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https://www.readbyqxmd.com/read/28743138/-iso-9001-2015-certification-in-quality-management
#1
Christian Enders, Gabriele E Lang, Gerhard K Lang, Jens Ulrich Werner
Quality management improves the structures, processes and results of organizations of all kinds. Many practices and clinics have their existing quality management system certified according to ISO 9001, (e.g., to check their own quality management system or to obtain a testimonial against third parties). The latest version ISO 9001:2015 contains some changes, both structurally and in terms of content. These changes can be met with reasonable efforts. An ISO 9001:2015 certification represents a value for your organization, but these advantages are often not directly measurable...
July 2017: Klinische Monatsblätter Für Augenheilkunde
https://www.readbyqxmd.com/read/28743035/current-trials-to-reduce-surgical-intervention-in-ductal-carcinoma-in-situ-of-the-breast-critical-review
#2
REVIEW
M Toss, I Miligy, A M Thompson, H Khout, A R Green, I O Ellis, E A Rakha
The high proportion of ductal carcinoma in situ (DCIS) presented in mammographic screening and the relatively low risk of progression to invasive disease have raised questions related to overtreatment. Following a review of current DCIS management protocols a more conservative approach has been suggested. Clinical trials have been introduced to evaluate the option of avoiding surgical intervention in a proportion of patients with DCIS defined as "low-risk" using certain clinicopathological criteria. These trials can potentially provide evidence-based models of active surveillance (with or without endocrine therapy) as a future management approach...
July 22, 2017: Breast: Official Journal of the European Society of Mastology
https://www.readbyqxmd.com/read/28742881/epiphytes-in-wooded-pastures-isolation-matters-for-lichen-but-not-for-bryophyte-species-richness
#3
Thomas Kiebacher, Christine Keller, Christoph Scheidegger, Ariel Bergamini
Sylvo-pastoral systems are species-rich man-made landscapes that are currently often severely threatened by abandonment or management intensification. At low tree densities, single trees in these systems represent habitat islands for epiphytic cryptogams. Here, we focused on sycamore maple (Acer pseudoplatanus) wooded pastures in the northern European Alps. We assessed per tree species richness of bryophytes and lichens on 90 sycamore maple trees distributed across six study sites. We analysed the effects of a range of explanatory variables (tree characteristics, environmental variables and isolation measures) on the richness of epiphytic bryophytes and lichens and various functional subgroups (based on diaspore size, habitat preference and red list status)...
2017: PloS One
https://www.readbyqxmd.com/read/28742871/comprehensive-immune-profiling-reveals-substantial-immune-system-alterations-in-a-subset-of-patients-with-amyotrophic-lateral-sclerosis
#4
Michael P Gustafson, Nathan P Staff, Svetlana Bornschlegl, Greg W Butler, Mary L Maas, Mohamed Kazamel, Adeel Zubair, Dennis A Gastineau, Anthony J Windebank, Allan B Dietz
Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease with a median lifespan of 2-3 years after diagnosis. There are few meaningful treatments that alter progression in this disease. Preclinical and clinical studies have demonstrated that neuroinflammation may play a key role in the progression rate of ALS. Despite this, there are no validated biomarkers of neuroinflammation for use in clinical practice or clinical trials. Biomarkers of neuroinflammation could improve patient management, provide new therapeutic targets, and possibly help stratify clinical trial selection and monitoring...
2017: PloS One
https://www.readbyqxmd.com/read/28742820/facilitators-and-barriers-to-physical-activity-in-people-with-chronic-low-back-pain-a-qualitative-study
#5
Laura Boutevillain, Arnaud Dupeyron, Caroline Rouch, Emilie Richard, Emmanuel Coudeyre
BACKGROUND: For medical teams, one of the main objectives of rehabilitation for people with chronic low back pain is adherence to physical activity (PA). OBJECTIVE: The objective of this study was to identify PA barriers and facilitators in this population. METHODS: This qualitative study included 4 discussion groups and 16 semi-structured interviews conducted among people with non-specific chronic low back pain who were involved in a specific rehabilitation program or seen in primary care settings...
