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https://www.readbyqxmd.com/read/29777635/reducing-the-number-of-obstetrical-beds-by-challenging-traditions
#1
Camilla Dalby Salvig, Marie Højriis Storkholm, Jannie Dalby Salvig, Niels Uldbjerg
The aim of this commentary is to describe changes in women care at an obstetric department that made it possible to reduce the number of beds from 40 to 29. Patient pathways were reviewed and revised using lean methodology. The mean length of stay was reduced from 70 to 59 hours and the mean numbers of hospitalizations per woman from 1.26 to 1.20. At the organizational level, we introduced a Family Department, home management of newborns, home monitoring of the women with cardiotocography and blood samples, and intrapartum Group B Streptococcus-PCR...
May 19, 2018: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/29776642/blunt-splenic-injury-during-colonoscopy-is-it-as-rare-as-we-think
#2
Erin G Andrade, Olubode A Olufajo, Eleanor L Drew, Grant V Bochicchio, Laurie J Punch
BACKGROUND: Post colonoscopy blunt splenic injury (PCBSI) is a rarely reported and poorly recognized event. We analyzed cases of PCBSI managed at our hospital and compared them to existing literature. METHODS: We identified 5 patients admitted with PCBSI through chart review. RESULTS: There were 5 cases of PCBSI identified from April 2016-July 2017. Four of the patients were older than 65 years, three had prior surgeries, and all were women...
May 12, 2018: American Journal of Surgery
https://www.readbyqxmd.com/read/29771041/-analysis-of-118-cases-of-benign-paroxysmal-positional-vertigo-after-trauma
#3
H L Xue, C X Li, L X Duan, Y L Jing
Objective: The aim of this study is to retrospective analysis the clinic features of 118 cases of benign paroxysmal positional vertigo after trauma. Method: Analyzes clinic features of injury in 118 cases of benign paroxysmal positional vertigo after trauma, and classified and localized the craniocerebral trauma. The 118 cases were tested with different positioning tests in the sequence of Dix hallpike test and rolling test. Then, proper otolith manual reduction was given. Result: In 118 cases of BPPV after trauma including 35 cases of skull fracture, 6 cases of concussion, 17 cases of scalp hematoma, 28 cases of scalp laceration, 14 cases of mild brain contusion and 18 cases of head combined injury...
May 20, 2017: Journal of Clinical Otorhinolaryngology, Head, and Neck Surgery
https://www.readbyqxmd.com/read/29764255/knot-positioning-during-mcdonald-cervical-cerclage-does-it-make-a-difference-a-cohort-study
#4
Hytham Atia, Mohamed Ellaithy, Ahmed Altraigey, Heba Ibrahim
OBJECTIVE: To study the effect of McDonald cerclage knot position on the different maternal and neonatal outcomes. METHODS: This historical cohort study included women with singleton pregnancy who had a prophylactic McDonald cervical cerclage between 1 May 2010 and 31 September 2017. Maternal and neonatal outcome parameters were compared between the anterior and posterior knot cerclage procedures. The primary outcome measure was the rate of term birth. RESULTS: 550 Women had a prophylactic McDonald cervical cerclage, 306 with anterior knot (Group A) and 244 with posterior knot (Group B)...
May 15, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29758367/clinical-and-neurosurgical-management-of-cranial-machete-injuries-the-experience-of-a-tertiary-referral-center-in-nicaragua
#5
Luis Zapata, Ernest J Wright, Peter Nakaji
BACKGROUND: The neurosurgical literature rarely describes managing open head injuries caused by machetes, although this is a common head injury in developing countries. We present our experience managing cranial machete injuries in Nicaragua over a 5-year period. METHODS: A retrospective chart review identified patients admitted to a neurosurgery service for cranial machete injury. RESULTS: Among 51 patients studied, the majority (n=42, 82%) presented with mild neurological deficits (Glasgow Coma Scale score ≥14)...
