumstances that may impact on health outcomes. Clinical pharmacy activities such as medication therapy management can identify and solve these problems, with potential to improve medication safety and effectiveness. Objective To evaluate ability of medication therapy management service to detect drug-related problems and prevent adverse drug events. This study also aimed to assess the risk factors for drugrelated problem occurrence. Setting Medical intensive care unit of a public tertiary hospital in Brazil...
December 15, 2018: International Journal of Clinical Pharmacy
B French, K Sayal, D Daley
Attention deficit hyperactivity disorder (ADHD) is a developmental disorder affecting up to 5% of children and adults and is underdiagnosed in many European countries. The process of access to care for this disorder is complex and variable across countries. In general, those affected, or their caregiver, will seek help through their primary care practitioners who are then often responsible for referral to other professionals for diagnosis and provision of treatment. Previous studies have highlighted that many barriers to recognition exist in primary care settings (such as misconceptions, lack of education or lack of resources), preventing access to care for this population and potentially affecting diagnosis rate...
December 14, 2018: European Child & Adolescent Psychiatry
Kristin M Beima-Sofie, Susan Brown Trinidad, Kenneth Ngure, Renee Heffron, Jared M Baeten, Grace C John-Stewart, Maureen Kelley
This study explored how multinational HIV experts weigh clinical, evidential, and ethical considerations regarding pre-exposure prophylaxis in pregnant/breastfeeding women. Semi-structured interviews were conducted with experts in HIV policy, research, treatment, and implementation from three global regions. A constant comparative approach identified major themes. Experts noted that exclusion of pregnant women from research limits evidence regarding risks/benefits, emphasizing that underinclusion of pregnant women in RCTs shifts the onus of evidence-building to clinical care...
December 14, 2018: AIDS and Behavior
A D Ordu, K Rippel, L T Garthe, C Scheurig-Münkler, T Kröncke, F Schwarz
CLINICAL/METHODICAL ISSUE: Radiologic imaging for the assessment of individual cardiovascular risk. STANDARD RADIOLOGICAL METHODS: The correct estimation of the individual cardiovascular risk is prerequisite for the prevention of cardiovascular diseases. Here, extensive evidence is available for coronary calcium scans as well as coronary CT angiography (CTA). METHODICAL INNOVATIONS: Summary of the available evidence for the use of calcium score and coronary CTA...
December 14, 2018: Der Radiologe
Rebecca Y Du, Melissa A LoPresti, Caroline C Hadley, Sandi Lam
PURPOSE: In lower-income populations, high rates of neural tube defects (NTDs) are a concern. Nutritional folate deficiencies and mycotoxins in contaminated food supplies increase risk of NTDs. As physicians in public health and involved in the care of children with NTDs, pediatric neurosurgeons have an interest in the treatment and prevention of NTDs. We aimed to evaluate the literature to assess the awareness and the existence of best practices/educational materials on this issue to better guide management...
December 14, 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Supakanya Wongrakpanich, Katalin Danji, Lewis Lipsitz, Sarah Berry
Falls are highly prevalent and lead to major health morbidity and mortality in older adults. We developed a "STOP-FALLING" checklist as a multifactorial intervention tool kit for a single long-term care facility. The objective of this study was to determine feasibility and adherence of the checklist, and to determine whether STOP-FALLING reduces total number of falls, frequent fallers, and fall-related injuries. This is a quality improvement demonstration project comparing the effect on falls 3 months before and 3 months after introducing a STOP-FALLING checklist...
December 11, 2018: Journal of the American Medical Directors Association
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