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https://www.readbyqxmd.com/read/28641352/-do-general-surgeons-feel-adequately-prepared-for-the-complex-questions-associated-with-the-handling-of-multi-resistant-pathogens-results-of-the-mr2-survey
#1
Matthias May, Philipp J Spachmann, Steffen Lebentrau, Harald Schumacher, Christian Gilfrich, Hans-Martin Fritsche, Malte Vetterlein, Sabine Brookman-May, Martin Schostak, Florian M Wagenlehner, Maximilian Burger, Alexander Novotny, Robert Obermaier
Background At the present time, there is no evidence available as to the knowledge of general surgeons regarding multi-resistant pathogens (MRP) and the rational use of antibiotic medication (antibiotic stewardship/ABS) compared with physicians from other disciplines. Methods As part of the MR2 survey (Multiinstitutional Reconnaissance of practice with MultiResistant bacteria - a survey focussing on German hospitals), a questionnaire comprising 4 + 35 items was distributed to urologists, internists, gynaecologists and general surgeons in 18 hospitals...
June 2017: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/28640793/intraoperative-computed-tomography-ct-for-treating-giant-carotid-intracavernous-aneurysms
#2
Zhe Xue, Fuyu Wang, Zhenghui Sun, Hui Zhang, Chen Wu, Dongsheng Kong, Bainan Xu
BACKGROUND Giant carotid intracavernous aneurysm refers to those lesions larger than 2.5 cm and derived from a cavernous segment, accounting for about 30% of all intracranial tumors. Dynamic CT perfusion imaging (PCT) is a common method recently employed to evaluate cerebral perfusion. This study investigated the efficacy and clinical application of intraoperative CT in the surgery for giant symptomatic carotid intracavernous aneurysm. MATERIAL AND METHODS A retrospective analysis was performed on 23 cases with giant symptomatic carotid intracavernous aneurysm...
June 22, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28640776/early-fever-after-trauma-does-it-matter
#3
Holly E Hinson, Susan Rowell, Cynthia Morris, Amber L Lin, Martin A Schreiber
BACKGROUND: Fever is strongly associated with poor outcome after traumatic brain injury (TBI). We hypothesized that early fever is a direct result of brain injury and thus would be more common in TBI than in patients without brain injury, and associated with inflammation. METHODS: We prospectively enrolled patients with major trauma with and without TBI from a busy level I trauma center ICU. Patients were assigned to one of four groups based on their presenting Head Abbreviated Injury Severity Scale scores (HAIS): Polytrauma: Head AIS score >2, one other region>2, Isolated Head: Head AIS score>2, all other regions <3, Isolated Body: One region >2, excluding Head/Face, Minor Injury: No region with AIS>2...
June 20, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28640730/treating-patients-with-venous-leg-ulcers-in-the-acute-setting-part-1
#4
Irene Anderson
Leg ulcers present with a variety of aetiologies, sometimes in combination. The most common aetiology is venous, with treament involving compression, elevation and exercise; the most common treatment setting is the community. However, people with leg ulcers do sometimes require admission to hospital for conditions and situations which may, or may not, be ulcer-related. There is a lack of contemporary evidence on the experience of inpatients and insufficient analysis of the impact on healing and complications to the lower limb when patients with leg ulcers and compression therapy are admitted to hospital...
June 22, 2017: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/28637185/a-novel-method-of-open-reduction-and-internal-fixation-of-a-displaced-manubrial-fracture-using-distal-clavicle-locking-plates
#5
Daniel Miller, M Adeel Akhtar, Jonathan Fergusson, James L McVie
A 52-year-old man sustained a sternal fracture after a blunt traumatic chest injury. He was in severe pain in the intensive care unit, which resulted in difficulty breathing and increased analgesic requirement, and a decision was made to stabilize his manubrial fracture. Orthopaedic and thoracic surgeons jointly performed open reduction and internal fixation of the displaced manubrial fracture using 2 distal clavicle locking plates. This resulted in improvement in patient's pain and helped with his subsequent recovery and discharge from the hospital...
