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https://www.readbyqxmd.com/read/28934403/improving-inpatient-medication-adherence-using-attendant-education-in-a-tertiary-care-hospital-in-uganda
#1
Patricia Alupo, Richard Ssekitoleko, Tracy Rabin, Robert Kalyesubula, Ivan Kimuli, Benjamin E Bodnar
Quality problem: Although widely utilized in resource-rich health care systems, the use of quality improvement (QI) techniques is less common in resource-limited environments. Uganda is a resource-limited country in Sub-Saharan Africa that faces many challenges with health care delivery. These challenges include understaffing, inconsistent drug availability and inefficient systems that limit the provision of clinical care. Initial assessment: Poor adherence to prescribed inpatient medications was identified as a key shortcoming of clinical care on the internal medicine wards of Mulago National Referral Hospital, Kampala, Uganda...
August 1, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28932302/predictive-value-of-tracheal-rapid-ultrasound-exam-performed-in-the-emergency-department-for-verification-of-tracheal-intubation
#2
Babak Masoumi, Reza Azizkhani, Gilava Hedayati Emam, Morteza Asgarzadeh, Behrouz Zargar Kharazi
BACKGROUND: Verification of the correct placement of the endotracheal tube (ETT) has been one of the most challenging issues of airway management in the field of emergency medicine. Early detection of oesophagal intubation through a reliable method is important for emergency physicians. AIM: The aim of this study was to assess the diagnostic accuracy of tracheal rapid ultrasound exam (TRUE) to assess endotracheal tube misplacement during emergency intubation. METHODS: This was an observational prospective study performed in the emergency department of the major tertiary referral hospital in the city...
August 15, 2017: Open Access Macedonian Journal of Medical Sciences
https://www.readbyqxmd.com/read/28928474/using-experimental-evolution-to-identify-druggable-targets-that-could-inhibit-the-evolution-of-antimicrobial-resistance
#3
Heer H Mehta, Amy G Prater, Yousif Shamoo
With multi-drug and pan-drug-resistant bacteria becoming increasingly common in hospitals, antibiotic resistance has threatened to return us to a pre-antibiotic era that would completely undermine modern medicine. There is an urgent need to develop new antibiotics and strategies to combat resistance that are substantially different from earlier drug discovery efforts. One such strategy that would complement current and future antibiotics would be a class of co-drugs that target the evolution of resistance and thereby extend the efficacy of specific classes of antibiotics...
September 20, 2017: Journal of Antibiotics
https://www.readbyqxmd.com/read/28922339/incidence-and-risk-factors-of-anaesthesia-related-perioperative-cardiac-arrest-a-6-year-observational-study-from-a-tertiary-care-university-hospital
#4
Andreas Hohn, Jan-Nicolas Machatschek, Jeremy Franklin, Stephan A Padosch
BACKGROUND: In recent decades, the incidences of anaesthesia-related perioperative mortality and adverse outcomes have decreased drastically. However, to date, data on perioperative cardiac arrest and risk factors of perioperative cardiac arrest from European countries are scarce. OBJECTIVES: To determine the incidences of perioperative cardiac arrest and rates of anaesthesia-related and anaesthesia-contributory cardiac arrest. Identification of pre-existing risk factors leading to perioperative cardiac arrest...
September 15, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28919404/emergency-in-the-clinic-a-simulation-curriculum-to-improve-outpatient-safety
#5
Eve Espey, Gillian Baty, John Rask, Michelle Chungtuyco, Brenda Pereda, Lawrence Leeman
BACKGROUND: Emergency response skills are essential when events such as seizure, anaphylaxis or hemorrhage occur in the outpatient setting. As services and procedures increasingly move outside the hospital, training to manage complications may improve outcomes. OBJECTIVE: The objective of this study was to evaluate a simulation-based curriculum in outpatient emergency management skills with the outcome measures of graded objective performance and learner self-efficacy...
