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https://www.readbyqxmd.com/read/28635575/-high-risk-obstetrics-in-tertiary-centres-anaesthetist-hybrid-operating-suite-and-obstetric-critical-care-unit
#1
C D van der Marel, A J Eggink, R J Stolker
The frequency of pregnancy-related morbidity has increased over recent decades, as has the number of patients with complex congenital cardiac anomalies reaching fertile age, resulting in an increasing number of high-risk pregnancies. In order to optimalise maternal and foetal outcome in these patients, not only is the availability of optimal in-hospital facilities (e.g. obstetric critical care unit, hybrid operating suite) important, but also a multidisciplinary approach which is mandatory for successful maternal and foetal outcome...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28635351/assessing-the-quality-of-bereavement-care-after-perinatal-death-development-and-piloting-of-a-questionnaire-to-assess-parents-experiences
#2
Esther Aiyelaagbe, Rebecca E Scott, Victoria Holmes, Emma Lane, Alexander E P Heazell
Understanding parents' experience of care is essential to develop high-quality perinatal bereavement services. This study aimed at developing a questionnaire to identify parents' needs and record their experience of care. The patient experience questionnaire was developed by professionals and parents, and piloted in a tertiary maternity unit. Responses were received from 58 parents. Sensitivity and kindness of staff and time spent with their baby were ranked as 'very important' by 95% of parents. Care in these areas largely met their needs (90%), although 5% of respondents stated that partners could have been more involved...
June 21, 2017: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28634534/etiological-factors-of-short-stature-in-children-and-adolescents-experience-at-a-tertiary-care-hospital-in-egypt
#3
Almontaser Hussein, Hekma Farghaly, Eman Askar, Kotb Metwalley, Khaled Saad, Asmaa Zahran, Hisham A Othman
BACKGROUND: Accurate anthropometric measurements and critical analysis of growth data allow the clinician to promptly recognize children with short stature. The aim of this study was to determine the frequency of etiological factors causing short stature among children referred to the pediatric endocrinology clinic of Assiut University Children's Hospital, the main tertiary care center in Upper Egypt. METHODS: We conducted this descriptive observational study from May 2012 to December 2015, to analyze 637 children (boys 354, girls 283) with short stature...
May 2017: Therapeutic Advances in Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28634533/a-study-to-evaluate-the-prevalence-of-impaired-awareness-of-hypoglycaemia-in-adults-with-type-2-diabetes-in-outpatient-clinic-in-a-tertiary-care-centre-in-singapore
#4
Ling Zhu, Li Chang Ang, Wee Boon Tan, Xiaohui Xin, Yong Mong Bee, Su-Yen Goh, Ming Ming Teh
BACKGROUND: Impaired awareness of hypoglycaemia (IAH) predisposes affected patients to severe hypoglycaemia. There are few data on prevalence of IAH in adults with insulin-treated type 2 diabetes in Asia. We aim to ascertain the prevalence of IAH among insulin-treated patients with type 2 diabetes in an outpatient clinic in a tertiary care centre in Singapore. METHODS: A total of 374 patients with insulin-treated type 2 diabetes attending the outpatient diabetes clinic in a tertiary referral centre in Singapore were recruited over a 4-month period...
May 2017: Therapeutic Advances in Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28634503/monitoring-the-diagnostic-process-on-an-inpatient-neurology-service
#5
Amar Dhand, Robert Bucelli, Arun Varadhachary, Michael Tsiaklides, Gabriela de Bruin, Gurpreet Dhaliwal
The Institute of Medicine report Improving Diagnosis in Health Care called for tools to monitor physicians' diagnostic process. We addressed this need by developing a tool for clinicians to record and analyze their diagnostic process. The tool was a secure web application in which clinicians used a structured grading system to assess the relative impact of clinical, laboratory, and neuroimaging data for every new diagnosis. Four neurohospitalists used the tool for 6.5 months on a general neurology ward service at a single tertiary-level teaching hospital...
