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https://www.readbyqxmd.com/read/28812382/can-elevated-lactate-and-ldh-produce-a-false-positive-enzymatic-ethanol-result-in-live-patients-presenting-to-the-emergency-department
#1
Nicholas Nacca, Michael J Hodgman, Kirselle Lao, Matthew Elkins, Michael G Holland
BACKGROUND: There have been allegations in the courtroom that elevated serum lactic acid in trauma victims can yield a falsely elevated serum ethanol assay. Most hospitals utilize an indirect method of ethanol measurement where a serum sample is added to a mix of alcohol dehydrogenase and oxidized nicotinamide adenine dinucleotide (NAD+). This allows any ethanol in the patient's serum to be metabolized to acetaldehyde, and in the process results in the reduction of NAD + to NADH. NADH is then measured using spectrophotometry...
August 16, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28812056/initiating-a-standardized-regional-referral-and-counter-referral-system-in-guatemala-a-mixed-methods-study
#2
Rupa Kapoor, Leslie Avendaño, Maria Antonieta Sandoval, Andrea T Cruz, Esther M Sampayo, Miguel A Soto, Elizabeth A Camp, Heather L Crouse
Background:Few data exist for referral processes in resource-limited settings. We utilized mixed-methods to evaluate the impact of a standardized algorithm and training module developed for locally identified needs in referral/counter-referral procedures between primary health centers (PHCs) and a Guatemalan referral hospital. Methods: PHC personnel and hospital physicians participated in surveys and focus groups pre-implementation and 3, 6, and 12 months post-implementation to evaluate providers' experience with the system...
2017: Global Pediatric Health
https://www.readbyqxmd.com/read/28812000/diagnostic-imaging-features-of-necrotizing-enterocolitis-a-narrative-review
#3
REVIEW
Francesco Esposito, Rosanna Mamone, Marco Di Serafino, Carmela Mercogliano, Valerio Vitale, Gianfranco Vallone, Patrizia Oresta
Necrotizing enterocolitis (NEC) is an inflammatory process, characterized by intestinal necrosis of variable extension, leading to perforation, generalized peritonitis and death. The classical pathogenetic theory focuses on mucosal damage related to a stress induced intestinal ischemia leading to mucosal injury and bacterial colonization of the wall. A more recent hypothesis emphasizes the role of immaturity of gastrointestinal and immune system, particularly of the premature, responsible of bowel wall vulnerability and suffering...
June 2017: Quantitative Imaging in Medicine and Surgery
https://www.readbyqxmd.com/read/28811211/72h-returns-a-trigger-tool-for-diagnostic-error
#4
Emily Aaronson, Pierre Borczuk, Theodore Benzer, Elizabeth Mort, Elizabeth Temin
BACKGROUND: Patients who return to the Emergency Department (ED) within 72h of discharge are often used for ED Quality Assurance efforts, however little is known about the yield of this kind of review and the types of errors it identifies. Our objective was to identify the prevalence, types and severity of errors in these cases. METHODS: Retrospective review of patients who presented to an urban, university affiliated ED between 10/1/2012-9/30/2015 who returned within 72 h requiring hospital admission...
August 8, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28811014/assessing-need-for-pharmacist-involvement-to-improve-care-coordination-for-patients-on-lai-antipsychotics-transitioning-from-hospital-to-home-a-work-system-approach
#5
Olufunmilola Abraham, Michelle N Myers, Amanda L Brothers, Jamie Montgomery, Bryan A Norman, Tanya Fabian
BACKGROUND: The use of Long-Acting Injectable (LAI) antipsychotic medications has increased for patients with Serious Mental Illness (SMI). Care coordination for this population is complex, and pharmacist involvement may improve and support long-term medication adherence and patient outcomes. OBJECTIVES: (1) Examine pharmacists' role in addressing care coordination and adherence challenges for patients taking Long-Acting Injectable (LAI) antipsychotics; and (2) explore patients' medication use experiences with LAI antipsychotics and educational needs...
