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https://www.readbyqxmd.com/read/29793140/effectiveness-of-a-voluntary-family-befriending-service-a-mixed-methods-evaluation-using-the-donabedian-model
#1
S V Gentry, E F J Powers, N Azim, M Maidrag
OBJECTIVES: Voluntary befriending schemes operate in many countries, promoting public health by supporting vulnerable individuals and families. Use of third sector and voluntary services to complement health and social care provision is increasingly important globally in the context of economic and demographic challenges, but the evidence base around such collaborations is limited. This article reports the results of operational evaluation research seeking to use robust routine work to generate transferable findings for use by those commissioning and providing services...
May 21, 2018: Public Health
https://www.readbyqxmd.com/read/29793139/the-use-of-low-intensity-pulsed-ultrasound-in-treating-delayed-union-of-fifth-metatarsal-fractures
#2
Kar Hao Teoh, Robert Whitham, Jenny F Wong, Kartik Hariharan
BACKGROUND: There are no studies looking at the success rate of low-intensity pulsed ultrasound (LIPUS) in fifth metatarsal fracture delayed unions to our knowledge. The aim of this study is to investigate the use of LIPUS treatment for delayed union of fifth metatarsal fractures. METHODS: A retrospective review of patients who were treated with LIPUS following a delayed union of fifth metatarsal fracture was conducted over a three-year period. RESULTS: There were thirty patients (9 males, 21 females) in this cohort...
January 31, 2018: Foot
https://www.readbyqxmd.com/read/29792735/hip-fracture-in-the-setting-of-limited-life-expectancy-the-importance-of-considering-goals-of-care-and-prognosis
#3
C Bree Johnston, Amanda Holleran, Thuan Ong, Ursula McVeigh, Elizabeth Ames
IMPORTANCE: Many older patients with a limited life expectancy experience fragility fracture of the hip, and this event is associated with increased risk of premature mortality, functional decline, and institutionalization. The treating team, in collaboration with patients and their families, must determine whether a surgical or conservative approach is in the patient's best interest when a patient has limited life expectancy. OBSERVATION: Goals of care discussions appear to be rare in the setting of fragility fracture...
May 24, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29792350/management-of-veins-during-microvascular-decompression-for-idiopathic-trigeminal-neuralgia
#4
Xu Zhao, Shuai Hao, Minqing Wang, Chao Han, Deguang Xing, Chengwei Wang
OBJECT: To summarize our experience in treating veins during microvascular decompression (MVD) procedures for idiopathic trigeminal neuralgia (TN). METHODS: A total of 210 patients who underwent single MVD for idiopathic TN were retrospectively studied. The offending vessels were summarized. The treatment choices for veins during the operation were reviewed. Postoperative long-term outcomes were determined by follow-up. RESULTS: Veins accounted for 26...
May 24, 2018: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/29792259/going-digital-a-checklist-in-preparing-for-hospital-wide-electronic-medical-record-implementation-and-digital-transformation
#5
Ian A Scott, Clair Sullivan, Andrew Staib
Objective In an era of rapid digitisation of Australian hospitals, practical guidance is needed in how to successfully implement electronic medical records (EMRs) as both a technical innovation and a major transformative change in clinical care. The aim of the present study was to develop a checklist that clearly and comprehensively defines the steps that best prepare hospitals for EMR implementation and digital transformation. Methods The checklist was developed using a formal methodological framework comprised of: literature reviews of relevant issues; an interactive workshop involving a multidisciplinary group of digital leads from Queensland hospitals; a draft document based on literature and workshop proceedings; and a review and feedback from senior clinical leads...
May 24, 2018: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/29792218/sudden-cardiac-arrest-under-spinal-anesthesia-in-a-mission-hospital-a-case-report-and-review-of-the-literature
#6
Bamidele Johnson Alegbeleye
BACKGROUND: Sudden cardiac arrest following spinal anesthesia is relatively uncommon and a matter of grave concern for any anesthesiologist as well as clinicians in general. There have been, however, several reports of such cases in the literature. Careful patient selection, appropriate dosing of the local anesthetic, volume loading, close monitoring, and prompt intervention at the first sign of cardiovascular instability should improve outcomes. The rarity of occurrence and clinical curiosity of this entity suggest reporting of this unusual and possibly avoidable clinical event...
May 24, 2018: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/29791985/-management-of-acute-cholecystitis
#7
REVIEW
Seung Ok Lee, Sung Kyun Yim
Acute cholecystitis is a common serious complication of gallstones. The reported mortality of acute cholecystitis is approximately 3%, but the rate increases with age or comorbidity of the patient. If appropriate treatment is delayed, complications can develop as a consequence with a grave prognosis. The current standard of care in acute cholecystitis is an early laparoscopic cholecystectomy with the appropriate administration of fluid, electrolyte, and antibiotics. On the other hand, the severity of the disease and patient's operational risk must be considered...
