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https://www.readbyqxmd.com/read/28811789/single-incision-laparoscopic-cholecystectomy-with-conventional-instruments-and-ports-initial-experience-at-tertiary-care-public-sector-hospital
#1
Abdul Razaque Shaikh, Syed Asad Ali, Ambreen Munir, Aijaz Ali Shaikh
OBJECTIVE: To find out safety and feasibility of single incision laparoscopic cholecystectomy (SLIC) using conventional instruments. METHODS: This study was conducted at surgical department of LUMHS Jamshoro Pakistan from Jan: 2014 to Dec: 2015. All cases of symptomatic cholelithiasis that consented for laparoscopic surgery were included. The exclusion criteria were acute cholecystitis, acute gall stone pancreatitis, common bile duct stones and patients with co-morbid...
May 2017: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/28811297/patterns-of-nsaids-use-and-their-association-with-other-analgesic-use-in-ckd
#2
Min Zhan, Wendy L St Peter, Rebecca M Doerfler, Corinne M Woods, Jacob B Blumenthal, Clarissa J Diamantidis, Chi-Yuan Hsu, James P Lash, Eva Lustigova, Erin B Mahone, Akinlolu O Ojo, Anne Slaven, Louise Strauss, Jonathan J Taliercio, Wolfgang C Winkelmayer, Dawei Xie, Jeffery C Fink
BACKGROUND AND OBJECTIVES: Avoiding nonsteroidal anti-inflammatory drugs is important for safe CKD care. This study examined nonsteroidal anti-inflammatory drug use patterns and their association with other analgesic use in CKD. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: The Chronic Renal Insufficiency Cohort Study is an observational cohort study that enrolled 3939 adults ages 21-74 years old with CKD between 2003 and 2008 using age-based eGFR inclusion criteria...
August 15, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28811150/best-practice-recommendations-for-the-retention-of-radiotherapy-records
#3
E Lockhart, K Bak, L J Schreiner, D C Hodgson, E Gutierrez, P Warde, M B Sharpe
This paper offers best practice recommendations for the maintenance and retention of radiotherapy health records and technical information for cancer programmes. The recommendations are based on a review of the published and grey literature, feedback from key informants from seven countries and expert consensus. Ideally, complete health records should be retained for 5 years beyond the patient's lifetime, regardless of where they are created and maintained. Technical information constituting the radiotherapy plan should also be retained beyond the patient's lifetime for 5 years, including the primary images, contours of delineated targets and critical organs, dose distributions and other radiotherapy plan objects...
August 12, 2017: Clinical Oncology: a Journal of the Royal College of Radiologists
https://www.readbyqxmd.com/read/28809740/early-successes-in-an-open-access-provincially-funded-hepatitis-c-treatment-program-in-prince-edward-island
#4
Daniel Smyth, Jordan W Francheville, Robin Rankin, Jeremy Beck, Connie Hoare, Stefanie Materniak, Greg German, Lisa Barrett, Natalie Bunimov-Wall
INTRODUCTION: The availability of curative hepatitis C therapies has created an opportunity to improve delivery and access. Local providers, government, industry, and community groups in Prince Edward Island developed an innovative province-wide care model. Our goal was to describe the first year of program implementation. MATERIAL AND METHODS: Using a community based prospective observational study design, all chronic hepatitis C referrals received from April 2015 to April 2016 were recorded in a database...
August 8, 2017: Annals of Hepatology
https://www.readbyqxmd.com/read/28809591/reducing-inappropriate-non-steroidal-anti-inflammatory-prescription-in-primary-care-patients-with-chronic-kidney-disease
#5
David M Keohane, Thomas Dennehy, Kenneth P Keohane, Eamonn Shanahan
Purpose The purpose of this paper is to reduce inappropriate non-steroidal anti-inflammatory prescribing in primary care patients with chronic kidney disease (CKD). Once diagnosed, CKD management involves delaying progression to end stage renal failure and preventing complications. It is well established that non-steroidal anti-inflammatories have a negative effect on kidney function and consequently, all nephrology consensus groups suggest avoiding this drug class in CKD. Design/methodology/approach The sampling criteria included all practice patients with a known CKD risk factor...
