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https://www.readbyqxmd.com/read/29040811/mobile-emergency-simulation-training-for-rural-health-providers
#1
Douglas Martin, Brent Bekiaris, Gregory Hansen
INTRODUCTION: Mobile emergency simulation offers innovative continuing medical educational support to regions that may lack access to such opportunities. Furthermore, satisfaction is a critical element for active learning. Together, the authors evaluated Canadian rural healthcare providers' satisfaction from high fidelity emergency simulation training using a modified motorhome as a mobile education unit (MEU). METHODS: Over a 5-month period, data was collected during 14 educational sessions in nine different southern Manitoban communities...
July 2017: Rural and Remote Health
https://www.readbyqxmd.com/read/29039999/treatment-and-survival-of-childhood-neuroblastoma-evidence-from-a-population-based-study-in-the-united-states
#2
Dairmuid Coughlan, Matthew Gianferante, Charles F Lynch, Jennifer L Stevens, Linda C Harlan
BACKGROUND: Childhood neuroblastoma describes a heterogeneous group of extracranial solid tumors, that are treated per risk profile. We sought to describe treatment patterns and survival using population-based data from throughout the United States. MATERIALS AND METHODS: Using the National Cancer Institute (NCI)'s Patterns of Care data, we analyzed treatment provided to newly diagnosed, histologically confirmed neuroblastoma patients in 2010 and 2011, registered to one of 14 Surveillance, Epidemiology, and End Results (SEER) cancer registries...
October 17, 2017: Pediatric Hematology and Oncology
https://www.readbyqxmd.com/read/29033559/pressure-injuries-in-elderly-with-acute-myocardial-infarction
#3
Klara Komici, Dino F Vitale, Dario Leosco, Angela Mancini, Graziamaria Corbi, Leonardo Bencivenga, Alessandro Mezzani, Bruno Trimarco, Carmine Morisco, Nicola Ferrara, Giuseppe Rengo
OBJECTIVES: To assess pressure injury (PI) incidence among patients hospitalized for acute myocardial infarction (AMI) in an intensive coronary care unit (ICCU) and to detect the impact of specific risk factors on the development of PI in this clinical setting. PATIENTS AND METHODS: Prospective cohort study in ICCU setting. Patients admitted for AMI: patients mean age 67.5±11.5 years (n=165). Norton Scale, Mini Nutritional Assessment (MNA), demographic, clinical and biochemical data collected at the time of ICCU admission have been tested in a logistic model to assess the odds ratios (ORs) of PI risk development...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/29032296/most-gleason-8-biopsies-are-downgraded-on-prostatectomy-does-4-4-7
#4
Ted Gansler, Stacey Fedewa, Robert Qi, Chun Chieh Lin, Ahmedin Jemal, Judd W Moul
PURPOSE: Non-representative biopsy sampling of prostate cancers with a biopsy Gleason score of 8 can adversely influence decisions regarding androgen deprivation among men receiving primary radiation therapy. The frequency of and factors associated with downgrading of Gleason 8 biopsies at prostatectomy are not well known. MATERIALS AND METHODS: Records from the National Cancer Database (a hospital-based registry in the United States) of 72,556 men with prostate cancer diagnosed 2010-2013, including 5,474 with Gleason 8 biopsies and no other high progression-risk criteria (per National Comprehensive Cancer Network guidelines)...
October 11, 2017: Journal of Urology
https://www.readbyqxmd.com/read/29026982/severe-hemoptysis-associated-with-bacterial-pulmonary-infection-clinical-features-significance-of-parenchymal-necrosis-and-outcome
#5
Guillaume Carteaux, Damien Contou, Guillaume Voiriot, Antoine Khalil, Marie-France Carette, Martine Antoine, Antoine Parrot, Muriel Fartoukh
PURPOSE: Severe hemoptysis (SH) associated with non-tuberculosis bacterial lower respiratory tract infection (LRTI) is poorly described, and the efficacy of the usual decision-making process is unknown. This study aimed at describing the clinical, radiological patterns, mechanism, and microbiological spectrum of SH related to bacterial LRTI, and assessing whether the severity of hemoptysis and the results of usual therapeutic strategy are influenced by the presence of parenchymal necrosis...
