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https://www.readbyqxmd.com/read/29334176/the-effect-of-22-5-khz-low-frequency-contact-ultrasound-debridement-lfcud-on-lower-extremity-wound-healing-for-a-vascular-surgery-population-a-randomised-controlled-trial
#1
Christine Anne Murphy, Pamela Houghton, Tim Brandys, Gregory Rose, Dianne Bryant
The aim of this study was to compare changes in wound size and appearance and health complication rates in patients with vasculopathy and lower-extremity wounds treated with or without low-frequency contact ultrasound debridement (LFCUD) This study was a randomised controlled trial. The study was conducted in a vascular surgery service, including outpatient wound clinic and inpatient ward, in a tertiary care academic centre. In total, 70 patients with vasculopathy and lower-extremity wounds of mixed aetiology were enrolled in the trial; 68 completed the study...
January 15, 2018: International Wound Journal
https://www.readbyqxmd.com/read/29333883/simultaneous-intestinal-and-kidney-transplantation-in-adults
#2
Irum Amin, Charlotte Rutter, Adam Barlow, Neil K Russell, J Andrew Bradley, Andrew Jackson, Andrew J Butler
AIM OF THE STUDY: Intestinal transplantation (IT) is a life-saving procedure for carefully selected patients with intestinal failure. We evaluated patients who had undergone simultaneous intestinal and kidney transplantation (SIKT) to determine whether UK guidelines for inclusion of a renal allograft (dialysis dependent or estimated glomerular filtration rate ((eGFR)) < 45 ml/min/1.73 m2) are justified. METHODS: A single centre analysis was undertaken of adults undergoing IT at the Cambridge Transplant Centre between December 2007 and January 2016...
January 15, 2018: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
https://www.readbyqxmd.com/read/29333494/ensuring-adequate-vascular-access-in-patients-with-major-trauma-a-quality-improvement-initiative
#3
Kevin Verhoeff, Rachelle Saybel, Pamela Mathura, Bonnie Tsang, Vanessa Fawcett, Sandy Widder
Ensuring adequate vascular access in major trauma patients prior to decompensative physiological processes is crucial to patient outcomes. Most protocols suggest achieving two 18-gauge or larger intravenous lines immediately in patients with major trauma. We discuss a quality improvement approach to ensure that >90% of patients with major trauma (as defined by an injury severity score ≥12) at a level one trauma centre receive timely and adequate fluid access. Applying Donabedian principles for process improvement, we used the Alberta Trauma Registry to perform a 4-month chart audit on patients with major trauma at the University of Alberta Hospital...
2018: BMJ Open Quality
https://www.readbyqxmd.com/read/29332425/dermatological-manifestations-in-patients-undergoing-in-vitro-fertilisation-a-prospective-study
#4
Aradhana Sood, Suvash Sahu, Sandeep Karunakaran, Rajneesh K Joshi, Deep Kumar Raman
BACKGROUND: Changing sociodemographic patterns with an increase in the age of childbirth have affected fertility rates worldwide. With advancing reproductive medicine, assisted reproductive techniques (ARTs) are becoming common. While dermatological manifestations in normal pregnancies have been well documented, there is a paucity of data regarding cutaneous manifestations in patients undergoing ART. OBJECTIVES: The objectives of our study were to estimate the incidence and types of dermatological manifestations in patients undergoing in vitro fertilisation (IVF) and to study their associations with age, type of infertility, and outcome of the procedure...
January 1, 2018: Journal of Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/29332169/measuring-cochlear-duct-length-in-asian-population-worth-giving-a-thought
#5
Mohnish Grover, Shitanshu Sharma, Shashank Nath Singh, Tanmaya Kataria, Rajendra Singh Lakhawat, Man Prakash Sharma
INTRODUCTION: The anatomy of the cochlea forms the basis for a successful cochlear implantation. Cochlear duct length (CDL) is defined as the length of the scala media as measured from the middle of the round window to helicotrema. Preoperative measurement of CDL is particularly important when precise intracochlear electrode array placement is desired. It can be done both histologically and radiologically. Preoperative high-resolution computed tomography (HRCT) scan which forms an integral part of cochlear implant workup is a useful tool to calculate CDL using 3D reconstructions...
