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https://www.readbyqxmd.com/read/28430978/culture-matters-indigenizing-patient-safety-in-bhutan
#1
Rinchen Pelzang, Megan-Jane Johnstone, Alison M Hutchinson
Studies show that if quality of healthcare in a country is to be achieved, due consideration must be given to the importance of the core cultural values as a critical factor in improving patient safety outcomes. The influence of Bhutan's traditional (core) cultural values on the attitudes and behaviours of healthcare professionals regarding patient care are not known. This study aimed to explore the possible influence of Bhutan's traditional cultural values on staff attitudes towards patient safety and quality care...
April 17, 2017: Health Policy and Planning
https://www.readbyqxmd.com/read/28430340/transurethral-contact-ureterolithotripsy-in-gas-%C3%B0-%C3%B0-2-medium
#2
Dmitry O Korolev, Peter V Glybochko, Leonid M Rapoport, Dmitry G Tsarichenko
BACKGROUND: Transurethral intracorporeal lithotripsy is the modality of choice for the endoscopic disintegration of large, long-standing, radiolucent or high-density stones. Despite several advantages and proven benefits of contact ureterolithotripsy/ureterolithoextraction (CULT), the application of irrigation carries significant risks of untoward perioperative events including retrograde stone migration and postoperative pyelonephritis. METHODS: We describe a new technique - endoscopic intracorporeal lithotripsy in the gas (СО2) medium...
April 14, 2017: Urologia
https://www.readbyqxmd.com/read/28430007/the-feasibility-and-impact-of-prospective-medication-review-in-the-emergency-department
#3
Billy Sin, Kwong Lau, Richard Tong, Josel Ruiz, Kimberly Sarosky, Robert DiGregorio, Shalom Butel, Sylvie de Souza
OBJECTIVE: We evaluated the feasibility and impact of prospective medication review (PMR) in the emergency department (ED). METHODS: This was a retrospective cohort study of all nonadmitted ED patients who were prescribed medication orders by ED clinicians from September 2014 to September 2015 to determine the time intervals utilized during each step of the medication use process and quantify the number of interventions conducted by the pharmacist and cost avoidance accrued from the interventions...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/28429988/patient-safety-in-nursing-homes-in-sweden-nurses-views-on-safety-and-their-role
#4
Frieda Andersson, Katarina Hjelm
Objective Knowledge about patient safety in nursing homes is limited. The aim of this study was to describe what patient safety means to nurses working in nursing homes for the elderly and how these nurses address patient safety. Method Qualitative study of semi-structured interviews with 15 nurses aged 27-62 years. Qualitative content analysis was applied. Results Nurses describe the meaning of patient safety in terms of proper care and treatment, and a sense of security. Based on nurses' description of patient safety, several factors were identified as prerequisites to achieve safe health care: competence; clear information transfer between health care organizations; continuity of care and appropriate environment...
January 1, 2017: Journal of Health Services Research & Policy
https://www.readbyqxmd.com/read/28429628/relationship-of-steroid-dosing-and-duration-of-mechanical-ventilation-in-adult-patients-with-acute-exacerbations-of-chronic-obstructive-pulmonary-disease
#5
Jennifer McCann, Katherine Teare, Emily Cochard, Brent Toney
BACKGROUND: The optimal steroid dose for patients who require mechanical ventilation (MV) for acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is unknown. OBJECTIVE: The primary objective of the study is to describe the relationship between steroid doses prescribed and duration of MV. METHODS: This was a retrospective study of patients admitted between October 2013 and September 2014 who were prescribed steroids and received MV for ≥48 hours for AECOPD...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/28429283/use-of-hormones-tissue-factors-and-bioengineering-in-the-management-of-hypospadias
#6
Aparajita Mitra, Yogesh Kumar Sarin
Hypospadiology is a rapidly evolving field. Progress in the understanding of how hormonal therapy affects the growth of the phallus has allowed surgeons to optimize the tissues for surgery. But conflicting data from a number of studies and a lack of consensus on drugs, their dosing, mode of delivery and timing of use means that the creation of protocols is unlikely to happen in the near future. Nonetheless, there is a hope and the standardization of scientific reporting will make it easier to compare data at the global level...