August 14, 2017: International Journal of Health Care Quality Assurance
https://www.readbyqxmd.com/read/28808942/primary-care-providers-opening-of-time-sensitive-alerts-sent-to-commercial-electronic-health-record-inbaskets
#6
Sarah L Cutrona, Hassan Fouayzi, Laura Burns, Rajani S Sadasivam, Kathleen M Mazor, Jerry H Gurwitz, Lawrence Garber, Devi Sundaresan, Thomas K Houston, Terry S Field
BACKGROUND: Time-sensitive alerts are among the many types of clinical notifications delivered to physicians' secure InBaskets within commercial electronic health records (EHRs). A delayed alert review can impact patient safety and compromise care. OBJECTIVE: To characterize factors associated with opening of non-interruptive time-sensitive alerts delivered into primary care provider (PCP) InBaskets. DESIGN AND PARTICIPANTS: We analyzed data for 799 automated alerts...
August 14, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28807104/understanding-practitioner-professionalism-in-aboriginal-and-torres-strait-islander-health-lessons-from-student-and-registrar-placements-at-an-urban-aboriginal-and-torres-strait-islander-primary-healthcare-service
#7
Deborah A Askew, Vivian J Lyall, Shaun C Ewen, David Paul, Melissa Wheeler
Aboriginal and Torres Strait Islander peoples continue to be pathologised in medical curriculum, leaving graduates feeling unequipped to effectively work cross-culturally. These factors create barriers to culturally safe health care for Aboriginal and Torres Strait Islander peoples. In this pilot pre-post study, the learning experiences of seven medical students and four medical registrars undertaking clinical placements at an urban Aboriginal and Torres Strait Islander primary healthcare service in 2014 were followed...
August 15, 2017: Australian Journal of Primary Health
https://www.readbyqxmd.com/read/28807069/a-pilot-project-demonstrating-that-combat-medics-can-safely-administer-parenteral-medications-in-the-emergency-department
#8
Steven G Schauer, Cord W Cunningham, Andrew D Fisher, Robert A DeLorenzo
Introduction Select units in the military have improved combat medic training by integrating their functions into routine clinical care activities with measurable improvements in battlefield care. This level of integration is currently limited to special operations units. It is unknown if regular Army units and combat medics can emulate these successes. The goal of this project was to determine whether US Army combat medics can be integrated into routine emergency department (ED) clinical care, specifically medication administration...
August 15, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28806954/-usability-of-data-integration-and-visualization-software-for-multidisciplinary-pediatric-intensive-care-a-human-factors-approach-to-assessing-technology
#9
Ying Ling Lin, Anne-Marie Guerguerian, Jessica Tomasi, Peter Laussen, Patricia Trbovich
BACKGROUND: Intensive care clinicians use several sources of data in order to inform decision-making. We set out to evaluate a new interactive data integration platform called T3™ made available for pediatric intensive care. Three primary functions are supported: tracking of physiologic signals, displaying trajectory, and triggering decisions, by highlighting data or estimating risk of patient instability. We designed a human factors study to identify interface usability issues, to measure ease of use, and to describe interface features that may enable or hinder clinical tasks...
August 14, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/28806826/-treatment-of-dupuytren-s-disease-with-collagenase-injections-in-germany-efficacy-and-adverse-effects-in-110-treated-joints
#10
Adrian Pototschnig, Elias Volkmer, Riccardo E Giunta
Background Since 2011, a new minimally-invasive treatment for Dupuytren's disease has been available in the form of injectable collagenase (Xiapex®, Pfizer). Purpose Our aim is to report about the results and adverse effects of injectable collagenase for the treatment of Dupuytren's disease in Germany. Patients and Methods We treated 78 patients (61 male, 17 female) with 87 injections in 87 digits (little finger n = 40, ring finger n = 37, middle finger n = 8 and index n = 2). We documented the range of motion before treatment, after 6 weeks and after 6 months...
