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https://www.readbyqxmd.com/read/27935907/eclampsia-feto-maternal-outcomes-in-a-tertiary-care-centre-in-eastern-nepal
#1
S Ghimire
INTRODUCTION: Eclampsia is a preventable and treatable cause of maternal morbidity and mortality with poor feto-maternal outcome in developing countries. Despite development in the level of health education expertise in human resources and institutional obstetric care in our country, the delay in early recognition of the problem, transportation to proper health facility and getting proper expert care are major hurdles to reduce complications. Therefore, we decided to study feto-maternal outcomes in our setting...
January 2016: JNMA; Journal of the Nepal Medical Association
https://www.readbyqxmd.com/read/27935767/effect-of-physical-activity-and-or-healthy-eating-on-gdm-risk-the-dali-lifestyle-study
#2
David Simmons, Roland Devlieger, André van Assche, Goele Jans, Sander Galjaard, Rosa Corcoy, Juan M Adelantado, Fidelma Dunne, Gernot Desoye, Jürgen Harreiter, Alexandra Kautzky-Willer, Peter Damm, Elisabeth R Mathiesen, Dorte M Jensen, Liselotte Andersen, Annunziata Lapolla, Maria G Dalfrà, Alessandra Bertolotto, Ewa Wender-Ozegowska, Agnieszka Zawiejska, David Hill, Frank J Snoek, Judith Gm Jelsma, Mireille Nm van Poppel
CONTEXT: Lifestyle approaches for preventing gestational diabetes mellitus (GDM) have produced mixed results. OBJECTIVE: The aim of this study was to compare the effectiveness of three lifestyle interventions (Healthy eating (HE), Physical activity (PA) and both HE and PA (HE+PA)) with usual care (UC) in reducing GDM risk. DESIGN: Multicentre Randomised Controlled Trial 2012-2014: The Dali Lifestyle Study Setting: Antenatal clinics across 11 centres in 9 European countries Patients: Consecutive pregnant women <20 weeks gestation with a BMI≥29 kg/m(2) and without GDM by IADPSG criteria (n=436)...
December 9, 2016: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/27935437/improving-health-care-student-attitudes-toward-older-adults-through-educational-interventions-a-systematic-review
#3
Linda Ross, Paul Jennings, Brett Williams
Educational institutions should aim to positively influence the attitudes of future health care practitioners toward older patients in order to ensure the provision of quality patient care. This systematic review of the literature aims to determine the effectiveness of educational interventions designed to improve healthcare student behaviours and/or attitudes towards older people. The 29 studies included in this review utilised a variety of interventions, methods and measurement tools. The most common type of educational intervention incorporated interaction with real patients...
December 9, 2016: Gerontology & Geriatrics Education
https://www.readbyqxmd.com/read/27934829/does-the-presence-of-klebsiella-pneumoniae-carbapenemase-and-new-delhi-metallo-%C3%AE-lactamase-1-genes-in-pathogens-lead-to-fatal-outcome
#4
P Mathur, S Sagar, S Kumar, V Sharma, D Gupta, S Lalwani, R Rani, A Muruganantham
INTRODUCTION: Infections due to multidrug-resistant (MDR) pathogens are a medical challenge. There is considerable apprehension among clinicians regarding pathogens reported as carrying New Delhi metallo-β-lactamase-1 (NDM) and Klebsiella pneumoniae carbapenemase (KPC) genes from their patients. In the face of extremely high rates of antimicrobial resistance, it is essential to gauge the clinical significance of isolation of pathogens carrying these genes from clinical samples. This study compares the outcome of patients infected with pathogens carrying NDM/KPC genes versus those without these genes...
October 2016: Indian Journal of Medical Microbiology
https://www.readbyqxmd.com/read/27934819/trend-of-human-brucellosis-over-a-decade-at-tertiary-care-centre-in-north-karnataka
#5
D P Patil, G S Ajantha, C Shubhada, P A Jain, A Kalabhavi, P C Shetty, M Hosamani, S Appannanavar, R D Kulkarni
BACKGROUND: Brucellosis is an important zoonotic disease. India having a major agrarian population is expected to have a higher prevalence. However, due to lack of laboratory facility or awareness among clinicians, the disease is largely underreported. The aim of this study was to know the prevalence and trend of human brucellosis over a decade, in patients attending a teaching hospital in North Karnataka, and to understand their geographical distribution. MATERIALS AND METHODS: The study was conducted from January 2006 to December 2015 at a tertiary care teaching hospital in North Karnataka...
