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https://www.readbyqxmd.com/read/28801413/effectiveness-of-rehabilitation-after-a-total-hip-arthroplasty-a-protocol-for-an-observational-study-for-the-comparison-of-usual-care-in-the-netherlands-versus-germany
#1
Gesine H Seeber, Annet Wijnen, Djordje Lazovic, Sjoerd K Bulstra, Günter Dietz, Christiaan P van Lingen, Martin Stevens
INTRODUCTION: Osteoarthritis is the most common joint disorder worldwide. Total hip arthroplasty (THA) is considered one of the most effective treatments for end-stage hip osteoarthritis. The number of THAs is expected to increase dramatically in the coming decades. Usual postoperative rehabilitation after primary THA differs between the German and the Dutch system. In the Netherlands, patients undergo fast-track surgery and are discharged into their home environment within a few days without receiving any aftercare...
August 11, 2017: BMJ Open
https://www.readbyqxmd.com/read/28801130/prospective-implementation-of-enhanced-recovery-after-surgery-protocols-to-radical-cystectomy
#2
Karl H Pang, Ruth Groves, Suresh Venugopal, Aidan P Noon, James W F Catto
BACKGROUND: Multimodal enhanced recovery after surgery (ERAS) regimens have improved outcomes from colorectal surgery. OBJECTIVE: We report the application of ERAS to patients undergoing radical cystectomy (RC). DESIGN, SETTING, AND PARTICIPANTS: Prospective collection of outcomes from consecutive patients undergoing RC at a single institution. INTERVENTION: Twenty-six components including prehabilitation exercise, same day admission, carbohydrate fluid loading, targeted intraoperative fluid resuscitation, regional local anaesthesia, cessation of nasogastric tubes, omitting oral bowel preparation, avoiding drain use, early mobilisation, chewing gum use, and audit...
August 8, 2017: European Urology
https://www.readbyqxmd.com/read/28800052/pediatric-post-anesthesia-care-unit-discharge-criteria-a-scoping-review-protocol
#3
Mary Ryals, Michelle Palokas
The objectives of this review are to explore existing literature on discharge criteria, tools and strategies utilized in pediatric post-anesthesia care units (PACUs) after outpatient surgery, examine and conceptually map the evidence, and identify gaps in the literature.Specifically, the review question is: what criteria, tools and strategies are being used in pediatric PACUs for discharge?
August 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/28799452/syncope-current-knowledge-uncertainties-and-strategies-for-management-optimisation-in-the-emergency-department
#4
Filippo Numeroso, Gianluigi Mossini, Giuseppe Lippi, Gianfranco Cervellin
Admission rates and expenditures for syncope remain high. This unsatisfactory management could be due to several factors, including lack of evidence-based strategy, poor accuracy of clinical decision rules, difficulty in disseminating guidelines, as well as uncertainties concerning management of intermediate-risk patients and role of observation protocols and syncope units. To optimise management, it has been proposed to adopt a pragmatic, symptoms-based definition of syncope and a classification related to the underlying mechanism rather than suspected aetiology...
August 11, 2017: Acta Cardiologica
https://www.readbyqxmd.com/read/28797529/voice-specialized-speech-language-pathologist-s-criteria-for-discharge-from-voice-therapy
#5
Amanda I Gillespie, Jackie Gartner-Schmidt
OBJECTIVE: No standard protocol exists to determine when a patient is ready and able to be discharged from voice therapy. The aim of the present study was to determine what factors speech-language pathologists (SLPs) deem most important when discharging a patient from voice therapy. A second aim was to determine if responses differed based on years of voice experience. METHODS: Step 1: Seven voice-specialized SLPs generated a list of items thought to be relevant to voice therapy discharge...
August 7, 2017: Journal of Voice: Official Journal of the Voice Foundation
https://www.readbyqxmd.com/read/28797307/using-smartphones-to-decrease-substance-use-via-self-monitoring-and-recovery-support-study-protocol-for-a-randomized-control-trial
#6
Christy K Scott, Michael L Dennis, David H Gustafson
BACKGROUND: Alcohol abuse, other substance use disorders, and risk behaviors associated with the human immunodeficiency virus (HIV) represent three of the top 10 modifiable causes of mortality in the US. Despite evidence that continuing care is effective in sustaining recovery from substance use disorders and associated behaviors, patients rarely receive it. Smartphone applications (apps) have been effective in delivering continuing care to patients almost anywhere and anytime. This study tests the effectiveness of two components of such apps: ongoing self-monitoring through Ecological Momentary Assessments (EMAs) and immediate recovery support through Ecological Momentary Interventions (EMIs)...
