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https://www.readbyqxmd.com/read/28938433/type-2-diabetes-and-osteoporosis-a-guide-to-optimal-management
#1
Stavroula Paschou, Anastasia D Dede, Panagiotis G Anagnostis, Andromachi Vryonidou, Daniel Morganstein, Dimitrios G Goulis
Context: Both type 2 diabetes (T2D) and osteoporosis are affected by aging and quite often co-exist. Furthermore, the fracture risk in patients with T2D is increased. The aim of this article is to review updated information on osteoporosis and fracture risk in patients with T2D, to discuss the effects of diabetes treatment on bone metabolism, as well as the effect of anti-osteoporotic medications on the incidence and control of T2D and to provide a personalized guide to the optimal management...
June 21, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28938413/prenatal-diagnosis-of-resistance-to-thyroid-hormone-and-its-clinical-implications
#2
Theodora Pappa, João Anselmo, Sunnee Mamanasiri, Alexandra M Dumitrescu, Roy E Weiss, Samuel Refetoff
Context: Resistance to thyroid hormone beta (RTHβ) is an autosomal dominant disorder characterized by reduced sensitivity of target tissues to thyroid hormones (TH). Individuals with RTHβ have high TH levels usually due to mutations in the TH receptor beta (THRB) gene. The management of RTHβ during pregnancy is challenging as wild-type (WT) fetuses born to RTHβ mothers have low birth weight and suppressed postnatal TSH, due to intrauterine exposure to excess TH. Objective: To determine birth weight and postnatal TSH of WT fetuses carried by mothers with RTHβ whose fT4 levels were maintained below 20% the upper limit of normal (ULN)...
August 4, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28937323/clinical-characteristics-and-temporal-profile-of-recovery-in-patients-with-favorable-outcomes-at-6-months-after-severe-traumatic-brain-injury
#3
Aditya Vedantam, Claudia S Robertson, Shankar P Gopinath
OBJECTIVE Early withdrawal of life-sustaining treatment due to expected poor prognosis is responsible for the majority of in-house deaths in severe traumatic brain injury (TBI). With increased focus on the decision and timing of withdrawal of care in patients with severe TBI, data on early neurological recovery in patients with a favorable outcome is needed to guide physicians and families. METHODS The authors reviewed prospectively collected data obtained in 1241 patients with head injury who were treated between 1986 and 2012...
September 22, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28936545/open-tracheostomy-training-a-nationwide-survey-among-otolaryngology-head-and-neck-surgery-residents
#4
Limor Muallem-Kalmovich, Jacob Pitaro, Ayman Asaly, Alex Kessler, Ephraim Eviatar, Moran Shteiner, Tal Marom
The aim of this study was to examine the training methods and needs of Otolaryngology-Head and Neck Surgery (OTO-HNS) residents to independently perform open tracheostomy (OT). An anonymous 26-items questionnaire pertaining to OT teaching aspects was distributed to all 93 Israeli OTO-HNS residents during March-June 2016. Residents were categorized as 'juniors,' if they were in their post-graduate year (PGY)-1 and PGY-2; 'mid-residency' (PGY-3 and PGY-4); or 'seniors' (PGY-5 and PGY-6). Response rate was 74% (n = 69)...
September 21, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28936486/the-burden-and-social-determinants-of-asthma-for-adults-in-the-state-of-georgia
#5
Mark Ebell, Christian Marchello, Jean O'Connor
BACKGROUND: Asthma is a serious chronic health condition, and social determinants may affect its prevalence. METHODS: Data from the Behavioral Risk Factors Surveillance Survey (BRFSS), the Georgia Asthma Call-back Survey (ACBS), and the Georgia hospital and emergency department survey for patients with a diagnosis of asthma were used. All data were from the years 2011 through 2014. SAS and SUDAAN software were used to calculate weighted prevalence estimates and to perform univariate and multivariate analyses of the association between social determinants, other risk factors, and asthma outcomes...