October 12, 2017: Lung
https://www.readbyqxmd.com/read/29026454/opportunities-and-obstacles-using-a-clinical-decision-support-system-for-maternal-care-in-burkina-faso
#6
S Alphonse Zakane, Lars L Gustafsson, Ali Sie, Göran Tomson, Svetla Loukanova, Pia Bastholm-Rahmner
OBJECTIVE: Maternal and neonatal mortality is high in sub-Saharan Africa. To support Healthcare Workers (HCWs), a computerized decision support system (CDSS) was piloted at six rural maternal care units in Burkina Faso. During the two years of the study period, it was apparent from reports that the CDSS was not used regularly in clinical practice. This study aimed to explore the reasons why HCWs failed to use the CDSS. METHODS: A workshop, organized as group discussions and a plenary session, was performed with 13 participants to understand their experience with the CDSS and suggest improvements if pertinent...
2017: Online Journal of Public Health Informatics
https://www.readbyqxmd.com/read/29025194/procalcitonin-to-initiate-or-discontinue-antibiotics-in-acute-respiratory-tract-infections
#7
REVIEW
Philipp Schuetz, Yannick Wirz, Ramon Sager, Mirjam Christ-Crain, Daiana Stolz, Michael Tamm, Lila Bouadma, Charles E Luyt, Michel Wolff, Jean Chastre, Florence Tubach, Kristina B Kristoffersen, Olaf Burkhardt, Tobias Welte, Stefan Schroeder, Vandack Nobre, Long Wei, Heiner C Bucher, Neera Bhatnagar, Djillali Annane, Konrad Reinhart, Angela Branche, Pierre Damas, Maarten Nijsten, Dylan W de Lange, Rodrigo O Deliberato, Stella Ss Lima, Vera Maravić-Stojković, Alessia Verduri, Bin Cao, Yahya Shehabi, Albertus Beishuizen, Jens-Ulrik S Jensen, Caspar Corti, Jos A Van Oers, Ann R Falsey, Evelien de Jong, Carolina F Oliveira, Bianca Beghe, Matthias Briel, Beat Mueller
BACKGROUND: Acute respiratory infections (ARIs) comprise of a large and heterogeneous group of infections including bacterial, viral, and other aetiologies. In recent years, procalcitonin (PCT), a blood marker for bacterial infections, has emerged as a promising tool to improve decisions about antibiotic therapy (PCT-guided antibiotic therapy). Several randomised controlled trials (RCTs) have demonstrated the feasibility of using procalcitonin for starting and stopping antibiotics in different patient populations with ARIs and different settings ranging from primary care settings to emergency departments, hospital wards, and intensive care units...
October 13, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29024808/critical-care-nurses-experiences-of-withdrawal-of-treatment-a-systematic-review-of-qualitative-evidence
#8
REVIEW
Brandi Vanderspank-Wright, Nikolaos Efstathiou, Amanda D Vandyk
BACKGROUND: Death and dying is a reality of the clinical context of the intensive care unit. Death often follows a decision to withdraw life-sustaining treatments. Critical care nurses, are the primary care providers to patients and families at the end-of-life in the intensive care unit. OBJECTIVE: To synthesize qualitative evidence on the experiences of critical care nurses who have cared for patients and families throughout the process of withdrawal of life-sustaining treatment...
September 28, 2017: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/29019627/dry-drowning-myths-and-misconceptions
#9
M Denise Dowd
Drowning is a leading cause of death in children and is highly preventable. More than 10 people die of drowning in the United States each day, most of them adults. Rates of drowning are highest in children given their developmental vulnerabilities. Drowning incidents that result in cardiopulmonary arrest have a straightforward emergency clinical response, but the management approaches to the more common scenario of brief, nonfatal submersion is less clear. Clinicians must make clinical-care decisions based on evidence to provide safe and effective care in a timely manner and to help families avoid unnecessary anxiety...
