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https://www.readbyqxmd.com/read/28724143/potentially-avoidable-surgical-intensive-care-unit-admissions-and-disposition-delays
#1
Navpreet K Dhillon, Ara Ko, Eric J T Smith, Mayumi Kharabi, Joseph Castongia, Michael Nurok, Bruce L Gewertz, Eric J Ley
Importance: High health care costs encourage initiatives that avoid overuse of resources and identify opportunities to promote appropriate care. Objective: To investigate the causes of potentially avoidable surgical intensive care unit (SICU) admissions and disposition delays to determine whether targeted interventions could decrease these stays. Design, Setting, and Participants: This prospective, observational study focused on potentially avoidable SICU days, as determined by observers with input from the rounding intensivists at a 24-bed open SICU at an urban, academic hospital...
July 19, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28723116/integrated-magnetic-bead-quantum-dot-immunoassay-for-malaria-detection
#2
Chloe Kim, Gwendolyn Hoffmann, Peter C Searson
Malaria persists as a disease of high morbidity and mortality due to improper diagnosis, overuse of drugs, rapidly evolving drug resistant parasites, and poor disease monitoring. The two common tests used in developing countries, microscopic examination of Glemsa slides and rapid diagnostic tests (RDTs), have limitations associated with variability in specificity and sensitivity, and qualitative outcome. Here we report on an immunoassay using magnetic beads for capture and quantum dots for detection of histidine-rich protein 2 (HRP2)...
June 23, 2017: ACS Sensors
https://www.readbyqxmd.com/read/28720637/intersection-syndrome-the-subtle-squeak-of-an-overused-wrist
#3
Thomas M Skinner
Patient histories that include wrist pain can be pivotal in the distinction between intersection syndrome (IS) and the more common de Quervain's tenosynovitis (DQT). Presented here is a 26-year-old pregnant woman with a history of rowing who developed left radial/dorsal wrist pain and a rubbing/squeaking sensation. Nine months of conservative DQT therapy and a landmark-guided corticosteroid injection failed to relieve her symptoms. An in-clinic ultrasound showed tenosynovitis at the intersection of the first and second compartments, confirming a diagnosis of IS...
July 2017: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/28717627/the-influence-of-playing-surface-on-injury-risk-in-italian-elite-rugby-players
#4
Riccardo Maria Lanzetti, Domenico Lupariello, Teresa Venditto, Pierpaolo Rota, Matteo Guzzini, Antonio Vadalà, Attilio Rota, Andrea Ferretti
BACKGROUND: There is a growing interest in the use of artificial turf surfaces in rugby. In particular, artificial surfaces may be an useful means of increasing participation in the sport by allowing greater usage of a given pitch, especially in regions where natural turf pitches are difficult to maintain. METHODS: The incidence of site, nature, cause, and severity of training and match injuries was prospectively recorded in two professional teams (one equipped with World Rugby certified third generation artificial turf and the other with natural grass over the 2014-2015 season)...
January 2017: Muscles, Ligaments and Tendons Journal
https://www.readbyqxmd.com/read/28717613/morphometric-evaluation-of-human-tendocalcaneus-a-cadaveric-study-of-south-indian-male-population
#5
Naveen Kumar, Ashwini P Aithal, Satheesha B Nayak, Jyothsna Patil, Abhinitha Padavinangadi, Biswa Bina Ray
INTRODUCTION: Tendocalcaneus or Achilles tendon is formed by the fusion of the tendons of gastrocnemius and soleus muscles. Normal morphometric measurements of tendo-calcaneus serves an important landmark in its anthropometric evaluation and biomechanical characteristics. Hence the objective of this study was to provide detailed morphometric profile of tendocalcaneus in south indian cadaveric male population. MATERIALS AND METHOD: A total of 64 dissected adult limbs was studied...