2017: PloS One
https://www.readbyqxmd.com/read/28742797/a-comparison-of-selective-aortic-arch-perfusion-and-resuscitative-endovascular-balloon-occlusion-of-the-aorta-for-the-management-of-hemorrhage-induced-traumatic-cardiac-arrest-a-translational-model-in-large-swine
#6
Ed B G Barnard, James E Manning, Jason E Smith, Jason M Rall, Jennifer M Cox, James D Ross
BACKGROUND: Survival rates remain low after hemorrhage-induced traumatic cardiac arrest (TCA). Noncompressible torso hemorrhage (NCTH) is a major cause of potentially survivable trauma death. Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) at the thoracic aorta (Zone 1) can limit subdiaphragmatic blood loss and allow for IV fluid resuscitation when intrinsic cardiac activity is still present. Selective Aortic Arch Perfusion (SAAP) combines thoracic aortic balloon hemorrhage control with intra-aortic oxygenated perfusion to achieve return of spontaneous circulation (ROSC) when cardiac arrest has occurred...
July 2017: PLoS Medicine
https://www.readbyqxmd.com/read/28742770/role-of-the-perioperative-surgical-home-in-optimizing-the-perioperative-use-of-opioids
#7
Thomas R Vetter, Zeev N Kain
Several federal agencies have recently noted that the United States is in the midst of an unprecedented "opioid epidemic," with an increasing number of opioid-related overdoses and deaths. Providers currently face 3 population-level, public health challenges in providing optimal perioperative pain care: (1) the continued lack of overall improvement in the excessive incidence of inadequately treated postoperative pain, (2) minimizing or preventing postoperative opioid-related side effects, and (3) addressing current opioid prescribing patterns, and the accompanying problematic surge in prescription opioid diversion, misuse, abuse, addiction, and overdose...
July 24, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28742719/pediatric-gastroenterologists-approach-to-venous-thromboembolism-prophylaxis-in-pediatric-inflammatory-bowel-disease
#8
Kimberley Ann Chien, Hoda T Hammad, Linda Gerber, Sujit Sheth, Robbyn Sockolow, Nicole Elena Kucine
The risk of venous thromboembolism (VTE) is significantly increased in inflammatory bowel disease (IBD) patients. For the adult population, prophylaxis guidelines exist to help guide physicians in their management of high-risk IBD patients. While it is known that children with IBD also experience increased rates of VTE, there is no clear consensus on how best to prevent these unwanted complications. We sought to better understand practicing pediatric gastroenterologists' awareness of this issue and practices surrounding prevention of VTE in their pediatric patients...
July 22, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28742697/are-thoracotomy-and-or-intrathoracic-anastomosis-still-predictors-of-postoperative-mortality-after-esophageal-cancer-surgery-a-nationwide-study
#9
Sébastien Degisors, Arnaud Pasquer, Florence Renaud, Hélène Béhal, Flora Hec, Anne Gandon, Marguerite Vanderbeken, Gilbert Caranhac, Alain Duhamel, Guillaume Piessen, Christophe Mariette
BACKGROUND: Intrathoracic (vs cervical) anastomosis and a thoracotomy (vs absence) have previously been associated with increasing postoperative mortality (POM). Recent improvements in surgical practices and perioperative management may have changed these dogmas. OBJECTIVES: The aim of this study was to evaluate the impact of performing intrathoracic anastomosis and/or thoracotomy on POM after esophageal cancer surgery in recent years. METHODS: All consecutive patients who underwent esophageal cancer surgery with reconstruction between 2010 and 2012 in France were included (n = 3286)...
July 24, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28742690/do-surgeons-react-a-retrospective-analysis-of-surgeons-response-to-harassment-of-a-colleague-during-simulated-operating-theatre-scenarios
#10
Hannah Gostlow, Camila Vega Vega, Nicholas Marlow, Wendy Babidge, Guy Maddern
OBJECTIVE: To assess and report on surgeons' ability to identify and manage incidences of harassment. BACKGROUND: The Royal Australasian College of Surgeons is committed to driving out discrimination, bullying, harassment, and sexual harassment from surgical training and practice, through changing the culture of the workplace. To eradicate these behaviors, it is first critical to understand how the current workforce responds to these actions. METHODS: A retrospective analysis of video data of an operating theatre simulation was conducted to identify how surgeons, from a range of experience levels, react to instances of harassment...
