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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/28334777/clinicians-interpretations-of-point-of-care-urine-culture-versus-laboratory-culture-results-analysis-from-the-four-country-poetic-trial-of-diagnosis-of-uncomplicated-urinary-tract-infection-in-primary-care
#2
Saskia Hullegie, Mandy Wootton, Theo J M Verheij, Emma Thomas-Jones, Janine Bates, Kerenza Hood, Micaela Gal, Nick A Francis, Paul Little, Michael Moore, Carl Llor, Timothy Pickles, David Gillespie, Nigel Kirby, Curt Brugman, Christopher C Butler
Background.: Urine culture at the point of care minimises delay between obtaining the sample and agar inoculation in a microbiology laboratory, and quantification and sensitivity results can be available more rapidly in primary care. Objective.: To identify the degree to which clinicians' interpretations of a point-of-care-test (POCT) urine culture (Flexicult™ SSI-Urinary Kit) agrees with laboratory culture in women presenting to primary care with symptoms of uncomplicated urinary tract infections (UTI)...
March 1, 2017: Family Practice
https://www.readbyqxmd.com/read/28334728/does-emergency-presentation-of-cancer-represent-poor-performance-in-primary-care-insights-from-a-novel-analysis-of-linked-primary-and-secondary-care-data
#3
Peter Murchie, Sarah M Smith, Michael S Yule, Rosalind Adam, Melanie E Turner, Amanda J Lee, Shona Fielding
BACKGROUND: People diagnosed with cancer following emergency presentation have poorer short-term survival. To what extent this signifies a missed opportunity for earlier diagnosis in primary care remains unclear as little detailed data exist on the patient/general practitioner interaction beforehand. METHODS: Analysis of primary care and regional data for 1802 cancer patients from Northeast Scotland. Adjusted odds ratios (OR) and 95% confidence intervals (CIs) for patient and GP practice predictors of emergency presentation...
March 23, 2017: British Journal of Cancer
https://www.readbyqxmd.com/read/28334672/effects-of-4-mbc-and-triclosan-in-embryos-of-the-frog-pelophylax-perezi
#4
Diana Martins, Marta S Monteiro, Amadeu M V M Soares, Carla Quintaneiro
The widespread and increasing use of personal care products (PCPs) have led to environmental contamination by substances included in these products. These substances have been detected in aquatic compartments and shown to cause adverse effects on non-target aquatic organisms. In this work toxicity of the antimicrobial triclosan (TCS) and of the UV-filter 3-(4-methylbenzylidene) camphor (4-MBC) was assessed in the embryos of Perez' frog Pelophylax perezi. Lethal and sub-lethal parameters were evaluated in embryos in Gosner stage 8-9 exposed to 0...
March 15, 2017: Chemosphere
https://www.readbyqxmd.com/read/28334584/delayed-workup-of-rectal-bleeding-in-adult-primary-care-examining-process-of-care-failures
#5
Saul N Weingart, Elena M Stoffel, Daniel C Chung, Thomas D Sequist, Ruth I Lederman, Stephen R Pelletier, Helen M Shields
BACKGROUND: Although delayed colorectal cancer diagnoses figure prominently in medical malpractice claims, little is known about the quality of primary care clinicians' workup of rectal bleeding. METHODS: In this study, 438 patients were identified using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes for rectal bleeding, hemorrhoids, and blood in the stool at 10 Boston adult primary care practices. Following nurse chart abstraction, physician reviewers assessed the overall quality of care and key care processes...
January 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28334564/data-driven-implementation-of-alarm-reduction-interventions-in-a-cardiovascular-surgical-icu
#6
Sharon H Allan, Peter A Doyle, Adam Sapirstein, Maria Cvach
BACKGROUND: Alarm fatigue in the ICU setting has been well documented in the literature. The ICU's high-intensity environment requires staff's vigilant attention, and distraction from false and non-actionable alarms pulls staff away from important tasks, creates dissatisfaction, and is a potential patient safety risk if alarms are missed or ignored. This project was intended to improve patient safety by optimizing alarm systems in a cardiovascular surgical intensive care unit (CVSICU)...
