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https://www.readbyqxmd.com/read/28340389/minilaparotomy-without-general-anesthesia-for-the-treatment-of-sigmoid-volvulus-in-high-risk-patients-a-case-series-of-4-patients
#1
Ernesto L Enrique, Kareem A Hamdy
BACKGROUND: Sigmoid volvulus (SV) is a common cause of large bowel obstruction worldwide. Presenting symptoms can be nonspecific and varied amongst the elderly population, making medical and surgical management challenging. This population is at markedly increase risk of complications and mortality with surgery under general anesthesia. In this case series, we describe 4 cases of sigmoid volvulus in octogenarians. GOALS: To demonstrate that sigmoid colectomy under local anesthesia, with or without intravenous conscious sedation, is feasible and can be done safely and with a low rate of converting to a general anesthetic...
March 2, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28339900/electronic-clinical-decision-support-for-blood-product-ordering-reduces-unnecessary-transfusion-but-may-induce-alert-fatigue
#2
Jeffrey Papiernik, Ji Won Ahn, Ronald Jackups
No abstract text is available yet for this article.
March 1, 2017: American Journal of Clinical Pathology
https://www.readbyqxmd.com/read/28339701/comparison-of-three-commercial-knowledge-bases-for-detection-of-drug-drug-interactions-in-clinical-decision-support
#3
Kin Wah Fung, Joan Kapusnik-Uner, Jean Cunningham, Stefanie Higby-Baker, Olivier Bodenreider
Objective: : To compare 3 commercial knowledge bases (KBs) used for detection and avoidance of potential drug-drug interactions (DDIs) in clinical practice. Methods: : Drugs in the DDI tables from First DataBank (FDB), Micromedex, and Multum were mapped to RxNorm. The KBs were compared at the clinical drug, ingredient, and DDI rule levels. The KBs were evaluated against a reference list of highly significant DDIs from the Office of the National Coordinator for Health Information Technology (ONC)...
February 22, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28339692/decrease-in-unnecessary-vitamin-d-testing-using-clinical-decision-support-tools-making-it-harder-to-do-the-wrong-thing
#4
Andrew H Felcher, Rachel Gold, David M Mosen, Ashley B Stoneburner
Objective: To evaluate the impact of clinical decision support (CDS) tools on rates of vitamin D testing. Screening for vitamin D deficiency has increased in recent years, spurred by studies suggesting vitamin D's clinical benefits. Such screening, however, is often unsupported by evidence and can incur unnecessary costs. Materials and Methods: We evaluated how rates of vitamin D screening changed after we implemented 3 CDS tools in the electronic health record (EHR) of a large health plan: (1) a new vitamin D screening guideline, (2) an alert that requires clinician acknowledgement of current guidelines to continue ordering the test (a "hard stop"), and (3) a modification of laboratory ordering preference lists that eliminates shortcuts...
February 19, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28339629/orders-on-file-but-no-labs-drawn-investigation-of-machine-and-human-errors-caused-by-an-interface-idiosyncrasy
#5
Richard Schreiber, Dean F Sittig, Joan Ash, Adam Wright
In this report, we describe 2 instances in which expert use of an electronic health record (EHR) system interfaced to an external clinical laboratory information system led to unintended consequences wherein 2 patients failed to have laboratory tests drawn in a timely manner. In both events, user actions combined with the lack of an acknowledgment message describing the order cancellation from the external clinical system were the root causes. In 1 case, rapid, near-simultaneous order entry was the culprit; in the second, astute order management by a clinician, unaware of the lack of proper 2-way interface messaging from the external clinical system, led to the confusion...
February 16, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28339449/reversal-of-progressive-conscious-disturbance-with-epidural-blood-patch-for-cerebrospinal-fluid-leakage-at-c2-level
#6
Yi-Chen Lai, Yuan-Yi Chia, Wei-Hung Lien
Intracranial hypotension syndrome (IHS) is generally caused by cerebrospinal fluid (CSF) leakage. Complications include bilateral subdural hygroma or haematoma and herniation of the cerebellar tonsils. Epidural blood patch (EBP) therapy is indicated if conservative treatment is ineffective. We reported the case of a 46-year-old man with a history of postural headache and dizziness. The patient was treated with bed rest and daily hydration with 2000 mL of fluid for 2 weeks. However, dizziness and headache did not resolve, and he became drowsy and disoriented with incomprehensible speech...
March 2017: Pain Physician
https://www.readbyqxmd.com/read/28339323/media-coverage-of-fda-drug-safety-communications-about-zolpidem-a-quantitative-and-qualitative-analysis
#7
Steve Woloshin, Lisa M Schwartz, Sara Dejene, Paula Rausch, Gerald J Dal Pan, Esther H Zhou, Aaron S Kesselheim
FDA issues Drug Safety Communications (DSCs) to alert health care professionals and the public about emerging safety information affecting prescription and over-the-counter drugs. News media may amplify DSCs, but it is unclear how DSC messaging is transmitted through the media. We conducted a content analysis of the lay media coverage reaching the broadest audience to characterize the amount and content of media coverage of two zolpidem DSCs from 2013. After the first DSC, zolpidem news stories increased from 19 stories/week in the preceding 3 months to 153 following its release...
