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https://www.readbyqxmd.com/read/29224055/peri-operative-antibiotic-treatment-of-bacteriuria-reduces-early-deep-surgical-site-infections-in-geriatric-patients-with-proximal-femur-fracture
#1
Ronny Langenhan, Stefanie Bushuven, Niklas Reimers, Axel Probst
PURPOSE: The aim of this study was to conduct a re-evaluation of current strategies for peri-operative prophylaxis of infections in orthopaedic surgery of geriatric patients (≥65 years) with proximal femoral fractures (PFF). METHODS: Between 01/2010 and 08/2014 all post-operative infections after stabilization of PFF of 1,089 geriatric patients were recorded retrospectively. All patients pre-operatively received a single dose of 1.5 g cefuroxime (group 1). These were compared to prospectively determined post-operative rates of surgical site infection (SSI) of 441 geriatric patients, which were operated on between 09/2014 and 03/2017 due to PFF...
December 9, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/29209119/how-severe-is-moderately-severe-acute-pancreatitis-clinical-validation-of-revised-2012-atlanta-classification
#2
Povilas Ignatavicius, Aiste Gulla, Karolis Cernauskis, Giedrius Barauskas, Zilvinas Dambrauskas
AIM: To explore the outcomes and the appropriate treatment for patients with moderately severe acute pancreatitis (AP). METHODS: Statistical analysis was performed on data from the prospectively collected database of 103 AP patients admitted to the Department of Surgery, Hospital of Lithuanian University of Health Sciences in 2008-2013. All patients were confirmed to have the diagnosis of AP during the first 24 h following admission. The severity of pancreatitis was assessed by MODS and APACHE II scale...
November 21, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/29205275/antenatal-maternal-education-for-improving-postnatal-perineal-healing-for-women-who-have-birthed-in-a-hospital-setting
#3
REVIEW
Sonia M O'Kelly, Zena Eh Moore
BACKGROUND: The female perineum becomes suffused and stretched during pregnancy, and further strain during vaginal childbirth contributes to approximately 85% of women experiencing some degree of trauma to the perineal region. Multiple factors play a role in the type and severity of trauma experienced, including parity, delivery method, and local practices. There is ongoing debate about best midwifery practice to reduce perineal trauma. Once perineal trauma has occurred, treatment also varies greatly, depending on its degree and severity, local practice and customs, and personal preference...
December 4, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29201144/length-of-stay-costs-and-complications-in-lumbar-disc-herniation-surgery-by-standard-plif-versus-a-new-dynamic-interspinous-stabilization-technique
#4
Manuel Segura-Trepichio, David Candela-Zaplana, José Manuel Montoza-Nuñez, Antonio Martin-Benlloch, Andreu Nolasco
Background: The number of lumbar spine surgeries has been increasing during the last 20 years, which also leads to an increase in hospital costs and complications related to surgery. Therefore, there is a greater concern about the costs and safety of the techniques and implants used. Methods: Patients (aged from 18 to 50 years) presenting with lumbago /sciatica (ICD-10-CM M54.3, M54.4) due to lumbar disc herniation lasting more than 12 weeks, were included. Patients with disc herniation larger than size-2 or size-3 according to the MSU Classification were eligible for participation...
2017: Patient Safety in Surgery
https://www.readbyqxmd.com/read/29193516/the-effectiveness-of-clinical-pathway-directed-care-on-hospitalisation-related-outcomes-in-patients-with-severe-traumatic-brain-injury-a-quasi-experimental-study
#5
Warda Ramadan Abouzeid Mohamed, Matthew J Leach, Nagwa Ahmad Reda, Mohammad Mohamed Abd-Ellatif, Mona Aly Mohammed, Mervat Anwar Abdel Aziz
BACKGROUND: Severe traumatic brain injury (STBI) is a major cause of disability and mortality in young adults. Clinical pathways endeavour to bring evidence and clinical practice closer together to foster the delivery of best practice and to improve patient outcomes. OBJECTIVE: To compare the effectiveness of clinical pathway directed care to usual care on hospitalisation-related outcomes in patients with STBI. DESIGN: Quasi-experimental study...
