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https://www.readbyqxmd.com/read/28719767/capacity-of-commune-health-stations-in-chi-linh-district-hai-duong-province-for-prevention-and-control-of-noncommunicable-diseases
#1
Nguyen Thi Thuy Nga, Bui Thi My Anh, Nguyen Nguyen Ngoc, Dang Minh Diem, Vu Duy Kien, Tran Bich Phuong, Tran Quynh Anh, Hoang Van Minh
The primary health care system in Vietnam has been playing an important role in prevention and control of diseases. This study aimed to describe the capacity of commune health stations in Chi Linh district, Hai Duong province for prevention and control of noncommunicable diseases (NCDs). A mixed-methods (quantitative and qualitative approaches) approach was applied to collect data in 20 commune health stations. The participants, including health workers, stakeholders, and patients with NCDs, were selected for the study...
July 2017: Asia-Pacific Journal of Public Health
https://www.readbyqxmd.com/read/28719481/opioid-prescribing-practices-in-pediatric-acute-care-settings
#2
Michelle DePhillips, Jennifer Watts, Jennifer Lowry, M Denise Dowd
OBJECTIVES: Deaths due to prescription opioid overdoses are at record-high levels. Limiting the amount of opioid prescribed has been suggested as a prevention strategy. The purpose of this study was to describe the opioid prescribing practices in the emergency departments and urgent care sites of a Midwestern tertiary care children's hospital system. METHODS: This retrospective medical record review examined the visits from the 2 pediatric emergency departments and 2 pediatric urgent care sites in the system from June 1, 2012, to May 31, 2013, during which an outpatient opioid prescription was written...
July 17, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28716998/extended-training-to-prepare-gps-for-future-workforce-needs-a-qualitative-investigation-of-a-1-year-fellowship-in-urgent-care
#3
Jeremy Dale, Rachel Russell, Frances Harkness, Veronica Wilkie, Matthew Aiello
BACKGROUND: It has been argued that UK general practice specialist training should be extended to better prepare GPs for the challenges facing 21st-century health care. Evidence is needed to inform how this should occur. AIM: To investigate the experience of recently trained GPs undertaking a 1-year full-time fellowship programme designed to provide advanced skills training in urgent care, integrated care, leadership, and academic practice; and its impact on subsequent career development...
July 17, 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/28708268/screening-protocols-to-monitor-respiratory-status-in-primary-immunodeficiency-disease-findings-from-a-european-survey-and-subclinical-infection-working-group
#4
Stephen Jolles, Silvia Sánchez-Ramón, Isabella Quinti, Pere Soler-Palacín, Carlo Agostini, Benoit Florkin, Louis-Jean Couderc, Nicholas Brodszki, Alison Jones, Hilary Longhurst, Klaus Warnatz, Filomeen Haerynck, Andrea Matucci, Esther de Vries
Many patients with primary immunodeficiency (PID) who have antibody deficiency develop progressive lung disease due to underlying subclinical infection and inflammation. To understand how these patients are monitored we conducted a retrospective survey based on patient records of 13 PID centres across Europe, regarding the care of 1,061 adult and 178 paediatric patients with PID on IgG replacement. The most common diagnosis was common variable immunodeficiency in adults (75%), and hypogammaglobulinaemia in children (39%)...
July 14, 2017: Clinical and Experimental Immunology
https://www.readbyqxmd.com/read/28708194/getting-into-urgent-care
#5
Sean Price
Many primary care physicians opt to open "urgent care" facilities or add urgent care services to their practices. Although there are advantages - such as billing and appointment scheduling flexibility - there are headaches as well.
July 1, 2017: Texas Medicine
https://www.readbyqxmd.com/read/28695351/robustness-and-effectiveness-of-the-triage-system-in-the-pediatric-context
#6
Marcello Montefiori, Enrico di Bella, Lucia Leporatti, Paolo Petralia
BACKGROUND: The increasing use of emergency departments (EDs) potentially compromises their effectiveness and quality. The evaluation of the performance of the triage code system in a pediatric context is important because waiting time affects the quality of care for acutely ill patients. OBJECTIVE: In this study, we aimed to assess the effectiveness and robustness of the triage code system in a pediatric context and identify the determinants of waiting times for urgent and non-urgent patients...
