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https://www.readbyqxmd.com/read/28324991/features-of-cerebral-oxygenation-detects-brain-injury-in-premature-infants
#1
John M O'Toole, Mmoloki Kenosi, Daragh Finn, Geraldine B Boylan, Eugene M Dempsey
Babies born prematurely can develop brain injury within days after birth. Early identification of high-risk infants enables appropriate clinical care to mitigate potential lifelong disabilities. Near infra-red spectroscopy is an established technology that can provide continuous measurements of cerebral oxygen saturation (rcSO2) over this critical period. We develop a feature set of the rcSO2 signal for the purpose of detecting brain injury. Our feature set contains amplitude, spectral, and fractal dimension features within 5 frequency bands...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28324902/dysphagia-management-in-the-schools-past-present-and-future
#2
Cynthia R O'Donoghue, Elizabeth E Nottingham
As the number of speech-language pathologists (SLPs) responsible for swallowing and feeding services in the educational setting increases, guidance informing this specialized practice continues to emerge. Although SLPs have provided dysphagia management for children in medical settings for many years, the extension of dysphagia services to the schools is comparatively new. This shift in care delivery for what was previously a hospital-based practice is now occurring more frequently, and in an environment void of extensive medical supports (i...
April 2017: Seminars in Speech and Language
https://www.readbyqxmd.com/read/28324325/the-universe-of-ana-testing-a-case-for-point-of-care-ana-testing
#3
Konstantin N Konstantinov, Robert L Rubin
Testing for total antinuclear antibodies (ANA) is a critical tool for diagnosis and management of autoimmune diseases at both the primary care and subspecialty settings. Repurposing of ANA from a test for lupus to a test for any autoimmune condition has driven the increase in ANA requests. Changes in ANA referral patterns include early or subclinical autoimmune disease detection in patients with low pre-test probability and use of negative ANA results to rule out underlying autoimmune disease. A positive result can lead to further diagnostic considerations...
December 2017: Auto- Immunity Highlights
https://www.readbyqxmd.com/read/28324029/vital-directions-for-health-and-health-care-priorities-from-a-national-academy-of-medicine-initiative
#4
Victor J Dzau, Mark B McClellan, J Michael McGinnis, Sheila P Burke, Molly J Coye, Angela Diaz, Thomas A Daschle, William H Frist, Martha Gaines, Margaret A Hamburg, Jane E Henney, Shiriki Kumanyika, Michael O Leavitt, Ruth M Parker, Lewis G Sandy, Leonard D Schaeffer, Glenn D Steele, Pamela Thompson, Elias Zerhouni
Importance: Recent discussion has focused on questions related to the repeal and replacement of portions of the Affordable Care Act (ACA). However, issues central to the future of health and health care in the United States transcend the ACA provisions receiving the greatest attention. Initiatives directed to certain strategic and infrastructure priorities are vital to achieve better health at lower cost. Objectives: To review the most salient health challenges and opportunities facing the United States, to identify practical and achievable priorities essential to health progress, and to present policy initiatives critical to the nation's health and fiscal integrity...
March 21, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28323960/fgf23-is-not-associated-with-age-related-changes-in-phosphate-but-enhances-renal-calcium-reabsorption-in-girls
#5
Deborah M Mitchell, Harald Jüppner, Sherri-Ann M Burnett-Bowie
Context: Fibroblast growth factor 23 (FGF23) is a critical determinant of phosphate homeostasis. The role of FGF23, however, in regulating physiologic changes in serum phosphate and renal phosphate handling across childhood is not well-described. In addition, animal models have suggested a role for FGF23 in regulating renal calcium excretion. Objective: To assess changes in FGF23 concentrations across childhood in relation to changes in mineral ions and hormones of mineral ion homeostasis...
January 31, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28323690/organizational-structural-design-in-spine-care
#6
Alok D Sharan, Gregory D Schroeder, Michael E West, Alexander R Vaccaro
For a company to provide high value to its customers, its organization design is critical. As health care transitions to a value-based model, it is critical that spinal care organizations are structured in such a way that they can maximize value to both the patient and the payers. This article will discuss the 3 most common ways that an organization can be structured, and the benefits and problems of each design in spinal care.
April 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28323688/challenges-of-inpatient-glycemic-control
#7
Sally O Gerard, Josephine Ritchie
Hyperglycemia occurs in more than 30% of hospitalized patients. The condition has been associated with higher mortality and poor outcomes. Systems to effectively treat dysglycemia have been put into place, although many focus on critical care areas. The purpose of this article is to provide an overview of the challenges for glycemic control in non-critical care areas. Standardized order sets, critical pathways, professional education, and collaborative systems can support improved control.