September 14, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28916405/love-death-a-retrospective-and-prospective-follow-up-mortality-study-over-45-years
#6
Lena Lange, Barbra Zedler, Marcel A Verhoff, Markus Parzeller
BACKGROUND: Although sexual activity can cause moderate stress, it can cause natural death in individuals with pre-existing illness. The aim of this study was to identify additional pre-existing health problems, sexual practices, and potential circumstances that may trigger fatal events. METHODS: This medicolegal postmortem, retrospective, and prospective study is based on data of autopsies performed at the Institute of Legal Medicine of the University hospital, Goethe-University, Frankfurt/Main, Germany...
September 12, 2017: Journal of Sexual Medicine
https://www.readbyqxmd.com/read/28913150/features-of-ovarian-brenner-tumors-experience-of-a-single-tertiary-center
#7
Batuhan Turgay, Kazibe Koyuncu, Salih Taşkın, Uğur Fırat Ortaç
OBJECTIVE: Brenner tumors are rare neoplasms of the ovary. The aim of this study was to investigate the clinical features of Brenner tumors. MATERIALS AND METHODS: The clinical features of 22 patients who were treated in Ankara University Faculty of Medicine Obstetrics and Gynecology Department between 2005 and 2015 were evaluated retrospectively from hospital medical records. RESULTS: The patients were aged 34 to 79 years at the time of diagnosis and the mean age was 55...
June 2017: Turk J Obstet Gynecol
https://www.readbyqxmd.com/read/28910997/paediatric-nuclear-medicine-imaging
#8
Lorenzo Biassoni, Marina Easty
Background: Nuclear medicine imaging explores tissue viability and function by using radiotracers that are taken up at cellular level with different mechanism. This imaging technique can also be used to assess blood flow and transit through tubular organs. Nuclear medicine imaging has been used in paediatrics for decades and this field is continuously evolving. Sources of data: The data presented comes from clinical experience and some milestone papers on the subject...
September 1, 2017: British Medical Bulletin
https://www.readbyqxmd.com/read/28893214/a-mixed-methods-study-on-evaluating-the-performance-of-a-multi-strategy-national-health-program-to-reduce-maternal-and-child-health-disparities-in-haryana-india
#9
Madhu Gupta, Hans Bosma, Federica Angeli, Manmeet Kaur, Venkatesan Chakrapani, Monica Rana, Onno C P van Schayck
BACKGROUND: A multi pronged community based strategy, known as National Rural Health Mission (NRHM), was implemented from 2005-06 to 2012-13 in India to curtail maternal and child health (MCH) disparities between poor and rich, rural and urban areas, and boys and girls,. This study aimed to determine the degree to which MCH plans of NRHM implemented, and resulted in improving the MCH outcomes and reducing the inequalities. METHODS: An explanatory sequential mixed methods study was conducted, first to assess the degree of implementation of MCH plans by estimating the budget utilization rates of each MCH plan, and the effectiveness of these plans by comparing demographic health surveys data conducted post (2012-13), during (2007-08) and pre- (2002-04) NRHM implementation period, in the quantitative study...
September 11, 2017: BMC Public Health
https://www.readbyqxmd.com/read/28887290/individual-feedback-to-reduce-inappropriate-antimicrobial-prescriptions-for-treating-acute-upper-respiratory-tract-infections-in-an-outpatient-setting-of-a-thai-university-hospital
#10
Pinyo Rattanaumpawan, Nuttagarn Chuenchom, Visanu Thamlikitkul
BACKGROUND: Excessive antimicrobial use for acute Upper Respiratory InfectionBackground Excessive antimicrobial use for acute Upper Respiratory Infections (URIs) is one of the most common problems in clinical practice. Interventions are needed to reduce antimicrobial overuse in these common infections.s (URIs) is one of the most common problems in clinical practice. Interventions are needed to reduce antimicrobial overuse in these common infections. METHODS: During a 9-month study period (June 2014-February 2015), we conducted a quasi-experimental (pre/post) study among internal medicine residents and fellows in an outpatient setting of Siriraj Hospital, Thailand...
