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https://www.readbyqxmd.com/read/29212509/incremental-cost-and-cost-effectiveness-of-low-dose-high-frequency-training-in-basic-emergency-obstetric-and-newborn-care-as-compared-to-status-quo-part-of-a-cluster-randomized-training-intervention-evaluation-in-ghana
#1
Michelle Willcox, Heather Harrison, Amos Asiedu, Allyson Nelson, Patricia Gomez, Amnesty LeFevre
BACKGROUND: Low-dose, high-frequency (LDHF) training is a new approach best practices to improve clinical knowledge, build and retain competency, and transfer skills into practice after training. LDHF training in Ghana is an opportunity to build health workforce capacity in critical areas of maternal and newborn health and translate improved capacity into better health outcomes. METHODS: This study examined the costs of an LDHF training approach for basic emergency obstetric and newborn care and calculates the incremental cost-effectiveness of the LDHF training program for health outcomes of newborn survival, compared to the status quo alternative of no training...
December 6, 2017: Globalization and Health
https://www.readbyqxmd.com/read/29206726/standardization-of-pediatric-interfacility-transport-handover-measuring-the-development-of-a-shared-mental-model
#2
Anthony A Sochet, Kelsey S Ryan, Jennifer L Bartlett, Thomas A Nakagawa, Ladonna Bingham
OBJECTIVES: To determine if standardization of pediatric interfacility transport handover is associated with the development of a prototypical shared mental model between healthcare providers. DESIGN: A single center, prepost, retrospective cohort study. SETTINGS: A 259-bed, tertiary care, pediatric referral center. PATIENTS: Children 0 to 18 years old transferred to our critical care units or emergency center from October 2016 to February 2017...
December 4, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29180550/information-transfer-and-the-hospital-discharge-summary-national-primary-care-provider-perspectives-of-challenges-and-opportunities
#3
Paul M Robelia, Deanne T Kashiwagi, Sarah M Jenkins, James S Newman, Atsushi Sorita
PURPOSE: The hospital discharge summary (HDS) serves as a critical method of patient information transfer between hospitalist and primary care provider (PCP). This study was designed to increase our understanding of PCP preferences for, and perceived deficiencies in, the discharge summary. METHODS: We designed a mail survey that was sent to a random sample of 800 American Academy of Family Physicians members nationally. The survey response rate was 59%. We analyzed the availability of summaries at hospital followup, whether all desired information was contained in the summary and whether certain specific items were completed...
November 2017: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29177300/towards-a-dissociative-spc-like-water-model-probing-the-impact-of-intramolecular-coulombic-contributions
#4
Martin J Wiedemair, Thomas S Hofer
The dissociative water potential introduced by Garofalini et al. proved to be a simple and effective description to account for proton transfer in aqueous media, enabling for instance the execution of simulation studies at different pH values. In this model the charge of each particle is represented by a point-charge surrounded by a Gaussian charge-cloud of opposite sign, thus four Coulombic terms (point-charge-point-charge, point-charge-charge-cloud, charge-cloud-point-charge and charge-cloud-charge-cloud) are required per atom pair...
November 27, 2017: Physical Chemistry Chemical Physics: PCCP
https://www.readbyqxmd.com/read/29171788/endovascular-retrieval-of-a-migrating-pedicle-screw-within-the-inferior-vena-cava-after-instrumented-spinal-surgery-case-report
#5
Cheng-Yo Yen, Shih-Chieh Yang, Hung-Shu Chen, Yuan-Kun Tu
During L3-5 instrumented spinal surgery for degenerative spondylolisthesis in a 75-year-old woman, the right L-3 pedicle screw was accidentally pushed into the retroperitoneum and then migrated to the inferior vena cava (IVC). The patient was transferred to the surgical intensive care unit, and after careful discussion with cardiology specialists, a minimally invasive endovascular technique was used to remove the migrating pedicle screw within the IVC and thus salvage this critical case. Pedicle screw instrumentation is an effective procedure, but not risk free...
