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https://www.readbyqxmd.com/read/28651311/outcomes-of-very-elderly-%C3%A2-80-years-critical-ill-patients-in-a-medical-intensive-care-unit-of-a-tertiary-hospital-in-korea
#1
Seung Hun Lee, Tae Won Lee, Sunmi Ju, Jung-Wan Yoo, Seung Jun Lee, Yu Ji Cho, Yi Yeong Jeong, Jong Deog Lee, Ho Cheol Kim
Background/Aims: This study evaluated clinical characteristics and outcomes in very elderly (≥ 80 years of age) critical-ill patients admitted to a medical intensive care unit (MICU) in a regional single tertiary hospital. Methods: We retrospectively evaluated prospectively collected data in the MICU for the period of December 2011 to May 2014. Patients were divided into ≥ 80 and < 80 years of age and clinical characteristics and outcomes were compared among these patients...
June 26, 2017: Korean Journal of Internal Medicine
https://www.readbyqxmd.com/read/28651163/ex-vivo-assessment-of-valve-thickness-calcification-of-patients-with-calcific-aortic-stenosis-in-relation-to-in-vivo-clinical-outcomes
#2
Ching-Li Cheng, Hsiao-Huang Chang, Pei-Jung Huang, Wei-Chen Wang, Shan-Yang Lin
Calcific aortic stenosis (AS) plays a critical role in the risk of cardiovascular disease. This preliminary study examined the relationship between the ex vivo valve thickness/calcification and in vivo clinical outcomes of Chinese patients with calcific AS. Six Chinese patients (3 patients with tricuspid aortic valves (TAV)) and 3 patients with. bicuspid aortic valves (BAV) with calcific AS undergoing heart valve replacement were initially chosen for this study. In vivo medical imaging of these calcific AS patients was evaluated using computed tomography and echocardiography...
June 22, 2017: Journal of the Mechanical Behavior of Biomedical Materials
https://www.readbyqxmd.com/read/28650921/effect-of-continuity-of-care-on-drug-drug-interactions
#3
Jiun-Yu Guo, Yiing-Jenq Chou, Christy Pu
BACKGROUND: Drug-drug interaction (DDI) is a critical concern in health care systems because it is directly associated with patient outcomes and is generally preventable. However, few studies have been conducted on whether poor continuity of care (COC) is a determinant of DDIs and whether this effect varies by level of comorbidity. Patients with higher comorbidity normally require more complex treatment regimens than other patients, and hence their COC is more critical for ensuring the accuracy of their medication information...
June 23, 2017: Medical Care
https://www.readbyqxmd.com/read/28650412/pressure-injury-knowledge-in-critical-care-nurses
#4
Donna M Miller, Lisa Neelon, Kathleen Kish-Smith, Laura Whitney, Christopher J Burant
PURPOSE: The purpose of this study was to identify pressure injury knowledge in critical care nurses related to prevention and staging following multimodal education initiatives. DESIGN: Postintervention descriptive study. SETTING AND SAMPLE: The sample comprised 32 RNs employed in medical intensive care/coronary intensive care or surgical intensive care units. The study setting was a 237-bed Veterans Affairs acute care hospital in the Midwestern United States...
June 21, 2017: Journal of Wound, Ostomy, and Continence Nursing
https://www.readbyqxmd.com/read/28650384/incident-reporting-in-emergency-medicine-a-thematic-analysis-of-events
#5
Emily Loving Aaronson, David Brown, Theodore Benzer, Shaw Natsui, Elizabeth Mort
BACKGROUND: Incident reporting is a recognized tool for healthcare quality improvement. These systems, which aim to capture near-misses and harm events, enable organizations to gather critical information about failure modes and design mitigation strategies. Although many hospitals have employed these systems, little is known about safety themes in emergency medicine incident reporting. Our objective was to systematically analyze and thematically code 1 year of incident reports. METHODS: A mixed-methods analysis was performed on 1 year of safety reporting data from a large, urban tertiary-care emergency department using a modified grounded theory approach...
