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https://www.readbyqxmd.com/read/28343907/-intra-uterine-insemination-at-either-24%C3%A2-or-48hours-after-ovulation-induction-pregnancy-and-birth-rates
#1
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: Gynecol Obstet Fertil Senol
https://www.readbyqxmd.com/read/28343639/the-benefits-of-a-preoperative-mrsa-swabbing-protocol
#2
Hope Herd
Infection control practices pose a challenge to nursing care in general, but can have a huge negative impact on the perioperative process. Prior to July of 2012, our institution did not perform routine methacillin resistant staphylococcus aureus (MRSA) screening on preoperative patients with a prior history of MRSA. This resulted in patients remaining in isolation throughout their entire perioperative course. Screening for MRSA was delayed until the patient arrived in the medical surgical unit. Many of these patients were later found to have negative nasal swabs...
April 2017: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/28343456/implementation-of-neurocritical-care-is-associated-with-improved-outcomes-in-traumatic-brain-injury
#3
Mypinder S Sekhon, Peter Gooderham, Brian Toyota, Navid Kherzi, Vivien Hu, Vinay K Dhingra, Morad S Hameed, Dean R Chittock, Donald E Griesdale
Background Traditionally, the delivery of dedicated neurocritical care (NCC) occurs in distinct NCC units and is associated with improved outcomes. Institution-specific logistical challenges pose barriers to the development of distinct NCC units; therefore, we developed a consultancy NCC service coupled with the implementation of invasive multimodal neuromonitoring, within a medical-surgical intensive care unit. Our objective was to evaluate the effect of a consultancy NCC program on neurologic outcomes in severe traumatic brain injury patients...
March 27, 2017: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
https://www.readbyqxmd.com/read/28341559/-moyamoya-disease-associated-with-kidney-angiodysplasia-in-a-child
#4
A Dibi, Z Maana, F Jabourik, A Bentahila
INTRODUCTION: Moyamoya disease is a progressive, chronic occlusive vascular disease of the circle of Willis arteries leading to the development of collateral circulation to compensate the occlusion. CASE REPORT: An 11-year-old girl presented an abrupt loss of consciousness and a right-sided motor deficit. Clinical examination found hypertension with 220/120mmHg arterial blood pressure. Brain magnetic resonance imaging showed a large left hemispheric ischemic lesion...
March 21, 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28338582/validation-of-the-clinician-graded-electronic-facial-paralysis-assessment-the-eface
#5
Lauren Sh Chong, Timothy J Eviston, Tsu-Hui Hubert Low, Shaheen Hasmat, Susan E Coulson, Jonathan R Clark
BACKGROUND: Facial paralysis remains a debilitating condition despite advances in medical, surgical and adjunctive interventions. Established grading systems used to assess facial paralysis and interventional outcomes have well described limitations. The Electronic Facial Paralysis Assessment (the eFACE), a clinician-graded zone-based facial function scale, has recently emerged as a grading tool that may provide greater sensitivity when assessing incomplete paralysis and post-surgical improvement...
March 3, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28338222/long-term-self-reported-cognitive-problems-after-delirium-in-the-intensive-care-unit-and-the-effect-of-systemic-inflammation
#6
Annemiek E Wolters, Linda M Peelen, Dieuwke S Veldhuijzen, Irene J Zaal, Dylan W de Lange, Wietze Pasma, Diederik van Dijk, Olaf L Cremer, Arjen J C Slooter
OBJECTIVES: To describe the association between intensive care unit (ICU) delirium and self-reported cognitive problems in 1-year ICU survivors, and investigate whether this association was altered by exposure to systemic inflammation during ICU stay. DESIGN: Prospective cohort study. SETTING: Dutch medical-surgical ICU. PARTICIPANTS: One-year ICU survivors, admitted to the ICU ≥48 hours. MEASUREMENTS: Self-reported cognitive problems were measured with the Cognitive Failures Questionnaire (CFQ)...
