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Field Hospital

Respati W Ranakusuma, Yupitri Pitoyo, Eka D Safitri, Sarah Thorning, Elaine M Beller, Sudigdo Sastroasmoro, Chris B Del Mar
BACKGROUND: Acute otitis media (AOM) is a common acute infection in children. Pain is its most prominent and distressing symptom. Antibiotics are commonly prescribed for AOM, although they have only a modest effect in reducing pain at two to three days. There is insufficient evidence for benefits of other treatment options, including systemic corticosteroids. However, systemic corticosteroids are potent anti-inflammatory drugs, and so theoretically could be effective, either alone or as an addition to antibiotics...
March 15, 2018: Cochrane Database of Systematic Reviews
Bruce Cv Campbell, Mark W Parsons
This review summarizes the current state of knowledge regarding the use of imaging to guide stroke treatment. Brain imaging plays a central role in the diagnosis of stroke and identification of the mechanism of stroke, which is relevant to acute treatment, prognosis, and secondary prevention. The chief potential modalities are computed tomography (CT) and magnetic resonance imaging (MRI). Currently, most imaging occurs in hospital but mobile stroke units have expanded CT brain imaging into the prehospital field...
January 1, 2018: International Journal of Stroke: Official Journal of the International Stroke Society
Yifei Lin, Deyi Luo, Banghua Liao, Tongxin Yang, Ye Tian, Tao Jin, Guiming Wang, Hongying Zhou, Hong Li, Kunjie Wang
OBJECTIVE: To compare postoperative outcomes between the perineal inverted-U and the vertical midline incision approaches of the urethroplasty and clarify them via gross anatomy. PATIENTS AND METHODS: A total of 461 male patients, from Jan. 2006 to Jun. 2014, who underwent the urethroplasty via perineal midline vertical or inverted-U incision approach were recruited retrospectively. By match pairing for etiology and stricture length, 410 patients from two groups (205 for each group) were selected...
March 14, 2018: World Journal of Urology
Eiman Zargaran, Richard Spence, Lauren Adolph, Andrew Nicol, Nadine Schuurman, Pradeep Navsaria, Damon Ramsey, S Morad Hameed
Importance: Collection and analysis of up-to-date and accurate injury surveillance data are a key step in the maturation of trauma systems. Trauma registries have proven to be difficult to establish in low- and middle-income countries owing to the burden of trauma volume, cost, and complexity. Objective: To determine whether an electronic trauma health record (eTHR) used by physicians can serve as simultaneous clinical documentation and data acquisition tools. Design, Setting, and Participants: This 2-part quality improvement study included (1) preimplementation and postimplementation eTHR study with assessments of satisfaction by 41 trauma physicians, time to completion, and quality of data collected comparing paper and electronic charting; and (2) prospective ecologic study describing the burden of trauma seen at a Level I trauma center, using real-time data collected by the eTHR on consecutive patients during a 12-month study period...
March 14, 2018: JAMA Surgery
Alireza Sadeghnia, Behzad Koorang Beheshti, Majid Mohammadizadeh
Background: Considering all the latest achievements in neonatal respiratory care, bronchopulmonary dysplasia (BPD) is still among the most prevalent morbidity causes in premature infants. Involvement in this process results in longer period of hospitalization for the newborn and in the long run makes the living conditions more difficult. Taking the multifactorial pathogenesis into account, approaches to tackle chronic lung disease (CLD) are mainly focused on interventions and prevention procedures...
2018: International Journal of Preventive Medicine
Rashmi Agarwalla, Rambha Pathak, Mitasha Singh, Farzana Islam, Mamta Parashar
Background: Ragpickers are informal workers who collect recyclable materials to earn a small wage on daily basis. They work in vulnerable conditions and awareness regarding occupational and environmental hazard is essential for them. Objective: To study the effectiveness of awareness program on various occupational health hazards among the ragpickers. Materials and Methods: This interventional study was conducted from May through October 2016 among the ragpickers living near field practice area of Department of Community Medicine and those living in slum areas around HAHC Hospital, New Delhi, India...