August 10, 2017: Trials
https://www.readbyqxmd.com/read/28795846/a-novel-non-opioid-protocol-for-medically-supervised-opioid-withdrawal-and-transition-to-antagonist-treatment
#7
Gregory Rudolf, Jim Walsh, Abigail Plawman, Paul Gianutsos, William Alto, Lloyd Mancl, Vania Rudolf
BACKGROUND: The clinical feasibility of a novel non-opioid and benzodiazepine-free protocol was assessed for the treatment of medically supervised opioid withdrawal and transition to subsequent relapse prevention strategies. METHODS: A retrospective chart review of DSM-IV diagnosed opioid-dependent patients admitted for inpatient medically supervised withdrawal examined 84 subjects (52 males, 32 females) treated with a 4-day protocol of scheduled tizanidine, hydroxyzine, and gabapentin...
August 10, 2017: American Journal of Drug and Alcohol Abuse
https://www.readbyqxmd.com/read/28793969/lung-ultrasound-in-internal-medicine-a-bedside-help-to-increase-accuracy-in-the-diagnosis-of-dyspnea
#8
Tiziano Perrone, Alessia Maggi, Carmelo Sgarlata, Ilaria Palumbo, Elisa Mossolani, Sara Ferrari, Ariel Melloul, Roberta Mussinelli, Michele Boldrini, Ambra Raimondi, Aderville Cabassi, Francesco Salinaro, Stefano Perlini
BACKGROUND: Dyspnea is one of the most frequent causes of admission in Internal Medicine wards, leading to a sizeable utilization of medical resources. STUDY DESIGN AND METHODS: The role of bedside lung ultrasound (LUS) was evaluated in 130 consecutive patients (age: 81±9years), in whom blindly collected LUS results were compared with data obtained by clinical examination, medical history, blood analysis, and chest X-ray. Dyspnea etiology was classified as "cardiac" (n=80), "respiratory" (n=36) or "mixed" (n=14), according to the discharge diagnosis (congestive heart failure either alone [n=80] or associated with pneumonia [n=14], pneumonia [n=24], and obstructive disventilatory syndrome [n=12])...
August 6, 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/28793287/early-discharge-programme-on-hospital-at-home-evaluation-for-patients-with-immediate-postoperative-course-after-laparoscopic-colorectal-surgery
#9
Marcos Pajarón-Guerrero, Manuel Francisco Fernández-Miera, Juan Carlos Dueñas-Puebla, Carmen Cagigas-Fernández, Iciar Allende-Mancisidor, Lidia Cristóbal-Poch, Manuel Gómez-Fleitas, Maria Asuncion Manzano-Peral, Carmen Rosa Gonzalez-Fernandez, Ana Aguilera-Zubizarreta, Pedro Sanroma-Mendizábal
BACKGROUND: To audit the safety of the early hospital discharge care model offered by a Hospital-at-home (HAH) unit during early postoperative follow-up of these patients, and to determine whether this care model is more efficient compared to the traditional care model. METHODS: A prospective study of 50 patients included consecutively for 1 year in an early discharge programme after laparoscopic colorectal surgery was performed. As of day 3 after surgery, if the patient met the relevant inclusion criteria they were transferred to the HAH unit...
August 9, 2017: European Surgical Research. Europäische Chirurgische Forschung. Recherches Chirurgicales Européennes
https://www.readbyqxmd.com/read/28790545/smoking-cessation-advisory-intervention-in-patients-with-cardiovascular-disease
#10
Ioannis Vogiatzis, Alexandra Pantzartzidou, Sarantis Pittas, Eleutherios Papavasiliou
INTRODUCTION: Several studies have examined the efficacy of smoking cessation therapies in the general population. However little is known about the efficacy of these advisory methods in cardiovascular patients. AIM: The aim of the study is to determine the prevalence and the characteristics of smoking abstinence in cardiovascular patients, after a smoking intervention during hospitalization. METHODS: The study involved 442 patients, smokers admitted for cardiovascular disease to the Department of Cardiology...
