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https://www.readbyqxmd.com/read/28107357/vasopressor-use-for-severe-hypotension-a-multicentre-prospective-observational-study
#1
Francois Lamontagne, Deborah J Cook, Maureen O Meade, Andrew Seely, Andrew G Day, Emmanuel Charbonney, Karim Serri, Yoanna Skrobik, Paul Hebert, Charles St-Arnaud, Hector Quiroz-Martinez, Michaël Mayette, Daren K Heyland
BACKGROUND: The optimal approach to titrate vasopressor therapy is unclear. Recent sepsis guidelines recommend a mean arterial pressure (MAP) target of 65 mmHg and higher for chronic hypertensive patients. As data emerge from clinical trials comparing blood pressure targets for vasopressor therapy, an accurate description of usual care is required to interpret study results. Our aim was to measure MAP values during vasopressor therapy in Canadian intensive care units (ICUs) and to compare these with stated practices and guidelines...
2017: PloS One
https://www.readbyqxmd.com/read/28107334/distress-during-radiation-therapy-assessment-among-patients-with-breast-or-prostate-cancer%C3%A2
#2
Stephen J Stapleton, Teresa D Valerio, Kim Astroth, Shermian Woodhouse
BACKGROUND: Distress is regarded as the sixth vital sign in cancer care, but few studies describe distress in patients undergoing radiation therapy. 
. OBJECTIVES: The purpose of this study was to assess distress levels among patients with breast or prostate cancer undergoing radiation therapy and investigate which problems contribute to patients' distress levels. 
. METHODS: A retrospective medical record review was conducted for 217 patients with breast or prostate cancer at a midwestern community cancer center...
February 1, 2017: Clinical Journal of Oncology Nursing
https://www.readbyqxmd.com/read/28107317/photography-in-telemedicine-improving-diagnosis-of-chronic-graft-versus-host-disease%C3%A2
#3
Brianna Busby, Shannon Campbell, Rachel Cole, Charisse DeVries, Kamille Dobbins, Mary Beth Trimble, Mihkaila Wickline
BACKGROUND: The long-term follow-up (LTFU) team at the Seattle Cancer Care Alliance uses telemedicine to diagnose and treat post-transplantation complications in hematopoietic cell transplantation (HCT) survivors. Photos are often requested via the telemedicine service to aid in diagnosis, but they are typically of poor quality, making them unusable.
. OBJECTIVES: This project offered bachelor of science in nursing students, partnered with a comprehensive cancer center, the opportunity to participate in an evidence-based practice project to improve detection and management of chronic graft-versus-host disease (cGVHD) in patients after HCT...
February 1, 2017: Clinical Journal of Oncology Nursing
https://www.readbyqxmd.com/read/28107316/lymphedema-improving-screening-and-treatment-among-at-risk-breast-cancer-survivors
#4
Kelly Reichart
Inadequate peripheral lymphedema screening is a persistent gap in the provision of quality survivorship care at many breast cancer centers. Lymphedema should be identified and treated during the subclinical stage, when it is more likely reversible. The purpose of this project was to integrate a screening process for patients with breast cancer at risk for lymphedema, using bioimpedance spectroscopy via the L-Dex®, in a breast cancer center. A protocol was developed that included specific criteria for early patient referral to physical therapy...
February 1, 2017: Clinical Journal of Oncology Nursing
https://www.readbyqxmd.com/read/28107315/weight-management-perception-interest-and-preferences-in-adult-cancer-survivors%C3%A2
#5
Fang Fang Zhang, Susan Meagher, Susan Koch-Weser, Mary Singer, Geetika Dhaundiyal, John Erban, Edward Saltzman
BACKGROUND: Obesity in cancer survivors has been recognized as a growing crisis in cancer care, but cancer survivors may not perceive weight status as important and may not be motivated to manage weight. 
. OBJECTIVES: This study aims to evaluate survivors' perception, interest, and preferences for weight management and to identify characteristics that may affect attitudes toward weight management. 
. METHODS: This cross-sectional survey assessed cancer survivors' attitudes toward weight management with patients attending oncology outpatient clinics at Tufts Medical Center in Boston, Massachusetts...
February 1, 2017: Clinical Journal of Oncology Nursing
https://www.readbyqxmd.com/read/28107309/-delay-to-operating-room-fails-to-identify-adverse-outcomes-at-a-level-i-trauma-center
#6
Paul R Lewis, Jayraan Badiee, Michael J Sise, Richard Y Calvo, Jason B Brill, James D Wallace, Steven R Shackford, Casey E Dunne, Vishal Bansal, C Beth Sise
BACKGROUND: The American College of Surgeons Committee on Trauma devised process audit filters to identify opportunities for improvement (OFI), prevent adverse outcomes, and improve quality. Delay to the operating room for primary trauma laparotomy is a process audit filter that has not been definitively associated with improved outcomes. We sought to evaluate the effectiveness of delay to the operating room of greater than 2 hours (DOR) to independently identify an adverse outcome or an OFI at our Level I trauma center...
