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https://www.readbyqxmd.com/read/29232665/the-laryngeal-mask-airway-and-its-use-in-neonatal-resuscitation-a-critical-review-of-where-we-are-in-2017-2018
#1
Satvik Chaitanya Bansal, Stefano Caoci, Eugene Dempsey, Daniele Trevisanuto, Charles Christoph Roehr
Studies using videotape recordings and respiratory function monitoring have shown that both face mask (FM) application and endotracheal tube (ETT) placement represent a challenge for resuscitators. Hence, there is a strong need for devices that can largely be used independently of individual operator training levels, in order to ensure more reliable support in time-critical situations, such as neonatal resuscitation. The laryngeal mask airway device (LMA) has evolved as a potentially very valuable tool. We conducted a systematic review of studies evaluating the use of the LMA in neonatal resuscitation...
December 13, 2017: Neonatology
https://www.readbyqxmd.com/read/29229362/french-validation-and-adaptation-of-the-grobman-nomogram-for-prediction-of-vaginal-birth-after-cesarean-delivery
#2
Jean-Baptiste Haumonte, Mélina Raylet, Marie Christophe, Franck Mauviel, Armelle Bertrand, Raoul Desbriere, Claude d'Ercole
OBJECTIVE: To validate Grobman nomogram for predict vaginal birth after cesarean delivery (VBAC) in a French population and adapt it. STUDY DESIGN: Multicenter retrospective study of maternal and obstetric factors associated with VBAC between May 2012 and May 2013 in 6 maternity. External validation and adaptation of the prenatal and intrapartum Grobman nomograms for vaginal birth prediction after cesarean delivery in a French cohort RESULTS: The study included 523 women with previous cesarean deliveries; 70% underwent a trial of labor for a subsequent delivery (n=367) with a success rate of 65% (n=240)...
December 8, 2017: Journal of Gynecology Obstetrics and Human Reproduction
https://www.readbyqxmd.com/read/29225448/commentary-de-implementation-science-a-virtuous-cycle-of-ceasing-and-desisting-low-value-care-before-implementing-new-high-value-care
#3
EDITORIAL
Karina W Davidson, Siqin Ye, George A Mensah
Implementation science has traditionally focused on increasing the delivery of evidence-based care. The science of systematically stopping low-value and wasteful care is substantially under-recognized, and if successful, may decrease the workload of clinicians. De-implementation science identifies problem areas of low-value and wasteful practice, carries out rigorous scientific examination of the factors that initiate and maintain such behaviors, and then employs evidence-based interventions to cease these practices...
2017: Ethnicity & Disease
https://www.readbyqxmd.com/read/29223212/how-to-engage-your-team-to-implement-delayed-cord-clamping
#4
Rebecca L Gams, Kimberly K Popp, Julianne Cramer, Thomas N George, Phillip N Rauk, Samantha A Sommerness, Jane A Sublette
This article describes how a health care team changed practice by implementing delayed cord clamping as standard practice. After administration of a survey to assess clinicians' knowledge and to discover barriers to this proposed practice change, members of a multidisciplinary committee used the results to create a guideline for delayed cord clamping and a plan for successful implementation. Integral to embedding and sustaining changes in practice was development of the Delivery Room Brief and Debrief Tool and inclusion of the process into nursing guidelines and the electronic health record...
December 2017: Nursing for Women's Health
https://www.readbyqxmd.com/read/29214668/photofrin%C3%A2-photodynamic-therapy-with-intratumor-photosensitizer-injection-provides-similar-tumor-response-while-reducing-systemic-skin-photosensitivity-pilot-murine-study
#5
Timothy M Baran
OBJECTIVES: The goal of this study was to compare tumor response to Photofrin® photodynamic therapy using intravenous and intratumoral injection of photosensitizer. Systemic skin photosensitivity and photosensitizer distribution were also compared between the two delivery methods. METHODS: SCCVII tumors were initiated in the hind legs of female C3H mice and grown to a volume of ∼1,000 mm3 . Photofrin® was delivered intravenously via the tail vein at a concentration of 2 mg/kg or intratumorally at concentrations ranging from 0...
