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https://www.readbyqxmd.com/read/28107239/management-of-pharyngeal-fistulas-after-anterior-cervical-spine-surgery-a-treatment-algorithm-for-severe-complications
#1
Christian Simon, Carl H Fürstenberg, Markus Eichler, Stefan Rohde, Cem Bulut, Bernd Wiedenhöfer
STUDY DESIGN: This study is a retrospective database query to identify all anterior spinal approaches. OBJECTIVES: The objectives were to assess all patients with pharyngocutaneous fistulas (PCFs) after anterior cervical spine surgery. SUMMARY OF BACKGROUND DATA: Patients with the diagnosis of PCFs were treated at the University of Heidelberg Spine Medical Center, Spinal Cord Injury Unit and Department of Otolaryngology (Germany), between 2005 and 2011...
February 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28104101/preventing-hospitalizations-from-acute-exacerbations-of-chronic-obstructive-pulmonary-disease
#2
REVIEW
Jessica E Burchette, G Douglas Campbell, Stephen A Geraci
Chronic obstructive lung disease is among the leading causes of adult hospital admissions and readmissions in the United States. Preventing acute exacerbations is the primary approach in therapy. Combinations of smoking cessation, pulmonary rehabilitation, vaccinations and inhaled and oral medications may all reduce the overall risk of acute exacerbations. When prevention is unsuccessful, treatment of exacerbations often does not require hospitalization but can be safely executed in the outpatient setting. In the patient who does not require mechanical ventilation or who manifests respiratory acidosis, oxygen supplementation, frequent short-acting inhaled bronchodilators, oral corticosteroids and often antibiotics can abort the decompensation and sometimes return the patient to his or her pre-attack baseline lung function...
January 2017: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/28103397/the-economic-burden-of-nurse-sensitive-adverse-events-in-22-medical-surgical-units-retrospective-and-matching-analysis
#3
Eric Tchouaket, Carl-Ardy Dubois, Danielle D'Amour
AIMS: To assess the economic burden of nurse-sensitive adverse events (NSAEs) in 22 acute care units in Quebec by estimating excess hospital-related costs and calculating resulting additional hospital days. BACKGROUND: Recent changes in the worldwide economic and financial contexts have made the cost of patient safety a topical issue. Yet our knowledge about the economic burden of safety of nursing care is quite limited in Canada in general and Quebec in particular...
January 19, 2017: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/28102025/the-direct-referral-to-endovascular-center-criteria-a-proposal-for-pre-hospital-evaluation-of-acute-stroke-in-the-madrid-stroke-network
#4
J Rodríguez-Pardo, B Fuentes, M Alonso de Leciñana, Á Ximénez-Carrillo, G Zapata-Wainberg, J Álvarez-Fraga, F J Barriga, L Castillo, J Carneado-Ruiz, J Díaz-Guzman, J Egido-Herrero, A de Felipe, J Fernández-Ferro, L Frade-Pardo, Á García-Gallardo, A García-Pastor, A Gil-Núñez, C Gómez-Escalonilla, M Guillán, Y Herrero-Infante, J Masjuan-Vallejo, M Á Ortega-Casarrubios, J Vivancos-Mora, E Díez-Tejedor
BACKGROUND AND PURPOSE: For patients with acute ischaemic stroke due to large-vessel occlusion, it has recently been shown that mechanical thrombectomy (MT) with stent retrievers is better than medical treatment alone. However, few hospitals can provide MT 24 h/day 365 days/year, and it remains unclear whether selected patients with acute stroke should be directly transferred to the nearest MT-providing hospital to prevent treatment delays. Clinical scales such as Rapid Arterial Occlusion Evaluation (RACE) have been developed to predict large-vessel occlusion at a pre-hospital level, but their predictive value for MT is low...
January 19, 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/28100561/investigation-of-the-degree-of-organisational-influence-on-patient-experience-scores-in-acute-medical-admission-units-in-all-acute-hospitals-in-england-using-multilevel-hierarchical-regression-modelling
#5
Paul Sullivan, Derek Bell
OBJECTIVES: Previous studies found that hospital and specialty have limited influence on patient experience scores, and patient level factors are more important. This could be due to heterogeneity of experience delivery across subunits within organisations. We aimed to determine whether organisation level factors have greater impact if scores for the same subspecialty microsystem are analysed in each hospital. SETTING: Acute medical admission units in all NHS Acute Trusts in England...