October 2016: Indian Journal of Medical Microbiology
https://www.readbyqxmd.com/read/27934811/performance-of-the-2010-american-college-of-rheumatology-european-league-against-rheumatism-acr-eular-criteria-for-classification-of-rheumatoid-arthritis-in-an-indian-population-an-observational-study-in-a-single-centre
#6
Mvv Pavan Kedar, Raviraja V Acharya, K Prakashini
BACKGROUND & OBJECTIVES: The 1987 American College of Rheumatology (ACR) criteria were criticised for classifying patients only in the late stage. The 2010 ACR/European League against Rheumatism (ACR/EULAR) classification criteria for rheumatoid arthritis (RA) were thus formulated to recognize the early stage of disease with high sensitivity. This pilot study was designed to estimate and compare the sensitivities of the 1987 ACR and 2010 ACR/EULAR classification criteria for RA. METHODS: In a tertiary care hospital, the medical records of 97 patients diagnosed with RA were reviewed...
August 2016: Indian Journal of Medical Research
https://www.readbyqxmd.com/read/27933580/headache-service-quality-evaluation-of-quality-indicators-in-14-specialist-care-centres
#7
Sara Schramm, Derya Uluduz, Raquel Gil Gouveia, Rigmor Jensen, Aksel Siva, Ugur Uygunoglu, Giorgadze Gvantsa, Maka Mania, Mark Braschinsky, Elena Filatova, Nina Latysheva, Vera Osipova, Kirill Skorobogatykh, Julia Azimova, Andreas Straube, Ozan Emre Eren, Paolo Martelletti, Valerio De Angelis, Andrea Negro, Mattias Linde, Knut Hagen, Aleksandra Radojicic, Jasna Zidverc-Trajkovic, Ana Podgorac, Koen Paemeleire, Annelien De Pue, Christian Lampl, Timothy J Steiner, Zaza Katsarava
BACKGROUND: The study was a collaboration between Lifting The Burden (LTB) and the European Headache Federation (EHF). Its aim was to evaluate the implementation of quality indicators for headache care Europe-wide in specialist headache centres (level-3 according to the EHF/LTB standard). METHODS: Employing previously-developed instruments in 14 such centres, we made enquiries, in each, of health-care providers (doctors, nurses, psychologists, physiotherapists) and 50 patients, and analysed the medical records of 50 other patients...
December 2016: Journal of Headache and Pain
https://www.readbyqxmd.com/read/27933144/a-project-to-improve-the-management-of-patients-on-warfarin-in-a-primary-care-setting-through-the-introduction-of-a-poc-analysis
#8
Thore Karlsson
When noticed that patients commonly misunderstood their warfarin prescriptions when they were given by telephone. We found that the average TIR (time in range) (the relative time period the patients PT-INR value was in the therapeutic range) for patients decreased, and we noticed that the numbers of incidents increased. We made several interventions over a period of close to three years (2010-2012) to improve the quality of care, increase patients' TIRs, and decrease incidents. The interventions included; taking extra care when speaking to patients about their warfarin prescriptions on the phone and using an express mail delivery system to make sure patients got their letters in time...
2016: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/27932571/esmolol-before-cardioplegia-and-as-cardioplegia-adjuvant-reduces-cardiac-troponin-release-after-cardiac-surgery-a-randomized-trial
#9
Elena Bignami, Marcello Guarnieri, Annalisa Franco, Chiara Gerli, Monica De Luca, Fabrizio Monaco, Giovanni Landoni, Alberto Zangrillo
BACKGROUND: Cardioplegic solutions are the standard in myocardial protection during cardiac surgery, since they interrupt the electro-mechanical activity of the heart and protect it from ischemia during aortic cross-clamping. Nevertheless, myocardial damage has a strong clinical impact. We tested the hypothesis that the short-acting beta-blocker esmolol, given immediately before cardiopulmonary bypass and as a cardioplegia additive, would provide an extra protection to myocardial tissue during cardiopulmonary bypass by virtually reducing myocardial activity and, therefore, oxygen consumption to zero...
December 8, 2016: Perfusion
https://www.readbyqxmd.com/read/27932338/meaning-of-living-with-severe-chronic-obstructive-lung-disease-a-qualitative-study
#10
Gabriella Marx, Maximilian Nasse, Henrikje Stanze, Sonja Owusu Boakye, Friedemann Nauck, Nils Schneider
OBJECTIVES: To explore what it means for patients to live with chronic obstructive pulmonary disease (COPD) as an incurable and constantly progressing disease. DESIGN: Qualitative longitudinal study using narrative and semistructured interviews. This paper presents findings of the initial interviews. Analysis using grounded theory. SETTING: Lung care clinics and community care in Lower Saxony, Germany. PARTICIPANTS: 17 patients with advanced-stage COPD (Global Initiative for Chronic Obstructive Lung Disease (GOLD) III/IV)...