November 24, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/29170342/45%C3%A2-patient-evaluation-of-trauma-service
#6
Balraj Jagdev, Hannah Gardiner, Chris Turner
: Patient Experience of the Trauma System (PETS)Trauma care is highly organised, time critical medicine. Changes to patient management in trauma care are often the result of Random Control Trials, and expert opinion following rigorous evaluation of the evidence. Highly efficient, injury focused care is required to achieve the best outcomes for patients. One area that has not been researched so thoroughly however, is the patient experience of trauma care. As evidence already suggests that patients with high stress levels have poorer outcomes, we wanted to investigate the patient perception of the trauma system...
December 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29166922/herpes-simplex-type-1-pneumonitis-and-acute-respiratory-distress-syndrome-in-a-patient-with-chronic-lymphatic-leukemia-a-case-report
#7
Miriam Luginbuehl, Alexander Imhof, Alexander Klarer
BACKGROUND: Pulmonary pathogenicity of herpes simplex virus type 1 in patients in intensive care without classic immunosuppression as well as the necessity of antiviral treatment in the case of herpes simplex virus detection in respiratory specimens in these patients is controversial. We present a case of acute respiratory distress syndrome in a patient with stable chronic lymphatic leukemia not requiring treatment, in whom we diagnosed herpes simplex virus type 1 bronchopneumonitis based on herpes simplex virus type 1 detection in bronchoalveolar lavage fluid and clinical response to antiviral treatment...
November 23, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/29152906/short-term-outcomes-following-implementation-of-a-dedicated-young-adult-congenital-heart-disease-transition-program
#8
Sumeet S Vaikunth, Roberta G Williams, Merujan Y Uzunyan, Han Tun, Cheryl Barton, Philip M Chang
OBJECTIVE: Transition from pediatric to adult care is a critical time for patients with congenital heart disease. Lapses in care can lead to poor outcomes, including increased mortality. Formal transition clinics have been implemented to improve success of transferring care from pediatric to adult providers; however, data regarding outcomes remain limited. We sought to evaluate outcomes of transfer within a dedicated transition clinic for young adult patients with congenital heart disease...
November 20, 2017: Congenital Heart Disease
https://www.readbyqxmd.com/read/29152759/retrieval-of-adult-patients-on-extracorporeal-membrane-oxygenation-by-an-intensive-care-physician-model
#9
Aidan J C Burrell, David V Pilcher, Vincent A Pellegrino, Stephen A Bernard
The optimal staffing model during the inter-hospital transfer of patients on extracorporeal membrane oxygenation (ECMO) is not known. We report the complications and outcomes of patients who were commenced on ECMO at a referring hospital by intensive care physicians and compare these findings with patients who had ECMO established at an ECMO center in Australia. This was a single center, retrospective observational study based on a prospectively collected ECMO database from Melbourne, Australia. Patients with severe cardiac and/or respiratory failure failing conventional supportive treatment between 2007-2013 were placed on ECMO via a physician-led model of ECMO retrieval, including two intensivists in a four person team, using percutaneous ECMO cannulation...
November 19, 2017: Artificial Organs
https://www.readbyqxmd.com/read/29135618/pathway-for-the-management-of-hyperglycemia-in-the-cardiac-care-unit
#10
Seyed Hamed Hosseini Dehkordi, Jeanine Albu, Emad F Aziz, Eyal Herzog
Inpatient hyperglycemia has been associated with increased morbidity and mortality in critically ill patients. Optimal control of blood glucose (BG) levels using insulin infusion protocols has been shown to improve clinical outcomes. Protocols have been developed to prescribe a safe and effective rate of insulin infusion for optimal control of BG levels; however, a major obstacle in their implementation is their complexity. We have revised and updated our previously published pathway for the management of hyperglycemia, which introduces the "wheel" concept for insulin dosing...