January 18, 2017: BMJ Open
https://www.readbyqxmd.com/read/28099637/factors-associated-with-maternal-death-in-an-intensive-care-unit
#6
Suzanne Vieira Saintrain, Juliana Gomes Ramalho de Oliveira, Maria Vieira de Lima Saintrain, Zenilda Vieira Bruno, Juliana Lima Nogueira Borges, Elizabeth De Francesco Daher, Geraldo Bezerra da Silva
Objective: To identify factors associated with maternal death in patients admitted to an intensive care unit. Methods: A cross-sectional study was conducted in a maternal intensive care unit. All medical records of patients admitted from January 2012 to December 2014 were reviewed. Pregnant and puerperal women were included; those with diagnoses of hydatidiform mole, ectopic pregnancy, or anembryonic pregnancy were excluded, as were patients admitted for non-obstetrical reasons...
October 2016: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/28099635/currently-used-dosage-regimens-of-vancomycin-fail-to-achieve-therapeutic-levels-in-approximately-40-of-intensive-care-unit-patients
#7
Vitor Yuzo Obara, Carolina Petrus Zacas, Claudia Maria Dantas de Maio Carrilho, Vinicius Daher Alvares Delfino
Objective: This study aimed to assess whether currently used dosages of vancomycin for treatment of serious gram-positive bacterial infections in intensive care unit patients provided initial therapeutic vancomycin trough levels and to examine possible factors associated with the presence of adequate initial vancomycin trough levels in these patients. Methods: A prospective descriptive study with convenience sampling was performed. Nursing note and medical record data were collected from September 2013 to July 2014 for patients who met inclusion criteria...
October 2016: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/28099219/a-review-of-the-clinical-utility-of-intravascular-ultrasound-ivus-and-optical-coherence-tomography-oct-in-the-assessment-and-treatment-of-coronary-artery-disease
#8
Stephen Daniel Matthews, William H Frishman
Coronary artery disease (CAD) remains one of the leading causes of morbidity and mortality in the United States. As a medical society, we continue to search for ways to better treat CAD and prevent acute coronary syndrome (ACS). As it stands, only statins and anti-platelets agents have been proven to significantly reduce the occurrence of ACS. A histopathological understanding of the pathogenesis of ACS has provided insight into the importance of plaque morphology. Therefore, it has been proposed that increasing the ability to detect true vulnerable, "at-risk" lesions, would foster the use of percutaneous coronary intervention as a means for the prevention of ACS...
January 11, 2017: Cardiology in Review
https://www.readbyqxmd.com/read/28098590/analgesia-and-sedation-requirements-in-mechanically-ventilated-trauma-patients-with-acute-preinjury-use-of-cocaine-and-or-amphetamines
#9
Bridgette Kram, Shawn J Kram, Michelle L Sharpe, Michael L James, Maragatha Kuchibhatla, Mark L Shapiro
BACKGROUND: The purpose of this study was to determine whether mechanically ventilated trauma patients with a positive urine drug screen (UDS) for cocaine and/or amphetamines have different opioid analgesic and sedative requirements compared with similar patients with a negative drug screen for these stimulants. METHODS: This retrospective, single-center cohort study at a tertiary care, academic medical and level 1 trauma center in the United States included patients ≥16 years of age who were admitted to an adult intensive care unit with a diagnosis of trauma between 2009 and 2013 with a UDS documented within 24 hours of admission, and were mechanically ventilated for >24 hours...
January 16, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28097095/limited-knowledge-of-acetaminophen-in-patients-with-liver-disease
#10
Sammy Saab, Peter G Konyn, Matthew R Viramontes, Melissa A Jimenez, Jonathan F Grotts, Wally Hamidzadah, Veronica P Dang, Negin L Esmailzadeh, Gina Choi, Francisco A Durazo, Mohamed M El-Kabany, Steven-Huy B Han, Myron J Tong
Background and Aims: Unintentional acetaminophen overdose remains the leading cause of acute liver failure in the United States. Patients with underlying liver disease are at higher risk of poor outcomes from acetaminophen overdose. Limited knowledge of acetaminophen may be a preventable contributor to elevated rates of overdose and thus acute liver failure. The purpose of this study is to assess knowledge of acetaminophen dosing and presence of acetaminophen in common combination products in patients with liver disease...
