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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/28938795/lipid-lowering-nutraceuticals-in-clinical-practice-position-paper-from-an-international-lipid-expert-panel
#2
Arrigo F G Cicero, Alessandro Colletti, Gani Bajraktari, Olivier Descamps, Dragan M Djuric, Marat Ezhov, Zlatko Fras, Niki Katsiki, Michel Langlois, Gustavs Latkovskis, Demosthenes B Panagiotakos, Gyorgy Paragh, Dimitri P Mikhailidis, Olena Mitchenko, Bernhard Paulweber, Daniel Pella, Christos Pitsavos, Željko Reiner, Kausik K Ray, Manfredi Rizzo, Amirhossein Sahebkar, Maria-Corina Serban, Laurence S Sperling, Peter P Toth, Dragos Vinereanu, Michal Vrablík, Nathan D Wong, Maciej Banach
In recent years, there has been growing interest in the possible use of nutraceuticals to improve and optimize dyslipidemia control and therapy. Based on the data from available studies, nutraceuticals might help patients obtain theraputic lipid goals and reduce cardiovascular residual risk. Some nutraceuticals have essential lipid-lowering properties confirmed in studies; some might also have possible positive effects on nonlipid cardiovascular risk factors and have been shown to improve early markers of vascular health such as endothelial function and pulse wave velocity...
September 1, 2017: Nutrition Reviews
https://www.readbyqxmd.com/read/28938738/resolution-of-infertility-and-number-of-children-1386-couples-followed-for-a-median-of-13-years
#3
A A Righarts, A Gray, N P Dickson, L Parkin, W R Gillett
STUDY QUESTION: How common were children among infertile couples? SUMMARY ANSWER: A total of 61.7% of infertile couples presenting for care subsequently had live born children 13.1 years after first being clinically assessed, with a mean of 1.7 children among those who had at least one. WHAT IS KNOWN ALREADY: While the prognoses for infertile couples undertaking specific treatments have been well described, less is known about those not undergoing these treatments or the total number of children...
October 1, 2017: Human Reproduction
https://www.readbyqxmd.com/read/28938728/modeling-of-live-birth-rates-and-cost-effectiveness-of-oocyte-cryopreservation-for-cancer-patients-prior-to-high-and-low-risk-gonadotoxic-chemotherapy
#4
B Lyttle Schumacher, N Grover, T Mesen, A Steiner, J Mersereau
STUDY QUESTION: What is the live-birth rate (LBR) and cost-effectiveness of fertility preservation with oocyte cryopreservation (FP-OC) compared to expectant management in cancer patients age 25-40 based on estimated gonadotoxicity of treatments 5 years after cancer diagnosis? SUMMARY ANSWER: Oocyte cryopreservation prior to cancer treatment is more costly, yet more effective (producing more live births), than not undergoing oocyte cryopreservation but it is most beneficial for patients undergoing high-risk chemotherapy (HRC)...
October 1, 2017: Human Reproduction
https://www.readbyqxmd.com/read/28938433/type-2-diabetes-and-osteoporosis-a-guide-to-optimal-management
#5
Stavroula Paschou, Anastasia D Dede, Panagiotis G Anagnostis, Andromachi Vryonidou, Daniel Morganstein, Dimitrios G Goulis
Context: Both type 2 diabetes (T2D) and osteoporosis are affected by aging and quite often co-exist. Furthermore, the fracture risk in patients with T2D is increased. The aim of this article is to review updated information on osteoporosis and fracture risk in patients with T2D, to discuss the effects of diabetes treatment on bone metabolism, as well as the effect of anti-osteoporotic medications on the incidence and control of T2D and to provide a personalized guide to the optimal management...
June 21, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28938387/critical-sized-bone-defects-sequence-and-planning
#6
Paul Toogood, Theodore Miclau
Bone defects associated with open fractures require a careful approach and planning. At initial presentation, an emergent irrigation and debridement is required. Immediate definitive fixation is frequently safe, with the exception of those injuries that normally require staged management or very severe type IIIB and IIIC injuries. Traumatic wounds that can be approximated primarily should be closed at the time of initial presentation. Wounds that cannot be closed should have a negative pressure wound therapy dressing applied...
October 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28938306/different-clinical-course-and-complications-in-interagency-registry-for-mechanically-assisted-circulatory-support-1-patients-managed-with-or-without-extracorporeal-membrane-oxygenation
#7
Jason J Han, Jennifer Chung, Carol W Chen, Ann C Gaffey, Alex Sotolongo, Christyna Justice, Alyse E Ameer, J Eduardo Rame, Christian Bermudez, Michael A Acker, Pavan Atluri
Extracorporeal membrane oxygenation (ECMO) as a bridge to left ventricular assist device (LVAD) implantation has shown promise in improving end-organ function and optimizing outcomes in some critically ill patients, but the practice remains controversial. Retrospective review of patients who received LVADs from May 2008 to September 2016 at a high-volume, tertiary care cardiovascular center was performed. Subjects were Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) class 1 patients divided into ECMO bridge and non-ECMO bridge cohorts...