March 24, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28337077/antithrombin-iii-doses-rounded-to-available-vial-sizes-in-critically-ill-pediatric-patients
#7
Winifred M Stockton, Eimeira Padilla-Tolentino, Carolyn E Ragsdale
OBJECTIVES: Children have decreased levels of antithrombin III (AT III) compared to adults. These levels may be further decreased during acute illness. Administration of exogenous AT III can increase anticoagulant efficacy. The objective of this study was to evaluate AT III doses rounded to available vial sizes compared to partial vial doses in critically ill pediatric patients, including patients receiving extracorporeal membrane oxygenation (ECMO) and continuous renal replacement therapy (CRRT)...
January 2017: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/28336202/medical-surgical-activity-and-the-current-state-of-training-of-urology-residents-in-spain-results-of-a-national-survey
#8
M E Rodríguez-Socarrás, J Gómez Rivas, M García-Sanz, L Pesquera, L Tortolero-Blanco, M Ciappara, A Melnick, J Colombo, G Patruno, Á Serrano-Pascual, J Bachiller-Burgos, J M Cozar-Olmo
OBJECTIVES: To determine the actual state of medical-surgical activity and training for urology residents in Spain. MATERIAL AND METHOD: We designed 2 anonymous surveys, which were uploaded with the Google Docs(©) tool so that the respondents could answer the surveys online. The online collection period was September 2015 to January 2016. The collected data were processing using the statistical programme IBM SPSS for Windows, Version 21.0 and the programme R version 3...
March 20, 2017: Actas Urologicas Españolas
https://www.readbyqxmd.com/read/28323687/multilevel-factors-associated-with-injurious-falls-in-acute-care-hospitals
#9
Yunchuan Lucy Zhao, Marjorie Bott, Jianghua He, Heejung Kim, Shin Hye Park, Nancy Dunton
Using National Database of Nursing Quality Indicators data from July 2013 to June 2014, this correlational study examined the associations of injurious falls among all patient falls with multilevel factors in hospitals. The sample included all falls recorded in adult medical, surgical, combined medical-surgical, and step-down units (N = 2299) in participating hospitals (N = 488). Hierarchical negative binominal regression analyses were performed. Results revealed hospital and unit organizational factors associated with inpatient injurious falls...
March 20, 2017: Journal of Nursing Care Quality
https://www.readbyqxmd.com/read/28322664/trust-development-with-the-spanish-speaking-mexican-american-patient
#10
Sharon M Jones
Interpersonal trust between patient and nurse is important in patient-centered care. Trust development may be more difficult if the patient and nurse do not speak the same language. In this grounded theory study, Spanish-speaking Mexican American adults ( n = 20) hospitalized on a medical-surgical or obstetric unit in the Midwestern United States were interviewed. Through data analysis, a model of how trust develops between nurse and patient revealed eight categories and the core category Caring for Me Well Even When Not Understanding Me...
January 1, 2017: Western Journal of Nursing Research
https://www.readbyqxmd.com/read/28322104/feasibility-of-laparoscopic-abdominal-wall-reconstruction-in-an-outpatient-community-hospital-setting-using-cptfe-prosthetic-mesh-a-prospective-multicenter-case-series
#11
Terry Unruh, Joseph Adjei Boachie, Eduardo Smith-Singares
Objective This study investigated the use of prosthetic condensed polytetrafluoroethylene (cPTFE) for laparoscopic ventral hernia repair (LVHR) in an outpatient community-hospital setting. Methods Patients underwent LVHR with cPTFE at one of three community hospitals. Primary endpoint was hernia recurrence at 1-year postoperatively. Secondary endpoints included pain, surgical site infection, medical/surgical complications, and patient-reported outcomes. Results This study included 65 females and 52 males, aged 46...