December 7, 2017: Lasers in Surgery and Medicine
https://www.readbyqxmd.com/read/29207895/nonpharmacological-management-of-neonatal-abstinence-syndrome-a-review-of-the-literature
#6
Gareth Ryan, Anishnaabe Bimaadiziwin, Joe Dooley, Lianne Gerber Finn, Len Kelly
BACKGROUND: Infants with neonatal abstinence syndrome (NAS) experience withdrawal that occurs as a result of termination of placental opioid supply following delivery. Common symptoms include restlessness, tremors, agitation and gastrointestinal disturbances. Severe NAS is often treated using opioids and/or sedatives. Although commonly employed effectively in neonatal care, there is a lack of published information regarding nonpharmacological management of the NAS infant. OBJECTIVE: The purpose of this review was to summarize the current literature on nonpharmacological management of NAS...
December 5, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29207736/awareness-of-patients-rights-among-inpatients-of-a-tertiary-care-teaching-hospital-a-cross-sectional-study
#7
Upasana Agrawal, Brayal C D'Souza, Arun Mavaji Seetharam
Introduction: The rights of a patient are a set of rules of conduct which govern the interaction between the patients' and healthcare professionals. Every patient has a right to be informed about their rights and also the responsibility of the healthcare provider. Aim: To assess awareness among inpatient about patients' rights at an academic accredited hospital. Materials and Methods: A questionnaire based cross-sectional study was carried out among 350 patients admitted to the wards of a Tertiary Care Teaching Hospital...
September 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/29202118/emergency-department-asthma-medication-delivery-program-an-initiative-to-provide-discharge-prescriptions-and-education
#8
Kayla Durkin, Tricia Montgomery, Kristen Lamberjack, Cindy C Hafer, James Naprawa, Shannon Yarosz
Background: Prescription fill rates for children being discharged from the emergency department (ED) after asthma exacerbations are low, placing the child at risk for additional ED visits or admissions for asthma. This article describes the implementation of an ED asthma prescription delivery service designed to improve pharmacy prescription capture and decrease ED revisit rates. Methods: A core group developed a service to provide asthma prescriptions and education to patients in their ED room before discharge...
July 2017: Pediatric Quality & Safety
https://www.readbyqxmd.com/read/29202002/a-comparison-of-outcomes-between-a-lumen-apposing-metal-stent-with-electrocautery-enhanced-delivery-system-and-a-bi-flanged-metal-stent-for-drainage-of-walled-off-pancreatic-necrosis
#9
Noor L H Bekkali, Manu K Nayar, John S Leeds, Richard M Charnley, Matthew T Huggett, Kofi W Oppong
Background and study aims:  Bi-flanged metal stents (BFMS) have shown promise in the drainage of walled-off pancreatic necrosis (WON), but their placement requires multiple steps and the use of other devices. More recently, a novel device consisting of a combined lumen-apposing metal stent (LAMS) and electrocautery-enhanced delivery system has been introduced. The aim of this study was to compare the placement and outcomes of the two devices. Patients and methods:  This was a retrospective review of consecutive patients undergoing endoscopic ultrasound-guided placement of BFMS or LAMS for drainage of symptomatic WON...
December 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/29200065/cardiac-arrest-in-the-operating-room-part-2-special-situations-in-the-perioperative-period
#10
Matthew D McEvoy, Karl-Christian Thies, Sharon Einav, Kurt Ruetzler, Vivek K Moitra, Mark E Nunnally, Arna Banerjee, Guy Weinberg, Andrea Gabrielli, Gerald A Maccioli, Gregory Dobson, Michael F O'Connor
As noted in part 1 of this series, periprocedural cardiac arrest (PPCA) can differ greatly in etiology and treatment from what is described by the American Heart Association advanced cardiac life support algorithms, which were largely developed for use in out-of-hospital cardiac arrest and in-hospital cardiac arrest outside of the perioperative space. Specifically, there are several life-threatening causes of PPCA of which the management should be within the skill set of all anesthesiologists. However, previous research has demonstrated that continued review and training in the management of these scenarios is greatly needed and is also associated with improved delivery of care and outcomes during PPCA...