September 21, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28938302/anesthesia-information-management-clinical-decision-support
#8
Robert E Freundlich, Jesse M Ehrenfeld
PURPOSE OF REVIEW: Perioperative informatics tools continue to be developed at a rapid pace and offer clinicians the potential to greatly enhance clinical decision making. The goal of this review is to bring the reader updates on perioperative information management and discuss future research directions in the field. RECENT FINDINGS: Clinical decision support tools become more timely, accurate, and, in some instances, have been shown to improve patient outcomes...
September 21, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28938300/enhancing-the-quality-and-safety-of-the-perioperative-patient
#9
Sven Staender, Andrew Smith
PURPOSE OF REVIEW: Many possible hazards bedevil the perioperative patient. This review focuses on a number of aspects of perioperative management where the patient's quality and safety can be enhanced. RECENT FINDINGS: Our understanding of the relationship between preoperative preparation and postoperative outcomes has improved. There have also been recent developments in our understanding of how to construct useful cognitive aids and make the best use of checklists by understanding the cultural environment supporting their use...
September 21, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28938253/guidelines-for-the-diagnosis-and-management-of-critical-illness-related-corticosteroid-insufficiency-circi-in-critically-ill-patients-part-i-society-of-critical-care-medicine-sccm-and-european-society-of-intensive-care-medicine-esicm-2017
#10
Djillali Annane, Stephen M Pastores, Bram Rochwerg, Wiebke Arlt, Robert A Balk, Albertus Beishuizen, Josef Briegel, Joseph Carcillo, Mirjam Christ-Crain, Mark S Cooper, Paul E Marik, Gianfranco Umberto Meduri, Keith M Olsen, Sophia C Rodgers, James A Russell, Greet Van den Berghe
OBJECTIVE: To update the 2008 consensus statements for the diagnosis and management of critical illness-related corticosteroid insufficiency (CIRCI) in adult and pediatric patients. PARTICIPANTS: A multispecialty task force of 16 international experts in critical care medicine, endocrinology, and guideline methods, all of them members of the Society of Critical Care Medicine and/or the European Society of Intensive Care Medicine. DESIGN/METHODS: The recommendations were based on the summarized evidence from the 2008 document in addition to more recent findings from an updated systematic review of relevant studies from 2008 to 2017 and were formulated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology...
September 21, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28938252/emotional-impact-of-end-of-life-decisions-on-professional-relationships-in-the-icu-an-obstacle-to-collegiality
#11
Alexandra Laurent, Magalie Bonnet, Gilles Capellier, Pierre Aslanian, Paul Hebert
OBJECTIVES: End-of-life decisions are not only common in the ICU but also frequently elicit strong feelings among health professionals. Even though we seek to develop more collegial interprofessional approaches to care and health decision-making, there are many barriers to successfully managing complex decisions. The aim of this study is to better understand how emotions influence the end-of-life decision-making process among professionals working in ICU. DESIGN: Qualitative study with clinical interviews...
September 21, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28938242/clinical-data-warehouse-an-effective-tool-to-create-intelligence-in-disease-management
#12
Mahtab Karami, Azin Rahimi
Clinical business intelligence tools such as clinical data warehouse enable health care organizations to objectively assess the disease management programs that affect the quality of patients' life and well-being in public. The purpose of these programs is to reduce disease occurrence, improve patient care, and decrease health care costs. Therefore, applying clinical data warehouse can be effective in generating useful information about aspects of patient care to facilitate budgeting, planning, research, process improvement, external reporting, benchmarking, and trend analysis, as well as to enable the decisions needed to prevent the progression or appearance of the illness aligning with maintaining the health of the population...
September 21, 2017: Health Care Manager
https://www.readbyqxmd.com/read/28938233/no-apparent-association-between-bipolar-disorder-and-cancer-in-a-large-epidemiological-study-of-outpatients-in-a-managed-care-population
#13
Natan R Kahan, Barbara Silverman, Irena Liphshitz, Dan-Andrei Waitman, Itzhak Ben-Zion, Alexander M Ponizovsky, Abraham Weizman, Alexander Grinshpoon
An association between bipolar disorder (BD) and cancer risk has been reported. The purpose of this study was to investigate this association through linkage analysis of a national HMO database and a national cancer registry. All members of the Leumit Health Services (LHS) HMO of Israel from 2000 to 2012 were included. Members with a recorded diagnosis of BD and a record of at least one written or dispensed prescription for pharmacotherapy for treatment of BD were classified as patients with BD. We linked the LHS population with the Israel National Cancer Registry database to capture all cases of cancer reported...