November 29, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29182799/inhaled-magnesium-sulfate-in-the-treatment-of-acute-asthma
#6
REVIEW
Rachel Knightly, Stephen J Milan, Rodney Hughes, Jennifer A Knopp-Sihota, Brian H Rowe, Rebecca Normansell, Colin Powell
BACKGROUND: Asthma exacerbations can be frequent and range in severity from mild to life-threatening. The use of magnesium sulfate (MgSO₄) is one of numerous treatment options available during acute exacerbations. While the efficacy of intravenous MgSO₄ has been demonstrated, the role of inhaled MgSO₄ is less clear. OBJECTIVES: To determine the efficacy and safety of inhaled MgSO₄ administered in acute asthma. SPECIFIC AIMS: to quantify the effects of inhaled MgSO₄ I) in addition to combination treatment with inhaled β₂-agonist and ipratropium bromide; ii) in addition to inhaled β₂-agonist; and iii) in comparison to inhaled β₂-agonist...
November 28, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29182126/a-comparison-of-ketamine-sedation-and-general-anaesthesia-for-manipulation-of-paediatric-forearm-fractures
#7
R W Jordan, A Aquilina, D J Westacott, S Cooke
The purpose of the study was to compare the use of ketamine sedation and general anaesthesia for manipulation of paediatric wrist and forearm fractures. A retrospective analysis was performed of patients under 16 years treated at our centre between October 2014 and October 2015. Exclusion criteria were open fractures and fractures with complete displacement. Outcomes measured were fracture reduction, the quality of the cast, fracture redisplacement, further surgical intervention and use of theatre time. 66 children were manipulated over the study period; 31 received ketamine sedation and 35 general anaesthesia...
December 2016: Acta Orthopaedica Belgica
https://www.readbyqxmd.com/read/29178934/effectiveness-of-case-management-in-the-prevention-of-copd-re-admissions-a-pilot-study
#8
Annelies E van Eeden, Ingrid van de Poll, Gertrud van Vulpen, Tim Roldaan, Wies Wagenaar, Melinde R S Boland, Ron Wolterbeek, Niels H Chavannes
BACKGROUND: Chronic obstructive pulmonary disease (COPD) exacerbations are associated with high disease burden and costs, especially in the case of hospitalizations. The overall number of hospital admissions due to exacerbations of COPD has increased. It is remarkable that re-admissions account for a substantial part of these hospitalizations. This pilot study investigates the use of case management to reduce re-admissions due to COPD. METHODS: COPD patients with more than one hospitalization per year due to an exacerbation were included...
November 25, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/29149469/cuffed-versus-uncuffed-endotracheal-tubes-for-general-anaesthesia-in-children-aged-eight-years-and-under
#9
REVIEW
Flavia A De Orange, Rebeca Gac Andrade, Andrea Lemos, Paulo Sgn Borges, José N Figueiroa, Pete G Kovatsis
BACKGROUND: Since the introduction of endotracheal intubation in paediatrics, uncuffed endotracheal tubes (ETTs) have been the standard of care for children under eight years old, based on the presumption that complications, particularly postoperative stridor, are higher with cuffed ETTs. The major disadvantages of uncuffed ETTs cited for this shift in procedure include the difficulty in achieving tidal volumes due to leakage around an uncuffed ETT. To seal the airway adequately, uncuffed tubes may need to be exchanged for another tube with a larger diameter, which sometimes requires several attempts before the appropriate size is found...
November 17, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29128315/parathyroid-hormone-calcidiol-calcitriol-and-adverse-events-in-the-acute-coronary-syndrome
#10
P Ramos Ruiz, L Jaulent Huertas, M Castañeda Sancirilo, J J Martínez Díaz, G Clavel Ruipérez, L García de Guadiana Romualdo, S Wasniewski, M Merelo Nicolás, I García Escribano, F Soria Arcos, J A Castillo Moreno, L Consuegra Sánchez
OBJECTIVE: To know the clinical profile as well as the prognostic significance of elevated levels of parathyroid hormone (PTH) in patients admitted for acute coronary syndrome (ACS). DESIGN AND SETTING: Observational and prospective study of patients admitted for ACS in a single Spanish center during a period of six months. INTERVENTION AND VARIABLES OF INTEREST: The circulating concentrations of PTH, calcidiol, calcitriol, NT-proBNP, C-reactive protein, cystatinC and fibrinogen were determined within the first 48h at admission...