January 13, 2018: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/29331668/earlier-and-enhanced-rehabilitation-of-mechanically-ventilated-patients-in-critical-care-a-feasibility-randomised-controlled-trial
#6
David McWilliams, Charlotte Jones, Gemma Atkins, James Hodson, Tony Whitehouse, Tonny Veenith, Emma Reeves, Lauren Cooper, Catherine Snelson
BACKGROUND: Systematic reviews of early rehabilitation within intensive care units have highlighted the need for robust multi-centre randomised controlled trials with longer term follow up. This trial aims to explore the feasibility of earlier and enhanced rehabilitation for patients mechanically ventilated for ≥5days and to assess the impact on possible long term outcome measures for use in a definitive trial. METHODS: Patients admitted to a large UK based intensive care unit and invasively ventilated for ≥5days were randomised to the rehabilitation intervention or standard care on a 1:1 basis, stratified by age and SOFA score...
January 4, 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/29331633/organ-donation-in-the-icu-a-document-analysis-of-institutional-policies-protocols-and-order-sets
#7
Simon J W Oczkowski, John E Centofanti, Pamela Durepos, Erika Arseneau, Julija Kelecevic, Deborah J Cook, Maureen O Meade
OBJECTIVE: To better understand how local policies influence organ donation rates. RESEARCH METHODOLOGY/DESIGN: We conducted a document analysis of our ICU organ donation policies, protocols and order sets. We used a systematic search of our institution's policy library to identify documents related to organ donation. We used Mindnode software to create a publication timeline, basic statistics to describe document characteristics, and qualitative content analysis to extract document themes...
January 10, 2018: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/29331602/a-cross-continental-analysis-of-weight-gain-psychiatric-diagnoses-and-medication-use-during-inpatient-psychiatric-treatment-the-international-study-on-physical-illness-in-mentally-ill
#8
Christina Engelke, Christian Lange-Asschenfeldt, Stephanie Peter, Kai G Kahl, Karel Frasch, Jens I Larsen, Graziella G Bickel, Bernhard Bork, Bent A Jacobsen, Signe O Wallenstein-Jensen, Christoph Lauber, Birthe Mogensen, Jørgen A Nielsen, Wulf Rössler, Kenji J Tsuchiya, Kristian L Toftegaard, Ulla A Andersen, Richard Uwakwe, Povl Munk-Jørgensen, Joachim Cordes
Weight gain among psychiatric inpatients is a widespread phenomenon. This change in body mass index (BMI) can be caused by several factors. Based on recent research, we assume the following factors are related to weight gain during psychiatric inpatient treatment: psychiatric medication, psychiatric diagnosis, sex, age, weight on admission and geographic region of treatment. 876 of originally recruited 2328 patients met the criteria for our analysis. Patients were recruited and examined in mental health care centres in Nigeria (N = 265), Japan (N = 145) and Western-Europe (Denmark, Germany and Switzerland; N = 466)...
December 22, 2017: European Psychiatry: the Journal of the Association of European Psychiatrists
https://www.readbyqxmd.com/read/29331188/-care-pathway-and-life-course-of-drug-addicted-patients
#9
Franck Warembourg, Victoria Varin
Placing drug addicts, notably heroin addicts, at the centre of their care project, itself part of a life project, is the objective of the Le Lac d'Argent association in Annecy. Caregivers have been able to reflect on their practices and help to fight against preconceived ideas. This article presents the experience of a global support approach.
January 2018: Revue de L'infirmière
https://www.readbyqxmd.com/read/29329567/modified-pilates-as-an-adjunct-to-standard-physiotherapy-care-for-urinary-incontinence-a-mixed-methods-pilot-for-a-randomised-controlled-trial
#10
Adi Lausen, Louise Marsland, Samantha Head, Joanna Jackson, Berthold Lausen
BACKGROUND: Urinary incontinence (UI) is a distressing condition affecting at least 5 million women in England and Wales. Traditionally, physiotherapy for UI comprises pelvic floor muscle training, but although evidence suggests this can be effective it is also recognised that benefits are often compromised by patient motivation and commitment. In addition, there is increasing recognition that physical symptoms alone are poor indicators of the impact of incontinence on individuals' lives...
