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https://www.readbyqxmd.com/read/28422280/integrating-frailty-research-into-the-medical-specialties-report-from-a-u13-conference
#1
Jeremy Walston, Thomas N Robinson, Susan Zieman, Frances McFarland, Christopher R Carpenter, Keri N Althoff, Melissa K Andrew, Caroline S Blaum, Patrick J Brown, Brian Buta, E Wesley Ely, Luigi Ferrucci, Kevin P High, Stephen B Kritchevsky, Kenneth Rockwood, Kenneth E Schmader, Felipe Sierra, Kaycee M Sink, Ravi Varadhan, Arti Hurria
Although the field of frailty research has expanded rapidly, it is still a nascent concept within the clinical specialties. Frailty, conceptualized as greater vulnerability to stressors because of significant depletion of physiological reserves, predicts poorer outcomes in several medical specialties, including cardiology, human immunodeficiency virus care, and nephrology, and in the behavioral and social sciences. Lack of a consensus definition, proliferation of measurement tools, inadequate understanding of the biology of frailty, and lack of validated clinical algorithms for frail individuals hinders incorporation of frailty assessment and frailty research into the specialties...
April 19, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28416176/maternal-early-warning-systems-towards-reducing-preventable-maternal-mortality-and-severe-maternal-morbidity-through-improved-clinical-surveillance-and-responsiveness
#2
Lisa C Zuckerwise, Heather S Lipkind
Despite increasing awareness of obstetric safety initiatives, maternal mortality and severe maternal morbidity in the United States have continued to increase over the past 20 years. Since results from large-scale surveillance programs suggest that up to 50% of maternal deaths may be preventable, new efforts are focused on developing and testing early warning systems for the obstetric population. Early warning systems are a set of specific clinical signs or symptoms that trigger the awareness of risk and an urgent patient evaluation, with the goal of reducing severe morbidity and mortality through timely diagnosis and treatment...
April 14, 2017: Seminars in Perinatology
https://www.readbyqxmd.com/read/28406346/a-novel-laparoscopic-grasper-with-two-parallel-jaws-capable-of-extracting-the-mechanical-behaviour-of-soft-tissues
#3
Dariush Nazarynasab, Farzam Farahmand, Alireza Mirbagheri, Elnaz Afshari
Data related to force-deformation behaviour of soft tissue plays an important role in medical/surgical applications such as realistically modelling mechanical behaviour of soft tissue as well as minimally invasive surgery (MIS) and medical diagnosis. While the mechanical behaviour of soft tissue is very complex due to its different constitutive components, some issues increase its complexity like behavioural changes between the live and dead tissues. Indeed, an adequate quantitative description of mechanical behaviour of soft tissues requires high quality in vivo experimental data to be obtained and analysed...
April 13, 2017: Journal of Medical Engineering & Technology
https://www.readbyqxmd.com/read/28400680/changes-in-b-type-natriuretic-peptide-and-related-hemodynamic-parameters-following-a-fluid-challenge-in-critically-ill-patients-with-severe-sepsis-or-septic-shock
#4
Shahed Omar, Ahmad Ali, Yahya Atiya, Rudo Lufuno Mathivha, Joel M Dulhunty
CONTEXT: Severe sepsis or septic shock. AIMS: The aim of this study is to examine the effect of a fluid challenge on the B-type natriuretic peptide (BNP) and the hemodynamic state. SETTINGS AND DESIGN: This observational study was conducted in an intensivist-led academic, mixed medical-surgical Intensive Care Unit. SUBJECTS AND METHODS: Focused transthoracic echocardiogram, plasma BNP, and hemodynamic measurements were recorded at baseline and following a 500 ml fluid challenge in thirty patients...