October 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/29017656/-development-and-construction-mode-of-critical-care-medicine-22-years-of-development-and-construction-of-intensive-care-units-of-guizhou-medical-university
#10
Difen Wang, Ying Liu, Jiangquan Fu, Yuanyi Liu, Yumei Cheng, Ying Wang, Liang Li, Ming Liu, Yan Tang, Feng Shen, Xu Liu, Jia Yuan, Xianjun Chen, Hongying Bi, Hongxia Wang, Wei Li, Qimin Chen, Cui Wang
OBJECTIVE: To provide decision-making basis for promoting the rapid and healthy development of critical care medicine/intensive care unit (ICU) through discussing the mode of development and construction of the department of ICU. METHODS: The situations of ICU of Affiliated Hospital of Guizhou Medical University from July 1994 to December 2016 were analyzed and summed up. Data of the situations in different development stages included the location and area of the ward, the number of beds, the number of physicians and nurses, the structure of academic titles and educational levels, the number of patients admitted to ICU per year, the proportion of patients used ventilator per year, the mortality, the mode of the discipline management, the number of medical postgraduates and undergraduates trained in the ICU, the number of teaching hours, the achievements, the number of research projects, the number of published monographs and papers, the number of the multicenter trials that we participated in, the construction of the team, the personal honor, and so on...
October 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29017578/family-integrated-care-ficare-in-level-ii-neonatal-intensive-care-units-study-protocol-for-a-cluster-randomized-controlled-trial
#11
Karen M Benzies, Vibhuti Shah, Khalid Aziz, Wanrudee Isaranuwatchai, Luz Palacio-Derflingher, Jeanne Scotland, Jill Larocque, Kelly Mrklas, Esther Suter, Christopher Naugler, Henry T Stelfox, Radha Chari, Abhay Lodha
BACKGROUND: Every year, about 15 million of the world's infants are born preterm (before 37 weeks gestation). In Alberta, the preterm birth rate was 8.7% in 2015, the second highest among Canadian provinces. Approximately 20% of preterm infants are born before 32 weeks gestation (early preterm), and require care in a Level III neonatal intensive care unit (NICU); 80% are born moderate (32 weeks and zero days [32(0/7)] to 33(6/7) weeks) and late preterm (34(0/7) to 36(6/7) weeks), and require care in a Level II NICU...
October 10, 2017: Trials
https://www.readbyqxmd.com/read/29017389/the-canadian-laboratory-initiative-on-pediatric-reference-intervals-a-caliper-white-paper
#12
Khosrow Adeli, Victoria Higgins, Karin Trajcevski, Nicole White-Al Habeeb
Laboratory investigations provide physicians with objective data to aid in disease diagnosis, clinical decision making, and patient follow up. Clinical interpretation of laboratory test results relies heavily on the availability of appropriate population-based reference intervals (i.e. normative values) or decision limits developed through clinical outcome studies. Although reference intervals are fundamental to accurate laboratory test interpretation, and thus critically important to healthcare, the need for sound evidence-based reference intervals has been largely overlooked, particularly in the pediatric population...
October 11, 2017: Critical Reviews in Clinical Laboratory Sciences
https://www.readbyqxmd.com/read/28994142/appropriate-use-of-echocardiography-and-relation-to-clinical-decision-making-in-both-inpatients-and-outpatients-in-a-developing-country
#13
Minna Moreira Dias Romano, Marina Branco, Henrique Turin Moreira, André Schmidt, Joseph Kisslo, Benedito Carlos Maciel
BACKGROUND: Use of echocardiography (echo) has exponentially increased in recent decades. Concerned about this scientific society developed appropriate use criteria (AUC). Clinical management still suffers geographical variations, and no objective data are available about echo AUC in developing countries. We aimed to evaluate (1) the appropriateness of referrals and (2) their relation to changes in clinical decision management. METHODS: Prospective analysis of referrals from January to December 2014...
October 10, 2017: Echocardiography
https://www.readbyqxmd.com/read/28991659/proposed-cut-scores-for-tests-of-the-brief-international-cognitive-assessment-of-multiple-sclerosis-bicams
#14
Meghan Beier, Elizabeth S Gromisch, Abbey J Hughes, Kevin N Alschuler, Renee Madathil, Nancy Chiaravalloti, Frederick W Foley
OBJECTIVE: Cognitive impairment (CI) is common in multiple sclerosis (MS). An international consensus committee developed the Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) to screen for CI commonly seen in MS. BICAMS cut scores would allow clinicians to, efficiently and effectively, identify patients with possible CI and could aid in clinical decision-making. The aim of this study was to establish cut scores for the neuropsychological tests of the BICAMS. METHODS: This study utilized data collected from MS Centers in the United States...
