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https://www.readbyqxmd.com/read/29162078/a-tailored-counseling-and-home-based-rehabilitation-program-to-increase-physical-activity-and-improve-mobility-among-community-dwelling-older-people-after-hospitalization-protocol-of-a-randomized-controlled-trial
#1
K Turunen, L Aaltonen, J Kumpumäki, E Portegijs, S Keikkala, M-L Kinnunen, T Finni, S Sipilä, R Nikander
BACKGROUND: Physical activity (PA) decreases during hospitalization. In particular, the amount of PA engaged in by older people who are hospitalized following musculoskeletal injury is likely to be limited for months after discharge home. Given the importance of an active lifestyle for their recovery and the prevention of future adverse outcomes, there is clearly a need for interventions to increase PA. This article describes the protocol of a randomized controlled trial set up to investigate the effects of a physical activity oriented home rehabilitation program (ProPA) on PA and the restoration of mobility in community-dwelling older people...
November 21, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29160123/fast-tracking-for-total-knee-replacement-reduces-use-of-institutional-care-without-compromising-quality
#2
Konsta J Pamilo, Paulus Torkki, Mikko Peltola, Maija Pesola, Ville Remes, Juha Paloneva
Background and purpose - Fast-tracking shortens the length of the primary treatment period (length of stay, LOS) after total knee replacement (TKR). We evaluated the influence of the fast-track concept on the length of uninterrupted institutional care (LUIC) and other outcomes after TKR. Patients and methods - 4,256 TKRs performed in 4 hospitals between 2009-2010 and 2012-2013 were identified from the Finnish Hospital Discharge Register and the Finnish Arthroplasty Register. Hospitals were classified as fast track (Hospital A) and non-fast track (Hospitals B, C and D)...
November 21, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/29159958/evaluation-of-a-low-risk-mild-traumatic-brain-injury-and-intracranial-hemorrhage-emergency-department-observation-protocol
#3
Brian J Yun, Pierre Borczuk, Lulu Wang, Stephen Dorner, Benjamin A White, Ali S Raja
OBJECTIVES: Among emergency physicians, there is wide variation in admitting practices for patients who suffered a mild traumatic brain injury (TBI) with an intracranial hemorrhage (ICH). The purpose of this study was to evaluate the effects of implementing a protocol in the emergency department (ED) observation unit for patients with mild TBI and ICH. METHODS: This retrospective cohort study was approved by the Institutional Review Board. Study subjects were patients ≥18 years of age with an International Classification of Diseases (ICD) code corresponding to a traumatic IC, and admitted to an ED observation unit (EDOU) of an urban, academic level 1 trauma center between February 1, 2015 and January 31, 2017...
November 20, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29153106/risk-factors-associated-with-case-fatality-in-225-diarrhoeic-calves-a-retrospective-study
#4
A Boccardo, S Biffani, A Belloli, F Biscarini, G Sala, D Pravettoni
The aim of this retrospective study was to identify the major risk factors associated with case fatality in diarrhoeic calves undergoing a standard therapeutic protocol. Clinical and laboratory findings were reviewed in 225 Holstein Friesian diarrhoeic calves over a 2 year period. Calves were treated according to a fluid therapy protocol using an oral electrolyte solution or an IV infusion. After therapy, 159 calves were discharged in a healthy state, whereas 66 calves died. Logistic regression analysis showed that serum total protein (STP) concentration (odds ratio, OR, 0...
October 2017: Veterinary Journal
https://www.readbyqxmd.com/read/29151041/assessment-of-thrombus-length-in-acute-ischemic-stroke-by-post-contrast-magnetic-resonance-angiography
#5
Ramanan Ganeshan, Alexander H Nave, Jan F Scheitz, Katharina A Schindlbeck, Karl Georg Haeusler, Christian H Nolte, Kersten Villringer, Jochen B Fiebach
OBJECTIVES: Post-contrast magnetic resonance angiography (PC-MRA) enables visualization of vessel segments distal to an intra-arterial thrombus in acute ischemic stroke. We hypothesized that PC-MRA also allows clot length measurement in different intracranial vessels. METHODS: Patients with MRI-confirmed ischemic stroke and intracranial artery occlusion within 24 hours of symptom onset were prospectively evaluated. PC-MRA was added to a standard stroke MRI protocol...