May 11, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29754258/glycerol-induced-injury-as-a-new-model-of-muscle-regeneration
#6
REVIEW
Mohamed A A Mahdy
Skeletal muscle regenerates efficiently following injuries and diseases. However, muscle regeneration is compromised in several conditions by adipocyte infiltration and excessive collagen deposition. Adipocyte infiltration is a characteristic feature of sarcopenia, diabetes, cachexia, muscular dystrophies and advanced cases of Duchenne muscular dystrophy (DMD), while excessive collagen deposition is a hallmark of muscular dystrophies and severe muscle injuries, such as lacerations, contusions and strains. Muscle adipogenesis and fibrosis are major causes of muscle weakness that impairs muscle function...
May 12, 2018: Cell and Tissue Research
https://www.readbyqxmd.com/read/29747958/emergency-department-intubation-success-with-succinylcholine-versus-rocuronium-a-national-emergency-airway-registry-study
#7
Michael D April, Allyson Arana, Daniel J Pallin, Steven G Schauer, Andrea Fantegrossi, Jessie Fernandez, Joseph K Maddry, Shane M Summers, Mark A Antonacci, Calvin A Brown
STUDY OBJECTIVE: Although both succinylcholine and rocuronium are used to facilitate emergency department (ED) rapid sequence intubation, the difference in intubation success rate between them is unknown. We compare first-pass intubation success between ED rapid sequence intubation facilitated by succinylcholine versus rocuronium. METHODS: We analyzed prospectively collected data from the National Emergency Airway Registry, a multicenter registry collecting data on all intubations performed in 22 EDs...
May 7, 2018: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/29742224/massive-hemoptysis-successfully-treated-with-extracorporeal-membrane-oxygenation-and-endobronchial-thrombolysis
#8
Antônio Aurélio de Paiva Fagundes Júnior, Renato Bueno Chaves, Amanda Robassini Dos Santos, Humberto Alves de Oliveira, Marcello Henrique Paschoal
Extracorporeal membrane oxygenation has been used to treat refractory hypoxemia in numerous clinical scenarios. The fundamental principles for the management of massive hemoptysis patients include protecting the airway and healthy lung, locating the source of bleeding and controlling the hemorrhage. We report the case of a patient with acute respiratory failure associated with massive hemoptysis secondary to lung laceration during cardiac surgery. The use of extracorporeal membrane oxygenation allowed patient survival...
March 2018: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/29737221/injuries-in-karate-systematic-review
#9
Roger E Thomas, Jodie Ornstein
OBJECTIVES: to identify all studies of Karate injuries and assess injury rates, types, location, and causes. METHODS: Six electronic and four grey literature databases were searched. Two reviewers independently assessed titles/abstracts, abstracted data and assessed risk-of-bias with the Newcastle-Ottawa scale. Average injury rates/1000AE (AE = athletic-encounter) and/1000minutesAE, injury location and type weighted by study size were calculated. RESULTS: In competitions rates of injury/1000AE and/1000 minutesAE were similar for males (111...
May 8, 2018: Physician and Sportsmedicine
https://www.readbyqxmd.com/read/29735290/incidence-timing-and-risk-factors-for-secondary-revision-after-primary-revision-of-traumatic-digit-amputations
#10
Andrew P Harris, Avi D Goodman, Joseph A Gil, Andrew D Sobel, Neill Y Li, Jeremy E Raducha, Grayson L Baird, Julia A Katarincic
PURPOSE: Primary revision amputation is the most common treatment method for traumatic digit amputations in the United States. Few studies have reported secondary revision rates after primary revision amputation. The primary aim of our study was to identify risk factors for secondary revision within 1 year of the index procedure. Secondarily, we describe the incidence and timing of complications requiring secondary revision. METHODS: Our institution's emergency department (ED) database was reviewed for traumatic digit amputations over a 6-year period...