July 24, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28742673/practice-bulletin-no-181-prevention-of-rh-d-alloimmunization
#11
(no author information available yet)
Advances in the prevention and treatment of Rh D alloimmunization have been one of the great success stories of modern obstetrics. There is wide variation in prevalence rates of Rh D-negative individuals between regions, for example from 5% in India to 15% in North America (1). However, high birth rates in low prevalence areas means Rh hemolytic disease of the newborn is still an important cause of morbidity and mortality in countries without prophylaxis programs (1). In such countries, 14% of affected fetuses are stillborn and one half of live born infants suffer neonatal death or brain injury (1)...
August 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28742667/practice-bulletin-no-181-summary-prevention-of-rh-d-alloimmunization
#12
(no author information available yet)
Advances in the prevention and treatment of Rh D alloimmunization have been one of the great success stories of modern obstetrics. There is wide variation in prevalence rates of Rh D-negative individuals between regions, for example from 5% in India to 15% in North America (1). However, high birth rates in low prevalence areas means Rh hemolytic disease of the newborn is still an important cause of morbidity and mortality in countries without prophylaxis programs (1). In such countries, 14% of affected fetuses are stillborn and one half of live born infants suffer neonatal death or brain injury (1)...
August 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28742645/quality-improvement-in-management-of-acute-coronary-syndrome-continuing-medical-education-and-peer-coaching-improve-antiplatelet-medication-adherence-and-reduce-hospital-readmissions
#13
Amy Larkin, Michael LaCouture, Kathleen Geissel, Peri Barr, Eric R Bates, Christopher P Cannon, Deepak L Bhatt
BACKGROUND: Reducing hospital readmissions and improving patient adherence to antiplatelet medications after an acute coronary syndrome (ACS) event are important goals for improving patient health and decreasing healthcare costs. Nearly half of patients will have a secondary event within 1 year of the initial ACS event. Quality improvement (QI) initiatives that include continuing medical education and peer coaching may improve physician practice patterns and, therefore, patient outcomes...
September 2017: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/28742598/arterial-and-venous-doppler-in-evaluation-of-the-at-risk-fetus
#14
Sifa Turan, Ozhan M Turan
Our practice utilizes Doppler ultrasound as one of the most objective and effective methods to assess at-risk pregnancies. This review will discuss the application of arterial and venous Doppler techniques in assessing and managing various diseases and conditions for high-risk fetuses.
September 2017: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28742500/adverse-effects-of-androgen-deprivation-therapy-in-patients-with-prostate-cancer-focus-on-metabolic-complications
#15
REVIEW
Vasileios Tzortzis, Michael Samarinas, Ioannis Zachos, Athanasios Oeconomou, Louis L Pisters, Alexandra Bargiota
Prostate cancer is the most common cancer among men and androgen deprivation therapy (ADT) is the most effective treatment for this disease. The cornerstone of the treatment of prostate cancer is inhibition of testosterone production which interrupts testosterone-induced growth of the prostate tumor. The dramatic decrease in testosterone levels, however, has several undesirable effects on the metabolic profile and bone metabolism and can also lead to fatigue, loss of libido, gynecomastia, and anemia, provoke vasomotor flushing, and generally affect the quality of life...
April 2017: Hormones: International Journal of Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28742437/health-and-safety-adoption-from-use-of-a-risk-assessment-document-on-irish-farms
#16
John McNamara, Patrick Griffin, James Kinsella, James Phelan
OBJECTIVES: This paper describes levels of implementation of occupational health and safety (OHS) controls on a sample of Irish farms following completion of a risk assessment document (RAD) made available as part of a statutory code of practice (COP) for the agriculture sector. The paper describes the legislation mandating the COP and the operation of a prevention initiative (PI) among key stakeholders to develop and promote farmer use of the COP and RAD. METHODS: RADs were collected for farmers (n = 475) and the number and type of OHS controls listed for action were tabulated...