June 22, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28649887/has-the-new-kirkpatrick-generation-built-a-better-hammer-for-our-evaluation-toolbox
#6
Katherine A Moreau
Although Kirkpatrick's original outcome-focused model is widely used to evaluate medical education programs, it is subject to criticism. To combat this criticism and address the complexities of learning environments, the New World Kirkpatrick Model has emerged. This brief article describes key aspects of the New World Kirkpatrick Model for program evaluation. Specifically, it highlights three major criticisms of Kirkpatrick's original model and discusses the ways in which this new model attempts to rebut them...
June 26, 2017: Medical Teacher
https://www.readbyqxmd.com/read/28649859/medical-authority-managerial-power-and-political-will-a-bourdieusian-analysis-of-antibiotics-in-the-hospital
#7
Emma Kirby, Alex Broom, Alexandra Gibson, Jennifer Broom, Trent Yarwood, Jeffrey Post
Antibiotic resistance poses a significant global threat, yet clinically inappropriate antibiotic use within hospitals continues despite the implementation of abatement strategies. Antibiotic use and the viability of existing antibiotic options now sit precariously at the nexus of political will, institutional governance and clinical priorities 'at the bedside'. Yet no study has hitherto explored the perspectives of managers, instead of focusing on clinicians. In this article, drawing on qualitative interviews with hospital managers, we explore accounts of responding to antimicrobial resistance, managing antibiotic governance and negotiating clinical and managerial priorities...
June 1, 2017: Health (London)
https://www.readbyqxmd.com/read/28648671/late-complications-of-percutaneous-tracheostomy-using-the-balloon-dilation-technique
#8
J B Araujo, J M Añón, A García de Lorenzo, A M García-Fernandez, M Esparcia, J Adán, S Relanzon, D Quiles, V de Paz, A Molina
OBJECTIVE: The purpose of this study was to determine the late complications in critically ill patients requiring percutaneous tracheostomy (PT) using the balloon dilation technique. DESIGN: A prospective, observational cohort study was carried out. SCOPE: Two medical-surgical intensive care units (ICU). PATIENTS: All mechanically ventilated adult patients consecutively admitted to the ICU with an indication of tracheostomy...
June 22, 2017: Medicina Intensiva
https://www.readbyqxmd.com/read/28648568/application-of-machine-learning-classification-for-structural-brain-mri-in-mood-disorders-critical-review-from-a-clinical-perspective
#9
REVIEW
Yong-Ku Kim, Kyoung-Sae Na
Mood disorders are a highly prevalent group of mental disorders causing substantial socioeconomic burden. There are various methodological approaches for identifying the underlying mechanisms of the etiology, symptomatology, and therapeutics of mood disorders; however, neuroimaging studies have provided the most direct evidence for mood disorder neural substrates by visualizing the brains of living individuals. The prefrontal cortex, hippocampus, amygdala, thalamus, ventral striatum, and corpus callosum are associated with depression and bipolar disorder...
June 22, 2017: Progress in Neuro-psychopharmacology & Biological Psychiatry
https://www.readbyqxmd.com/read/28648522/are-children-born-with-birth-defects-at-increased-risk-of-injuries-in-early-childhood
#10
Rachel E Rutkowski, Jason L Salemi, Jean Paul Tanner, Suzanne Anjohrin, Philip Cavicchia, Heather Lake-Burger, Russell S Kirby
OBJECTIVE: To investigate the extent to which children with birth defects experience differential likelihood of various injuries and injury-related hospitalizations in early childhood. STUDY DESIGN: The Florida Birth Defects Registry was used to identify infants born 2006-2010 with select birth defects. Injury matrices were used to detect injuries in inpatient, ambulatory, and emergency department admissions for each infant up to their third birthday. χ(2)tests were used to compare sociodemographic and perinatal characteristics of children, by presence of an injury-related hospital admission...