December 28, 2016: Journal of Clinical and Translational Hepatology
https://www.readbyqxmd.com/read/28096032/creation-of-an-intensive-care-unit-and-organizational-changes-in-an-adult-emergency-department-impact-on-acute-stroke-management
#11
Laurent Puy, Chantal Lamy, Sandrine Canaple, Audrey Arnoux, Nicolas Laine, Ella Iacob, Jean-Marc Constans, Olivier Godefroy
BACKGROUND AND PURPOSE: Following the reorganization of a University Medical Center onto a single campus, an Intensive Care Unit was created within the adult Emergency Department (ED ICU). We assessed the effects of these organizational changes on acute stroke management and the intravenous administration of recombinant tissue plasminogen activator (IV rtPA), as characterized by the thrombolysis rate, door-to-needle time (DNT) and outcome at 3months. METHODS: Between October 2013 and September 2015, we performed a retrospective, observational, single-center, comparative study of patients admitted for ischemic stroke and treated with IV rtPA during two 321-day periods (before and after the creation of the ED ICU)...
January 10, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28094172/interval-changes-in-myocardial-performance-index-predict-outcome-in-severe-sepsis
#12
Junaid Nizamuddin, Feroze Mahmood, Avery Tung, Ariel Mueller, Samuel M Brown, Shahzad Shaefi, Michael O'Connor, Daniel Talmor, Sajid Shahul
OBJECTIVES: Septic cardiomyopathy is a well-described consequence of septic shock and is associated with increased sepsis-related mortality. The myocardial performance index (MPI), a parameter derived from echocardiographic tissue Doppler measurements, allows for a more sensitive assessment of global cardiac function than do traditional metrics for cardiac function. The authors hypothesized that changes in left ventricular MPI in patients with severe sepsis would be associated with a higher 90-day mortality...
November 2, 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28093536/noma-overview-of-a-neglected-disease-and-human-rights-violation
#13
REVIEW
M Leila Srour, Klaas Marck, Denise Baratti-Mayer
Noma is an orofacial gangrene affecting malnourished children and mainly observed in tropical countries, particularly sub-Saharan Africa. Epidemiological data on noma are scarce, but a current estimate of the global incidence is 30,000-40,000 cases per year, with a mortality rate of approximately 85% and a burden of disease calculated to be a loss of 1-10 million disability-adjusted life years. The etiology of noma is multifactorial with malnutrition as an ever present factor, often in combination with concomitant diseases, such as measles, malaria, and human immunodeficiency virus (HIV), and poor oral hygiene...
January 16, 2017: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/28089444/health-care-associated-infections-in-neonates-children-and-adolescents-an-analysis-of-paediatric-data-from-the-european-centre-for-disease-prevention-and-control-point-prevalence-survey
#14
Walter Zingg, Susan Hopkins, Angèle Gayet-Ageron, Alison Holmes, Mike Sharland, Carl Suetens
BACKGROUND: In 2011-12, the European Centre for Disease Prevention and Control (ECDC) held the first Europe-wide point-prevalence survey of health-care-associated infections in acute care hospitals. We analysed paediatric data from this survey, aiming to calculate the prevalence and type of health-care-associated infections in children and adolescents in Europe and to determine risk factors for infection in this population. METHODS: Point-prevalence surveys took place from May, 2011, to November, 2012, in 1149 hospitals in EU Member States, Iceland, Norway, and Croatia...
January 12, 2017: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/28076685/diffusion-of-evidence-based-intensive-care-unit-organizational-practices-a-state-wide-analysis
#15
Rachel Kohn, Vanessa Madden, Jeremy M Kahn, David A Asch, Amber E Barnato, Scott D Halpern, Meeta Prasad Kerlin
RATIONALE: Several intensive care unit (ICU) organizational practices have been associated with improved patient outcomes. However, the uptake of these evidence-based practices is unknown. OBJECTIVE: To assess diffusion of ICU organizational practices across the state of Pennsylvania. METHODS: We conducted two web-based, cross-sectional surveys of ICU organizational practices in Pennsylvania acute care hospitals, in 2005 (chief nursing officer respondents) and 2014 (ICU nurse manager respondents)...
