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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/27926766/teledermatology-for-the-diagnosis-and-management-of-skin-cancer-a-systematic-review
#2
Anna Finnane, Kathy Dallest, Monika Janda, H Peter Soyer
Importance: As technology becomes more commonplace in dermatological practice, it is essential to continuously review the accuracy of teledermatology devices and services compared with in-person care. The last systematic review was conducted over 5 years ago. Objective: To synthesize and assess the quality of the evidence to address 3 research questions: (1) How accurate is teledermatology for skin cancer diagnosis compared with usual care (face-to-face [FTF] diagnosis)? (2) Does teledermatology save clinician and/or patient time, compared with usual care? (3) What are the enablers and barriers to adoption of teledermatology in clinical practice for the diagnosis of skin cancer? Evidence Review: The review protocol was registered in the PROSPERO database...
December 7, 2016: JAMA Dermatology
https://www.readbyqxmd.com/read/27925040/the-diagnosis-of-acute-appendicitis-in-pregnant-versus-non-pregnant-women-a-comparative-study
#3
Abbas Aras, Erbil Karaman, Çağhan Pekşen, Remzi Kızıltan, Mehmet Çetin Kotan
Objective: To investigate whether the diagnosis of acute appendicitis is affected by pregnancy or not. Method: A retrospective study with the analysis of the medical records of all women suspected of having appendicitis who underwent appendectomy at our hospital between June 2010 and March 2015 were reviewed. The patients were divided into two groups according to whether they were pregnant or not during the surgery: group I, pregnant women, and group II, non-pregnant women...
October 2016: Revista da Associação Médica Brasileira
https://www.readbyqxmd.com/read/27924410/does-antibiotic-resistance-evolve-in-hospitals
#4
Anna Seigal, Portia Mira, Bernd Sturmfels, Miriam Barlow
Nosocomial outbreaks of bacteria are well documented. Based on these incidents, and the heavy usage of antibiotics in hospitals, it has been assumed that antibiotic resistance evolves in hospital environments. To test this assumption, we studied resistance phenotypes of bacteria collected from patient isolates at a community hospital over a 2.5-year period. A graphical model analysis shows no association between resistance and patient information other than time of arrival. This allows us to focus on time-course data...
December 6, 2016: Bulletin of Mathematical Biology
https://www.readbyqxmd.com/read/27924107/newborn-healthcare-in-urban-india
#5
REVIEW
J Sharma, D Osrin, B Patil, S B Neogi, M Chauhan, R Khanna, R Kumar, V K Paul, S Zodpey
The rapid population growth in urban India has outpaced the municipal capacity to build essential infrastructures that make life in cities safe and healthy. Local and national governments alike are grappling with the challenges of urbanization with thousands migrating from villages to cities. Thus, urbanization in India has been accompanied by a concentration of poverty and urban public healthcare has emerged as one of the most pressing priorities facing our country. Newborn mortality rates in urban settings are lower than rural areas, early neonatal deaths account for greater proportion than late neonatal deaths...
December 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/27923536/early-initiation-of-newborn-individualized-developmental-care-and-assessment-program-nidcap-reduces-length-of-stay-a-quality-improvement-project
#6
Cheryl Moody, Tiffany J Callahan, Heather Aldrich, Bonnie Gance-Cleveland, Sharon Sables-Baus
Infants born at ≤32weeks gestation are at risk of developmental delays. Review of the literature indicates NIDCAP improves parental satisfaction, minimizes developmental delays, and decreases length of stay, thus reducing cost of hospitalization. Half (50.6%) of the infants admitted to this 84-bed Level IV Neonatal Intensive Care Unit (NICU) with a gestational age of ≤32weeks were referred for NIDCAP. The specific aims of this quality improvement project were to 1) compare the age at discharge for infants meeting inclusion criteria enrolled in NIDCAP with the age at discharge for those eligible infants not enrolled in NIDCAP; and 2) investigate the timing of initiation of NIDCAP (e...
December 3, 2016: Journal of Pediatric Nursing
https://www.readbyqxmd.com/read/27923434/listening-to-the-patient-voice-in-narcolepsy-diagnostic-delay-disease-burden-and-treatment-efficacy
#7
Kiran Maski, Erin Steinhart, David Williams, Thomas Scammell, Julie Flygare, Kimberly McCleary, Monica Gow
STUDY OBJECTIVES: Describe common symptoms, comorbidities, functional limitations, and treatment responsiveness among patients with narcolepsy. Investigate the effect of pediatric onset of narcolepsy symptoms on time to diagnosis of narcolepsy and presence of comorbid depression. METHODS: Cross-sectional survey of 1,699 people in the United States with self-reported diagnosis of narcolepsy. We utilized mixed-methods data analyses to report study findings. RESULTS: Most participants reported receiving a diagnosis of narcolepsy more than 1 y after symptom onset...
