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https://www.readbyqxmd.com/read/28631809/anabolic-steroids-for-treating-pressure-ulcers
#1
REVIEW
Cho Naing, Maxine A Whittaker
BACKGROUND: Pressure ulcers, also known as bed sores, pressure sores or decubitus ulcers develop as a result of a localised injury to the skin or underlying tissue, or both. The ulcers usually arise over a bony prominence, and are recognised as a common medical problem affecting people confined to a bed or wheelchair for long periods of time. Anabolic steroids are used as off-label drugs (drugs which are used without regulatory approval) and have been used as adjuvants to usual treatment with dressings, debridement, nutritional supplements, systemic antibiotics and antiseptics, which are considered to be supportive in healing of pressure ulcers...
June 20, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28627221/management-and-family-burdens-endorsed-by-parents-of-youth-7-years-old-with-type-1-diabetes
#2
Kara Harrington, Claire T Boyle, Kellee M Miller, Marisa E Hilliard, Barbara J Anderson, Michelle Van Name, Linda A DiMeglio, Lori M Laffel
BACKGROUND: This study investigated unique burdens experienced by parents of young children with type 1 diabetes in the context of contemporary diabetes management. METHODS: Self-report surveys and medical record information from the T1D Exchange clinic registry were used. Parental burden and family impact scores were tabulated across demographic and clinical characteristics, overall and according to age group (<4, 4-<6, and 6-<7 years). RESULTS: The mean age of the 549 children was 5...
February 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28625229/mass-gathering-medical-care-in-electronic-dance-music-festivals
#3
Kathleen M FitzGibbon, Jose V Nable, Benjamin Ayd, Benjamin J Lawner, Angela C Comer, Richard Lichenstein, Matthew J Levy, Kevin G Seaman, Ian Bussey
Introduction Electronic dance music (EDM) festivals represent a unique subset of mass-gathering events with limited guidance through literature or legislation to guide mass-gathering medical care at these events. Hypothesis/Problem Electronic dance music festivals pose unique challenges with increased patient encounters and heightened patient acuity under-estimated by current validated casualty predication models. METHODS: This was a retrospective review of three separate EDM festivals with analysis of patient encounters and patient transport rates...
June 19, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28618903/planning-secondary-prevention-room-for-improvement
#4
Alejandro Cortés-Beringola, Donna Fitzsimons, Antonio Pelliccia, Guillermo Moreno, Roberto Martín-Asenjo, Héctor Bueno
The prognosis of patients after acute coronary syndromes is still suboptimal, mainly due to the risk of recurrent adverse coronary events, which is greatest during the first year, but persists over one's lifetime. Meaningful progress in preventing cardiovascular events has been achieved. However, there remains much room for improvement by embracing innovative therapies and investing in multidisciplinary approaches. Pharmacological interventions focused on optimising antithrombotic and lipid-lowering therapies are both pillars of secondary prevention that have seen recent ground-breaking advances...
June 2017: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/28617684/non-infarct-related-artery-revascularization-in-st-segment-elevation-myocardial-infarction-patients-with-multivessel-disease
#5
Asim N Cheema, Shamir R Mehta, Subodh Verma, Akshay Bagai
PURPOSE OF REVIEW: Multivessel disease (MVD) is common in ST-segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI) and is associated with significant risk of future cardiovascular (CV) events including short and longer-term mortality. In this review, we examine the pathophysiologic construct contributing to adverse prognosis of MVD in STEMI, relevant available evidence that currently guides the management of the noninfarct-related artery (IRA) stenosis and define the remaining knowledge gaps for future studies...
June 15, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28612689/evaluation-of-flood-preparedness-in-government-healthcare-facilities-in-eastern-province-sri-lanka
#6
Jessica M Farley, Inoka Suraweera, W L S P Perera, Jeremy Hess, Kristie L Ebi
BACKGROUND: Sri Lanka is vulnerable to floods and other hydro-meteorological disasters. Climate change is projected to increase the intensity of these events. OBJECTIVE: This study aimed to assess the flood preparedness in healthcare facilities in Eastern Province. DESIGN: This was a cross-sectional, descriptive, mixed methods study conducted in Trincomalee District. Surveys were conducted in 31 government healthcare facilities, using a pre-tested, structured questionnaire covering the last 5 years...
2017: Global Health Action
https://www.readbyqxmd.com/read/28610634/medication-related-visits-in-a-pediatric-emergency-department-an-8-years-retrospective-analysis
#7
Cristiano Rosafio, Serena Paioli, Cinzia Del Giovane, Valentina Cenciarelli, Nilla Viani, Paolo Bertolani, Lorenzo Iughetti
BACKGROUND: There are limited data on the characterization of medication-related visits (MRVs) to the emergency department (ED) in pediatric patients in Italy. We have estimated the frequency, severity, and classification of MRVs to the ED in pediatric patients. METHODS: We retrospectively analyzed data for children seeking medical evaluation for a MRV over an 8 years period. A medication-related ED visit was identified by using a random pharmacist assessment, emergency physician assessment, and in case of conflicting events, by a third investigators random assessment...
