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https://www.readbyqxmd.com/read/27913657/cost-benefit-analysis-of-telehealth-in-pre-hospital-care
#1
James R Langabeer, Tiffany Champagne-Langabeer, Diaa Alqusairi, Junghyun Kim, Adria Jackson, David Persse, Michael Gonzalez
OBJECTIVE: There has been very little use of telehealth in pre-hospital emergency medical services (EMS), yet the potential exists for this technology to transform the current delivery model. In this study, we explore the costs and benefits of one large telehealth EMS initiative. METHODS: Using a case-control study design and both micro- and gross-costing data from the Houston Fire Department EMS electronic patient care record system, we conducted a cost-benefit analysis (CBA) comparing costs with potential savings associated with patients treated through a telehealth-enabled intervention...
December 2, 2016: Journal of Telemedicine and Telecare
https://www.readbyqxmd.com/read/27912757/the-sydney-triage-to-admission-risk-tool-start-to-predict-emergency-department-disposition-a-derivation-and-internal-validation-study-using-retrospective-state-wide-data-from-new-south-wales-australia
#2
Michael M Dinh, Saartje Berendsen Russell, Kendall J Bein, Kris Rogers, David Muscatello, Richard Paoloni, Jon Hayman, Dane R Chalkley, Rebecca Ivers
BACKGROUND: Disposition decisions are critical to the functioning of Emergency Departments. The objectives of the present study were to derive and internally validate a prediction model for inpatient admission from the Emergency Department to assist with triage, patient flow and clinical decision making. METHODS: This was a retrospective analysis of State-wide Emergency Department data in New South Wales, Australia. Adult patients (age ≥ 16 years) were included if they presented to a Level five or six (tertiary level) Emergency Department in New South Wales, Australia between 2013 and 2014...
December 3, 2016: BMC Emergency Medicine
https://www.readbyqxmd.com/read/27911335/european-cross-sectional-survey-of%C3%A2-current-care-practices-for-duchenne-muscular-dystrophy-reveals-regional-and%C3%A2-age-dependent-differences
#3
Julia Vry, Kathrin Gramsch, Sunil Rodger, Rachel Thompson, Birgit F Steffensen, Jes Rahbek, Sam Doerken, Adrian Tassoni, María de Los Angeles Beytía, Velina Guergueltcheva, Teodora Chamova, Ivailo Tournev, Anna Kostera-Pruszczyk, Anna Kaminska, Anna Lusakowska, Lenka Mrazova, Lenka Pavlovska, Jana Strenkova, Petr Vondráček, Marta Garami, Veronika Karcagi, Ágnes Herczegfalvi, Katherine Bushby, Hanns Lochmüller, Janbernd Kirschner
BACKGROUND: Publication of comprehensive clinical care guidelines for Duchenne muscular dystrophy (DMD) in 2010 was a milestone for DMD patient management. Our CARE-NMD survey investigates the neuromuscular, medical, and psychosocial care of DMD patients in Europe, and compares it to the guidelines. METHODS: A cross-sectional survey of 1677 patients contacted via the TREAT-NMD patient registries was conducted using self-report questionnaires in seven European countries...
November 29, 2016: Journal of Neuromuscular Diseases
https://www.readbyqxmd.com/read/27909486/misleading-advertising-by-attorneys-concerning-noacs-is-adversely-costly-to-our-patients-and-our-society
#4
EDITORIAL
James A, Reiffel M D
Over the past five years, "ambulance-chasing" attorneys have aggressively advertised for patients who have bled on a new oral anticoagulant (NOAC) or their family members. It is an infrequent day when American consumers do not see a TV advertisement saying something like: "Have you or a loved-one had a serious bleeding event while taking [fill in the NOAC]? If so, you may be entitled to monetary compensation. Call XXX, attorneys at law, and we will get you the money you deserve."
February 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27909277/-complete-transection-of-the-cervical-trachea-caused-by-chest-blunt-trauma
#5
Masahiro Yamada, Masami Abiko
A 52-year-old man was injured when driving through the gate by a motorcycle without noticing the rope between the gateposts. He developed hoarseness, subcutaneous emphysema and dyspnea, and was transferred to our hospital by an ambulance. Chest X-ray and computed tomography showed subcutaneous and mediastinal emphysema, and complete transection of the cervical trachea. Since respiratory distress progressed rapidly, we performed tracheostomy in the intensive care unit, and the patient was carried to the operating room...