January 2017: Muscles, Ligaments and Tendons Journal
https://www.readbyqxmd.com/read/28710547/cross-cultural-adaptation-and-validation-of-the-italian-version-of-the-kerlan-jobe-orthopaedic-clinic-shoulder-and-elbow-score
#6
Giovanni Merolla, Katia Corona, Gustavo Zanoli, Simone Cerciello, Stefano Giannotti, Giuseppe Porcellini
BACKGROUND: The Kerlan-Jobe Orthopaedic Clinic (KJOC) Shoulder and Elbow score is a reliable and sensitive tool to measure the performance of overhead athletes. The purpose of this study was to carry out a cross-cultural adaptation and validation of the KJOC questionnaire in Italian and to assess its reliability, validity, and responsiveness. MATERIALS AND METHODS: Ninety professional athletes with a painful shoulder were included in this study and were assigned to the "injury group" (n = 32) or the "overuse group" (n = 58); 65 were managed conservatively and 25 were treated by arthroscopic surgery...
July 14, 2017: Journal of Orthopaedics and Traumatology: Official Journal of the Italian Society of Orthopaedics and Traumatology
https://www.readbyqxmd.com/read/28710229/pirate-project-point-of-care-informatics-based-randomised-controlled-trial-for-decreasing-overuse-of-antibiotic-therapy-in-gram-negative-bacteraemia
#7
Angela Huttner, Werner C Albrich, Pierre-Yves Bochud, Angèle Gayet-Ageron, Anne Rossel, Elodie von Dach, Stephan Harbarth, Laurent Kaiser
INTRODUCTION: Antibiotic overuse drives antibiotic resistance. The optimal duration of antibiotic therapy for Gram-negative bacteraemia (GNB), a common community and hospital-associated infection, remains unknown and unstudied via randomised controlled trials (RCTs). METHODS AND ANALYSIS: This investigator-initiated, multicentre, non-inferiority, informatics-based point-of-care RCT will randomly assign adult hospitalised patients receiving microbiologically efficacious antibiotic(s) for GNB to (1) 14 days of antibiotic therapy, (2) 7 days of therapy or (3) an individualised duration determined by clinical response and 75% reduction in peak C reactive protein (CRP) values...
July 13, 2017: BMJ Open
https://www.readbyqxmd.com/read/28707116/rotator-cuff-degeneration-of-the-healthy-shoulder-in-patients-with-unilateral-arm-amputation-is-not-worsened-by-overuse
#8
S Gumina, V Candela, L Mariani, T Venditto, C Catalano, S Castellano, V Santilli, G Giannicola, A Castagna
PURPOSE: In order to evaluate whether overuse has a significant role in rotator cuff tear (RCT) aetiology, we evaluated both shoulders of patients with old unilateral arm amputation expecting a higher rate of RC degeneration in the healthy side. METHODS: Nineteen males and six females (mean age: 57.3 ± 10.1) with an old (>20 years) unilateral arm amputation were submitted to an MRI of both shoulders. Tendon status and muscle tropism were evaluated according to Sugaya and Fuchs classifications, respectively; the acromion humeral distance was measured...
July 13, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28706332/role-of-elsholtzia-communis-in-counteracting-stress-by-modulating-expression-of-hspa14-c-ebp-homologous-protein-nuclear-factor-erythroid-derived-2-like-2-factor-caspase-3-and-brain-derived-neurotrophic-factor-in-rat-hippocampus
#9
Chandana Choudhury Barua, Pompy Patowary, Arundhati Purkayastha, Prakash Haloi, Manab Jyoti Bordoloi
OBJECTIVE: Elsholtzia communis (Collett and Hemsl.) Diels has been widely distributed and is reported for many therapeutic effects. The present study aims to investigate the antistress activity of the leaf extract and its possible molecular mechanism. MATERIALS AND METHODS: Hydroethanolic extract of leaves of E. communis (100 and 200 mg/kg, p.o.) were administered for 7 days to stress-induced male Wistar rats. The experimental animals were divided into five groups (n = 6)...
March 2017: Indian Journal of Pharmacology
https://www.readbyqxmd.com/read/28706101/low-value-clinical-practices-in-injury-care-a-scoping-review-protocol
#10
Lynne Moore, Khadidja Malloum Boukar, Pier-Alexandre Tardif, Henry T Stelfox, Howard Champion, Peter Cameron, Belinda Gabbe, Natalie Yanchar, John Kortbeek, François Lauzier, France Légaré, Patrick Archambault, Alexis F Turgeon
INTRODUCTION: Preventable injuries lead to 200 000 hospital stays, 60 000 disabilities, and 13 000 deaths per year in Canada with direct costs of $20 billion. Overall, potentially unnecessary medical interventions are estimated to consume up to 30% of healthcare resources and may expose patients to avoidable harm. However, little is known about overuse for acute injury care. We aim to identify low-value clinical practices in injury care. METHODS AND ANALYSIS: We will perform a scoping review of peer-reviewed and non-peer-reviewed literature to identify research articles, reviews, recommendations and guidelines that identify at least one low-value clinical practice specific to injury populations...