June 13, 2017: Italian Journal of Pediatrics
https://www.readbyqxmd.com/read/28592339/mass-casualty-incidents-in-the-underground-mining-industry-applying-the-haddon-matrix-on-an-integrative-literature-review
#8
Karl Gunnar Engström, John Angrén, Ulf Björnstig, Britt-Inger Saveman
OBJECTIVE: Underground mining is associated with obvious risks that can lead to mass casualty incidents. Information about such incidents was analyzed in an integrated literature review. METHODS: A literature search (1980-2015) identified 564 modern-era underground mining reports from countries sharing similar occupational health legislation. These reports were condensed to 31 reports after consideration of quality grading and appropriateness to the aim. The Haddon matrix was used for structure, separating human factors from technical and environmental details, and timing...
June 8, 2017: Disaster Medicine and Public Health Preparedness
https://www.readbyqxmd.com/read/28588932/fasting-with-diabetes-a-prospective-observational-study
#9
Muhammad Jawad Noon, Haseeb Ahmad Khawaja, Osama Ishtiaq, Quratulain Khawaja, Sana Minhas, Asfandyar Khan Niazi, Abdul Mannan Khan Minhas, Umar Rasool Malhi
OBJECTIVES: To determine the proportion of diabetic patients who develop adverse glycaemic events when fasting regularly. DESIGN: Prospective observational study conducted at a tertiary care hospital in South Asia. Five hundred and twenty-three patients were assessed for eligibility, and 150 were included in the final analysis. Diabetic patients over 18 years of age who were willing to fast regularly and make a chart of their daily blood sugar levels were included in the study...
August 2016: BMJ Global Health
https://www.readbyqxmd.com/read/28580737/pragmatic-approach-to-chest-pain-patients-discharged-with-undetectable-high-sensitivity-troponin-t-and-normal-electrocardiogram-the-stabs-ct-protocol
#10
Warrick Bishop, Gary Girao
A strategy that discharges chest pain patients with negative high-sensitivity troponin and non-ischaemic electrocardiography changes may still result in 0.44% of patients experiencing myocardial infarction within 30 days. We observed that a pragmatic approach that systematically discharged 25 patients on cardio-protective medications of aspirin, metoprolol and atorvastatin followed with prompt (<10 days) coronary computed tomography angiography resulted in no major adverse cardiac event and adverse drug reaction 30 days post-presentation...
June 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28577813/a-power-experience-a-phenomenological-study-of-interprofessional-education
#11
Joyce Engel, Dawn Prentice, Karyn Taplay
The purpose of this supplementary analysis of a hermeneutic phenomenological study of the experience of interprofessional collaboration for nursing and medical students was to explore the experience of power that was threaded throughout the original study. Seventeen students participated in guided, face-to-face conversations in the original study (Prentice, Engel, Taplay, & Stobbe, 2014). Through the processes of deductive analysis and inductive reasoning, 2 themes of power emerged from these research conversations: (a) complicated knowledge is power and (b) the power and silence of intimidation...
May 2017: Journal of Professional Nursing: Official Journal of the American Association of Colleges of Nursing
https://www.readbyqxmd.com/read/28577263/modelling-for-the-proposed-roll-out-of-the-111-service-in-wales-a-case-study
#12
Mark Tuson, Tracey England, Doris Behrens, Richard Bowen, Dorothy Edwards, John Frankish, Jude Kay
NHS Direct Wales provides a single point of access where members of the public can telephone and seek medical support and/or advice. The service is provided for all the Health Boards in Wales by a single virtual call centre run from a main location in Swansea with 2 satellite locations. Patients in Wales can also access a local General Practitioner service during the evenings and at weekends, by phoning their Out of Hours service. The introduction of a '111' service is intended to combine these two operations on a pan-Wales basis using the existing NHS Direct Wales call centre and staff, with the existing Health Board Out of Hours 'hubs'...
June 2, 2017: Health Care Management Science
https://www.readbyqxmd.com/read/28576754/stroke-avoidance-for-children-in-rep%C3%A3%C2%BAblica-dominicana-sacred-protocol-for-a-prospective-study-of-stroke-risk-and-hydroxyurea-treatment-in-sickle-cell-anemia
#13
Neelum D Jeste, Luisanna M Sánchez, Gabriela S Urcuyo, Melissa E Bergés, Judy P Luden, Susan E Stuber, Teresa S Latham, Rafael Mena, Rosa M Nieves, Russell E Ware
BACKGROUND: In the Dominican Republic, where the burden of sickle cell anemia (SCA) is high, many children lack access to routine screening and preventative care. Children with SCA are at risk for stroke, an event that leads to significant morbidity and mortality. In the United States, screening via transcranial Doppler (TCD) identifies children with SCA at highest stroke risk, allowing early intervention with blood transfusions. The need for indefinite transfusions for primary stroke prevention limits their practicality in limited-resource countries...