2017: Journal of the Georgia Public Health Association
https://www.readbyqxmd.com/read/28936143/assessment-of-readiness-of-academic-emergency-departments-in-the-central-region-of-saudi-arabia-to-receive-a-sick-child
#6
Fahad Saleh Alhajjaj, Abdullah Saleh Aldamigh
OBJECTIVE: We sought to assess the readiness of general emergency departments (EDs) in academic hospitals in the central region of the Kingdom of Saudi Arabia (KSA) to manage pediatric patients using an international tool: The American Academy of Pediatrics, American College of Emergency Physicians, and Emergency Nurses Association guidelines, which include facilities, personnel, safety, and other components. METHODS: We assessed eligible centers during multiple visits from January 2016 to May 2016 in which we inspected the EDs and conducted interviews with their respective leadership in which we independently recorded our observations...
July 2017: International Journal of Health Sciences
https://www.readbyqxmd.com/read/28935832/an-electronic-trigger-based-on-care-escalation-to-identify-preventable-adverse-events-in-hospitalised-patients
#7
Viraj Bhise, Dean F Sittig, Viralkumar Vaghani, Li Wei, Jessica Baldwin, Hardeep Singh
BACKGROUND: Methods to identify preventable adverse events typically have low yield and efficiency. We refined the methods of Institute of Healthcare Improvement's Global Trigger Tool (GTT) application and leveraged electronic health record (EHR) data to improve detection of preventable adverse events, including diagnostic errors. METHODS: We queried the EHR data repository of a large health system to identify an 'index hospitalization' associated with care escalation (defined as transfer to the intensive care unit (ICU) or initiation of rapid response team (RRT) within 15 days of admission) between March 2010 and August 2015...
September 21, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/28935626/wide-variability-in-prethrombectomy-workflow-practices-in-the-united-states-a-multicenter-survey
#8
A P Kansagra, G C Meyers, M S Kruzich, D T Cross, C J Moran
BACKGROUND AND PURPOSE: Clinical outcomes in patients with acute ischemic stroke caused by large vessel occlusion depend on the speed and quality of workflows leading to mechanical thrombectomy. In the absence of universally accepted best practices for workflow, developing stroke hospitals can benefit from improved awareness of real-world workflows in effect at experienced centers. To this end, we surveyed prethrombectomy workflow practices at stroke centers throughout the United States...
September 21, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28935457/-development-and-implementation-of-an-outpatient-clinic-at-an-initial-reception-centre-for-asylum-seekers-in-the-german-federal-state-of-baden-wuerttemberg
#9
C Nikendei, D Huhn, G Adler, P Becker von Rose, T M Eckstein, B Fuchs, S C Gewalt, B Greiner, T Günther, W Herzog, T Junghanss, T Krczal, D Lorenzen, T Lutz, M A Manigault, N Reinhart, M Rodenberg, I Schelletter, J Szecsenyi, R Steen, C Straßner, M Thomsen, K Wahedi, K Bozorgmehr
In 2015, more than 890,000 asylum seekers were registered in Germany. The provision of medical and psychosocial care for asylum seekers is facing numerous obstacles. Access to health care is mostly insufficient, particularly in initial reception centres. The present article describes the development and implementation of an interdisciplinary outpatient clinic for asylum seekers at the main registration authority in the state of Baden-Wuerttemberg operated by physicians of the University Hospital of Heidelberg and the local Medical Association in Heidelberg...
September 19, 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/28934404/organizational-and-managerial-factors-associated-with-clinical-practice-guideline-adherence-a-simulation-based-study-in-36-french-hospital-wards
#10
Florence Saillour-Glénisson, Marion Kret, Sandrine Domecq, Matthieu Sibé, Valentin Daucourt, Virginie Migeot, David Veillard, Philippe Michel
Objectives: To identify managerial and organizational characteristics of multi-specialty medicine wards and individual characteristics of health professionals that are most strongly associated with clinical practice guidelines (CPG) adherence. Design: Cross-sectional stratified cluster sample design. Setting: Data were gathered from 36 randomly selected multi-specialty medicine wards. Participants: The study population included all health professionals involved in patient care working in the participating wards...