May 5, 2018: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29735199/a-pilot-study-on-the-effects-of-direct-contact-of-two-different-surgical-burs-on-the-cadaveric-lingual-nerve
#11
S M Al-Amery, W C Ngeow, P Nambiar, M Naidu
The lingual guttering technique for third molar surgery carries the risk of injury to the lingual nerve if the surgical bur comes into direct contact with it. This study investigated the extent of nerve injury caused by two different burs, a tungsten carbide bur and the Dentium implant bur; the latter is designed to be soft tissue friendly. This study also examined whether ultrasound and magnetic resonance imaging are able to detect any injury inflicted. This cadaveric research involved subjecting 12 lingual nerves to the drilling effect of two different burs at two different speeds...
May 4, 2018: International Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29733036/a-systematic-review-of-lost-time-injuries-in-the-global-mining-industry
#12
Behdin Nowrouzi-Kia, Basem Gohar, Jennifer Casole, Carla Chidu, Jennifer Dumond, Alicia McDougall, Behnam Nowrouzi-Kia
BACKGROUND: Mining is a hazardous occupation with elevated rates of lost-time injury and disability. OBJECTIVE: The purpose of this study is twofold: 1) To identify the type of lost-time injuries in the mining workforce, regardless of the kind of mining and 2) To examine the antecedent factors to the occupational injury (lost-time injuries). METHODS: We identified and extracted primary papers related to lost-time injuries in the mining sector by conducting a systematic search of the electronic literature in the eight health and related databases...
May 1, 2018: Work: a Journal of Prevention, Assessment, and Rehabilitation
https://www.readbyqxmd.com/read/29730096/a-qualitative-exploration-of-techniques-used-by-expert-midwives-to-preserve-the-perineum-intact
#13
C Begley, K Guilliland, L Dixon, M Reilly, C Keegan, C McCann, V Smith
BACKGROUND: The perineum stretches during birth to allow passage of the baby, but 85% of women sustain some degree of perineal trauma during childbirth, which is painful post-partum. Episiotomy rates vary significantly, with some countries having rates of >60%. Recent Irish and New Zealand studies showed lower severe perineal trauma and episiotomy rates than other countries. AIM: To explore expert Irish and New Zealand midwives' views of the skills that they employ in preserving the perineum intact during spontaneous vaginal birth...
May 2, 2018: Women and Birth: Journal of the Australian College of Midwives
https://www.readbyqxmd.com/read/29730093/adverse-events-and-satisfaction-with-use-of-intranasal-midazolam-for-emergency-department-procedures-in-children
#14
Laurie Malia, V Matt Laurich, Jesse J Sturm
PURPOSE: Procedural sedation is commonly performed in the emergency department (ED). Having safe and fast means of providing sedation and anxiolysis to children is important for the child's tolerance of the procedure, parent satisfaction and efficient patient flow in the ED. OBJECTIVE: To evaluate fasting times associated with the administration of intranasal midazolam (INM) and associated complications. Secondary objectives included assessing provider and caregiver satisfaction scores...
April 30, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29728657/major-ocular-trauma-in-taiwan-2002-2004-versus-2012-2014
#15
Yi-Sheng Chang, Yu-Ti Teng, Yi-Hsun Huang, Mei-Ling Liu, Jia-Horung Hung, Sheng-Min Hsu, Fu-Chin Huang, Min-Hsiu Shih, Wan-Ju Chen, Chun-Chieh Lai, Shu-Fang Hsiao, Shih-Hao Wang, Sung-Huei Tseng
We investigated the temporal changes in major eye injuries in Taiwan by reviewing the medical records of all patients with ocular trauma hospitalized at the National Cheng Kung University Hospital during 2002-2004 and 2012-2014. A total of 169 eyes (161 patients) during 2002-2004 and 121 eyes (120 patients) during 2012-2014 were enrolled (mean ± SD age: 41.9 ± 20.8 years in 2002-2004, and 51.8 ± 19.3 years in 2012-2014). Males accounted for ~75% of patients. The most frequent injury-causing object was metallic material (~24%), and blunt traumas were most frequently attributable to traffic accidents and falls...