March 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28399011/effect-of-a-patient-repositioning-device-in-an-intensive-care-unit-on-hospital-acquired-pressure-injury-occurances-and-cost-a-before-after-study
#5
Melinda Edger
PURPOSE: The principal aim of this study was to determine the hospital-acquired pressure injury (HAPI) rate before and after introduction of a repositioning device, measure staff-perceived level of exertion with device use, and assess return on investment. DESIGN: 1 group, before-and-after study. SUBJECTS AND SETTING: The sample comprised 717 patients cared for in a 17-bed intensive care unit. The study setting was the medical-surgical intensive care unit at Bon Secours Maryview Medical Center located in the mid-Atlantic United States (Portsmouth, Virginia)...
April 7, 2017: Journal of Wound, Ostomy, and Continence Nursing
https://www.readbyqxmd.com/read/28397555/pyriform-aperture-stenosis-a-novel-approach-to-stenting
#6
Aaron Smith, Amanda Kull, Prasad Thottam, Anthony Sheyn
OBJECTIVES: Congenital nasal pyriform aperture stenosis (CNPAS) is one of several causes of neonatal respiratory distress. Congenital nasal pyriform aperture stenosis can be diagnosed by clinical presentation and evaluated by computed tomography for degree of stenosis. Surgical management of indicated cases involves drillout of pyriform aperture with placement of stents. The following case presents a novel approach to choice of stent in these patients. CASE PRESENTATION: We report the case of an infant diagnosed with CNPAS who underwent surgical correction at 9 days of life, with placement of mometasone fuorate stents...
April 1, 2017: Annals of Otology, Rhinology, and Laryngology
https://www.readbyqxmd.com/read/28393620/progressively-worsening-premature-coronary-artery-disease-adding-anticoagulation-stabilizes-reverses-clinical-symptomatic-disease-progression-in-thrombophilic-atherothrombotic-patients-a-pilot-study
#7
Matan Rothschild, Vybhav Jetty, Christopher Mahida, Ping Wang, Marloe Prince, Naila Goldenberg, Charles J Glueck
In 35 patients with 116 severe premature cardiovascular disease (CVD) events (median age: 48 years), 14 having worsening CVD despite maximal intervention, we evaluated thrombophilia and speculated that anticoagulation might arrest-reverse progressive thrombophilic-atherothrombotic CVD. Thrombophilia-hypofibrinolysis in the 35 patients was compared to 110 patients with venous thromboembolism (VTE) without CVD and to 110 healthy normal controls. Efficacy-safety of anticoagulation was prospectively assessed in 14 of the 35 patients whose CVD worsened over 2 years despite maximal medical-surgical intervention...
January 1, 2017: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/28387610/the-influence-of-apico-coronal-implant-placement-on-post-surgical-crestal-bone-loss-in-humans
#8
Carlo Ercoli, Georges Jammal, Madeline Buyers, Alexandra Athanasiou Tsigarida, Konstantinos Michail Chochlidakis, Changyong Feng, Jack Caton
BACKGROUND: Contradictory results exist regarding the influence of apicocoronal implant placement on crestal bone levels. METHODS: Complete charts of patients ≥18 y.o. with dental implant/s were included. Demographic, medical, surgical and prosthetic information was recorded. Implant Bone levels were evaluated at initial placement, implant uncovery, prosthetic delivery and 3-6, 7-11, and 12-18 months post-implant placement. RESULTS: 55 patients'charts and 134 implants were included...
April 7, 2017: Journal of Periodontology
https://www.readbyqxmd.com/read/28386393/what-are-the-associations-between-the-quantity-of-faculty-evaluations-and-residents-perception-of-quality-feedback
#9
Joseph M Blankush, Brijen J Shah, Scott H Barnett, Gaber Badran, Amanda Mercado, Reena Karani, David Muller, I Michael Leitman
OBJECTIVES: To determine if there is a correlation between the numbers of evaluations submitted by faculty and the perception of the quality of feedback reported by trainees on a yearly survey. METHOD: 147 ACGME-accredited training programs sponsored by a single medical school were included in the analysis. Eighty-seven programs (49 core residency programs and 38 advanced training programs) with 4 or more trainees received ACGME survey summary data for academic year 2013-2014...
