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https://www.readbyqxmd.com/read/29331946/management-of-patients-on-antithrombotic-agents-undergoing-emergency-and-elective-endoscopy-joint-asian-pacific-association-of-gastroenterology-apage-and-asian-pacific-society-for-digestive-endoscopy-apsde-practice-guidelines
#1
Francis K L Chan, Khean-Lee Goh, Nageshwar Reddy, Kazuma Fujimoto, Khek Yu Ho, Seiji Hokimoto, Young-Hoon Jeong, Takanari Kitazono, Hong Sik Lee, Varocha Mahachai, Kelvin K F Tsoi, Ming-Shiang Wu, Bryan P Yan, Kentaro Sugano
This Guideline is a joint official statement of the Asian Pacific Association of Gastroenterology (APAGE) and the Asian Pacific Society for Digestive Endoscopy (APSDE). It was developed in response to the increasing use of antithrombotic agents (antiplatelet agents and anticoagulants) in patients undergoing gastrointestinal (GI) endoscopy in Asia. After reviewing current practice guidelines in Europe and the USA, the joint committee identified unmet needs, noticed inconsistencies, raised doubts about certain recommendations and recognised significant discrepancies in clinical practice between different regions...
January 13, 2018: Gut
https://www.readbyqxmd.com/read/29329118/ce-managing-sepsis-and-septic-shock-current-guidelines-and-definitions
#2
Mary Beth Flynn Makic, Elizabeth Bridges
Recent updates emphasize early recognition and prompt intervention. ABSTRACT: Sepsis is a leading cause of critical illness and hospital mortality. Early recognition and intervention are essential for the survival of patients with this syndrome. In 2002, the Society of Critical Care Medicine (SCCM) and the European Society of Intensive Care Medicine (ESICM) launched the Surviving Sepsis Campaign (SSC) to reduce overall patient morbidity and mortality from sepsis and septic shock by driving practice initiatives based on current best evidence...
January 11, 2018: American Journal of Nursing
https://www.readbyqxmd.com/read/29327135/acquiring-and-maintaining-point-of-care-ultrasound-pocus-competence-for-anesthesiologists
#3
REVIEW
T Jared McCormick, Elizabeth Clarke Miller, Robert Chen, Viren N Naik
PURPOSE: Point-of-care ultrasound (POCUS) involves the bedside use of ultrasound to answer specific diagnostic questions and to assess real-time physiologic responses to treatment. Although POCUS has become a well-established resource for emergency and critical care physicians, anesthesiologists are still working to obtain POCUS skills and to incorporate them into routine practice. This review defines the benefits of POCUS to anesthesia practice, identifies challenges to establishing POCUS in routine anesthesia care, and offers solutions to help guide its incorporation going forward...
January 11, 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29324733/antibiotics-dispensed-to-privately-insured-pregnant-women-with-urinary-tract-infections-united-states-2014
#4
Elizabeth C Ailes, April D Summers, Emmy L Tran, Suzanne M Gilboa, Kathryn E Arnold, Dana Meaney-Delman, Jennita Reefhuis
Urinary tract infections (UTIs) occur in about 8% of pregnant women, and untreated UTIs can have serious consequences, including pyelonephritis, preterm labor, low birth weight, and sepsis (1). Pregnant women are typically screened for UTIs during early pregnancy, and those with bacteriuria are treated with antibiotics (1,2). Antibiotic stewardship is critical to improving patient safety and to combating antibiotic resistance. Because of the potential risk for birth defects, including anencephaly, heart defects, and orofacial clefts, associated with use of sulfonamides and nitrofurantoin during pregnancy (3), a 2011 committee opinion from the American College of Obstetricians and Gynecologists (ACOG) recommended that sulfonamides and nitrofurantoin may be prescribed in the first trimester of pregnancy only when other antimicrobial therapies are deemed clinically inappropriate (4)...