November 30, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29197224/variations-in-the-number-of-births-by-day-of-the-week-and-morbidity-and-mortality-in-very-low-birth-weight-infants
#11
Fermín García-Muñoz Rodrigo, Loida García Cruz, Gloria Galán Henríquez, Lourdes Urquía Martí, Sonia Rivero Rodríguez, Alfredo García-Alix, Josep Figueras Aloy
OBJECTIVE: To know the distribution of births of very low birth weight infants by day of the week, and whether this distribution affects the morbidity and mortality in this group of patients. METHODS: This was a retrospective analysis of data collected prospectively in the Spanish SEN1500 network (2002-2011). Outborn infants, patients with major congenital anomalies, and those who died in the delivery room were excluded. Births were grouped into "weekdays" and "weekends...
November 29, 2017: Jornal de Pediatria
https://www.readbyqxmd.com/read/29196154/labour-induction-practices-in-france-a-population-based-declarative-survey-in-94-maternity-units
#12
P Blanc-Petitjean, M Salomé, C Dupont, C Crenn-Hebert, A Gaudineau, F Perrotte, P Raynal, E Clouqueur, G Beucher, B Carbonne, F Goffinet, C Le Ray
INTRODUCTION: In 2010, 22.7% of deliveries in France were induced. The current lack of high level of evidence data about the methods and indications for induction of labour has promoted heterogeneous and non-recommended practices. The extent of these different practices is not adequately known in France today, although they may influence perinatal outcomes. The objective of this study was to report current practices of induction of labour in France. MATERIAL AND METHODS: This study surveyed 94 maternity units in seven perinatal networks...
November 28, 2017: Journal of Gynecology Obstetrics and Human Reproduction
https://www.readbyqxmd.com/read/29188679/a-new-surgical-positioning-system-for-robotic-assisted-minimally-invasive-spine-surgery-and-transpedicular-approach-to-the-disc
#13
G Vadalà, D Accoto, F Russo, I Portaccio, M Rossini, S Valentini, R Papalia, V Denaro
Minimally Invasive Spine Surgery (MISS) procedures for the treatment of spinal pathologies have experienced exponential growth due to improved techniques and decreased trauma to the patient. Several MISS procedures that require the use of a trans-pedicular cannula as a guiding tool for pedicle screw placement, delivery of biomaterials to the vertebral body or injection of biologics to the disc space have been described. Although these are clear advantages of MISS, the limited dissection and exposure may reduce the accuracy and stability of operation and make spine surgeons rely heavily on intraoperative fluoroscopy, raising concerns over the level of radiation exposure...
October 2017: Journal of Biological Regulators and Homeostatic Agents
https://www.readbyqxmd.com/read/29179773/sustained-inflations-versus-uk-standard-inflations-during-initial-resuscitation-of-prematurely-born-infants-in-the-delivery-room-a-study-protocol-for-a-randomised-controlled-trial
#14
Katie A Hunt, Kamal Ali, Theodore Dassios, Anthony D Milner, Anne Greenough
BACKGROUND: Many infants born at less than 34 weeks of gestational age will require resuscitation in the delivery suite. Yet, different resuscitation techniques are specified in different national guidelines, likely reflecting a limited evidence base. One difference is the length of mechanical inflation initially delivered to infants either via a facemask or endotracheal tube. Some guidelines specify short inflations delivered at rates of 40-60/min, others recommend initial inflations lasting 2-3 s or sustained inflations lasting for ≥ 5 s for initial resuscitation...
November 28, 2017: Trials
https://www.readbyqxmd.com/read/29174008/-the-use-of-the-debriefing-assessment-for-simulation-in-healthcare-dash-in-a-simulation-based-team-learning-program-for-newborn-resuscitation-in-the-delivery-room
#15
C Durand, T Secheresse, M Leconte
OBJECTIVE: To evaluate the contribution of the Debriefing Assessment for Simulation in Healthcare (DASH, Centre for Medical Simulation, Harvard) in a high-fidelity simulation in situ program used for newborn resuscitation training. METHODS: The DASH was scored by trainees and instructors at the end of the session. The instructors' feedback and opinions were collected. RESULTS: The study included 16 training sessions (ten maternity units) with 156 trainees and ten instructors (45 DASH)...