August 2017: Handchirurgie, Mikrochirurgie, Plastische Chirurgie
https://www.readbyqxmd.com/read/28806035/a-primer-on-diagnostic-and-financial-implications-of-d-dimer-testing
#11
Kalyan Chakravarthy Potu, Sujithasree Ketineni, Randall Lamfers
Given the high incidence of deep vein thrombosis/pulmonary embolism (DVT/PE) (300,000 to 600,000 per year in the U.S.) and the 30 percent mortality rate associated with undiagnosed PE, diagnostic evaluation is very important. One of the tools used to evaluate for DVT and PE is D-dimer testing. A negative D-dimer test, along with a low Wells clinical probability score, can safely rule out DVT/PE without the need for additional imaging. This approach can reduce cost; however, D-dimer testing is not indicated in all patients...
September 2016: South Dakota Medicine: the Journal of the South Dakota State Medical Association
https://www.readbyqxmd.com/read/28805464/advancing-preparedness-for-highly-hazardous-contagious-diseases-admitting-10-simulated-patients-with-mers-cov
#12
Angela Vasa, Philip W Smith, Michelle Schwedhelm, Theodore J Cieslak, John Lowe, Christopher J Kratochvil, Elizabeth L Beam, Kate Boulter, Angela Hewlett
The Ebola outbreak of 2014-2016 highlighted the need for the development of a more robust healthcare infrastructure in the United States to provide isolation care for patients infected with a highly hazardous contagious disease. Routine exercises and skills practice are required to effectively and safely prepare care teams to confidently treat this special population of patients. The Nebraska Biocontainment Unit (NBU) at Nebraska Medicine in Omaha has been conducting exercises since 2005 when the unit was opened...
August 14, 2017: Health Security
https://www.readbyqxmd.com/read/28805336/matrix-stimulation-in-cancer-pain-methodology-safety-and-effectiveness
#13
M Mücke, M Tils, R Conrad, D Kravchenko, H Cuhls, L Radbruch, M Marinova, V Peuckmann-Post, R Rolke
BACKGROUND: This feasibility study addresses the applicability of matrix electrodes for the reduction of ongoing pain in cancer patients via low-frequency electrical stimulation (LFS). METHODS: Low-frequency matrix stimulation (4 Hz) was applied to the skin within the 'Head's zones' referring to the tumour localization of cancer pain patients. Pain at baseline was compared to a 3-day treatment interval consisting of 5 min of matrix stimulation in the morning and evening followed by a 3-day follow-up period without therapy...
August 14, 2017: European Journal of Pain: EJP
https://www.readbyqxmd.com/read/28802344/creating-a-highly-reliable-neonatal-intensive-care-unit-through-safer-systems-of-care
#14
REVIEW
Patoula G Panagos, Stephen A Pearlman
Neonates requiring intensive care are at high risk for medical errors due to their unique characteristics and high acuity. Designing a safer work environment begins with safe processes. Creating a culture of safety demands the involvement of all organizational levels and an interdisciplinary approach. Adverse events can result from suboptimal communication and lack of a shared mental model. This chapter describes tools to promote better patient safety in the NICU through monitoring adverse events, improving communication and using information technology...
September 2017: Clinics in Perinatology
https://www.readbyqxmd.com/read/28802288/efficacy-and-safety-of-pectin-supplemented-enteral-nutrition-in-intensive-care-a-randomized-controlled-trial
#15
Fengchan Xi, Xingwei Xu, Shanjun Tan, Tao Gao, Jialiang Shi, Yanxi Kong, Wenkui Yu, Jieshou Li, Ning Li
BACKGROUND AND OBJECTIVES: Enteral nutrition (EN) can improve clinical outcomes as an important treatment in critically ill patients. However, when patients suffer from gastrointestinal function disorders, intestinal intolerance occurs and EN administration may be delayed and even fails to perform. Pectin, a structural heteropolysaccharide, could protect gastrointestinal function from disorders in many gastrointestianl diseases. The present study aimed to determine whether pectin-supplemented EN was safe and improved clinical outcomes in intensive care unit (ICU) patients...