September 2017: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/28810956/the-reasons-for-living-scale-military-version-assessing-protective-factors-against-suicide-in-a-military-sample
#6
Anne-Marie Deutsch, R Gregory Lande
INTRODUCTION: Military suicide rates have been rising over the past decade and continue to challenge military treatment facilities. Assessing suicide risk and improving treatments are a large part of the mission for clinicians who work with uniformed service members. This study attempts to expand the toolkit of military suicide prevention by focusing on protective factors over risk factors. In 1983, Marsha Linehan published a checklist called the Reasons for Living Scale, which asked subjects to check the reasons they choose to continue living, rather than choosing suicide...
July 2017: Military Medicine
https://www.readbyqxmd.com/read/28810931/a-comprehensive-regional-clinical-and-educational-ecpr-protocol-decreases-time-to-ecmo-in-patients-with-refractory-out-of-hospital-cardiac-arrest
#7
Brian Grunau, Sarah Carrier, Jamil Bashir, William Dick, Luke Harris, Robert Boone, Dan Kalla, Frank Scheuermeyer, Brian Twaites, Ron Straight, James Abel, Ken McDonald, Ruth MacRedmond, David Agulnik, Joe Finkler, Jeanne MacLeod, Jim Christenson, Anson Cheung
OBJECTIVE: Extracorporeal membrane oxygenation within CPR (ECPR) may improve survival for refractory out-of-hospital cardiac arrest (OHCA). We developed a prehospital, emergency department (ED), and hospital-based clinical and educational protocol to improve the key variable of time-to-ECPR (TTE). METHODS: In a single urban health region we involved key prehospital, clinical, and administrative stakeholders over a 2-year period, to develop a regional ECPR program with destination to a single urban tertiary care hospital...
August 16, 2017: CJEM
https://www.readbyqxmd.com/read/28810567/factors-related-to-infection-after-fixation-in-the-process-of-late-healed-bone-fracture
#8
Xiaoming Zhang, Xuebin Zhan, Peng Zou, Huixia An
We studied the factors related to infection after fixation in the process of bone late healed fracture and explored the factors that could predict the risk of postoperative infection. A total of 100 patients with open fractures of the tibia and fibula diagnosed in Zhengzhou No. 7 People's Hospital from 2007 to 2016 were enrolled in this study. Patients were subjected to staging surgery treatment. We divided them into the infection group (n=52) and the non-infection group (n=48) according to whether or not infection occurred after operation...
August 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28810456/components-of-preoperative-anxiety-a-qualitative-study
#9
Amy King, Jim Bartley, Deborah L Johanson, Elizabeth Broadbent
Limited research has explored preoperative anxiety through qualitative methodologies. This study aimed to identify specific factors that contribute to preoperative anxiety. A total of 17 patients awaiting general, plastic reconstructive and hand, orthopaedic, or ear, nose, and throat/otorhinolaryngology surgery were interviewed about their concerns in a public hospital. Thematic analysis identified five main sources of anxiety: surgical procedures, surgical complications, symptoms, recovery process, and organisation and delivery of care...
May 1, 2017: Journal of Health Psychology
https://www.readbyqxmd.com/read/28809926/impact-of-fortified-versus-unfortified-lipid-based-supplements-on-morbidity-and-nutritional-status-a-randomised-double-blind-placebo-controlled-trial-in-ill-gambian-children
#10
Stefan A Unger, Saikou Drammeh, Jahid Hasan, Kabiru Ceesay, Edrisa Sinjanka, Sainey Beyai, Bakary Sonko, Bai Lamin Dondeh, Anthony J Fulford, Sophie E Moore, Andrew M Prentice
BACKGROUND: Multiple micronutrients (MMN) are commonly prescribed in pediatric primary healthcare in sub-Saharan Africa to improve nutritional status and appetite without evidence for their effectiveness or international clinical guidelines. Community-wide MMN supplementation has shown limited and heterogeneous impact on growth and morbidity. Short-term ready-to-use therapeutic foods in acutely sick children in a hospital setting also had limited efficacy regarding subsequent growth. The effectiveness of MMN in improving morbidity or growth in sick children presenting for primary care has not been assessed...