December 8, 2016: BMJ Open
https://www.readbyqxmd.com/read/27932335/multicentre-randomised-placebo-controlled-trial-of-oral-anticoagulation-with-apixaban-in-systemic-sclerosis-related-pulmonary-arterial-hypertension-the-sphinx-study-protocol
#11
Alicia Calderone, Wendy Stevens, David Prior, Harshal Nandurkar, Eli Gabbay, Susanna M Proudman, Trevor Williams, David Celermajer, Joanne Sahhar, Peter K K Wong, Vivek Thakkar, Nathan Dwyer, Jeremy Wrobel, Weng Chin, Danny Liew, Margaret Staples, Rachelle Buchbinder, Mandana Nikpour
INTRODUCTION: Systemic sclerosis (SSc) is a severe and costly multiorgan autoimmune connective tissue disease characterised by vasculopathy and fibrosis. One of the major causes of SSc-related death is pulmonary arterial hypertension (PAH), which develops in 12-15% of patients with SSc and accounts for 30-40% of deaths. In situ thrombosis in the small calibre peripheral pulmonary vessels resulting from endothelial dysfunction and an imbalance of anticoagulant and prothrombotic mediators has been implicated in the complex pathophysiology of SSc-related PAH (SSc-PAH), with international clinical guidelines recommending the use of anticoagulants for some types of PAH, such as idiopathic PAH...
December 8, 2016: BMJ Open
https://www.readbyqxmd.com/read/27932262/the-coach-program-a-joint-approach-to-patient-education-and-support
#12
Yael Shaked, Patricia Dickson, Kathy Workman
Hospital lengths of stay for orthopaedic procedures are declining internationally. Discharge home from hospital following total joint replacement surgery can be stressful due to pain and physical restrictions. Thus, many patients report experiencing increased anxiety and feeling a sudden withdrawal of support from their medical team. The Coach Program maximizes human resources and family-centred care by formally integrating an individual whom the patient identifies as their primary support into their health care team...
December 5, 2016: Healthcare
https://www.readbyqxmd.com/read/27931883/quality-of-counselling-for-knee-and-shoulder-arthroscopy-patients-during-day-surgery
#13
Pirjo Kaakinen, Helka Ervasti, Maria Kääriäinen
BACKGROUND: Counselling for day surgery patients is one of the core components for a knee or shoulder arthroscopy patient to succeed in self-care. AIM: This cross-sectional study examined the quality of counselling given to patients (n = 86) during their day surgery, using the Counselling Quality Instrument (CQI). METHODS: The data were analysed using basic and multivariate statistical methods. RESULTS: Most respondents were male and aged over 50 years...
June 23, 2016: International Journal of Orthopaedic and Trauma Nursing
https://www.readbyqxmd.com/read/27931749/-hereditary-epidermolysis-bullosa-french-national-guidelines-pnds-for-diagnosis-and-treatment
#14
C Chiaverini, E Bourrat, J Mazereeuw-Hautier, S Hadj-Rabia, C Bodemer, J-P Lacour
Hereditary epidermolysis bullosa (EB) is a heterogeneous group of rare genetic diseases characterized by fragile skin and/or mucous membrane, and it may be either local or generalized. It is caused by mutations in genes encoding different proteins involved mainly in the structure and function of the dermal-epidermal junction. Nineteen genes have so far been identified. They are classified by level of skin cleavage (from top to bottom) into four groups: EB simplex, junctional EB, dystrophic EB and Kindler syndrome...
December 5, 2016: Annales de Dermatologie et de Vénéréologie
https://www.readbyqxmd.com/read/27931214/how-effective-are-volunteers-at-supporting-people-in-their-last-year-of-life-a-pragmatic-randomised-wait-list-trial-in-palliative-care-elsa
#15
Catherine Walshe, Steven Dodd, Matt Hill, Nick Ockenden, Sheila Payne, Nancy Preston, Guillermo Perez Algorta
BACKGROUND: Clinical care alone at the end of life is unlikely to meet all needs. Volunteers are a key resource, acceptable to patients, but there is no evidence on care outcomes. This study aimed to determine whether support from a social action volunteer service is better than usual care at improving quality of life for adults in the last year of life. METHODS: A pragmatic, multi-centre wait-list controlled trial, with participants randomly allocated to receive the volunteer support intervention either immediately or after a 4 week wait...