November 18, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29151009/risk-stratification-triage-and-implementation-of-an-expedited-hip-fracture-treatment-protocol-is-it-safe-and-effective
#6
William Zelenty, Richard Yoon, Lorraine Hutzler, Nirmal Tejwani, Joseph Bosco
INTRODUCTION: The population of patients in the USA over the age of 65 is expected to significantly increase over the next 40 years. These patients are at increased risk for hip fractures and will pose a burden to providers in the near future. In order to provide high value care, providers will need to maintain positive outcomes, mitigate complications, and reduce overall cost burdens. This study was designed to investigate the safety and efficacy of a patient transfer protocol between a large academic medical center and a single specialty orthopaedic institution...
December 2017: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/29149905/the-kusamala-program-for-primary-caregivers-of-children-6-59-months-of-age-hospitalized-with-severe-acute-malnutrition-in-malawi-study-protocol-for-a-cluster-randomized-controlled-trial
#7
Allison I Daniel, Meta van den Heuvel, Wieger P Voskuijl, Melissa Gladstone, Mike Bwanali, Isabel Potani, Celine Bourdon, Jenala Njirammadzi, Robert H J Bandsma
BACKGROUND: Severe acute malnutrition (SAM) is associated with high mortality rates and impairments in growth and development in children that do survive. There are complex nutritional, health, and behavioural risk factors involving severely malnourished children and their primary caregivers, requiring integrated intervention approaches. METHODS: A cluster-randomized controlled trial at the Queen Elizabeth Central Hospital in Blantyre, Malawi will be conducted to evaluate the effectiveness of a 4-day hospital-based intervention programme directed at primary caregivers...
November 17, 2017: Trials
https://www.readbyqxmd.com/read/29147469/non-pharmacologic-interventions-to-improve-sleep-of-medicine-inpatients-a-controlled-study
#8
Selina Dobing, Anita Dey, Finlay McAlister, Jennifer Ringrose
Background: Sleep quality in hospitalized medicine patients is poor, with environmental factors among the most frequently cited reasons. Objective: We tested the efficacy of a non-pharmacologic intervention on the sleep quality of medicine inpatients. Design/Methods: A controlled study to evaluate our non-pharmacologic multidisciplinary 'TUCK-in' protocol (which includes timed lights-off periods, minimizing night-time noise, distribution of earplugs at bedtime, cued toileting before bedtime, and identification and reduction of modifiable interruptions) was deployed on two of five identical medicine wards...
2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/29146661/what-is-the-relationship-between-physical-activity-and-cardiovascular-risk-factors-in-stroke-survivors-post-completion-of-rehabilitation-protocol-for-a-longitudinal-study
#9
Natalie A Fini, Julie Bernhardt, Anne E Holland
INTRODUCTION: Physical activity (PA) can modify cardiovascular and other health risks in people with stroke, but we know little about long-term PA in this group. This study aims to describe PA levels and investigate relationships between PA, cardiovascular risk factors, mobility and participant characteristics (eg, age, mood and fatigue) in the 2 years following rehabilitation discharge after first stroke. METHODS AND ANALYSIS: This is a longitudinal observational study with follow-up at 6, 12 and 24 months after rehabilitation discharge...
November 15, 2017: BMJ Open
https://www.readbyqxmd.com/read/29146647/initial-non-operative-management-of-uncomplicated-appendicitis-in-children-a-protocol-for-a-multicentre-randomised-controlled-trial-apac-trial
#10
Max Knaapen, Johanna H van der Lee, Roel Bakx, Sarah-May L The, Ernst W E van Heurn, Hugo A Heij, Ramon R Gorter
INTRODUCTION: Based on epidemiological, immunological and pathology data, the idea that appendicitis is not necessarily a progressive disease is gaining ground. Two types are distinguished: simple and complicated appendicitis. Non-operative treatment (NOT) of children with simple appendicitis has been investigated in several small studies. So far, it is deemed safe. However, its effectiveness and effect on quality of life (QoL) have yet to be established in an adequately powered randomised trial...