January 12, 2018: BMC Women's Health
https://www.readbyqxmd.com/read/29328018/-a-day-in-the-life-of-a-medical-resident-on-the-ward
#11
A R Schuurman, S A Bos, K de Wit, R de Graaf, W J Wiersinga
OBJECTIVE: To investigate how internal medicine residents allocate their time during a hospital dayshift on the wards. DESIGN: Prospective observational cohort study (time and motion study). METHODS: Data were collected from 36 internal medicine residents working at the Internal Medicine Department of the Academic Medical Centre in Amsterdam, the Netherlands. Trained observers monitored 22 residents using a newly developed smartphone-application, registering their dayshift activities (meetings and education, direct patient contact, administrative tasks, lunch/break, other) and location (workstation, conference room, ward and patient rooms, other)...
2018: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/29328014/-innovation-in-transport-of-critical-care-patients
#12
Q Muijrers, O Thomas
The differentiation of specialist care means that not every hospital can meet specific care requirements. Because of this, frequent transport of critical care patients is necessary. In most circumstances, regular ambulance transport is used, either with or without an accompanying physician. In some cases, a mobile intensive care unit (MICU) can be deployed. However, the MICU is not 24/7 operational in our area and significant waiting times can occur. Additionally, space and resources in a regular ambulance are limited...
2018: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/29327445/don-t-just-do-something-stand-there-the-value-and-art-of-deliberate-clinical-inertia
#13
Gerben Keijzers, Louise Cullen, Diana Egerton-Warburton, Daniel M Fatovich
It can be difficult to avoid unnecessary investigations and treatments, which are a form of low-value care. Yet every intervention in medicine has potential harms, which may outweigh the potential benefits. Deliberate clinical inertia is the art of doing nothing as a positive response. This paper provides suggestions on how to incorporate deliberate clinical inertia into our daily clinical practice, and gives an overview of current initiatives such as 'Choosing Wisely' and the 'Right Care Alliance'. The decision to 'do nothing' can be complex due to competing factors, and barriers to implementation are highlighted...
January 12, 2018: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29327382/retrospective-analysis-of-forward-and-reverse-abo-typing-discrepancies-among-patients-and-blood-donors-in-a-tertiary-care-hospital
#14
R N Makroo, B Kakkar, S Agrawal, M Chowdhry, B Prakash, P Karna
OBJECTIVE: The aim of our study was to determine the incidence and causes of ABO typing discrepancies among patients and blood donors at our centre. BACKGROUND: An accurate interpretation of the ABO blood group of an individual is of utmost importance to ensure patient safety and good transfusion practices. METHODS: A retrospective observational study was carried out in the Department of Transfusion Medicine in our hospital from March 2013 to December 2015...
January 12, 2018: Transfusion Medicine
https://www.readbyqxmd.com/read/29326333/comet-a-multicomponent-home-based-disease-management-programme-versus-routine-care-in-severe-copd
#15
Romain Kessler, Pere Casan-Clara, Dieter Koehler, Silvia Tognella, Jose Luis Viejo, Roberto W Dal Negro, Salvador Díaz-Lobato, Karina Reissig, José Miguel Rodríguez González-Moro, Gilles Devouassoux, Jean-Michel Chavaillon, Pierre Botrus, Jean-Michel Arnal, Julio Ancochea, Anne Bergeron-Lafaurie, Carlos De Abajo, Winfried J Randerath, Andreas Bastian, Christian G Cornelissen, Georg Nilius, Joëlle B Texereau, Jean Bourbeau
The COPD Patient Management European Trial (COMET) investigated the efficacy and safety of a home-based COPD disease management intervention for severe COPD patients.The study was an international open-design clinical trial in COPD patients (forced expiratory volume in 1 s <50% of predicted value) randomised 1:1 to the disease management intervention or to the usual management practices at the study centre. The disease management intervention included a self-management programme, home telemonitoring, care coordination and medical management...
