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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/28437859/multiple-sclerosis-broke-my-heart
#2
Géraldine Androdias, Emilien Bernard, Damien Biotti, Nicolas Collongues, Françoise Durand-Dubief, Julie Pique, Ingrid Sanchez, Clément Delmas, Jacques Ninet, Romain Marignier, Sandra Vukusic
We report 5 cases of acute heart failure (AHF) related to multiple sclerosis (MS) relapses. AHF was inaugural in 3 patients, always preceded or accompanied by signs of brainstem dysfunction; it was severe, requiring intensive care management. Echocardiography showed left ventricular hypokinesis. No other cause of AHF has been found. All patients showed a new medullary lesion on brain MRI. All had rapid and complete recovery of ventricular function after intravenous corticosteroids. We concluded to a takotsubo phenomenon...
April 24, 2017: Annals of Neurology
https://www.readbyqxmd.com/read/28437818/-towards-a-rehabilitation-and-participation-oriented-psychotherapy
#3
Beate Muschalla, Jürgen Bengel, Matthias Morfeld, Ulrike Worringen
Mental disorders (such as recurrent mood disorders, personality disorders, or psychotic disorders) come along with enduring impairment in daily life activities. Therefore psychotherapeutic actions in inpatient or outpatient settings require a life-span and participation-oriented treatment perspective. Participation-oriented treatment aims at social and vocational integration in general life despite enduringly recurring or resting symptoms. According to the model of health problems offered by the International Classification of Functioning, Disability and Health, ICF (WHO, 2001), disability can be defined as context-dependent activity impairment due to illness...
April 24, 2017: Die Rehabilitation
https://www.readbyqxmd.com/read/28437817/-challenges-of-diversity-sensitive-care-in-medical-rehabilitation
#4
P Brzoska, O Razum
Diversity markers such as sex, migration background and socioeconomic status are associated with different needs and expectations in health care. In rehabilitation these needs and expectations are often not adequately accounted for. This may affect health care outcomes. In order to improve rehabilitative care, it is not sufficient to only focus on selected diversity criteria such as migration background. This has two reasons: First, health care users are defined by a wide range of different diversity markers; second, diversity markers are closely interrelated...
April 24, 2017: Die Rehabilitation
https://www.readbyqxmd.com/read/28437809/reactive-rather-than-proactive-diabetes-management-in-the-perioperative-period
#5
Inge Hommel, Petra J van Gurp, Alfons A den Broeder, Hub Wollersheim, Femke Atsma, Marlies E J L Hulscher, Cees J Tack
As perioperative hyperglycemia is associated with poor postoperative patient outcomes, clinical guidelines provide recommendations for optimal perioperative glucose control. It is unclear to what extent recommended glucose levels are met in daily practice, and little is known about factors that influence these levels. We describe blood glucose levels throughout the hospital care pathway in 375 non-critically ill patients with diabetes who underwent major surgery (abdominal, cardiac, or orthopedic) in 6 hospitals, examine determinants of these levels including adherence to 9 quality indicators for optimal perioperative diabetes care, and perform qualitative interviews to identify barriers for optimal care...
April 24, 2017: Hormone and Metabolic Research, Hormon- und Stoffwechselforschung, Hormones et Métabolisme
https://www.readbyqxmd.com/read/28437795/effect-of-using-the-heart-score-in-patients-with-chest-pain-in-the-emergency-department-a-stepped-wedge-cluster-randomized-trial
#6
Judith M Poldervaart, Johannes B Reitsma, Barbra E Backus, Hendrik Koffijberg, Rolf F Veldkamp, Monique E Ten Haaf, Yolande Appelman, Herman F J Mannaerts, Jan-Melle van Dantzig, Madelon van den Heuvel, Mohamed El Farissi, Bernard J W M Rensing, Nicolette M S K J Ernst, Ineke M C Dekker, Frank R den Hartog, Thomas Oosterhof, Ghizelda R Lagerweij, Eugene M Buijs, Maarten W J van Hessen, Marcel A J Landman, Roland R J van Kimmenade, Luc Cozijnsen, Jeroen J J Bucx, Clara E E van Ofwegen-Hanekamp, Maarten-Jan Cramer, A Jacob Six, Pieter A Doevendans, Arno W Hoes
Background: The HEART (History, Electrocardiogram, Age, Risk factors, and initial Troponin) score is an easy-to-apply instrument to stratify patients with chest pain according to their short-term risk for major adverse cardiac events (MACEs), but its effect on daily practice is unknown. Objective: To measure the effect of use of the HEART score on patient outcomes and use of health care resources. Design: Stepped-wedge, cluster randomized trial...
