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Y H Ma, J Wu, B Jia, J X Xue, T L Wang
Objective: The purpose of this study was to assess the efficacy of ultrasound-guided continuous fascia iliaca compartment block combined with oral analgesics for pre-operative pain control in elderly patients with hip fracture. Methods: One hundred and sixteen patients with hip fractures in Xuan Wu Hospital of Capital Medical University during Dec. 2015 to Dec. 2016 were included. These patients were randomized into 2 groups: control group (group C) (receiving the traditional analgesia: tramadol 50 mg and paracetamol 500 mg tid, po from admission to surgery), study group (group S) (receiving ultrasound-guided continuous fascia iliaca compartment block combined with oral analgesics for pre-operative pain control from admission to surgery)...
March 13, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
João Manuel Graveto, Cristina Santos, Paulo Santos Costa, Elisabete Fernandes, Susana Alarico, Nádia Osório, Helena Albano, Vânia Oliveira
OBJECTIVE: To describe the determining factors in hand hygiene management among nurses and identify associated collective health challenges. METHOD: Cross-sectional descriptive study. Data were collected using a questionnaire that was applied in four internal medicine units of a hospital of reference in Portugal. RESULTS: The sample was composed of 50 nurses aged 26 to 55 years (mean age of 34.88 years); 80% were women, 58% had a Bachelor's degree, and had 5-30 years of nursing practice (X̄ =11...
2018: Revista Brasileira de Enfermagem
Daniel Souza Lima, Abdon José Murad Júnior, Márcio Alencar Barreira, Guilherme Cardoso Fernandes, Gustavo Rego Coelho, José Huygens Parente Garcia
BACKGROUND: The Amazon region is one of the main endemic areas of hepatitis delta in the world and the only one related to the presence of genotype 3 of the delta virus. OBJECTIVE: To analyze the profile, mortality and survival of cirrhotic patients submitted to liver transplantation for chronic hepatitis delta virus and compare with those transplanted by hepatitis B virus monoinfection. METHODS: Retrospective, observational and descriptive study...
January 2018: Arquivos de Gastroenterologia
Daniele Marchioni, Stefano De Rossi, Davide Soloperto, Livio Presutti, Luca Sacchetto, Alessia Rubini
OBJECTIVE: To define a new surgical option, with lower morbidity, for the treatment of intralabyrinthine schwannomas. STUDY DESIGN: Retrospective case review. SETTING: Tertiary referral centers. PATIENTS: Eight patients affected by an intralabyrinthine schwannoma, with or without extension to the internal auditory canal, that underwent surgery with a transcanal transpromontorial approach, were included in the study. The average age at presentation was 47 years...
March 20, 2018: European Archives of Oto-rhino-laryngology
Supriya Singh, Kamary Coriolano, Jacob Davidson, Megan Cashin, Timothy Carey, Debra Bartley
Trampolines are widely used by children, but trampoline injuries can be severe and may require hospital care or even surgery. This pilot study examined the effectiveness of an educational intervention on caregivers' perceptions of trampoline use and safety for their children. Primary caregivers were recruited from the orthopedic clinic at the Children's Hospital at our institution in 2015. Caregivers were asked to complete a survey at two time points, initially in clinic and one week post educational intervention...
June 2018: Preventive Medicine Reports
Mohammad Safarian, Ali Taghipour, Abdolreza Norouzy, Mostafa Mozhdehifard, Mahdieh Pouryazdanpanah
Background: Recently, nutrition support was implemented as a part of clinical services in hospitals. The implementation of nutrition support needs to be assessed for its improvement. Objective: This study aimed to develop and validate a questionnaire to assess the state of nutrition support in Iranian hospitals. Methods: A mixed method approach was used in this study. This study was performed in training hospitals of Iran in 2016. In the development stage, pre-determined keywords were searched on international electronic databases...
December 2017: Electronic Physician
Paul L Weygandt, Scott M Dresden, Emilie S Powell, Joe Feinglass
Introduction: Illinois hospitals have experienced a marked decrease in the number of uninsured patients after implementation of the Affordable Care Act (ACA). However, the full impact of health insurance expansion on trauma mortality is still unknown. The objective of this study was to determine the impact of ACA insurance expansion on trauma patients hospitalized in Illinois. Methods: We performed a retrospective cohort study of 87,001 trauma inpatients from third quarter 2010 through second quarter 2015, which spans the implementation of the ACA in Illinois...