April 2017: Medical Archives
https://www.readbyqxmd.com/read/28789708/effectiveness-of-person-and-family-centered-care-transition-interventions-a-systematic-review-protocol
#11
Chantal Backman, Julie Chartrand, Orvie Dingwall, Beverley Shea
BACKGROUND: Care transitions from the hospital to home are critical to the sustainability of our health care system. Ineffective care transitions can be caused by high incidences of post-discharge adverse events, by poor communication with patients, and/or by inadequate information transfer between providers from the hospital to home. Any one of these can lead to fragmented care, high readmission rates, increased visits to the emergency department, and ultimately poor patient outcomes...
August 8, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/28782157/initial-clinical-experiences-with-novel-diagonal-ecls-system-in-pediatric-cardiac-patients
#12
Yildiz Okan, Haydin Sertac, Ozturk Erkut, Kasar Taner, Onan I Selen, Altin H Firat, Cine Nihat, Ayyildiz Pelin, Erkan Halime, Guzeltas Alper
Extracorporeal life support (ECLS) provides mechanical support following cardiac surgery when respiratory or cardiac failure occurs. The aim of this study was to analyze the safety and feasibility of the Medos Deltastream diagonal pump (DP3) ECLS system in pediatric cardiac patients. We described the technical considerations and risk factors related to the survival outcomes in 102 pediatric cardiac patients who received ECLS support between March 2011 and April 2016. We switched from the DP2 system, which was used for the initial 25 patients, to the DP3 system after November 2012...
August 2017: Artificial Organs
https://www.readbyqxmd.com/read/28768548/the-anticoagulated-trauma-patient-in-the-age-of-the-direct-oral-anticoagulants-a-canadian-perspective
#13
Brendan Wood, Barto Nascimento, Sandro Rizoli, Michelle Sholzberg, Amanda McFarlan, Andrea Phillips, Alun D Ackery
BACKGROUND: The anticoagulated trauma patient presents a particular challenge to the critical care physician. Our understanding of these patients is defined and extrapolated by experience with patients on warfarin pre-injury. Today, many patients who would have been on warfarin are now prescribed the Direct Oral Anticoagulants (DOACs) a class of anticoagulants with entirely different mechanisms of action, effects on routine coagulation assays and approach to reversal. METHODS: Trauma registry data from Toronto's (Ontario, Canada) two Level 1 trauma centres were used to identify patients on oral anticoagulation pre-injury from June 1, 2014 to June 1, 2015...
August 2, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28767599/investigation-of-the-status-quo-of-massive-blood-transfusion-in-china-and-a-synopsis-of-the-proposed-guidelines-for-massive-blood-transfusion
#14
Jiang-Cun Yang, Qiu-Shi Wang, Qian-Li Dang, Yang Sun, Cui-Xiang Xu, Zhan-Kui Jin, Ting Ma, Jing Liu
The aim of this study was to provide an overview of massive transfusion in Chinese hospitals, identify the important indications for massive transfusion and corrective therapies based on clinical evidence and supporting experimental studies, and propose guidelines for the management of massive transfusion. This multiregion, multicenter retrospective study involved a Massive Blood Transfusion Coordination Group composed of 50 clinical experts specializing in blood transfusion, cardiac surgery, anesthesiology, obstetrics, general surgery, and medical statistics from 20 tertiary general hospitals across 5 regions in China...
August 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28762896/ambulance-delivered-transdermal-glyceryl-trinitrate-versus-sham-for-ultra-acute-stroke-rationale-design-and-protocol-for-the-rapid-intervention-with-glyceryl-trinitrate-in-hypertensive-stroke-trial-2-right-2-trial-isrctn26986053
#15
Jason P Appleton, Polly Scutt, Mark Dixon, Harriet Howard, Lee Haywood, Diane Havard, Trish Hepburn, Tim England, Nikola Sprigg, Lisa J Woodhouse, Joanna M Wardlaw, Alan A Montgomery, Stuart Pocock, Philip M Bath
Rationale Vascular nitric oxide levels are low in acute stroke and donors such as glyceryl trinitrate have shown promise when administered very early after stroke. Potential mechanisms of action include augmentation of cerebral reperfusion, thrombolysis and thrombectomy, lowering blood pressure, and cytoprotection. Aim To test the safety and efficacy of four days of transdermal glyceryl trinitrate (5 mg/day) versus sham in patients with ultra-acute presumed stroke who are recruited by paramedics prior to hospital presentation...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28762594/evaluation-of-outpatient-therapeutic-programme-otp-for-treatment-of-severe-acute-malnutrition-in-yemen-a-focus-on-treatment-default-and-its-risk-factors
#16
Mohammed Al Amad, Lina Al-Eryani, Abdulwahed Al Serouri, Yousef S Khader
OBJECTIVES: This study aimed to measure the treatment default rate among children with severe acute malnutrition (SAM) who were admitted to the outpatient therapeutic programme (OTP) in Yemen and determine its risk factors. METHODS: A prospective study was conducted among children with SAM who were newly admitted to the 11 OTPs in primary health centres of Sana'a city. A pretested semistructured questionnaire was used for data collection at admission and at after 2 months of admission to the OTP...