April 25, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28437793/mindfulness-based-stress-reduction-for-treating-low-back-pain-a-systematic-review-and-meta-analysis
#7
Dennis Anheyer, Heidemarie Haller, Jürgen Barth, Romy Lauche, Gustav Dobos, Holger Cramer
Background: Mindfulness-based stress reduction (MBSR) is frequently used to treat pain-related conditions, but its effects on low back pain are uncertain. Purpose: To assess the efficacy and safety of MBSR in patients with low back pain. Data Sources: Searches of MEDLINE/PubMed, Scopus, the Cochrane Library, and PsycINFO to 15 June 2016. Study Selection: Randomized controlled trials (RCTs) that compared MBSR with usual care or an active comparator and assessed pain intensity or pain-related disability as a primary outcome in patients with low back pain...
April 25, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28437620/american-association-of-clinical-endocrinologists-and-american-college-of-endocrinology-guidelines-for-management-of-dyslipidemia-and-prevention-of-cardiovascular-disease
#8
Paul S Jellinger, Yehuda Handelsman, Paul D Rosenblit, Zachary T Bloomgarden, Vivian A Fonseca, Alan J Garber, George Grunberger, Chris K Guerin, David S H Bell, Jeffrey I Mechanick, Rachel Pessah-Pollack, Kathleen Wyne, Donald Smith, Eliot A Brinton, Sergio Fazio, Michael Davidson
OBJECTIVE: The development of these guidelines is mandated by the American Association of Clinical Endocrinologists (AACE) Board of Directors and American College of Endocrinology (ACE) Board of Trustees and adheres with published AACE protocols for the standardized production of clinical practice guidelines (CPGs). METHODS: Recommendations are based on diligent reviews of the clinical evidence with transparent incorporation of subjective factors, according to established AACE/ACE guidelines for guidelines protocols...
April 2017: Endocrine Practice
https://www.readbyqxmd.com/read/28437573/using-internal-and-external-reviewers-can-help-to-optimise-neonatal-mortality-and-morbidity-conferences
#9
Michael-Andrew Assaad, Annie Janvier, Anie Lapointe
AIM: This study determined if there was a difference in the conclusions reached by paediatricians in morbidity and mortality conferences based on their level of involvement in a case. METHODS: All neonatal deaths occurring between August 2014 and September 2015 at Sainte-Justine Hospital, Montreal, Quebec, Canada, were reviewed by internal physicians involved in the case and external physicians who were not. The reviewers were asked to identify positive and negative clinical practice items and provide written recommendations...
April 24, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28437566/physical-therapists-perceptions-of-telephone-and-internet-video-mediated-service-models-for-exercise-management-of-people-with-osteoarthritis
#10
Belinda J Lawford, Kim L Bennell, Jessica Kasza, Rana S Hinman
OBJECTIVE: Investigate physical therapists' perceptions of, and willingness to use, telephone- and internet-mediated service models for exercise therapy for people with knee and/or hip osteoarthritis. METHODS: An internet-based survey of Australian physical therapists comprising three sections: i) demographic information; and 16 positively-framed perception statements about delivering exercise via ii) telephone and; iii) video over the internet, for people with hip and/or knee osteoarthritis...