June 2, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28575417/implications-of-electronic-health-record-downtime-an-analysis-of-patient-safety-event-reports
#14
Ethan Larsen, Allan Fong, Christian Wernz, Raj M Ratwani
Objective: We sought to understand the types of clinical processes, such as image and medication ordering, that are disrupted during electronic health record (EHR) downtime periods by analyzing the narratives of patient safety event report data. Materials and Methods: From a database of 80 381 event reports, 76 reports were identified as explicitly describing a safety event associated with an EHR downtime period. These reports were analyzed and categorized based on a developed code book to identify the clinical processes that were impacted by downtime...
May 30, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28573096/mucoperiosteal-flap-necrosis-after-primary-palatoplasty-in-patients-with-cleft-palate
#15
Percy Rossell-Perry, Omar Cotrina-Rabanal, Luis Barrenechea-Tarazona, Roberto Vargas-Chanduvi, Luis Paredes-Aponte, Carolina Romero-Narvaez
BACKGROUND: The prevalence of flap necrosis after palatoplasty in patients with cleft palate. The prevalence of mucoperiosteal flap necrosis after palatoplasty remains unknown, and this complication is rare. This event is highly undesirable for both the patient and the surgeon. We present here a new scale to evaluate the degree of hypoplasia of the palate and identify patients with cleft palate at high risk for the development of this complication. METHODS: In this case series, a 20-year retrospective analysis (1994-2014) identified patients from our records (medical records and screening day registries) with nonsyndromic cleft palate who underwent operations at 3 centers...
May 2017: Archives of Plastic Surgery
https://www.readbyqxmd.com/read/28571154/fraternal-twin-tumours-of-the-oesophagus-and-stomach-presenting-in-the-advanced-stage-a-rare-case-with-a-fatal-end
#16
Saraswathy Sreeram, Chaithra Gowthuvalli Venkataramana, Jyoti Ramanath Kini, Ranjitha Rao, Nirupama Murali
Synchronous primary tumours of the aerodigestive tract presenting with different histologies is a very rare event. A case with such an association is presented here. A 50-year-old lady presented with symptoms of abdominal obstruction like abdominal pain, distention and vomiting since one month. Her radiological imaging and biopsies revealed a primary oesophageal squamous cell carcinoma and primary gastric adenocarcinoma. Western medical literature has shown the occurrence of multiple synchronous cancers; however, cases from India have seldom been reported...
April 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28570334/safety-considerations-during-transitions-of-care-from-inpatient-to-outpatient-settings
#17
Marcus Ponce de Leon, Anna D Hohler
Hospital admissions are times of intense change. New medications are started, treatment regimens are modified, and care plans that will continue in the outpatient setting are initiated. After discharge, most patients receive care from different providers than those seen in the hospital. This situation will increase as inpatient-based practice patterns, such as neurohospitalist practices, become more prevalent. Communication failures during the transition from hospital to clinic increase the risk of adverse events...
June 2017: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/28566775/orthopedic-surgery-in-cerebral-palsy-instructional-course-lecture
#18
Deepak Sharan
Orthopedic surgery (OS) plays an important role in the management of cerebral palsy (CP). The objectives of OS are to optimize functions and prevent deformity. Newer developments in OS for CP include emphasis on hip surveillance, minimally invasive procedures, use of external fixators instead of plates and screws, better understanding of lever arm dysfunctions (that can only be corrected by bony OS), orthopedic selective spasticity-control surgery, and single-event multilevel lever arm restoration and anti spasticity surgery, which have led to significant improvements in gross motor function and ambulation, especially in spastic quadriplegia, athetosis, and dystonia...
May 2017: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/28544284/the-national-healthcare-system-claims-databases-in-france-sniiram-and-egb-powerful-tools-for-pharmacoepidemiology
#19
Julien Bezin, Mai Duong, Régis Lassalle, Cécile Droz, Antoine Pariente, Patrick Blin, Nicholas Moore
The French health care system is based on universal coverage by one of several health care insurance plans. The SNIIRAM database merges anonymous information of reimbursed claims from all these plans, linked to the national hospital-discharge summaries database system (PMSI) and the national death registry. It now covers 98.8% of the French population, over 66 million persons, from birth (or immigration) to death (or emigration), making it possibly the world's largest continuous homogeneous claims database...
May 24, 2017: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/28540506/assessing-the-feasibility-of-the-effectiveness-of-discontinuing-bisphosphonates-trial-a-pilot-study
#20
N C Wright, P J Foster, A S Mudano, J A Melnick, M E Lewiecki, W J Shergy, J R Curtis, G R Cutter, M I Danila, M L Kilgore, E C Lewis, S L Morgan, D T Redden, A H Warriner, K G Saag
The Effectiveness of Discontinuing Bisphosphonates (EDGE) study is a planned pragmatic clinical trial to guide "drug holiday" clinical decision making. This pilot study assessed work flow and feasibility of such a study. While participant recruitment and treatment adherence were suboptimal, administrative procedures were generally feasible and minimally disrupted clinic flow. INTRODUCTION: The comparative effectiveness of continuing or discontinuing long-term alendronate (ALN) on fractures is unknown...
May 24, 2017: Osteoporosis International
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