December 2016: Journal of International Medical Research
https://www.readbyqxmd.com/read/28321375/cost-effectiveness-analysis-of-surgical-versus-medical-treatment-of-prolactinomas
#12
Corinna C Zygourakis, Brandon S Imber, Rebecca Chen, Seunggu J Han, Lewis Blevins, Annette Molinaro, James G Kahn, Manish K Aghi
Background Few studies address the cost of treating prolactinomas. We performed a cost-utility analysis of surgical versus medical treatment for prolactinomas. Materials and Methods We determined total hospital costs for surgically and medically treated prolactinoma patients. Decision-tree analysis was performed to determine which treatment produced the highest quality-adjusted life years (QALYs). Outcome data were derived from published studies. Results Average total costs for surgical patients were $19,224 ( ± 18,920)...
April 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28299720/ketamine-infusion-as-a-counter-measure-for-opioid-tolerance-in-mechanically-ventilated-children-a-pilot-study
#13
Felix Neunhoeffer, Anja Hanser, Martin Esslinger, Vanja Icheva, Matthias Kumpf, Ines Gerbig, Michael Hofbeck, Jörg Michel
BACKGROUND: Drug rotation to prevent opioid tolerance is well recognized in chronic pain management. However, ketamine infusion as a counter measure for opioid tolerance is rarely described in mechanically ventilated children developing tolerance from prolonged opioid infusion. PATIENTS AND METHODS: We performed a retrospective study in a 14-bed medical-surgical-cardiac pediatric intensive care unit. Thirty-two mechanically ventilated children who had developed tolerance from prolonged intravenous infusion of opioids received a continuous intravenous infusion of ketamine as an opioid substitute for more than 2 days, scheduled in a drug rotation protocol...
March 15, 2017: Paediatric Drugs
https://www.readbyqxmd.com/read/28297072/operational-failures-detected-by-frontline-acute-care-nurses
#14
Kathleen R Stevens, Eileen P Engh, Heather Tubbs-Cooley, Deborah Marks Conley, Tammy Cupit, Ellen D'Errico, Pam DiNapoli, Joleen Lynn Fischer, Ruth Freed, Anne Marie Kotzer, Carolyn L Lindgren, Marie Ann Marino, Lisa Mestas, Jessica Perdue, Rebekah Powers, Patricia Radovich, Karen Rice, Linda P Riley, Peri Rosenfeld, Linda Roussel, Nancy A Ryan-Wenger, Linda Searle-Leach, Nicole M Shonka, Vicki L Smith, Laura Sweatt, Mary Townsend-Gervis, Ellen Wathen, Janice S Withycombe
Frontline nurses encounter operational failures (OFs), or breakdowns in system processes, that hinder care, erode quality, and threaten patient safety. Previous research has relied on external observers to identify OFs; nurses have been passive participants in the identification of system failures that impede their ability to deliver safe and effective care. To better understand frontline nurses' direct experiences with OFs in hospitals, we conducted a multi-site study within a national research network to describe the rate and categories of OFs detected by nurses as they provided direct patient care...
March 15, 2017: Research in Nursing & Health
https://www.readbyqxmd.com/read/28293685/healthcare-team-perceptions-of-a-portal-for-parents-of-hospitalized-children-before-and-after-implementation
#15
Michelle M Kelly, Shannon M Dean, Pascale Carayon, Tosha B Wetterneck, Peter L T Hoonakker
BACKGROUND: Patient electronic health record (EHR) portals can enhance patient and family engagement by providing information and a way to communicate with their healthcare team (HCT). However, portal implementation has been limited to ambulatory settings and met with resistance from HCTs. OBJECTIVE: We evaluated HCT perceptions before and 6-months after implementation of an inpatient EHR portal application on a tablet computer given to parents of hospitalized children...
March 15, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28285032/the-association-between-physician-turnover-the-july-effect-and-survival-after-in-hospital-cardiac-arrest
#16
Laura Myers, Bassem Mikhael, Paul Currier, Katherine Berg, Anupam Jena, Michael Donnino, Lars W Andersen
IMPORTANCE: The July Effect refers to adverse outcomes that occur as a result of turnover of the physician workforce in teaching hospitals during the month of June. OBJECTIVE: As a surrogate for physician turnover, we used a multivariable difference-in-difference approach to determine if there was a difference in outcomes between May and July in teaching versus non-teaching hospitals. DESIGN: We used prospectively collected observational data from United States hospitals participating in the Get With The Guidelines(®)-Resuscitation registry...