January 12, 2018: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/29324608/quality-assurance-practices-in-obstetric-care-a-survey-of-hospitals-in-california
#5
Lisbet S Lundsberg, Henry C Lee, Grace Villarin Dueñas, Kimberly D Gregory, Holly K Grossetta Nardini, Christian M Pettker, Jessica L Illuzzi, Xiao Xu
OBJECTIVE: To assess hospital practices in obstetric quality management activities and identify institutional characteristics associated with utilization of evidence-supported practices. METHODS: Data for this study came from a statewide survey of obstetric hospitals in California regarding their organization and delivery of perinatal care. We analyzed responses from 185 hospitals that completed quality assurance sections of the survey to assess their practices in a broad spectrum of quality enhancement activities...
January 9, 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29322576/a-mixed-method-thematic-review-health-related-decision-making-by-the-older-person
#6
REVIEW
Lindy King, Ann Harrington, Ecushla Linedale, Elizabeth Tanner
AIMS: To undertake a mixed method thematic literature review that explored how elderly adults approached decision making in regard to their health care following discharge. BACKGROUND: A critical time for appropriate health decisions occurs during hospital discharge planning with nursing staff. However, little is known how the 89% of elderly living at home make decisions regarding their health care. Research into older adults' management of chronic conditions emerges as an important step to potentially encourage symptom monitoring, prevent missed care and detect deterioration...
January 10, 2018: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29321209/issues-and-challenges-for-research-in-major-trauma
#7
EDITORIAL
Sharon Ann Swain, Graham Stiff
The starting point for evidence-based guidelines is the systematic review and critical appraisal of the relevant literature. This review highlights the risk of bias identified while critically appraising the evidence to inform the National Institute of Health and Care Excellence guideline on the assessment and initial management of major trauma.
January 10, 2018: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29319654/trauma-and-intensive-care-nursing-knowledge-and-attitude-of-foley-catheter-insertion-and-maintenance
#8
Brenda Shaver, Stephanie A Eyerly-Webb, Zoe Gibney, Linda Silverman, Candace Pineda, Rachele J Solomon
In the acute care setting, the majority of urinary tract infections are associated with indwelling urinary catheters. Despite guidelines for proper use, catheter-associated urinary tract infections (CAUTIs) continue to occur in critically ill/injured patients. There is a paucity of data on the translation between CAUTI prevention education and behavioral change. This project evaluated nurse's clinical knowledge and attitude toward Foley catheter insertion and maintenance to determine the benefits of addressing gaps in knowledge and inconsistencies in attitude through education...
January 2018: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/29319481/a-critical-review-of-recent-clinical-practice-guidelines-for-pediatric-urinary-tract-infection
#9
Michael Chua, Jessica Ming, Shang-Jen Chang, Joana Dos Santos, Niraj Mistry, Jan Michael Silangcruz, Mark Bayley, Martin Koyle
INTRODUCTION: Concerns regarding the quality, credibility, and applicability of recently published pediatric urinary tract infection (UTI) clinical practice guidelines have been raised due to the inconsistencies of recommendations between them. We aimed to determine the quality of the recent clinical practice guidelines on pediatric UTI by using the Appraisal of Guidelines Research and Evaluation (AGREE II) instrument, and summarize the standard of care in diagnosis and management of pediatric UTI from the top three clinical practice guidelines...
December 22, 2017: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
https://www.readbyqxmd.com/read/29315601/estimates-of-side-effects-counseling-in-family-planning-using-three-data-sources-implications-for-monitoring-and-survey-design
#10
Yoonjoung Choi
With growing attention to monitoring and improving quality of care, it is critical to have evidence-based recommendations to measure quality of care indicators and guidelines to interpret estimates from different data sources. This study facilitates methodological discussion regarding measurement of counseling for side effects in family planning, a critical component of quality. The study assesses and compares estimates of side effects counseling based on three data sources. Data came from nationally representative facility and household surveys, Service Provision Assessments, and Demographic and Health Surveys in four countries...