April 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/28382678/recognising-and-responding-to-in-hospital-clinical-deterioration-an-integrative-review-of-interprofessional-practice-issues
#10
REVIEW
Emily Allen, Doug Elliott, Debra Jackson
AIMS AND OBJECTIVES: To identify, appraise and synthesise current evidence regarding organisation-wide interprofessional practice issues that facilitate or inhibit effective recognition and response to clinical deterioration, using a theoretical Rapid Response System (RRS) model. BACKGROUND: Recognition and response to clinical deterioration, in adult general medical-surgical ward patients, is embedded as a routine interprofessional practice in acute healthcare organisations worldwide...
April 5, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28372033/behavioral-emergency-response-team-implementation-improves-patient-safety-staff-safety-and-staff-collaboration
#11
Cdr Jennifer M Zicko, Lcdr Rebecca A Schroeder, Cdr William S Byers, Lt Adam M Taylor, Cdr Dennis L Spence
BACKGROUND: Staff members working on our nonmental health (non-MH) units (i.e., medical-surgical [MS] units) were not educated in recognizing or deescalating behavioral emergencies. Published evidence suggests a behavioral emergency response team (BERT) composed of MH experts who assist with deescalating behavioral emergencies may be beneficial in these situations. Therefore, we sought to implement a BERT on the inpatient non-MH units at our military treatment facility. AIMS: The objectives of this evidence-based practice process improvement project were to determine how implementation of a BERT affects staff and patient safety and to examine nursing staffs' level of knowledge, confidence, and support in caring for psychiatric patients and patients exhibiting behavioral emergencies...
April 3, 2017: Worldviews on Evidence-based Nursing
https://www.readbyqxmd.com/read/28371035/valuing-the-role-of-the-non-medical-surgical-assistant-in-australia
#12
Toni Hains, Catherine Turner, Yu Gao, Haakan Strand
No abstract text is available yet for this article.
April 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28370979/cohort-study-on-emergency-general-surgery-patients-and-an-observation-unit
#13
Marilla Dickfos, Hany Ibrahim, Andrew Evans, Robert Franz
BACKGROUND: Medium-sized, non-trauma hospitals experience many of the same difficulties as tertiary centres do when it comes to managing emergency general surgery patients. However, acute surgical units are not a financially viable option in these hospitals. To improve the care of emergency general surgery patients at one such hospital, a Rapid Assessment Medical Surgical (RAMS) unit was developed to decrease the time to review and increase the efficiency in caring for these patients...
March 30, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28369383/no-role-for-patient-body-weight-on-renal-function-assessment-for-drug-dosing
#14
Robert E Ariano, Sheryl A Zelenitsky, Kristen R Poncsak, J Christine Davis, Lavern M Vercaigne
Objectives: To evaluate the ability of body-weight-driven renal function assessment (RFA) formulae to predict on-target elimination rate ranges for gentamicin in patients with varying degrees of renal function. Methods: A 6 year retrospective pharmacokinetic study was conducted at a university teaching hospital. Results: A total of 85 patients met the inclusion criteria and 127 pharmacokinetic files were analysed from patients on medical-surgical wards (53%) and medical-surgical ICUs (13%) receiving intravenous gentamicin for treatment, as well as those for patients receiving it for surgical prophylaxis (34%)...
March 27, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/28366942/renal-and-cardiac-assessment-of-living-kidney-donor-candidates
#15
REVIEW
Ngan N Lam, Krista L Lentine, Amit X Garg
Living kidney donation provides the best therapeutic outcomes for eligible patients with end-stage renal disease. To ensure suitability for living kidney donation, donor candidates undergo a thorough medical, surgical, and psychosocial evaluation by a multidisciplinary transplant assessment team. Numerous guidelines are available to assist clinicians in the process of donor evaluation and selection. These guidelines outline the minimum recommended requirements for donor screening and additional tests that are indicated when abnormalities arise; however, evidence suggests that some of these additional tests might not be required in certain donor candidates...