July 12, 2017: BMJ Open
https://www.readbyqxmd.com/read/28700964/clinical-and-laboratory-predictors-of-infectious-complications-in-patients-after-out-of-hospital-cardiac-arrest
#11
Josef Kroupa, Jiri Knot, Jaroslav Ulman, Frantisek Bednar, Alena Dohnalova, Zuzana Motovska
PURPOSE: Identification of clinical and laboratory predictors related to Infectious Complications (ICs) in patients after Out-of-Hospital Cardiac Arrest (OHCA). METHODS: Patients, aged >18, after an OHCA between 9/2013 and 11/2015, surviving >24h, were studied. RESULTS: Study group consisted of 42 patients (mean age 63.4years, 88.1% men). Forty percent of patients had IC; lower respiratory tract infections were most common (87.5% of cases)...
July 4, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28695907/overuse-of-repeat-upper-endoscopy-in-the-veterans-health-administration-a-retrospective-analysis
#12
Joel H Rubenstein, Heiko Pohl, Megan A Adams, Eve Kerr, Robert Holleman, Sandeep Vijan, Jason A Dominitz, John M Inadomi, Dawn Provenzale, Joseph Francis, Sameer D Saini
OBJECTIVES: Americans undergo ∼7 million esophagogastroduodenoscopies (EGDs) annually, and one-third of Medicare beneficiaries undergo a repeat EGD within 3 years. As many as 43% of these repeat EGDs are inappropriate. We aimed to determine the rate of repeat inappropriate EGD within the Veterans Health Administration (VHA), and identify factors associated with repeat EGD. METHODS: We conducted retrospective analyses of Veterans undergoing an index EGD at 159 VHA facilities between 1 January 2003 and 30 June 2007...
July 11, 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28694251/advances-in-the-causes-and-management-of-community-acquired-pneumonia-in-adults
#13
REVIEW
Richard G Wunderink, Grant Waterer
Community acquired pneumonia remains a common cause of morbidity and mortality. Usually, the causal organism is not identified and treatment remains empiric. Recent computed tomography and magnetic resonance imaging studies have challenged the accuracy of the clinical diagnosis of pneumonia, and epidemiologic studies are changing our perspective of what causes community acquired pneumonia, especially the role of viral pathogens and the frequent finding of multiple pathogens. The past decade has seen increasing overuse of empiric coverage of meticillin resistant Staphylococcus aureus and antibiotic resistant Gram negative pathogens owing to inappropriate application of guidelines for healthcare associated pneumonia...
July 10, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28693535/alfredson-versus-silbernagel-exercise-therapy-in-chronic-midportion-achilles-tendinopathy-study-protocol-for-a-randomized-controlled-trial
#14
Bas Habets, Robert E H van Cingel, Frank J G Backx, Bionka M A Huisstede
BACKGROUND: Midportion Achilles tendinopathy (AT) is a common overuse injury, usually requiring several months of rehabilitation. Exercise therapy of the ankle plantar flexors (i.e. tendon loading) is considered crucial during conservative rehabilitation. Alfredson's isolated eccentric and Silbernagel's combined concentric-eccentric exercise programs have both shown beneficial results, but it is unknown whether any of these programs is superior for use in clinical practice. Therefore, the primary objective of this study is to compare the effectiveness of both programs on clinical symptoms...
July 11, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28693330/reducing-unnecessary-blood-chemistry-testing-in-the-emergency-department-implementation-of-choosing-wisely
#15
Arjun K Venkatesh, David Hajdasz, Craig Rothenberg, Meir Dashevsky, Vivek Parwani, Mark Sevilla, Marc Shapiro, Ian Schwartz
Point of care (POC) laboratory testing is used to improve emergency department (ED) throughput but often overuses resources by duplicating formal laboratory testing. This study sought to evaluate the effect of a multimodal intervention on duplicate chemistry testing. This pre-post analysis included all visits to 2 urban EDs between June 2014 and June 2016. The multimodal intervention including provider education, signage, electronic health record redesign, and audit and feedback focused on reducing duplicate chemistry testing...
