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https://www.readbyqxmd.com/read/28528421/end-of-life-care-for-glioblastoma-patients-at-a-large-academic-cancer-center
#1
Kamini E Kuchinad, Roy Strowd, Anne Evans, W Anthony Riley, Thomas J Smith
Glioblastoma (GBM) is a universally fatal disease, complicated by significant cognitive and physical disabilities, inherent to the disease course. The purpose of this study was to retrospectively analyze end-of-life care for GBM patients at an academic center and compare utilization of these services to national quality of care guidelines, with the goal of identifying opportunities to improve end-of-life care. Single center retrospective cohort study of GBM patients at Johns Hopkins Hospital (JHH) between 2009 and 2014, using electronic medical records and hospice records...
May 20, 2017: Journal of Neuro-oncology
https://www.readbyqxmd.com/read/28528356/operating-room-fires-in-periocular-surgery
#2
Michael A Connor, Anne M Menke, Ivan Vrcek, John W Shore
AIM: A survey of ophthalmic plastic and reconstructive surgeons as well as seven-year data regarding claims made to the Ophthalmic Mutual Insurance Company (OMIC) is used to discuss operating room fires in periocular surgery. METHODS: A retrospective review of all closed claim operating room fires submitted to OMIC was performed. A survey soliciting personal experiences with operating room fires was distributed to all American Society of Oculoplastic and Reconstructive Surgeons...
May 20, 2017: International Ophthalmology
https://www.readbyqxmd.com/read/28528323/c-graph-a-validated-scoring-system-for-early-stratification-of-neurologic-outcome-after-out-of-hospital-cardiac-arrest-treated-with-targeted-temperature-management
#3
Erich L Kiehl, Alex M Parker, Ralph M Matar, Matthew F Gottbrecht, Michelle C Johansen, Mark P Adams, Lori A Griffiths, Steven P Dunn, Katherine L Bidwell, Venu Menon, Kyle B Enfield, Lawrence W Gimple
BACKGROUND: Out-of-hospital cardiac arrest (OHCA) results in significant morbidity and mortality, primarily from neurologic injury. Predicting neurologic outcome early post-OHCA remains difficult in patients receiving targeted temperature management. METHODS AND RESULTS: Retrospective analysis was performed on consecutive OHCA patients receiving targeted temperature management (32-34°C) for 24 hours at a tertiary-care center from 2008 to 2012 (development cohort, n=122)...
May 20, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28528210/do-patients-need-to-stay-in-bed-all-day-in-the-epilepsy-monitoring-unit-safety-data-from-a-non-restrictive-setting
#4
Laura Craciun, Jørgen Alving, Elena Gardella, Daniella Terney, Pirgit Meritam, Melita Cacic Hribljan, Sándor Beniczky
PURPOSE: To assess whether injuries occur more often in an Epilepsy Monitoring Unit (EMU) where portable EEG amplifiers are used, and where patients can freely move within a large area during the monitoring. METHODS: Patients were monitored at the Danish Epilepsy Center, in an EMU specifically designed for this purpose, and they were under continuous surveillance by personnel dedicated to the EMU. Adverse events (AEs) - including injuries, were prospectively noted, as part of the safety policy of the hospital...
May 13, 2017: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/28528129/prophylactic-hydration-to-prevent-contrast-induced-nephropathy-much-ado-about-nothing
#5
Christina M Wyatt, Marianne Camargo, Steven G Coca
Clinical guidelines recommend prophylactic hydration to reduce the risk of contrast-induced nephropathy in high-risk patients, including those with chronic kidney disease. A recent single-center randomized trial showed no significant difference in the incidence of contrast-induced nephropathy in ambulatory patients with stage 3 chronic kidney disease who were randomized to no prophylactic hydration versus normal saline hydration. While these results may identify patients who are less likely to benefit from prophylactic hydration, nephrologists and interventionalists should carefully consider the generalizability of these results to individual patients...