April 21, 2017: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/28429093/a-case-of-glioblastoma-resected-immediately-after-administering-bevacizumab-consideration-on-histopathological-findings-and-safety-of-surgery
#7
Yukina Tokuda, Ryota Tamura, Kentaro Ohara, Kazunari Yoshida, Hikaru Sasaki
Surgery after administering bevacizumab should be carefully considered particularly because of wound healing concerns. A 27-year-old man presented with multiple tumor recurrences after gross total removal of a left temporal oligodendroglioma (1p/19q-noncodeleted). Whole brain radiotherapy with concomitant temozolomide and bevacizumab was immediately prescribed; however, the patient's condition deteriorated because of brain herniation. Three days after administering bevacizumab, an emergency tumor removal with external decompression and a ventriculo-peritoneal shunt was performed...
April 20, 2017: Brain Tumor Pathology
https://www.readbyqxmd.com/read/28427779/fish-oil-lc-pufas-do-not-affect-blood-coagulation-parameters-and-bleeding-manifestations-analysis-of-8-clinical-studies-with-selected-patient-groups-on-omega-3-enriched-medical-nutrition
#8
Stephanie Jeansen, Renger F Witkamp, Jossie A Garthoff, Ardy van Helvoort, Philip C Calder
BACKGROUND & AIMS: The increased consumption of fish oil enriched-products exposes a wide diversity of people, including elderly and those with impaired health to relatively high amounts of n-3 long-chain polyunsaturated fatty acids (n-3 LC-PUFAs). There is an ongoing debate around the possible adverse effects of n-3 LC-PUFAs on bleeding risk, particularly relevant in people with a medical history of cardiovascular events or using antithrombotic drugs. METHODS: This analysis of 8 clinical intervention studies conducted with enteral medical nutrition products containing fish oil as a source of n-3 LC-PUFAs addresses the occurrence of bleeding-related adverse events and effects on key coagulation parameters (Prothrombin Time [PT], (activated) and Partial Thromboplastin Time [(a)PTT])...
March 29, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28427304/translating-u-500r-randomized-clinical-trial-evidence-to-the-practice-setting-a-diabetes-educator-expert-prescriber-team-approach
#9
Paula M Bergen, Davida F Kruger, April D Taylor, Wael E Eid, Arti Bhan, Jeffrey A Jackson
Purpose The purpose of this article is to provide recommendations to the diabetes educator/expert prescriber team for the use of human regular U-500 insulin (U-500R) in patients with severely insulin-resistant type 2 diabetes, including its initiation and titration, by utilizing dosing charts and teaching materials translated from a recent U-500R clinical trial. Conclusions Clinically relevant recommendations and teaching materials for the optimal use and management of U-500R in clinical practice are provided based on the efficacy and safety results of and lessons learned from the U-500R clinical trial by Hood et al, current standards of practice, and the authors' clinical expertise...
April 1, 2017: Diabetes Educator
https://www.readbyqxmd.com/read/28427133/-effects-of-application-of-vancomycin-in-the-early-stage-of-patients-with-extremely-severe-burn
#10
Z Zhu, G W Cao, J J Bao, Z H Hu, Z Shen, H Tao, B Cao, F Xu
Objective: To evaluate the effects of application of vancomycin in the early stage of patients with extremely severe burn, in order to provide reference to drug for anti-infection treatment in the early stage of patients with extremely severe burn. Methods: Data of 15 patients of Kunshan explosion on August 2nd, 2014, admitted to the Department of Intensive Care in our hospital were retrospectively analyzed. The clinical efficacy of continuously intravenous dripping of vancomycin (combined with imipenem) in the early stage of burns (before and on post burn day 14) was analyzed...