May 25, 2018: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
https://www.readbyqxmd.com/read/29791984/-the-management-of-common-bile-duct-stones
#8
REVIEW
Chang Hwan Park
Common bile duct (CBD) stone is a relatively frequent disorder with a prevalence of 10-20% in patients with gallstones. This is also associated with serious complications, including obstructive jaundice, acute suppurative cholangitis, and acute pancreatitis. Early diagnosis and prompt treatment is the most important for managing CBD stones. According to a recent meta-analysis, endoscopic ultrasonography and magnetic resonance cholangiopancreatography have high sensitivity, specificity, and accuracy for the diagnosis of CBD stones...
May 25, 2018: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
https://www.readbyqxmd.com/read/29791712/surgical-management-after-hysteroscopic-sterilization-minimally-invasive-approach-incorporating-intraoperative-fluoroscopy-for-symptomatic-patients-with-2-essure%C3%A2-devices
#9
E Scott Sills, Natalie S Rickers, Xiang Li
OBJECTIVE: To describe a non-hysterectomy surgical technique for symptomatic patients with >2 Essure® (Bayer Healthcare, Whippany, New Jersey) devices. DESIGN: Patients (n=4) presented with sharp pelvic pain, irregular vaginal bleeding, dyspareunia, weight gain, hair loss, fatigue, and/or diffuse skin rash, all of which were absent before undergoing hysteroscopic sterilization (HS). Hysterosalpingogram obtained before surgical excision of contraceptive tubal implants confirmed more than two Essure® devices in all patients...
June 1, 2018: Surgical Technology International
https://www.readbyqxmd.com/read/29791187/a-single-lab-test-to-aid-pierre-robin-sequence-severity-diagnosis
#10
Artur Fahradyan, Beina Azadgoli, Michaela Tsuha, Mark M Urata, Stacey H Francis
OBJECTIVE: The workup of patients with Pierre Robin sequence (PRS) consists of a physical examination, O2 saturation, and polysomnography to determine the severity of respiratory obstruction and need for surgery. We suggest that capillary blood gas (CBG) may be a better physiologic representation of airway obstruction and should be routinely used in the management of patients with PRS. DESIGN: This is a multicenter study based on a retrospective review of medical records...
January 1, 2018: Cleft Palate-craniofacial Journal
https://www.readbyqxmd.com/read/29790968/-macrovascular-decompression-of-dolichoectatic-vertebral-artery-causing-hemifacial-spasm-using-goretex-sling-2-dimensional-operative-video
#11
Stephan A Munich, Jacques J Morcos
Hemifacial spasm is characterized by painless and involuntary spasms of the muscles supplied by the facial nerve, most commonly involving the orbicularis oculi. The most common cause of hemifacial spasm is compression of the facial nerve's root by the anterior inferior, or posterior inferior, cerebellar arteries (AICA or PICA). However, in <1% of cases, the compression can be due to a dolichoectatic vertebral artery. Microvascular decompression using Teflon patties may be sufficient when the offending artery is small (eg, AICA or PICA)...
May 22, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29790813/-express-increased-nav1-7-expression-in-the-dorsal-root-ganglion-contributes-to-pain-hypersensitivity-after-plantar-incision-in-rats
#12
Jiaoli Sun, Ningbo Li, Guangyou Duan, Yi Liu, Shanna Guo, Cong Wang, Changmao Zhu, Xianwei Zhang
Postoperative pain remains a complex problem that is difficult to manage in the clinical context, seriously affecting rehabilitation and the quality of life of patients after surgery. Nociceptors, of which the cell bodies are located in the dorsal root ganglion (DRG), are crucial for initiating and conducting the pain signal. The peripheral voltage-gated sodium channels, including Nav1.7, which is mainly expressed in the DRG, are key to understanding the mechanism underlying postoperative pain. Nav1.7, in particular, of which mutations in the encoding gene (SCN9A) can determine whether pain occurs, has aroused most attention...
January 1, 2018: Molecular Pain
https://www.readbyqxmd.com/read/29790726/minimally-invasive-approaches-to-craniosynostosis
#13
Arjun V Pendharkar, Maryam N Shahin, Claudio Cavallo, Xiaochun Zhao, Allen L Ho, Eric S Sussman, Gerald A Grant
Craniosynostosis (CS) is defined as the premature fusion of one or more calvarial sutures. This carries several consequences, including abnormal/asymmetric cranial vault development, increased intracranial pressure, compromised neurocognitive development, and craniofacial deformity. Definitive management is surgical with the goal of protecting cerebral development by re-establishing normal cranial vault expansion and correcting cosmetic deformity. In today's practice, CS surgery has advanced radically from simple craniectomies to major cranial vault reconstructive (CVR) procedures...
May 22, 2018: Journal of Neurosurgical Sciences
https://www.readbyqxmd.com/read/29790625/managing-paediatric-bleeding-disorder-patients-undergoing-surgical-procedures-leveraging-the-electronic-medical-record
#14
C Tarango, D Dahale, N Dodson, A Otte, P J Schoettker
INTRODUCTION: Individuals with bleeding disorders have a high risk of bleeding complications with surgical procedures. Careful planning and management of peri-operative treatment is vital for their safety. Yet, inter-provider communication and communication between patients/families and providers is not reliable. AIM: Our haemophilia treatment centre (HTC) created a care gap report that used the electronic medical record to inform our team when patients with bleeding disorders were scheduled for procedures...