May 18, 2017: Kidney International
https://www.readbyqxmd.com/read/28527964/impact-of-high-priority-allocation-on-lung-and-heart-lung-transplantation-for-pulmonary-hypertension
#6
Laurent Savale, Jérôme Le Pavec, Olaf Mercier, Sacha Mussot, Xavier Jaïs, Dominique Fabre, Caroline O'Connell, David Montani, François Stephan, Olivier Sitbon, Gérald Simonneau, Philippe Dartevelle, Marc Humbert, Elie Fadel
BACKGROUND: Since 2006 and 2007, patients in France with severe pulmonary hypertension (PH) who are at imminent risk of death, despite optimal treatment in the intensive care unit, are placed on a high-priority list (HPL) for heart-lung transplantation (HLT) or double-lung transplantation (DLT). We assessed the effect of this approach on the waiting list and outcomes after transplantation. METHODS: We conducted a single-center, retrospective, before-and-after study of consecutive patients with severe group 1, 1', or 4 PH listed for DLT or HLT between 2000 and 2013 (ie, 6 years before and 6 years after HPL implementation)...
May 18, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28527721/indicators-and-outcomes-of-transfer-to-tertiary-pediatric-hospitals-for-patients-with-testicular-torsion
#7
Janae Preece, Christina Ching, Katelyn Yackey, Venkata Jayanthi, Daryl McLeod, Seth Alpert, Daniel DaJusta
INTRODUCTION: Testicular torsion threatens testicular viability with increased risk of loss with delayed management. Still, healthy adolescents continue to be transferred from community hospitals to tertiary hospitals for surgical management for torsion even though adult urologists may be available. We sought to determine reasons behind patient transfer and to evaluate whether transfer to tertiary centers for testicular torsion leads to increased rates of testicular loss. MATERIALS AND METHODS: A retrospective chart review was performed for patients presenting to our free-standing pediatric tertiary care facility with surgically confirmed testicular torsion during the 5-year period between January 2011 and January 2016...
April 27, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28527637/the-state-of-shared-decision-making-in-malaysia
#8
Yew Kong Lee, Chirk Jenn Ng
Shared decision making (SDM) activities in Malaysia began around 2010. Although the concept is not widespread, there are opportunities to implement SDM in both the public and private healthcare sectors. Malaysia has a multicultural society and cultural components (such as language differences, medical paternalism, strong family involvement, religious beliefs and complementary medicine) influence medical decision making. In terms of policy, the Ministry of Health has increasingly mentioned patient-centered care as a component of healthcare delivery while the Malaysian Medical Council's guidelines on doctors' duties mentioned collaborative partnerships as a goal of doctor-patient relationships...
May 17, 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/28527500/using-technology-to-enhance-patient-physician-interactions
#9
REVIEW
David Voran
The computer is an integral part of a clinical office examination room. How a physician simultaneously uses the computer and interacts with patients will either enhance or deter patient engagement in areas of health maintenance and rehabilitation. With the growing emphasis on patient-centered care and management of chronic health conditions, patient engagement plays an ever-increasing role in U.S. health care. This paper reviews and discusses the 4 broad factors that influence the traditional physician-patient examination room interaction: physician computer/technology skills and dexterity, verbal and nonverbal communication, design and spatial arrangement, and hardware considerations...
May 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/28527199/the-value-of-contrast-enhanced-ultrasound-ceus-using-a-high-end-ultrasound-system-in-the-characterization-of-endoleaks-after-endovascular-aortic-repair-evar
#10
J Rübenthaler, M Reiser, V Cantisani, D Rjosk-Dendorfer, D A Clevert
PURPOSE: To evaluate the value of contrast-enhanced ultrasound (CEUS) using a high-end ultrasound system in the characterization of endoleaks after endovascular aortic repair (EVAR). MATERIAL AND METHODS: In this mono-center study, 41 patients were retrospectively analyzed after being examined using a modern high-end ultrasound system (RS80A with Prestige, Samsung Medison Co., Ltd., Seoul, Korea). The maximum diameters of the aneurysms were measured in two planes (right-left and ventral-dorsal)...
