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https://www.readbyqxmd.com/read/27919120/reconstructive-surgery-for-treating-pressure-ulcers
#1
REVIEW
Jason Kf Wong, Kavit Amin, Jo C Dumville
BACKGROUND: The management of pressure ulcers involves several interventions ranging from pressure-relieving measures such as repositioning, to treatments that can include reconstructive surgery. Such surgery may be considered for recalcitrant wounds when full thickness skin loss arises and deeper structures such as muscle fascia and even bone are exposed. The surgery commonly involves wound debridement followed by the addition of new tissue into the wound. Whilst reconstructive surgery is an accepted means of ulcer management, the benefits and harms of surgery compared with non-surgical treatments, or alternative surgical approaches are not clear...
December 6, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27916749/inequalities-in-receipt-of-mental-and-physical-healthcare-in-people-with-dementia-in-the-uk
#2
Claudia Cooper, Rebecca Lodwick, Kate Walters, Rosalind Raine, Jill Manthorpe, Steve Iliffe, Irene Petersen
BACKGROUND: UK Dementia Strategies prioritise fair access to mental and physical healthcare. We investigated whether there are inequalities by deprivation or gender in healthcare received by people with dementia, and compared healthcare received by people with and without dementia. METHODS: we investigated primary care records of 68,061 community dwelling dementia patients and 259,337 people without dementia (2002-13). We tested hypotheses that people with dementia from more deprived areas, and who are women receive more psychotropic medication, fewer surgery consultations, are less likely to receive annual blood pressure, weight monitoring and an annual review, compared with those from less deprived areas and men...
December 4, 2016: Age and Ageing
https://www.readbyqxmd.com/read/27911951/body-surface-area-and-baseline-blood-pressure-predict-subclinical-anthracycline-cardiotoxicity-in-women-treated-for-early-breast-cancer
#3
Paul Kotwinski, Gillian Smith, Jackie Cooper, Julie Sanders, Louise Ma, Albert Teis, David Kotwinski, Michael Mythen, Dudley J Pennell, Alison Jones, Hugh Montgomery
BACKGROUND AND AIMS: Anthracyclines are highly effective chemotherapeutic agents which may cause long-term cardiac damage (chronic anthracycline cardiotoxicity) and heart failure. The pathogenesis of anthracycline cardiotoxicity remains incompletely understood and individual susceptibility difficult to predict. We sought clinical features which might contribute to improved risk assessment. METHODS: Subjects were women with early breast cancer, free of pre-existing cardiac disease...
2016: PloS One
https://www.readbyqxmd.com/read/27907828/surgical-apgar-score-in-patients-undergoing-lumbar-fusion-for-degenerative-spine-diseases
#4
Chien-Yu Ou, Shih-Yuan Hsu, Jian-Hao Huang, Yu-Hua Huang
OBJECTIVE: Lumbar fusion is a procedure broadly performed for degenerative diseases of spines, but it is not without significant morbidities. Surgical Apgar Score (SAS), based on intraoperative blood loss, blood pressure, and heart rate, was developed for prognostic prediction in general and vascular operations. We aimed to examine whether the application of SAS in patients undergoing fusion procedures for degeneration of lumbar spines predicts in-hospital major complications. METHODS: One hundred and ninety-nine patients that underwent lumbar fusion operation for spine degeneration were enrolled in this retrospective study...
November 21, 2016: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/27906761/surgical-education-and-health-care-reform-defining-the-role-and-value-of-trainees-in-an-evolving-medical-landscape
#5
Oluwadamilola M Fayanju, Reena Aggarwal, Rebeccah B Baucom, Cristina R Ferrone, David Massaro, Kyla P Terhune
OBJECTIVE: Health care reform and surgical education are often separated functionally. However, especially in surgery, where resident trainees often spend twice as much time in residency and fellowship than in undergraduate medical education, one must consider their contributions to health care. SUMMARY BACKGROUND DATA: In this short commentary, we briefly review the status of health care in the United States as well as some of the recent and current changes in graduate medical education that pertain to surgical trainees...
