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https://www.readbyqxmd.com/read/100001003/emergency-management-of-sepsis-the-simple-stuff-saves-lives
#1
David Sweet, Julian Marsden, Kendall Ho, Christina Krause, James A Russell
Many emergency departments have implemented sepsis protocols since the 2001 publication of results from the early goal-directed therapy trial, which showed early targeted resuscitation lowers mortality. As part of an attempt to improve clinical and operational outcomes for emergency departments across British Columbia, we reviewed sepsis management literature and considered sepsis protocol implementation in the province’s emergency departments. During the literature review we found that many observational studies confirmed an association between implementation of emergency sepsis protocols and decreased mortality...
May 2012: BC medical journal: BCMJ
https://www.readbyqxmd.com/read/29334608/factors-associated-with-prolonged-patient-attributable-delay-in-the-diagnosis-of-colorectal-cancer
#2
Irene Zarcos-Pedrinaci, Teresa Téllez, Francisco Rivas-Ruiz, María Del Carmen Padilla-Ruiz, Julia Alcaide, Antonio Rueda, María Luisa Baré, María Manuela Morales Suárez-Varela, Eduardo Briones, Cristina Sarasqueta, Nerea Fernández-Larrea, Antonio Escobar, José María Quintana, Maximino Redondo
Purpose: The delayed diagnosis of colorectal cancer (CRC) may be attributable to sociodemographic characteristics, to aspects of tumour histopathology or to the functioning of the health system. We seek to determine which of these factors most influences prolonged patient-attributable delay (PPAD) in the diagnosis and treatment of CRC. Materials and method: A prospective, multicentre observational study was conducted in 22 Spanish hospitals. In total, 1,785 patients were recruited to the study between 2010 and 2012 and underwent elective or urgent surgery...
January 2, 2018: Cancer Research and Treatment: Official Journal of Korean Cancer Association
https://www.readbyqxmd.com/read/29334546/impact-of-early-antiretroviral-therapy-eligibility-on-hiv-acquisition-household-level-evidence-from-rural-south-africa
#3
Catherine E Oldenburg, Jacob Bor, Guy Harling, Frank Tanser, Tinofa Mutevedzi, Maryam Shahmanesh, George R Seage, Victor De Gruttola, Matthew J Mimiaga, Kenneth H Mayer, Deenan Pillay, Till Bärnighausen
OBJECTIVES: We investigate the effect of immediate ART eligibility on HIV incidence among HIV-uninfected household members. DESIGN: Regression discontinuity study arising from a population-based cohort. METHODS: Household members of patients seeking care at the Hlabisa HIV Treatment and Care Programme in rural KwaZulu-Natal South Africa between January 2007 and August 2011 with CD4 counts up to 350 cells/μl were eligible for inclusion if they had at least two HIV tests and were HIV-uninfected at the time the index patient linked to care (N = 4,115)...
January 13, 2018: AIDS
https://www.readbyqxmd.com/read/29332913/early-extubation-in-the-operating-room-after-congenital-open-heart-surgery
#4
Takuma Fukunishi, Norihiko Oka, Takeshi Yoshii, Kensuke Kobayashi, Nobuyuki Inoue, Tetsuya Horai, Tadashi Kitamura, Hirotsugu Okamoto, Kagami Miyaji
Early extubation in the operating room after congenital open-heart surgery is feasible, but extubation in the intensive care unit after the operation remains common practice at many institutions. The purpose of this study was to evaluate retrospectively the adequacy of our early-extubation strategy and exclusion criteria through analysis based on the Risk Adjustment in Congenital Heart Surgery method (RACHS-1).This retrospective analysis included 359 cases requiring cardiopulmonary bypass (male, 195; female, 164; weight > 3...
January 15, 2018: International Heart Journal
https://www.readbyqxmd.com/read/29332636/implementation-of-an-electronic-routine-outcome-monitoring-at-an-inpatient-unit-for-psychosomatic-medicine
#5
Jonas Egeter, Katharina Hüfner, Monika Sztankay, Bernhard Holzner, Barbara Sperner-Unterweger
BACKGROUND: Patient-reported outcomes (PROs) can be part of an electronic routine outcome monitoring (eROM). eROM can improve patient involvement, treatment outcomes and simplify scientific data assessment. Available studies on eROM focus on its evaluation only and lack a detailed description of the prior implementation procedure. OBJECTIVE: The aim was to implement an eROM assessment at a division of Psychosomatic Medicine and provide a detailed description of the implementation procedure...