December 2017: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/29092052/long-lasting-successful-dissemination-of-resistance-to-oxazolidinones-in-mdr-staphylococcus-epidermidis-clinical-isolates-in-a-tertiary-care-hospital-in-france
#11
Laurent Dortet, Philippe Glaser, Najiby Kassis-Chikhani, Delphine Girlich, Philippe Ichai, Marc Boudon, Didier Samuel, Elodie Creton, Dilek Imanci, Rémy Bonnin, Nicolas Fortineau, Thierry Naas
Objectives: Patient- and procedure-related changes in modern medicine have turned CoNS into one of the major nosocomial pathogens. Treatments of CoNS infections are challenging owing to the large proportion of MDR strains and oxazolidinones often remain the last active antimicrobial molecules. Here, we have investigated a long-lasting outbreak (2010-13) due to methicillin- and linezolid-resistant (LR) CoNS (n = 168), involving 72 carriers and 49 infected patients. Methods: Antimicrobial susceptibilities were tested by the disc diffusion method and MICs were determined by broth microdilution or Etest...
October 30, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/29072871/disseminated-intravascular-coagulation-in-an-under-recognised-zoonotic-infection
#12
Sarah Lawrence, Andrew Claxton, Mark Holland, Jack Hodd
A 51 year old man presented with severe sepsis, disseminated intravascular coagulation (DIC) and multiorgan dysfunction after a 24 hour history of diarrhoea and malaise. Despite fluid resuscitation and receiving a platelet transfusion, freshfrozen plasma and intravenous broad-spectrum antibiotics, he remained anuric with a worsening metabolic acidosis. He was transferred to critical care for organ support including renal replacement therapy. He subsequently developed purpura fulminans. Blood cultures were positive for Captocytophaga carnimorsis, a gram-negative canine zoonosis that is an underdiagnosed cause of severe sepsis, for which DIC at presentation is characteristic...
2017: Acute Medicine
https://www.readbyqxmd.com/read/29068858/outcomes-of-ventilated-patients-with-sepsis-who-undergo-interhospital-transfer-a-nationwide-linked-analysis
#13
Barret Rush, Patrick D Tyler, David J Stone, Benjamin P Geisler, Keith R Walley, Leo Anthony Celi
OBJECTIVES: The outcomes of critically ill patients who undergo interhospital transfer are not well understood. Physicians assume that patients who undergo interhospital transfer will receive more advanced care that may translate into decreased morbidity or mortality relative to a similar patient who is not transferred. However, there is little empirical evidence to support this assumption. We examined country-level U.S. data from the Nationwide Readmissions Database to examine whether, in mechanically ventilated patients with sepsis, interhospital transfer is associated with a mortality benefit...
October 24, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29061072/perinatally-hiv-infected-youths-after-transition-from-pediatric-to-adult-care-a-single-center-experience-from-northern-italy
#14
Ilaria Izzo, Eugenia Quiros-Roldan, Barbara Saccani, Erika Chiari, Salvatore Casari, Emanuele Focà, Maria Chiara Pezzoli, Maria Antonia Forleo, Andrea Bonito, Raffaele Badolato, Laura Dotta, Francesco Castelli
With the development of combination antiretroviral therapy (cART), the first generation of perinatally HIV-infected children has reached young adulthood. A retrospective study was conducted on perinatally HIV-infected young adults after transition to adult care in Brescia (Northern Italy). Twenty-four patients were transferred to Infectious Disease outpatient Clinic from Pediatric Clinic between 2004 and 2016. Median age at transition was 18 years. 37.5% were male, and 75% were Italian. Median CD4(+) T-cell count was 534 cell/μL, and 9/24 presented detectable HIV-RNA at the time of transition...
November 17, 2017: AIDS Research and Human Retroviruses
https://www.readbyqxmd.com/read/29053532/using-a-complex-patient-management-scenario-to-help-bridge-the-education-practice-gap
#15
Adriane Burgess, Hannah Murphy Buc, Janice M Brennan
Preparing nursing students for transition to practice is challenging in light of the increasing complexity of today's health care environment. A clinical simulation was developed to engage senior-level bachelor of science in nursing students in the management of a critically ill patient whose deterioration warranted timely transfer to an intensive care unit. In this fast-paced, highly charged simulation, students were challenged to implement priority setting, delegation, communication methods, and teamwork...
