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https://www.readbyqxmd.com/read/28635482/diagnosis-and-management-of-myasthenia-gravis
#1
Christopher Barber
Myasthenia gravis is a rare long-term neurological condition that is characterised by fluctuating skeletal muscle weakness and fatigue, as well as respiratory difficulties. It is both an acquired autoimmune disease and a chronic neuromuscular disorder. Because of its rarity, myasthenia gravis is relatively unknown and may be unfamiliar to many nurses. While there are various types of myasthenia, this article focuses on myasthenia gravis, exploring its symptoms, diagnosis and treatment, and examining the nurse's role in managing the condition...
June 21, 2017: Nursing Standard
https://www.readbyqxmd.com/read/28627285/older-military-veteran-care-many-still-believe-they-are-forgotten
#2
Cathy Young, Patricia L Conard, Myrna L Armstrong, Darlene Lacy
BACKGROUND: Almost 44% of our nation's 23 million men and women veterans are 65 years of age or older. Most are proud of their service, yet many believe their services for our country were forgotten, especially those in combat between 1950 and 1975. PURPOSE: Further information to ultimately assist their holistic well-being will be important for nursing practice as countless older veterans are beginning to obtain more care within civilian facilities. Using the Korean War (1950-1953) as a backdrop to illustrate the interconnectiveness of older veteran physical, emotional, and spiritual concerns that can occur from a military deployment, the major purposes of this article are to provide a brief historical snapshot of that war and discuss prior-era military environmental situations that now are producing the lingering effects from their combat exposure...
June 1, 2017: Journal of Holistic Nursing: Official Journal of the American Holistic Nurses' Association
https://www.readbyqxmd.com/read/28625532/emergency-department-do-not-resuscitate-order-in-patients-with-spontaneous-intracerebral-hemorrhage
#3
Ju-Sing Fan, Hsien-Hao Huang, Yen-Chia Chen, Chorng-Kuang How, David Hung-Tsang Yen
OBJECTIVES: To explore the determinant factors and prognostic significance of emergency department do-not-resuscitate (ED-DNR) orders for patients with spontaneous intracerebral hemorrhage (SICH). METHODS: Consecutive adult SICH patients treated in our ED from January 1, 2012 to December 31, 2016 were selected as the eligible cases from our hospital's stroke database. Patients' information was comprehensively reviewed from the database and medical and nursing charts...
June 10, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28617165/transplant-professionals-perceptions-of-long-term-care-residents-candidacy-for-kidney-transplantation
#4
Megan Urbanski, Teri Browne, Mythili Ghanta, Serban Constantinescu, Avrum Gillespie, Heather Hammer, Heather Traino
CONTEXT: Given the aging end-stage renal disease (ESRD) population, kidney transplant (KTx) centers may experience an increase in referrals of patients living in long-term care (LTC) settings (eg, skilled nursing facilities, assisted living facilities, group homes, and boarding homes). OBJECTIVE: To identify best practices among KTx professionals when considering individuals in LTC settings for transplantation. DESIGN AND SETTING: A cross-sectional survey administered online to US transplant professionals via e-mail LISTSERVs and other professional networks...
June 2017: Progress in Transplantation
https://www.readbyqxmd.com/read/28612089/the-intensive-care-delirium-research-agenda-a-multinational-interprofessional-perspective
#5
REVIEW
Pratik P Pandharipande, E Wesley Ely, Rakesh C Arora, Michele C Balas, Malaz A Boustani, Gabriel Heras La Calle, Colm Cunningham, John W Devlin, Julius Elefante, Jin H Han, Alasdair M MacLullich, José R Maldonado, Alessandro Morandi, Dale M Needham, Valerie J Page, Louise Rose, Jorge I F Salluh, Tarek Sharshar, Yahya Shehabi, Yoanna Skrobik, Arjen J C Slooter, Heidi A B Smith
Delirium, a prevalent organ dysfunction in critically ill patients, is independently associated with increased morbidity. This last decade has witnessed an exponential growth in delirium research in hospitalized patients, including those critically ill, and this research has highlighted that delirium needs to be better understood mechanistically to help foster research that will ultimately lead to its prevention and treatment. In this invited, evidence-based paper, a multinational and interprofessional group of clinicians and researchers from within the fields of critical care medicine, psychiatry, pediatrics, anesthesiology, geriatrics, surgery, neurology, nursing, pharmacy, and the neurosciences sought to address five questions: (1) What is the current standard of care in managing ICU delirium? (2) What have been the major recent advances in delirium research and care? (3) What are the common delirium beliefs that have been challenged by recent trials? (4) What are the remaining areas of uncertainty in delirium research? (5) What are some of the top study areas/trials to be done in the next 10 years? Herein, we briefly review the epidemiology of delirium, the current best practices for management of critically ill patients at risk for delirium or experiencing delirium, identify recent advances in our understanding of delirium as well as gaps in knowledge, and discuss research opportunities and barriers to implementation, with the goal of promoting an integrated research agenda...