April 20, 2017: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
https://www.readbyqxmd.com/read/28427116/current-trends-in-the-management-of-gastroesophageal-reflux-disease
#11
REVIEW
Dalbir S Sandhu, Ronnie Fass
Gastroesophageal reflux disease (GERD) defined as heartburn and/or regurgitation is one of the most common gastrointestinal disorder managed by gastroenterologists and primary care physicians. There is an increase in GERD prevalence since 1995 particularly in North America and East Asia. Over the past three decades proton pump inhibitors (PPIs) had become the mainstay medical therapy for management of GERD. However, over the last decade there is an increasing awareness amongst physicians and patient population regarding the side effects of otherwise considered safe PPIs...
April 24, 2017: Gut and Liver
https://www.readbyqxmd.com/read/28427070/practical-lessons-from-protocol-t-for-the-management-of-diabetic-macular-edema
#12
Lekha Mukkamala, Neelakshi Bhagat, Marco Zarbin
PURPOSE: To review the results of Diabetic Retinopathy Clinical Research Network Protocol T, as applied to clinical practice. METHODS: Review of major publications reporting the results of Protocol T, a randomized single-masked (in year-1 only), multicenter clinical trial comparing aflibercept, bevacizumab, and ranibizumab as treatment option for center-involving diabetic macular edema (DME). The main outcome measures were change in visual acuity (VA), central subfield thickness (CST) on optical coherence tomography, cost effectiveness, burden of care, and safety...
2017: Developments in Ophthalmology
https://www.readbyqxmd.com/read/28427002/incidental-posterior-mediastinal-paraganglioma-the-safe-approach-to-management-case-report
#13
Juan A Muñoz-Largacha, Roan J Glocker, Jacob Moalem, Michael J Singh, Virginia R Litle
INTRODUCTION: Paragangliomas are neuroendocrine tumors arising from chromaffin cells located in sympathetic paraganglia. Mediastinal paragangliomas are extremely rare and can be classified as functional or non-functional according to their ability for secreting catecholamines. Patients can be asymptomatic and the diagnosis is usually incidental. Complete surgical resection remains the standard of care for paragangliomas. PRESENTATION OF CASE: We present a 44-year-old woman with a functional mediastinal paraganglioma incidentally found during the perioperative imaging workup for a diagnosed breast carcinoma...
March 31, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28426811/procalcitonin-for-selecting-the-antibiotic-regimen-in-outpatients-with-low-risk-community-acquired-pneumonia-using-a-rapid-point-of-care-testing-a-single-arm-clinical-trial
#14
Mar Masiá, Sergio Padilla, Victoria Ortiz de la Tabla, Matilde González, Cristina Bas, Félix Gutiérrez
OBJECTIVE: We aimed to assess the role of procalcitonin (PCT) to guide the initial selection of the antibiotic regimen for low-risk community-acquired pneumonia (CAP). METHODS: A single-arm clinical trial was conducted including outpatients with CAP and Pneumonia Severity Index risk classes I-II. Antimicrobial selection was based on the results of PCT measured with a rapid point-of-care testing. According to serum PCT levels, patients were assigned to two treatment strategies: oral azithromycin if PCT was <0...
2017: PloS One
https://www.readbyqxmd.com/read/28426239/performance-of-an-artificial-pancreas-system-for-young-children-with-type-1-diabetes
#15
Mark D DeBoer, Marc D Breton, Christian Wakeman, Elaine M Schertz, Emma G Emory, Jessica L Robic, Laura L Kollar, Boris P Kovatchev, Daniel R Cherñavvsky
BACKGROUND: Young children 5-8 years old with type 1 diabetes (T1D) exhibit clear needs for improved glycemic control but may be limited in their ability to safely interact with an artificial pancreas system. Our goal was to evaluate the safety and performance of an artificial pancreas (AP) system among young children with T1D. RESEARCH DESIGN AND METHODS: In a randomized, crossover trial, children with T1D age 5-8 years were enrolled to receive on separate study periods (in random order) either the UVa AP using the DiAs Control Platform software with child-resistant lock-out screens (followed as an out-patient admission) or their usual insulin pump+continuous glucose monitor (CGM) care at home...
