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H X Shi, J Z Wu, G B Chen, B Z Zhu, W Y Yan, L Chen, Y J Xiao, L Y Zhang
Objective: To assess the effectiveness in optimizing resources and shortening critical children's waiting time in pediatric emergency department (PED) with five-level pediatric emergency triage system (PETS). Methods: This retrospective study was conducted in the First Affiliated Hospital of Xiamen University after PETS was applied. The data of patients who visited the pediatric emergency department from January 2015 to December 2017 were collected and analyzed, including age, sex, diseases, visiting time, triage rate and destination...
December 2, 2018: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
Cynthia J Sieck, Daniel M Walker, Jennifer L Hefner, Jaclyn Volney, Timothy R Huerta, Ann Scheck McAlearney
BACKGROUND:  Patient portals, and the secure messaging feature in particular, have been studied in the outpatient setting, but research in the inpatient setting is relatively less mature. OBJECTIVE:  To understand the topics discussed in secure messaging in the inpatient environment, we analyzed and categorized messages sent within an inpatient portal. MATERIALS AND METHODS:  This observational study examined the content of all secure messages sent from December 2013 to June 2017 within an inpatient portal at a large Midwestern academic medical center (AMC)...
October 2018: Applied Clinical Informatics
Frank A Giordano, Grit Welzel, Victor Siefert, Lennart Jahnke, Thomas Ganslandt, Frederik Wenz, Anca-Ligia Grosu, Felix Heinemann, Nils H Nicolay
There is accumulating evidence from randomized trials suggesting that digital patient-centered care allows a more reliable detection of tumour-related symptoms and adverse events - with a direct impact on overall survival. Consequently, a variety of unsynchronized approaches were kicked off to (electronically) measure patient-reported outcomes (PROs). Despite increasing evidence that PRO data are highly relevant for patient care, the data generated in these initial projects lack standardized processing pathways in order to impact clinical routine; therefore, potential future routine PRO assessments require adequate analysis, storage and processing to allow a robust, reproducible and reliable incorporation into routine clinical decision-making...
December 5, 2018: Oncology
Stephanie Petty, Tom Dening, Amanda Griffiths, Donna Maria Coleston
Background and Objectives: People with dementia are vulnerable when in hospital, with serious risks to their physical and emotional well-being. Hospital staff are expected to understand and respond to the emotions of the patient; however, it is not known how this can be achieved. We provide a concise description of achievable emotion-focused care for patients with dementia. Design and Methods: Exploratory qualitative interviews were conducted with a whole U.K. hospital ward providing dementia care, constituting 47 staff members...
December 4, 2018: Gerontologist
Gillian A M Tarr, Linda Chui, Bonita E Lee, Xiao-Li Pang, Samina Ali, Alberto Nettel-Aguirre, Otto G Vanderkooi, Byron M Berenger, James Dickinson, Phillip I Tarr, Steven Drews, Judy MacDonald, Kelly Kim, Stephen B Freedman
Background: The ability to identify bacterial pathogens that necessitate specific clinical management or public health action in children with acute gastroenteritis is crucial to patient care and public health. However, existing stool testing guidelines offer inconsistent recommendations, and their performance characteristics are unknown. We evaluated six leading gastroenteritis guidelines (e.g. those of the Centers for Disease Control and Prevention and Infectious Disease Society of America) that recommend when to test children's stool for bacterial enteropathogens...
December 4, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Antônio Carlos Ferreira, Antônio Lúcio Teixeira, Marise Fagundes Silveira, Mariângela Carneiro
INTRODUCTION: Quality of life (QoL) is important for people living with HIV/AIDS, particularly as the disease progresses. This study evaluated the QoL of people living with HIV/AIDS (PLWHA), as well as its predictors, in one of the most impoverished regions of Brazil. METHODS: This cross-sectional study was conducted with patients older than 18 years with HIV/AIDS from two specialized HIV/AIDS care centers in the city of Montes Claros between 2013 and 2014. Sample size was calculated considering the estimates of mean scores for various dimensions of the European Portuguese version of the World Health's Organization Quality of Life Instrument in HIV Infection (WHOQOL-HIV Bref)...
November 2018: Revista da Sociedade Brasileira de Medicina Tropical
Gabriel de Almeida Ferreira, Marcelo Abrão Rezende, Roberta Lilian Fernandes de Sousa Meneghim, Silvana Artioli Schellini
OBJECTIVE: To evaluate the effectiveness of mobile ophthalmic unit screenings and to investigate barriers between community care and resolution of the problem at a tertiary center. METHODS: This prospective study evaluated a convenience sample from 10 municipalities in São Paulo State, Brazil. Patients were assessed in the municipality by a mobile ophthalmic unit and underwent a complete ophthalmic consultation. Patients were referred as warranted to a tertiary hospital...