February 2018: Journal of Psychosomatic Research
https://www.readbyqxmd.com/read/29331206/mechanical-thrombectomy-determining-the-proportion-of-eligible-acute-ischemic-stroke-patients-in-the-cohort-of-single-academic-stroke-center
#6
Marcin Wiącek, Rafał Kaczorowski, Bartosz Sieczkowski, Natalia Kanas, Halina Bartosik-Psujek
BACKGROUND AND PURPOSE: Mechanical thrombectomy (MT) is now well-established treatment method for selected patients with acute ischemic stroke (AIS) and efforts are being made to incorporate it into the systems of stroke care. Our objective is to assess the number of AIS individuals eligible for MT in the cohort of single academic stroke center. METHODS: We retrospectively reviewed initial non-invasive vascular imaging data of AIS patients presenting within 5h of symptom onset for the presence of large vessel occlusion (LVO) over 2-year period (2015-2016)...
December 26, 2017: Neurologia i Neurochirurgia Polska
https://www.readbyqxmd.com/read/29330016/clinical-impact-of-delayed-catheter-removal-for-patients-with-central-venous-catheter-related-gram-negative-bacteremia
#7
Yu-Mi Lee, Chisook Moon, Young Jin Kim, Hee-Joo Lee, Mi Suk Lee, Ki-Ho Park
BACKGROUND: Gram-negative bacteria are increasingly the cause of catheter-related bloodstream infections (CRBSI), which show a rapidly rising prevalence of multidrug-resistant strains. We evaluated the impact of delayed central venous catheter (CVC) removal on clinical outcomes in patients with gram-negative CRBSI. METHODS: Between January 2007 and December 2016, patients with gram-negative bacteremia and CVC placement, from two tertiary care hospitals, were retrospectively included...
January 9, 2018: Journal of Hospital Infection
https://www.readbyqxmd.com/read/29329535/measurement-of-the-potential-geographic-accessibility-from-call-to-definitive-care-for-patient-with-acute-stroke
#8
J Freyssenge, F Renard, A M Schott, L Derex, N Nighoghossian, K Tazarourte, C El Khoury
BACKGROUND: The World Health Organization refers to stroke, the second most frequent cause of death in the world, in terms of pandemic. Present treatments are only effective within precise time windows. Only 10% of thrombolysis patients are eligible. Late assessment of the patient resulting from admission and lack of knowledge of the symptoms is the main explanation of lack of eligibility. METHODS: The aim is the measurement of the time of access to treatment facilities for stroke victims, using ambulances (firemen ambulances or EMS ambulances) and private car...
January 12, 2018: International Journal of Health Geographics
https://www.readbyqxmd.com/read/29328511/stigma-and-unmet-sexual-and-reproductive-health-needs-among-international-migrant-sex-workers-at-the-mexico-guatemala-border
#9
Teresita Rocha-Jiménez, Sonia Morales-Miranda, Carmen Fernández-Casanueva, Kimberly Brouwer, Shira M Goldenberg
OBJECTIVE: To explore international migrant sex workers' experiences and narratives pertaining to the unmet need for and access to sexual and reproductive health (SRH) at the Mexico-Guatemala border. METHODS: An inductive qualitative analysis was conducted based on ethnographic fieldwork (2012-2015) including participant observation and audio-recorded in-depth interviews. The participants were female sex workers aged 18 years or older and international migrants working at the Mexico-Guatemala border...
January 12, 2018: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/29326764/a-prospective-study-to-evaluate-the-management-of-sub-trochanteric-femur-fractures-with-long-proximal-femoral-nail
#10
M Kumar, V Akshat, A Kanwariya, M Gandhi
Introduction: Sub-trochanteric fractures of the femur remains one of the most challenging fractures faced by orthopaedic surgeons. This study was done to analyse the management and complications of sub-trochanteric fractures using long proximal femoral nail (PFN). Materials and Methods: This was a prospective study of 50 patients with sub-trochanteric fractures of femur who were treated with long PFN at a tertiary care center from July 2012 to June 2016. The fractures were classified according to Seinsheimer classification...