March 2018: Western Journal of Emergency Medicine
Joshua Brown, Jeffery Talbert, Ryan Pennington, Qiong Han, Driss Raissi
Background: Retrieval of inferior vena cava filters (IVCFs) is important to decrease the long-term risk of complications associated with indwelling devices. Our hospital experienced low retrieval rates and implemented a low-cost intervention and evaluation for quality improvement. The working hypothesis was that a simple, mailed letter intervention could increase retrieval rates by increasing patient and primary care provider knowledge of the need for retrieval. Methods: For all prospective patients who received a retrievable IVCF during the intervention period from January 1, 2014 to February 29, 2016, patients and their primary care providers were mailed letters encouraging contact with the clinic for evaluation of eligibility for retrieval...
2018: Patient Safety in Surgery
Iosif Gulkarov, James Schiffenhaus, Ivan Wong, Ashwad Afzal, Felix Khusid, Berhane Worku
Venoarterial extracorporeal membrane oxygenation (VA-ECMO) is an invaluable rescue therapy for patients suffering from cardiopulmonary arrest, but it is not without its drawbacks. There are cases where patients recover their cardiac function, yet they fail to wean to mechanical conventional ventilation (MCV). The use of high-frequency percussive ventilation (HFPV) has been described in patients with acute respiratory failure (RF) who fail MCV. We describe our experience with five patients who underwent VA-ECMO for cardiopulmonary arrest who were successfully weaned from VA-ECMO with HFPV after failure to wean with MCV...
March 2018: Journal of Extra-corporeal Technology
Alexander Fisher, Leon Fisher, Wichat Srikusalanukul, Paul N Smith
INTRODUCTION: The data on predictive value of the routinely obtained preoperative biochemical parameters in hip fracture (HF) patients are limited. The aims of this study were to examine in older HF patients (1) the relationships between a broad set of routine laboratory parameters at admission and in-hospital mortality, and (2) evaluate the prognostic value the biomarkers and clinical characteristics (alone or in combination) provide to predict a fatal outcome. PATIENTS AND METHODS: In 1820 consecutive patients with low-trauma osteoporotic HF aged >60 years (mean age 82...
March 8, 2018: Injury
Miran Brvar, Ming Yin Chan, Andrew H Dawson, Richard R Ribchester, Michael Eddleston
INTRODUCTION: Treatment of acute organophosphorus or carbamate insecticide self-poisoning is often ineffective, with tens of thousands of deaths occurring every year. Researchers have recommended the addition of magnesium sulfate or calcium channel blocking drugs to standard care to reduce acetylcholine release at cholinergic synapses. OBJECTIVE: We aimed to review systematically the evidence from preclinical studies in animals exposed to organophosphorus or carbamate insecticides concerning the efficacy of magnesium sulfate and calcium channel blocking drugs as therapy compared with placebo in reducing mortality or clinical features of poisoning...
March 20, 2018: Clinical Toxicology
Gabriela Ensinck, Adriana Ernst, Gustavo Lazarte, Antonela Romagnoli, Yanina Sguassero, Nanci Míguez, Santiago López Papucci, Alicia Aletti, Ana Chiossone, Fernanda Pigozzi, Matías Pinotti, Ana Cantador
INTRODUCTION: Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) infections are a common reason for consultation in pediatrics. Most of them present as skin and soft tissue infections; however, invasive infections have increased during the last decade. OBJECTIVES: The main objective was to describe the clinical-epidemiological characteristics of CA-MRSA infections. The secondary objective was to compare prevalence, clinical presentation and antibiotic susceptibility with a pre-study period (1/2004-12/2007)...
April 1, 2018: Archivos Argentinos de Pediatría
Robert J Morrison, Kelly M Malloy, Rishi R Bakshi
Objective To assess the impact of implementation of a "1-step" documentation query system on comorbidity capture and quality outcomes within the Department of Otolaryngology-Head and Neck Surgery. Methods Implementation of the 1-step documentation query system was instituted for all otolaryngology-head and neck surgery faculty at a single institution. Individual query responses and impact metrics were analyzed. Departmental case-mix index (CMI), risk of mortality (ROM), and severity of illness (SOI) were collated over a 14-month implementation period and compared to a 12-month preimplementation period...
March 1, 2018: Otolaryngology—Head and Neck Surgery
Rhys D Pockett, Phil McEwan, Joshua Ray, Irwin Tran, Simon Shutler, Steven Martin, Zaheer Yousef, Ameet Bakhai
OBJECTIVES: The effects of acute coronary syndrome (ACS) events on health-related quality of life (HRQoL) and the time dependency of these effects are unknown. This study aimed to characterise health utilities in ACS patients to aid development of future economic models estimating the cost per quality-adjusted life-year impact of ACS events and potential treatments. METHODS: Multicentre, non-interventional, longitudinal evaluation of health utility in patients experiencing ACS or stroke events...