November 15, 2017: BMJ Open
https://www.readbyqxmd.com/read/29138293/icare-acs-improving-care-processes-for-patients-with-suspected-acute-coronary-syndrome-a-study-of-cross-system-implementation-of-a-national-clinical-pathway
#11
Martin P Than, John W Pickering, Jeremy M Dryden, Sally J Lord, S Andrew Aitken, Sally J Aldous, Kate E Allan, Michael W Ardagh, John W N Bonning, Rosie Callender, Laura R E Chapman, Jonathan P Christiansen, Andre P J Cromhout, Louise Cullen, Joanne M Deely, Gerard P Devlin, Katherine A Ferrier, Christopher M Florkowski, Christopher M A Frampton, Peter M George, Gregory J Hamilton, Allan S Jaffe, Andrew J Kerr, G Luke Larkin, Richard M Makower, Timothy J E Matthews, William A Parsonage, W Frank Peacock, Bradley F Peckler, Nicholaas C van Pelt, Louise Poynton, A Mark Richards, Anthony G Scott, Mark B Simmonds, David Smyth, Oliver P Thomas, Andrew C Y To, Stephen A Du Toit, Richard W Troughton, Kim M Yates
BACKGROUND : Efforts to safely reduce length of stay for emergency department patients with symptoms suggestive of acute coronary syndrome (ACS) have had mixed success. Few system-wide efforts affecting multiple hospital emergency departments have ever been evaluated. We evaluated the effectiveness of a nationwide implementation of clinical pathways for potential ACS in disparate hospitals. METHODS : This was a multicenter pragmatic stepped-wedge before-and-after trial in 7 New Zealand acute care hospitals with 31 332 patients investigated for suspected ACS with serial troponin measurements...
November 14, 2017: Circulation
https://www.readbyqxmd.com/read/29138075/the-optimal-treatment-options-of-septated-chronic-subdural-haematoma-a-retrospective-comparison-of-craniotomy-versus-endoscopic-assisted-burr-hole-craniostomy
#12
Jibo Zhang, Xingyue Fan, Xuemeng Liu, Jincao Chen, Wei Wang, Kai Fu
OBJECTIVE: To complete a retrospective comparison of endoscope-assisted burr-hole craniostomy (EBHC) and craniotomy in the treatment of septated chronic subdural hematoma (SCSH). METHODS: A retrospective case note review comparing EBHC and craniotomy of SCSH was therefore performed. Data of patients with a SCSH for EBHC or craniotomy during the period from January 2011 to January 2017 were retrospectively collected and analysed. Of 70 patients, 43 underwent EBHC and 27 patients were treated by craniotomy...
November 11, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29137682/cefepime-induced-neurotoxicity-a-systematic-review
#13
Lauren E Payne, David J Gagnon, Richard R Riker, David B Seder, Elizabeth K Glisic, Jane G Morris, Gilles L Fraser
BACKGROUND: Cefepime is a widely used antibiotic with neurotoxicity attributed to its ability to cross the blood-brain barrier and exhibit concentration-dependent ϒ-aminobutyric acid (GABA) antagonism. Neurotoxic symptoms include depressed consciousness, encephalopathy, aphasia, myoclonus, seizures, and coma. Data suggest that up to 15% of ICU patients treated with cefepime may experience these adverse effects. Risk factors include renal dysfunction, excessive dosing, preexisting brain injury, and elevated serum cefepime concentrations...
November 14, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29135740/experiences-of-women-discharged-less-than-24%C3%A2-hours-post-vaginal-birth-a-systematic-review-protocol
#14
Lynette Cusack, Morgan Roberta Smith
The objective of this qualitative review is to synthesize the best available evidence on the meaning of early hospital discharge for women following a normal vaginal birth.
November 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/29135664/pain-relief-after-operative-treatment-of-an-extremity-fracture-a-noninferiority-randomized-controlled-trial
#15
Gijs T T Helmerhorst, Ruben Zwiers, David Ring, Peter Kloen
BACKGROUND: Opioid pain medication is frequently given to patients recovering from a surgical procedure for an extremity fracture in spite of evidence that acetaminophen may be adequate. The aim of this study was to determine whether prescription of step 1 pain medication (acetaminophen) is noninferior to step 2 pain medication (acetaminophen and tramadol) after operative treatment of an extremity fracture. METHODS: Fifty-two patients with a single extremity fracture were randomized from July 2012 to March 2015 in this 2-week follow-up, noninferiority trial in a level-I trauma center in the Netherlands...
