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https://www.readbyqxmd.com/read/28214762/paracaecal-hernia-a-case-report-on-the-evolving-role-of-laparoscopy
#1
Ammar Tayaran, Haider Abdulrasool, Hai T Bui
A paracaecal hernia, a type of pericaecal hernias, is a rare cause of small intestinal obstruction. Failure of early recognition and reduction of this type of internal hernia may lead to strangulation of the herniated intestine. There has been a number of case reports in the literature about the different types of pericaecal hernias, however the anatomy of these hernias is still poorly understood and the management is still evolving. We are presenting a 75year old woman, who presented clinically and radiologically with distal small intestinal obstruction...
January 17, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28213384/impact-of-a-pharmacy-student-driven-medication-delivery-service-at-hospital-discharge
#2
Jacalyn Rogers, Vinita Pai, Jenna Merandi, Char Catt, Justin Cole, Shannon Yarosz, Allison Wehr, Kayla Durkin, Chet Kaczor
PURPOSE: A pharmacy student-driven discharge service developed for patients to reduce the number of medication errors on after-visit summaries (AVSs) is discussed. METHODS: An audit of AVS documents was conducted before the implementation period (September 3 to October 23, 2013) to identify medication errors. As part of the audit, a pharmacist review of the discharge medication list was completed to determine the number and types of errors that occurred. A student-driven discharge service with AVS review was developed in collaboration with nursing and medical residents...
March 1, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28206936/independent-preoperative-predictors-of-prolonged-length-of-stay-after-laparoscopic-appendectomy-in-patients-over-30-years-of-age-experience-from-a-single-institution
#3
Eric S Wise, Stephen P Gadomski, Annette M Ilg, Camilo Bermudez, Emily W Chan, Michelle L Izmaylov, Samantha J Gridley, Jessica V Kaczmarek, Sir Norman T Melancon, Sarwat Ahmad, Kyle M Hocking, Jose J Diaz, Stephen M Kavic
Prompt discharge after laparoscopic appendectomy (LA) is a marker of quality of care, fiscally desirable and feasible in select patients. Patients over 30 comprise a more heterogeneous cohort known to experience worse outcomes after LA. We aimed to identify easily available preoperative risk factors portending a postoperative length of stay ≥2 days among patients above age 30. In this investigation, 296 included patients from a single institution who underwent LA for acute appendicitis from 2010 to 2014 were retrospectively reviewed for preoperative demographics, laboratory studies, comorbidities, presentation characteristics, radiographic finding, and other rationally selected factors for association with postoperative length of stay ≥2 days...
November 1, 2016: American Surgeon
https://www.readbyqxmd.com/read/28202833/-emergency-decompressive-craniotomy-in-the-emergency-room-was-effective-in-severe-acute-subdural-hematoma-treatment-two-case-reports
#4
Naoto Shiomi, Tadashi Echigo, Hideki Oka, Masahiro Nozawa, Michiko Okada, Shiho Hiraizumi, Fumitaka Kato, Hirokazu Koseki, Yoichi Hashimoto, Akihiko Hino
The outcome of severe acute subdural hematoma is unfavorable. In particular, patients with levels of consciousness of Glasgow Coma Scale(GCS)3 or 4 tend to be refractory to treatment. Decompressive craniotomy should be promptly performed to remove hematoma. However, if an operating room is not immediately available, emergency burr hole surgery is sometimes performed in the emergency room(primary care room)prior to craniotomy. A previous study has reported that the interval from injury to surgery influences the outcome of severe acute subdural hematoma...
February 2017: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/28202427/the-insula-lobe-and-sudden-unexpected-death-in-epilepsy-a-hypothesis
#5
Jia Li, Qianwen Ming, Weihong Lin
Sudden unexpected death in epilepsy (SUDEP) is a major cause of death in patients with refractory epilepsy, particularly those with chronic epilepsy. The physiopathological mechanisms underlying SUDEP have not been elucidated. Autonomic dysregulation of cardiac or respiratory function is thought to underlie SUDEP. Here, we present a summary of available evidence on the involvement of the insular lobe in the regulation of cardiorespiratory function. Ictal discharge that originates in the cortex can, primarily or secondarily, involve the insula lobe through epileptogenic signal networks, leading to cardiorespiratory dysfunction, central apnoea, arrhythmias, and sudden death in patients with epilepsy...
February 15, 2017: Epileptic Disorders: International Epilepsy Journal with Videotape
https://www.readbyqxmd.com/read/28184303/deprescribing-medicines-in-the-acute-setting-to-reduce-the-risk-of-falls
#6
Vanessa Marvin, Emily Ward, Alan J Poots, Katie Heard, Arvind Rajagopalan, Barry Jubraj
BACKGROUND: Falls are a common cause of morbidity and hospitalisation in older people. Inappropriate prescribing and polypharmacy contribute to falls risk in elderly patients. This study's aim was to quantify the problem and find out if medication review in the hospital setting led to deprescribing of medicines associated with falls risk. METHODS: Admissions records for elderly patients were examined to identify those whose presenting complaint included a fall. Inpatient medication charts, pharmaceutical care notes, medical notes and discharge summaries were examined to identify any falls-risk medicines from admission histories and to determine if any medication review took place, and whether or not changes were made as a result...