July 10, 2017: Applied Health Economics and Health Policy
https://www.readbyqxmd.com/read/28694734/case-report-of-unexplained-hypocalcaemia-in-a-slightly-haemolysed-sample
#7
Michael Cornes
The case presented highlights a common pre-analytical problem identified in the laboratory that was initially missed. It concerns a young, generally healthy adult patient with no significant medical history and no significant family history. They presented with common flu like symptoms to their primary care clinician who considered this was most likely a viral problem that would pass with time. The clinician, however, did some routine bloods to reassure the patient despite a lack of clinical indication. When the sample was analysed the sample was haemolysed with strikingly low calcium...
June 15, 2017: Biochemia Medica: časopis Hrvatskoga Društva Medicinskih Biokemičara
https://www.readbyqxmd.com/read/28693596/prioritising-responses-of-nurses-to-deteriorating-patient-observations-pronto-protocol-testing-the-effectiveness-of-a-facilitation-intervention-in-a-pragmatic-cluster-randomised-trial-with-an-embedded-process-evaluation-and-cost-analysis
#8
Tracey K Bucknall, Gill Harvey, Julie Considine, Imogen Mitchell, Jo Rycroft-Malone, Ian D Graham, Mohammadreza Mohebbi, Jennifer Watts, Alison M Hutchinson
BACKGROUND: Vital signs are the primary indicator of physiological status and for determining the need for urgent clinical treatment. Yet, if physiological signs of deterioration are missed, misinterpreted or mismanaged, then critical illness, unplanned intensive care admissions, cardiac arrest and death may ensue. Although evidence demonstrates the benefit of early recognition and management of deteriorating patients, failure to escalate care and manage deteriorating patients remains a relatively frequent occurrence in hospitals...
July 11, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28688466/leukemic-transformation-in-myeloproliferative-neoplasms-a-literature-review-on-risk-characteristics-and-outcome
#9
REVIEW
Meera Yogarajah, Ayalew Tefferi
Myeloproliferative neoplasms (MPNs) operationally include essential thrombocythemia, polycythemia vera, primary myelofibrosis (PMF), and prefibrotic PMF. All 4 MPN variants might progress into blast-phase disease (MPN-BP). For essential thrombocythemia, reported risk factors for leukemic transformation include advanced age, extreme thrombocytosis, anemia, leukocytosis, and sequence variants/mutations involving TP53 and EZH2 (for expansion of gene symbols, see www.genenames.org); for polycythemia vera, advanced age, leukocytosis, abnormal karyotype, mutations involving SRSF2 and IDH2, and treatment with pipobroman, chlorambucil, or P32; and for PMF, increased blast percentage, thrombocytopenia, abnormal karyotype, triple-negative driver mutational status, and sequence variants/mutations involving SRSF2, RUNX1, CEBPA, and SH2B3...
July 2017: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/28687951/approach-to-upset-stomach
#10
Rishi Bolia
An "Upset stomach" is a common problem encountered by physicians involved in the care of children. It includes, diarrhea, vomiting or abdominal pain. Though often mild and self-limiting, at times there are uncommon life-threatening conditions that require urgent care. It is important for primary physicians to recognize "alarm signs" and make a referral to the specialist at the right time. At the same time it is important to recognize what is normal and re-assure the caregivers. A detailed history and a proper systemic examination are important at presentation, looking for any "red flags"...