March 8, 2017: Resuscitation
https://www.readbyqxmd.com/read/28282305/ce-original-research-identifying-hospitalized-patients-at-risk-for-harm-a-comparison-of-nurse-perceptions-vs-electronic-risk-assessment-tool-scores
#17
Andrea Stafos, Susan Stark, Kathryn Barbay, Kristen Frost, David Jackel, Lindsey Peters, Elizabeth Riggs, Susan Schedler, Shalan Stroud
: Objective: In many hospitals, nurse-led "safety huddles" are used to relay patient safety information, although whether this effectively identifies patients at risk for harm has not been determined. New electronic risk assessment tools are designed to identify patients at risk for harm during hospitalization, based on specific markers in the electronic health record. This study sought to compare the results of both methods. The findings may help to enhance decision making at the level of care delivery. METHODS: A nonexperimental correlational study was conducted over a three-week period in 2015 in a large metropolitan acute care community hospital...
April 2017: American Journal of Nursing
https://www.readbyqxmd.com/read/28279377/use-of-imaging-endpoints-in-clinical-trials
#18
REVIEW
Linda D Gillam, Jonathon Leipsic, Neil J Weissman
Cardiovascular imaging is an integral component of many clinical trials beyond those for which the primary goal is to evaluate or validate imaging technologies. The scope of such trials is broad, ranging from those in which a medical, surgical, or interventional cardiovascular device or drug is being evaluated to those in which there is concern about cardiovascular adverse events complicating treatment for noncardiac conditions. This paper discusses study design as it pertains to the incorporation of imaging elements, the important role played by imaging core laboratories, the rationale for and approaches to involvement of imagers in clinical trials, and guidance by the U...
March 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28277152/visuospatial-processing-in-adolescents-with-critical-congenital-heart-disease-organization-integration-and-implications-for-academic-achievement
#19
Jessica L Bean Jaworski, Matthew T White, David R DeMaso, Jane W Newburger, David C Bellinger, Adam R Cassidy
Among the most significant factors affecting quality of life in individuals with critical congenital heart disease (CCHD) are neurodevelopmental challenges, including deficits in visuospatial processing and academic achievement. Few studies have compared outcomes across CCHD subgroups, despite their significant differences in anatomy/physiology and medical/surgical courses. This study compared visuospatial processing abilities using the Developmental Scoring System for the Rey-Osterrieth Complex Figure (DSS-ROCF) across groups of adolescents with CCHD (d-transposition of the great arteries [TGA, n = 139], Tetralogy of Fallot [TOF, n = 68], single-ventricle cardiac anatomy requiring the Fontan operation [SVF, n = 145]) and a group of healthy controls (CTR, n = 111), and examined the validity of visuospatial processing in predicting concurrent academic outcomes...
February 16, 2017: Child Neuropsychology: a Journal on Normal and Abnormal Development in Childhood and Adolescence
https://www.readbyqxmd.com/read/28276285/gastric-conduit-obstruction-due-to-gastroduodenal-compression-a-new-complication-post-ivor-lewis-oesophagectomy
#20
Victoria A Perkins, Samuel McFerran, Ali Kordzadeh, Elias Sdralis, Bruno Lorenzi, Alexandros Charalabopoulos
INTRODUCTION: Oesophagectomy for oesophageal carcinoma carries a high risk of significant morbidity and mortality. Delayed gastric emptying is a relatively common complication following this procedure. A variety of medical, surgical and endoscopic strategies have been described to manage it. The vast majority of cases are related to post-operative pyloric dysfunction and are amenable to conventional management strategies. PATIENTS AND METHODS: We present a new case of a patient with a duodenal hiatus hernia resulting in extrinsic gastroduodenal compression by the massively distended gastric conduit as a cause of gastric outlet obstruction following laparoscopic-assisted Ivor-Lewis oesophagectomy 2 years previously...
March 9, 2017: Acta Chirurgica Belgica
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