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https://www.readbyqxmd.com/read/29643155/femoral-nerve-block-intervention-in-neck-of-femur-fracture-finof-a-randomised-controlled-trial
#1
Martin Rowlands, Gerrie van de Walt, Jim Bradley, Alexa Mannings, Sarah Armstrong, Nigel Bedforth, Iain K Moppett, Opinder Sahota
OBJECTIVE: Fractured neck of femur is a severely painful condition with significant mortality and morbidity. We investigated whether early and continuous use of femoral nerve block can improve pain on movement and mobility after surgery in older participants with fragility neck of femur fracture. DESIGN: Prospective single-centre, randomised controlled pragmatic trial. SETTING: Secondary care, acute National Health Service Trust, UK. PARTICIPANTS: Participants admitted with a history and examination suggesting fractured neck of femur...
April 10, 2018: BMJ Open
https://www.readbyqxmd.com/read/29609909/-why-is-the-morbidly-obese-patient-at-high-risk-of-anesthetic-complications
#2
Audrey De Jong, Daniel Verzilli, Marie Geniez, Gérald Chanques, David Nocca, Samir Jaber
Obesity is often associated with obstructive sleep apnea (OSA), which increases the risk of intraoperative and postoperative complications. The role of preoperative screening of OSA is crucial, with adequate management based on continuous positive pressure before, during and after surgery. The obese patient is at risk of postoperative complications: difficult airway management, acute respiratory failure following extubation due to atelectasis and airway obstruction, added to morphine overdosing. Optimal management of difficult mask ventilation and intubation, protective ventilation, combined to the reduction of sedatives and analgesics and the sitting position as soon as possible with a postoperative monitoring should decrease the occurrence of complications...
March 30, 2018: La Presse Médicale
https://www.readbyqxmd.com/read/29593839/optimal-early-active-mobilisation-protocol-after-extensor-tendon-repairs-in-zones-v-and-vi-a-systematic-review-of-literature
#3
REVIEW
Shirley Jf Collocott, Edel Kelly, Richard F Ellis
Introduction: Early mobilisation protocols after repair of extensor tendons in zone V and VI provide better outcomes than immobilisation protocols. This systematic review investigated different early active mobilisation protocols used after extensor tendon repair in zone V and VI. The purpose was to determine whether any one early active mobilisation protocol provides superior results. Methods: An extensive literature search was conducted to identify articles investigating the outcomes of early active mobilisation protocols after extensor tendon repair in zone V and VI...
March 2018: Hand Therapy
https://www.readbyqxmd.com/read/29588861/standing-practice-in-rehabilitation-early-after-stroke-spires-a-functional-standing-frame-programme-prolonged-standing-and-repeated-sit-to-stand-to-improve-function-and-quality-of-life-and-reduce-neuromuscular-impairment-in-people-with-severe-sub-acute-stroke
#4
Angie Logan, Jennifer Freeman, Bridie Kent, Jillian Pooler, Siobhan Creanor, Jane Vickery, Doyo Enki, Andrew Barton, Jonathan Marsden
Background: The most common physical deficit caused by a stroke is muscle weakness which limits a person's mobility. Mobility encompasses activities necessary for daily functioning: getting in and out bed, on/off toilet, sitting, standing and walking. These activities are significantly affected in people with severe stroke who typically spend most of their time in bed or a chair and are immobile. Immobility is primarily caused by neurological damage but exacerbated by secondary changes in musculoskeletal and cardiorespiratory systems...
2018: Pilot and Feasibility Studies
https://www.readbyqxmd.com/read/29580965/designing-a-nurse-delivered-delirium-bundle-what-intensive-care-unit-staff-survivors-and-their-families-think
#5
Leona Bannon, Jennifer McGaughey, Mike Clarke, Daniel F McAuley, Bronagh Blackwood
BACKGROUND: Implementation of quality improvement interventions can be enhanced by exploring the perspectives of those who will deliver and receive them. We designed a non-pharmacological bundle for delirium management for a feasibility trial, and we sought to obtain the views of intensive care unit (ICU) staff, survivors, and families on the barriers and facilitators to its implementation. OBJECTIVE: The objective of this study is to determine the barriers and facilitators to a multicomponent bundle for delirium management in critically ill patients comprising (1) education and family participation, (2) sedation minimisation and pain, agitation, and delirium protocol, (3) early mobilisation, and (4) environmental interventions for sleep, orientation, communication, and cognitive stimulation...