June 22, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28648009/-diagnostic-performance-of-t-spot-tb-on-peripheral-blood-in-combination-with-adenosine-deaminase-on-pleural-fluid-for-the-diagnosis-of-tuberculous-pleurisy-within-different-age-group
#11
H Y Xu, D Q Zhang, J R Ye, S S Su, Y P Xie, C S Chen, Y P Li
Objective: To evaluate the performance of T cell enzyme-linked immuno-spot assay (T-SPOT) on peripheral blood in combination with adenosine deaminase (ADA) on pleural fluid for diagnosis of tuberculous (TB) pleurisy within different age groups. Methods: The data of patients with pleural effusion from the Department of Pulmonary and Critical Care Medicine of the First Affiliated Hospital of Wenzhou Medical University from April 2012 to November 2016 were retrospectively analyzed, and the diagnoses of these patients were histopathologically confirmed through medical thoracoscopy...
June 27, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28647635/new-vein-compression-entities-in-patients-with-unexplained-leg-swelling
#12
Alaina Garrie, Lauren E Jones, Julia F Chen, Robert W Feldtman, Kenneth R Kollmeyer, Jasmine L Richmond, Craig A Ferrara, Pablo V Uceda, Lelesse Mocio, Samuel S Ahn
BACKGROUND: This retrospective study identifies often overlooked anatomical sites for non-thrombotic venous outflow obstruction (NTVO) in patients with unexplained lower extremity edema and pain. MATERIALS AND METHODS: We retrospectively reviewed the charts of 75 consecutive patients experiencing symptoms of unexplained lower extremity edema with pain that were unexplained by ultrasound, computed tomography angiography (CTA), and magnetic resonance imaging (MRI), who subsequently underwent venography in an outpatient medical office from 2010 to 2014...
June 21, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28647501/driving-simulators-in-the-clinical-assessment-of-fitness-to-drive-in-sleepy-individuals-a-systematic-review
#13
REVIEW
David R Schreier, Christina Banks, Johannes Mathis
Road traffic injuries are projected to be the leading cause of death for those aged between 15 and 29 years by the year 2030, and sleepiness is estimated to be the underlying cause in up to 15-20% of all motor vehicle accidents. Sleepiness at the wheel is most often caused by socially induced sleep deprivation or poor sleep hygiene in otherwise healthy individuals, medical disorders, or the intake of drugs. Validated methods for objectifying sleepiness are urgently sought, particularly in the context of driving...
May 4, 2017: Sleep Medicine Reviews
https://www.readbyqxmd.com/read/28647377/establishing-rarity-in-the-context-of-orphan-medicinal-product-designation-in-the-european-union
#14
REVIEW
Stelios Tsigkos, Matthias Hoffer, Maria Sheean, Segundo Mariz, Kristina Larsson, Frauke Naumann-Winter, Laura Fregonese, Bruno Sepodes
In the European Union (EU) legislative framework for orphan medicinal product designation, establishing that a condition affects not more than five in 10 000 people is a prerequisite for applications based on rarity. Demonstrating this requirement to the Committee of Orphan Medicinal Products (COMP) can be a particularly challenging task for sponsors. Here, we identify and examine three common issues with the estimation of prevalence in orphan drug applications in the EU (the discernment between diagnosed and undiagnosed cases; the duration of the disease; and the need for an explicit contemporary conclusion) as critical factors for acceptable prevalence estimation...
June 21, 2017: Drug Discovery Today
https://www.readbyqxmd.com/read/28647217/recognition-and-management-of-hemostatic-disorders-in-critically-ill-patients-needing-to-undergo-an-invasive-procedure
#15
REVIEW
Marcella C A Müller, Simon J Stanworth, Michiel Coppens, Nicole P Juffermans
Abnormal laboratory coagulation test results are frequently documented in critically ill patients, and these patients often also need to undergo invasive procedures. Clinicians have an understandable desire to minimize any perceived heightened risk of bleeding complications in those patients who require invasive procedures. In this setting, prophylactic administration of platelets or plasma is commonplace. This review explores the nature of these sequential statements and the degree to which these statements are supported by evidence...