June 20, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28637170/neuroprotective-effect-of-pressure-oriented-flow-regulation-and-ph-stat-management-in-selective-antegrade-brain-perfusion-during-total-aortic-arch-repair
#6
Hisato Ito, Toru Mizumoto, Yasuhiro Sawada, Kazuya Fujinaga, Hironori Tempaku, Yasunori Yamamoto, Katsuhiro Tsutsui, Hideto Shimpo
OBJECTIVES: The aim of this study was to assess the safety and effectiveness of our selective antegrade brain perfusion (SABP) strategy, which is characterized by moderate hypothermic and low-pressure management under pH-stat using a completely closed cardiopulmonary bypass circuit with a single centrifugal pump. METHODS: Forty-nine consecutive patients (median age, 74) underwent total aortic arch replacement using a 4-branched graft. SABP was conducted with individual cannulation in all arch vessels...
June 20, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28637076/-clinical-course-of-an-early-childhood-onset-granulomatosis-with-polyangiitis
#7
Marco Krasselt, Matthias Pierer, Kerstin Amann, Anette Bachmann, Tom H Lindner
History A 26-year-old male patient presented with an eight-week history of unspecific symptoms such as weight loss and fever. Besides, he also suffered from haemoptysis, cough, and arthralgia. Since the age of twelve years, the patient has been treated for Wegner's granulomatosis. At the age of 20 years he received a kidney transplant which failed only four years later. Investigations The relapse we clinically suspected was confirmed by CT scan showing bilateral pulmonary manifestations. Moreover, we found highly positive antibodies against proteinase 3...
June 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28637044/depressed-patients-hospitalized-in-southeast-facing-rooms-are-discharged-earlier-than-patients-in-northwest-facing-rooms
#8
Krzysztof Gbyl, Helle Østergaard Madsen, Signe Dunker Svendsen, Paul Michael Petersen, Ida Hageman, Carlo Volf, Klaus Martiny
BACKGROUND AND AIM: Improvement in patients admitted to inpatient wards with severe depression is slow, and such patients are often discharged with residual symptoms which put them at risk for relapse. New treatments that can speed up recovery are highly desired. This naturalistic follow-up study in a specialized affective disorders unit investigated the impact of daylight on the length of hospital stay and improvement of depression. METHODS: For a period of 1 year, we collected data on sociodemographics, length of stay, vitamin D, and depression severity for patients in an inpatient affective disorders unit...
June 22, 2017: Neuropsychobiology
https://www.readbyqxmd.com/read/28636737/is-there-an-association-between-migraine-and-allergic-rhinitis
#9
Işıl Adadan Güvenç, Mustafa Acar, Nuray Bayar Muluk, Nagehan Erdogmus Kucukcan, Cemal Cingi
We conducted a prospective study to evaluate nasal signs and symptoms and to perform allergen-specific immunoglobulin E (IgE) testing to investigate the relationship between migraine and allergic rhinitis. Our study group consisted of 40 patients diagnosed with migraine-22 men and 18 women, aged 21 to 38 years (mean: 25.7). We compared their findings with a control group of 40 healthy adults-15 men and 25 women, aged 19 to 36 years (mean: 25.1). Allergen-specific IgE measurements were obtained with six groups of allergens: fungi, grass pollens, tree pollens, wild herbs, house dust mite 1, and house dust mite 2...
June 2017: Ear, Nose, & Throat Journal
https://www.readbyqxmd.com/read/28636707/incidence-and-predictors-of-opioid-prescription-at-discharge-after-traumatic-injury
#10
Muhammad Ali Chaudhary, Andrew J Schoenfeld, Alyssa F Harlow, Anju Ranjit, Rebecca Scully, Ritam Chowdhury, Meesha Sharma, Stephanie Nitzschke, Tracey Koehlmoos, Adil H Haider
Importance: In the current health care environment with increased scrutiny and growing concern regarding opioid use and abuse, there has been a push toward greater regulation over prescriptions of opioids. Trauma patients represent a population that may be affected by this regulation, as the incidence of pain at hospital discharge is greater than 95%, and opioids are considered the first line of treatment for pain management. However, the use of opioid prescriptions in trauma patients at hospital discharge has not been explored...