February 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28334526/an-unusual-non-emissive-behavior-of-rubrene-j-aggregates-a-rare-violation
#7
Nikhil Aggarwal, Archita Patnaik
Structure - property correlations in Rubrene (RB) colloidal J-aggregates were unravelled by steady state and time resolved spectroscopy in conjunction with excited state density functional calculations. The RB J-aggregate with a slippage angle θ = 30.4(0), estimated from the monomeric transition dipole moment directions, exhibited a broad FWHM of 1073 cm(-1) and a 5 nm red shifted absorption band carrying a transition dipole moment (M ⃗_(λagg )= 1.80 D) almost equivalent to the monomeric dye (M ⃗_(λmon )=1...
March 23, 2017: Journal of Physical Chemistry. B
https://www.readbyqxmd.com/read/28334438/insurance-denials-for-cancer-clinical-trial-participation-after-the-affordable-care-act-mandate
#8
Christine B Mackay, Kaitlyn R Antonelli, Suanna S Bruinooge, Jarron M Saint Onge, Shellie D Ellis
BACKGROUND: The Affordable Care Act (ACA) includes a mandate requiring most private health insurers to cover routine patient care costs for cancer clinical trial participation; however, the impact of this provision on cancer centers' efforts to accrue patients to clinical trials has not been well described. METHODS: First, members of cancer research centers and community-based institutions (n = 252) were surveyed to assess the status of insurance denials, and then, a focused survey (n = 77) collected denial details...
March 23, 2017: Cancer
https://www.readbyqxmd.com/read/28333866/prevention-of-gastrointestinal-side-effects-in-paediatric-oncology-what-are-the-guidelines
#9
Karis K F Cheng
PURPOSE OF REVIEW: Gastrointestinal side-effects, particularly with regard to alimentary tract mucositis and chemotherapy-induced nausea and vomiting (CINV), continue to be frequent and debilitating symptomatic conditions among children and adolescents receiving cytotoxic cancer therapy. Further avenues of progress for mucositis and CINV prevention in paediatric oncology setting are warranted. RECENT FINDINGS: The current article reviews the major guidelines and literature published in 2016 pertaining to the prevention of mucositis and CINV...
March 22, 2017: Current Opinion in Supportive and Palliative Care
https://www.readbyqxmd.com/read/28333678/evaluation-of-the-antibacterial-activity-of-green-propolis-extract-and-meadowsweet-extract-against-staphylococcus-aureus-bacteria-importance-in-would-care-compounding-preparations
#10
Nogueira Rodrigo José Lupatini, Panagiota Danopoulos, Rosita Swikidisa, Pinheiro Vanessa Alves
The use of natural products in compounded wound care formulas is an exciting avenue to pursue for compounding pharmacists since these natural products may contain compounds that promote healing on their own. The use of these natural extracts as an alternative therapy for wound care may also provide several benefits, such as decreased inflammation, infection, side effects, and treatment costs. Thus far, several studies have demonstrated antimicrobial activity for various natural product extracts, including green propolis and meadowsweet...
July 2016: International Journal of Pharmaceutical Compounding
https://www.readbyqxmd.com/read/28332780/differentiation-of-patented-crystalline-glucosamine-sulfate-from-other-glucosamine-preparations-will-optimize-osteoarthritis-treatment
#11
REVIEW
Sukit Saengnipanthkul, Saranatra Waikakul, Sattaya Rojanasthien, Kitti Totemchokchyakarn, Attarit Srinkapaibulaya, Tai Cheh Chin, Nguyen Mai Hong, Olivier Bruyère, Cyrus Cooper, Jean-Yves Reginster, Myat Lwin
Symptomatic slow-acting drugs for osteoarthritis (SYSADOAs) are recommended for the medium- to long-term management of knee osteoarthritis (OA) due to their abilities to control pain, improve function and delay joint structural changes. Among SYSADOAs, evidence is greatest for the patented crystalline glucosamine sulfate (pCGS) formulation (Mylan). Glucosamine is widely available as glucosamine sulfate (GS) and glucosamine hydrochloride (GH) preparations that vary substantially in molecular form, pharmaceutical formulation and dose regimen...