July 8, 2017: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/28687464/antibiotic-stewardship-in-the-retail-clinic-setting-implementation-in-1100-clinics-nationwide
#11
Jennifer M Polinski, Sandra L Harmon, Kimberly J Henderson, Tobias Barker, Andrew Sussman, Nancy J Gagliano
In light of increasing antibiotic resistance and a slowed antibiotic development pipeline, stewardship is more urgent than ever. To date, most stewardship guidelines and best practice recommendations for implementation focus on local or regional health care organizations. CVS MinuteClinic has implemented a consistent, evidence-based stewardship approach in its >1100 clinics in 33 states. The approach is associated with higher quality antibiotic use than that in primary care practices and emergency departments...
July 4, 2017: Healthcare
https://www.readbyqxmd.com/read/28682456/how-hospital-clinicians-select-patients-for-skilled-nursing-facilities
#12
Robert E Burke, Emily Lawrence, Amy Ladebue, Roman Ayele, Brandi Lippmann, Ethan Cumbler, Rebecca Allyn, Jacqueline Jones
OBJECTIVE: To understand how hospital-based clinicians evaluate older adults in the hospital and decide who will be transferred to a skilled nursing facility (SNF) for postacute care. DESIGN: Semistructured interviews paired with a qualitative analytical approach informed by Social Constructivist theory. SETTING: Inpatient care units in three hospitals. Purposive sampling was used to maximize variability in hospitals, units within hospitals, and staff on those units...
July 6, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28671868/stemi-and-nstemi-acs-in-a-30-year-old-patient-an-extremely-rare-complication-of-a-left-atrial-myxoma
#13
Francesco Bartolomucci, Antonio Tito, Eliano Pio Navarese, Fortunato Iacovelli, Marco Mele, Claudio Larosa, Marco Matteo Ciccone, Mauro Cassese, Martino Pepe
Primary cardiac tumors are a rare entity whose incidence in the general population ranges from 0.0017% to 0.28%. Myxomas represent nearly half of all primary benign cardiac tumors and they prevalently affect female patients. Embolic manifestation is rare with a reported incidence of 0.06%.We present the case of a 30-year-old male patient with acute anterolateral infarction caused by total occlusion of the left anterior descending artery as a consequence of a left atrial myxoma embolization. Urgent surgical resection of the mass didn't avoid early recurrence of atrial myxoma, whose second presentation was again myocardial infarction...
June 30, 2017: Heart Surgery Forum
https://www.readbyqxmd.com/read/28666445/challenges-for-gatekeeping-a-qualitative-systems-analysis-of-a-pilot-in-rural-china
#14
Jin Xu, Anne Mills
BACKGROUND: Gatekeeping involves a generalist doctor who controls patients' access to specialist care, and has been discussed as an important policy option to rebalance the primary care and hospital sectors in low- and middle-income countries, despite thin evidence. A gatekeeping pilot in a Chinese rural setting launched in 2013 has offered an opportunity to study the functioning of gatekeeping under such conditions. METHODS: In this qualitative study within a mixed-method evaluation of the gatekeeping pilot, we developed an innovative systems analysis method, combining the World Health Organisation categorisation of health system building blocks, the "Framework" approach of policy analysis and causal loop analysis...
July 1, 2017: International Journal for Equity in Health
https://www.readbyqxmd.com/read/28662926/defining-the-burden-scope-and-future-of-vascular-acute-care-surgery
#15
Donald G Harris, Anthony Herrera, Charles B Drucker, Richa Kalsi, Nandakumar Menon, Shahab Toursavadkohi, Jose J Diaz, Robert S Crawford
OBJECTIVE: The paradigm of acute care surgery has revolutionized nonelective general surgery. Similarly, nonelective vascular surgery may benefit from specific management and resource capabilities. To establish the burden and scope of vascular acute care surgery, we analyzed the characteristics and outcomes of patients hospitalized for vascular surgical procedures in Maryland. METHODS: A retrospective analysis of a statewide inpatient database was performed to identify patients undergoing noncardiac vascular procedures in Maryland from 2009 to 2013...