January 2017: European Journal of Hospital Pharmacy. Science and Practice
https://www.readbyqxmd.com/read/28178023/risk-factors-for-acute-care-hospital-readmission-in-older-persons-in-western-countries-a-systematic-review
#7
Mona Kyndi Pedersen, Gabriele Meyer, Lisbeth Uhrenfeldt
BACKGROUND: Hospital readmission in older persons is common and reported as a post-discharge adverse outcome from hospitalization. Readmission relates to a mix of factors associated with increasing age, living conditions, progression of disease as well as factors related to the processes of care. To allow health professionals to focus more intensively on patients at risk of readmission, there is a need to identify the characteristics of those patients. OBJECTIVES: To identify and synthesize the best available evidence on risk factors for acute care hospital readmission within one month of discharge in older persons in Western countries...
February 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/28166642/improving-timeliness-of-discharge-summaries-at-an-academic-affiliated-veterans-administration-hospital
#8
Blake John Anderson, Krysta Johnson-Martinez, Benjamin Flink, Jonathan Gandhi, Anne Tomolo
No abstract text is available yet for this article.
February 1, 2017: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/28157644/the-future-for-follow-up-of-gynaecological-cancer-in-europe-summary-of-available-data-and-overview-of-ongoing-trials
#9
REVIEW
S C Leeson, K Beaver, N P M Ezendam, R Mačuks, P L Martin-Hirsch, T Miles, M M Jeppesen, P T Jensen, P Zola
After completing treatment, most patients follow a pre-determined schedule of regular hospital outpatient appointments, which includes clinical examinations, consultations and routine tests. After several years of surveillance, patients are transferred back to primary care. However, there is limited evidence to support the effectiveness and efficiency of this approach. This paper examines the current rationale and evidence base for hospital-based follow-up after treatment for gynaecological cancer. We investigate what alternative models of care have been formally evaluated and what research is currently in progress in Europe, in order to make tentative recommendations for a model of follow-up...
January 19, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28152940/code-status-documentation-in-the-electronic-medical-record-for-patients-with-stage-iv-pancreatic-cancer
#10
Janet M Armstrong, Joseph D Ma, Carolyn Revta, Eric Roeland
: 125 Background: Improving incidence of code status documentation in the electronic medical record (EMR) has been suggested a better guidance for clinical care compared with a traditional advance directive. We have previously reported that in the absence of a template in the EMR, code status documentation was 36% and inconsistent in patients with advanced cancer. Utilizing a different cohort of patients with metastatic pancreatic cancer, we examined the prevalence of EMR code status documentation...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152885/creating-an-online-resource-providing-hospital-cancer-surgery-volumes-in-california
#11
Laurence C Baker, Jennifer Malin, Joseph Parker, Merry Holliday-Hanson, Niya Fong, Stephanie Teleki, Lance Lang, Maryann O'Sullivan
: 172 Background: Little evidence is available to help patients and providers, payers and policymakers find the highest-quality hospitals for cancer surgery. We initiated a groundbreaking effort in California ( www.calqualitycare.org ) to publicly report hospital cancer surgery volume data online. METHODS: With financial support from the nonprofit California HealthCare Foundation, we assembled a multidisciplinary team to oversee the project and ensure sound methodology...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152819/electronic-operative-reports-to-support-quality-improvement-and-patient-centered-care
#12
Elaine Maloney, Mary Agent-Katwala, Geoff Porter
: 95 Background: Operative reports (OP) for cancer surgery are usually narrated, although they provide inconsistent and incomplete information for patient care. National standards for cancer OP were unavailable until 2007. Over 10 years, surgeons in four Canadian provinces have transitioned from narrative to electronic synoptic reporting (ESP) for specific cancers. The electronic OP are now considered a patient medical record and integral to subsequent patient care. Surgeons are using electronic reports for quality assurance, billing, medical-legal conflict resolution and research...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152793/transitions-in-care-and-reduction-in-discharge-errors
#13
Tara Szyamnski, Megan Begnoche, Carol Chase, Michelle Moreau, Jessica Barnett
: 77 Background: Patients are often overwhelmed at the time of hospital discharge and focus on home rather than the discharge process. Fragmented communication and lack of planning between the hospital team, patient, family and primary oncologist can lead to frustration and delays in implementation of palliative or curative therapies and potential hospital readmission when the plan of care is not followed in a timely manner. Our goal is to avoid medication errors, delays in implementation of a care plan and reemergence of symptoms or new symptoms as a result of a suboptimal discharge transition...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28125429/which-indicators-to-include-in-a-crowding-scale-in-an-emergency-department-a-national-french-delphi-study
#14
Guilhem Noel, Camille Drigues, Gilles Viudes
BACKGROUND: Emergency department (ED) crowding is a serious international public health issue with a negative impact on quality of care. Despite two decades of research, there is no consensus on the indicators used to quantify crowding. The aim of our study was to select the most valid ED crowding indicators. MATERIALS AND METHODS: The Delphi method was used. Selected indicators originated from a literature review and propositions from FEDORU (National Emergency Department Observatory Network) workgroup...