March 23, 2018: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/29570742/impact-of-acute-phase-complications-and-interventions-on-6-month-survival-after-stroke-a-prospective-observational-study
#6
Antonio Di Carlo, Maria Lamassa, Marco Franceschini, Francesca Bovis, Lorenzo Cecconi, Sanaz Pournajaf, Stefano Paravati, Annibale Biggeri, Domenico Inzitari, Salvatore Ferro
The outcome of stroke patients is complex and multidimensional. We evaluated the impact of acute-phase variables, including clinical state, complications, resource use and interventions, on 6-month survival after first-ever stroke, taking into account baseline conditions exerting a possible effect on outcome. As part of a National Research Program, we performed a prospective observational study of acute stroke patients in four Italian Regions. Consecutive patients admitted for a period of 3 months to the emergency rooms of participating hospitals were included...
2018: PloS One
https://www.readbyqxmd.com/read/29507719/the-patient-needing-prolonged-mechanical-ventilation-a-narrative-review
#7
REVIEW
Nicolino Ambrosino, Michele Vitacca
Background: Progress in management has improved hospital mortality of patients admitted to the intensive care units, but also the prevalence of those patients needing weaning from prolonged mechanical ventilation, and of ventilator assisted individuals. The result is a number of difficult clinical and organizational problems for patients, caregivers and health services, as well as high human and financial resources consumption, despite poor long-term outcomes. An effort should be made to improve the management of these patients...
2018: Multidisciplinary Respiratory Medicine
https://www.readbyqxmd.com/read/29479483/traumatic-spinal-injury-and-spinal-cord-injury-point-for-active-physiological-conservative-management-as-compared-to-surgical-management
#8
REVIEW
W S El Masri Y
The controversy about surgical vs conservative treatment of the injured spine with cord damage is centuries old. Until the end of the Second World War the majority of patients died or lived a short miserable life. Subsequently, Guttmann, an experienced neurosurgeon, realised surgery was not beneficial and sometimes detrimental to the person with spinal cord injury. Guttman, Frankel and others demonstrated with expert conservative management of the spine and the multi-system consequences of cord damage most patients made some neurological recovery and most with incomplete cord injury recovered ambulation regardless of X-ray findings...
2018: Spinal Cord Series and Cases
https://www.readbyqxmd.com/read/29463292/effectiveness-of-interventions-aimed-at-improving-physical-and-psychological-outcomes-of-fall-related-injuries-in-people-with-dementia-a-narrative-systematic-review
#9
Shannon Robalino, Sarange B Nyakang'o, Fiona R Beyer, Chris Fox, Louise M Allan
BACKGROUND: The annual prevalence of falls in people with dementia ranges from 47 to 90%. Falls are a common reason for hospital admission in people with dementia, and there is limited research evidence regarding the care pathways experienced by this population. In addition to immediate management of an injury, prevention of further falls is likely to be an important part of any successful intervention. This review aims to assess the effectiveness of interventions for improving the physical and psychological wellbeing of people with dementia who have sustained a fall-related injury...
February 20, 2018: Systematic Reviews
https://www.readbyqxmd.com/read/29423867/uncemented-thompson-s-hemiarthroplasty-safe-palliative-and-cost-effective-surgery-in-the-infirm-patient-a-consecutive-series-of-1445-cases
#10
G Manoharan, B D Chatterton, T S Moores, P J Roberts
BACKGROUND: Guidelines on the management of displaced intracapsular fractures recommend using an Orthopaedic Data Evaluation Panel-rated cemented implant. Prior to the National Institute for Health and Care Excellence guidelines, uncemented implants were commonly used in the UK. METHODS: We retrospectively examined the outcomes of patients with uncemented Thompson's hemiarthroplasties at our unit, between April 2005 and December 2010. Patients who underwent revision surgery before December 2011 were identified...