January 2018: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/29326330/program-of-integrated-care-for-patients-with-chronic-obstructive-pulmonary-disease-and-multiple-comorbidities-pic-copd-a-randomised-controlled-trial
#16
Louise Rose, Laura Istanboulian, Lise Carriere, Anna Thomas, Han-Byul Lee, Shaghayegh Rezaie, Roshan Shafai, Ian Fraser
We sought to evaluate the effectiveness of a multi-component, case manager-led exacerbation prevention/management model for reducing emergency department visits. Secondary outcomes included hospitalisation, mortality, health-related quality of life, chronic obstructive pulmonary disease (COPD) severity, COPD self-efficacy, anxiety and depression.Two-centre randomised controlled trial recruiting patients with ≥2 prognostically important COPD-associated comorbidities. We compared our multi-component intervention including individualised care/action plans and telephone consults (12-weekly then 9-monthly) with usual care (both groups)...
January 2018: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/29326190/a-qualitative-study-of-patients-feedback-about-outpatient-parenteral-antimicrobial-therapy-opat-services-in-northern-england-implications-for-service-improvement
#17
Maureen Twiddy, Carolyn J Czoski Murray, Samantha J Mason, David Meads, Judy M Wright, Elizabeth D Mitchell, Jane Minton
OBJECTIVE: Outpatient parenteral antimicrobial therapy (OPAT) provides opportunities for improved cost savings, but in the UK, implementation is patchy and a variety of service models are in use. The slow uptake in the UK and Europe is due to a number of clinical, financial and logistical issues, including concern about patient safety. The measurement of patient experience data is commonly used to inform commissioning decisions, but these focus on functional aspects of services and fail to examine the relational aspects of care...
January 10, 2018: BMJ Open
https://www.readbyqxmd.com/read/29325571/development-of-a-hospital-based-patient-reported-outcome-framework-for-lung-cancer-patients-a-study-protocol
#18
Natasha Moloczij, Karla Gough, Benjamin Solomon, David Ball, Linda Mileshkin, Mary Duffy, Mei Krishnasamy
BACKGROUND: Patient-reported outcome (PRO) data is central to the delivery of quality health care. Establishing sustainable, reliable and cost-efficient methods for routine collection and integration of PRO data into health information systems is challenging. This protocol paper describes the design and structure of a study to develop and pilot test a PRO framework to systematically and longitudinally collect PRO data from a cohort of lung cancer patients at a comprehensive cancer centre in Australia...
January 11, 2018: Health and Quality of Life Outcomes
https://www.readbyqxmd.com/read/29324861/cost-of-treatment-for-head-and-neck-cancer-in-india
#19
Akashdeep Singh Chauhan, Shankar Prinja, Sushmita Ghoshal, Roshan Verma, Arun S Oinam
There are no published data on the cost of cancer treatment for guiding reimbursement decisions in India. The present study was designed to estimate the cost of treating head and neck cancer (HNC) with the aim of determining package rates. The present study was undertaken in the Departments of Radiotherapy and Otolaryngology of a large tertiary care hospital in North India. Economic health system costs incurred were assessed using a bottom-up methodology. Data on all resources-capital or recurrent, incurred on the delivery of HNC treatment were collected from April 2014 to March 2015...
2018: PloS One
https://www.readbyqxmd.com/read/29324651/incidence-microbiological-profile-and-risk-factors-of-healthcare-associated-infections-in-intensive-care-units-a-10-year-observation-in-a-provincial-hospital-in-southern-poland
#20
Małgorzata Kołpa, Marta Wałaszek, Agnieszka Gniadek, Zdzisław Wolak, Wiesław Dobroś
Healthcare-associated infections (HAIs) occurring in patients treated in an intensive care unit (ICU) are serious complications in the treatment process. Aetiological factors of these infections can have an impact on treatment effects, treatment duration and mortality. The aim of the study was to determine the prevalence and microbiological profile of HAIs in patients hospitalized in an ICU over a span of 10 years. The active surveillance method was used to detect HAIs in adult patients who spent over 48 h in a general ICU ward located in southern Poland between 2007 and 2016...
January 11, 2018: International Journal of Environmental Research and Public Health
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