November 28, 2016: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
https://www.readbyqxmd.com/read/27922701/elolyckor-kan-ge-skador-som-visar-sig-efter-l%C3%A3-ng-tid-det-akuta-omh%C3%A3-ndertagandet-kan-vara-avg%C3%A3-rande-p%C3%A3-sikt
#8
Martin Tondel, Anna Blomqvist, Kristina Jakobsson, Tohr Nilsson, Bodil Persson, Sara Thomée, Lars-Gunnar Gunnarsson
Immediate and delayed outcomes after electrical injury. A guide for clinicians In Sweden about 300 electrical injuries are recorded each year at the Swedish National Electrical Safety Board. Most of our knowledge of the health consequences of these arise from clinical case series. Severe electrical injuries have direct thermal effects and may result in ventricular fibrillation, skin burns, as well as muscular and nerve affection. Long-term consequences include pain, vascular symptoms, cognitive and neurological symptoms and signs...
December 1, 2016: Läkartidningen
https://www.readbyqxmd.com/read/27922501/an-overview-of-congenital-myopathies
#9
Jean K Mah, Jeffrey T Joseph
PURPOSE OF REVIEW: This article uses a case-based approach to highlight the clinical features as well as recent advances in molecular genetics, muscle imaging, and pathophysiology of the congenital myopathies. RECENT FINDINGS: Congenital myopathies refer to a heterogeneous group of genetic neuromuscular disorders characterized by early-onset muscle weakness, hypotonia, and developmental delay. Congenital myopathies are further classified into core myopathies, centronuclear myopathies, nemaline myopathies, and congenital fiber-type disproportion based on the key pathologic features found in muscle biopsies...
December 2016: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/27921198/-metabolic-surgery-or-conservative-measures-as-therapy-of-obese-type%C3%A2-2%C3%A2-diabetics
#10
REVIEW
Udo Jahn, Thomas Schubert, Sibylle Schlepp, Heinz Jürgen Deuber
After bariatric surgery there are some favourable effects on comorbidities of obesity as glucose and lipid metabolism besides weight loss. Therefore surgical measures targeting at improvement of such metabolic disorders especially diabetes type 2 has been called "metabolic surgery". The complexity of its underlying metabolic mechanisms is not yet clear, but restriction of energy and weight loss (maintenance) seem to be the cornerstones.Risks of these procedures which are drawn of the established methods of bariatric surgery are reported to be relatively low in qualified centers...
December 5, 2016: Wiener Medizinische Wochenschrift
https://www.readbyqxmd.com/read/27921037/acute-kidney-injury-in-western-countries
#11
REVIEW
Josée Bouchard, Ravindra L Mehta
BACKGROUND: Acute kidney injury (AKI) is frequent and is associated with poor outcomes, including increased mortality, higher risk of chronic kidney disease, and prolonged hospital lengths of stay. The epidemiology of AKI mainly derives from studies performed in Western high-income countries. More limited data are available from Western low-income and middle-income countries (LMICs) located in Central and South America. SUMMARY: In this review, we summarize the most recent data on the epidemiology of AKI in Western countries, aiming to contrast results from industrialized high-income countries with LMICs...
October 2016: Kidney Diseases
https://www.readbyqxmd.com/read/27921017/factors-impacting-mortality-in-the-pre-hospital-period-after-road-traffic-accidents-in-urban-india
#12
Ananthnarayan Chandrasekharan, Aditya J Nanavati, Sandhya Prabhakar, Subramaniam Prabhakar
BACKGROUND: India currently has the dubious distinction of experiencing the highest number of road traffic accidents in the world. OBJECTIVES: We believe that this study on road traffic accidents may help to identify factors in the pre-hospital setting that may influence mortality rates. PATIENTS AND METHODS: A prospective observational study was carried out in a metro area in India over a period of one year. The study included consecutive patients admitted to the trauma service after road traffic accidents...
July 2016: Trauma Monthly
https://www.readbyqxmd.com/read/27920323/bridging-the-divide-between-dental-and-medical-care
#13
Gayathri Subramanian
A cancer patient delays needed dental care before radiation treatment and develops a painful, incurable disease.