January 5, 2018: Studies in Family Planning
https://www.readbyqxmd.com/read/29314429/nurses-handoff-and-patient-safety-culture-in-perinatal-care-units
#11
Mi Yu, Hyang Yuol Lee, Gwen Sherwood, Eun Man Kim
AIM AND OBJECTIVES: This study aimed to examine nursing handoff, identify causes of handoff errors, evaluate current methods of handoff, and determine the factors associated with handoff evaluation in delivery rooms and neonatal units of hospitals in South Korea. BACKGROUND: Handoff is a critical communication process in clinical settings. Less attention has been paid to the handoff practice to assure safe perinatal care in hospitals. DESIGN: This is a cross-sectional descriptive study...
January 3, 2018: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29314219/pediatric-psoriasis-evolving-perspectives
#12
Lawrence F Eichenfield, Amy S Paller, Wynnis L Tom, Jeffrey Sugarman, Adelaide A Hebert, Sheila Fallon Friedlander, Elaine Siegfried, Nanette Silverberg, Kelly M Cordoro
BACKGROUND/OBJECTIVES: Childhood-onset psoriasis is a common skin disorder that has recently received increasing attention, particularly because of its significant medical, social, financial, and psychological burdens and its associated comorbidities. With limited data available and lack of standardized management guidelines for pediatric psoriasis, an expert panel desired to provide an updated critical overview and practical guidance for management of the affected population. METHODS: A panel of pediatric dermatologists with extensive experience in pediatric psoriasis defined and prioritized a core set of topics, performed an English-language literature review, prepared critical evaluations and presentations of topic areas, and carried out a consensus meeting and follow-up consensus manuscript...
January 4, 2018: Pediatric Dermatology
https://www.readbyqxmd.com/read/29313072/-antibiotic-stewardship-measures-for-optimizing-prescription-of-anti-infective-agents
#13
REVIEW
C Lanckohr, H Bracht
Antibiotic stewardship (ABS) comprises a bundle of different interventions to improve anti-infective treatment in a hospital setting. An important component of ABS interventions is the interdisciplinary approach to infection management. Besides improving infrastructural aspects on a hospital level, including surveillance of the use of anti-infective agents and nosocomial infections, collation and interpretation of statistics on resistance and formulation of local treatment guidelines, ABS teams go to the wards and advise treating physicians on antibiotic therapy...
January 8, 2018: Der Anaesthesist
https://www.readbyqxmd.com/read/29310974/sepsis-in-tropical-regions-report-from-the-task-force-on-tropical-diseases-by-the-world-federation-of-societies-of-intensive-and-critical-care-medicine
#14
Steven McGloughlin, Guy A Richards, Mohd Basri Mat Nor, Shirish Prayag, Tim Baker, Pravin Amin
Sepsis and septic shock in the tropics are caused by a wide array of organisms. These infections are encountered mainly in low and middle-income countries (LMIC) where a lack of infrastructure and medical facilities contribute to the high morbidity and mortality. Published sepsis guidelines are based on studies primarily performed in high income countries and as such recommendations may or may not be relevant to practice in the tropics. Failure to adhere to guidelines, particularly among non-intensive care specialists even in high-income countries, is an area of concern for sepsis management...
December 30, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29308749/-2017-clinical-breakthroughs-in-critical-care-medicine
#15
Wei Huang
New achievements in critical care medicine 2017 may include updating of "Surviving Sepsis Campaign" international guideline. Comparing evaluation of sequential (sepsis-related) organ failure assessment (SOFA) and quick sequential organ failure assessment (qSOFA), combination therapies with steroid, vitamin B1 and vitamin C in patients with sepsis, identification of endophenotype of sepsis, as well phenotype of acute respiratory distress syndrome (ARDS). However, it is also need to mention some of negative trials, such as levosimendan in patients undergoing cardiac surgery, low-dose immunoglobulin G and polymyxin B hemoperfusion for patient with septic shock, and enteral versus parenteral early nutrition in ventilated adults with shock...