November 29, 2018: Revista de Saúde Pública
Hasan Yusefzadeh, Alireza Didarloo, Bahram Nabilou
OBJECTIVES: Injection safety during anesthesia is a challenging health care issue in Iranian hospitals. Anesthesia is one of the most medication-intensive procedures in healthcare and injecting patients are an integral part of that care. The present study aimed to assess the status of medication injection safety practice in a teaching center. DESIGN, SETTING, PARTICIPANTS: A prospective cross-sectional study was done in 2014-2015 at a 500-bed secondary level teaching hospital affiliated with Urmia University of Medical Sciences, Iran...
2018: PloS One
Katherine Young, Amar Gupta, Rafael Palacios
BACKGROUND: A shortage of pediatricians and long wait times in the hospitals render more efficient follow-up visits increasingly important. Virtual visits between physician and patient offer a solution to this problem. Increased awareness, improved technology, and efficient scheduling methods will contribute to the quality and adoption of telemedicine programs. INTRODUCTION: The aim of this study was to analyze the impact of pediatric telemedicine on wait times and visit durations, as compared with in-person visits...
December 5, 2018: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
Harun Kundi, Jeffrey J Popma, Kamal R Khabbaz, Louis M Chu, Jordan B Strom, Linda R Valsdottir, Changyu Shen, Robert W Yeh
Importance: Hospital outcomes for transcatheter aortic valve replacement (TAVR) may be dependent on the quality of evaluation, personnel, and procedural and postprocedural care common to patients undergoing cardiac surgery. Objectives: We sought to assess whether those hospitals with better patient outcomes for surgical aortic valve replacement (SAVR) subsequently achieved better TAVR outcomes after launching TAVR programs. Design, Setting, and Participants: This national cohort included US patients 65 years and older...
December 5, 2018: JAMA Cardiology
Victoria M Fratto, Aileen Chang, Tracy Anton, Heather Y Sun, Leah M Lamale-Smith, Dolores H Pretorius
This study evaluates the impact of extended cardiac views on examination time, repeat imaging, and anomaly detection before and after implementation of 76811 guidelines (American Institute of Ultrasound in Medicine Consensus 2014). It is a retrospective study of singleton pregnancies undergoing detailed ultrasound imaging at 18 weeks' gestation or greater before and after the protocol change in an academic, tertiary care fetal center. Views required prior to 2014: 4-chamber, left outflow tract, right outflow tract...
December 3, 2018: Ultrasound Quarterly
Susanne Muehlschlegel
PURPOSE OF REVIEW: This article reviews the epidemiology, clinical presentation, diagnosis, and management of patients with aneurysmal subarachnoid hemorrhage (SAH). SAH is a type of hemorrhagic stroke and is a neurologic emergency with substantial morbidity and mortality. This article reviews the most common and potentially life-threatening neurologic and medical complications to promote their early recognition and prevent secondary brain injury. RECENT FINDINGS: Over the past 30 years, the incidence of SAH has remained stable; yet, likely because of improved care in specialized neurocritical care units, discharge mortality has considerably decreased...
December 2018: Continuum: Lifelong Learning in Neurology
Franca Wagner, Melanie Buchwalder, Roland Wiest, Marco D Caversaccio, Dominique Vibert
OBJECTIVE: To compare the neurotological results of five patients suffering from progressive hearing loss and ataxia due to superficial siderosis (SS) with the magnetic resonance imaging (MRI) findings. STUDY DESIGN: Retrospective case review. SETTING: Primary and hospital care center. PARTICIPANTS: Five adult patients with neurotological symptoms of SS underwent MRI with acquisition of our temporal bone protocol including 3D-constructive interference in steady state (3D-CISS) and susceptibility-weighted imaging (SWI)...
December 3, 2018: Otology & Neurotology
R Abdullaiev, G Oleynik, V Kremen, A Gryazin, E Timchenko
The problem of treating patients with loss of the skin and with a complicated course of the wound process remains topical. The problem is that, despite the relative technical simplicity of the dermatension method, the most significant complication is the decubitus of the stretchable flap, which is associated with a relatively high incidence of acute blood circulatory disturbances in the stretch tissues due to vascular compression with an excessive amount of injected fluid. The aim of the work is to improve the method of dermatension in reconstructive and recovery surgery of soft tissue defects of various genesis by planning and implementing dermatension at all its steps with instrumental control of the process using ultrasound and ICT in a complex...
