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https://www.readbyqxmd.com/read/28403889/muscle-mri-at-the-time-of-questionable-disease-flares-in-juvenile-dermatomyositis-jdm
#1
Rabheh Abdul-Aziz, Chack-Yung Yu, Brent Adler, Sharon Bout-Tabaku, Katherine E Lintner, Melissa Moore-Clingenpeel, Charles H Spencer
BACKGROUND: The course of JDM has improved substantially over the last 70 years with early and aggressive treatments. Yet it remains difficult to detect disease flares as symptoms may be mild; signs of rash and muscle weakness vary widely and are often equivocal; laboratory tests of muscle enzyme levels are often normal; electromyography and muscle biopsy are invasive. Alternative tools are needed to help decide if more aggressive treatment is needed. Our objective is to determine the effectiveness of muscle Magnetic Resonance Imaging (MRI) in detecting JDM flares, and how an MRI affects physician's decision-making regarding treatment...
April 12, 2017: Pediatric Rheumatology Online Journal
https://www.readbyqxmd.com/read/28375496/a-review-and-survey-of-neurosurgeon-hospital-relationships-evolution-and-options
#2
Dong H Kim, Bernard Duco, Daniel Wolterman, Charles Stokes, Rod Brace, Robert A Solomon, Nicholas Barbaro, Richard Westmark, David MacDougall, James Bean, Joanna O'Leary, Nicole Moayeri, Ralph G Dacey, Mitchel S Berger, Robert Harbaugh
As healthcare delivery shifts from fee-for-service, episodic care to pay for performance and population health, both hospitals and physicians are looking for new forms of integration. A number of regulations and restrictions govern physician relationships with hospitals. In this paper, we review the legal basis for such relationships and the options available. We also survey neurosurgeons and hospital executives to gain their perspective on the current situation and likely future. Two series of structured interviews were conducted with 10 neurosurgeons who work in a range of situations in diverse markets, and with Memorial Hermann Healthcare System senior executive leadership...
April 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28351762/does-ulipristal-acetate-affect-surgical-experience-at-laparoscopic-myomectomy
#3
Lea Luketic, Lindsay Shirreff, Sari Kives, Grace Liu, Ramadan El Sugy, Nicholas Leyland, Meir Jonathon Solnik, Ally Murji
STUDY OBJECTIVE: To compare surgical experience of laparoscopic/robotic myomectomy in premenopausal patients pretreated with ulipristal acetate (UPA) with women not hormonally pretreated. DESIGN: Retrospective, multicenter cohort study of laparoscopic/robotic myomectomy procedure videos (Canadian Task Force Classification III). SETTING: Multiple university-affiliated tertiary care hospitals. PATIENTS: Fifty-five premenopausal women who underwent laparoscopic/robotic myomectomy for intramural fibroids and were either pretreated with 3-months of UPA or had no hormonal pretreatment...
March 25, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28336681/accuracy-and-reliability-of-stroke-diagnosis-in-the-pediatric-emergency-department
#4
Mark T Mackay, Adriana Yock-Corrales, Leonid Churilov, Paul Monagle, Geoffrey A Donnan, Franz E Babl
BACKGROUND AND PURPOSE: Access to acute stroke interventions in the emergency department (ED) relies on correct clinical diagnosis. Our aims were to determine the accuracy and reliability of pediatric ED physician diagnosis of childhood stroke and other conditions presenting with brain attack symptoms. METHODS: Prospective study of consecutive children aged 1 month to 18 years presenting to the ED from June 2009 to December 2010 with focal neurological deficits...
March 23, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28332994/predicting-patient-specific-dosimetric-benefits-of-proton-therapy-for-skull-base-tumors-using-a-geometric-knowledge-based-method
#5
David C Hall, Alexei V Trofimov, Brian A Winey, Norbert J Liebsch, Harald Paganetti
PURPOSE: To predict the organ at risk (OAR) dose levels achievable with proton beam therapy (PBT), solely based on the geometric arrangement of the target volume in relation to the OARs. A comparison with an alternative therapy yields a prediction of the patient-specific benefits offered by PBT. This could enable physicians at hospitals without proton capabilities to make a better-informed referral decision or aid patient selection in model-based clinical trials. METHODS AND MATERIALS: Skull-base tumors were chosen to test the method, owing to their geometric complexity and multitude of nearby OARs...
