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https://www.readbyqxmd.com/read/28445523/preventive-child-health-care-at-elementary-school-age-the-costs-of-routine-assessments-with-a-triage-approach
#1
Janine Bezem, Catharina van der Ploeg, Mattijs Numans, Simone Buitendijk, Paul Kocken, Elske van den Akker
BACKGROUND: Triage in Preventive Child Health Care (PCH) assessments could further the efficient use of human resources and budgets and therefore make extra care possible for children with specific needs. We assessed the costs of routine PCH assessments with and without triage for children aged 5/6 years and 10/11 years. In a triage approach, PCH assistants conduct pre-assessments to identify children requiring follow-up assessments by a physician or nurse. In the usual approach, all children are assessed by a physician and an assistant (children aged 5/6 years) or a nurse (children aged 10/11 years)...
2017: PloS One
https://www.readbyqxmd.com/read/28444987/platelet-count-spleen-length-and-platelet-count-to-spleen-length-ratio-for-the-diagnosis-of-oesophageal-varices-in-people-with-chronic-liver-disease-or-portal-vein-thrombosis
#2
REVIEW
Agostino Colli, Juan Cristóbal Gana, Jason Yap, Thomasin Adams-Webber, Natalie Rashkovan, Simon C Ling, Giovanni Casazza
BACKGROUND: Current guidelines recommend screening of people with oesophageal varices via oesophago-gastro-duodenoscopy at the time of diagnosis of hepatic cirrhosis. This requires that people repeatedly undergo unpleasant invasive procedures with their attendant risks, although half of these people have no identifiable oesophageal varices 10 years after the initial diagnosis of cirrhosis. Platelet count, spleen length, and platelet count-to-spleen length ratio are non-invasive tests proposed as triage tests for the diagnosis of oesophageal varices...
April 26, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28444085/blood-pressure-documentation-in-the-emergency-department
#3
Ana Carolina Queiroz Godoy Daniel, Juliana Pereira Machado, Eugenia Velludo Veiga
Objective: To analyze the frequency of blood pressure documentation performed by nursing professionals in an emergency department. Methods: This is a cross-sectional, observational, descriptive, and analytical study, which included medical records of adult patients admitted to the observation ward of an emergency department, between March and May 2014. Data were obtained through a collection instrument divided into three parts: patient identification, triage data, and blood pressure documentation...
2017: Einstein
https://www.readbyqxmd.com/read/28442120/american-gastroenterological-association-institute-technical-review-on-the-role-of-elastography-in-chronic-liver-diseases
#4
Siddharth Singh, Andrew J Muir, Douglas T Dieterich, Yngve T Falck-Ytter
Chronic liver diseases (CLDs), due to chronic hepatitis C; hepatitis B; nonalcoholic fatty liver diseases (NAFLD); and alcoholic liver disease, are a leading cause of morbidity and mortality globally. Early identification of patients with cirrhosis at high risk of progression to liver-related complications may facilitate timely care and improve outcomes. With risks and misclassification associated with invasive tests, such as liver biopsy, noninvasive imaging modalities for liver fibrosis assessment have gained popularity...
May 2017: Gastroenterology
https://www.readbyqxmd.com/read/28441939/estimation-of-the-severity-of-breathlessness-in-the-emergency-department-a-dyspnea-score
#5
Tibor Gondos, Viktor Szabó, Ágnes Sárkány, Adrienn Sárkány, Gábor Halász
BACKGROUND: Dyspnea is a frequent complaint in emergency departments (ED). It has a significant amount of subjective and affective components, therefore the dyspnea scores, based on the patients' rating, can be ambiguous. Our purpose was to develop and validate a simple scoring system to evaluate the severity of dyspnea in emergency care, based on objectively measured parameters. METHODS: We performed a double center, prospective, observational study including 350 patients who were admitted in EDs with dyspnea...