November 2017: Malaysian Orthopaedic Journal
https://www.readbyqxmd.com/read/29326522/fragile-x-syndrome-a-rare-case-report-with-unusual-oral-features
#11
Prayas Ray, Arpanna Singh, Jayanta Kumar Dash, Prasanna Kumar Sahoo, Jitendra Kumar Dash
Fragile X syndrome (FXS) is a rare variant of special health-care need demonstrating delayed developmental milestones and associated with intellectual and emotional disabilities ranging from learning problem to mental retardation. The syndrome is usually not diagnosed until 8-9 years of age since the clinical manifestations of the syndrome are greatly attenuated in childhood. The physical characteristics such as facial features, hyperactivity, attention deficit, autistic behavior, and macroorchidism are quite evident in younger age group...
October 2017: Contemporary Clinical Dentistry
https://www.readbyqxmd.com/read/29325572/modeling-the-relationship-between-women-s-perceptions-and-future-intention-to-use-institutional-maternity-care-in-the-western-highlands-of-guatemala
#12
Emily Peca, John Sandberg
BACKGROUND: Despite global gains, women in hard-to-reach areas are at a relatively higher risk of death and disability related to childbirth. Traditional methods of measuring satisfaction may mask negative experiences (such as disrespect and abuse) that can drive down demand for institutional care. Better measurement of women's perceptions of care quality, especially among marginalized populations with historically low utilization of institutional care, are needed to inform how to improve services and foster greater utilization of (potentially life-saving) clinical care...
January 11, 2018: Reproductive Health
https://www.readbyqxmd.com/read/29325162/an-analysis-of-adverse-events-in-the-rehabilitation-department-using-the-veterans-affairs-root-cause-analysis-system
#13
Gregory W Hagley, Peter D Mills, Brian Shiner, Robin R Hemphill
Background: Root cause analyses (RCA) are often completed in health care settings to determine causes of adverse events (AEs). RCAs result in action plans designed to mitigate future patient harm. National reviews of RCA reports have assessed the safety of numerous health care settings and suggested opportunities for improvement. However, few studies have assessed the safety of receiving care from physical therapists, occupational therapists, or speech and language pathology pathologists...
January 9, 2018: Physical Therapy
https://www.readbyqxmd.com/read/29325097/barriers-to-health-care-services-for-migrants-living-with-hiv-in-spain
#14
Patricia Ndumbi, J Del Romero, F Pulido, M Velasco Arribas, F Dronda, J Ramón Blanco Ramos, P García de Olalla, I Ocaña, J Belda-Ibañez, J Del Amo, D Álvarez-Del Arco
Background: In Spain, migrants are disproportionately affected by HIV and experience high rates of late diagnosis. We investigated barriers to health care access among migrants living with HIV (MLWH) in Spain. Methods: Cross sectional electronic survey of 765 adult HIV-positive migrants recruited within 18 health care settings between July 2013 and July 2015. We collected epidemiological, demographic, behavioral and clinical data. We estimated the prevalence and risk factors of self-reported barriers to health care using multivariable logistic regression...
January 8, 2018: European Journal of Public Health
https://www.readbyqxmd.com/read/29324951/signs-and-symptoms-in-gaucher-disease-priority-nursing-diagnoses
#15
Márcia Koja Breigeiron, Vitória da Costa Moraes, Janice Carneiro Coelho
OBJECTIVE: Identify the signs and symptoms of patients with Gaucher Disease, inferring possible priority nursing diagnoses. METHOD: Cross-sectional study, developed in a specialized laboratory, between 2013 and 2015. The sample (n = 91) comprised the records of patients with genetic diagnosis for Gaucher Disease. The study respected research norms. RESULTS: Prevalence of female sex (57.1%), age at diagnosis between 0 and 10 years, and origin from the Southeast Region of Brazil were prevalent...