April 24, 2017: Arthritis Care & Research
https://www.readbyqxmd.com/read/28437516/a-rare-case-of-misdiagnosed-silent-lung-cancer-with-solitary-metastasis-to-the-temporomandibular-joint-condyle
#11
Luca Guarda-Nardini, Edoardo Stellini, Adolfo Di Fiore, Daniele Manfredini
This article describes the case history of a 59-year-old female patient who sought advice for temporomandibular joint (TMJ) pain and sounds but who was actually diagnosed with a primary lung cancer with metastasis to the TMJ. The patient had a history of TMJ pain and deflection in jaw movement that progressively worsened over a few months and did not improve with the usual standard of care treatment provided by an orofacial pain practitioner. Magnetic resonance and computed tomography (CT) prescribed at a tertiary clinic showed an osteolytic bone mass within the right TMJ condyle...
April 2017: Journal of Oral & Facial Pain and Headache
https://www.readbyqxmd.com/read/28437512/dentist-practice-patterns-and-therapeutic-confidence-in-the-treatment-of-pain-related-to-temporomandibular-disorders-in-a-dental-practice-based-research-network
#12
Naoki Kakudate, Yoko Yokoyama, Futoshi Sumida, Yuki Matsumoto, Valeria V Gordan, Gregg H Gilbert, Ana M Velly, Eric L Schiffman
AIMS: To quantify the practice patterns of Japanese dentists in the management of pain related to temporomandibular disorders (TMD) and to identify specific characteristics that are significantly associated with the decision to perform occlusal adjustment for TMD-related pain. METHODS: A cross-sectional study was conducted consisting of a questionnaire survey of dentists affiliated with the Dental Practice-Based Research Network Japan (JDPBRN) (n = 148). Participants were asked how they diagnosed and treated TMD-related pain...
April 2017: Journal of Oral & Facial Pain and Headache
https://www.readbyqxmd.com/read/28437494/patellofemoral-pain-an-enigma-explained-by-homeostasis-and-common-sense
#13
William R Post, Scott F Dye
We present a rational, scientific, low-risk approach to patellofemoral pain (anterior knee pain) based on an understanding of tissue homeostasis. Loss of tissue homeostasis from overload and/or injury produces pain. Bone overload and synovial inflammation are common sources of such pain. Chondromalacia and malalignment are findings that almost always do not need to be "corrected" to relieve pain. Patience and persistence in nonoperative care results in consistent success. Surgery should be rare and done only after extensive nonoperative management and in the setting of clearly defined pathology...
March 2017: American Journal of Orthopedics
https://www.readbyqxmd.com/read/28437492/clinical-rehabilitation-of-anterior-knee-pain-current-concepts
#14
Laurie A Hiemstra, Sarah Kerslake, Elizabeth A Arendt
Rehabilitation is the hallmark of the nonoperative treatment of anterior knee pain (AKP). Whether a patient has had appropriate rehabilitation can be assessed in the office with a selection of basic and advanced screening tests. Most important, providing specific instructions in your referral to a therapist skilled in treating patients with AKP can ensure that any identified deficits are appropriately addressed. The etiology of AKP is multifactorial. Whatever its "cause," AKP alters neuromuscular function, and correcting these altered body movement patterns will benefit the patient...
March 2017: American Journal of Orthopedics
https://www.readbyqxmd.com/read/28437370/ethics-guide-recommendations-for-organ-donation-focused-physicians-endorsed-by-the-canadian-medical-association
#15
Sam D Shemie, Christy Simpson, Jeff Blackmer, Shavaun MacDonald, Sonny Dhanani, Sylvia Torrance, Paul Byrne
Donation physicians are specialists with expertise in organ and tissue donation and have been recognized internationally as a key contributor to improving organ and tissue donation services. Subsequent to a 2011 Canadian Critical Care Society-Canadian Blood Services consultation, the donation physician role has been gradually implemented in Canada. These professionals are generally intensive care unit physicians with an enhanced focus and expertise in organ/tissue donation. They must manage the dual obligation of caring for dying patients and their families while providing and/or improving organ donation services...