April 26, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/28440675/near-infrared-spectroscopy-nirs-to-detect-traumatic-intracranial-haematoma-a-systematic-review-and-meta-analysis
#6
Robert J Brogan, Vassilios Kontojannis, Bhavin Garara, Hani J Marcus, Mark H Wilson
OBJECTIVES AND METHODS: Head injury is the most common trauma presentation to UK emergency departments, with around 1.2 million patients each year. The key management principal for this time critical illness remains early surgical intervention. With the development of handheld near-infrared spectroscopy (NIRS) devices, there is now the possibility of triaging and diagnosing these patients immediately, where computed tomography (CT) scanner is unavailable. NIRS has two related but distinct potential uses within clinical medicine...
April 25, 2017: Brain Injury: [BI]
https://www.readbyqxmd.com/read/28440078/synthetic-route-development-for-the-laboratory-preparation-of-eupalinilide-e
#7
Trevor C Johnson, Matthew R Chin, Dionicio Siegel
Following the discovery that the guaianolide natural product eupalinilide E promotes the expansion of hematopoietic stem and progenitor cells; the development of a synthetic route to provide laboratory access to the natural product became a priority. Exploration of multiple synthetic routes yielded an approach that has permitted a scalable synthesis of the natural product. Two routes that failed to access eupalinilide E were triaged either as a result of providing an incorrect diastereomer or due to lack of synthetic efficiency...
April 25, 2017: Journal of Organic Chemistry
https://www.readbyqxmd.com/read/28436211/primary-hpv-testing-verification-a-retrospective-ad-hoc-analysis-of-screening-algorithms-on-women-doubly-tested-for-cytology-and-hpv
#8
Jessica Tracht, Allison Wrenn, Isam-Eldin Eltoum
BACKGROUND: To evaluate human papillomavirus (HPV) testing as a primary screening tool, we retrospectively analyzed data comparing (1) HPV testing to the algorithms of the ATHENA Study: (2) cytology alone, (3) cytology with ASCUS triage in women 25-29 and (4) cotesting ≥ 30 or (5) cotesting ≥ 25. METHODS: We retrospectively analyzed data from women tested with both cytology and HPV testing from 2010 to 2013. Cumulative risk (CR) for CIN3+ was calculated...
April 23, 2017: Diagnostic Cytopathology
https://www.readbyqxmd.com/read/28436125/the-quipp-app-a-safe-alternative-to-a-treat-all-strategy-for-threatened-preterm-labour
#9
Helena A Watson, Jenny Carter, Paul T Seed, Rachel M Tribe, Andrew H Shennan
OBJECTIVES: To evaluate the impact of a treat-all policy (advocated by NICE) compared to the QUIPP app (predictive model combining history of spontaneous preterm birth gestation and quantitative fetal fibronectin) for women in threatened preterm labour at <30 weeks gestation. METHODS: We conducted a subanalysis of prospectively collected data of pregnant women presenting with symptoms of preterm labour from the EQUIPP (REC Ref. 10/H0806/68) and PETRA (REC Ref...
April 24, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28434878/molecular-phenotyping-combines-molecular-information-biological-relevance-and-patient-data-to-improve-productivity-of-early-drug-discovery
#10
Faye Marie Drawnel, Jitao David Zhang, Erich Küng, Natsuyo Aoyama, Fethallah Benmansour, Andrea Araujo Del Rosario, Sannah Jensen Zoffmann, Frédéric Delobel, Michael Prummer, Franziska Weibel, Coby Carlson, Blake Anson, Roberto Iacone, Ulrich Certa, Thomas Singer, Martin Ebeling, Marco Prunotto
Today, novel therapeutics are identified in an environment which is intrinsically different from the clinical context in which they are ultimately evaluated. Using molecular phenotyping and an in vitro model of diabetic cardiomyopathy, we show that by quantifying pathway reporter gene expression, molecular phenotyping can cluster compounds based on pathway profiles and dissect associations between pathway activities and disease phenotypes simultaneously. Molecular phenotyping was applicable to compounds with a range of binding specificities and triaged false positives derived from high-content screening assays...