February 8, 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/29409236/tibiotalocalcaneal-nail-fixation-and-soft-tissue-coverage-of-gustilo-anderson-grade-3b-open-unstable-ankle-fractures-in-a-frail-population-a-case-series-in-a-major-trauma-centre
#11
Lesley Armstrong, John Jackson, Andrew Riddick
BACKGROUND: Gustilo-Anderson grade 3B open ankle fracture-dislocations requiring stable fixation and soft tissue coverage are increasingly common in frail populations. METHODS: We identified all patients with open ankle fracture-dislocations treated with a tibiotalocalcaneal nail and soft tissue coverage over a five-year period. We retrospectively recorded pre-morbid status, fracture and soft tissue injury pattern, surgical details, post-operative mobility, length of hospital stay, complication and re-operation rate and survival...
April 13, 2017: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/29402313/the-improve-gap-trial-aiming-to-improve-evidence-based-management-of-community-acquired-pneumonia-study-protocol-for-a-stepped-wedge-randomised-controlled-trial
#12
Elizabeth H Skinner, Melanie Lloyd, Edward Janus, May Lea Ong, Amalia Karahalios, Terry P Haines, Anne-Maree Kelly, Melina Shackell, Harin Karunajeewa
BACKGROUND: Community-acquired pneumonia is a leading worldwide cause of hospital admissions and healthcare resource consumption. The largest proportion of hospitalisations now occurs in older patients, with high rates of multimorbidity and complex care needs. In Australia, this population is usually managed by hospital inpatient general internal medicine units. Adherence to consensus best-practice guidelines is poor. Ensuring evidence-based care and reducing length of stay may improve patient outcomes and reduce organisational costs...
February 5, 2018: Trials
https://www.readbyqxmd.com/read/29379383/comparison-of-single-shot-intrathecal-morphine-injection-and-continuous-epidural-bupivacaine-for-post-operative-analgaesia-after-elective-abdominal-hysterectomy
#13
Wan Mohd Nazaruddin Wan Hassan, Anafairos Md Nayan, Azmi Abu Hassan, Rhendra Hardy Mohamad Zaini
Background: Abdominal hysterectomy (AH) is painful. The aim of this study was to compare intrathecal morphine (ITM) and epidural bupivacaine (EB) for their analgaesia effectiveness after this surgery. Methods: Thirty-two patients undergoing elective AH were randomised into Group ITM (ITM 0.2 mg + 2.5 mL 0.5% bupivacaine) (n = 16) and Group EB (0.25% bupivacaine bolus + continuous infusion of 0.1% bupivacaine-fentanyl 2 μg/mL) (n = 16).The procedure was performed before induction, and all patients subsequently received standard general anaesthesia...
December 2017: Malaysian Journal of Medical Sciences: MJMS
https://www.readbyqxmd.com/read/29367085/serum-bone-biomarkers-osteocalcin-and-pyridinoline-in-mares-during-pregnancy-and-lactation-and-in-foals-during-early-post-natal-life
#14
Stephen T Anderson, Lisa J Kidd, Anita J Barton, Ristan M Greer
Breeding mares typically foal yearly. Little is known about the dynamics of maternal bone stores during gestation and lactation, the timing of any maternal bone mobilisation, re-accretion post-foaling, or the dynamics of bone metabolism in foals. We measured serum osteocalcin (OC) and serum pyridinoline (PYD) concentrations in 18 mares monthly from 6months gestation to foaling, and in both mares and foals for 4months after birth. From 6 to 11months of gestation, there was no change in mean monthly OC. Serum PYD increased between 7months gestation and foaling...
January 19, 2018: Research in Veterinary Science
https://www.readbyqxmd.com/read/29350687/intraocular-currents-bernoulli-s-principle-and-non-drainage-scleral-buckling-for-rhegmatogenous-retinal-detachment
#15
D Wong, Y K Chan, T Bek, I Wilson, E Stefánsson
For many years, it is not fully understood how non-drainage scleral buckling surgery brings about spontaneous reattachment of the detached retina when retinal breaks remain open at the end of surgery. Various explanations have been put forward, but none more interesting than the effect of fluid currents associated with eye movements. One such explanation involved the physics of the Bernoulli's principle. Daniel Bernoulli was an eighteenth century Swiss mathematician and he described an equation based on the conservation of energy...