November 15, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29135621/efficacy-of-implementation-of-a-chest-pain-center-at-a-community-hospital
#16
Alexandra Davis, Jason Chiu, Stanley K Lau, Yih Jen Kok, Jonathan Y H Wu
INTRODUCTION: Chest pain is the second leading cause for emergency department (ED) visits in the United States; however, <20% of the patients have acute coronary syndrome that require immediate attention. The HEART score is designed for rapid risk stratification of ED chest pain patients using the following criteria: history, electrocardiogram, age, risk factors, and troponin. It has been shown to be superior in identifying patients with low (HEART score 0-3) and high (7-10) risk of major adverse cardiac events, who can then be rapidly discharged or admitted for intervention...
December 2017: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/29135620/safety-of-a-1-hour-rule-out-high-sensitive-troponin-t-protocol-in-patients-with-chest-pain-at-the-emergency-department
#17
E Röttger, S de Vries-Spithoven, J B Reitsma, A Limburg, C E E van Ofwegen-Hanekamp, A W Hoes, J M Poldervaart
BACKGROUND: The 1-hour rule-out high-sensitive cardiac troponin T protocol (hs-cTnT), in which a serial troponin measurement is performed 1 hour after the first to assess the possibility of acute coronary syndrome (ACS), has been implemented in the European guidelines in 2015. Our aim was to assess the safety of this protocol in low-risk patients in the Emergency Department (ED) when implemented in daily practice. METHODS: Patients with acute chest pain presenting to the ED of our hospital and younger than 75 years were included (May 2013 to October 2014, The Netherlands)...
December 2017: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/29133330/improving-best-practise-for-patients-receiving-hospital-discharge-letters-a-realist-review-protocol
#18
Katharine Weetman, Geoffrey Wong, Emma Scott, Stephanie Schnurr, Jeremy Dale
INTRODUCTION: Discharge documents are important for transferring information from hospitals to the referring clinician; in the UK and many countries, this is often the patient's general practitioner or family physician. However, patients may or may not receive their discharge letters, and whether patients should routinely receive discharge letters remains unclear. METHODS AND ANALYSIS: The review will consolidate evidence on patients receiving discharge letters through the theory-driven approach of a realist review...
November 12, 2017: BMJ Open
https://www.readbyqxmd.com/read/29133320/effect-of-an-intensive-3-week-preoperative-home-rehabilitation-programme-in-patients-with-chronic-obstructive-pulmonary-disease-eligible-for-lung-cancer-surgery-a-multicentre-randomised-controlled-trial
#19
Hélène Laurent, Géraud Galvaing, Emilie Thivat, Emmanuel Coudeyre, Sylvie Aubreton, Ruddy Richard, Fabrice Kwiatkowski, Frederic Costes, Marc Filaire
INTRODUCTION: Surgery is the standard curative treatment for lung cancer but is only possible in patients with local tumour and preserved exercise capacity. Improving fitness before surgery can reduce postoperative complications and mortality. However, preoperative rehabilitation remains difficult to implement for several reasons. We aim to investigate the effectiveness of an intensive 3-week home-based preoperative exercise training programme on hospital discharge ability, postoperative complications and physical performance in patients with chronic obstructive pulmonary disease (COPD) who are eligible for lung cancer surgery...
November 12, 2017: BMJ Open
https://www.readbyqxmd.com/read/29133152/laparoscopic-assisted-uterus-retrieval-from-live-organ-donors-for-uterine-transplant
#20
Shailesh Puntambekar, Milind Telang, Pankaj Kulkarni, Sanjeev Jadhav, Ravindra Sathe, Neeta Warty, Seema Puntambekar, Sandesh Kade, Mangesh Panse, Nikhil Agarkhedkar, Giriraj Gandhi, Manoj Manchekar, Hirav Parekh, Kajal Parikh, Riddhi Desai, Mehul Mehta, Mihir Chitale, Sambit Nanda
OBJECTIVE: The authors present the first ever laparoscopic assisted uterus retrieval in live donor for uterus transplant. DESIGN: A step-by-step surgical demonstration SETTING: Galaxy CARE Laparoscopy Institute, Pune, India PATIENT(S): Two patients, ages 21 and 26 with Mayer Rokitansky Kuster Hauser (MRKH) syndrome and Ashermann's syndrome respectively, with their mothers as donors. INTERVENTION(S): A Twelve member team was formed. After review of available literature on uterine transplant a protocol was formulated and submitted to the IRB...
November 10, 2017: Journal of Minimally Invasive Gynecology
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