2017: Asia Pacific Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/28801969/anesthetic-management-for-intestinal-transplantation-a-decade-of-experience
#16
Jeron Zerillo, Sang Kim, Bryan Hill, David Shapiro, Hung-Mo Lin, Alyssa Burnham, Jang Moon, Kishore Iyer, Samuel DeMaria
BACKGROUND: Intestinal transplantation (ITx) is the definitive therapy for patients suffering from intestinal failure. Previous published reports suggest that these cases should be managed peri-operatively with the same intensive monitors and techniques as in liver transplantation. METHODS: We retrospectively reviewed the anesthetic management of sixty-seven isolated intestinal, intestinal-pancreas and intestinal-kidney transplants over the previous decade (2005-2015) in our tertiary care institution...
August 12, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28800569/surgery-for-refractory-coccygodynia-operative-versus-nonoperative-treatment
#17
John P Kleimeyer, Kirkham B Wood, Greger Lønne, Tyler Herzog, Kevin Ju, Lisa Beyer, Christine Park
STUDY DESIGN: This is a retrospective cohort study. OBJECTIVE: To evaluate the long-term outcomes for patients with refractory coccygodynia treated with coccygectomy compared to a nonsurgical regimen of sitting aids, physical therapy, medications, and injections. SUMMARY OF BACKGROUND DATA: The surgical treatment of coccygodynia remains controversial. To date, there has only been one small comparative study of surgical versus nonsurgical treatment...
August 15, 2017: Spine
https://www.readbyqxmd.com/read/28800256/the-critical-care-crisis-of-opioid-overdoses-in-the-united-states
#18
Jennifer P Stevens, Michael J Wall, Lena Novack, John Marshall, Douglas J Hsu, Michael D Howell
RATIONALE: Opioid abuse is increasing, but its impact on critical care resources in the United States is unknown. OBJECTIVE: We hypothesized that there would be a rising need for critical care among opioid-associated overdoses in the United States. METHODS: We analyzed all adult admissions using a retrospective cohort study from 162 hospitals in 44 states discharged between January 1, 2009 - September 31, 2015 to describe the incidence of intensive care unit (ICU) admissions for opioid overdose over this time...
August 11, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28799481/evolving-motivations-patients-and-caregivers-perceptions-about-seeking-myotonic-dystrophy-dm1-and-huntington-s-disease-care
#19
Kori A LaDonna, Christopher J Watling, Susan L Ray, Christine Piechowicz, Shannon L Venance
Patient-centered care provision is challenging under ideal circumstances; myotonic dystrophy (DM1) and Huntington's disease (HD) are examples of chronic, progressive health conditions that may challenge its limits. If we can understand how care unfolds in these conditions, health care providers may be better equipped to address patients' needs. Constructivist grounded theory informed data collection and analysis. Fourteen patients with DM1 or HD, and 10 caregivers participated in semistructured interviews. Constant comparative analysis was used to identify themes...
September 2017: Qualitative Health Research
https://www.readbyqxmd.com/read/28799452/syncope-current-knowledge-uncertainties-and-strategies-for-management-optimisation-in-the-emergency-department
#20
Filippo Numeroso, Gianluigi Mossini, Giuseppe Lippi, Gianfranco Cervellin
Admission rates and expenditures for syncope remain high. This unsatisfactory management could be due to several factors, including lack of evidence-based strategy, poor accuracy of clinical decision rules, difficulty in disseminating guidelines, as well as uncertainties concerning management of intermediate-risk patients and role of observation protocols and syncope units. To optimise management, it has been proposed to adopt a pragmatic, symptoms-based definition of syncope and a classification related to the underlying mechanism rather than suspected aetiology...
August 11, 2017: Acta Cardiologica
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