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https://www.readbyqxmd.com/read/29786813/prediction-of-mortality-in-pediatric-traumatic-brain-injury-implementations-from-a-tertiary-pediatric-intensive-care-facility
#1
Ebru Atike Ongun, Oğuz Dursun
BACKGROUND: To explore the mortality risk factors of traumatic brain injury in pediatric intensive care unit admissions. METHODS: Eighty-eight children (categorized using the Glasgow Coma Scale) between September 2014 and December 2016 were analyzed. Emergency department and intensive care course, treatment strategies, axonal injury, intubation and tracheostomy rates, length of intensive care and hospitalization, Rotterdam-CT scores, injury severity scores, and PRISM-III scores were recorded...
May 2018: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/29786028/evaluation-of-a-distance-learning-academic-support-program-for-medical-graduates-during-rural-hospital-service-in-india
#2
Rashmi Vyas, Anand Zachariah, Isobel Swamidasan, Priya Doris, Ilene Harris
Background: Christian Medical College (CMC), Vellore, India, a tertiary care hospital, designed a year-long Fellowship in Secondary Hospital Medicine (FSHM) for CMC graduates, with the aim to support them during rural service and be motivated to consider practicing in these hospitals. The FSHM was a blend of 15 paper-based distance learning modules, 3 contact sessions, community project work, and networking. This paper reports on the evaluation of the FSHM program. Methods: The curriculum development process for the FSHM reflected the six-step approach including problem identification, needs assessment, formulating objectives, selecting educational strategies, implementation, and evaluation...
September 2017: Education for Health: Change in Training & Practice
https://www.readbyqxmd.com/read/29785713/outcomes-of-oesophageal-self-dilation-for-patients-with-refractory-benign-oesophageal-strictures
#3
Y Qin, D B Sunjaya, S Myburgh, T Sawas, D A Katzka, J A Alexander, M Halland
BACKGROUND: Current management of refractory benign oesophageal strictures with endoscopic dilations and stenting leads to resolution of dysphagia in only 30% of patients. Oesophageal self-dilation may be an alternative. AIM: To evaluate the efficacy and safety of oesophageal self-dilation at a tertiary referral centre. METHODS: We conducted a retrospective review of patients with refractory benign oesophageal strictures who participated in oesophageal self-dilation at Mayo Clinic (Rochester, MN, USA) between 2003 and 2017...
May 21, 2018: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/29785548/operative-vaginal-delivery-in-case-of-persistent-occiput-posterior-position-after-manual-rotation-failure-a-6-month-follow-up-on-pelvic-floor-function
#4
Paul Guerby, Olivier Parant, Elodie Chantalat, Christophe Vayssiere, Fabien Vidal
PURPOSE: To compare the short- and long-term perineal consequences (at 6 months postpartum) and short-term neonatal consequences of instrumental rotation (IR) to those induced by assisted delivery (AD) in the occiput posterior (OP) position, in case of manual rotation failure. METHODS: A prospective observational cohort study; tertiary referral hospital including all women presenting with persistent OP position who delivered vaginally after manual rotation failure with attempted IR or AD in OP position from September 2015 to October 2016...
May 21, 2018: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/29785507/assessing-mortality-models-in-systemic-sclerosis-related-interstitial-lung-disease
#5
Robert L Mango, Eric L Matteson, Cynthia S Crowson, Jay H Ryu, Ashima Makol
PURPOSE: The gender, age, and lung physiology (GAP) model, interstitial lung diseases-GAP (ILD-GAP) model, and the smoking history, age, and diffusion capacity of the lung (SADL) model were compared using a systemic sclerosis-ILD (SSc-ILD) cohort to evaluate which best determined prognosis. METHODS: The models were applied to a cohort of 179 patients with SSc seen at a tertiary care center within 1 year of ILD diagnosis. Demographics, clinical characteristics, and mortality were recorded...
May 21, 2018: Lung
https://www.readbyqxmd.com/read/29785455/robotic-assisted-laparoscopic-median-arcuate-ligament-release-7-year-experience-from-a-single-tertiary-care-center
#6
Usah Khrucharoen, Yen-Yi Juo, Yas Sanaiha, Yijun Chen, Juan C Jimenez, Erik P Dutson
BACKGROUND: Despite previous reports of robotic-assisted laparoscopic release for median arcuate ligament syndrome (MALS), the safety and efficacy profile of this approach has been difficult to establish due to the rarity of this diagnostic entity. We aim to present our experience from a tertiary minimally invasive surgery referral center. METHODS: A case series was performed whereby all patients who underwent robotic-assisted MAL release from July 2010 to July 2017 at our institution were included...
May 21, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29785148/the-use-of-augmented-reality-glasses-in-central-line-simulation-see-one-simulate-many-do-one-competently-and-teach-everyone
#7
Cynthia Y Huang, Jonathan B Thomas, Abdullah Alismail, Avi Cohen, Waleed Almutairi, Noha S Daher, Michael H Terry, Laren D Tan
Objective: The aim of this study was to investigate the feasibility of using augmented reality (AR) glasses in central line simulation by novice operators and compare its efficacy to standard central line simulation/teaching. Design: This was a prospective randomized controlled study enrolling 32 novice operators. Subjects were randomized on a 1:1 basis to either simulation using the augmented virtual reality glasses or simulation using conventional instruction...