February 2018: Eye
https://www.readbyqxmd.com/read/29349662/roles-and-maturation-of-iron-sulfur-proteins-in-plastids
#16
REVIEW
Jonathan Przybyla-Toscano, Mélanie Roland, Frédéric Gaymard, Jérémy Couturier, Nicolas Rouhier
One reason why iron is an essential element for most organisms is its presence in prosthetic groups such as hemes or iron-sulfur (Fe-S) clusters, which are notably required for electron transfer reactions. As an organelle with an intense metabolism in plants, chloroplast relies on many Fe-S proteins. This includes those present in the electron transfer chain which will be, in fact, essential for most other metabolic processes occurring in chloroplasts, e.g., carbon fixation, nitrogen and sulfur assimilation, pigment, amino acid, and vitamin biosynthetic pathways to cite only a few examples...
January 18, 2018: Journal of Biological Inorganic Chemistry: JBIC
https://www.readbyqxmd.com/read/29277974/registered-nurse-intent-to-promote-physical-activity-for-hospitalised-liver-transplant-recipients
#17
Jocelyn A Pearson, Kara Mangold, Heidi E Kosiorek, Morgan Montez, Diane M Smith, Brenda J Tyler
AIM: To describe how registered nurse work motivation, attitudes, subjective norm and perceived behavioural control influence intention to promote physical activity in hospitalised adult liver transplant recipients. DESIGN: Descriptive study of clinical registered nurses caring for recipients of liver transplant at a tertiary medical centre. METHODS: Intent to Mobilise Liver Transplant Recipient Scale, Work Extrinsic and Intrinsic Motivation Scale, and demographics were used to explore registered nurses' work motivation, attitudes, subjective norms, perceived behavioural control and intention to promote physical activity of hospitalised adult liver transplant recipients during the acute postoperative phase...
December 26, 2017: Journal of Nursing Management
https://www.readbyqxmd.com/read/29277031/antimony-and-arsenic-partitioning-during-fe-2-induced-transformation-of-jarosite-under-acidic-conditions
#18
Niloofar Karimian, Scott G Johnston, Edward D Burton
Jarosite [KFe3 (SO4 )2 (OH)6 ] is considered a potent scavenger for arsenic (As) and antimony (Sb) under oxidizing conditions. Fluctuations in water levels in re-flooded acid sulfate soils (ASS) can lead to high Fe2+ (aq) concentrations (∼10-20 mM) in the soil solution under acidic to circumneutral pH conditions. This may create favorable conditions for the Fe2+ -induced transformation of jarosite. In this study, synthetic arsenate [As(V)]/antimonate [Sb(V)]-bearing jarosite was subjected to Fe2+ (aq) (20 mM) at pH 4...
March 2018: Chemosphere
https://www.readbyqxmd.com/read/29259820/national-survey-of-ebola-related-knowledge-attitudes-and-practices-before-the-outbreak-peak-in-sierra-leone-august-2014
#19
Mohamed F Jalloh, Paul Sengeh, Roeland Monasch, Mohammad B Jalloh, Nickolas DeLuca, Meredith Dyson, Sheku Golfa, Yukiko Sakurai, Lansana Conteh, Samuel Sesay, Vance Brown, Wenshu Li, Jonathan Mermin, Rebecca Bunnell
Background: The 2014-2015 Ebola epidemic in West Africa was the largest ever to occur. In the early phases, little was known about public knowledge, attitudes and practices (KAP) relating to Ebola virus disease (Ebola). Data were needed to develop evidence-driven strategies to address gaps in knowledge and practice. Methods: In August 2014, we conducted interviews with 1413 randomly selected respondents from 9 out of 14 districts in Sierra Leone using multistage cluster sampling...
2017: BMJ Global Health
https://www.readbyqxmd.com/read/29239152/the-safety-and-efficiency-of-a-fast-track-protocol-for-sleeve-gastrectomy-a-team-approach
#20
Sebastiaan J Vreeswijk, Pim W van Rutte, Simon W Nienhuijs, R Arthur Bouwman, J Frans Smulders, Marc P Buise
BACKGROUND: Increasing numbers of morbid obese patients has led to increased numbers of bariatric procedures. Fast-track protocols are being developed to enhance the available resources, while maintaining a safe procedure. Reported results on safety merely apply to a mixed bariatric population. The objective was to evaluate safety and efficiency of the fast-track principles in patients undergoing sleeve gastrectomy. METHODS: Retrospective observational study including patients undergoing primary sleeve gastrectomy at the Obesity Centre of the Catharina Hospital Eindhoven, the Netherlands...
December 13, 2017: Minerva Anestesiologica
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