March 20, 2018: Journal of Medical Economics
Janka Palancsai Siftar, Monika Sobocan, Iztok Takac
The present study aimed to determine the amount of fluid medium passing through the Fallopian tubes into the peritoneal cavity during a hysteroscopy. This was done to understand the pathophysiology of complications related to the hysteroscopy. Conducted in a general hospital setting, the study examined the fluid inflow-outflow during a hysteroscopy both in pre- and post-menopausal women. A hysteroscopy was performed vaginoscopically for both diagnostic and therapeutic procedures. The study involved 117 patients...
March 20, 2018: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
Simon J Mitchell, Michael H Bennett, Phillip Bryson, Frank K Butler, David J Doolette, James R Holm, Jacek Kot, Pierre Lafère
Guidelines for the pre-hospital management of decompression illness (DCI) had not been formally revised since the 2004 Divers Alert Network/Undersea and Hyperbaric Medical Society workshop held in Sydney, entitled "Management of mild or marginal decompression illness in remote locations". A contemporary review was initiated by the Diver's Alert Network and undertaken by a multinational committee with members from Australasia, the USA and Europe. The process began with literature reviews by designated committee members on: the diagnosis of DCI; first aid strategies for DCI; remote triage of possible DCI victims by diving medicine experts; evacuation of DCI victims; effect of delay to recompression in DCI; pitfalls in management when DCI victims present at hospitals without diving medicine expertise and in-water recompression...
March 31, 2018: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
Daisy Sanchez, Derek Dubay, Baliga Prabhakar, David J Taber
INTRODUCTION: To improve kidney transplant allocation equitability, a new Kidney Allocation System (KAS) was implemented December 4, 2014. The purpose of this study was to determine if the impact of KAS on peri-operative outcomes differed by recipient race/ethnicity. METHODS: This was a time series analysis using data aggregated in monthly intervals from October 2012 through September 2015 using the University HealthSystem Consortium (UHC). This includes national data aggregated at the center level of all US kidney transplant centers that participate in the UHC (416 centers)...
March 19, 2018: Journal of Racial and Ethnic Health Disparities
Uzair Ansari, Ibrahim El-Battrawy, Christian Fastner, Michael Behnes, Katherine Sattler, Aydin Huseynov, Stefan Baumann, Erol Tülümen, Martin Borggrefe, Ibrahim Akin
BACKGROUND: Recent hypotheses have suggested the pathophysiological role of catecholamines in the evolution of the Takotsubo syndrome (TTS). The extent of cardiac and circulatory compromise dictates the use of some form of supportive therapy. This study was designed to investigate the clinical outcomes associated with catecholamine use in TTS patients. METHODS: Our institutional database constituted a collective of 114 patients diagnosed with TTS between 2003 and 2015...
March 20, 2018: BMC Cardiovascular Disorders
Ledys S Copete-Pertuz, Jersson Plácido, Efraím A Serna-Galvis, Ricardo A Torres-Palma, Amanda Mora
In this work, Leptosphaerulina sp. (a Colombian native fungus) significantly removed three Isoxazolyl-Penicillin antibiotics (IP): oxacillin (OXA, 16000 μg L-1 ), cloxacillin (CLX, 17500 μg L-1 ) and dicloxacillin (DCX, 19000 μg L-1 ) from water. The biological treatment was performed at pH 5.6, 28 °C, and 160 rpm for 15 days. The biotransformation process and lack of toxicity of the final solutions (antibacterial activity (AA) and cytotoxicity) were tested. The role of enzymes in IP removal was analysed through in vitro studies with enzymatic extracts (crude and pre-purified) from Leptosphaerulina sp...
March 2, 2018: Science of the Total Environment
Andreas Klinger, Patrick Sperling, Hendrik Jansen, Johannes Wirbelauer, Daniel Vergho, Florian Seitz, Norbert Roewer, Thomas Meyer, Ralf Michael Muellenbach
A 16-month-old boy suffers a massive trauma (open dislocated pelvic fracture and decollement with haemorrhagic shock) due to a traffic accident. We present the characteristics and obstacles in the prehospital and early hospital emergency care of this severe and rare trauma in a pediatric patient with an emphasis on medical-operational tactics.
March 2018: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
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