May 4, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29727315/autopsy-features-of-fatal-donkey-attack
#16
Lajos Fogel, Gyula Varga, Marta Hubay, Endre Felszeghy, Peter Varga, Roger W Byard
Lethal donkey attacks have very rarely been described. The case of a 65-year-old man who was found deceased on a country road with 2 domestic donkeys nearby is, therefore, reported. Examination of the body revealed contusions and lacerations of the face and scalp, a comminuted fracture of the left maxilla, comminuted fracturing of the right radius and ulna and of the left anterior superior iliac spine, a flail chest, and pulmonary contusions. In addition, there were bite marks on the left thigh, right buttock, right axilla/upper arm, and left cheek which corresponded to the dental arcades of the donkeys...
May 2, 2018: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/29720907/sedation-and-analgesia-using-medications-delivered-via-the-extravascular-route-in-children-undergoing-laceration-repair
#17
REVIEW
Jamie L Miller, Amanda C Capino, Amber Thomas, Kevin Couloures, Peter N Johnson
OBJECTIVES: To describe the method of delivery, dosage regimens, and outcomes of sedatives and analgesics administered via the extravascular route for laceration repair in children. METHODS: Medline, Embase, and International Pharmaceutical Abstracts were searched using the keywords "child," "midazolam," "ketamine," dexmedetomidine," "fentanyl," "nitrous oxide" (N2 O), and "laceration repair." Articles evaluating the use of extravascular sedation in children for laceration repair published in the English language between 1946 and June 2017 were included...
March 2018: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/29719849/avulsion-of-ampulla-of-vater-secondary-to-a-blunt-abdominal-injury-treated-with-pancreatoduodenectomy-a-case-report-and-literature-review
#18
Mustafa Ozsoy, Ogun Ersen, Zehra Ozsoy, Sezgin Yilmaz, Yüksel Arıkan
The incidence of complex hepatobiliary injury secondary to blunt abdominal injuries varies between 3.4 and 5%. A 25-year old male patient underwent an urgent operation due to a motorcycle accident. During intraabdominal exploration, Grade 4 laceration was detected at the liver and bleeding was controlled through primary repair. In the postoperative seventh day, he was referred due to 1500 cc bile leakage from the drainage tube. During the operation, an extensive Kocher maneuver was done and the second part of duodenum was observed to be exposed to total avulsion from the head of the pancreas...
April 2018: Bulletin of Emergency and Trauma
https://www.readbyqxmd.com/read/29719643/quantitative-analysis-of-macular-thickness-following-open-globe-injury-in-subjects-with-clear-media-and-no-retinal-damage
#19
Farshad Ostadian, Fereydoun Farrahi, Maryam Hajizadeh
Purpose: To evaluate the change in macular thickness after open globe injury (OGI) in patients with clear media and without retinal damage using optical coherence tomography (OCT). Methods: In this longitudinal observational pilot study, 17 patients with clear media and without retinal damage who underwent repair of OGI for corneal, corneoscleral, or scleral laceration were studied. In addition to routine follow-up, all patients were examined at the first and third postoperative months and best corrected visual acuity (BCVA), slit-lamp examination, applanation tonometry, dilated fundus examinations, and macular OCT scans were documented...
April 2018: Journal of Ophthalmic & Vision Research
https://www.readbyqxmd.com/read/29706551/anesthesia-for-collagenase-clostridium-histolyticum-injection-in-patients-with-dupuytren-disease-a-cohort-analysis
#20
Rafael Sanjuan-Cerveró, Francisco J Carrera-Hueso, Pedro Vazquez-Ferreiro, Clayton A Peimer
Procedural pain is one of the most common adverse effects reported by patients with Dupuytren disease (DD) treated with collagenase clostridium histolyticum (CCH). The aim of this study was to assess the effectiveness of wrist block before CCH injection in reducing procedural pain and to analyze its impact on adverse effects. We performed a prospective, single-center study in which we compared two groups of patients in a consecutive cohort. In the first group (NO-BLOCK), wrist block was only performed before finger extension, whereas in the second group (BLOCK), it was performed before CCH injection and finger extension...
April 12, 2018: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
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