September 5, 2017: Journal of Global Antimicrobial Resistance
https://www.readbyqxmd.com/read/28886784/development-of-a-new-infusion-protocol-for-austere-trauma-resuscitations
#11
Stewart A Stancil
Intravenous fluid therapy for hemorrhagic shock has undergone enormous changes since it was first conducted almost 200 years ago. In the past 40 years especially, practices have dramatically changed with regards to fluid resuscitation. In pre-hospital, combat, austere, and rural emergency medicine the stakes are especially high to deliver an effective and logical resuscitation fluid strategy to a patient that is suffering from hemorrhagic shock. This article follows a prior article published in July 2014. It highlights the development of new cutting edge intravenous therapy regimens that maximize hemodynamic outcomes that can be effected by those providers that care for injured patients without the benefit of ample resources...
September 2017: Air Medical Journal
https://www.readbyqxmd.com/read/28879784/non-chemotherapy-drug-induced-neutropenia-an-update
#12
Emmanuel Andrès, Rachel Mourot-Cottet
To date, non-chemotherapy drug-induced severe neutropenia (neutrophil count of ≤0.5 x 10(9)/L) also called idiosyncratic drug-induced agranulocytosis is little discussed in the literature. In the present paper, we report and discuss the clinical data and management of this rare disorder. Areas covered: To do this, we carried out a review of the literature using PubMed database of the US National Library of Medicine. We also used data from the American Society of Hematology educational books, textbooks of Hematology and Internal medicine, and information gleaned from international meetings...
September 7, 2017: Expert Opinion on Drug Safety
https://www.readbyqxmd.com/read/28874007/new-horizons-in-comprehensive-geriatric-assessment
#13
S G Parker, A McLeod, P McCue, K Phelps, M Bardsley, H C Roberts, S P Conroy
In this article, we discuss the emergence of new models for delivery of comprehensive geriatric assessment (CGA) in the acute hospital setting. CGA is the core technology of Geriatric Medicine and for hospital inpatients it improves key outcomes such as survival, time spent at home and institutionalisation. Traditionally It is delivered by specialised multidisciplinary teams, often in dedicated wards, but in recent years has begun to be taken up and developed quite early in the admission process (at the 'front door'), across traditional ward boundaries and in specialty settings such as surgical and pre-operative care, and oncology...
September 1, 2017: Age and Ageing
https://www.readbyqxmd.com/read/28864448/discussion-and-documentation-of-future-care-a-before-and-after-study-examining-the-impact-of-an-alternative-approach-to-recording-treatment-decisions-on-advance-care-planning-in-an-acute-hospital
#14
Alexandra C Malyon, Julia R Forman, Jonathan P Fuld, Zoë Fritz
OBJECTIVE: To determine whether discussion and documentation of decisions about future care was improved following the introduction of a new approach to recording treatment decisions: the Universal Form of Treatment Options (UFTO). METHODS: Retrospective review of the medical records of patients who died within 90 days of admission to oncology or respiratory medicine wards over two 3-month periods, preimplementation and postimplementation of the UFTO. A sample size of 70 per group was required to provide 80% power to observe a change from 15% to 35% in discussion or documentation of advance care planning (ACP), using a two-sided test at the 5% significance level...
September 1, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28836974/insulin-prices-availability-and-affordability-a-cross-sectional-survey-of-pharmacies-in-hubei-province-china
#15
Chenxi Liu, Xinping Zhang, Chaojie Liu, Margaret Ewen, Zinan Zhang, Guoqin Liu
BACKGROUND: Poor access to affordable insulin results in serious and needless complications and premature deaths for those with diabetes who need this essential medicine. To help address this issue, we assessed insulin availability, prices, affordability and price components in Hubei Province as China has the heaviest burden of diabetes globally. METHODS: In 2016, insulin availability and price data was collected in the capital and five other cities. A total of 30 public sector outlets (hospitals and primary care institutions) and 30 private pharmacies were sampled, using an adaptation of the World Health Organization/Health Action International methodology, Data was collected for all human and analogue insulins in stock, then analyzed by type (prandial, basal or pre-mixed) and duration of action...