July 2017: Neurohospitalist
https://www.readbyqxmd.com/read/28633708/once-daily-dosing-of-amikacin-for-treatment-of-mycobacterium-abscessus-lung-disease
#6
H Lee, Y M Sohn, J Y Ko, S-Y Lee, B W Jhun, H Y Park, K Jeon, D H Kim, S-Y Kim, J E Choi, I J Moon, S J Shin, H J Park, W-J Koh
SETTING: Tertiary referral centre, Samsung Medical Center, South Korea. OBJECTIVE: To evaluate the pharmacokinetic parameters and toxicities of once-daily amikacin (AMK) dosing for lung disease due to Mycobacterium abscessus. DESIGN: A retrospective review of 48 patients with M. abscessus lung disease who received once-daily AMK for 4 weeks between January 2012 and June 2015. RESULTS: With a starting dose of 15 mg/kg/day and adjustment of AMK dose according to the peak serum level (Cmax), the Cmax target of 55-65 μg/ml was achieved in 31...
July 1, 2017: International Journal of Tuberculosis and Lung Disease
https://www.readbyqxmd.com/read/28633636/typology-of-birth-centres-in-the-netherlands-using-the-rainbow-model-of-integrated-care-results-of-the-dutch-birth-centre-study
#7
Inge C Boesveld, Marc A Bruijnzeels, Marit Hitzert, Marieke A A Hermus, Karin M van der Pal-de Bruin, M Elske van den Akker-van Marle, Eric A P Steegers, Arie Franx, Raymond G de Vries, Therese A Wiegers
BACKGROUND: The goal of integrated care is to offer a continuum of care that crosses the boundaries of public health, primary, secondary, and tertiary care. Integrated care is increasingly promoted for people with complex needs and has also recently been promoted in maternity care systems to improve the quality of care. Especially when located near an obstetric unit, birth centres are considered to be ideal settings for the realization of integrated care. At present, however, we know very little about the degree of integration in these centres and we do not know if increased levels of integration improve the quality of the care delivered...
June 21, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28633556/oxidative-stress-and-dna-damage-in-newborns-born-to-mothers-with-hyperglycemia-%C3%A2-a-prospective-cohort-study
#8
K Dulasi Durga, B Adhisivam, G Vidya, B Vishnu Bhat, Bobby Zachariahc, Chand Parkashd
BACKGROUND: Hyperglycemic mothers have increased oxidative stress during pregnancy which can adversely affect the outcome in their neonates Objectives: To measure the oxidative stress and DNA damage in newborns born to mothers with hyperglycemia and correlate their immediate outcome with the amount of oxidative stress and DNA damage. METHODS: This prospective cohort study conducted in a tertiary care teaching hospital, south India included 3 groups - newborns born to pregestational diabetic mothers (PGDM), gestational diabetic mothers (GDM) and euglycemic mothers with 24 newborns in each...
June 20, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28632927/prospective-associations-between-environmental-heavy-metal-exposure-and-renal-outcomes-in-adults-with-chronic-kidney-disease
#9
Chun-Chieh Tsai, Chia-Lin Wu, Chew-Teng Kor, Ie-Bin Lian, Chin-Hua Chang, Teng-Hsiang Chang, Chia-Chu Chang, Ping-Fang Chiu
BACKGROUND: In Taiwan, Changhua County residents were exposed to high heavy metal pollution and exhibited high heavy metal levels in blood and urine. We examined associations between heavy metals in residential soil and renal outcomes of residents with chronic kidney disease (CKD). METHOD: From January 01, 2003 to June 30, 2015, we retrospectively identified CKD patients with an estimated glomerular filtration rate of <60 mL/min/1.73 m(2) at one tertiary care center...
June 20, 2017: Nephrology
https://www.readbyqxmd.com/read/28632578/acute-abdominal-pain-recognition-and-management-of-constipation-in-the-emergency-department
#10
Stefania Norbedo, Giulia Bassanese, Francesca Barbieri, Egidio Barbi
OBJECTIVE: The main aim of the study was to investigate the incidence and the clinically relevant features of functional constipation in patients evaluated for acute abdominal pain in a tertiary care pediatric emergency department. METHODS: This is a retrospective study. We analyzed 4394 medical records and recorded the information (demographics, triage code, symptoms, medical history, physical evaluation, laboratory tests, radiological studies, procedures, and treatments) of all patients admitted for acute abdominal pain to the emergency department of the IRCCS Burlo Garofolo, Trieste, during 2010 to 2013...