May 23, 2018: Haemophilia: the Official Journal of the World Federation of Hemophilia
https://www.readbyqxmd.com/read/29790447/data-driven-process-to-improve-va-surgical-flow
#15
Balmatee Bidassie, William Gunnar, Leigh Starr, George Van Buskirk, Lisa Warner, Clifford Anckaitis, Angela Howard
Purpose During years 2014-2016, Veterans Health Administration National Surgery Office conducted a surgical flow improvement initiative (SFII) to assist low-performing surgery programs to improve their operating room efficiency (ORE). The initiative was co-sponsored by VHA National Surgery Office and VHA Office of Systems Redesign and Improvement. The paper aims to discuss this issue. Design/methodology/approach An SFII algorithm, based on first-time-start (FTS), cancellation rate (CR), lag time (LT) and OR utilization, assigned an ORE performance Level (1-low to 4-high) to each VA Medical Center (VAMC)...
May 14, 2018: International Journal of Health Care Quality Assurance
https://www.readbyqxmd.com/read/29790445/a-study-of-deficiencies-in-teamwork-skills-among-jordan-caregivers
#16
Omar Al-Araidah, Nader Al Theeb, Mariam Bader, Nabeel Mandahawi
Purpose The purpose of this paper is to present the deficiencies in teamwork skills at Jordan hospitals as seen by team members. The study aims to identify training needs to improve teamwork-related soft skills of caregivers to enhance staff satisfaction and improve quality of care. Moreover, the paper provides a methodology to identify the training needs in any healthcare workplace by repeating the same questionnaire. Design/methodology/approach A self-administrated questionnaire was designed to study deficiencies in teamwork and team leadership at Jordan hospitals as seen by team members...
May 14, 2018: International Journal of Health Care Quality Assurance
https://www.readbyqxmd.com/read/29790441/competences-management-for-improving-performance-in-health-organizations
#17
Simone Fanelli, Gianluca Lanza, Antonello Zangrandi
Purpose The purpose of this paper is to describe the design and construction of a privilege mapping system (clinical and organizational competences) of the medical staff of the Niguarda Hospital in Milan, Italy. The second aim is to measure and assess the impact of implementing an evaluation process of clinical competences at the same hospital. Design/methodology/approach The paper retraces the development and implementation of the evaluation of the privilege system, highlighting the subjects involved, the phases and outputs...
May 14, 2018: International Journal of Health Care Quality Assurance
https://www.readbyqxmd.com/read/29790116/prediction-of-shunt-dependency-after-intracerebral-hemorrhage-and-intraventricular-hemorrhage
#18
Lu-Ting Kuo, Hsueh-Yi Lu, Jui-Chang Tsai, Yong-Kwang Tu
BACKGROUND: Spontaneous intracerebral hemorrhage is a disease with high morbidity and mortality. Extension of the hemorrhage into the ventricles is associated with the development of acute hydrocephalus and a poor outcome. Although it can be managed by external ventricular drainage (EVD), a subset of these patients require placement of permanent ventricular shunts. This study aimed to examine the factors on admission that can predict shunt dependency after EVD management. METHODS: Seventy-two patients who underwent EVD were included in this study...
May 22, 2018: Neurocritical Care
https://www.readbyqxmd.com/read/29790083/point-quantification-elastography-in-the-evaluation-of-liver-elasticity-in-healthy-volunteers-a-reliability-study-based-on-operator-expertise
#19
Cristina Felicani, Chiara De Molo, Horia Stefanescu, Fabio Conti, Elena Mazzotta, Veronica Gabusi, Elena Nardi, Antonio Maria Morselli-Labate, Pietro Andreone, Carla Serra
PURPOSE: The assessment of liver fibrosis is essential in the management of patients with chronic liver diseases. Liver biopsy is considered the gold standard procedure for this purpose, though the recent development of new elastosonographic techniques to measure liver stiffness (LS) noninvasively is promising. Point quantification elastography (PQE) showed good results but less is known about the level of skill needed to obtain reliable results. The aim of the study was to evaluate the reproducibility of PQE in assessing LS in healthy subjects comparing three operators with different expertise...
May 22, 2018: Journal of Ultrasound
https://www.readbyqxmd.com/read/29790042/orthopaedic-regenerative-tissue-engineering-en-route-to-the-holy-grail-disequilibrium-between-the-demand-and-the-supply-in-the-operating-room
#20
REVIEW
Ibrahim Fatih Cengiz, Hélder Pereira, Laura de Girolamo, Magali Cucchiarini, João Espregueira-Mendes, Rui L Reis, Joaquim Miguel Oliveira
Orthopaedic disorders are very frequent, globally found and often partially unresolved despite the substantial advances in science and medicine. Their surgical intervention is multifarious and the most favourable treatment is chosen by the orthopaedic surgeon on a case-by-case basis depending on a number of factors related with the patient and the lesion. Numerous regenerative tissue engineering strategies have been developed and studied extensively in laboratory through in vitro experiments and preclinical in vivo trials with various established animal models, while a small proportion of them reached the operating room...
May 22, 2018: Journal of Experimental Orthopaedics
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