January 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29305954/clinical-use-of-the-polymyxins-the-tale-of-the-fox-and-the-cat
#16
Eric Wenzler, Kristen L Bunnell, Larry H Danziger
BACKGROUND: There is a need to identify practice patterns of polymyxin use, quantify gaps in knowledge, and recognize areas of persistent confusion. METHODS: A structured electronic survey was distributed to physicians, pharmacists, and microbiologists. Demographic information was obtained along with data regarding the availability, stewardship principles, therapeutic usage, dosing, microbiological testing, and knowledge, attitudes, and beliefs regarding the polymyxins...
January 3, 2018: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/29304308/acute-kidney-injury-and-sepsis
#17
Steven J Skube, Stephen A Katz, Jeffrey G Chipman, Christopher J Tignanelli
BACKGROUND: Worldwide, both acute kidney injury (AKI) and sepsis are significant clinical complications, particularly in critical care patients. Sepsis is an important cause of AKI, and AKI is a common complication of sepsis. METHODS: We reviewed the literature, including current practice guidelines, on sepsis-associated AKI. RESULTS: We assessed causes of renal failure, potential mechanisms of sepsis-associated acute kidney injury, current practice guidelines, diagnostic criteria and methods, prevention strategies, treatment options, and outcomes...
January 5, 2018: Surgical Infections
https://www.readbyqxmd.com/read/29301631/primary-prevention-with-statins%C3%A2-in%C3%A2-the%C3%A2-elderly
#18
REVIEW
Martin Bødtker Mortensen, Erling Falk
The burden of atherosclerotic cardiovascular disease (ASCVD) in high-income countries is mostly borne by the elderly. With increasing life expectancy, clear guidance on sensible use of statin therapy to prevent a first and potentially devastating ASCVD event is critically important to ensure a healthy aging population. Since 2013, 5 major North American and European guidelines on statin use in primary prevention of ASCVD have been released by the American College of Cardiology/American Heart Association, the UK National Institute for Health and Care Excellence, the Canadian Cardiovascular Society, U...
January 2, 2018: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29297617/recommendations-for-the-treatment-of-children-with-radiotherapy-in-low-and-middle-income-countries-lmic-a-position-paper-from-the-pediatric-radiation-oncology-society-pros-lmic-and-pediatric-oncology-in-developing-countries-podc-working-groups-of-the-international
#19
Jeannette Parkes, Clayton Hess, Hester Burger, Yavuz Anacak, Verity Ahern, Scott C Howard, Moawia Elhassan, Soha Ahmed, Mithra Ghalibafian, Ahmed Nadeem Abbasi, Bilal Mazhar Qureshi, Mohamed Zaghloul, Eduardo Zubizarreta, Pierre Bey, Alan Davidson, Eric Bouffet, Natia Esiashvili
Pediatric radiotherapy is a critical part of pediatric oncology protocols and the quality of the radiotherapy may determine the future quality of life for long-term survivors. Multidisciplinary team decision making provides the basis for high-quality care. However, delivery of high-quality radiotherapy is dependent on resources. This article provides guidelines for delivery of good quality radiation therapy in resource-limited countries based on rational procurement and maintenance planning, protocol development, three-dimensional planning, quality assurance, and adequate staff numbers and training...
December 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/29295760/the-contents-of-a-patient-diary-and-its-significance-for-persons-cared-for-in-an-icu-a-qualitative-study
#20
Sandra Strandberg, Lisa Vesterlund, Åsa Engström
OBJECTIVES: The aim of this study was to describe the contents of a patient diary and its significance for persons cared for in an ICU. RESEARCH METHODOLOGY: An empirical study with a qualitative design. Eight telephone interviews and one face-to-face interview were conducted with nine persons previously been treated in an ICU and been given a patient diary. In addition, the person would have read his/her diary. The data have been analysed with qualitative content analysis...
December 30, 2017: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
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