November 30, 2016: Annals of Surgery
https://www.readbyqxmd.com/read/27906391/large-area-growth-of-vertically-aligned-luminescent-mos2-nanosheets
#6
G Deokar, N S Rajput, P Vancsó, F Ravaux, M Jouiad, D Vignaud, F Cecchet, J-F Colomer
Vertically aligned MoS2 nanosheets (NSs) with exposed edges were successfully synthesized over a large area (∼2 cm(2)). The NSs were grown using an ambient pressure chemical vapor deposition technique via rapid sulfurization of sputter deposited thick molybdenum films. Extensive characterization of the grown MoS2 NSs has been carried out using high resolution scanning and transmission electron microscopy (SEM & TEM). A special care was given to the TEM lamella preparation process by means of a focused ion beam to preserve the NS growth direction...
December 1, 2016: Nanoscale
https://www.readbyqxmd.com/read/27893619/substituting-systolic-blood-pressure-with-shock-index-in-the-national-trauma-triage-protocol
#7
Ansab A Haider, Asad Azim, Peter Rhee, Narong Kulvatunyou, Kareem Ibraheem, Andrew Tang, Terence O'Keeffe, Hajira Iftikhar, Gary Vercruysse, Bellal Joseph
INTRODUCTION: The National Trauma Triage Protocol (NTTP) is an algorithm that guides emergency medical services providers through four decision steps to identify the patients that would benefit from trauma center care. The NTTP defines a systolic blood pressure (SBP) of less than 90 mm Hg as one of the criteria for trauma center need. The aim of our study was to determine the impact of substituting SBP of less than 90 mm Hg with shock index (SI) on triage performance. METHODS: A 2-year (2011-2012) retrospective analysis of all trauma patients 18 years or older in the National Trauma Databank was performed...
December 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27887644/copenhagen-comorbidity-in-hiv-infection-cocomo-study-a-study-protocol-for-a-longitudinal-non-interventional-assessment-of-non-aids-comorbidity-in-hiv-infection-in-denmark
#8
Andreas Ronit, Judith Haissman, Ditte Marie Kirkegaard-Klitbo, Thomas Skårup Kristensen, Anne-Mette Lebech, Thomas Benfield, Jan Gerstoft, Henrik Ullum, Lars Køber, Andreas Kjær, Klaus Kofoed, Jørgen Vestbo, Børge Nordestgaard, Jens Lundgren, Susanne Dam Nielsen
BACKGROUND: Modern combination antiretroviral therapy (cART) has improved survival for people living with HIV (PLWHIV). Non-AIDS comorbidities have replaced opportunistic infections as leading causes of mortality and morbidity, and are becoming a key health concern as this population continues to age. The aim of this study is to estimate the prevalence and incidence of non-AIDS comorbidity among PLWHIV in Denmark in the cART era and to determine risk factors contributing to the pathogenesis...
November 26, 2016: BMC Infectious Diseases
https://www.readbyqxmd.com/read/27886201/cryptococcal-meningitis-epidemiology-immunology-diagnosis-and-therapy
#9
REVIEW
Peter R Williamson, Joseph N Jarvis, Anil A Panackal, Matthew C Fisher, Síle F Molloy, Angela Loyse, Thomas S Harrison
HIV-associated cryptococcal meningitis is by far the most common cause of adult meningitis in many areas of the world that have high HIV seroprevalence. In most areas in Sub-Saharan Africa, the incidence of cryptococcal meningitis is not decreasing despite availability of antiretroviral therapy, because of issues of adherence and retention in HIV care. In addition, cryptococcal meningitis in HIV-seronegative individuals is a substantial problem: the risk of cryptococcal infection is increased in transplant recipients and other individuals with defects in cell-mediated immunity, and cryptococcosis is also reported in the apparently immunocompetent...
November 25, 2016: Nature Reviews. Neurology
https://www.readbyqxmd.com/read/27884846/real-world-evidence-studies-into-treatment-adherence-thresholds-for-intervention-and-disparities-in-treatment-in-people-with-type-2-diabetes-in-the-uk
#10
Andrew McGovern, William Hinton, Ana Correa, Neil Munro, Martin Whyte, Simon de Lusignan
PURPOSE: The University of Surrey-Lilly Real World Evidence (RWE) diabetes cohort has been established to provide insights into the management of type 2 diabetes mellitus (T2DM). There are 3 areas of study due to be conducted to provide insights into T2DM management: exploration of medication adherence, thresholds for changing diabetes therapies, and ethnicity-related or socioeconomic-related disparities in management. This paper describes the identification of a cohort of people with T2DM which will be used for these analyses, through a case finding algorithm, and describes the characteristics of the identified cohort...