April 13, 2017: Cell Chemical Biology
https://www.readbyqxmd.com/read/28431590/delays-in-door-to-needle-time-for-acute-ischemic-stroke-in-the-emergency-department-a-comprehensive-stroke-center-experience
#11
Ashkan Mowla, Jordan Doyle, Navdeep S Lail, Hamidreza Rajabzadeh-Oghaz, Christopher Deline, Peyman Shirani, Marilou Ching, Annemarie Crumlish, Deborah A Steck, David Janicke, Elad I Levy, Robert N Sawyer
BACKGROUND: Current American Stroke Association guidelines recommend initiating intravenous thrombolysis (IVT) for acute ischemic stroke (AIS) within 60min of patient arrival, given the benefits of IVT for AIS are time dependent. This study aimed to identify the delaying factors in door-to-needle time (DTN) in the emergency department of one of the largest comprehensive stroke centers in New York State. We also recommended measures to reduce the delays. METHODS: We retrospectively reviewed the medical charts of all AIS patients who received IVT in our emergency department patients between April 1, 2012 and December 31, 2015 to identify those with a DTN time of >60min...
May 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28431558/epidemiology-and-genotype-distribution-of-human-papillomavirus-hpv-in-southwest-china-a-cross-sectional-five-years-study-in-non-vaccinated-women
#12
Yishu Tang, Lan Zheng, Shuangshuang Yang, Bing Li, Huiting Su, Li-Ping Zhang
BACKGROUND: Large-size data on type-specific HPV prevalence in Southwest China are required to estimate the cervical cancer burden in the country and to prepare for HPV-based cervical screening program and further HPV vaccination of China. This HPV study is a pooled analysis of data from five years in Chongqing of China, which is cross-sectional in design using data collecting. RESULTS: The positivity of HPV was 26.2% (10542/40311), single type was 25.7% (10360/40311), multiple type was 8...
April 21, 2017: Virology Journal
https://www.readbyqxmd.com/read/28431197/serum-c-reactive-protein-procalcitonin-and-lactate-dehydrogenase-for-the-diagnosis-of-pancreatic-necrosis
#13
REVIEW
Oluyemi Komolafe, Stephen P Pereira, Brian R Davidson, Kurinchi Selvan Gurusamy
BACKGROUND: The treatment of people with pancreatic necrosis differs from that of people with oedematous pancreatitis. It is important to know the diagnostic accuracy of serum C-reactive protein (CRP), serum procalcitonin, and serum lactate dehydrogenase (LDH) as a triage test for the detection of pancreatic necrosis in people with acute pancreatitis, so that an informed decision can be made as to whether the person with pancreatic necrosis needs further investigations such as computed tomography (CT) scan or magnetic resonance imaging (MRI) scan and treatment for pancreatic necrosis started...
April 21, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28430021/family-perspectives-on-telemedicine-for-pediatric-subspecialty-care
#14
Kristin N Ray, Laura Ellen Ashcraft, Ateev Mehrotra, Elizabeth Miller, Jeremy M Kahn
BACKGROUND: Children often have difficulty accessing subspecialty care, and telemedicine may improve access to subspecialty care, but information is lacking on how best to implement telemedicine programs to maximize acceptance and, ultimately, maximize impact for patients and their families. METHODS AND MATERIALS: To understand how subspecialty telemedicine is perceived and to identify design elements with the potential to improve telemedicine uptake and impact, we conducted and analyzed semi-structured interviews with 21 informants, including parents and caregivers of children with subspecialty care needs and adolescent and young adult patients with subspecialty care needs...
April 21, 2017: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/28427481/triage-and-the-lost-art-of-decoding-vital-signs-restoring-physiologically-based-triage-skills-in-complex-humanitarian-emergencies
#15
Frederick M Burkle
Triage management remains a major challenge, especially in resource-poor settings such as war, complex humanitarian emergencies, and public health emergencies in developing countries. In triage it is often the disruption of physiology, not anatomy, that is critical, supporting triage methodology based on clinician-assessed physiological parameters as well as anatomy and mechanism of injury. In recent times, too many clinicians from developed countries have deployed to humanitarian emergencies without the physical exam skills needed to assess patients without the benefit of remotely fed electronic monitoring, laboratory, and imaging studies...