May 18, 2017: Clinical Hemorheology and Microcirculation
https://www.readbyqxmd.com/read/28526976/how-to-achieve-patient-centered-testing-role-of-the-protocol-nurse
#11
Patricia N Salimi, Joelyn B Niggel, Friederike K Keating
INTRODUCTION: Patient-centered cardiac testing is predicated on choosing the right test for the right patient. We studied the effects of changing from script-driven scheduling to nurse-driven protocoling of stress tests. METHODS AND RESULTS: A protocol nurse reviewed records before scheduling and communicated with patients and ordering providers if needed. We found that instituting nurse protocolling of all non-imaging (ETT) and nuclear (MPI) stress tests (N = 3071) resulted in protocol changes in 37% of our patients, and reduced the proportion of tests that could not be performed as scheduled by 56% and cancelations by 71% (P < 0...
May 19, 2017: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
https://www.readbyqxmd.com/read/28526862/significant-clinical-factors-associated-with-long-term-mortality-in-critical-cancer-patients-requiring-prolonged-mechanical-ventilation
#12
Li-Ta Keng, Kuei-Pin Chung, Shu-Yung Lin, Sheng-Kai Liang, Jui-Chen Cheng, I-Chun Chen, Yen-Fu Chen, Hou-Tai Chang, Chia-Lin Hsu, Jih-Shuin Jerng, Hao-Chien Wang, Ping-Hung Kuo, Huey-Dong Wu, Jin-Yuan Shih, Chong-Jen Yu
Studies about prognostic assessment in cancer patients requiring prolonged mechanical ventilation (PMV) for post-intensive care are scarce. We retrospectively enrolled 112 cancer patients requiring PMV support who were admitted to the respiratory care center (RCC), a specialized post-intensive care weaning facility, from November 2009 through September 2013. The weaning success rate was 44.6%, and mortality rates at hospital discharge and after 1 year were 43.8% and 76.9%, respectively. Multivariate logistic regression showed that weaning failure, in addition to underlying cancer status, was significantly associated with an increased 1-year mortality (odds ratio, 6...
May 19, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28526667/patient-centered-decision-support-formative-usability-evaluation-of-integrated-clinical-decision-support-with-a-patient-decision-aid-for-minor-head-injury-in-the-emergency-department
#13
Edward R Melnick, Erik P Hess, George Guo, Maggie Breslin, Kevin Lopez, Anthony J Pavlo, Fuad Abujarad, Seth M Powsner, Lori A Post
BACKGROUND: The Canadian Computed Tomography (CT) Head Rule, a clinical decision rule designed to safely reduce imaging in minor head injury, has been rigorously validated and implemented, and yet expected decreases in CT were unsuccessful. Recent work has identified empathic care as a key component in decreasing CT overuse. Health information technology can hinder the clinician-patient relationship. Patient-centered decision tools to support the clinician-patient relationship are needed to promote evidence-based decisions...
May 19, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28526303/the-use-of-biobrane-%C3%A2-for-wound-coverage-in-stevens-johnson-syndrome-and-toxic-epidermal-necrolysis
#14
Alan D Rogers, Erin Blackport, Robert Cartotto
INTRODUCTION: Published experience describing the use of Biobrane(®) for wound management in Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis (SJS-TEN) is limited to case reports and case series involving ten or fewer patients. We have used Biobrane(®) in the care of SJS-TEN since 2000, and the purpose of this study was to review our experience with the application of Biobrane(®) for wound coverage in SJS-TEN. METHODS: A retrospective review of all cases of SJS-TEN admitted to an adult regional ABA-verified burn center between January 1, 2000 and June 1, 2015 was conducted...
May 16, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28526284/low-bone-mineral-density-may-be-associated-with-long-term-risk-of-cancer-in-the-middle-aged-population-a-retrospective-observational-study-from-a-single-center
#15
Hsin-Fu Lee, Chiao-En Wu, Yu-Sheng Lin, Jaw-Shan Hwang, Chu-Hua Wu, Pao-Hsien Chu
BACKGROUND: It is generally understood that cancer patients are at an increased risk for osteoporosis. Additionally, recent studies have suggested a shared pathophysiological mechanism between the development of cancer and osteoporosis. The purpose of this investigation was to investigate whether low bone mineral density is associated with cancer risk. METHODS: We enrolled 8780 subjects who underwent dual-energy X-ray absorptiometry (DXA) and cancer screening from January 1, 2008-December 31, 2012 from a cohort selected from Chang Gung Health Care Center in Taiwan...