December 2016: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/27909207/below-knee-amputation-failure-and-poor-functional-outcomes-are-higher-than-predicted-in-contemporary-practice
#6
Jesse A Columbo, Brian W Nolan, Ryland S Stucke, Eva M Rzucidlo, Karen L Walker, Richard J Powell, Bjoern D Suckow, David H Stone
OBJECTIVE: The perceived functional benefit of below-knee amputation (BKA) must be carefully weighed against the need for potential reinterventions. This study sought to examine the contemporary clinical and functional outcomes of patients undergoing BKA in the endovascular era. METHODS: All patients who underwent BKA from January 2008 to December 2014 at a single tertiary medical center were retrospectively reviewed. Demographics, comorbidities, ambulation status, and transcutaneous oximetry (TcPO2) values were recorded...
November 30, 2016: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/27908843/treatment-of-acute-coronary-syndrome-by-telemedically-supported-paramedics-compared-with-physician-based-treatment-a-prospective-interventional-multicenter-trial
#7
Jörg C Brokmann, Clemens Conrad, Rolf Rossaint, Sebastian Bergrath, Stefan K Beckers, Miriam Tamm, Michael Czaplik, Frederik Hirsch
BACKGROUND: Prehospital treatment of acute coronary syndrome (ACS) in German emergency medical services (EMSs) is reserved for EMS physicians due to legal issues. OBJECTIVE: The objective of this prospective, interventional, multicenter trial was to evaluate the quality of telemedically-delegated therapy and the possible complications in patients with ACS. METHODS: After approval by the ethics committee and trial registration, a one-year study phase was started in August 2012 with 5 ambulances, telemedically equipped and staffed with paramedics, in 4 German EMS districts...
December 1, 2016: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/27904909/from-left-ventricular-assist-device-to-transplant-to-home-an-interdisciplinary-team-approach-to-treating-medically-complex-cardiac-patients-during-the-bridge-to-transplantation-a-case-report
#8
Keith J Foster, Angelica Cota, Stephanie Cleves
CASE REPORT: A 56-year-old man presented with advanced heart failure requiring implantation of a left ventricular assist device and was discharged home. after implantation He returned to the hospital with right posterior putamen stroke and after a comprehensive rehabilitation programme was discharged home with the ability to be independent. The patient later underwent heart transplantation and subsequently required readmission to inpatient rehabilitation. He again completed a comprehensive rehabilitation programme and returned home with the ability to be independent with use of a single-point cane for ambulation...
November 30, 2016: Journal of Rehabilitation Medicine
https://www.readbyqxmd.com/read/27903937/identification-and-validation-of-clinically-meaningful-benchmarks-in-the-12-item-multiple-sclerosis-walking-scale
#9
Myla D Goldman, Melanie D Ward, Robert W Motl, David E Jones, John H Pula, Diego Cadavid
BACKGROUND: The 12-item Multiple Sclerosis Walking Scale (12-MSWS) is a validated questionnaire which assessed walking function; it has been widely adopted in multiple sclerosis (MS) clinical research. OBJECTIVE: Identify and validate clinically meaningful 12-MSWS benchmarks in MS. METHODS: Cross-sectional study of 159 MS patients permitted identification of clinically meaningful 12-MSWS benchmarks based on their relationship to real-life anchors...
November 30, 2016: Multiple Sclerosis: Clinical and Laboratory Research
https://www.readbyqxmd.com/read/27903076/the-potential-of-optimizing-prehospital-triage-of-patients-with-suspected-acute-myocardial-infarction-using-high-sensitivity-cardiac-troponin-t-and-copeptin
#10
Carsten Stengaard, Jacob T Sørensen, Søren A Ladefoged, Jens F Lassen, Martin B Rasmussnen, Claus Kjær Pedersen, Antoine Ayer, Hans Erik Bøtker, Christian J Terkelsen, Kristian Thygesen
PURPOSE: In patients with a suspected acute myocardial infarction (AMI), to evaluate the potential for early triage based on measurement of high-sensitivity cardiac troponin T (hs-cTnT) and copeptin in blood samples collected in the prehospital phase. MATERIALS AND METHODS: In this retrospective study, we measured hs-cTnT and copeptin in blood samples collected in the ambulance form 962 patients with suspected AMI. The diagnostic accuracy was estimated by receiver-operating characteristics curve area under the curve (AUC) for both biomarkers and a combined model...