June 26, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28657243/nurse-triage-in-an-irish-out-of-hours-general-practice-co-operative
#16
D Mulcahy, C O'Callaghan, A Hannigan
Specially trained triage nurses play a crucial role in the operation of out-of-hours GP co-operatives. This study aimed to establish the proportion of all patient contacts with the out-of-hours GP co-operative based in the Mid-West of Ireland (Shannondoc), which were managed by triage nurses. A retrospective, descriptive analysis was conducted on the database of contacts to the Shannondoc urgent, out-of-hours primary care co-operative. Of the 110,039 contacts to the service in 2013, 19,147 (17.4%) were classified as being managed by nurses and 14...
March 10, 2017: Irish Medical Journal
https://www.readbyqxmd.com/read/28653190/therapeutics-against-filovirus-infection
#17
John Connor, Gary Kobinger, Gene Olinger
Therapies for filovirus infections are urgently needed. The paradoxical issue facing therapies is the need for rigorous safety and efficacy testing, adhering to the principle tenant of medicine to do no harm, while responding to the extreme for a treatment option during an outbreak. Supportive care remains a primary goal for infected patients. Years of research into filoviruses has provided possible medical interventions ranging from direct antivirals, host-factor supportive approaches, and passive immunity...
June 27, 2017: Current Topics in Microbiology and Immunology
https://www.readbyqxmd.com/read/28646952/drug-resistant-tuberculosis-primary-transmission-and-management
#18
Alexander C Outhred, Philip N Britton, Ben J Marais
The DOTS strategy assisted global tuberculosis (TB) control, but was unable to prevent the emergence and spread of drug-resistant strains. Genomic evidence confirms the transmission of drug-resistant Mycobacterium tuberculosis strains in many different settings, indicative of epidemic spread. These findings emphasise the need for enhanced infection control measures in health care and congregate settings. Young children in TB endemic areas are particularly vulnerable. Although advances in TB drug and vaccine development are urgently needed, improved access to currently available preventive therapy and treatment for drug resistant TB could reduce the disease burden and adverse outcomes experienced by children...
June 2017: Journal of Infection
https://www.readbyqxmd.com/read/28646858/reasons-for-encounter-by-different-levels-of-urgency-in-out-of-hours-emergency-primary-health-care-in-norway-a-cross-sectional-study
#19
Guttorm Raknes, Steinar Hunskaar
BACKGROUND: Frequencies of reasons for encounter (RFEs) in emergency primary care out-of-hours (OOH) services are relevant for planning of capacities as well as to target the training of staff at casualty clinics. We aimed to present frequencies of RFEs in the different organ systems, and to identify the most frequent RFEs at different urgency levels. METHODS: We analyzed data on RFEs in Norwegian OOH services. International Classification of Primary Care (ICPC-2) RFE codes were recorded in all contacts to eight representative OOH casualty clinics in 2014 and 2015 covering 20 municipalities with a total population of 260 196...
June 24, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/28645982/a-multicentre-randomised-controlled-non-inferiority-trial-comparing-nasal-high-flow-with-nasal-continuous-positive-airway-pressure-as-primary-support-for-newborn-infants-with-early-respiratory-distress-born-in-australian-non-tertiary-special-care-nurseries
#20
Brett J Manley, Calum T Roberts, Gaston R B Arnolda, Ian M R Wright, Louise S Owen, Kim M Dalziel, Jann P Foster, Peter G Davis, Adam G Buckmaster
INTRODUCTION: Nasal high-flow (nHF) therapy is a popular mode of respiratory support for newborn infants. Evidence for nHF use is predominantly from neonatal intensive care units (NICUs). There are no randomised trials of nHF use in non-tertiary special care nurseries (SCNs). We hypothesise that nHF is non-inferior to nasal continuous positive airway pressure (CPAP) as primary support for newborn infants with respiratory distress, in the population cared for in non-tertiary SCNs. METHODS AND ANALYSIS: The HUNTER trial is an unblinded Australian multicentre, randomised, non-inferiority trial...
June 23, 2017: BMJ Open
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