January 11, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28074658/hyperglycemia-as-a-prognosis-predictor-of-length-of-stay-and-functional-outcomes-in-patients-with-acute-ischemic-stroke
#16
Abdul Gofir, Budi Mulyono, Sri Sutarni
Background Hyperglycemia has been shown to influence prognosisoutcome of stroke. The objective of this study was to determine the correlation betweenhyperglycemia with length of stay (LOS) and functional outcomes in ischemic stroke patients. This is the first study to correlate hyperglycemia in ischemic stroke patients with their functional outcome as assessed by using Barthel index. Methods This is a prospective cohort study of patients admitted to the Stroke Unit of Dr. Sardjito General Hospital for ischemic stroke from January 2012 to June 2014...
January 11, 2017: International Journal of Neuroscience
https://www.readbyqxmd.com/read/28073934/the-influence-of-customer-medicine-seller-transactional-dynamics-on-childhood-diarrhoea-management-a-qualitative-study-in-ghana
#17
Lauren Rosapep, Emily Sanders, Kathryn Banke
In 2004, the World Health Organization (WHO) and United Nations Children's Fund (UNICEF) jointly revised the recommended treatment for acute paediatric diarrhoea to specify supplementing reduced osmolarity oral rehydration salts (ORS) with zinc. In many countries, however, a significant knowledge-practice gap persists in appropriate diarrhoea management among private healthcare providers. For example, the United States Agency for International Development (USAID)-funded Strengthening Health Outcomes through the Private Sector (SHOPS) project recently demonstrated that over-the-counter medicine sellers (MS) in Ghana recommended inappropriate diarrhoea treatments, despite their demonstrated knowledge of appropriate treatment protocols...
January 10, 2017: Health Policy and Planning
https://www.readbyqxmd.com/read/28073631/-assessing-motivation-to-smoking-cessation-in-hospitalized-patients
#18
Juana María Sepúlveda-Sánchez, José Carlos Canca-Sánchez, Francisco Rivas-Ruiz, Mónica Martín-García, Celia Lorente Márquez, Eva María Timonet-Andreu
AIM: To assess motivation to quit smoking in patients admitted to an acute care hospital, determine predictors of readiness to change, and identify a risk group that requires targeted motivational interviewing. METHODS: A cross-sectional descriptive study. A retrospective study was performed on the medical records of 248 patients aged >18 years with smoking habits admitted to the medical and surgery units of a district hospital between May 2014 and April 2015...
January 7, 2017: Enfermería Clínica
https://www.readbyqxmd.com/read/28073114/a-study-of-acute-poisoning-cases-admitted-to-the-university-hospital-emergency-department-in-tabriz-iran
#19
Mehdi Oraie, Mir-Jamal Hosseini, Mina Islambulchilar, Seyed-Hasan Hosseini, Mehdi Ahadi-Barzoki, Habib Sadr, Hashem Yaghoubi
Chemical substances have an important threat due to extensive use in medicine, agriculture, industry and environment. In this retrospective study, etiological and demographic characteristics of acute poisoning cases admitted to a hospital in Iran were investigated. We compared these data with those reported from other parts of the country and the international experiences to evaluate any difference if exists. 7 052 poisoned cases admitted to the hospital from April 2006 to March 2013, by data collected from the medical record in poison center section...
January 10, 2017: Drug Research
https://www.readbyqxmd.com/read/28072937/prognosis-of-patients-with-rheumatic-diseases-admitted-to-intensive-care
#20
M Beil, S Sviri, V de la Guardia, I Stav, E Ben-Chetrit, P V van Heerden
Variable mortality rates have been reported for patients with rheumatic diseases admitted to an intensive care unit (ICU). Due to the absence of appropriate control groups in previous studies, it is not known whether the presence of a rheumatic disease constitutes a risk factor. Moreover, the accuracy of the Acute Physiology and Chronic Health Evaluation II (APACHE II) score for predicting outcome in this group of patients has been questioned. The primary goal of this study was to compare outcome of patients with rheumatic diseases admitted to a medical ICU to those of controls...
January 2017: Anaesthesia and Intensive Care
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