December 1, 2016: Biomarkers: Biochemical Indicators of Exposure, Response, and Susceptibility to Chemicals
https://www.readbyqxmd.com/read/27901269/ability-of-independently-ambulant-children-with-cerebral-palsy-to-ride-a-two-wheel-bicycle-a-case-control-study
#11
Rachel Toovey, Susan M Reid, Barry Rawicki, Adrienne R Harvey, Kerrianne Watt
AIM: Limited information exists on the ability of children with cerebral palsy (CP) to ride a two-wheel bicycle, an activity that may improve health and participation. We aimed to describe bicycle-riding ability and variables associated with ability to ride in children with CP (Gross Motor Functional Classification System [GMFCS] levels I-II) compared with children with typical development. METHOD: This case-control study surveyed parents of 114 children with CP and 87 children with typical development aged 6 to 15 years (115 males, mean age 9y 11mo, standard deviation [SD] 2y 10mo)...
November 30, 2016: Developmental Medicine and Child Neurology
https://www.readbyqxmd.com/read/27900630/current-delivery-of-hyperthermic-intraperitoneal-chemotherapy-with-cytoreductive-surgery-cs-hipec-and-perioperative-practices-an-international-survey-of-high-volume-surgeons
#12
Allison H Maciver, Eisar Al-Sukhni, Jesus Esquivel, Joseph J Skitzki, John M Kane, Valerie A Francescutti
BACKGROUND: Cytoreductive surgery and heated intraperitoneal chemotherapy (CS/HIPEC) is performed for selected indications at a limited number of specialized centers worldwide. Currently there is no standardized approach to the perioperative care process. We sought to capture current practices in the perioperative management of patients who undergo CS/HIPEC at high-volume centers. METHODS: Surgeon members of the American Society of Peritoneal Surface Malignancies working at high-volume CS/HIPEC centers (>10 cases/year) were invited to complete an online survey...
November 29, 2016: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/27899945/transradial-approach-for-coronary-procedures-in-the-elderly-population
#13
REVIEW
Shamsi Aamir, Shah Mohammed, Rathore Sudhir
Transradial cardiac catheterisation has been reported to be more beneficial compared to other approaches with easier and safer post-procedural haemostasis, better patient comfort, earlier ambulation and possibility of performing procedure and discharge on the same day. There is only limited data examining transradial access in the elderly population. In this review we looked at the available literature to give an insight into how the transradial approach compared to the transfemoral and other approaches in the elderly population...
September 2016: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/27899280/behavioural-phenotype-of-histamine-h4-receptor-knockout-mice-focus-on-central-neuronal-functions
#14
Maria Domenica Sanna, Carla Ghelardini, Robin L Thurmond, Emanuela Masini, Nicoletta Galeotti
The functional expression of H4 receptors (H4R) within neurons of the central nervous system has been recently reported, but their role is poorly understood. The present study aims to elucidate the role of neuronal H4R by providing the first description of the behavioural phenotype of H4R-deficient (H4R knockout, H4R-KO) mice. Mice lacking H4R underwent behavioural studies to evaluate locomotor activity, pain perception, anxiety, depression, memory and feeding behaviour. H4R-KO mice showed a significant increase in ambulation in an open field as well as in exploratory activity in the absence of any modification of motor coordination...
November 26, 2016: Neuropharmacology
https://www.readbyqxmd.com/read/27898168/the-association-between-t-pa-administration-and-in-hospital-mortality-following-acute-ischemic-stroke-in-puerto-rican-patients
#15
Kevin Shah, Samuel Kohrman, Suehyb Alkhatib, Juan González, Fernando Santiago, Marcia Varella, Juan Zevallos
OBJECTIVE: Despite being the standard of care, thrombolytic therapy with tissue plasminogen activator (t-PA) is currently administered to only 5% of acute ischemic stroke (AIS) patients in the United States. Published scientific information regarding both the use of t-PA for AIS in Hispanic patients and its impact on short-term mortality is scarce. The objectives of this study are to investigate, among Puerto Rican patients hospitalized with AIS, the rate of t-PA administration, and the risk of in-hospital mortality in patients who received t-PA vs...