August 1, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28761868/standardizing-the-protocols-for-enhanced-recovery-from-colorectal-cancer-surgery-are-we-a-step-closer-to-ideal-recovery
#17
Mosab Shetiwy, Tamer Fady, Fayez Shahatto, Ahmed Setit
PURPOSE: Enhanced recovery protocols are being implemented into the standard of care in surgical practice. This study aimed to insert a steadfast set of elements into the perioperative care pathway to establish an improved recovery program for colorectal cancer patients. METHODS: Seventy patients planned for elective laparoscopic colorectal resection were randomized into 2 groups: conventional recovery group (n = 35) and enhanced recovery group (n = 35). The primary outcome was the length of hospital stay...
June 2017: Annals of Coloproctology
https://www.readbyqxmd.com/read/28760210/a-randomized-trial-of-a-1-hour-troponin-t-protocol-in-suspected-acute-coronary-syndromes-design-of-the-rapid-assessment-of-possible-acs-in-the-emergency-department-with-high-sensitivity-troponin-t-rapid-tnt-study
#18
Cynthia Papendick, Andrew Blyth, Anil Seshadri, Michael J R Edmonds, Tom Briffa, Louise Cullen, Stephen Quinn, Jon Karnon, Anthony Chuang, Adam J Nelson, Matthew Horsfall, Erin Morton, Derek P Chew
BACKGROUND: Protocols incorporating high-sensitivity troponin to guide decision making in the disposition of patients with suspected acute coronary syndromes (ACS) in the emergency department have received a lot of attention. Traditionally, patients with chest pain have required long periods of observation in emergency department before being deemed safe for discharge. In an era of limited health service resources, a protocol that could discharge patients safely within an hour of presentation is extremely attractive...
August 2017: American Heart Journal
https://www.readbyqxmd.com/read/28753074/acute-pneumonitis-associated-with-nickel-carbonyl-exposure-in-the-workplace
#19
Nena Bowman, E Martin Caravati, B Zane Horowitz, Barbara Insley Crouch
BACKGROUND: We describe the clinical course of one industrial technician occupationally exposed to nickel carbonyl (NiC). CASE REPORT: A 50-year-old male industrial technician presented with complaints of nausea, myalgia, and cough to a local clinic after suspected occupational exposure to nickel carbonyl. He has no history of lung disease or smoking. His initial urine nickel concentration was 692 ug/L. He had infiltrates on the initial chest X-ray (CXR) and an oxygen saturation (O2) of 97% on room air...
July 28, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28751837/anmco-sic-consensus-document-cardiology-networks-for-outpatient-heart-failure-care
#20
Nadia Aspromonte, Michele Massimo Gulizia, Andrea Di Lenarda, Andrea Mortara, Ilaria Battistoni, Renata De Maria, Michele Gabriele, Massimo Iacoviello, Alessandro Navazio, Daniela Pini, Giuseppe Di Tano, Marco Marini, Renato Pietro Ricci, Gianfranco Alunni, Donatella Radini, Marco Metra, Francesco Romeo
Changing demographics and an increasing burden of multiple chronic comorbidities in Western countries dictate refocusing of heart failure (HF) services from acute in-hospital care to better support the long inter-critical out-of- hospital phases of HF. In Italy, as well as in other countries, needs of the HF population are not adequately addressed by current HF outpatient services, as documented by differences in age, gender, comorbidities and recommended therapies between patients discharged for acute hospitalized HF and those followed-up at HF clinics...
May 2017: European Heart Journal Supplements: Journal of the European Society of Cardiology
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