January 2018: Revista Brasileira de Enfermagem
https://www.readbyqxmd.com/read/29324551/the-i-pass-mnemonic-and-the-occurrence-of-handoff-related-errors-in-adult-acute-care-hospitals-a-systematic-review-protocol
#16
Brittany Ransom, Karen Winters
What is the effectiveness of the I-PASS mnemonic in reducing handoff related errors during inter- or intrahospital transfers for hospitalized patients?The objective of this systematic review is to identify the impact of the I-PASS mnemonic during hospitalized patient inter- or intrahospital transfers on medication errors, transfer delays, treatment delays and mortality.More specifically, the objective is to identify the effect that the I-PASS mnemonic has on handoff related errors during inter or intrahospital patient transfers by comparing rates pre and post I-PASS implementation...
January 2018: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/29322962/etiologic-spectrum-and-prognosis-in-noncompressive-acute-transverse-myelopathies-an-experience-of-80-patients-at-a-tertiary-care-facility
#17
Shuchit Pandey, Ravindra K Garg, Hardeep S Malhotra, Amita Jain, Kiran P Malhotra, Neeraj Kumar, Rajesh Verma, Praveen K Sharma
INTRODUCTION: We evaluated the spectrum of acquired demyelinating and inflammatory disorders in patients presenting with an acute transverse myelopathy. We also studied differences between an acute idiopathic transverse myelitis and myelitis resulting from other etiologies. MATERIALS AND METHODS: Eighty consecutive patients with acute transverse myelopathy were included. At inclusion, clinical profile, serum and cerebrospinal fluid parameters, brain and spinal cord magnetic resonance imaging, and visual evoked potentials were obtained...
January 2018: Neurology India
https://www.readbyqxmd.com/read/29321568/characterization-of-the-cry1ah-resistance-in-asian-corn-borer-and-its-cross-resistance-to-other-bacillus-thuringiensis-toxins
#18
Muhammad Zeeshan Shabbir, Yudong Quan, Zhenying Wang, Alejandra Bravo, Mario Soberón, Kanglai He
Transgenic crops producing insecticidal proteins are effective to manage lepidopteran pests. Development of insect-resistance is the major threat to Bacillus thuringiensis (Bt) crops such as Cry1Ah-Maize. Laboratory selection with Bt-Cry1Ah toxin incorporated in artificial diet, during 48 generations of Asian corn borer (ACB) Ostrinia furnacalis produced 200-fold resistance. This resistant colony ACB-AhR readily consumed and survived on Cry1Ah-expressing Bt-maize. Cross-resistance analysis showed high cross-resistance to Cry1F (464-fold), moderate cross-resistance to Cry1Ab (28...
January 10, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29320996/healthy-apple-program-to-support-child-care-centers-to-alter-nutrition-and-physical-activity-practices-and-improve-child-weight-a-cluster-randomized-trial
#19
Jodi D Stookey, Jane Evans, Curtis Chan, Lisa Tao-Lew, Tito Arana, Susan Arthur
BACKGROUND: North Carolina Nutrition and Physical Activity Self-Assessment for Child Care (NAP SACC) resources improve child body mass index (BMI) when the resources are introduced by nurses to child care providers, and offered with workshops and incentives. In San Francisco, public health and child care agencies partnered to adapt NAP SACC resources into an annual "Healthy Apple" quality improvement program (HAP). METHODS: This cluster randomized controlled trial pilot-tested integration of the HAP with bi-annual public health screenings by nurses...
December 19, 2017: BMC Public Health
https://www.readbyqxmd.com/read/29320588/a-guide-to-tissue-engineered-skin-substitutes
#20
Penelope J Kallis, Adam J Friedman, Hadar Lev-Tov
<p>Wounds that exhibit delayed healing have a tremendous impact on health care expenditures and place patients at serious risk for severe complications including death. The healing of a chronic wound requires the restoration of multiple factors that normally work in concert to repair the damaged skin barrier. Skin substitutes have shown great promise for use as adjunctive therapies for refractory wounds by providing cells, soluble mediators, and extracellular matrix materials needed to stimulate healing...
January 1, 2018: Journal of Drugs in Dermatology: JDD
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