February 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28107301/implementation-of-a-pediatric-orthopaedic-bundle-to-reduce-surgical-site-infections
#7
Jan Schriefer, James Sanders, Julie Michels, Kori Wolcott, Connor Ruddy, Jenna Hanson
Surgical site infections (SSIs) cost an estimated $27,288 per case. An analysis of the National Surgical Quality Improvement Program data at the University of Rochester Medical Center suggested that rates of SSIs could be lowered in comparison with both peers and baseline. The aim of this study was to reduce the number of SSIs to zero through the implementation of a "bundle" or a combination of practices. Meetings were held with the multidisciplinary care team that includes surgeons and staff from pediatric pharmacy, pediatric infectious diseases, anesthesia, and nursing to create a care bundle for all pediatric orthopaedic surgery patients...
January 2017: Orthopaedic Nursing
https://www.readbyqxmd.com/read/28107295/healthcare-transformation-and-changing-roles-for-nursing
#8
Susan W Salmond, Mercedes Echevarria
Factors driving healthcare transformation include fragmentation, access problems, unsustainable costs, suboptimal outcomes, and disparities. Cost and quality concerns along with changing social and disease-type demographics created the greatest urgency for the need for change. Caring for and paying for medical treatments for patients suffering from chronic health conditions are a significant concern. The Affordable Care Act includes programs now led by the Centers for Medicare & Medicaid Services aiming to improve quality and control cost...
January 2017: Orthopaedic Nursing
https://www.readbyqxmd.com/read/28107262/suspected-cerebral-edema-in-diabetic-ketoacidosis-is-there-still-a-role-for-head-ct-in-treatment-decisions
#9
Carmen L Soto-Rivera, Lisa A Asaro, Michael S D Agus, Danielle D DeCourcey
OBJECTIVES: Neurologic deterioration associated with cerebral edema in diabetic ketoacidosis is typically sudden in onset, progresses rapidly, and requires emergent treatment. The utility of brain imaging by head CT in decisions to treat for cerebral edema has not been previously studied. The objective of this study was to describe the characteristics of pediatric patients with diabetic ketoacidosis who develop altered mental status and evaluate the role of head CT in this cohort. DESIGN: Retrospective analysis of clinical, biochemical, and radiologic data...
January 19, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28106678/the-influence-of-emerging-nursing-administrative-and-leadership-researchers-an-interview-with-dr-lesly-kelly
#10
Jeffrey M Adams
This department highlights emerging nursing leaders who have demonstrated leadership in advancing innovation and patient care in practice, policy, research, education, and theory. This interview profiles Lesly Kelly, PhD, RN, Assistant Professor at the Arizona State University College of Nursing and Health Innovation and Nursing and Clinical Research Program Director at Banner-University Medical Center Phoenix.
February 2017: Journal of Nursing Administration
https://www.readbyqxmd.com/read/28106653/outcomes-of-rectovaginal-fistula-repair
#11
Jenifer N Byrnes, Jennifer J Schmitt, Benjamin M Faustich, Kristin C Mara, Amy L Weaver, Heidi K Chua, John A Occhino
OBJECTIVES: Rectovaginal fistulae (RVF) often represent surgical challenges, and treatment must be individualized. We describe outcomes after primary surgical repair stratified by fistula etiology and surgical approach. METHODS: This retrospective cohort study included women who underwent surgical management of RVF at a tertiary care center between July 1, 2001 and December 31, 2013. Cases were stratified according to the following etiology: cancer (RVF-C), inflammatory bowel disease or infectious (RVF-I), and other (RVF-O)...
January 18, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28106610/-opt-out-and-access-to-anesthesia-care-for-elective-and-urgent-surgeries-among-u-s-medicare-beneficiaries
#12
Eric C Sun, Franklin Dexter, Thomas R Miller, Laurence C Baker
BACKGROUND: In 2001, the Centers for Medicare and Medicaid Services issued a rule allowing U.S. states to "opt out" of the regulations requiring physician supervision of nurse anesthetists in an effort to increase access to anesthesia care. Whether "opt out" has successfully achieved this goal remains unknown. METHODS: Using Medicare administrative claims data, we examined whether "opt out" reduced the distance traveled by patients, a common measure of access, for patients undergoing total knee arthroplasty, total hip arthroplasty, cataract surgery, colonoscopy/sigmoidoscopy, esophagogastroduodenoscopy, appendectomy, or hip fracture repair...
January 19, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28106246/patient-centered-medicine-in-palliative-cancer-care-the-impossible-choice-between-physician-s-responsibility-and-patient-s-preferences
#13
Elena Vegni, Lidia Borghi
No abstract text is available yet for this article.
January 16, 2017: Tumori
https://www.readbyqxmd.com/read/28106243/author-s-reply-to-patient-centered-medicine-in-palliative-cancer-care-the-impossible-choice-between-physician-s-responsibility-and-patient-s-preferences
#14
Stefania Gori, Vittorina Zagonel
No abstract text is available yet for this article.