August 1, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28934403/improving-inpatient-medication-adherence-using-attendant-education-in-a-tertiary-care-hospital-in-uganda
#11
Patricia Alupo, Richard Ssekitoleko, Tracy Rabin, Robert Kalyesubula, Ivan Kimuli, Benjamin E Bodnar
Quality problem: Although widely utilized in resource-rich health care systems, the use of quality improvement (QI) techniques is less common in resource-limited environments. Uganda is a resource-limited country in Sub-Saharan Africa that faces many challenges with health care delivery. These challenges include understaffing, inconsistent drug availability and inefficient systems that limit the provision of clinical care. Initial assessment: Poor adherence to prescribed inpatient medications was identified as a key shortcoming of clinical care on the internal medicine wards of Mulago National Referral Hospital, Kampala, Uganda...
August 1, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28933619/african-american-adults-and-seasonal-influenza-vaccination-changing-our-approach-can-move-the-needle
#12
Sandra Crouse Quinn
Consistent disparities in influenza (flu) vaccine uptake among African Americans, coupled with a disproportionate burden of chronic diseases, places too many African Americans at high risk for complications, hospitalizations and premature mortality. This disparity is the result of individual attitudes and beliefs, social norms, and health care practices. Recent research identifies critical factors affecting vaccine uptake among African American adults including perceived risk of vaccine side effects, social norms that do not support for vaccination, and lower knowledge of the flu and the vaccine...
September 21, 2017: Human Vaccines & Immunotherapeutics
https://www.readbyqxmd.com/read/28932686/a-positive-rapid-strep-test-in-a-young-adult-with-acute-pharyngitis-be-careful-what-you-wish-for
#13
Burke A Cunha
In young adults with acute pharyngitis, the main differential diagnosis is between GAS pharyngitis, EBV infectious mononucleosis, or other causes of viral pharyngitis. A positive RST does not differentiate GAS colonization from infection as is well illustrated by this case. Laboratory test results must be interpreted in the appropriate clinical context to be diagnostically meaningful. The RST only detects group A streptococci, but does not, of itself, implicate a causative role in the patient's pharyngitis...
2017: IDCases
https://www.readbyqxmd.com/read/28932499/evaluation-of-noise-pollution-level-in-the-operating-rooms-of-hospitals-a-study-in-iran
#14
Masoumeh Dorri Giv, Karim Ghazikhanlou Sani, Majid Alizadeh, Ali Valinejadi, Hesamedin Askari Majdabadi
INTRODUCTION: Noise pollution in the operating rooms is one of the remaining challenges. Both patients and physicians are exposed to different sound levels during the operative cases, many of which can last for hours. This study aims to evaluate the noise pollution in the operating rooms during different surgical procedures. MATERIALS AND METHODS: In this cross-sectional study, sound level in the operating rooms of Hamadan University-affiliated hospitals (totally 10) in Iran during different surgical procedures was measured using B&K sound meter...
June 2017: Interventional Medicine & Applied Science
https://www.readbyqxmd.com/read/28932497/evaluation-of-amiodarone-versus-metoprolol-in-treating-atrial-fibrillation-after-coronary-artery-bypass-grafting
#15
Alireza Kamali, Amir Sanatkar, Mehrzad Sharifi, Esmaeil Moshir
INTRODUCTION: Atrial fibrillation (AF) is the most common arrhythmia affecting patients in open heart ICU after coronary artery bypass grafting (CABG). Most cardiac surgery textbooks recommend beta blockers as the drug of choice for treating such a condition while many experienced physicians and a number of anesthesiology references offer amiodarone as the drug of choice. Therefore, because of insufficient evidence and the aforementioned controversy, we decided to conduct a study evaluating these two antiarrhythmic medicines...
June 2017: Interventional Medicine & Applied Science
https://www.readbyqxmd.com/read/28932302/predictive-value-of-tracheal-rapid-ultrasound-exam-performed-in-the-emergency-department-for-verification-of-tracheal-intubation
#16
Babak Masoumi, Reza Azizkhani, Gilava Hedayati Emam, Morteza Asgarzadeh, Behrouz Zargar Kharazi
BACKGROUND: Verification of the correct placement of the endotracheal tube (ETT) has been one of the most challenging issues of airway management in the field of emergency medicine. Early detection of oesophagal intubation through a reliable method is important for emergency physicians. AIM: The aim of this study was to assess the diagnostic accuracy of tracheal rapid ultrasound exam (TRUE) to assess endotracheal tube misplacement during emergency intubation. METHODS: This was an observational prospective study performed in the emergency department of the major tertiary referral hospital in the city...
