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https://www.readbyqxmd.com/read/29141073/forces-of-tool-tissue-interaction-to-assess-surgical-skill-level
#1
Taku Sugiyama, Sanju Lama, Liu Shi Gan, Yaser Maddahi, Kourosh Zareinia, Garnette R Sutherland
Importance: The application of optimal forces between surgical instruments and tissue is fundamental to surgical performance and learning. To date, this force has not been measured clinically during the performance of microsurgery. Objectives: To establish a normative catalog of force profiles during the performance of surgery, to compare force variables among surgeons with different skill levels, and to evaluate whether such a force-based metric determines or differentiates skill level...
November 15, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/29140969/risk-factors-for-ventilator-associated-events-in-a-picu
#2
Raeley Guess, Jarin Vaewpanich, Jorge A Coss-Bu, Siriporn Phongjitsiri, Curtis Kennedy, Jeffrey Starke, Satid Thammasitboon
OBJECTIVE: The term ventilator-associated events includes ventilator-associated condition, infection-related ventilator-associated complication, and ventilator-associated pneumonia. We sought to identify potential new risk factors for ventilator-associated condition and infection-related ventilator-associated complication in the PICU population. DESIGN: Matched case control study. SETTING: Children's hospital at a tertiary care academic medical center...
November 14, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29140941/phenotype-and-management-of-infantile-onset-inflammatory-bowel-disease-experience-from-a-tertiary-care-center-in-china
#3
Ziqing Ye, Ying Zhou, Ying Huang, Yuhuan Wang, Junping Lu, Zifei Tang, Shijian Miao, Kuiran Dong, Zhinong Jiang
BACKGROUND: Infantile-onset inflammatory bowel disease (IBD) comprises rare and clinically severe disorders. We examined the phenotypes and genetic causes of patients with infantile-onset IBD from a tertiary medical center. METHODS: We enrolled 38 patients with infantile-onset IBD and applied standardized treatment with medical, surgical, and supportive care. Targeted sequencing and whole-exome sequencing were performed. Clinical data were retrieved from medical records...
December 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/29139552/critical-evaluation-of-the-palm-coein-classification-system-among-women-with-abnormal-uterine-bleeding-in-low-resource-settings
#4
Divya Shubham, Anjali S Kawthalkar
OBJECTIVE: To assess the feasibility of the PALM-COEIN system for the classification of abnormal uterine bleeding (AUB) in low-resource settings and to suggest modifications. METHODS: A prospective study was conducted among women with AUB who were admitted to the gynecology ward of a tertiary care hospital and research center in central India between November 2014 and October 2016. All patients were managed as per department protocols. The causes of AUB were classified before treatment using the PALM-COEIN system (classification I) and on the basis of the histopathology reports of the hysterectomy specimens (classification II); the results were compared using classification II as the gold standard...
November 15, 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/29138886/clinical-predictors-of-stenotrophomonas-maltophilia-bacteremia-in-adult-patients-with-hematologic-malignancy
#5
Si-Ho Kim, Sun Young Cho, Cheol-In Kang, Hyeri Seok, Kyungmin Huh, Young Eun Ha, Doo Ryeon Chung, Nam Yong Lee, Kyong Ran Peck, Jae-Hoon Song
Stenotrophomonas maltophilia (SM) has emerged as an important nosocomial pathogen with high morbidity and mortality. Because of its unique antimicrobial susceptibility pattern, appropriate antimicrobial therapy for SM bacteremia is still challenging, especially in immunocompromised patients. The present study was performed to assess clinical predictors of SM bacteremia in adult patients with hematologic malignancy. From 2006 through 2016, a case-control study was performed at a tertiary-care hospital. Case patients were defined as SM bacteremia in patients with hematologic malignancy...
November 14, 2017: Annals of Hematology
https://www.readbyqxmd.com/read/29138701/valsalva-related-subretinal-hemorrhage-as-a-presenting-symptom-of-polypoidal-choroidal-vasculopathy
#6
Yousif Subhi, Torben L Sørensen
Purpose: To describe a case of Valsalva-related subretinal hemorrhage as a presenting symptom of polypoidal choroidal vasculopathy (PCV). The patient refrained from treatment against our best advice, and thus this is also a rare case of the natural course of an untreated PCV. Methods: Case report. Results: A 66-year-old female with a respiratory infection coughed intensely until exhaustion, after which she developed visual symptoms on the right eye...