April 1, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/28319491/breaking-down-the-objective-structured-clinical-examination-an-evaluation-of-the-helping-babies-breathe-osces
#6
Teresa L Seto, Meredith E Tabangin, Kathryn K Taylor, Srirama Josyula, Juan Carlos Vasquez, Beena D Kamath-Rayne
INTRODUCTION: Helping Babies Breathe (HBB) is a simulation-based neonatal resuscitation curriculum designed for low-resource settings. At the completion of the workshop, learners complete the following four assessments: a multiple-choice question (MCQ) test, bag-mask ventilation (BMV) checklist, and two objective structured clinical examinations (OSCEs). Objective structured clinical examinations are clinical performance assessments that evaluate learners' skills in simulated scenarios...
March 18, 2017: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
https://www.readbyqxmd.com/read/28291092/measuring-patient-mobility-in-the-icu-using-a-novel-noninvasive-sensor
#7
Andy J Ma, Nishi Rawat, Austin Reiter, Christine Shrock, Andong Zhan, Alex Stone, Anahita Rabiee, Stephanie Griffin, Dale M Needham, Suchi Saria
OBJECTIVES: To develop and validate a noninvasive mobility sensor to automatically and continuously detect and measure patient mobility in the ICU. DESIGN: Prospective, observational study. SETTING: Surgical ICU at an academic hospital. PATIENTS: Three hundred sixty-two hours of sensor color and depth image data were recorded and curated into 109 segments, each containing 1,000 images, from eight patients. INTERVENTIONS: None...
April 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28242768/american-orthopaedic-foot-and-ankle-society-aofas-ankle-hindfoot-score-a-study-protocol-for-the-translation-and-validation-of-the-dutch-language-version
#8
Esther M M Van Lieshout, A Siebe De Boer, Duncan E Meuffels, P Ted Den Hoed, Cornelis H Van der Vlies, Wim E Tuinebreijer, Michael H J Verhofstad
INTRODUCTION: The American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Score is among the most commonly used instruments for measuring the outcome of treatment in patients who sustained a complex ankle or hindfoot injury. It combines a clinician-reported and a patient-reported part. A valid Dutch version of this instrument is currently not available. Such a translated and validated instrument would allow objective comparison across hospitals or between patient groups, and with shown validity and reliability it may become a quality of care indicator in future...
February 27, 2017: BMJ Open
https://www.readbyqxmd.com/read/28241211/families-as-partners-in-hospital-error-and-adverse-event-surveillance
#9
Alisa Khan, Maitreya Coffey, Katherine P Litterer, Jennifer D Baird, Stephannie L Furtak, Briana M Garcia, Michele A Ashland, Sharon Calaman, Nicholas C Kuzma, Jennifer K O'Toole, Aarti Patel, Glenn Rosenbluth, Lauren A Destino, Jennifer L Everhart, Brian P Good, Jennifer H Hepps, Anuj K Dalal, Stuart R Lipsitz, Catherine S Yoon, Katherine R Zigmont, Rajendu Srivastava, Amy J Starmer, Theodore C Sectish, Nancy D Spector, Daniel C West, Christopher P Landrigan, Brenda K Allair, Claire Alminde, Wilma Alvarado-Little, Marisa Atsatt, Megan E Aylor, James F Bale, Dorene Balmer, Kevin T Barton, Carolyn Beck, Zia Bismilla, Rebecca L Blankenberg, Debra Chandler, Amanda Choudhary, Eileen Christensen, Sally Coghlan-McDonald, F Sessions Cole, Elizabeth Corless, Sharon Cray, Roxi Da Silva, Devesh Dahale, Benard Dreyer, Amanda S Growdon, LeAnn Gubler, Amy Guiot, Roben Harris, Helen Haskell, Irene Kocolas, Elizabeth Kruvand, Michele Marie Lane, Kathleen Langrish, Christy J W Ledford, Kheyandra Lewis, Joseph O Lopreiato, Christopher G Maloney, Amanda Mangan, Peggy Markle, Fernando Mendoza, Dale Ann Micalizzi, Vineeta Mittal, Maria Obermeyer, Katherine A O'Donnell, Mary Ottolini, Shilpa J Patel, Rita Pickler, Jayne Elizabeth Rogers, Lee M Sanders, Kimberly Sauder, Samir S Shah, Meesha Sharma, Arabella Simpkin, Anupama Subramony, E Douglas Thompson, Laura Trueman, Tanner Trujillo, Michael P Turmelle, Cindy Warnick, Chelsea Welch, Andrew J White, Matthew F Wien, Ariel S Winn, Stephanie Wintch, Michael Wolf, H Shonna Yin, Clifton E Yu
Importance: Medical errors and adverse events (AEs) are common among hospitalized children. While clinician reports are the foundation of operational hospital safety surveillance and a key component of multifaceted research surveillance, patient and family reports are not routinely gathered. We hypothesized that a novel family-reporting mechanism would improve incident detection. Objective: To compare error and AE rates (1) gathered systematically with vs without family reporting, (2) reported by families vs clinicians, and (3) reported by families vs hospital incident reports...