June 21, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28636702/analysis-of-survival-after-initiation-of-continuous-renal-replacement-therapy-in-a-surgical-intensive-care-unit
#11
James M Tatum, Galinos Barmparas, Ara Ko, Navpreet Dhillon, Eric Smith, Daniel R Margulies, Eric J Ley
Importance: Continuous renal replacement therapy (CRRT) benefits patients with renal failure who are too hemodynamically unstable for intermittent hemodialysis. The duration of therapy beyond which continued use is futile, particularly in a population of patients admitted to and primarily cared for by a surgical service (hereinafter referred to as surgical patients), is unclear. Objective: To analyze proportions of and independent risk factors for survival to discharge after initiation of CRRT among patients in a surgical intensive care unit (SICU)...
June 21, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28636639/predictive-value-of-serum-transthyretin-for-outcome-in-acute-ischemic-stroke
#12
Wojciech Ambrosius, Slawomir Michalak, Radosław Kazmierski, Natalia Andrzejewska, Wojciech Kozubski
INTRODUCTION: The impact of choroid plexus with its blood-cerebrospinal fluid barrier in the ischemic stroke pathology is poorly explored. Transthyretin (TTR) is a protein synthesized in liver and just in choroid plexus. OBJECTIVES: The current study was designed to assess the prognostic value of serum TTR for functional outcome (at the time of hospital discharge) and long-term (one-year) overall mortality in ischemic stroke patients. PATIENTS AND METHODS: We conducted a prospective observational study...
2017: PloS One
https://www.readbyqxmd.com/read/28636579/regeneration-orientation-is-better-than-resistance-orientation-in-behaviour-activation-results-from-an-intervention-study-with-psychosomatic-patients
#13
Josephine Otto, Michael Linden
The meaning of positive activities in mental health is widely known and found its entrance in therapeutically and empirical work. It also found it's entrance to current therapeutic developments. Different strategies for assessment and promotion of activity level exist. Patients were acquired from a department of psychosomatic medicine in a German rehabilitation center and randomly allocated to two treatment groups ("regeneration" vs "resistance" group). Data from 62 patients in the regeneration group and 65 patients in the resistance group was compared with 43 patients who received a "treatment as usual"...
June 2017: Psychiatria Danubina
https://www.readbyqxmd.com/read/28635634/despite-inflammation-supplemented-essential-amino-acids-may-improve-circulating-levels-of-albumin-and-haemoglobin-in-patients-after-hip-fractures
#14
Roberto Aquilani, Ginetto Carlo Zuccarelli, Anna Maria Condino, Michele Catani, Carla Rutili, Consiglia Del Vecchio, Pietro Pisano, Manuela Verri, Paolo Iadarola, Simona Viglio, Federica Boschi
Essential amino acids (EAAs) are nutritional substrates that promote body protein synthesis; thus we hypothesised that their supplementation may improve circulating albumin (Alb) and haemoglobin (Hb) in rehabilitative elderly patients following hip fractures (HF). Out of the 145 HF patients originally enrolled in our study, 112 completed the protocol. These subjects were divided into two randomised groups, each containing 56 patients. For a period of two months, one group (age 81.4 ± 8.1 years; male/female 27/29) received a placebo, and the other (age 83...
June 21, 2017: Nutrients
https://www.readbyqxmd.com/read/28635194/volitional-rehabilitative-assessments-in-patients-admitted-in-a-post-intensive-care-step-down-unit-a-feasibility-study
#15
Mara Paneroni, Francesco D' Abrosca, Georges Fokom, Laura Comini, Michele Vitacca
A high variability in functional tests and activities used during the pulmonary rehabilitation has been observed in post-intensive care unit (ICU) patients, and the best battery of tests to adopt has not been described yet. We tested in patients admitted in a post-ICU Step Down Unit the ability to perform the more frequent functional volitional tests. The relations of each single volitional test with general disability and dyspnea at discharge were also evaluated. Ten volitional tests including: bedside spirometry test (ST: FEV1%, FVC%), maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), Peak Expiratory Flow during Cough (PCEF), Quadriceps Muscle Strength (QMS), latissimus Dorsi and teres Major Strength (DMS), Brachial biceps Muscle Strength (BMS), effort tolerance measured by sit-to-stand test, Takahashi test and 6-Min Walking Test (6MWT), were evaluated in post-ICU patients at entry and discharge from in-hospital rehabilitation...