March 24, 2017: Journal of Health Communication
https://www.readbyqxmd.com/read/28339314/an-analysis-of-ems-and-ed-detection-of-stroke
#8
Ian Medoro, David C Cone
BACKGROUND AND PURPOSE: Studies have shown a reduction in time-to-CT and improved process measures when EMS personnel notify the ED of a "stroke alert" from the field. However, there are few data on the accuracy of these EMS stroke alerts. The goal of this study was to examine diagnostic test performance of EMS and ED stroke alerts and related process measures. METHODS: The EMS and ED records of all stroke alerts in a large tertiary ED from August 2013-January 2014 were examined and data abstracted by one trained investigator, with data accuracy confirmed by a second investigator for 15% of cases...
March 24, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28335540/a-vehicle-steering-recognition-system-based-on-low-cost-smartphone-sensors
#9
Xinhua Liu, Huafeng Mei, Huachang Lu, Hailan Kuang, Xiaolin Ma
Recognizing how a vehicle is steered and then alerting drivers in real time is of utmost importance to the vehicle and driver's safety, since fatal accidents are often caused by dangerous vehicle maneuvers, such as rapid turns, fast lane-changes, etc. Existing solutions using video or in-vehicle sensors have been employed to identify dangerous vehicle maneuvers, but these methods are subject to the effects of the environmental elements or the hardware is very costly. In the mobile computing era, smartphones have become key tools to develop innovative mobile context-aware systems...
March 20, 2017: Sensors
https://www.readbyqxmd.com/read/28334561/determining-current-insulin-pen-use-practices-and-errors-in-the-inpatient-setting
#10
Katelyn E Brown, John B Hertig
BACKGROUND: The use of insulin pens in the inpatient setting has continued to be a controversial decision. Insulin pens provide several advantages, but given significant reports of medication errors, several organizations have issued alerts to caution users about safety concerns. A survey was conducted to assess the prevalence of insulin pen use and current utilization trends in the inpatient setting. METHODS: The 31-question guided-logic survey was developed based on review of primary literature regarding insulin pen utilization and evaluated by a panel of medication safety experts from a variety of health care settings...
December 2016: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28334558/feasibility-and-added-value-of-executive-walkrounds-in-long-term-care-organizations-in-the-netherlands
#11
Loes van Dusseldorp, Getty Huisman-de Waal, Hub Hamers, Gert Westert, Lisette Schoonhoven
BACKGROUND: Currently available tools for the management of safety in health care are largely based on quantitative management information. Executive WalkRounds (WalkRounds [WR]) seems useful as a leadership tool to detect "soft signals"-alerts of unsafe situations or practices-and to enhance the mutual trust between frontline staff and the board of directors. The majority of the research on WR has been performed in hospitals. Therefore, a study was conducted to assess how the boards of directors of long term care organizations value WR as a leadership tool to perceive soft signals, and whether soft signals are of added value to enhance patient safety...
December 2016: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28333744/clinical-alert-candida-auris
#12
Betsy Todd
A new pathogen is making its presence known.
April 2017: American Journal of Nursing
https://www.readbyqxmd.com/read/28333619/the-effect-of-vibrotactile-cuing-on-recovery-strategies-from-a-treadmill-induced-trip
#13
Beom-Chan Lee, Bernard J Martin, Timothy A Thrasher, Charles S Layne
Effective fall prevention technologies need to detect and transmit the key information that will alert an individual in advance about a potential fall. This study investigated advanced vibrotactile cuing that may facilitate trip recovery for balance-impaired individuals who are prone to falling. A split-belt treadmill that simulated unpredictable trip perturbations was developed to compare balance recovery without and with cuing. Kinetic and kinematic measures from force plates and full body motion capture system were used to characterize the recovery responses...
March 2017: IEEE Transactions on Neural Systems and Rehabilitation Engineering
https://www.readbyqxmd.com/read/28333165/mass-coral-mortality-under-local-amplification-of-2%C3%A2-%C3%A2-c-ocean-warming
#14
Thomas M DeCarlo, Anne L Cohen, George T F Wong, Kristen A Davis, Pat Lohmann, Keryea Soong
A 2 °C increase in global temperature above pre-industrial levels is considered a reasonable target for avoiding the most devastating impacts of anthropogenic climate change. In June 2015, sea surface temperature (SST) of the South China Sea (SCS) increased by 2 °C in response to the developing Pacific El Niño. On its own, this moderate, short-lived warming was unlikely to cause widespread damage to coral reefs in the region, and the coral reef "Bleaching Alert" alarm was not raised. However, on Dongsha Atoll, in the northern SCS, unusually weak winds created low-flow conditions that amplified the 2 °C basin-scale anomaly...