June 15, 2017: Transfusion Medicine Reviews
https://www.readbyqxmd.com/read/28646897/an-exploration-of-facilitators-and-challenges-in-the-scale-up-of-a-national-public-sector-community-health-worker-cadre-in-zambia-a-qualitative-study
#16
Sydney Chauwa Phiri, Margaret Lippitt Prust, Caroline Phiri Chibawe, Ronald Misapa, Jan Willem van den Broek, Nikhil Wilmink
BACKGROUND: In 2010 a public sector cadre of community health workers called Community Health Assistants (CHAs) was created in Zambia through the National Community Health Worker Strategy to expand access to health services. This cadre continues to be scaled up to meet the growing demands of Zambia's rural population. We summarize factors that have facilitated the scale-up of the CHA program into a nationwide CHW cadre and the challenges of introducing and institutionalizing the cadre within the Zambian health system...
June 24, 2017: Human Resources for Health
https://www.readbyqxmd.com/read/28646357/management-of-hyperglycemia-and-diabetes-in-the-emergency-department
#17
REVIEW
Justin B Echouffo-Tcheugui, Rajesh Garg
PURPOSE OF REVIEW: Hyperglycemia in the emergency department (ED) is being recognized as a public health problem and presents a clinical challenge. This review critically summarizes available evidence on the burden, etiology, diagnosis, and practical management strategies for hyperglycemia in the ED. RECENT FINDINGS: Diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar state (HHS) are hyperglycemic emergencies that commonly present to the ED. However, the most common form of hyperglycemia in ED is associated with non-hyperglycemic medical emergencies...
August 2017: Current Diabetes Reports
https://www.readbyqxmd.com/read/28645956/exploring-the-components-of-physician-volunteer-engagement-a-qualitative-investigation-of-a-national-canadian-simulation-based-training-programme
#18
Aimee J Sarti, Stephanie Sutherland, Angele Landriault, Kirk DesRosier, Susan Brien, Pierre Cardinal
OBJECTIVES: Conceptual clarity on physician volunteer engagement is lacking in the medical literature. The aim of this study was to present a conceptual framework to describe the elements which influence physician volunteer engagement and to explore volunteer engagement within a national educational programme. SETTING: The context for this study was the Acute Critical Events Simulation (ACES) programme in Canada, which has successfully evolved into a national educational programme, driven by physician volunteers...
June 23, 2017: BMJ Open
https://www.readbyqxmd.com/read/28645552/mortality-following-augmentation-cystoplasty-a-transitional-urologist-s-viewpoint
#19
REVIEW
D A Husmann
INTRODUCTION: Three complications have been hypothesized to increase patient mortality following enterocystoplasty: spontaneous bladder perforation, bladder neoplasia, and chronic renal failure (CRF). The present study examined risk of their occurrence and discussed ways to improve the quality of care. MATERIALS AND METHODS: The present transitional clinic followed 385 patients with a history of bladder augmentation using either ileal, sigmoid, or ascending colon...
June 3, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28645517/glucose-control-diabetes-status-and-mortality-in-critically-ill-patients-the-continuum-from-intensive-care-unit-admission-to-hospital-discharge
#20
James S Krinsley, Paula Maurer, Sharon Holewinski, Roy Hayes, Douglas McComsey, Guillermo E Umpierrez, Stanley A Nasraway
OBJECTIVE: To describe the relationships among glycemic control, diabetes mellitus (DM) status, and mortality in critically ill patients from intensive care unit (ICU) admission to hospital discharge. PATIENTS AND METHODS: This is a retrospective investigation of 6387 ICU patients with 5 or more blood glucose (BG) tests and 4462 ICU survivors admitted to 2 academic medical centers from July 1, 2010, through December 31, 2014. We studied the relationships among mean BG level, hypoglycemia (BG level <70 mg/dL [to convert to mmol/L, multiply by 0...
June 7, 2017: Mayo Clinic Proceedings
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