2018: Advances in Medical Education and Practice
https://www.readbyqxmd.com/read/29785092/patient-satisfaction-with-care-in-an-urban-tertiary-referral-academic-glaucoma-clinic-in-the-us
#8
Kristen M Peterson, Carrie E Huisingh, Christopher Girkin, Cynthia Owsley, Lindsay A Rhodes
Background: The purpose of this study was to determine the factors associated with glaucoma patients' satisfaction with their medical care by fellowship-trained glaucoma specialists in an urban tertiary referral clinic in the US. Methods: A total of 110 established patients aged ≥60 years with a diagnosis of either primary open angle glaucoma, glaucoma suspect, or ocular hypertension monitored by an ophthalmologist with fellowship training in glaucoma were enrolled at an academic, urban, tertiary referral eye clinic...
2018: Patient Preference and Adherence
https://www.readbyqxmd.com/read/29784445/hand-hygiene-adherence-in-relation-to-influenza-season-during-6-consecutive-years
#9
Rosamaria Fulchini, Philipp Kohler, Christian R Kahlert, Werner C Albrich, Rolf Kuhn, Matthias Hoffmann, Matthias Schlegel
Hand hygiene (HH) is the single most important measure in reducing the burden of healthcare-acquired infections. Based on 12,740 HH opportunities observed during 6 consecutive years at our tertiary care center, HH adherence among healthcare workers (HCWs) was significantly better during influenza season compared to non-influenza periods, after controlling for important covariables (odds ratio = 1.17, 95% confidence interval 1.05-1.30). This finding suggests that HH awareness is increased during influenza periods, which could have implications for HCW education...
May 18, 2018: American Journal of Infection Control
https://www.readbyqxmd.com/read/29784263/tertiary-care-referrals-for-fractures-in-children
#10
Jennifer K Marsh, David J Murray, Anshuman Sharma, Kavya Narayana Reddy, Alyssa Naes
PURPOSE: With limited local access to pediatric subspecialty care outside major metropolitan areas, tertiary care hospitals treat many children originally seen at outside facilities for relatively brief but urgent surgical procedures. This referral-based care imposes significant financial and psychological stress on the families. DESIGN: Prospective, survey methodology was used. METHODS: Families of children aged 0-18 years admitted to the St...
June 2018: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/29784155/parental-knowledge-of-pediatric-eye-health-in-an-ophthalmology-clinic-setting-validation-and-delivery-of-the-eyee-questionnaire
#11
Natalia Fong, Bethany Easterbrook, Forough Farrokhyar, Kourosh Sabri
OBJECTIVE: We aimed to develop and assess the reliability of a questionnaire assessing parental knowledge on core topics in pediatric eye health. METHODS: In Phase I, the Evaluate Your Eye Education Questionnaire (EYEE-Q) was developed and distributed to ascertain face validity (n = 20). In Phase II, participants completed EYEE-Q twice to determine test-retest reliability (n = 40). In Phase III, EYEE-Q was administered to parents in a tertiary level pediatric ophthalmology clinic to assess knowledge (n = 193)...
June 2018: Canadian Journal of Ophthalmology. Journal Canadien D'ophtalmologie
https://www.readbyqxmd.com/read/29784051/contributions-of-a-survey-and-retrospective-cohort-study-to-the-planning-of-a-randomised-controlled-trial-of-corticosteroids-in-the-treatment-of-paediatric-septic-shock
#12
Anna Liu, Kusum Menon
BACKGROUND: Randomised controlled trials (RCTs) are challenging to conduct in a paediatric critical-care environment. Background work, including surveys and observational studies, is often used to determine disease estimates, sample sizes and design protocols when planning such RCTs. Our objective was to determine the necessity of performing a survey or a retrospective chart review or both when planning an RCT on corticosteroids in the treatment of paediatric septic shock. METHODS: We compared information on corticosteroid use for moderate to severe paediatric septic shock obtained from a survey of physician beliefs and stated practices with that obtained from a retrospective cohort study...
May 21, 2018: Trials
https://www.readbyqxmd.com/read/29783911/can-predictive-modeling-identify-head-and-neck-oncology-patients-at-risk-for-readmission
#13
Amy M Manning, Keith A Casper, Kay St Peter, Keith M Wilson, Jonathan R Mark, Ryan M Collar
Objective Unplanned readmission within 30 days is a contributor to health care costs in the United States. The use of predictive modeling during hospitalization to identify patients at risk for readmission offers a novel approach to quality improvement and cost reduction. Study Design Two-phase study including retrospective analysis of prospectively collected data followed by prospective longitudinal study. Setting Tertiary academic medical center. Subjects and Methods Prospectively collected data for patients undergoing surgical treatment for head and neck cancer from January 2013 to January 2015 were used to build predictive models for readmission within 30 days of discharge using logistic regression, classification and regression tree (CART) analysis, and random forests...