February 1, 2017: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/28684060/top-10-myths-regarding-the-diagnosis-and-treatment-of-cellulitis
#16
Erin K McCreary, Melissa E Heim, Lucas T Schulz, Robert Hoffman, Jeffrey Pothof, Barry Fox
BACKGROUND: Cellulitis is commonly treated in the emergency department (ED). Patients who present with cellulitis incur significant health care costs and may be overtreated with antibiotics. The accurate diagnosis and treatment of cellulitis plays an important role in cost-effective, high-quality medical care, as well as appropriate antibiotic utilization. OBJECTIVE: We aim to describe common fallacies regarding cellulitis. We present 10 myths that result in misdiagnosis, overtreatment, or inappropriate empiric management of cellulitis...
July 3, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28683750/use-of-malaria-rapid-diagnostic-tests-by-community-health-workers-in-afghanistan-cluster-randomised-trial
#17
Toby Leslie, Mark Rowland, Amy Mikhail, Bonnie Cundill, Barbara Willey, Asif Alokozai, Ismail Mayan, Anwar Hasanzai, Sayed Habibullah Baktash, Nader Mohammed, Molly Wood, Habib-U-Rahman Rahimi, Baptiste Laurent, Cyril Buhler, Christopher J M Whitty
BACKGROUND: The World Health Organisation (WHO) recommends parasitological diagnosis of malaria before treatment, but use of malaria rapid diagnostic tests (mRDTs) by community health workers (CHWs) has not been fully tested within health services in south and central Asia. mRDTs could allow CHWs to diagnose malaria accurately, improving treatment of febrile illness. METHODS: A cluster randomised trial in community health services was undertaken in Afghanistan. The primary outcome was the proportion of suspected malaria cases correctly treated for polymerase chain reaction (PCR)-confirmed malaria and PCR negative cases receiving no antimalarial drugs measured at the level of the patient...
July 7, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28680897/high-prevalence-of-nontraumatic-shoulder-pain-in-a-regional-sample-of-female-high-school-volleyball-athletes
#18
Kayt E Frisch, Jacob Clark, Chad Hanson, Chris Fagerness, Adam Conway, Lindsay Hoogendoorn
BACKGROUND: Shoulder pain is becoming increasingly problematic in young players as volleyball gains popularity. Associations between repetitive motion and pain and overuse injury have been observed in other overhand sports (most notably baseball). Studies of adult athletes suggest that there is a shoulder pain and overuse problem present in volleyball players, but minimal research has been done to establish rates and causes in juvenile participants. PURPOSE: To establish rates of shoulder pain, regardless of whether it resulted in a loss of playing time, in female high school volleyball players...
June 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/28680770/reducing-over-utilization-of-cardiac-telemetry-with-pop-ups-in-an-electronic-medical-record-system
#19
Wajeeha Rizvi, Cyrus M Munguti, Jeet Mehta, K James Kallail, Darrell Youngman, Samer Antonios
Non-invasive cardiac monitoring has well-established indications and protocols. Telemetry is often overused leading to a shortage of tele-beds and an increment of hospital expenses. In some cases, patients are kept on telemetry longer than the indicated length because providers are unaware of its ongoing use. We investigated the effect of reminder pop-ups, incorporated into an electronic medical record (EMR), on minimizing the use of telemetry. Three regional hospitals implemented an electronic pop-up reminder for discontinuing the use of telemetry when no longer indicated...
May 29, 2017: Curēus
https://www.readbyqxmd.com/read/28680281/choosing-wisely-in-cancer-control-across-canada-a-set-of-baseline-indicators
#20
K Tran, R Rahal, S Fung, G Lockwood, C Louzado, J Xu, H Bryant
Value-based care, which balances high-quality care with the most efficient use of resources, has been considered the next frontier in cancer care and a means to maintain health system sustainability. Created to promote value-based care, Choosing Wisely Canada-modelled after Choosing Wisely in the United States-is a national clinician-driven campaign to identify unnecessary or harmful services that are frequently used in Canada. As part of the campaign, national medical societies have developed recommendations for tests and treatments that clinicians and patients should question...
June 2017: Current Oncology
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