May 18, 2017: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
https://www.readbyqxmd.com/read/28634542/angioedema-perioperative-management
#16
Andrew A Maynard, Christina F Burger, Joseph J Schlesinger
OBJECTIVE: To describe the perioperative management of a patient with acquired angioedema (AAE). METHODS: A 66-year-old Caucasian male presented from an outside hospital with a history of acquired angioedema and gastrointestinal stromal tumor-related intractable urticaria and mastocytosis. He was admitted for urgent laparoscopic partial gastrectomy, secondary to gastric outlet obstruction symptomatology. Previous combined attacks were characterized by a widespread rash, abdominal pain and respiratory distress resulting in hospitalization...
2017: SAGE open medical case reports
https://www.readbyqxmd.com/read/28634501/subarachnoid-hemorrhage-and-long-term-stroke-risk-after-traumatic-brain-injury
#17
Nicholas A Morris, Joséphine Cool, Alexander E Merkler, Hooman Kamel
BACKGROUND: Recent studies suggest that traumatic brain injury (TBI) is a risk factor for subsequent ischemic stroke, even years after the initial insult. The mechanisms of the association remain unclear. The presence of traumatic subarachnoid hemorrhage (tSAH) may mediate the effect of TBI on long-term stroke risk, as it has previously been linked to short-term vasospasm and delayed cerebral ischemia. METHODS: Using administrative claims data, we conducted a retrospective cohort study of acute care hospitalizations...
July 2017: Neurohospitalist
https://www.readbyqxmd.com/read/28634310/-a-case-of-coexistent-glossopharyngeal-neuralgia-and-hemifacial-spasm-successfully-treated-with-transposition-of-the-vertebral-artery
#18
Takashi Fujii, Naoki Otani, Yohei Otsuka, Takashi Matsumoto, Shunsuke Tanoue, Hideaki Ueno, Satoshi Tomura, Arata Tomiyama, Terushige Toyooka, Kojiro Wada, Kentaro Mori
A case of coexistent glossopharyngeal neuralgia and hemifacial spasm was treated by transposition of the vertebral artery. A 60-year-old man was referred to our hospital due to pain in the left posterior part of the tongue that was difficult to control with oral medication at a local hospital. The diagnosis was left glossopharyngeal neuralgia based on the symptoms, imaging findings, and lidocaine test results. Moreover, the patient had left hemifacial spasm. Microvascular decompression was performed, which confirmed that the vertebral artery was compressing the lower cranial nerve and the posterior inferior cerebellar artery was compressing the root exit zone of the facial nerve...
June 2017: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/28633782/factors-predicting-length-of-hospital-stay-and-extended-care-facility-admission-after-hindfoot-arthrodesis-procedures
#19
Jacob Deister, Brian G Cothern, Chad Williams, Andrew W Froehle, Richard T Laughlin
Delayed identification of patients requiring admission to extended care facilities (ECFs) can lead to greater healthcare costs through an increased length of hospital stay (LOHS). Previous studies of hip and knee arthroplasty identified factors associated with a likely discharge to an ECF. These issues have not been extensively studied for major hindfoot procedures. We conducted a retrospective review of 198 cases treated during a 3-year period to identify the risk factors for an extended LOHS and ECF admission after ankle arthrodesis, triple arthrodesis, pantalar arthrodesis, and subtalar arthrodesis...
July 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28633658/nucleated-red-blood-cells-critical-illness-survivors-and-postdischarge-outcomes-a-cohort-study
#20
Steven W Purtle, Clare M Horkan, Takuhiro Moromizato, Fiona K Gibbons, Kenneth B Christopher
BACKGROUND: Little is known about risk factors associated with out-of-hospital outcomes in survivors of critical illness. We hypothesized that the presence of nucleated red blood cells in patients who survived critical care would be associated with adverse outcomes following hospital discharge. METHODS: We performed a two-center observational cohort study of patients treated in medical and surgical intensive care units in Boston, Massachusetts. All data were obtained from the Research Patient Data Registry at Partners HealthCare...
June 21, 2017: Critical Care: the Official Journal of the Critical Care Forum
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