March 23, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28332992/clinical-implementation-of-a-model-based-in%C3%A2-vivo-dose-verification-system-for-stereotactic-body-radiation-therapy-volumetric-modulated-arc-therapy-treatments-using-the-electronic-portal-imaging-device
#15
Peter M McCowan, Ganiyu Asuni, Eric Van Uytven, Timothy VanBeek, Boyd M C McCurdy, Shaun K Loewen, Naseer Ahmed, Bashir Bashir, James B Butler, Amitava Chowdhury, Arbind Dubey, Ahmet Leylek, Maged Nashed
PURPOSE: To report findings from an in vivo dosimetry program implemented for all stereotactic body radiation therapy patients over a 31-month period and discuss the value and challenges of utilizing in vivo electronic portal imaging device (EPID) dosimetry clinically. METHODS AND MATERIALS: From December 2013 to July 2016, 117 stereotactic body radiation therapy-volumetric modulated arc therapy patients (100 lung, 15 spine, and 2 liver) underwent 602 EPID-based in vivo dose verification events...
April 1, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/28331751/subcutaneous-oleomas-following-sunflower-oil-injection-a-novel-case-and-review-of-literature
#16
Özgür Sarıca, Arda Kayhan, Hüseyin Cengiz Demirkürek, Ayşenur Akyıldız İğdem
Liquid foreign material injection has been used as an early medical intervention since the end of nineteenth century for the augmentation of body shape. Nowadays, these types of procedures have been abandoned by health professionals due to late onset of serious complications. However, it is still misused by some subcultures such as bodybuilders, passive homosexuals, transsexuals, and patients with mental illness. This article discusses a male patient who injected himself with a large amount of sunflower oil, which became complicated by an inflammatory response-abscess formation and sclerosing lipogranuloma of breasts...
July 2016: J Breast Health (2013)
https://www.readbyqxmd.com/read/28330829/does-telehealth-monitoring-identify-exacerbations-of-chronic-obstructive-pulmonary-disease-and-reduce-hospitalisations-an-analysis-of-system-data
#17
Melissa Kargiannakis, Deborah A Fitzsimmons, Claire L Bentley, Gail A Mountain
BACKGROUND: The increasing prevalence and associated cost of treating chronic obstructive pulmonary disease (COPD) is unsustainable. Health care organizations are focusing on ways to support self-management and prevent hospital admissions, including telehealth-monitoring services capturing physiological and health status data. This paper reports on data captured during a pilot randomized controlled trial of telehealth-supported care within a community-based service for patients discharged from hospital following an exacerbation of their COPD...
March 22, 2017: JMIR Medical Informatics
https://www.readbyqxmd.com/read/28330787/acute-impact-of-caffeinated-alcoholic-beverages-on-cognition-a-systematic-review
#18
REVIEW
Laurence Lalanne, Pierre-Eric Lutz, François Paille
INTRODUCTION: Energy drinks are popular beverages that are supposed to counteract sleepiness, increase energy, maintain alertness and reduce symptoms of hangover. Cognitive enhancing seems to be related to many compounds such as caffeine, taurine and vitamins. Currently, users mostly combine psychostimulant effects of energy drinks to counteract sedative effects of alcohol. However, recent literature suggests that this combination conducts to feel less intoxicated but still impaired. The goal of the present article is to review cognitive impact and subjective awareness in case of caffeinated alcoholic beverage (CAB) intoxication...
March 19, 2017: Progress in Neuro-psychopharmacology & Biological Psychiatry
https://www.readbyqxmd.com/read/28330633/association-between-psychotropic-and-cardiovascular-iatrogenic-alerts-and-risk-of-hospitalizations-in-elderly-people-treated-for-dementia-a-self-controlled-case-series-study-based-on-the-matching-of-2-french-health-insurance-databases
#19
Lorene Zerah, Jacques Boddaert, Armelle Leperre-Desplanques, Dominique Bonnet-Zamponi, Marc Verny, Jean Deligne, Pierre-Yves Boelle
BACKGROUND: Elderly people are at risk of repeated hospitalizations, some of which may be drug related and preventable. In 2011, a group of French healthcare experts selected 5 iatrogenic alerts (IAs), based on criteria identified in a literature search and from their professional experience, to assess the appropriateness of medication in elderly patients. OBJECTIVES: Our objective was to examine the association between hospitalizations and IAs in elderly patients treated for Alzheimer disease who are particularly sensitive to adverse drug events...
March 18, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28329867/effectiveness-of-a-virtual-reality-forest-on-people-with-dementia-a-mixed-methods-pilot-study
#20
Wendy Moyle, Cindy Jones, Toni Dwan, Tanya Petrovich
Purpose of the Study: To measure and describe the effectiveness of a Virtual Reality Forest (VRF) on engagement, apathy, and mood states of people with dementia, and explore the experiences of staff, people with dementia and their families. Design and Methods: A mixed-methods study conducted between February and May 2016. Ten residents with dementia, 10 family members, and 9 care staff were recruited from 2 residential aged care facilities, operated by one care provider, located in Victoria, Australia...
March 15, 2017: Gerontologist
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