June 13, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28605633/epileptic-vs-psychogenic-nonepileptic-seizures-a-video-based-survey
#6
Danielle Wasserman, Moshe Herskovitz
Psychogenic non epileptic seizures (PNES) are present in up to 30% of patients undergoing video EEG. Delay in PNES diagnosis is an average of 7.2years. Patients are exposed to costly, hazardous medications and other iatrogenic morbidities. Our aim was to investigate the ability to correctly diagnose ES from PNES in different groups and seniorities of medical professionals based on video alone. We showed ten video episodes' recordings (5 PNES, 5 ES) to doctors and nurses from ER, Internal Medicine ward and Neurology department, and inquired about the episodes' nature...
June 9, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28592372/scene-time-interval-and-good-neurological-recovery-in-out-of-hospital-cardiac-arrest
#7
Ki Hong Kim, Sang Do Shin, Kyoung Jun Song, Young Sun Ro, Yu Jin Kim, Ki Jeong Hong, Joo Jeong
OBJECTIVES: It is unclear whether scene time interval (STI) is associated with better neurological recovery in the emergency medical service (EMS) system with intermediate service level. METHODS: Adult out-of-hospital cardiac arrest (OHCA) patients with presumed cardiac etiology (2012 to 2014) were analyzed, excluding patients not-resuscitated, occurred in ambulance/medical/nursing facility, unknown STI or extremely longer STI (>60 min), and unknown outcomes...
May 29, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28585677/sciatic-nerve-injuries-from-gluteal-intramuscular-injection-according-to-records-of-high-health-council
#8
Hakan Hadi Kadioğlu
AIM: The purpose of the study was to analyze the cases discussed in High Health Council (HHC) and to determine the solutions for the problems on gluteal intramuscular injection (IMI) applications. MATERIAL AND METHODS: In the 9 year period, the cases of IMI related sciatic nerve injury (SNI) sending to take an opinion the Turkey HHC were reviewed. Cases were analyzed in demographic information, degree of nerve damage; side of gluteal region applied on injection, injected drugs, primary disease and appropriateness of parenteral therapy indications, and management...
May 7, 2017: Turkish Neurosurgery
https://www.readbyqxmd.com/read/28584645/clinical-manifestations-in-two-patients-with-pyruvate-dehydrogenase-deficiency-and-long-term-survival
#9
Takanobu Yoshida, Jun Kido, Hiroshi Mitsubuchi, Shirou Matsumoto, Fumio Endo, Kimitoshi Nakamura
Pyruvate dehydrogenase E1-alpha deficiency (PDHAD) results in lactic acidosis and hyperpyruvatemia. Two patients with PDHAD, a man with a p.R263Q mutation, and a girl with a p.C145del mutation in PDHE1α, presented with lactic acidosis with neurological disorder. These patients were able to survive for a long period under careful nursing care. Herein, we discuss the factors contributing to their relatively stable clinical course, albeit with intellectual disability.
2017: Human Genome Variation
https://www.readbyqxmd.com/read/28583702/barriers-to-genetic-testing-for-pediatric-medicaid-beneficiaries-with-epilepsy
#10
Eric J Kutscher, Sucheta M Joshi, Anup D Patel, Baria Hafeez, Zachary M Grinspan
BACKGROUND: Children with public insurance (Medicaid) have increased barriers to specialty care in the United States. For children with epilepsy, the relationship between public insurance and barriers to genetic testing is understudied. METHODS: We surveyed a sample of US child neurology clinicians. We performed quantitative and qualitative analysis of responses. RESULTS: There were 302 responses (of 1982 surveyed; response rate 15%) from clinicians from 46 states, the District of Columbia, and Puerto Rico, including board-certified child neurologists (82%), resident physicians (6%), nurses (3%), and nurse practitioners (3%)...