August 2017: PLoS Medicine
https://www.readbyqxmd.com/read/28809678/ultrasound-aided-vertebral-level-localization-for-lumbar-surgery
#11
Nora Baka, Sieger Leenstra, Theo van Walsum
Localization of the correct vertebral level for surgical entry during lumbar hernia surgery is not straightforward. In this paper we develop and evaluate a solution using free-hand 2D ultrasound (US) imaging in the operation room (OR). Our system exploits the difference in spinous process shapes of the vertebrae. The spinous processes are pre-operatively outlined and labeled in a lateral lumbar X-ray of the patient. Then, in the OR the spinous processes are imaged with 2D sagittal US, and are automatically segmented and registered with the X-ray shapes...
August 10, 2017: IEEE Transactions on Medical Imaging
https://www.readbyqxmd.com/read/28809612/a-retrospective-study-evaluating-the-efficacy-of-identification-and-management-of-sepsis-at-a-district-level-hospital-internal-medicine-department-in-the-western-cape-province-south-africa-in-comparison-with-the-guidelines-stipulated-in-the-2012-survivi
#12
Raisa Bhikoo, Sarah Versfeld, M M De V Basson, Almero H Oosthuizen
BACKGROUND: Currently there is little information on the identification, management and outcomes of patients with sepsis in developing countries. Simple cost-effective measures such as accurate identification of patients with sepsis and early antibiotic administration are achievable targets, within reach without having to make use of unsustainable protocols constructed in developed countries. OBJECTIVES: To assess the ability of clinicians at a district-level hospital to identify and manage sepsis, and to assess patient outcome in terms of in-hospital mortality and length of hospital stay given the above management...
July 28, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/28809592/survey-process-quality-a-question-of-healthcare-manager-approach
#13
Petra Nilsson, Kerstin Blomqvist
Purpose The purpose of this paper is to explore how healthcare first-line managers think about and act regarding workplace survey processes. Design/methodology/approach This interview study was performed at a hospital in south Sweden. First-line healthcare managers ( n=24) volunteered. The analysis was inspired by phenomenography, which aims to describe the ways in which different people experience a phenomenon. The phenomenon was a workplace health promotion (WHP) survey processes. Findings Four main WHP survey process approaches were identified among the managers: as a possibility, as a competition, as a work task among others and as an imposition...
August 14, 2017: International Journal of Health Care Quality Assurance
https://www.readbyqxmd.com/read/28809590/brand-trust-and-image-effects-on-customer-satisfaction
#14
Sayed Hamid Khodadad Hosseini, Leila Behboudi
Purpose The purpose of this paper is to investigate brand trust and brand image effects on healthcare service users. Nowadays, managers and health activists are showing increased tendency to marketing and branding to attract and satisfy customers. Design/methodology/approach The current study's design is based on a conceptual model examining brand trust and brand image effects on customer satisfaction. Data obtained from 240 questionnaires (310 respondents) were analyzed using path analysis. Findings Results revealed that the most effective items bearing the highest influence on customer satisfaction and on benefiting from healthcare services include brand image, staff sincerity to its patients, interactions with physicians and rapport...