March 20, 2017: Journal of Nursing Care Quality
https://www.readbyqxmd.com/read/28323673/clinical-pearls-of-maternal-critical-care-part-2-sickle-cell-disease-in-pregnancy
#8
Vinod Patil, Gamunu Ratnayake, Galina Fastovets
PURPOSE OF REVIEW: The current review outlines the challenges in managing pregnant women with sickle-cell anemia, who are at risk of becoming critically ill during pregnancy. RECENT FINDINGS: Sickle obstetric patients pose unique challenges to the anesthetist and intensivist. We discuss the role of prophylactic transfusions for specific indications like acute anemia and twin pregnancies. The management and prevention of vaso-occlusive crises and chest crisis are also outlined...
March 18, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28323672/safety-interventions-on-the-labor-and-delivery-unit
#9
Rachel M Kacmar
PURPOSE OF REVIEW: The present review highlights recent advances in efforts to improve patient safety on labor and delivery units and well tolerated care for pregnant patients in general. RECENT FINDINGS: Recent studies in obstetric patient safety have a broad focus but repetitive themes for interdisciplinary training include: simulating critical events, having open multidisciplinary communication, frequent reviews of cases of maternal morbidity, and implementing maternal early warning systems...
March 18, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28323591/treatment-and-monitoring-of-central-serous-chorioretinopathy-in-pilots
#10
Ari Shinojima, Ryusaburo Mori, Kyoko Fujita, Mitsuko Yuzawa
BACKGROUND: Central serous chorioretinopathy (CSC), which has the characteristics of a serous retinal detachment (SRD) in the macular area, affects mostly men in the 30- to 50-yr age range. Some patients have persistent SRD, which may cause retinal thinning and photoreceptor impairment. CSC symptoms are gradual vision loss and/or metamorphopsia. Some commercial airline pilots are concerned about CSC symptoms, which can disqualify them from flying for months and can also reoccur. Thus, careful monitoring and treatment of CSC are critical for pilots, especially those with chronic or recurrent CSC...
December 1, 2016: Aerospace Medicine and Human Performance
https://www.readbyqxmd.com/read/28320079/ketamine-reduces-the-need-for-intubation-in-patients-with-acute-severe-mental-illness-and-agitation-requiring-transport-to-definitive-care-an-observational-study
#11
Cathrin S Parsch, Adrianne Boonstra, David Teubner, Wade Emmerton, Brian McKenny, Daniel Y Ellis
OBJECTIVES: The aim of this study was to review mental health patients transported by a dedicated statewide critical care retrieval team before and after the implementation of a ketamine sedation guideline. METHODS: This is a a retrospective cohort study of mental health patients with acute behavioural disturbance, transported between January 2010 and December 2015. RESULTS: A total of 78 patients were transported in the study period, 50 before and 28 after implementation of the ketamine guideline in June 2013...
March 20, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28319986/perceived-ethics-dilemmas-among-pioneer-accountable-care-organizations
#12
Craig R Westling, Thom Walsh, William A Nelson
This study of Pioneer accountable care organizations (ACOs) suggests that the ACO model is creating moral distress for physicians and business leaders in seven critical ways:Despite an overall sense of optimism associated with the ACO model, our research identified an underlying sense of moral distress at most sites. A clear opportunity exists for ACOs to use a more comprehensive, coordinated approach to proactively resolving ethical dilemmas while continuing the march toward risk-based contracts.
January 2017: Journal of Healthcare Management / American College of Healthcare Executives
https://www.readbyqxmd.com/read/28319979/patient-experience-a-critical-indicator-of-healthcare-performance
#13
Pamela H Guler
Patient experience has become a critical differentiator for healthcare organizations, and it will only grow in importance as transparency and consumerism dominate the healthcare landscape. Creating and sustaining a consistently exceptional experience that promotes patient engagement and the best outcomes is far more than just "satisfying" patients, going well beyond amenities that may be provided.Perception of care experience is often shaped by methods we use to address the biopsychosocial needs of patients...
April 2017: Frontiers of Health Services Management
https://www.readbyqxmd.com/read/28319973/maximizing-healthcare-professionals-use-of-new-computer-technologies-in-a-small-urban-hospital-s-critical-care-unit
#14
Patricia C Vadillo, Estrellita S Rojo, Adelaida Garces, Maria G Checton
No abstract text is available yet for this article.