April 20, 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28424862/laparoscopic-management-of-choledochal-cysts-is-a-keyhole-view-missing-the-big-picture
#16
REVIEW
Mark D Stringer
In recent years, numerous articles have promoted laparoscopic surgical treatment of choledochal cysts in children. Most of these reports assert that laparoscopic excision and biliary reconstruction are as safe as open surgery and achieve equivalent or better results. However, these conclusions are based on retrospective analyses with median follow-up periods that rarely exceed 5 years. Closer scrutiny of the laparoscopic literature indicates that the optimum procedure for treating type I and most type IVa choledochal cysts, namely radical excision of the extrahepatic bile ducts and reconstruction by wide hilar hepaticoenterostomy, preferably hepaticojejunostomy, is not being carried out in most cases...
April 19, 2017: Pediatric Surgery International
https://www.readbyqxmd.com/read/28424537/awake-craniotomy-anesthetic-management-using-dexmedetomidine-propofol-and-remifentanil
#17
Andrea Prontera, Stefano Baroni, Andrea Marudi, Franco Valzania, Alberto Feletti, Francesca Benuzzi, Elisabetta Bertellini, Giacomo Pavesi
INTRODUCTION: Awake craniotomy allows continuous monitoring of patients' neurological functions during open surgery. Anesthesiologists have to sedate patients in a way so that they are compliant throughout the whole surgical procedure, nevertheless maintaining adequate analgesia and anxiolysis. Currently, the use of α2-receptor agonist dexmedetomidine as the primary hypnotic-sedative medication is increasing. METHODS: Nine patients undergoing awake craniotomy were treated with refined monitored anesthesia care (MAC) protocol consisting of a combination of local anesthesia without scalp block, low-dose infusion of dexmedetomidine, propofol, and remifentanil, without the need of airways management...
2017: Drug Design, Development and Therapy
https://www.readbyqxmd.com/read/28424138/comparative-analysis-of-the-paravertebral-analgesic-pump-catheter-with-the-epidural-catheter-in-elderly-trauma-patients-with-multiple-rib-fractures
#18
Brian S Shapiro, Tarik Wasfie, Mathew Chadwick, Kimberly R Barber, Raquel Yapchai
Presently, trauma guidelines recommend epidural analgesia as the optimal modality of pain relief from rib fractures. They are not ideally suited for elderly trauma patients and have disadvantages including bleeding risk. The paravertebral analgesic pump (PVP) eliminates such disadvantages and includes ease of placement in the trauma setting. This study compares pain control in patients treated by EPI versus PVP. This is a retrospective, historical cohort study comparing two methods of pain management in the trauma setting...
April 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28423128/peratrial-device-closure-of-atrial-septal-defect-under-transesophageal-echocardiographic-guidance-without-fluoroscopy-compared-to-conventional-on-pump-surgical-closure
#19
Zhixiang Guo, Chengxin Zhang, Huan Wang, Shenglin Ge
Objective: This study is designed to evaluate the advantages between peratrial device closure under transesophageal echocardiographic guidance and open heart surgery in atrial septal defect. Methods: From November 2011 to September 2014, 28 patients with atrial septal defect were treated. Fourteen patients received peratrial device closure under transesophageal echocardiographic guidance (TEE group) and 14 patients received cardiopulmonary bypass (CPB group). Clinical parameters during intraoperative and postoperative periods were examined...
January 2017: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28422912/vascular-complications-from-resuscitative-endovascular-balloon-occlusion-of-the-aorta-reboa-life-over-limb
#20
John R Taylor, John A Harvin, Clay Martin, John B Holcomb, Laura J Moore
BACKGROUND: Vascular complications from resuscitative endovascular balloon occlusion of the aorta (REBOA) have been reported as high as 13% with some patients requiring lower extremity amputation. We sought to review our institutions series of REBOA and assess our vascular complications. METHODS: Retrospective review of all patients undergoing REBOA from October 2011 through July 2016. Data was gathered from the Memorial Hermann Trauma registry and the hospital electronic medical records...
April 18, 2017: Journal of Trauma and Acute Care Surgery
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