April 20, 2017: Pediatric Neurology
https://www.readbyqxmd.com/read/28575774/a-randomized-controlled-trial-of-a-manual-based-psychosocial-group-intervention-for-young-people-with-epilepsy-pie
#11
Liam Dorris, Helen Broome, Margaret Wilson, Cathy Grant, David Young, Gus Baker, Selina Balloo, Susan Bruce, Jo Campbell, Bernie Concannon, Nadia Conway, Lisa Cook, Cheryl Davis, Bruce Downey, Jon Evans, Diane Flower, Jack Garlovsky, Shauna Kearney, Susan Lewis, Victoria Stephens, Stuart Turton, Ingram Wright
We conducted an exploratory RCT to examine feasibility and preliminary efficacy for a manual-based psychosocial group intervention aimed at improving epilepsy knowledge, self-management skills, and quality of life in young people with epilepsy. METHOD: Eighty-three participants (33:50m/f; age range 12-17years) were randomized to either the treatment or control group in seven tertiary paediatric neuroscience centres in the UK, using a wait-list control design. Participants were excluded if they reported suicidal ideation and/or scored above the cut off on mental health screening measures, or if they had a learning disability or other neurological disorder...
May 30, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28572100/decreasing-catheter-associated-urinary-tract-infections-in-the-neurological-intensive-care-unit-one-unit-s-success
#12
Brenda Richards, Bindhu Sebastian, Hillary Sullivan, Rosemarie Reyes, John F D'Agostino, Thomas Hagerty
BACKGROUND: Catheter-associated urinary tract infections are preventable adverse outcomes that increase hospital morbidity, mortality, and costs. These infections are particularly prevalent in intensive care units. OBJECTIVES: To describe the success of an 18-bed neurological intensive care unit in using several nurse-implemented strategies that reduced the number of catheter-associated urinary tract infections. METHODS: A prospective, interventional design with application of evidence-based practices to reduce catheter-associated urinary tract infections was used...
June 2017: Critical Care Nurse
https://www.readbyqxmd.com/read/28560917/caring-for-patients-with-parkinson-s-disease-in-general-hospital-settings
#13
Vicky Queen
Parkinson's disease (PD) is a common progressive neurological condition. There are 127,000 people with the disease in the UK, that is, one in every 500 of the population. In 2014-15 there were 14,000 hospital admissions of people with PD in England. However, PD is often not the primary cause of admission. Urinary tract infections and pneumonia, for example, are frequent causes of hospital admission for people with PD. Therefore, nurses on general medical and surgical wards will often care for people with PD...
May 31, 2017: Nursing Older People
https://www.readbyqxmd.com/read/28558399/-applicability-of-the-therapeutic-nursing-theory-in-neurological-early-rehabilitation-into-nursing-practice-a-case-study
#14
Sindy Lautenschläger, Jürgen Muser, Elisabeth Müller
Purpose The objective of the study is to describe how the theory of therapeutic nursing in neurological (early) rehabilitation can be transferred into nursing practice. Materials and Methods The theory was developed using the method of grounded theory by Glaser and Strauss. Open participatory observations (n=92) and episodic interviews (n=10) with nursing professionals and nursing auxiliaries were conducted in 5 inpatient rehabilitation clinics. Data analysis was performed using the constant comparative method by Glaser and Strauss...
May 30, 2017: Die Rehabilitation
https://www.readbyqxmd.com/read/28551929/-early-in-hospital-mortality-in-internal-medicine-wards-within-24-hours-a-potential-quality-indicator-or-a-variable-affected-by-multiple-factors
#15
Yaron Niv, Evgeny Berkov, Pazit Kanter, Evgeny Abrahmson, Uri Gabbay
AIMS: To evaluate in-hospital mortality rate within 24 hours in internal medicine wards and to evaluate if it may be used as quality indicator. BACKGROUND: In-hospital mortality rate is an outcome measure which apparently reflects quality of care. There are debates on whether it may be considered a quality indicator since it is difficult to compare different case-mixes between hospitals. Research on mortality within 24 hours had not been published. METHODS: An historical prospective study was conducted including the entire internal wards admissions to the Rabin Medical Center between 1/7/14 and 30/6/15...