November 8, 2017: Medicina Intensiva
https://www.readbyqxmd.com/read/29122733/readmissions-in-anticoagulated-intracranial-hemorrhage-patients-a-retrospective-review
#11
Monica M DiFiori, Laura C Lamb, Lori L Calavan, Christopher H Comey, James M Feeney
OBJECTIVE: The objective of this study was to determine the effect of Direct Oral Anticoagulants (DOACs) when compared to warfarin, on the 30-day readmission rates in patients with traumatic intracranial hemorrhage (ICH). METHODS: We conducted a retrospective review of patients from our hospital's trauma database admitted from June 2011 to October 2015 to our Level II trauma center after sustaining a traumatic ICH while anticoagulated. Patients were stratified based on the anticoagulation drug (DOAC or warfarin) they were prescribed upon admission...
November 6, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29115071/an-acute-medical-unit-in-a-korean-tertiary-care-hospital-reduces-the-length-of-stay-and-waiting-time-in-the-emergency-department
#12
Jung Hun Ohn, Nak Hyun Kim, Eun Sun Kim, Seon Ha Baek, Yejee Lim, Jaehyung Hur, Yun Jong Lee, Eu Suk Kim, Hak Chul Jang
A hospitalist-run acute medical unit (AMU) opened at a tertiary care hospital on August 2015 for the first time in Korea. Patients visiting the emergency department (ED) with acute medical problems are admitted to the AMU. They stay in that unit for less than 72 hours and are discharged or transferred to specialty wards if longer treatment is necessary. We reviewed 19,450 medical admissions through the ED from January 2014 to September 2016. The median length of stay (LOS) significantly decreased from 10.0 days (interquartile range [IQR], 5...
December 2017: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/29110656/in-patient-tolvaptan-use-in-siadh-care-audit-therapy-observation-and-outcome-analysis
#13
Malik Asif Humayun, Iain C Cranston
BACKGROUND: Indications for use of tolvaptan in SIADH-associated hyponatraemia remain controversial. We audited our local guidelines for Tolvaptan use in this situation to review treatment implications including drug safety, hospital admission episode analysis (episodes of liver toxicity, CNS myelinolysis, sodium-related re-admission rates), morbidity; mortality and underlying aetiologies. METHODS: We report a retrospective case series analysis of on-going treatment outcomes (case-note review) for 31 patients (age 73...
November 6, 2017: BMC Endocrine Disorders
https://www.readbyqxmd.com/read/29104962/predicting-hospital-re-admissions-from-nursing-care-data-of-hospitalized-patients
#14
Muhammad K Lodhi, Rashid Ansari, Yingwei Yao, Gail M Keenan, Diana Wilkie, Ashfaq A Khokhar
Readmission rates in the hospitals are increasingly being used as a benchmark to determine the quality of healthcare delivery to hospitalized patients. Around three-fourths of all hospital re-admissions can be avoided, saving billions of dollars. Many hospitals have now deployed electronic health record (EHR) systems that can be used to study issues that trigger readmission.However, most of the EHRs are high dimensional and sparsely populated, and analyzing such data sets is a Big Data challenge. The effect of some of the well-known dimension reduction techniques is minimized due to presence of non-linear variables...
2017: Advances in Data Mining. Industrial Conference on Data Mining
https://www.readbyqxmd.com/read/29103779/is-outpatient-unicompartmental-knee-arthroplasty-safe-to-perform-at-an-ambulatory-surgery-center-a-comparative-study-of-early-post-operative-complications
#15
John P Cody, Kiel J Pfefferle, Deborah J Ammeen, Kevin B Fricka
BACKGROUND: Unicompartmental knee arthroplasty (UKA) lends itself to the outpatient surgical setting. Prior literature has established a low rate of readmission and post-operative complications when performed in a hospital outpatient setting (HOP). To our knowledge, there have been no studies comparing complications of UKA performed at an ambulatory surgery center (ASC) and those in a HOP. METHODS: We retrospectively reviewed all patients who underwent outpatient UKA by a single surgeon from 2012 to 2016...