2017: Case Reports in Ophthalmological Medicine
https://www.readbyqxmd.com/read/29138663/toluidine-blue-rapid-and-simple-malaria-parasite-screening-and-species-identification
#7
Rupali Awale, Ratnaprabha Maji, Parag Patil, Raghavendra Lingiah, Ashok Kumar Mukhopadhyay, Subhadra Sharma
Malaria, a febrile illness mostly confined to the tropical countries is transmitted by bite of infected female Anopheles mosquito. In 2015 alone, 88% of the malaria burden and 90% deaths due to malaria were confined to the African and Asian countries. Although number of tests are available for rapid diagnosis and screening for malaria, peripheral blood smear examination remains the gold standard. Leishman stain is recommended by WHO however herein we evaluate one of the alternative methods of staining which is simple and rapid...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/29138606/mortality-in-italian-patients-with-rheumatoid-arthritis-evidence-for-a-low-mortality-rate-from-cancer-and-infections-in-patients-followed-up-at-a-tertiary-center
#8
Daniela Iacono, Serena Fasano, Virginia D'Abrosca, Ilenia Pantano, Gabriele Valentini
Objectives: Mortality in patients with rheumatoid arthritis (RA) has never been investigated in Italy. This study is devoted to investigating all the distinct causes of mortality in Italian RA patients. Methods: Clinical charts of patients consecutively admitted to an Italian tertiary center, from January 1, 2008 to December 31, 2014, were reviewed. Mortality rates (incidence mortality rate [IMR] and standardized mortality rate [SMR]) and causes of death as assessed at December 31, 2015, were registered...
2017: Open Access Rheumatology: Research and Reviews
https://www.readbyqxmd.com/read/29137903/implementation-of-alere-i-influenza-a-b-point-of-care-test-for-the-diagnosis-of-influenza-in-an-emergency-department
#9
E Trabattoni, V Le, B Pilmis, G Pean de Ponfilly, C Caisso, C Couzigou, B Vidal, A Mizrahi, O Ganansia, A Le Monnier, B Lina, J C Nguyen Van
STUDY OBJECTIVE: This study aimed to evaluate the impact of implementing rapid point-of-care testing (POCT) with the Alere i Influenza A & B in an emergency department (ED) during an influenza epidemic. METHODS: Direct nasal swabs were prospectively collected following the physical examination of patients aged >18years who presented to the ED of a tertiary hospital in France with influenza-like illness (ILI) symptoms (N=301) between February 1st and March 31st, 2016, which coincided with an influenza epidemic...
October 18, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29137607/improved-referral-and-survival-of-newborns-after-scaling-up-of-intensive-care-in-suriname
#10
Rens Zonneveld, Natanael Holband, Anna Bertolini, Francesca Bardi, Neirude P A Lissone, Peter H Dijk, Frans B Plötz, Amadu Juliana
BACKGROUND: Scaling up neonatal care facilities in developing countries can improve survival of newborns. Recently, the only tertiary neonatal care facility in Suriname transitioned to a modern environment in which interventions to improve intensive care were performed. This study evaluates impact of this transition on referral pattern and outcomes of newborns. METHODS: A retrospective chart study amongst newborns admitted to the facility was performed and outcomes of newborns between two 9-month periods before and after the transition in March 2015 were compared...
November 14, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/29137584/dexmedetomidine-associated-hyperthermia-a-retrospective-cohort-study-of-intensive-care-unit-admissions-between-2009-and-2016
#11
Ked Grayson, A E Tobin, T K Lim, D E Reid, M Ghani
Dexmedetomidine-associated hyperthermia has not been previously studied. Analysis is warranted to determine whether this potentially dangerous complication is more prevalent than previously realised. We aimed to examine the association between dexmedetomidine and temperature ≥39.5°C, including patient characteristics, temporality and potential risk factors. We conducted a retrospective cohort study of all intensive care unit (ICU) admissions between 1 July 2009 and 31 May 2016 in a tertiary ICU in Australia...
November 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/29137580/prevalence-and-predictors-of-persistent-post-surgical-opioid-use-a-prospective-observational-cohort-study
#12
N Stark, S Kerr, J Stevens
Post-surgical opioid prescribing intended for the short-term management of acute pain may lead to long-term opioid use. This study was undertaken to determine the prevalence of persistent post-surgical opioid use and patient-related factors associated with post-surgical opioid use. One thousand and thirteen opioid-naïve patients awaiting elective surgery in a tertiary private hospital in Sydney were enrolled. Preoperatively, patients completed a questionnaire comprising potential predictors of persistent post-surgical opioid use...
November 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/29137083/indications-and-outcomes-of-pediatric-keratoplasty-in-a-tertiary-eye-care-center-a-retrospective-review
#13
Rosario Gulias-Cañizo, Roberto Gonzalez-Salinas, Luis Fernando Hernandez-Zimbron, Everardo Hernandez-Quintela, Valeria Sanchez-Huerta
To evaluate indications and outcomes of pediatric keratoplasty in a tertiary eye center, and identify factors that affect visual outcomes.We performed a retrospective review of penetrating keratoplasty in children aged 0 to 18 years between 1995 and 2011 in the Asociación para Evitar la Ceguera en México IAP, Hospital "Dr. Luis Sánchez Bulnes".A total of 574 penetrating keratoplasties were performed during the study interval. Median follow-up was 5.0 years. Main indications included keratoconus (55.58%), postherpetic scarring (9...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29136649/discordance-between-actual-and-scheduled-check-in-times-at-a-heart-failure-clinic
#14
Eiran Z Gorodeski, Emer Joyce, Benjamin T Gandesbery, Eugene H Blackstone, David O Taylor, W H Wilson Tang, Randall C Starling, Rory Hachamovitch
INTRODUCTION: A 2015 Institute Of Medicine statement "Transforming Health Care Scheduling and Access: Getting to Now", has increased concerns regarding patient wait times. Although waiting times have been widely studied, little attention has been paid to the role of patient arrival times as a component of this phenomenon. To this end, we investigated patterns of patient arrival at scheduled ambulatory heart failure (HF) clinic appointments and studied its predictors. We hypothesized that patients are more likely to arrive later than scheduled, with progressively later arrivals later in the day...