May 16, 2017: Journal of the Formosan Medical Association, Taiwan Yi Zhi
https://www.readbyqxmd.com/read/28526182/pharmacologic-management-of-type-2-diabetes-mellitus-available-therapies
#16
James Thrasher
Choices for the treatment of type 2 diabetes mellitus (T2DM) have multiplied as our understanding of the underlying pathophysiologic defects has evolved. Treatment should target multiple defects in T2DM and follow a patient-centered approach that considers factors beyond glycemic control, including cardiovascular risk reduction. The American Association of Clinical Endocrinologists/American College of Endocrinology and the American Diabetes Association recommend an initial approach consisting of lifestyle changes and monotherapy, preferably with metformin...
May 12, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28526039/influences-on-patient-satisfaction-in-healthcare-centers-a-semi-quantitative-study-over-5%C3%A2-years
#17
Ruth D Thornton, Nicole Nurse, Laura Snavely, Stacey Hackett-Zahler, Kenice Frank, Robert A DiTomasso
BACKGROUND: Knowledge of ambulatory patients' satisfaction with clinic visits help improve communication and delivery of healthcare. The goal was to examine patient satisfaction in a primary care setting, identify how selected patient and physician setting and characteristics affected satisfaction, and determine if feedback provided to medical directors over time impacted patient satisfaction. METHODS: A three-phase, semi-quantitative analysis was performed using anonymous, validated patient satisfaction surveys collected from 889 ambulatory outpatients in 6 healthcare centers over 5-years...
May 19, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28526015/construction-and-implications-of-structural-equation-modeling-network-for-pediatric-cataract-a-data-mining-research-of-rare-diseases
#18
Erping Long, Shuangjuan Xu, Zhenzhen Liu, Xiaohang Wu, Xiayin Zhang, Jinghui Wang, Wangting Li, Runzhong Liu, Zicong Chen, Kexin Chen, Tongyong Yu, Dongxuan Wu, Xutu Zhao, Jingjing Chen, Zhuoling Lin, Qianzhong Cao, Duoru Lin, Xiaoyan Li, Jingheng Cai, Haotian Lin
BACKGROUND: The majority of rare diseases are complex diseases caused by a combination of multiple morbigenous factors. However, uncovering the complex etiology and pathogenesis of rare diseases is difficult due to limited clinical resources and conventional statistical methods. This study aims to investigate the interrelationship and the effectiveness of potential factors of pediatric cataract, for the exploration of data mining strategy in the scenarios of rare diseases. METHODS: We established a pilot rare disease specialized care center to systematically record all information and the entire treatment process of pediatric cataract patients...
May 19, 2017: BMC Ophthalmology
https://www.readbyqxmd.com/read/28526009/measuring-health-literacy-among-low-literate-people-an-exploratory-feasibility-study-with-the-hls-eu-questionnaire
#19
Hannelore Storms, Neree Claes, Bert Aertgeerts, Stephan Van den Broucke
BACKGROUND: Health literacy (HL) is defined as necessary competencies to make well-informed decisions. As patients' decision making is a key element of patient-centered health care, insight in patients' HL might help healthcare professionals to organize their care accordingly. This is particularly true for people in a vulnerable situation, potentially with limited HL, who are, for instance, at greater risk of having limited access to care [1, 2]. As HL correlates with education, instruments should allow inclusion of low literate people...
May 19, 2017: BMC Public Health
https://www.readbyqxmd.com/read/28525671/infection-in-critically-ill-pediatric-patients-on-continuous-renal-replacement-therapy
#20
Maria J Santiago, Jesús López-Herce, Eva Vierge, Ana Castillo, Amaya Bustinza, Jose M Bellón, Amelia Sánchez, Sarah Fernández
INTRODUCTION: Continuous renal replacement therapies (CRRT) are frequently used in critically ill children and may increase the risk of infection. However, the incidence, characteristics and prognosis of infection in critically ill children on CRRT have not been studied. METHODS: Data from a prospective, single-center register of critically ill children treated with CRRT was analyzed. RESULTS: 55 children (40% under 1 year of age) were treated with CRRT between June 2008 and January 2012; 43 patients (78...
May 18, 2017: International Journal of Artificial Organs
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