January 16, 2017: Tumori
https://www.readbyqxmd.com/read/28105754/process-of-becoming-a-mother-for-iranian-surrogacy-commissioning-mothers-a-grounded-theory-study
#15
Mitra Zandi, Zohreh Vanaki, Marziyeh Shiva, Eesa Mohammadi
AIM: Little knowledge is available about the experiences of the commissioning mothers during the process of surrogacy; thus, the present study was conducted in order to explore and analyze this process. METHODS: This study was conducted in a referral institute in Tehran with a qualitative approach and using grounded theory methodology. The data were collected through 39 unstructured, in-depth interviews that were conducted with 15 gestational commissioning mothers, two of their husbands, four surrogates, and four of the personnel at centers for assisted reproduction (some participants were interviewed more than once)...
January 20, 2017: Japan Journal of Nursing Science: JJNS
https://www.readbyqxmd.com/read/28105639/persistent-variation-in-medicare-payment-authorization-for-home-hemodialysis-treatments
#16
Adam S Wilk, Richard A Hirth, Wei Zhang, John R C Wheeler, Marc N Turenne, Tammie A Nahra, Kathryn K Sleeman, Joseph M Messana
OBJECTIVE: To analyze variation in medical care use attributable to Medicare's decentralized claims adjudication process as exemplified in home hemodialysis (HHD) therapy. DATA SOURCES/STUDY SETTING: Secondary data analysis using 2009-2012 paid Medicare claims for HHD and in-center hemodialysis (IHD). STUDY DESIGN: We compared variation across Medicare administrative contractors (MACs) in predicted paid treatments per standardized patient-month for HHD and IHD patients...
January 19, 2017: Health Services Research
https://www.readbyqxmd.com/read/28105634/does-radiologic-response-correlate-to-pathologic-response-in-patients-undergoing-neoadjuvant-therapy-for-borderline-resectable-pancreatic-malignancy
#17
Brent T Xia, Baojin Fu, Jiang Wang, Young Kim, S Ameen Ahmad, Vikrom K Dhar, Nick C Levinsky, Dennis J Hanseman, David A Habib, Gregory C Wilson, Milton Smith, Olugbenga O Olowokure, Jordan Kharofa, Ali H Al Humaidi, Kyuran A Choe, Daniel E Abbott, Syed A Ahmad
BACKGROUND AND OBJECTIVES: In patients with borderline resectable pancreas cancers, clinicians frequently consider radiographic response as the primary driver of whether patients should be offered surgical intervention following neoadjuvant therapy (NT). We sought to determine any correlation between radiographic and pathologic response rates following NT. METHODS: Between 2005 and 2015, 38 patients at a tertiary care referral center underwent NT followed by pancreaticoduodenectomy for borderline resectable pancreas cancer...
January 20, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28105408/predictors-of-prolonged-mechanical-ventilation-in-pediatric-patients-after-cardiac-surgery-for-congenital-heart-disease
#18
Avisa Tabib, Seyed Ehsan Abrishami, Mohammad Mahdavi, Hojjat Mortezaeian, Ziae Totonchi
BACKGROUND: The duration of mechanical ventilation (MV) is one of the most important clinical factors which predict outcomes in pediatric cardiac surgery. The prolonged mechanical ventilation (PMV) following cardiac surgery is a multifactorial phenomenon and there are conflicts regarding its predictors in pediatric population between different centers. OBJECTIVES: The current study aimed to describe PMV predictors in patients undergoing cardiac surgery for congenital heart disease in a tertiary center for pediatric cardiovascular diseases in Iran...
August 2016: Research in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28105373/vascular-changes-on-fluorescein-angiography-of-premature-infants-with-low-risk-of-retinopathy-of-prematurity-after-high-oxygen-exposure
#19
Maria Ana Martinez-Castellanos, Raul Velez-Montoya, Kenneth Price, Andree Henaine-Berra, Gerardo García-Aguirre, Virgilio Morales-Canton, Linda Alejandra Cernichiaro-Espinosa
PURPOSE: To describe a wide array of peripheral vascular changes using fluorescein angiography in preterm neonates, without high risk characteristics for developing retinopathy of prematurity, that were exposed to high oxygen concentration. METHODS: Retrospective, two center, case series. Newborns at two different hospitals with ≥1500 g or gestational age of ≥32 weeks, fluorescein angiography performed, and with high oxygen exposure without adequate control were included...
2017: International Journal of Retina and Vitreous
https://www.readbyqxmd.com/read/28104834/disparities-in-the-use-of-seizure-medications-after-intracerebral-hemorrhage
#20
Andrew M Naidech, Paloma Toledo, Shyam Prabhakaran, Jane L Holl
BACKGROUND AND PURPOSE: We investigated potential disparities in the use of prophylactic seizure medications in patients with intracerebral hemorrhage. METHODS: Review of multicenter electronic health record (EHR) data with simultaneous prospective data recording. EHR data were retrieved from HealthLNK, a multicenter EHR repository in Chicago, Illinois, from 2006 to 2012 (multicenter cohort). Additional data were prospectively coded (single-center cohort) from 2007 through 2015...
January 19, 2017: Stroke; a Journal of Cerebral Circulation
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