October 20, 2017: Nursing Education Perspectives
https://www.readbyqxmd.com/read/29051396/facial-transplantation-an-update-of-results-and-perspectives-from-tissue-engineering
#16
Francesco Simonacci, Roberto Toni, Edoardo Raposio
BACKGROUND/AIM: Facial transplantation is a revolutionary procedure developed recently, which is indicated if autologous transfers fail to restore human appearance. More than 30 patients have undergone facial transplantation in different centers worldwide. Here, we provide an update on its main anatomical, surgical, immunological, ethical, and follow- up aspects. We also provide innovative perspectives of regenerative medicine and tissue engineering that could hold promise for this emerging surgical field...
2017: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/29045063/evaluating-manufacturing-process-profile-comparability-with-multivariate-equivalence-testing-case-study-of-cell-culture-small-scale-model-transfer
#17
Yang Cao, Daniel Obeng, Guodong Hui, Luting Xue, Yukun Ren, Xianjie Yu, Fei Wang, Chad Atwell
This paper studies the Generalized Mahalanobis Distance (GMD) approach proposed by Hoffelder(1) which measures the dissimilarity of two multivariate Gaussian distributions with arbitrary covariance matrices and unequal sample sizes. This investigation demonstrated that, with appropriate adjustment, the GMD approach can achieve the targeted nominal Type I error and provide sufficient power for testing equivalence between two profile populations. The adjusted GMD approach was applied to examine the equivalence of harvest profiles between a 12L small scale model and 2000L manufacturing scale in a transfer study performed at Sanofi Speciality Care Framingham Biologics...
October 16, 2017: Biotechnology Progress
https://www.readbyqxmd.com/read/29041985/simplified-prognostic-model-for-critically-ill-patients-in-resource-limited-settings-in-south-asia
#18
Rashan Haniffa, Mavuto Mukaka, Sithum Bandara Munasinghe, Ambepitiyawaduge Pubudu De Silva, Kosala Saroj Amarasiri Jayasinghe, Abi Beane, Nicolette de Keizer, Arjen M Dondorp
BACKGROUND: Current critical care prognostic models are predominantly developed in high-income countries (HICs) and may not be feasible in intensive care units (ICUs) in lower- and middle-income countries (LMICs). Existing prognostic models cannot be applied without validation in LMICs as the different disease profiles, resource availability, and heterogeneity of the population may limit the transferability of such scores. A major shortcoming in using such models in LMICs is the unavailability of required measurements...
October 17, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29020010/assay-optimisation-and-technology-transfer-for-multi-site-immuno-monitoring-in-vaccine-trials
#19
Steven G Smith, Stephanie A Harris, Iman Satti, Donna Bryan, K Barry Walker, Hazel M Dockrell, Helen McShane, Mei Mei Ho
Cellular immunological assays are important tools for the monitoring of responses to T-cell-inducing vaccine candidates. As these bioassays are often technically complex and require considerable experience, careful technology transfer between laboratories is critical if high quality, reproducible data that allows comparison between sites, is to be generated. The aim of this study, funded by the European Union Framework Program 7-funded TRANSVAC project, was to optimise Standard Operating Procedures and the technology transfer process to maximise the reproducibility of three bioassays for interferon-gamma responses: enzyme-linked immunosorbent assay (ELISA), ex-vivo enzyme-linked immunospot and intracellular cytokine staining...
2017: PloS One
https://www.readbyqxmd.com/read/28979518/a-consensus-to-determine-the-ideal-critical-care-transfer-bag
#20
Gezz Van Zwanenberg, Melissa Dransfield, Rohit Juneja
BACKGROUND: Familiarity with environment, processes and equipment reduces the risk inherently associated with critical care transfers. Therefore, the North West London Critical Care Network decided to create a standardised ideal transfer bag and contents to improve patient safety. METHODS: A four-round modified Delphi survey developed a condensed and clinically tested content list. An expert panel then designed an ideal transfer bag based on agreed important principles...
November 2016: Journal of the Intensive Care Society
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