April 2017: Harefuah
https://www.readbyqxmd.com/read/28533166/risk-factors-for-30-day-mortality-in-patients-with-methicillin-resistant-staphylococcus-aureus-bloodstream-infections
#16
Pedro Ayau, Ana C Bardossy, Guillermo Sanchez, Ricardo Ortiz, Daniela Moreno, Pamela Hartman, Khulood Rizvi, Tyler C Prentiss, Mary B Perri, Meredith Mahan, Vanthida Huang, Katherine Reyes, Marcus J Zervos
OBJECTIVES: Methicillin-resistant Staphylococcus aureus (MRSA) blood stream infections (BSI) are a major health care problem accounting for a large percentage of nosocomial infections. The aim of this study was to identify risk factors associated with 30-day mortality in patients with MRSA BSI. METHODS: This was a retrospective study performed in Southeast Michigan. Over a 9- year period, a total of 1,168 patients were identified with MRSA BSI. Patient demographics and clinical data were retrieved and evaluated using electronic medical health records...
May 19, 2017: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/28527550/high-variance-in-pupillary-examination-findings-among-postanesthesia-care-unit-nurses
#17
Lilian Omburo, Sonja Stutzman, Charlene Supnet, Mica Choate, DaiWai M Olson
PURPOSE: On arrival to the postanesthesia care unit (PACU), patients are observed closely for significant neurological status changes. In particular, patients require frequent neurological examinations, which include assessment of the pupils for changes and/or abnormalities. DESIGN: This is a prospective, nonrandomized, observational study to examine the findings of pupillary examinations by nurses using different light sources in patients with existing pupillary assessments as ordered by standard of care...
June 2017: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/28524254/migraine-nurses-in-primary-care-costs-and-benefits
#18
Jan S P van den Berg, Timothy J Steiner, Petra J L Veenstra, Boudewijn J Kollen
OBJECTIVE: We examined the costs and benefits of introducing migraine nurses into primary care. BACKGROUND: Migraine is one of the most costly neurological diseases. METHODS: We analyzed data from our earlier nonrandomized cohort study comparing an intervention group of 141 patients, whose care was supported by nurses trained in migraine management, and a control group of 94 patients receiving usual care. Estimates of per-person direct costs were based on nurses' salaries and referrals to neurologists...
May 19, 2017: Headache
https://www.readbyqxmd.com/read/28514888/seeing-is-believing-healthcare-professionals-perceptions-of-a-complex-intervention-to-improve-care-towards-the-end-of-life-a-qualitative-interview-study
#19
Katherine Bristowe, Irene Carey, Adrian Hopper, Susanna Shouls, Wendy Prentice, Irene J Higginson, Jonathan Koffman
BACKGROUND: Methods to improve care, trust and communication are important in acute hospitals. Complex interventions aimed at improving care of patients approaching the end of life are increasingly common. While evaluating outcomes of complex interventions is essential, exploring healthcare professionals' perceptions is also required to understand how they are interpreted; this can inform training, education and implementation strategies to ensure fidelity and consistency in use. AIM: To explore healthcare professionals' perceptions of using a complex intervention (AMBER care bundle) to improve care for people approaching the end of life and their understandings of its purpose within clinical practice...
May 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28493774/urinary-catheter-related-visits-to-the-emergency-department-and-implications-for-community-services
#20
Tiziana Ansell, Danielle Harari
Thousands of patients live with urinary catheters and the potential complications deriving from long-term use. Disjointed community services may result in patients attending the emergency department (ED) to manage catheter complications. AIM: to conduct a service review of catheterised patients attending the ED of a large London hospital; to describe incidence, reasons for attendance and cost to inform future planning for out-of-hospital care. METHOD: a catheter collaborative, consisting of multidisciplinary health professionals and patients, formulated survey questions...
May 11, 2017: British Journal of Nursing: BJN
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