August 14, 2017: International Journal of Health Care Quality Assurance
https://www.readbyqxmd.com/read/28809180/exploring-socio-technical-insights-for-safe-nursing-handover
#15
Ming Chao Wong, Kwang Chien Yee, Paul Turner
Current efforts to improve nursing handover frequently use prescriptive approaches based on research evidence of handover issues within a single nursing ward or nursing specialty. Despite reported handover improvement, few studies adequately consider the transferability of results to other nursing handover environments or acknowledge the unique attributes that supported sustained improvement. With the increasing diffusion of electronic tools it has become even more critical to ensure that socio-technical issues that may impact on the quality and safety of nursing handovers are identified...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28808959/deaths-from-medicines-a-systematic-analysis-of-coroners-reports-to-prevent-future-deaths
#16
Robin E Ferner, Craig Easton, Anthony R Cox
INTRODUCTION: Since legislation in 2009, coroners in England and Wales must make reports in cases where they believe it is possible to prevent future deaths. We categorised the reports and examined whether they could reveal preventable medication errors or novel adverse drug reactions. METHODS: We examined 500 coroners' reports by pre-defined criteria to identify those in which medicines played a part, and to collect information on coroners' concerns. RESULTS: We identified 99 reports (100 deaths) in which medicines or a part of the medication process or both were mentioned...
August 14, 2017: Drug Safety: An International Journal of Medical Toxicology and Drug Experience
https://www.readbyqxmd.com/read/28807833/following-trends-in-steam-sterilizer-performance-by-quantitative-monitoring-of-non-condensable-gases
#17
R A C van Wezel, A van Gastel, A de Ranitz, J P C M van Doornmalen
BACKGROUND: Standards require a daily steam penetration test before starting production with a steam steriliser. In many cases the results of steam penetration tests are not used for improvements or optimization of processes. AIM: To detect if trend analysis with an objective and quantifying steam penetration test has added value for the end-user. METHOD: The databases of an objective quantifying steam penetration test, from the hospital and the manufacturer are coupled and analysed...
August 11, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28807696/a-tailored-intervention-to-improving-the-quality-of-intrahospital-nursing-handover
#18
Jochen Bergs, Frank Lambrechts, Ines Mulleneers, Kim Lenaerts, Caroline Hauquier, Geert Proesmans, Sarah Creemers, Dominique Vandijck
INTRODUCTION: Nursing handover is a process central to the delivery of high-quality and safe care. We aimed to improve the quality of nursing handover from the emergency department to ward and intensive care unit (ICU). METHODS: A quasi-experimental non-equivalent control group pre-test - post-test design was applied. Handover quality was measured using the Handover Evaluation Scale (HES). A tailored intervention, inspired by appreciative inquiry, was designed to improve the implementation of an existing handover form and procedure...
August 11, 2017: International Emergency Nursing
https://www.readbyqxmd.com/read/28805387/polymyxin-binding-to-the-bacterial-outer-membrane-reveals-cation-displacement-and-increasing-membrane-curvature-in-susceptible-but-not-in-resistant-lps-chemotypes
#19
Denys Ewerton da Silva Santos, Laércio Pol-Fachin, Roberto D Lins, Thereza A Soares
Lipid-A is the causative agent of Gram-negative sepsis and responsible for increasingly high mortality rate among hospitalized patients. Compounds that bind Lipid-A can limit this inflammatory process. The cationic antimicrobial peptide polymyxin B (Pmx-B) is one of the simplest molecules capable of selectively bind to Lipid-A, and may serve as a model for further development of Lipid-A binding agents. Gram-negative bacteria resistance to Pmx-B relies on the upregulation of a number of regulatory systems, which promote chemical modifications of the LPS structure, and leads to major changes in the physical-chemical properties of the outer membrane...
August 14, 2017: Journal of Chemical Information and Modeling
https://www.readbyqxmd.com/read/28805291/harms-of-unsuccessful-donation-after-circulatory-death-an-exploratory-study
#20
Lauren J Taylor, Anne Buffington, Joseph R Scalea, Norman Fost, Kenneth D Croes, Joshua D Mezrich, Margaret L Schwarze
While donation after circulatory death (DCD) has expanded options for organ donation, many who wish to donate are still unable to do so. We conducted face-to-face interviews with family members (n=15) who had direct experience with unsuccessful DCD and five focus groups with professionals involved in the donation process. We used qualitative content analysis to characterize harms of non-donation as perceived by participants. Participants reported a broad spectrum of harms impacting organ recipients, donors and donor families...
August 14, 2017: American Journal of Transplantation
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