May 2017: Transplantation
https://www.readbyqxmd.com/read/28437365/a-method-to-account-for-variation-in-congenital-heart-surgery-length-of-stay
#16
Andrew Brennan, Kimberlee Gauvreau, Jean Connor, Melvin Almodovar, James DiNardo, Puja Banka, Meena Nathan, Derek Mathieu, Aditya Kaza, John E Mayer, Lisa Bergersen
OBJECTIVES: We sought to develop a risk-adjustment methodology for length of stay in congenital heart surgery, as none exist. DESIGN: Prospective cohort analysis combined with previously obtained retrospective cohort analysis of a Department of Cardiovascular Surgery clinical database. PATIENTS: Patients discharged from Boston Children's Hospital between October 1, 2006, and May 31, 2014, that underwent a congenital heart surgery procedure(s) linked to one of 103 surgical procedure types...
April 21, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28437321/medical-expenditures-associated-with-diabetes-among-youth-with-medicaid-coverage
#17
Sundar S Shrestha, Ping Zhang, Theodore J Thompson, Edward W Gregg, Ann Albright, Giuseppina Imperatore
BACKGROUND: Information on diabetes-related excess medical expenditures for youth is important to understand the magnitude of financial burden and to plan the health care resources needed for managing diabetes. However, diabetes-related excess medical expenditures for youth covered by Medicaid program have not been investigated recently. OBJECTIVE: To estimate excess diabetes-related medical expenditures among youth aged below 20 years enrolled in Medicaid programs in the United States...
April 21, 2017: Medical Care
https://www.readbyqxmd.com/read/28437309/pain-management-during-newborn-screening-using-youtube-to-disseminate-effective-pain-management-strategies
#18
Denise Harrison, Jessica Reszel, Bill Dagg, Cheryl Aubertin, Mariana Bueno, Sandra Dunn, Ann Fuller, JoAnn Harrold, Catherine Larocque, Stuart Nicholls, Margaret Sampson
To assess the reach, acceptability, and effect of the BSweet2Babies video showing breast-feeding, skin-to-skin care, and sucrose during blood sampling on intention to recommend the video or advocate for use of the interventions. In July 2014, the video and an electronic survey were produced and posted. After 1 year, the online viewer survey responses and YouTube analytics were analyzed. One year after posting, the BSweet2Babies video had 10 879 views from 125 countries and 187 (1.7%) viewers completed the survey...
April 2017: Journal of Perinatal & Neonatal Nursing
https://www.readbyqxmd.com/read/28437302/pain-management-in-the-opioid-dependent-pregnant-woman
#19
Rebecca R Safley, Jamie Swietlikowski
Opioid dependence is an epidemic in the United States, and the percentage of pregnant women who are opioid dependent has increased dramatically in the last decade. Pain management, already a concern for intrapartum and postpartum care, is complicated in the context of opioid dependence. This clinical review surveys the literature on pain management in opioid-dependent pregnant women to summarize current consensus and evidence to guide clinical practice. Points of consensus for pain management in opioid-dependent pregnant women include continual opioid maintenance therapy throughout the pregnancy and the postpartum period; adequate management of acute pain; the contraindication of opioid agonist-antagonists for pain management; and the need for interdisciplinary teams using a multimodal approach to provide optimal care to opioid-dependent pregnant women...
April 2017: Journal of Perinatal & Neonatal Nursing
https://www.readbyqxmd.com/read/28437234/poliovirus-vaccination-during-the-endgame-insights-from-integrated-modeling
#20
Radboud J Duintjer Tebbens, Kimberly M Thompson
Managing the polio endgame requires access to sufficient quantities of poliovirus vaccines. After oral poliovirus vaccine (OPV) cessation, outbreaks may occur that require outbreak response using monovalent OPV (mOPV) and/or inactivated poliovirus vaccine. Areas covered: We review the experience and challenges with managing vaccine supplies in the context of the polio endgame. Building on models that explored polio endgame risks and the potential mOPV needs to stop outbreaks from live poliovirus reintroductions, we conceptually explore the potential demands for finished and bulk mOPV doses from a stockpile in the context of limited shelf-life of finished vaccine and time delays to convert bulk to finished vaccine...
April 24, 2017: Expert Review of Vaccines
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