May 2017: Indian Journal of Occupational and Environmental Medicine
F Morales-Martínez
This paper reviews the specialised geriatrics healthcare services of Costa Rica, with particular emphasis on the achievements made in the field of geriatrics following the author's specialist tertiary education and training period at the Professorial Unit at the City Hospital, Edinburgh, 33 years earlier. The paper charts the development and consolidation of an educational programme of geriatrics in Costa Rica against a background of the changing demographic in this Central American nation and the consequent and compelling need for universal coverage of healthcare services targeted to meet the needs of the burgeoning population of older adults...
December 2017: Journal of the Royal College of Physicians of Edinburgh
Selin Elmaoğulları, Zeyra Aycan
Abnormal uterine bleeding (AUB) is the major gynecologic complaint of adolescents admitting to hospital. Heavy menstrual bleeding (HMB) is the most common clinical presentation of AUB. Anovulatory cycles owing to immature hypothalamic-pituitary-ovarian axis is the leading etiology of HMB and there is an accompanying bleeding disorder in almost %20 of patients with HMB. Additionally, endocrine disorders such as hypothyroidism, hyperprolactinemia and polycystic ovary syndrome (PCOS) are possible causes of AUB...
February 28, 2018: Journal of Clinical Research in Pediatric Endocrinology
Anna Hartmann Schmidt, Morten Høyer, Bent Frode Skov Jensen, Mads Agerbaek
BACKGROUND: Resection of residual masses after chemotherapy plays a crucial role in management of patients with germ cell tumours (GCTs). The extent of surgery is controversial and we present the experiences from Aarhus University Hospital over a 20-year period. The aim was to evaluate survival, complications, working ability and quality of life (QOL) following a limited surgical procedure performed to resect residual masses in non-seminomatous testicular cancer patients after chemotherapy...
March 14, 2018: Acta Oncologica
Saksham Gupta, Ivo S Muskens, Luis Bradley Fandino, Alexander F C Hulsbergen, Marike L D Broekman
BACKGROUND: Surgical innovation has advanced outcomes in the field, but carries inherent risk for surgeons and patients alike. Oversight mechanisms exist to support surgeon-innovators through difficulties associated with the innovation process. METHODS: A literature review of ethical risks and oversight mechanisms was conducted. RESULTS: Oversight mechanisms range from the historical concept of surgical exceptionalism to departmental, hospital, and centralized committees...
March 13, 2018: World Journal of Surgery
H J Huang, X Y Chen, Z Y Zheng
Objective: To investigate the clinicopathological features, differential diagnosis, and genetic alteration of Langerhans cell sarcoma (LCS). Methods: Four cases of LCS were collected from Fujian Provincial Hospital and Fuzhou General Hospital of Nanjing Military Command of PLA from July 2013 to January 2017. Clinicopathological features and immunophenotype were retrospectively reviewed in four LCS cases combined with genetic mutation analysis of BRAF and ALK. Results: Four cases included 2 women and 2 men with ages from 42 to 79 years (median=59...
March 8, 2018: Zhonghua Bing Li Xue za Zhi Chinese Journal of Pathology
Steven G Schauer, James A Pfaff
BACKGROUND: Heat injuries are common in the military training environment. Base policies often mandate that heat causalities require evaluation at a higher level of care, which comes at significant use of resources. Laboratory studies are often ordered routinely, but their utility is unclear at this time. METHODS: This project evaluated the use of screening laboratory studies for heat casualties brought to Bayne-Jones Army Community Hospital, Fort Polk, Louisiana...
2018: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
Elliot M Ross, Theodore T Redman
BACKGROUND: Noncompressible junctional and truncal hemorrhage remains a significant cause of combat casualty death. Resuscitative endovascular balloon occlusion of the aorta (REBOA) is an effective treatment for many junctional and noncompressible hemorrhages. The current hospital standard for time of placement of REBOA is approximately 6 minutes. This study examined the training process and the ability of nonsurgical physicians to apply REBOA therapy in an austere field environment. METHODS: This was a skill acquisition and feasibility study...