September 2016: Journal of Healthcare Management / American College of Healthcare Executives
https://www.readbyqxmd.com/read/28319910/the-role-of-vasopressin-and-the-vasopressin-type-v1a-receptor-agonist-selepressin-in-septic-shock
#15
REVIEW
Antonio F Saad, Marc O Maybauer
Septic shock remains one of the major causes of morbidity and mortality in the critically ill. Despite early goal therapy and administration of cathecholaminergic agents, up to 30% of patients succumb to the disease. In this manuscript, we first summarize the standard of care of patients with septic shock and current guidelines. We review the physiologic role of vasopressin and its role in septic shock management. We then review the most up-to-date evidence on the potential role of V1a receptor agonists such as Selepressin, in septic shock...
March 15, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28319804/are-diabetes-guidelines-truly-evidence-based
#16
REVIEW
Matthew F Bouchonville, Sara Matani, Jason J DuBroff, Robert J DuBroff
The global epidemic of obesity and diabetes underscores the urgency to develop strategies to prevent cardiovascular (CV) disease in this vulnerable population. Clinical guidelines are intended to help the clinician manage these patients, but guidelines are often discordant among professional organizations and not always evidence based. Clinicians must rely upon the best available evidence, and therefore we critically reviewed the evidence behind the American Diabetes Association (ADA) 2016 guidelines on the prevention of CV disease in diabetes...
March 7, 2017: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/28319721/methods-for-specifying-spatial-boundaries-of-cities-in-the-world-the-impacts-of-delineation-methods-on-city-sustainability-indices
#17
Yuta Uchiyama, Koichiro Mori
The purpose of this paper is to analyze how different definitions and methods for delineating the spatial boundaries of cities have an impact on the values of city sustainability indicators. It is necessary to distinguish the inside of cities from the outside when calculating the values of sustainability indicators that assess the impacts of human activities within cities on areas beyond their boundaries. For this purpose, spatial boundaries of cities should be practically detected on the basis of a relevant definition of a city...
March 16, 2017: Science of the Total Environment
https://www.readbyqxmd.com/read/28319467/effects-of-iv-acetaminophen-on-core-body-temperature-and-hemodynamic-responses-in-febrile-critically-ill-adults-a-randomized-controlled-trial
#18
Hildy M Schell-Chaple, Kathleen D Liu, Michael A Matthay, Daniel I Sessler, Kathleen A Puntillo
OBJECTIVE: To determine the effects of IV acetaminophen on core body temperature, blood pressure, and heart rate in febrile critically ill patients. DESIGN: Randomized, double-blind, placebo-controlled clinical trial. SETTING: Three adult ICUs at a large, urban, academic medical center. PATIENTS: Forty critically ill adults with fever (core temperature, ≥ 38.3°C). INTERVENTION: An infusion of acetaminophen 1 g or saline placebo over 15 minutes...
March 17, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28319367/structural-stability-from-crystallographic-shear-in-tio2-nb2o5-phases-cation-ordering-and-lithiation-behavior-of-tinb24o62
#19
Kent J Griffith, Anatoliy Senyshyn, Clare P Grey
The host structure and reversible lithium insertion and extraction of an intercalation compound, TiNb24O62, are described. Neutron diffraction, applied for the first time to TiNb24O62, allowed an accurate refinement of the complex block superstructure, particularly with respect to the oxygen sublattice. Analysis of the transition-metal sites revealed significant cation ordering in the mixed-metal oxide. Electrochemical analysis demonstrated highly reversible lithium intercalation with ca. 190 mA·h·g(-1) after 100 cycles (C/10 rate, 3 months)...
March 20, 2017: Inorganic Chemistry
https://www.readbyqxmd.com/read/28319308/concepts-models-and-measurement-of-continuity-of-care-in-mental-health-services-a-systematic-appraisal-of-the-literature
#20
REVIEW
Nick Weaver, Michael Coffey, Jeanette Hewitt
INTRODUCTION: The increased complexity of community mental health services, and associated fragmentation of traditional dividing lines between services, has underscored the centrality of care continuity and coordination in modern mental healthcare. However, clarification of the key features of the care continuity concept has proved difficult and a consensus has not been reached. AIM/QUESTION: This review draws together and critically examines latest evidence concerning concepts, models and scales based on a multi-dimensional understanding of care continuity...
March 20, 2017: Journal of Psychiatric and Mental Health Nursing
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