August 15, 2017: Open Access Macedonian Journal of Medical Sciences
https://www.readbyqxmd.com/read/28932077/laparoscopic-appendectomy-for-acute-appendicitis-how-to-discourage-surgeons-using-inadequate-therapy
#17
REVIEW
Tomohide Hori, Takafumi Machimoto, Yoshio Kadokawa, Toshiyuki Hata, Tatsuo Ito, Shigeru Kato, Daiki Yasukawa, Yuki Aisu, Yusuke Kimura, Maho Sasaki, Yuichi Takamatsu, Taku Kitano, Shigeo Hisamori, Tsunehiro Yoshimura
Acute appendicitis (AA) develops in a progressive and irreversible manner, even if the clinical course of AA can be temporarily modified by intentional medications. Reliable and real-time diagnosis of AA can be made based on findings of the white blood cell count and enhanced computed tomography. Emergent laparoscopic appendectomy (LA) is considered as the first therapeutic choice for AA. Interval/delayed appendectomy at 6-12 wk after disease onset is considered as unsafe with a high recurrent rate during the waiting time...
August 28, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28931361/patient-family-and-physician-satisfaction-with-planning-for-direct-discharge-to-home-from-intensive-care-units-direct-from-icu-sent-home-study
#18
Joyce Nga Hei Lam, Vincent I Lau, Fran A Priestap, John Basmaji, Ian M Ball
BACKGROUND: In the new era of decreasing hospital bed availability, there is an increasing rate of direct discharge to home (DDH) from intensive care units (ICUs), despite sparse literature informing this practice. OBJECTIVES: To evaluate patient, family, and ICU attending physician satisfaction with planning for DDH from the ICU and intensivists' current DDH practices and perceptions. METHODS: Prospective cohort study, using convenience sampling, of adult patients undergoing DDH from an ICU between February 2016 and February 2017 using a modified FS-ICU 24 satisfaction survey completed by patients, family members, and attending physicians at the time of patient discharge to home from the ICU...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28930900/retrospective-evaluation-of-the-impact-of-a-geriatric-trauma-institute-on-fragility-hip-fracture-patient-outcomes
#19
Elizabeth D Katrancha, Jami Zipf, Nancy Abrahams, Richard Schroeder
BACKGROUND: Fragility hip fractures occur in the older than 65-year population at an alarming rate. It is estimated that 260,000 hip fractures occur annually. Patient outcomes following hip fractures are devastating. One of every 5 patients dies within 1 year of injury, and 1 of 3 remains in a nursing home for years after the injury. Published literature recommends an interdisciplinary approach to caring for hip-fractured patients and expediting surgery to improve outcomes. PURPOSE: The purpose of this study was to retrospectively evaluate the impact of the Geriatric Trauma Institute (GTI) on fragility hip fracture patient outcomes...
September 2017: Orthopaedic Nursing
https://www.readbyqxmd.com/read/28930786/the-relationship-between-2009-pandemic-h1n1-influenza-during-pregnancy-and-preterm-birth-a-population-based-cohort-study
#20
Deshayne B Fell, Robert W Platt, Olga Basso, Kumanan Wilson, Jay S Kaufman, David L Buckeridge, Jeffrey C Kwong
BACKGROUND: Previous studies of maternal influenza illness and preterm birth have yielded inconsistent results. Our objective was to assess the association between 2009 pandemic H1N1 (pH1N1) influenza during pregnancy and preterm birth in a large obstetrical population. METHODS: We linked a province-wide birth registry with health administrative databases to identify influenza-coded hospitalizations, emergency department visits, or physician visits among pregnant women during the 2009 H1N1 pandemic (our proxy for clinical pH1N1 influenza illness)...
September 19, 2017: Epidemiology
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