December 2016: Puerto Rico Health Sciences Journal
https://www.readbyqxmd.com/read/27898156/scoping-review-of-mobility-scooter-related-research-studies
#16
W Ben Mortenson, Jenny Kim
Mobility scooters are three- or four-wheeled power mobility devices regularly used by people who have difficulty ambulating. They also differ from power wheelchairs in terms of their driving controls, programmability, seating, and mounting method. Given their growing popularity and anecdotal concerns around their use, a scoping review was undertaken to identify empirical research about mobility scooters and to analyze their study design and purpose. Data sources included MedLINE, Cumulative Index to Nursing and Allied Health Literature, Embase, and PsychINFO...
2016: Journal of Rehabilitation Research and Development
https://www.readbyqxmd.com/read/27898155/balance-confidence-and-activity-of-community-dwelling-patients-with-transtibial-amputation
#17
Alena Mandel, Kailan Paul, Ruby Paner, Michael Devlin, Steve Dilkas, Tim Pauley
The purpose of this study was to examine the relationship between balance confidence and community-based physical activity. Twenty-two community-dwelling patients with right or left unilateral transtibial amputation who reported no falls in the past 6 mo completed the Activities-Specific Balance Confidence Scale (ABC) and wore a StepWatch Activity Monitor for 7 consecutive d in the community. Subjects were subsequently stratified as low ( <3,000 steps/d) or high (>/=3,000) steps/d) activity groups. Balance confidence was significantly lower among the low activity weekday group (LAG, 70...
2016: Journal of Rehabilitation Research and Development
https://www.readbyqxmd.com/read/27897380/lived-experience-of-involuntary-transport-under-mental-health-legislation
#18
Joanne Bradbury, Marie Hutchinson, John Hurley, Helen Stasa
Police have historically been responsible for transporting people during a mental health crisis in Australia. A major change to the New South Wales (NSW) Mental Health Act (MHA) in 2007 expanded the range of coercive transportation agencies to include NSW Ambulance (paramedics) and NSW Health (mental health nurses). Anecdotal reports, however, describe a lack of clarity around how these changes should be implemented in practice. This research aims to explore this lack of clarity through qualitative analysis of interviews with people with the lived experience of involuntary transport under the MHA...
November 29, 2016: International Journal of Mental Health Nursing
https://www.readbyqxmd.com/read/27897197/on-site-rapid-diagnosis-of-intracranial-hematoma-using-portable-multi-slice-microwave-imaging-system
#19
Ahmed Toaha Mobashsher, A M Abbosh
Rapid, on-the-spot diagnostic and monitoring systems are vital for the survival of patients with intracranial hematoma, as their conditions drastically deteriorate with time. To address the limited accessibility, high costs and static structure of currently used MRI and CT scanners, a portable non-invasive multi-slice microwave imaging system is presented for accurate 3D localization of hematoma inside human head. This diagnostic system provides fast data acquisition and imaging compared to the existing systems by means of a compact array of low-profile, unidirectional antennas with wideband operation...
November 29, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27896461/transversus-abdominis-plane-block-for-postoperative-pain-relief-after-hand-assisted-laparoscopic-colon-surgery-a-randomized-placebo-controlled-clinical-trial
#20
R Tikuisis, P Miliauskas, V Lukoseviciene, N Samalavicius, A Dulskas, L Zabuliene, V Zabulis, J Urboniene
BACKGROUND: Although hand-assisted laparoscopic surgery (HALS) offers patients smaller surgical incisions, they still experience pain. Currently, there is no consensus on the optimal analgesic package for patients undergoing HALS. The aim of this prospective, randomized, double-blinded, placebo-controlled clinical trial was to evaluate the effect of transversus abdominis plane (TAP) block on postoperative pain control (pain score and analgesic use) and other outcomes in colon cancer patients undergoing hand-assisted laparoscopic left hemicolectomy...
November 28, 2016: Techniques in Coloproctology
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