April 1, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28230578/essential-and-nonessential-blood-testing-in-the-clinical-teaching-unit
#10
Cody Sherren, Andrew Day, Roy Ilan
OBJECTIVES: The aim of the study was to evaluate the essential and nonessential blood tests ordered on the internal medicine clinical teaching units (CTUs) at Kingston General Hospital. Our aim was to establish a baseline performance measure identifying appropriate use of laboratory tests that could be used to inform improvement over time. METHODS: For an 8-week period, 14 CTU attending physicians at Kingston General Hospital were surveyed. They were asked for each of their patients, "What blood tests do you consider to be essential for tomorrow morning to maintain appropriate care for this patient?" The following day, blood tests that were ordered were compared with the "essential" list previously given by the attending physicians...
February 22, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28224348/a-need-to-reconsider-guidelines-on-management-of-primary-spontaneous-pneumothorax
#11
Jiyoon Yoon, Parthipan Sivakumar, Kevin O'Kane, Liju Ahmed
BACKGROUND: The key guidelines in the management of primary spontaneous pneumothorax (PSP) include the 2010 British Thoracic Society (BTS) Pleural Disease guideline and 2001 American College of Chest Physicians (ACCP) Consensus Statement. Current recommendations are dependent on radiographic measures which differ between these two guidelines. The aim of this study is to compare size classification of PSP cases, according to BTS and ACCP guidelines, and to evaluate guideline compliance...
December 2017: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28223862/whose-responsibility-is-medication-reconciliation-physicians-pharmacists-or-nurses-a-survey-in-an-academic-tertiary-care-hospital
#12
Amna Al-Hashar, Ibrahim Al-Zakwani, Tommy Eriksson, Mohammed Al Za'abi
Background: Medication errors occur frequently at transitions in care and can result in morbidity and mortality. Medication reconciliation is a recognized hospital accreditation requirement and designed to limit errors in transitions in care. Objectives: To identify beliefs, perceived roles and responsibilities of physicians, pharmacists and nurses prior to the implementation of a standardized medication reconciliation process. Methods: A survey was distributed to the three professions: pharmacists in the pharmacy and physicians and nurses in hospital in-patient units...
January 2017: Saudi Pharmaceutical Journal: SPJ: the Official Publication of the Saudi Pharmaceutical Society
https://www.readbyqxmd.com/read/28207539/role-of-coronary-angiography-for-out-of-hospital-cardiac-arrest-survivors-according-to-postreturn-of-spontaneous-circulation-on-an-electrocardiogram
#13
Tae Rim Lee, Sung Yeon Hwang, Won Chul Cha, Tae Gun Shin, Min Seob Sim, Ik Joon Jo, Keun Jeong Song, Joong Eui Rhee, Yeon Kwon Jeong
Survivors of out-of-hospital cardiac arrest (OHCA) have high mortality and morbidity. An acute coronary event is the most common cause of sudden cardiac death. For this reason, coronary angiography is an important diagnostic and treatment strategy for patients with postcardiac arrest. This study aimed to identify the correlation between postreturn of spontaneous circulation (ROSC) on an electrocardiogram (ECG) and results of coronary angiography of OHCA survivors.We collected data from our OHCA registry from January 2010 to November 2014...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28150098/physician-and-patient-views-on-public-physician-rating-websites-a-cross-sectional-study
#14
Alison M Holliday, Allen Kachalia, Gregg S Meyer, Thomas D Sequist
BACKGROUND: Numerical ratings and narrative comments about physicians are increasingly available online. These physician rating websites include independent websites reporting crowd-sourced data from online users and health systems reporting data from their internal patient experience surveys. OBJECTIVE: To assess patient and physician views on physician rating websites. DESIGN: Cross-sectional physician (electronic) and patient (paper) surveys conducted in August 2015...
February 1, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28145750/evaluation-of-dietitian-counselling-access-revealed-reduced-pediatrician-reported-hospital-admissions-and-increased-parental-knowledge-and-confidence
#15
Katherine Kay Watson-Jarvis, Lorna Driedger, Tanis R Fenton
Based on a 1999 needs assessment a pediatric community-based outpatient dietitian counselling service was created. By 2010 annual referrals had grown to almost 1500 (62% from physicians; 38% from public health nurses). An evaluation was undertaken to gather perspectives of practitioners and parents about access, satisfaction, referral practices, and changes in knowledge, attitudes, behaviour, and child well-being. Health professionals surveyed via email were 62 pediatricians (response rate 71%), 25 family physicians (21%), 87 public health nurses (31%), and 7 dietitian providers (100%)...