September 21, 2017: International Clinical Psychopharmacology
https://www.readbyqxmd.com/read/28938179/does-simulation-enhance-nurses-ability-to-assess-deteriorating-patients
#14
Maria Bliss, Leanne M Aitken
Recognising and responding to patient deterioration has been identified as a key skill in nursing care to ensure that care is escalated for prompt, efficient management of the potentially critically ill patient. Simulation is one teaching strategy that has been established in nurse education as a method for enhancing skills. The objective was to explore the experiences of registered nurses to ascertain whether they perceived that simulation enhanced their skills in recognising the deteriorating patient. An exploratory qualitative design was used...
September 12, 2017: Nurse Education in Practice
https://www.readbyqxmd.com/read/28938102/self-management-support-at-the-end-of-life-patients-carers-and-professionals-perspectives-on-managing-medicines
#15
N Campling, A Richardson, M Mulvey, M Bennett, B Johnston, S Latter
BACKGROUND: Pain is a frequently reported symptom by patients approaching the end of life and well-established that patients and carers hold fears relating to opioids, and experience side effects related to their use. The management of medicines is intrinsic to achieving effective pain relief. The concept of self-management support whilst well characterised in the context of chronic illness has not been elaborated with respect to end of life care. AIM: To identify patient, carer and professional views on the concept of self-management support at end of life, specifically in relation to analgesia and related medicines (for side-effect management) in order to describe, characterise and explain self-management support in this context...
September 6, 2017: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/28937973/oral-and-dental-health-issues-in-people-with-mental-disorders
#16
Julio Torales, Iván Barrios, Israel González
Patients with mental disorders are subject to a greater number of risk factors for oral and dental disease than the general population. This is mostly caused by the side effects of the medications that they receive, lack of self-care, difficulty to access health services, a negative attitude towards healthcare providers, and patients’ lack of cooperation in dental treatments. The most common psychiatric disorders in our population are depression, anxiety disorders, schizophrenia, bipolar disorder, and dementia...
September 21, 2017: Medwave
https://www.readbyqxmd.com/read/28937930/feasibility-of-a-multidisciplinary-caregiving-training-protocol-for-young-caregivers-in-families-with-als
#17
Melinda S Kavanaugh, Megan Howard, Lori Banker-Horner
Feasibility of a multidisciplinary caregiving training protocol for young caregivers in families with ALS. OBJECTIVES: To assess the feasibility of a multidisciplinary young caregiver group training protocol for children and youth who provide care to a family member with ALS. METHOD: Peer group experiential young caregiver model based on theories of self-management and self-efficacy. Training conducted by a multidisciplinary team of therapists in ALS (PT, OT, Speech and social work), as well as assistive device vendors...
September 22, 2017: Social Work in Health Care
https://www.readbyqxmd.com/read/28937800/when-is-neuropsychological-testing-medically-necessary-for-children-on-medicaid-in-new-mexico
#18
Noah K Kaufman, Carola Mullins, Andrew S Davis, Silvina Tonarelli, Hugo Sandoval, Luis Ramos-Duran
Healthcare for poor children, also known as Medicaid, is disproportionately relied upon by citizens of poor states such as New Mexico, where (a) there are more unintended pregnancies, (b) domestic violence during and after pregnancies occurs with regularity, (c) youth substance use is much more common, (d) crime rates are some of the worst in the country, (e) many never graduate from high school, and (f) incarceration is often inevitable. Yet, there is a dearth of research into the neuropsychological health of these children...
September 22, 2017: Applied Neuropsychology. Child
https://www.readbyqxmd.com/read/28937609/job-satisfaction-among-health-care-staff-in-township-health-centers-in-rural-china-results-from-a-latent-class-analysis
#19
Haipeng Wang, Chengxiang Tang, Shichao Zhao, Qingyue Meng, Xiaoyun Liu
Background: The lower job satisfaction of health-care staff will lead to more brain drain, worse work performance, and poorer health-care outcomes. The aim of this study was to identify patterns of job satisfaction among health-care staff in rural China, and to investigate the association between the latent clusters and health-care staff's personal and professional features; Methods: We selected 12 items of five-point Likert scale questions to measure job satisfaction. A latent-class analysis was performed to identify subgroups based on the items of job satisfaction; Results: Four latent classes of job satisfaction were identified: 8...
September 22, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/28937572/obstetric-care-consensus-no-6-periviable-birth
#20
(no author information available yet)
Approximately 0.5% of all births occur before the third trimester of pregnancy, and these very early deliveries result in the majority of neonatal deaths and more than 40% of infant deaths. A recent executive summary of proceedings from a joint workshop defined periviable birth as delivery occurring from 20 0/7 weeks to 25 6/7 weeks of gestation. When delivery is anticipated near the limit of viability, families and health care teams are faced with complex and ethically challenging decisions. Multiple factors have been found to be associated with short-term and long-term outcomes of periviable births in addition to gestational age at birth...
October 2017: Obstetrics and Gynecology
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