October 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28990396/physicians-perceptions-of-shared-decision-making-in-neonatal-and-pediatric-critical-care
#15
Claire A Richards, Helene Starks, M Rebecca O'Connor, Erica Bourget, Ross M Hays, Ardith Z Doorenbos
BACKGROUND: Most children die in neonatal and pediatric intensive care units after decisions are made to withhold or withdraw life-sustaining treatments. These decisions can be challenging when there are different views about the child's best interest and when there is a lack of clarity about how best to also consider the interests of the family. OBJECTIVE: To understand how neonatal and pediatric critical care physicians balance and integrate the interests of the child and family in decisions about life-sustaining treatments...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28987770/prognostic-scores-for-sorafenib-treated-hepatocellular-carcinoma-patients-a-new-application-for-the-hepatoma-arterial-embolisation-prognostic-score
#16
J Edeline, J-F Blanc, B Campillo-Gimenez, Y-T Ma, J King, O Faluyi, J Mathurin, S Ghazi, D H Palmer, T Meyer
BACKGROUND: No prognostic classification is currently used for patients treated with systemic therapies for Hepatocellular Carcinoma (HCC). METHODS: We retrospectively analysed data from patients treated with sorafenib for HCC from five centres in France and in the United Kingdom (UK). The training set comprised data from two centres and the validation set from three. Variables independently associated with Overall Survival (OS) in the training set were used to build the SAP (Sorafenib Advanced HCC Prognosis) score...
October 4, 2017: European Journal of Cancer
https://www.readbyqxmd.com/read/28985192/incorporating-supportive-care-into-the-hemodialysis-unit
#17
Rebecca J Schmidt
PURPOSE OF REVIEW: Advance care planning is underutilized in patients with dialysis-dependent kidney failure and the provision of high intensity rather than supportive care is a standard practice in most hemodialysis units wherever challenges to incorporating palliative or supportive care into unit processes remain formidable. RECENT FINDINGS: The practice of advance care planning empowers patients, families and physicians and drives decisions about future treatment that align with patients' values, wishes and changing clinical circumstances...
November 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/28983956/transitional-dialysis-care-units-a-new-approach-to-increase-home-dialysis-modality-uptake-and-patient-outcomes
#18
REVIEW
José A Morfín, Alex Yang, Elizabeth Wang, Brigitte Schiller
Home hemodialysis (HHD) and peritoneal dialysis (PD) are associated with better clinical outcomes, lower hospitalization rates, and improved quality of life compared with conventional in-center hemodialysis. However, <12% of patients requiring dialysis therapy use HHD or PD in the United States, even though over 90% of nephrologists would choose home-based dialysis modalities for themselves. Inadequate patient education and decision-making support are key barriers to patients choosing home-based therapy...
October 5, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28982611/nurse-driven-protocols-and-the-prevention-of-catheter-associated-urinary-tract-infections-a-systematic-review
#19
Danielle J Durant
BACKGROUND: Catheter-associated urinary tract infections (CAUTIs) are one of the most common hospital-acquired conditions and no longer reimbursable from Medicare as of 2008. Nurse-driven protocols (NDPs), which provide a medically approved rubric for professional nurses to make autonomous care decisions, can facilitate appropriate catheter use and timely removal, as advised in the Centers for Disease Control and Prevention's 2009 CAUTI prevention guidelines. However, little attempt has been made to systematically evaluate their effect on clinical outcomes...
October 2, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28978219/epidemiology-and-management-of-hyperlipidemia
#20
Samantha Karr
Cardiovascular disease (CVD) is the leading cause of death among adults in the United States, and people with hyperlipidemia are at roughly twice the risk of developing CVD as compared to those with normal total cholesterol levels.1 Patients with familial hypercholesterolemia (FH) have an even greater risk of developing CVD at an earlier age; therefore, early detection and treatment are imperative to reduce cardiovascular events and premature death. Statins are the mainstay treatment for hyperlipidemia; however, the limitations of statins include treatment resistance, intolerance due to adverse events, and a lack of adherence which contribute to poor outcomes...
June 2017: American Journal of Managed Care
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