December 1, 2016: Health Affairs
https://www.readbyqxmd.com/read/27920164/epistemic-injustice-in-healthcare-encounters-evidence-from-chronic-fatigue-syndrome
#14
Charlotte Blease, Havi Carel, Keith Geraghty
Chronic fatigue syndrome or myalgic encephalomyelitis (CFS/ME) remains a controversial illness category. This paper surveys the state of knowledge and attitudes about this illness and proposes that epistemic concerns about the testimonial credibility of patients can be articulated using Miranda Fricker's concept of epistemic injustice. While there is consensus within mainstream medical guidelines that there is no known cause of CFS/ME, there is continued debate about how best to conceive of CFS/ME, including disagreement about how to interpret clinical studies of treatments...
December 5, 2016: Journal of Medical Ethics
https://www.readbyqxmd.com/read/27919270/delayed-hyperbaric-oxygen-therapy-for-air-emboli-after-open-heart-surgery-case-report-and-review-of-a-success-story
#15
Eva Niyibizi, Guillaume Elyes Kembi, Claude Lae, Rodrigue Pignel, Tornike Sologashvili
BACKGROUND: The current case describes a rare diagnosis of iatrogenic air emboli after elective cardiopulmonary bypass that was successfully treated with delayed hyperbaric oxygen therapy, with good clinical evolution in spite of rare complications. CASE PRESENTATION: A 35 years old male was admitted to the intensive care unit (ICU) for post-operative management after being placed on cardiopulmonary bypass (CPB) for an elective ventricular septal defect closure and aortic valvuloplasty...
December 5, 2016: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/27918375/treatments-and-other-prognostic-factors-in-the-management-of-the-open-abdomen-a-systematic-review
#16
Adam T Cristaudo, Scott B Jennings, Kerry Hitos, Ronny Gunnarsson, Alan DeCosta
BACKGROUND: The open abdomen (OA) is an important approach for managing intra-abdominal catastrophes and continues to be the standard of care. Despite this, challenges remain with it associated with a high incidence of complications and poor outcomes. The objective of this article is to perform a systematic review in accordance with PRISMA guidelines to identify prognostic factors in OA patients in regards to definitive fascial closure (DFC), mortality and intra-abdominal complications...
November 30, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27918002/hair-care-practices-in-african-american-women-potential-for-allergic-contact-dermatitis
#17
Alicia Stallings, Apra Sood
Allergic contact dermatitis (ACD) is a delayed hypersensitivity reaction that occurs when the skin is re-exposed to a substance to which it was previously sensitized. One significant source of exposure to sensitizing chemicals is through personal grooming and beauty products. While the role of cosmetics and hair-care products in the development of ACD is well-documented, there has been very little literature that specifically addresses the role of hair-care practices of patients with tightly curled hair, such as in patients of African descent, in the development of ACD in this population...
December 2016: Seminars in Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/27917768/iatrogenic-medication-errors-in-a-paediatric-intensive-care-unit-in-durban-south-africa
#18
A Gokhul, P M Jeena, A Gray
BACKGROUND: Iatrogenic medication errors due to calculation errors are an under-reported concern in children. OBJECTIVE: To determine the incidence and source of iatrogenic medication errors in a paediatric intensive care unit (PICU). METHODS: A prospective study was conducted in the PICU at Inkosi Albert Luthuli Hospital, Durban, South Africa, over a 3-month period in 2014. Medication-related calculation skills of medical practitioners and nurses were assessed through the voluntary anonymous completion of a questionnaire...
December 1, 2016: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/27917759/south-african-guidelines-excellence-sage-adopt-adapt-or-contextualise
#19
J M Dizon, K Grimmer, Q Louw, T Kredo, T Young, S Machingaidze
Clinical practice guideline (CPG) activities must be planned carefully for efficient use of available resources and evidence-based implementation. De novo development of CPGs may sometimes 'recreate the wheel' and delay implementation. Three innovative alternatives to de novo CPG development (adopt, contextualise or adapt) are outlined, which have greater potential than de novo development to best use the limited available resources, personnel and time in settings such as South Africa.
December 1, 2016: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/27917669/use-of-core-biopsy-in-diagnosing-cervical-lymphadenopathy-a-viable-alternative-to-surgical-excisional-biopsy-of-lymph-nodes
#20
D Allin, S David, A Jacob, N Mir, A Giles, N Gibbins
OBJECTIVES Lymphoma often presents with a neck mass and while fine-needle aspiration cytology may be suggestive, tissue biopsy is required for reliable diagnosis and classification of a lymphoma that is sufficient to deliver the correct treatment for the patient. Traditionally, excisional biopsy of a lymph node has been the standard method of tissue sampling, providing ample tissue for assessment. However, this requires theatre time, and preceding fine-needle aspiration cytology, which may incur a delay. With careful use of tissue, coupled with advances in immunohistochemical and molecular investigative techniques, core biopsy provides a possible alternative to traditional fine-needle aspiration and excisional biopsy...
December 5, 2016: Annals of the Royal College of Surgeons of England
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