April 21, 2017: Disaster Medicine and Public Health Preparedness
https://www.readbyqxmd.com/read/28427444/interventions-to-reduce-wait-times-for-primary-care-appointments-a-systematic-review
#16
Dominique Ansell, James A G Crispo, Benjamin Simard, Lise M Bjerre
BACKGROUND: Accessibility and availability are important characteristics of efficient and effective primary healthcare systems. Currently, timely access to a family physician is a concern in Canada. Adverse outcomes are associated with longer wait times for primary care appointments and often leave individuals to rely on urgent care. When wait times for appointments are too long patients may experience worse health outcomes and are often left to use emergency department resources. The primary objective of our study was to systematically review the literature to identify interventions designed to reduce wait times for primary care appointments...
April 20, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28427086/self-sampling-to-improve-cervical-cancer-screening-coverage-in-switzerland-a-randomised-controlled-trial
#17
Manuela Viviano, Rosa Catarino, Emilien Jeannot, Michel Boulvain, Manuela Undurraga Malinverno, Pierre Vassilakos, Patrick Petignat
BACKGROUND: The aim of this study is to evaluate whether self-sampling can increase screening attendance of women who do not attend regular screening in Switzerland. METHODS: Participants were proactively recruited in Geneva between September 2011 and November 2015. Women (25-69 years) who had not undergone CC screening in the last 3 years were considered eligible. Through a 1 : 1 ratio randomisation, enrolled participants were invited to either undergo liquid-based cytology, which was performed by a health-care provider (control group, CG) or to take a self-sample for HPV-testing, which was mailed to their home (intervention group, IG)...
April 20, 2017: British Journal of Cancer
https://www.readbyqxmd.com/read/28426160/assessment-and-support-during-early-labour-for-improving-birth-outcomes
#18
REVIEW
Shinobu Kobayashi, Nobutsugu Hanada, Masayo Matsuzaki, Kenji Takehara, Erika Ota, Hatoko Sasaki, Chie Nagata, Rintaro Mori
BACKGROUND: The progress of labour in the early or latent phase is usually slow and may include painful uterine contractions. Women may feel distressed and lose their confidence during this phase. Support and assessment interventions have been assessed in two previous Cochrane Reviews. This review updates and replaces these two reviews, which have become out of date. OBJECTIVES: To investigate the effectiveness of assessment and support interventions for women during early labour...
April 20, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28425112/beyond-guidelines-discretionary-practice-in-face-to-face-triage-nursing
#19
Lars E F Johannessen
This article draws on ethnographic data from a Norwegian emergency primary care clinic (EPCC) to explore nurses' discretionary application of guidelines. Specifically, it analyses nurses' discretionary use of the Manchester Triage System (MTS) when performing face-to-face triage, that is, assessing the urgency of patients' complaints. The analysis shows how nurses assessed patients at odds with MTS prescriptions by collecting supplementary data, engaging in differential diagnostic and holistic reasoning, relying on emotion and intuition, and allowing colleagues and patients to influence their reasoning...
April 20, 2017: Sociology of Health & Illness
https://www.readbyqxmd.com/read/28424823/-coma-in-the-emergency-room
#20
M Braun, C J Ploner, T Lindner, M Möckel, W U Schmidt
Coma of unknown origin (CUO) is a frequent unspecific emergency symptom associated with a high mortality. A fast diagnostic work-up is essential given the wide spectrum of underlying diagnoses that are made up of approximately 50% primary central nervous system (CNS) pathologies and approximately 50% extracerebral, almost exclusively internal medical causes. Despite the high mortality associated with this symptom, there are currently no generally accepted management guidelines for adult patients presenting with CUO...
April 19, 2017: Der Nervenarzt
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