June 20, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28632575/clinical-profile-etiology-and-outcome-of-infantile-ocular-trauma-a-developing-country-perspective
#11
Vedang D Shah, Madhu Uddaraju, Amitabh Singh, Rashmi Ranjan Das
OBJECTIVE: The aim of this article was to study the clinical profile, etiology, and outcome of infantile ocular trauma in a developing country setting. METHODS: A retrospective study on corneal trauma in infants (≤12 months old) was undertaken in a tertiary care hospital during a 2-year period. An analysis of clinical profile, etiology, microbiological profile, clinical course, and outcome was studied. RESULTS: Seventy-six infants were included...
June 20, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28632493/interplay-between-papp-a-inflammation-and-adiposity-in-patients-with-angiographically-proven-acute-coronary-syndrome-acs
#12
Khageshwar Mahato, Moushumi Lodh, Ashok Parida, Ashok Kr Ahirwar, Rashmi Rasi Datta, Binita Goswami
Introduction Studies conducted in the recent past have demonstrated the role of inflammation, obesity and dysfunctional insulin signaling as contributing factors in the pathogenesis of acute coronary syndrome (ACS). However, pharmacological interventions targeting a single pathway have not proven useful in the long run. This indicates that a synergism occurs between the various risk factors and hence calls for a combinatorial approach. This study was planned to study the interplay, if any, between pregnancy associated plasma protein-A (PAPP-A), inflammation and adiposity in patients with ACS...
June 21, 2017: Hormone Molecular Biology and Clinical Investigation
https://www.readbyqxmd.com/read/28632428/clinical-and-socio-demographic-correlates-of-anxious-distress-in-asian-outpatients-with-major-depressive-disorder
#13
Narong Maneeton, Sirijit Suttajit, Benchalak Maneeton, Surinporn Likhitsathian, Kanokkwan Eurviyanukul, Pichet Udomratn, Edwin Shih-Yen Chan, Tian-Mei Si, Ahmad Hatim Sulaiman, Chia-Hui Chen, Dianne Bautista, Manit Srisurapanont
BACKGROUND: Anxious distress in major depressive disorder (MDD) is common and associated with poor outcomes and management difficulties. AIMS: This post hoc analysis aimed to examine the socio-demographic and clinical correlates of anxiety distress in Asian outpatients with MDD. METHODS: Instead of two out of five specifiers defined by the Diagnostic and Statistical Manual Version-5, anxious distress defined in this study was operationalized as the presence of at least two out of four proxy items drawn from the 90-item Symptom Checklist, Revised (SCL-90-R)...
June 20, 2017: Nordic Journal of Psychiatry
https://www.readbyqxmd.com/read/28632340/prescribing-in-the-oldest-old-inpatients-a-retrospective-analysis-of-patients-referred-for-specialist-geriatric-consultation
#14
Sivarajah Ilango, Peter Pillans, Nancye M Peel, Ian Scott, Leonard C Gray, Ruth E Hubbard
INTRODUCTION: While medications may prolong life and prevent morbidity in older people, adverse effects of polypharmacy are increasingly recognised. As patients age and become frail, prescribing may be expected to focus more on symptom control and minimise potentially harmful preventive medication use that confer little benefit within a short lifespan. Whether prescribing practice shifts to one of symptom control among the oldest old admitted to hospital remains unclear. METHODS: Retrospective analysis of all patients aged ≥85 years referred for comprehensive geriatric assessment at a tertiary care hospital between May 2006 and December 2014 for whom all prescribed medications were documented...
June 20, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28631639/prevalence-of-clostridium-difficile-infection-among-the-patients-attending-a-tertiary-care-teaching-hospital
#15
Lavanya Segar, Joshy M Easow, Sreenivasan Srirangaraj, Mohammad Hanifah, Noyal M Joseph, K S Seetha
BACKGROUND: Clostridium difficile, a most important nosocomial enteric pathogen, is recognized globally as responsible for antibiotic-associated diarrhea and colitis. It is associated with considerable morbidity and mortality due to widespread use of antibiotics. AIMS: The study was done to determine the prevalence of C. difficile infection (CDI) among the patients attending a tertiary care teaching hospital in Puducherry. SETTINGS AND DESIGN: We performed a prospective cohort study in Mahatma Gandhi Medical College and Research Institute...