2018: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
Jason D Pasley, William A Teeter, William B Gamble, Philip Wasick, Anna N Romagnoli, Amelia M Pasley, Thomas M Scalea, Megan L Brenner
BACKGROUND: The management of noncompressible torso hemorrhage remains a significant issue at the point of injury. Resuscitative endovascular balloon occlusion of the aorta (REBOA) has been used in the hospital to control bleeding and bridge patients to definitive surgery. Smaller delivery systems and wirefree devices may be used more easily at the point of injury by nonphysician providers. We investigated whether independent duty military medical technicians (IDMTs) could learn and perform REBOA correctly and rapidly as assessed by simulation...
2018: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
Nicole M Bzdyl, Nadezda Urosevic, Ben Payne, Ray Brockenshire, Michael McIntyre, Michael J Leung, Graham Weaire-Buchanan, Elizabeth Geelhoed, Timothy J J Inglis
PURPOSE: In this field trial of rapid blood culture identification (BCID), we aimed to determine whether the improved speed and accuracy of specific BCID predicted in our earlier pilot study could be obtained in regional hospitals by deploying a multiplex PCR FilmArray (Biomerieux, France) capability in their laboratories. METHODS: We trained local hospital laboratory staff to operate the FilmArray equipment and act on the results. To do this, we integrated the multiplex PCR into the standard laboratory blood culture workflow and reporting procedure...
March 13, 2018: Journal of Medical Microbiology
H Lemke, W Lenz, J Schiffner, A Lechleuthner, R Hoffmann, D Pennig, U Schweigkofler, H J Bail
The introduction of requirements for a minimum intake capacity of trauma patients by the German Trauma Society (DGU) into the so-called white book of treatment of seriously injured patients, is helpful for a sufficient preparation for threats and for dealing with mass casualties for trauma centers as well as for the emergency medical services (EMS). In the hospital information database provided by the Federation of German Medical Directors of Emergency Medical Services, more than 1300 hospitals are currently listed...
March 12, 2018: Der Unfallchirurg
Julie Hui-Chih Wu, Bradley J Langford, Kevin L Schwartz, Rosemary Zvonar, Sumit Raybardhan, Valerie Leung, Gary Garber
Background: Antimicrobial allergy labels, either self-reported or placed in a patient's medical record, are common, but in many cases they are not associated with a true immunoglobulin E-mediated allergic response. Objective: To assess the impact of antimicrobial allergy labels on antimicrobial prescribing, resource utilization, and clinical outcomes. Data Sources: The MEDLINE, Embase, CINAHL, and Scopus electronic databases were searched for the period 1990 to January 2016...
January 2018: Canadian Journal of Hospital Pharmacy
Livio Mordasini, Marco Moschini, Agostino Mattei, Christophe Iselin
PURPOSE OF REVIEW: GreenLight photoselective vaporization (GL-PV) is now established in the treatment of benign prostatic enlargement. The present review outlines the available technical armamentarium and summarizes the current best evidence on functional and safety outcomes. Moreover, future technical developments and refinements are presented. RECENT FINDINGS: GL-PV has evolved to be the most commonly performed procedure, second to conventional transurethral resection of the prostate (TURP) for surgical management of benign prostatic obstruction (BPO)...
March 9, 2018: Current Opinion in Urology
L O Gonçalves, M M Lopes, E R Rezende, G Rs Segundo
BACKGROUND: Few studies have assessed the incidence of eosinophilic esophagitis (EoE) in childhood. The study aim is to determine the incidence of EoE in pediatric patients submitted to upper gastrointestinal endoscopy (UGE), with analysis of epidemiological data regarding sex, age, symptomatology, the frequency of atopy and endoscopic and histological findings. METHODS: A retrospective, observational and analytical study performed with an evaluation of medical records of patients aged 0 to 14 years who underwent to upper gastrointestinal endoscopy in a tertiary hospital from January 2004 to January 2014...
March 12, 2018: Journal of Investigational Allergology & Clinical Immunology
Rakesh Kumar Chadda, Mamta Sood
Background: General hospital psychiatry units (GHPUs) are the major providers of mental health services in India. Unlike in high-income countries, GHPUs in India are also the main training centers for providing postgraduate training in psychiatry and allied disciplines. Aim: This paper traces the history of the GHPUs in India from beginning to the present. Material and Methods: PubMed, old issues of the Indian Journal of Psychiatry and related sources were searched with key words general hospital and psychiatry both electronically and manually to look for the related literature...
February 2018: Indian Journal of Psychiatry
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