July 25, 2017: Journal of Agromedicine
https://www.readbyqxmd.com/read/28742305/pediatric-heat-related-illness-recommendations-for-prevention-and-management
#17
Roberta J. Dunn, Tommy Y. Kim
Infants, children, and adolescents are at increased risk for heat-related illness due to their inability to remove themselves from dangerous environments. Evidence shows that morbidity and mortality from heat illness is related to the length of time core temperature is elevated, so rapid reduction and accurate serial measurements are crucial to prevention of organ system damage and death. The primary methods of patient cooling are conduction (ice-water immersion, cold packs) and convection (moisture and moving air)...
August 2017: Pediatric Emergency Medicine Practice
https://www.readbyqxmd.com/read/28742129/treatment-outcomes-of-pre-surgical-infant-orthopedics-in-patients-with-non-syndromic-cleft-lip-and-or-palate-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#18
Hamid Reza Hosseini, Eleftherios G Kaklamanos, Athanasios E Athanasiou
BACKGROUND: Non-syndromic clefts lip and/or palate (CL/P) defects may have manifold significant and detrimental consequences for the affected individuals and their family environment. Although the use of pre-surgical infant orthopedics (PSIO) was introduced as a means to improve management and treatment outcomes, there still remains a controversy. OBJECTIVE: To investigate the effectiveness of PSIO in patients with non-syndromic CL/P and evaluate the quality of the available evidence...
2017: PloS One
https://www.readbyqxmd.com/read/28741391/clinical-implications-benefits-and-pitfalls-of-using-and-reversing-non-vitamin-k-antagonist-oral-anticoagulants
#19
Alexandra S Moss, Gerasimos Dimitropoulos, Gregory Y H Lip
The use of non-Vitamin K antagonist oral anticoagulant (NOAC) drugs is increasingly common in clinical practice. As compared to vitamin K antagonists they are more straightforward to initiate, require no hematological monitoring and offer potentially more stable therapeutic indices. Concern has been raised with regard to their safety profiles particularly in the context of acute reversal in major bleeding. Further issues pertain to patient concordance. Areas Covered: This review article aims to provide an overview of the current evidence relating to NOAC safety as well as the management of NOAC-related major bleeding with particular emphasis on reversal agents in use and in development following a selective literature review...
July 25, 2017: Expert Review of Hematology
https://www.readbyqxmd.com/read/28741278/italian-intersociety-consensus-on-prevention-diagnosis-and-treatment-of-delirium-in-hospitalized-older-persons
#20
Giuseppe Bellelli, Alessandro Morandi, Marco Trabucchi, Guido Caironi, Daniele Coen, Carlo Fraticelli, Ciro Paolillo, Carolina Prevaldi, Angela Riccardi, Gianfranco Cervellin, Corrado Carabellese, Salvatore Putignano, Stefania Maggi, Antonio Cherubini, Paola Gnerre, Andrea Fontanella, Nicola Latronico, Concezione Tommasino, Antonio Corcione, Giovanni Ricevuti, Nicola Ferrara, Francesco De Filippi, Alberto Ferrari, Mario Guarino, Maria Pia Ruggieri, Pietro Amedeo Modesti, Carlo Locatelli, Patrizia Hrelia, Marco Otto Toscano, Emi Bondi, Antonio Tarasconi, Luca Ansaloni, Francesco Perticone
Delirium is a severe neuropsychiatric syndrome characterized by inattention and global cognitive dysfunction in the setting of an acute medical illness, medical complication, drug intoxication, or drug withdrawal. The most important risk factors are advanced age and dementia, whereas pain, dehydration, infections, stroke, metabolic disturbances, and surgery are the most common triggering factors. Although delirium is a common clinical syndrome in different settings of care (acute care hospitals, inpatient rehabilitation facilities, nursing homes, and hospices), it often remains under-recognized, poorly understood, and inadequately managed...
July 24, 2017: Internal and Emergency Medicine
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