December 9, 2016: BMC Medicine
https://www.readbyqxmd.com/read/27930803/pulmonary-rehabilitation-following-exacerbations-of-chronic-obstructive-pulmonary-disease
#16
REVIEW
Milo A Puhan, Elena Gimeno-Santos, Christopher J Cates, Thierry Troosters
BACKGROUND: Guidelines have provided positive recommendations for pulmonary rehabilitation after exacerbations of chronic obstructive pulmonary disease (COPD), but recent studies indicate that postexacerbation rehabilitation may not always be effective in patients with unstable COPD. OBJECTIVES: To assess effects of pulmonary rehabilitation after COPD exacerbations on hospital admissions (primary outcome) and other patient-important outcomes (mortality, health-related quality of life (HRQL) and exercise capacity)...
December 8, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27929354/differences-in-mrsa-prevalence-and-resistance-patterns-in-a-tertiary-center-before-and-after-joining-an-international-program-for-surveillance-of-antimicrobial-resistance
#17
Olivera Djuric, Snezana Jovanovic, Branka Stosovic, Tanja Tosic, Milica Jovanovic, Naomi Nartey, Jovana Todorovic, Ljiljana Markovic-Denic
Methicillin-resistant Staphylococcus aureus (MRSA) emerged as one of the most important causes of hospital-acquired bloodstream infections (BSIs), especially the multidrug resistant clones. The aim of the present study was to compare prevalence and resistance patterns of MRSA bacteremia in the major tertiary-care academic and referral center in Serbia before and after implementing an active antimicrobial resistance (AMR) surveillance. Laboratory-based before-after study was conducted during a two-year period (January 2012 to December 2013) in Clinical Centre of Serbia...
December 8, 2016: Acta Microbiologica et Immunologica Hungarica
https://www.readbyqxmd.com/read/27928509/unexpected-deaths-in-cardiology-outpatients-what-can-we-learn-from-case-review
#18
Thomas Michael Kitz, Nikki Burnand, Astrid Ortner, Ian G Rudd, Rod Sampson, Gordon F Rushworth, Stephen James Leslie
OBJECTIVES: A proportion of cardiac patients managed at a cardiology outpatient clinic will die between clinic visits. This study aimed to identify the cause of death, to determine if case review occurred and if a formal review of such cases might be useful. DESIGN: Single-centre retrospective cohort study. SETTING: A remote regional centre in the North of Scotland. PARTICIPANTS: All patients who had been removed from the cardiology outpatient clinic due to death in the community...
December 2016: JRSM Open
https://www.readbyqxmd.com/read/27927665/what-affects-response-rates-in-primary-healthcare-based-programmes-an-analysis-of-individual-and-unit-related-factors-associated-with-increased-odds-of-non-response-based-on-hcv-screening-in-the-general-population-in-poland
#19
Natalia Parda, Małgorzata Stępień, Karolina Zakrzewska, Kazimierz Madaliński, Agnieszka Kołakowska, Paulina Godzik, Magdalena Rosińska
OBJECTIVES: Response rate in public health programmes may be a limiting factor. It is important to first consider their delivery and acceptability for the target. This study aimed at determining individual and unit-related factors associated with increased odds of non-response based on hepatitis C virus screening in primary healthcare. DESIGN: Primary healthcare units (PHCUs) were extracted from the Register of Health Care Centres. Each of the PHCUs was to enrol adult patients selected on a random basis...
December 7, 2016: BMJ Open
https://www.readbyqxmd.com/read/27927660/effect-of-prehabilitation-in-gastro-oesophageal-adenocarcinoma-study-protocol-of-a-multicentric-randomised-control-trial-the-prehab-study
#20
Bertrand Le Roy, Bruno Pereira, Corinne Bouteloup, Frédéric Costes, Ruddy Richard, Marie Selvy, Caroline Pétorin, Johan Gagnière, Emmanuel Futier, Karem Slim, Bernard Meunier, Jean-Yves Mabrut, Christophe Mariette, Denis Pezet
INTRODUCTION: Perioperative chemotherapy is the gold standard treatment of the resectable gastro-oesophageal adenocarcinoma. However, 70% of patients cannot receive the complete sequence because of a postoperative complication or a decrease in functional and nutritional reserves. Recently, a new concept appeared in digestive surgery: prehabilitation. This interventional process consists of patient preparation, between surgical consultation and surgery, and is based on 3 components: (1) physical management, (2) nutritional care and (3) psychological care...
December 7, 2016: BMJ Open
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