October 2018: Georgian Medical News
Sinan Akay, Mehmet Burak Aşık, Sami Eksert
BACKGROUND: The aim of this study was to investigate the characteristics of shrapnel distribution in the body and a possible relationship to the type of weapon and type of location of the conflict. METHODS: The records of 246 patients admitted to a level-III trauma center with any kind of firearm injury were examined retrospectively. Ninety patients who had at least 1 radiologically-proven piece of shrapnel in their body were included in the study. For the purposes of the study, the body was divided into 5 regions (head/neck, thorax/back, abdomen/pelvis/waist, upper extremities, and lower extremities) and shrapnel distribution was noted according to these divisions...
November 2018: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
Heather Taffet Gold, Raj J Karia, Alissa Link, Rachel Lebwohl, Joseph D Zuckerman, Thomas J Errico, James D Slover, Aaron J Buckland, Devin M Mann, Michael N Cantor
We integrated and optimized patient-reported outcome measures into the electronic health record to provide quantitative, objective data regarding patients' health status, which is important for patient care, payer contracts, and research. With a multidisciplinary team from information technology, clinical informatics, population health, and physician champions, we used formal human-computer interaction techniques and user-centered design to integrate several technology platforms and computerized adaptive testing for the National Institutes of Health Patient-Reported Outcomes Measurement Information System...
December 5, 2018: Health Informatics Journal
Eoi Jong Seo, Taewoong Um, Young Hee Yoon
IMPORTANCE: Analyzing choroidal flow in central serous chorioretinopathy (CSC) with novel device BACKGROUND: To examine the abnormal morphology of choriocapillary flow with optical coherence tomography angiography (OCTA) according to the presence of subretinal fluid (SRF) in CSC. DESIGN: A hospital-based retrospective study PARTICIPANTS: We analyzed OCTA results of 68 eyes (68 patients) diagnosed as CSC with or without SRF (active and resolved CSC, respectively) at the Asan Medical Center...
December 5, 2018: Clinical & Experimental Ophthalmology
Daisuke Nagasato, Hitoshi Tabuchi, Hideharu Ohsugi, Hiroki Masumoto, Hiroki Enno, Naofumi Ishitobi, Tomoaki Sonobe, Masahiro Kameoka, Masanori Niki, Ken Hayashi, Yoshinori Mitamura
The aim of this study is to assess the performance of two machine-learning technologies, namely, deep learning (DL) and support vector machine (SVM) algorithms, for detecting central retinal vein occlusion (CRVO) in ultrawide-field fundus images. Images from 125 CRVO patients ( n =125 images) and 202 non-CRVO normal subjects ( n =238 images) were included in this study. Training to construct the DL model using deep convolutional neural network algorithms was provided using ultrawide-field fundus images. The SVM uses scikit-learn library with a radial basis function kernel...
2018: Journal of Ophthalmology
Jayshil J Patel, Jonathan Kurman, Easa Al-Ghandour, Krishna Thandra, Samih Mawari, Jeanette Graf, Jennifer Kovac, Lisa Rein, Steven Q Simpson
Purpose: To identify variables associated with 24-h mortality after inter-hospital transfer. Materials and methods: Single center retrospective study of adult patients transferred to a tertiary care medical ICU between 1 January 2010 and 15 April 2014. Demographic, clinical, physiologic, and laboratory data were collected. The Lasso method was used for logistic regression to identify predictors of 24-h mortality after inter-hospital ICU transfer. Results: We identified 773 patients...
November 2018: Journal of the Intensive Care Society
Navneet S Majhail, Elizabeth Murphy, Purushottam Laud, Jaime M Preussler, Ellen M Denzen, Beatrice Abetti, Alexia Adams, RaeAnne Besser, Linda J Burns, Jan Cerny, Rebecca Drexler, Theresa Hahn, Lensa Idossa, Balkrishna Jahagirdar, Naynesh Kamani, Alison Loren, Deborah Mattila, Joseph McGuirk, Heather Moore, Jana Reynolds, Wael Saber, Lizette Salazar, Barry Schatz, Patrick Stiff, John R Wingard, Karen L Syrjala, K Scott Baker
Survivorship care plans may facilitate long-term care for cancer survivors, but their effectiveness has not been established in hematopoietic cell transplantation recipients. We evaluated the impact of individualized survivorship care plans on patient-reported outcomes among transplant survivors. Adult (≥18 years at transplant) survivors who were 1-5 years post-transplantation, proficient in English, and without relapse or secondary cancers were eligible for this multicenter randomized trial. Care plans were developed based on risk-factors and treatment exposures using patient data routinely submitted by transplant centers to the Center for International Blood and Marrow Transplant Research and published guidelines for long-term follow-up of transplant survivors...
December 4, 2018: Haematologica
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