April 2017: Indian Journal of Pathology & Microbiology
https://www.readbyqxmd.com/read/28631638/clinicomicrobiological-profile-of-endophthalmitis-a-10-year-experience-in-a-tertiary-care-center-in-north-india
#16
Gita Satpathy, Niranjan Nayak, Meenakshi Wadhwani, Pradeep Venkwatesh, Atul Kumar, Yograj Sharma, Vishnu Sreenivas
PURPOSE: To determine the clinicomicrobiological profile of infectious agents and their antibiotic susceptibility in different type of endophthalmitis. METHODS: A retrospective review of clinical and microbiological records from January 2001 to December 2010, was performed in 1110 patients diagnosed with different type of endophthalmitis (postoperative, posttraumatic, endogenous and post keratitis) to record the demographic details, clinical presentations; microbiological agents isolated with their antimicrobial sensitivity pattern...
April 2017: Indian Journal of Pathology & Microbiology
https://www.readbyqxmd.com/read/28631636/profiling-of-peripheral-t-cell-lymphomas-in-kerala-south-india-a-5-year-study
#17
Rekha A Nair, Jayasudha Arundhathi Vasudevan, Priya Mary Jacob, Renu Sukumaran
BACKGROUND: Peripheral T-cell lymphomas (PTCLs) are non-Hodgkin's lymphomas (NHLs) with considerable variation in incidence across the world. They show a wide variety of clinicopathological features and generally associated with poor clinical outcome. Lymphoma data from different geographic regions will definitely aid in routine clinical practice and research work. PTCLs are reported with a higher frequency in Asia as compared to Western countries. OBJECTIVE: The objective of this study was to analyze the frequency and distribution of PTCLs diagnosed in a tertiary care cancer center in Kerala...
April 2017: Indian Journal of Pathology & Microbiology
https://www.readbyqxmd.com/read/28631634/phenotypic-and-molecular-characterization-of-cefotaximases-temoniera-and-sulfhydryl-variable-%C3%AE-lactamases-in-pseudomonas-and-acinetobacter-isolates-in-an-indian-tertiary-health-care-center
#18
Sana Jamali, Mohammed Shahid, Farrukh Sobia, Anuradha Singh, Haris M Khan
BACKGROUND: Cefotaximases (CTX-M), temoniera (TEM), and sulfhydryl variable (SHV) constitute a rapidly growing cluster of enzymes that have disseminated geographically. They are spreading to species other than Enterobacteriaceae and might be responsible for the presence of blaCTX-M,blaTEM, and blaSHVgenes in Pseudomonas and Acinetobacter spp. The present study was designed to characterize CTX-M, TEM, and SHV phenotypically and genotypically in Pseudomonas and Acinetobacter spp. MATERIALS AND METHODS: A total of 90 isolates (73 Pseudomonas and 17 Acinetobacter spp...
April 2017: Indian Journal of Pathology & Microbiology
https://www.readbyqxmd.com/read/28631632/risk-of-cardiac-pacemaker-pocket-infection-in-a-tertiary-care-hospital
#19
Jaswinder Singh Gill, Navreet Singh, S P Khanna
BACKGROUND: The risk of pacemaker pocket infections (PPIs) is rare with good antisepsis techniques and use of advanced antibiotics. However, injudicious antibiotic usage leads to the rise of multidrug-resistant bacteria, which may cause PPI. Few reports exist about the microbial spectrum of the PPI from our country, prompting us to study the same. METHODS: We conducted this retrospective observational study for 3 years (January 2013-February 2016) from all the patients with PPI...
April 2017: Indian Journal of Pathology & Microbiology
https://www.readbyqxmd.com/read/28631531/interleukin-1-receptor-antagonist-anakinra-intravenous-immunoglobulin-and-corticosteroids-in-the-management-of-critically-ill-adult-patients-with-hemophagocytic-lymphohistiocytosis
#20
Philipp Wohlfarth, Hermine Agis, Guido A Gualdoni, Johannes Weber, Thomas Staudinger, Peter Schellongowski, Oliver Robak
BACKGROUND: Hemophagocytic lymphohistiocytosis (HLH) causes multiple organ dysfunction frequently leading to intensive care unit (ICU) referral and/or death. We report on a series of critically ill adult patients treated with a non-etoposide-based regimen including interleukin 1 antagonist anakinra, intravenous immunoglobulin (IVIG), and/or corticosteroids (CS) for HLH. METHODS: Eight adult (≥18 years) ICU patients having received treatment with anakinra ± IVIG ± CS for HLH between March 2014 and March 2016 at a large tertiary care university hospital (Medical University of Vienna, Vienna, Austria) were retrospectively analyzed...
January 1, 2017: Journal of Intensive Care Medicine
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