April 3, 2017: Nature Reviews. Nephrology
https://www.readbyqxmd.com/read/28366224/management-of-prosthetic-joint-infection
#16
REVIEW
Aaron J Tande, Eric O Gomez Urena, Elie F Berbari, Douglas R Osmon
Although uncommon, prosthetic joint infection is a devastating complication. This challenging condition requires a coordinated management approach to achieve good patient outcomes. This review details the general principles to consider when managing patients with prosthetic joint infection. The different medical/surgical treatment strategies and how to appropriately select a strategy are discussed. The data to support each strategy are presented, along with discussion of antimicrobial strategies in specific situations...
March 30, 2017: Infectious Disease Clinics of North America
https://www.readbyqxmd.com/read/28362659/neuroleptic-malignant-syndrome-secondary-to-metoclopramide-use-in-an-elderly-gastroenterologic-surgery-patient
#17
Richard Breeden, Heath Ford, Carey Chrisman, Charles Mascioli
An 84-year-old African American woman was admitted to the hospital secondary to severe abdominal pain accompanied by septic shock. She underwent exploratory laparotomy, which revealed extensive small bowel necrosis likely due to small bowel torsion. A small bowel resection was performed with primary anastomoses and the patient was subsequently transferred to the intensive care unit (ICU). She recovered from shock but had a persistent gastroparesis interfering with enteral feeding, for which metoclopramide was prescribed...
March 2017: Gastroenterology Nursing: the Official Journal of the Society of Gastroenterology Nurses and Associates
https://www.readbyqxmd.com/read/28350642/increased-early-systemic-inflammation-in-icu-acquired-weakness-a-prospective-observational-cohort-study
#18
Esther Witteveen, Luuk Wieske, Tom van der Poll, Marike van der Schaaf, Ivo N van Schaik, Marcus J Schultz, Camiel Verhamme, Janneke Horn
OBJECTIVES: To investigate whether patients who develop ICU-acquired weakness have a different pattern of systemic inflammatory markers compared with critically ill patients who do not develop ICU-acquired weakness. DESIGN: Prospective observational cohort study. SETTING: Mixed medical-surgical ICU of a tertiary care hospital in the Netherlands. PATIENTS: Newly admitted critically ill patients, greater than or equal to 48 hours on mechanical ventilation with a nonneurologic ICU admission diagnosis, were included...
March 27, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28347178/current-evidence-regarding-routine-antibiotic-prophylaxis-in-hand-surgery
#19
John C Dunn, Austin B Fares, Nicholas Kusnezov, Miguel Pirela-Cruz, Gilberto Gonzalez, Justin D Orr, Mark Pallis
BACKGROUND: Although routine antibiotic prophylaxis immediately preceding an orthopedic surgery has become the standard of care in most cases, this practice is poorly defined in hand surgery. The purpose of this analysis is to review the most current literature of antibiotic use in hand surgery. METHODS: A careful review of the literature regarding routine antibiotic prophylaxis in hand surgery was made. Current relevant resources were used in the construction of this review...
March 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28343907/-intra-uterine-insemination-at-either-24%C3%A2-or-48hours-after-ovulation-induction-pregnancy-and-birth-rates
#20
L Haller, F Severac, C Rongieres, J Ohl, K Bettahar, I Lichtblau, O Pirello
OBJECTIVE: Comparing rates of pregnancy and childbirth between IUI at either 24 or 48hours after injection of HCG. METHODS: This is a single-center retrospective study of couples who underwent intrauterine insemination between January 2013 and December 2014 at Medical-Surgical Obstetrical Centre of Schiltigheim. Stimulation of ovulation was done by FSH or HMG, and ovulation induction by 250μg of recombinant HCG. The insemination was performed after 2 days (group D2) or the day after (group D1)...
March 24, 2017: Gynecologie, Obstetrique, Fertilite & Senologie
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