February 1, 2017: Canadian Journal of Dietetic Practice and Research
https://www.readbyqxmd.com/read/28143793/parent-and-provider-experience-and-shared-understanding-after-a-family-centered-nighttime-communication-intervention
#16
Alisa Khan, Jennifer Baird, Jayne E Rogers, Stephannie L Furtak, Kathryn A Williams, Brenda Allair, Katherine P Litterer, Meesha Sharma, Alla Smith, Mark A Schuster, Christopher P Landrigan
OBJECTIVE: To assess parent and provider experience and shared understanding after a family-centered, multidisciplinary nighttime communication intervention (nurse-physician brief, family huddle, family update sheet). METHODS: Prospective intervention study at a children's hospital from 5/2013-10/2013 (pre-intervention) and 5/2014-10/2014 (post-intervention). Participants included 464 parents, 176 nurses, and 52 resident-physicians of 582 hospitalized 0-17-year-old patients...
January 28, 2017: Academic Pediatrics
https://www.readbyqxmd.com/read/28123189/health-care-professionals-opinions-and-expectations-of-clinical-pharmacy-services-on-a-surgical-ward
#17
Bernadette Chevalier, Heather L Neville, Kara Thompson, Lisa Nodwell, Michael MacNeil
BACKGROUND: Pharmacists have made significant contributions to patient care and have been recognized as integral members of the interprofessional team. Health care professionals differ in their opinions and expectations of clinical pharmacy services. Very little has been published about health care professionals' perspectives on advanced clinical pharmacy roles, such as prescriptive authority or administration of vaccines. In 2013, clinical pharmacy services were introduced in a vascular and general surgery ward where a pharmacist had not previously been assigned...
November 2016: Canadian Journal of Hospital Pharmacy
https://www.readbyqxmd.com/read/28095145/performance-of-four-frailty-classifications-in-older-patients-with-cancer-prospective-elderly-cancer-patients-cohort-study
#18
Emilie Ferrat, Elena Paillaud, Philippe Caillet, Marie Laurent, Christophe Tournigand, Jean-Léon Lagrange, Jean-Pierre Droz, Lodovico Balducci, Etienne Audureau, Florence Canouï-Poitrine, Sylvie Bastuji-Garin
Purpose Frailty classifications of older patients with cancer have been developed to assist physicians in selecting cancer treatments and geriatric interventions. They have not been compared, and their performance in predicting outcomes has not been assessed. Our objectives were to assess agreement among four classifications and to compare their predictive performance in a large cohort of in- and outpatients with various cancers. Patients and Methods We prospectively included 1,021 patients age 70 years or older who had solid or hematologic malignancies and underwent a geriatric assessment in one of two French teaching hospitals between 2007 and 2012...
March 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28088248/the-spectrum-of-rheumatic-in-patient-diagnoses-at-a-pediatric-hospital-in-kenya
#19
Angela Migowa, Inés Colmegna, Carol Hitchon, Eugene Were, Evelyn Ng'ang'a, Thomas Ngwiri, John Wachira, Sasha Bernatsky, Rosie Scuccimarri
BACKGROUND: Pediatric rheumatic diseases are chronic illnesses that can cause considerable disease burden to children and their families. There is limited epidemiologic data on these diseases in East Africa. The aim of this study was to assess the spectrum of pediatric rheumatic diagnoses in an in-patient setting and determine the accuracy of ICD-10 codes in identifying these conditions. METHODS: Medical records from Gertrude's Children's Hospital in Kenya were reviewed for patients diagnosed with "diseases of the musculoskeletal system and connective tissue" as per ICD-10 diagnostic codes assigned at discharge between January and December 2011...
January 14, 2017: Pediatric Rheumatology Online Journal
https://www.readbyqxmd.com/read/28088009/cardiac-output-and-systemic-vascular-resistance-clinical-assessment-compared-with-a-noninvasive-objective-measurement-in-children-with-shock
#20
Asma Razavi, Christopher J L Newth, Robinder G Khemani, Fernando Beltramo, Patrick A Ross
PURPOSE: To evaluate physician assessment of cardiac output and systemic vascular resistance in patients with shock compared with an ultrasonic cardiac output monitor (USCOM). To explore potential changes in therapy decisions if USCOM data were available using physician intervention answers. STUDY DESIGN: Double-blinded, prospective, observational study in a tertiary hospital pediatric intensive care unit. Forty children (<18years) admitted with shock, requiring ongoing volume resuscitation or inotropic support...
June 2017: Journal of Critical Care
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