November 24, 2016: BMJ Open
https://www.readbyqxmd.com/read/27878785/lesions-requiring-wound-management-in-a-central-tertiary-neonatal-intensive-care-unit
#11
Angéla Meszes, Gyula Tálosi, Krisztina Máder, Hajnalka Orvos, Lajos Kemény, Zsanett Renáta Csoma
BACKGROUND: Most of the skin disorders that occur in neonatal intensive care units are due in part to the immaturity and vulnerability of the neonatal skin. Various iatrogenic diagnostic and therapeutic procedures are also conducive to iatrogenic damage. This study was to review the neonates admitted to our neonatal intensive care unit who needed wound management, and to assess the most common skin injuries and wounds, and their aetiology. METHODS: Data were extracted from medical records of neonates who needed wound management in our Neonatal Intensive Care Unit between January 31, 2012 and January 31, 2013...
November 23, 2016: World Journal of Pediatrics: WJP
https://www.readbyqxmd.com/read/27878783/prediction-of-significant-hyperbilirubinemia-in-term-neonates-by-early-non-invasive-bilirubin-measurement
#12
Manish Jain, Akash Bang, Anju Tiwari, Shuchi Jain
BACKGROUND: Neonatal jaundice is a common problem. We evaluated the utility and best cut-off values of 24-and 48-hour transcutaneous bilirubin indices (TcBI) in predicting subsequent significant hyperbilirubinemia and evaluated various associated maternal and fetal risk factors. METHODS: TcBI at 24 and 48 hours and serum bilirubin levels at 72 hours of age were obtained for healthy, term, appropriate for gestational age neonates. Neonates with prematurity, birth weight <2500 g, ABO or Rh incompatibility, onset of clinical jaundice <24 hours, clinical suspicion of septicemia, positive pressure ventilation at birth, admission in neonatal intensive care unit and contraindications for BiliChek were excluded...
November 23, 2016: World Journal of Pediatrics: WJP
https://www.readbyqxmd.com/read/27874258/predictive-validity-of-the-braden-scale-norton-scale-and-waterlow-scale-in-the-czech-republic
#13
Lenka Šateková, Katarína Žiaková, Renáta Zeleníková
The aim of this study was to determine the predictive validity of the Braden, Norton, and Waterlow scales in 2 long-term care departments in the Czech Republic. Assessing the risk for developing pressure ulcers is the first step in their prevention. At present, many scales are used in clinical practice, but most of them have not been properly validated yet (for example, the Modified Norton Scale in the Czech Republic). In the Czech Republic, only the Braden Scale has been validated so far. This is a prospective comparative instrument testing study...
November 22, 2016: International Journal of Nursing Practice
https://www.readbyqxmd.com/read/27863592/nursing-interventions-in-stroke-care-delivery-an-evidence-based-clinical-review
#14
Dimitrios Theofanidis, Bernard Gibbon
INTRODUCTION: Generally, nursing interventions during the acute stages following a stroke aim at preventing secondary brain injury (intracranial hypertension), maintaining the airways (due to paralysis of the pharynx muscles), providing general body support (vital signs, fluid and electrolyte balance), and anticipating the occurrence of complications (atelectasis and pneumonia). AIM: This literature review is to prioritize nursing interventions for acute stroke and to update nursing roles and input considering recommended levels of evidence of care to date...
December 2016: Journal of Vascular Nursing: Official Publication of the Society for Peripheral Vascular Nursing
https://www.readbyqxmd.com/read/27861136/a-prospective-descriptive-quality-improvement-study-to-investigate-the-impact-of-a-turn-and-position-device-on-the-incidence-of-hospital-acquired-sacral-pressure-ulcers-and-nursing-staff-time-needed-for-repositioning-patients
#15
Kimberly D Hall, Rebecca C Clark
Patients in critical care areas are at risk for developing hospital-acquired pressure ulcers (HAPUs) due to their physical conditions and limited ability to reposition themselves. A prospective, 2-phase quality improvement study was conducted from September to November 2011 and from February to April 2012 in 1 medical and 1 surgical ICU to investigate the impact of a turn-and-assist device on the incidence of HAPUs and the time and personnel required to reposition patients reported as person/minutes (staff x minutes)...