October 10, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29081670/evaluation-of-the-effectiveness-and-efficiency-of-the-triage-emergency-department-nursing-protocol-for-the-management-of-pain
#16
Loris Butti, Olga Bierti, Raffaela Lanfrit, Romina Bertolini, Sara Chittaro, Stefania Delli Compagni, Davide Del Russo, Rossella Letizia Mancusi, Franco Pertoldi
INTRODUCTION: Pain is a common symptom presented in the emergency department (ED) although it is often underestimated, poorly evaluated and treated. The application of a protocol for timely pain management ensured by the nurse can avoid the delays in the analgesic treatment and improve the patient's quality of waiting. AIMS: To check the effectiveness and efficiency of the protocol aimed at early pain management in triage, active in our ED. In particular, the response to analgesic treatment was evaluated 60 minutes after the administration and at discharge...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/29071422/reasons-and-risk-factors-for-ninety%C3%A2-day-re-admission-following-primary-total-knee-arthroplasty-in-a-high-volume-centre
#17
Sami A Saku, Rami Madanat, Tatu J Mäkinen
PURPOSE: We aimed to assess the rates, reasons, and risk factors for 90-day re-admissions after total knee arthroplasty (TKA) in a European healthcare setting. METHODS: We identified all primary elective TKA procedures performed in 2015 at a single high-volume centre. Patients with unplanned re-admissions within 90 days of primary discharge were compared to a 1:4 control cohort of patients having no relevant re-admission. We calculated re-admission rates, recorded the reasons for re-admission, and identified independent predictors of re-admission...
October 25, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/29064344/low-infection-related-re-admission-rates-in-a-retrospective-of-4725-children-with-appendicitis-using-a-clinical-pathway-in-a-tertiary-care-pediatric-center
#18
Nikolas E Marino, Kate Davenport, Mary Hilfiker, Simone Langness, Timothy Fairbanks, Erin Stucky Fisher, Robert Newbury, Allyson Andrews, Alan Wells, Juan D Chaparro, John S Bradley
BACKGROUND: Standardization of antibiotic management of appendicitis in tertiary care pediatric centers has been associated with improved outcomes. Rady Children's Hospital-San Diego implemented an appendicitis clinical pathway in 2005. We evaluated infection-related re-admission risk factors since 2010, when an electronic medical record was established, with the aim to optimize the clinical pathway. METHODS: Between January 2010 and August 2015, 4725 children with a diagnosis of appendicitis were evaluated for demographic data, pathology diagnoses, culture results, and inpatient and oral step-down antibiotic therapy regimens...
October 24, 2017: Surgical Infections
https://www.readbyqxmd.com/read/29063607/spinal-or-general-anaesthesia-for-lower-limb-amputation-in-peripheral-artery-disease-a-retrospective-cohort-study
#19
M Niskakangas, S Dahlbacka, J Liisanantti, M Vakkala, T Kaakinen
BACKGROUND: The present study aimed to determine which method of anaesthesia (spinal anaesthesia or general anaesthesia) is better in reducing post-operative analgesic requirements in patients undergoing major limb amputation for lower-limb ischaemia. Another aim was to find out if anaesthesiologists use neuraxial anaesthesia in high-risk patients despite abnormal coagulation profile or use of anticoagulation. METHODS: The study was a retrospective cohort study...
October 24, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29063527/high-participation-rate-among-25-721-patients-with-broad-age-range-in-a-hospital-based-research-project-involving-whole-genome-sequencing-the-lausanne-institutional-biobank
#20
Murielle Bochud, Christine Currat, Laurence Chapatte, Cindy Roth, Vincent Mooser
AIMS: We aimed to evaluate the interest of adult inpatients and selected outpatients in engaging in a large, real-life, hospital-based, genomic medicine research project and in receiving clinically actionable incidental findings. METHODS: Within the framework of the cross-sectional Institutional Biobank of Lausanne, Switzerland, a total of 25721 patients of the CHUV University Hospital were systematically invited to grant researchers access to their biomedical data and to donate blood for future analyses, including whole-genome sequencing...
October 24, 2017: Swiss Medical Weekly
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