May 1, 2018: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/29783852/usefulness-of-the-surprise-question-on-an-inpatient-oncology-service
#14
Sarguni Singh, Adrian Rodriguez, Darrell Lee, Sung-Joon Min, Stacy Fischer
BACKGROUND: Prognostication of survival in patients with advanced cancer has been challenging and contributes to poor illness understanding. Prognostic disagreement occurs even among providers and is a less studied phenomenon. OBJECTIVE: We introduced the surprise question (SQ), "Would I be surprised if this patient died in the next 1 year, 6 months, and 1 month?," at multidisciplinary rounds to increase palliative care referrals through the introduction of this prognostic prompt...
January 1, 2018: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/29782390/suspecting-hyperferritinemic-sepsis-in-iron-deficient-population-do-we-need-a-lower-plasma-ferritin-threshold
#15
Swarup Ghosh, Arun K Baranwal, Prateek Bhatia, Karthi Nallasamy
OBJECTIVES: Hyperferritinemia is being suggested to identify patients with sepsis-induced macrophage activation syndrome for early intervention. However, data among iron-deficient children are scarce. This study was planned to explore the biological behavior of plasma ferritin in children from communities with a high frequency of iron deficiency with septic shock and its association with the outcome. DESIGN: Prospective observational study. SETTING: Tertiary care teaching hospital in a low-middle income economy of South Asia...
May 18, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29782198/a-multidisciplinary-integrative-medicine-team-in-the-treatment-of-chronic-low-back-pain-an-observational-comparative-effectiveness-study
#16
Peter M Wayne, David M Eisenberg, Kamila Osypiuk, Brian J Gow, Claudia M Witt, Roger B Davis, Julie E Buring
OBJECTIVES: Chronic low-back pain (CLBP) is burdensome and costly, and a common condition for which adults use integrative therapies. The effectiveness of multidisciplinary integrative approaches has not been well studied. The purpose of this observational study was to compare characteristics and outcomes of CLBP patients treated at the Osher Clinical Center (OCC) versus other clinics at Brigham and Women's Hospital. DESIGN: Observational comparative effectiveness study...
May 21, 2018: Journal of Alternative and Complementary Medicine: Research on Paradigm, Practice, and Policy
https://www.readbyqxmd.com/read/29781955/involvements-of-parents-in-the-care-of-preterm-infants-a-pilot-study-evaluating-a-family-centered-care-intervention-in-a-chinese-neonatal-icu
#17
Rong Zhang, Rui-Wena Huang, Xi-Ronga Gao, Xiao-Minga Peng, Li-Hui Zhu, Ramanathan Rangasamy, Jos M Latour
OBJECTIVES: To evaluate the effectiveness and safety of a family-centered care intervention in a Chinese neonatal ICU. DESIGN: Pilot study using a randomized controlled trial design to inform a main randomized controlled trial study. SETTING: Stand-alone tertiary children's hospital in China with a 60-bed neonatal ICU serving as a regional neonatal ICU center. PATIENTS: Premature infants (n = 61) and their parents (n = 110)...
May 17, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29781927/a-case-of-corneal-neovascularization-misdiagnosed-as-total-limbal-stem-cell-deficiency
#18
Qihua Le, C Michael Samson, Sophie X Deng
PURPOSE: To report a case of corneal neovascularization misdiagnosed as total limbal stem cell deficiency (LSCD). METHODS: This is a case report of a 61-year-old woman who has a history of bilateral idiopathic scleritis, keratitis, and uveitis for more than 20 years. She was diagnosed with total LSCD in her left eye based on clinical presentation alone and was confirmed as a candidate for limbal transplantation at several major tertiary eye care centers in the United States...
May 16, 2018: Cornea
https://www.readbyqxmd.com/read/29781847/identification-of-the-critical-nontechnical-skills-for-surgeons-needed-for-high-performance-in-a-variable-resource-context-notss-vrc
#19
John W Scott, Yihan Lin, Georges Ntakiyiruta, Zeta Mutabazi, William A Davis, Megan A Morris, Douglas S Smink, Robert Riviello, Steven Yule
OBJECTIVE: To identify the critical nontechnical skills (NTS) required for high performance in variable-resource contexts (VRC). BACKGROUND: As surgical training and capacity increase in low- and middle-income countries (LMICs), new strategies for improving surgical education and care in these settings are required. NTS are critical for high performance in surgery around the world. However, the essential NTS used by surgeons operating in LMICs to overcome the challenges specific to their contexts have never been described...
May 17, 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29781691/enabling-factors-for-specialist-outreach-in-western-kwazulu-natal
#20
Robert I Caldwell, Merridy Grant, Bernard Gaede, Colleen Aldous
BACKGROUND: There exists a major disparity in access to specialist care between patients in urban and rural areas. Specialists are a scarce resource and are concentrated in urban areas. Specialist outreach attempts to fill the gap in service provision for patients situated remotely. While there is international evidence that multifaceted specialist outreach has achieved varying levels of success, factors that influence the effectiveness of outreach have not yet been fully elucidated in South Africa...
May 17, 2018: African Journal of Primary Health Care & Family Medicine
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