March 23, 2017: International Journal of Rheumatic Diseases
https://www.readbyqxmd.com/read/28332186/a-pilot-study-of-ultrasound-evaluation-of-gastric-emptying-in-patients-with-end-stage-renal-failure-a-comparison-with-healthy-controls
#12
C Chen, L Liu, C Y Wang, S-W Choi, V M Yuen
This prospective study was designed to evaluate gastric volume and content in patients with renal failure and healthy controls after an overnight fast, immediately after a light meal and at 6 h after the meal. Thirty subjects in each group were recruited. At each scanning session, gastric antral cross-sectional area was measured in the supine recumbent and right lateral decubitus positions, and a qualitative assessment of gastric contents was made using the Perlas three-point grading system. Six hours after the meal, the mean (SD) antral cross-sectional area in the supine position was 471 (195) mm(2) in patients with renal failure and 319 (106) mm(2) in healthy controls (p = 0...
March 23, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28331734/the-treatment-approach-and-social-support-needs-for-patients-with-breast-cancer
#13
Pınar Soylar, Metin F Genç
OBJECTIVE: Breast cancer is the most common type of cancer in women both in developed and developing countries. It has a higher mortality rate in low and middle income countries due to the late-stage diagnosis. The principal aim of this study was to investigate what patients with breast cancer did before presenting to Turgut Özal Medical Center and its relationship with late stage diagnosis. The study also aimed to identify the level of patients' perceived social support. MATERIALS AND METHODS: The study included 200 patients with breast cancer who were treated at the chemotherapy unit during 2013 and 2014...
April 2016: J Breast Health (2013)
https://www.readbyqxmd.com/read/28331365/mastectomy-skin-flap-necrosis-challenges-and-solutions
#14
REVIEW
Stuart A Robertson, Johann A Jeevaratnam, Avi Agrawal, Ramsey I Cutress
INTRODUCTION: Mastectomy skin flap necrosis (MSFN) has a reported incidence of 5%-30% in the literature. It is often a significant and underappreciated problem. The aim of this article was to review the associated challenges and possible solutions. METHODS: A MEDLINE search was performed using the search term "mastectomy skin flap necrosis". Titles and abstracts from peer-reviewed publications were screened for relevance. RESULTS: MSFN is a common complication and may present as partial- or full-thickness necrosis...
2017: Breast Cancer: Targets and Therapy
https://www.readbyqxmd.com/read/28330830/rates-delays-and-completeness-of-general-practitioners-responses-to-a-postal-versus-web-based-survey-a-randomized-trial
#15
Paul Sebo, Hubert Maisonneuve, Bernard Cerutti, Jean Pascal Fournier, Nicolas Senn, Dagmar M Haller
BACKGROUND: Web-based surveys have become a new and popular method for collecting data, but only a few studies have directly compared postal and Web-based surveys among physicians, and none to our knowledge among general practitioners (GPs). OBJECTIVE: Our aim is to compare two modes of survey delivery (postal and Web-based) in terms of participation rates, response times, and completeness of questionnaires in a study assessing GPs' preventive practices. METHODS: This randomized study was conducted in Western Switzerland (Geneva and Vaud) and in France (Alsace and Pays de la Loire) in 2015...