November 2016: Ostomy/wound Management
https://www.readbyqxmd.com/read/27852720/protocol-for-using-mixed-methods-and-process-improvement-methodologies-to-explore-primary-care-receptionist-work
#16
Ian Litchfield, Nicola Gale, Michael Burrows, Sheila Greenfield
INTRODUCTION: The need to cope with an increasingly ageing and multimorbid population has seen a shift towards preventive health and effective management of chronic disease. This places general practice at the forefront of health service provision with an increased demand that impacts on all members of the practice team. As these pressures grow, systems become more complex and tasks delegated across a broader range of staff groups. These include receptionists who play an essential role in the successful functioning of the surgery and are a major influence on patient satisfaction...
November 16, 2016: BMJ Open
https://www.readbyqxmd.com/read/27852525/optic-nerve-sheath-diameter-measurement-a-means-of-detecting-raised-intracranial-pressure-in-adult-traumatic-and-non-traumatic-neurosurgical-patients
#17
Mohd Raffiz, Jafri M Abdullah
INTRODUCTION: Bedside ultrasound measurement of optic nerve sheath diameter (ONSD) is emerging as a non-invasive technique to evaluate and predict raised intracranial pressure (ICP). It has been shown in previous literature that ONSD measurement has good correlation with surrogate findings of raised ICP such as clinical and radiological findings suggestive of raised ICP. OBJECTIVES: The objective of the study is to find a correlation between sonographic measurements of ONSD value with ICP value measured via the gold standard invasive intracranial ICP catheter, and to find the cut-off value of ONSD measurement in predicting raised ICP, along with its sensitivity and specificity value...
September 23, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27852461/the-development-of-intensive-care-in-the-military-environment
#18
REVIEW
Matthew J Roberts
If the history of critical care is to be addressed, the starting point must be the fundamental and defining qualities of intensive care units. These are the concentration of the sickest patients in a defined area of the hospital, staffed by the personnel most able to care for them (by virtue of specialist training), and the application of the most advanced monitoring or therapeutic techniques available at the time. In the military environment, the ability to provide critical care to ill or injured servicemen has developed in tandem with the civilian experience, but the pressures of the austere environment of the battlefield have, at times, held back military medical services from providing the highest level of care that servicemen might deserve and, indeed, expect in civilian life...
October 2016: Journal of Anesthesia History
https://www.readbyqxmd.com/read/27852221/non-coronary-chest-pain-does-not-affect-long-term-mortality-a-prospective-observational-study-using-a-matched-population-control
#19
Staffan Nilsson, Petter Järemo
BACKGROUND: Chest pain assumed to be of non-coronary origin (NCCP) may be linked to enhanced mortality due to coronary heart disease (CHD). The aim of this study was to follow NCCP patients, as defined in primary care, with respect to mortality and long-term morbidity of CHD. We further examined if NCCP associates with risk factors for CHD. METHODS: Patients consulting general practitioners (GPs) in 1998-2000 in three primary care centers in the southeast Sweden for chest pain regarded as NCCP were compared with controls matched for age, gender and residential area...
November 16, 2016: BMC Family Practice
https://www.readbyqxmd.com/read/27847720/dilemmas-of-korean-athletes-with-a-spinal-cord-injury-to-participate-in-sports-a-survey-based-on-the-icf-core-set-for-spinal-cord-injury
#20
Je Shik Nam, Ko Eun Lee, Ah Young Jun, Chong Suck Parke, Hyun Young Kim, You Hyeon Chae
OBJECTIVE: To explore the experiences of athletes with spinal cord injury (SCI) in Korea with respect to dilemmas of participating in sports with regards to the facilitators and barriers, using the International Classification of Functioning, Disability and Health (ICF). METHODS: The facilitators and barriers to sports participation of individuals with SCI were examined using 112 ICF categories. A questionnaire in dichotomous scale was answered, which covered the subjects 'Body functions', 'Body structures', 'Activity and participation' and 'Environmental factors'...
October 2016: Annals of Rehabilitation Medicine
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