2017: PloS One
https://www.readbyqxmd.com/read/29136332/design-considerations-for-an-ehealth-decision-support-tool-in-inflammatory-bowel-disease-self-management
#15
Belinda D Jackson, Danny Con, Peter De Cruz
BACKGROUND: Electronic health (eHealth) decision support tools have the potential to: facilitate inflammatory bowel disease (IBD) self-management; reduce health care utilization, and; alleviate the pressure on over-burdened outpatient clinics. The purpose of this study was to explore the perspectives of key stakeholders on the potential use of a decision support tool for IBD patients. METHODS: A qualitative study using focus group methodology was conducted at a tertiary IBD center in Melbourne, Australia in February 2015...
November 14, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/29135901/clinical-factors-associated-with-pediatric-brain-neoplasms-versus-primary-headache-a-case-control-analysis
#16
David C Sheridan, Bethany Waites, Bradley Lezak, Robert J Coryell, Kellie J Nazemi, Amber L Lin, Rongwei Fu, Matthew L Hansen
OBJECTIVE: Pediatric headaches are a common presentation to emergency departments accounting for almost half a million annual visits. Providers are left with the difficult task of deciding who has a secondary headache etiology that warrants neuroimaging. METHODS: We conducted a retrospective case-control study. Patients from a pediatric neuro-oncology clinic database with brain cancer and a headache at presentation were identified as cases. Controls were patients from 2 local pediatric tertiary care emergency departments with a final diagnosis of headache after negative neuroimaging...
November 14, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29135869/usefulness-of-high-resolution-3d-multi-sequences-for-peripheral-facial-palsy-differentiation-between-bell-s-palsy-and-ramsay-hunt-syndrome
#17
Junko Kuya, Keita Kuya, Yuki Shinohara, Yasuomi Kunimoto, Hiroaki Yazama, Toshihide Ogawa, Hiromi Takeuchi
OBJECTIVE: To investigate the usefulness of magnetic resonance imaging (MRI) including three-dimensional (3D) sequences in the differentiation between Bell's palsy (BP) and Ramsay Hunt syndrome (RHS). STUDY DESIGN: A prospective study. SETTING: Tertiary care center. PATIENTS: Twenty patients: 15 patients with BP and five patients with RHS. INTERVENTION: Diagnostic. MAIN OUTCOME MEASURE: Clinical diagnosis (BP or RHS)...
December 2017: Otology & Neurotology
https://www.readbyqxmd.com/read/29135814/neuro-ophthalmology-at-a-tertiary-eye-care-centre-in-india
#18
Rebika Dhiman, Digvijay Singh, Shiva P Gantayala, Vaitheeswaran L Ganesan, Pradeep Sharma, Rohit Saxena
BACKGROUND: Neuro-ophthalmology as a specialty is underdeveloped in India. The aim of our study was to determine the spectrum and profile of patients presenting to a tertiary eye care center with neuro-ophthalmic disorders. METHODS: A retrospective hospital-based study was conducted, and records of all patients seen at the neuro-ophthalmology clinic of Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India, over a 1-year period were retrieved and evaluated...
November 9, 2017: Journal of Neuro-ophthalmology: the Official Journal of the North American Neuro-Ophthalmology Society
https://www.readbyqxmd.com/read/29135753/prevention-of-neonatal-unplanned-extubations-in-the-neonatal-intensive-care-unit-a-best-practice-implementation-project
#19
Xiaojing Hu, Yuxia Zhang, Yun Cao, Guoying Huang, Yan Hu, Alexa McArthur
BACKGROUND: Adverse events of mechanically ventilated neonates such as unplanned extubations may be associated with serious negative outcomes. Unplanned extubation rates have been monitored by many neonatal intensive care units as a quality of care metric. OBJECTIVES: The objective was to implement evidence-based best practice and assess the effects of these strategies on minimizing unplanned extubation in the neonatal intensive care unit in a large tertiary children's hospital...
November 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/29135624/potassium-chloride-sustained-release-dosing-pathway-in-an-academic-medical-center
#20
Bryan M Cook, Danielle M Carter, Heather Dell'Orfano, Lina Matta
Potassium supplementation can be administered intravenously or orally with either immediate release or sustained release formulations. Sustained release potassium chloride allows for delayed absorption and peak effects. In the inpatient setting, it is important to monitor and prevent both hypokalemia and hyperkalemia. Our tertiary-care academic hospital created a clinical pathway for sustained release potassium chloride supplementation in the inpatient population. Our clinical pathway for sustained release potassium chloride creates dosing restrictions designed to prevent hyperkalemia, while allowing exceptions for patients with high requirements...
December 2017: Critical Pathways in Cardiology
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