March 22, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28330829/does-telehealth-monitoring-identify-exacerbations-of-chronic-obstructive-pulmonary-disease-and-reduce-hospitalisations-an-analysis-of-system-data
#16
Melissa Kargiannakis, Deborah A Fitzsimmons, Claire L Bentley, Gail A Mountain
BACKGROUND: The increasing prevalence and associated cost of treating chronic obstructive pulmonary disease (COPD) is unsustainable. Health care organizations are focusing on ways to support self-management and prevent hospital admissions, including telehealth-monitoring services capturing physiological and health status data. This paper reports on data captured during a pilot randomized controlled trial of telehealth-supported care within a community-based service for patients discharged from hospital following an exacerbation of their COPD...
March 22, 2017: JMIR Medical Informatics
https://www.readbyqxmd.com/read/28330688/management-of-spontaneous-pneumomediastinum-are-hospitalization-and-prophylactic-antibiotics-needed
#17
Masatomo Ebina, Akira Inoue, Akihiro Takaba, Koichi Ariyoshi
BACKGROUND: Spontaneous pneumomediastinum is defined as the presence of free air in the mediastinum without any apparent concomitant factors or disease. It is uncommon but usually benign and self-limiting. Generally, patients with spontaneous pneumomediastinum are admitted to hospital, and occasionally, prophylactic antibiotics are administered to prevent mediastinitis. The purpose of this study was to describe practices concerning the feasibility of outpatient treatment and follow-up of spontaneous pneumomediastinum and the necessity of prophylactic antibiotics...
March 10, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28329848/attitudes-toward-alzheimer-s-care-seeking-among-korean-americans-effects-of-knowledge-stigma-and-subjective-norm
#18
Banghwa Lee Casado, Michin Hong, Sang E Lee
Purpose: Early detection of Alzheimer's disease (AD) ensures that affected individuals and their caregivers can make appropriate plans for health care needs, yet many ethnic minorities delay seeking care for AD until the disease has progressed. This study examined attitudes toward care-seeking for AD among Korean Americans (KAs) and identified factors affecting their attitudes. Methods: A cross-sectional survey was used to collect data from 234 KA adults. We conducted hierarchical regression analyses to examine the effects of sociocultural background (age, gender, education, cultural orientation), AD knowledge and exposure to AD, and beliefs about AD (stigma of pity, shame, and public avoidance) and AD care (subjective norm) on KAs' attitudes toward seeking AD care from primary care physicians (PCPs) and AD specialists...
March 10, 2017: Gerontologist
https://www.readbyqxmd.com/read/28329428/the-diagnosis-and-lived-experience-of-polycystic-ovary-syndrome-a-qualitative-study
#19
Julie Tomlinson, Jonathan Pinkney, Linda Adams, Elizabeth Stenhouse, Alison Bendall, Oonagh Corrigan, Gayle Letherby
AIMS: To explore the impact of the diagnosis of polycystic ovary syndrome on health/ill health identity, how women experience this diagnosis and their health beliefs. BACKGROUND: polycystic ovary syndrome is a common and heterogeneous condition, giving rise to a wide range of different health concerns. Previous research on polycystic ovary syndrome has been dominated by the medical perspective and less is known about the experiences and needs of women. DESIGN: A qualitative study of 32 premenopausal adult women with polycystic ovary syndrome (diagnosis confirmed by Rotterdam criteria), aged between 18-45 years, recruited from a primary and secondary care setting...
March 22, 2017: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/28328966/integration-of-family-planning-services-into-hiv-care-clinics-results-one-year-after-a-cluster-randomized-controlled-trial-in-kenya
#20
Craig R Cohen, Daniel Grossman, Maricianah Onono, Cinthia Blat, Sara J Newmann, Rachel L Burger, Starley B Shade, Norah Bett, Elizabeth A Bukusi
OBJECTIVES: To determine if integration of family planning (FP) and HIV services led to increased use of more effective contraception (i.e. hormonal and permanent methods, and intrauterine devices) and decreased pregnancy rates. DESIGN: Cohort analysis following cluster randomized trial, when the Kenya Ministry of Health led integration of the remaining control (delayed integration) sites and oversaw integrated services at the original intervention (early integration) sites...
2017: PloS One
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