January 25, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28123748/the-e-crabel-score-an-updated-method-for-auditing-medical-records
#15
Tharsika Myuran, Oliver Turner, Bijan Ben Doostdar, Bryony Lovett
In 2001 the CRABEL score was devised in order to obtain a numerical score of the standard of medical note keeping. With the advent of electronic discharge letters, many components of the CRABEL score are now redundant as computers automatically include some documentation. The CRABEL score was modified to form the e-CRABEL score. "Patient details on discharge letter" and "Admission and discharge dates on discharge letter" were replaced with "Summary of investigations on discharge letter" and "Documentation of VTE prophylaxis on the drug chart"...
2017: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/28121947/rehabilitation-needs-and-participation-restriction-in-patients-with-cognitive-disorder-in-the-chronic-phase-of-traumatic-brain-injury
#16
Hironobu Sashika, Kaoruko Takada, Naohisa Kikuchi
The purpose of this study was to clarify psychosocial factors/problems, social participation, quality of life (QOL), and rehabilitation needs in chronic-phase traumatic brain injury (TBI) patients with cognitive disorder discharged from the level-1 trauma center (L1-TC), and to inspect the effects of rehabilitation intervention to these subjects.A mixed-method research (cross-sectional and qualitative study) was conducted at an outpatient rehabilitation department.Inclusion criteria of subjects were transfer to the L1-TC due to TBI; acute-stage rehabilitation treatment received in the L1-TC from November 2006 to October 2011; age of ≥18 and <70 years at the time of injury; a score of 0-3 on the Modified Rankin Scale at discharge and that of 4-5 due to physical or severe aggressive behavioral comorbid disorders...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28118657/association-of-intensive-care-unit-patient-to-intensivist-ratios-with-hospital-mortality
#17
Hayley B Gershengorn, David A Harrison, Allan Garland, M Elizabeth Wilcox, Kathryn M Rowan, Hannah Wunsch
Importance: The patient-to-intensivist ratio (PIR) across intensive care units (ICUs) is not standardized and the association of PIR with patient outcome is not well established. Understanding the impact of PIR on outcomes is necessary to optimize senior medical staffing and deliver high-quality care. Objective: To test the hypotheses that: (1) there is significant variation in the PIR across ICUs and (2) higher PIRs are associated with higher hospital mortality for ICU patients...
January 24, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28104042/electronic-health-records-and-online-medical-records-an-asset-or-a-liability-under-current-conditions
#18
Judith Allen-Graham, Lauren Mitchell, Natalie Heriot, Roksana Armani, David Langton, Michele Levinson, Alan Young, Julian A Smith, Tom Kotsimbos, John W Wilson
Objective The aim of the present study was to audit the current use of medical records to determine completeness and concordance with other sources of medical information.Methods Medical records for 40 patients from each of five Melbourne major metropolitan hospitals were randomly selected (n=200). A quantitative audit was performed for detailed patient information and medical record keeping, as well as data collection, storage and utilisation. Using each hospital's current online clinical database, scanned files and paperwork available for each patient audited, the reviewers sourced as much relevant information as possible within a 30-min time allocation from both the record and the discharge summary...
January 20, 2017: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/28096249/natural-language-processing-to-extract-symptoms-of-severe-mental-illness-from-clinical-text-the-clinical-record-interactive-search-comprehensive-data-extraction-cris-code-project
#19
Richard G Jackson, Rashmi Patel, Nishamali Jayatilleke, Anna Kolliakou, Michael Ball, Genevieve Gorrell, Angus Roberts, Richard J Dobson, Robert Stewart
OBJECTIVES: We sought to use natural language processing to develop a suite of language models to capture key symptoms of severe mental illness (SMI) from clinical text, to facilitate the secondary use of mental healthcare data in research. DESIGN: Development and validation of information extraction applications for ascertaining symptoms of SMI in routine mental health records using the Clinical Record Interactive Search (CRIS) data resource; description of their distribution in a corpus of discharge summaries...
January 17, 2017: BMJ Open
https://www.readbyqxmd.com/read/28095901/risk-assessment-tools-to-predict-location-of-discharge-and-need-for-supportive-services-for-medical-patients-after-discharge-from-hospital-a-systematic-review-protocol
#20
Daniel M Kobewka, Daniel McIsaac, Michaël Chassé, Kednapa Thavorn, Sunita Mulpuru, Luke T Lavallée, Shane English, Justin Presseau, Alan J Forster
BACKGROUND: Patients who are discharged from hospital after an acute medical illness often have impaired function that prevents them from returning to their previous place of residence. Assessing each patient's post-discharge needs takes time and resources but is important in order to reduce unplanned readmissions and adverse events post-discharge. METHODS/DESIGN: We will conduct a systematic review to synthesize the evidence on prognostic models and their reported accuracy in predicting the location of discharge after a medical admission to an acute care hospital...
January 17, 2017: Systematic Reviews
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