November 21, 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/29173319/impact-of-the-neonatal-resuscitation-program-recommended-low-oxygen-strategy-on-outcomes-of-infants-born-preterm
#16
COMPARATIVE STUDY
Vishal S Kapadia, Charitharth V Lal, Venkat Kakkilaya, Roy Heyne, Rashmin C Savani, Myra H Wyckoff
OBJECTIVE: To evaluate the impact of the Neonatal Resuscitation Program (NRP)-recommended low oxygen strategy (LOX) on neonatal morbidities, mortality, and neurodevelopmental outcomes in neonates born preterm. STUDY DESIGN: In March 2011, Parkland Hospital changed from a high oxygen strategy (HOX) of resuscitation with initial 100% oxygen and targeting 85%-94% oxygen saturation for delivery room resuscitation to a LOX with initial 21% oxygen and titrating oxygen to meet NRP-recommended transitional target saturations...
December 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/29170343/46%C3%A2-testing-of-the-always-events-approach-to-improve-the-patient-experience-in-the-emergency-department
#17
Cameron Kay, David Lowe
AIMS: This project aimed to identify issues patients would like to see improved when interacting with the Minor Injuries Unit (MIU) and as a result generate measurable and feasible Always Events (AEs) based on patient feedback that can be implemented via a Quality Improvement (QI) process. We then looked to assess and improve on the delivery of the agreed AEs to enhance MIU patient experience. METHODS: AEs were identified by using a short semi-structured survey questionnaire with a free text response section from 45 patients...
December 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29166810/anesthetic-management-of-amniotic-fluid-embolism-a-multi-center-prospective-cohort-study
#18
Shiri Skolnik, Alexander Ioscovich, Leonid A Eidelman, Atara Davis, Anat Shmueli, Amir Aviram, Sharon Orbach-Zinger
INTRODUCTION: Amniotic fluid embolism (AFE) is a rare and potentially lethal obstetric complication, commonly occurring during labor, delivery, or immediately postpartum. There is a paucity of data regarding incidence, risk factors, and clinical management. Our primary objective in this study was to evaluate clinical presentation of AFE and delineate anesthesia management of these cases. METHODS: This 10 years retrospective multi-center cohort study was performed in five tertiary university-affiliated medical centers, between the years 2005 and 2015...
November 22, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29164779/characterization-of-the-interaction-forces-in-a-drug-carrier-complex-of-doxorubicin-with-a-drug-binding-peptide
#19
Gergana Gocheva, Nina Ilieva, Kalina Peneva, Anela Ivanova
Polypeptide-based materials are used as building blocks for drug delivery systems aimed at toxicity decrease of chemotherapeutics. A molecular-level approach is adopted for investigating the non-covalent interactions between doxorubicin and a recently synthesized drug-binging peptide as a key part of a system for delivery to neoplastic cells. MD simulations in aqueous solution at room and body temperature are applied to investigate the structure and the binding modes within the drug-peptide complex. The tryptophans are outlined as the main chemotherapeutic adsorption sites and the importance of their placement in the peptide sequence is highlighted...
November 22, 2017: Chemical Biology & Drug Design
https://www.readbyqxmd.com/read/29160456/infrastructure-of-pharmacies-of-the-primary-health-care-in-the-brazilian-unified-health-system-analysis-of-pnaum-services-data
#20
Silvana Nair Leite, Fernanda Manzini, Juliana Álvares, Augusto Afonso Guerra, Ediná Alves Costa, Francisco de Assis Acurcio, Ione Aquemi Guibu, Karen Sarmento Costa, Margô Gomes de Oliveira Karnikowski, Orlando Mário Soeiro, Mareni Rocha Farias
OBJECTIVE: To characterize the infrastructure of the primary health care pharmacies of the Brazilian Unified Health System, aiming at humanizing the offered services. METHODS: This is a cross-sectional study, of quantitative approach, from data obtained in the Pesquisa Nacional de Acesso, Utilização e Promoção do Uso Racional de Medicamentos - Serviços, 2015 (PNAUM - National Survey on Access, Use and Promotion of Rational Use of Medicines - Services, 2015)...
November 13, 2017: Revista de Saúde Pública
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