August 24, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28834891/interdisciplinary-rehabilitation-for-a-patient-with-incomplete-cervical-spinal-cord-injury-and-multimorbidity-a-case-report
#16
Robert D Vining, Donna M Gosselin, Jeb Thurmond, Kimberlee Case, Frederick R Bruch
RATIONALE: This report describes interdisciplinary rehabilitation for a 51-year-old male recovering from incomplete cervical spinal cord injury (SCI) and multiple comorbidities following an automobile accident. PATIENT CONCERNS: The patient was admitted to a rehabilitation specialty hospital approximately 2 months post SCI and 2 separate surgical fusion procedures (C3-C6). DIAGNOSES: Clinical presentation at the rehabilitation hospital included moderate to severe motor strength loss in both upper and lower extremities, a percutaneous endoscopic gastronomy tube (PEG), dysphagia, bowel/bladder incontinence, dependence on a mechanical lift and tilting wheelchair due to severe orthostatic hypotension, and pre-existing shoulder pain from bilateral joint degeneration...
August 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28808959/deaths-from-medicines-a-systematic-analysis-of-coroners-reports-to-prevent-future-deaths
#17
Robin E Ferner, Craig Easton, Anthony R Cox
INTRODUCTION: Since legislation in 2009, coroners in England and Wales must make reports in cases where they believe it is possible to prevent future deaths. We categorised the reports and examined whether they could reveal preventable medication errors or novel adverse drug reactions. METHODS: We examined 500 coroners' reports by pre-defined criteria to identify those in which medicines played a part, and to collect information on coroners' concerns. RESULTS: We identified 99 reports (100 deaths) in which medicines or a part of the medication process or both were mentioned...
August 14, 2017: Drug Safety: An International Journal of Medical Toxicology and Drug Experience
https://www.readbyqxmd.com/read/28807059/lower-education-predicts-poor-response-to-dietary-intervention-in-pregnancy-regardless-of-neighbourhood-affluence-secondary-analysis-from-the-rolo-randomised-control-trial
#18
Eileen C O'Brien, Goiuri Alberdi, Aisling A Geraghty, Fionnuala M McAuliffe
OBJECTIVE: To determine if response to a low glycaemic index (GI) dietary intervention, measured by changes in dietary intake and gestational weight gain, differed across women of varying socio-economic status (SES). DESIGN: Secondary data analysis of the ROLO randomised control trial. The intervention consisted of a two-hour low-GI dietary education session in early pregnancy. Change in GI was measured using 3 d food diaries pre- and post-intervention. Gestational weight gain was categorised as per the 2009 Institute of Medicine guidelines...
August 15, 2017: Public Health Nutrition
https://www.readbyqxmd.com/read/28800938/using-hospital-use-trends-to-improve-transitional-care
#19
Joe Feinglass, Celeste A Mallama, Angela Rogers, Caroline Teter, Courtney Hurt, Christine Schaeffer
BACKGROUND: This study evaluates the Northwestern Medicine Group Transitional Care clinic (NMG-TC), which transitions patients from an urban hospital to primary care at partner community clinics. We evaluate change over the 55 month study period in emergency department, observation or inpatient use within 90 days of an initial NMG-TC visit. METHODS: Electronic health records were used to determine patient demographic, insurance and clinical characteristics, including inflation-adjusted total hospital charges in the 90 days prior and the 90 days after an initial NMG-TC visit...
August 8, 2017: Healthcare
https://www.readbyqxmd.com/read/28797611/video-instruction-is-more-effective-than-written-instruction-in-improving-inhaler-technique
#20
Romil F Shah, Rakesh M Gupta
INTRODUCTION: Many patients with asthma use inhalers incorrectly. Better inhaler technique is associated with better asthma control. We tested the effectiveness of a computer-based video training solution versus traditional written instructions, both which may be used in a resource-limited setting, for teaching inhaler technique. We hypothesized that computer based training will provide a higher quality of instruction which will improve technique more effectively than written training...
August 7, 2017: Pulmonary Pharmacology & Therapeutics
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