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https://www.readbyqxmd.com/read/28212182/what-s-new-in-obstetric-anesthesia-the-2016-gerard-w-ostheimer-lecture
#1
Philip E Hess
This special article presents potentially important trends and issues affecting the field of obstetric anesthesia drawn from publications in 2015. Both maternal mortality and morbidity in the United States have increased in recent years because, in part, of the changing demographics of the childbearing population. Pregnant women are older and have more pre-existing conditions and complex medical histories. Cardiovascular and noncardiovascular medical diseases now account for half of maternal deaths in the United States...
March 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28209120/factors-influencing-utilisation-of-maternal-health-services-by-adolescent-mothers-in-low-and-middle-income-countries-a-systematic-review
#2
Oluwasola Eniola Banke-Thomas, Aduragbemi Oluwabusayo Banke-Thomas, Charles Anawo Ameh
BACKGROUND: Adolescent mothers aged 15-19 years are known to have greater risks of maternal morbidity and mortality compared with women aged 20-24 years, mostly due to their unique biological, sociological and economic status. Nowhere Is the burden of disease greater than in low-and middle-income countries (LMICs). Understanding factors that influence adolescent utilisation of essential maternal health services (MHS) would be critical in improving their outcomes. METHODS: We systematically reviewed the literature for articles published until December 2015 to understand how adolescent MHS utilisation has been assessed in LMICs and factors affecting service utilisation by adolescent mothers...
February 16, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28206801/burden-and-mental-health-among-caregivers-of-veterans-with-traumatic-brain-injury-polytrauma
#3
Joan M Griffin, Minji K Lee, Lauren R Bangerter, Courtney Harold Van Houtven, Greta Friedemann-Sánchez, Sean M Phelan, Kathleen F Carlson, Laura A Meis
Veterans who survive multiple traumatic injuries, including traumatic brain injuries (TBI), must often rely on family caregivers for ongoing care and support with reintegration. Understanding factors associated with caregiving that help or harm caregivers' health is critical for identifying appropriate and effective interventions that support caregiver health and promote the provision of quality care to veterans. This study utilized cross-sectional data from the Family and Caregiver Experiences Study, a survey of 564 caregivers caring for veterans who served after September 11, 2001, survived TBI/polytrauma during service, and received inpatient rehabilitation care in a Veterans Affairs Polytrauma Rehabilitation Center...
2017: American Journal of Orthopsychiatry
https://www.readbyqxmd.com/read/28204949/caregiver-burden-and-the-medical-ethos
#4
Karsten Witt, Johanne Stümpel, Christiane Woopen
Are physicians sometimes morally required to ease caregiver burden? In our paper we defend an affirmative answer to this question. First, we examine the well-established principle that medical care should be centered on the patient. We argue that although this principle seems to give physicians some leeway to lessen caregivers' suffering, it is very restrictive when spelled out precisely. Based on a critical analysis of existing cases for transcending patient-centeredness we then go on to argue that the medical ethos should indeed contain a rule requiring physicians to alleviate caregiver burden under certain circumstances...
February 15, 2017: Medicine, Health Care, and Philosophy
https://www.readbyqxmd.com/read/28193322/geographic-distribution-of-trauma-burden-mortality-and-services-in-the-united-states-does-availability-correspond-to-patient-need
#5
Arturo J Rios-Diaz, David Metcalfe, Olubode A Olufajo, Cheryl K Zogg, Brian Yorkgitis, Mansher Singh, Adil H Haider, Ali Salim
BACKGROUND: The association between the need for trauma care and trauma services has not been characterized previously. We compared the distribution of trauma admissions with state-level availability of trauma centers (TCs), surgical critical care (SCC) providers, and SCC fellowships, and assessed the association between trauma care provision and state-level trauma mortality. STUDY DESIGN: We obtained 2013 state-level data on trauma admissions, TCs, SCC providers, SCC fellowship positions, per-capita income, population size, and age-adjusted mortality rates...
December 2016: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28187802/critical-care-management-of-traumatic-brain-injury
#6
D K Menon, A Ercole
Traumatic brain injury (TBI) is a growing global problem, which is responsible for a substantial burden of disability and death, and which generates substantial healthcare costs. High-quality intensive care can save lives and improve the quality of outcome. TBI is extremely heterogeneous in terms of clinical presentation, pathophysiology, and outcome. Current approaches to the critical care management of TBI are not underpinned by high-quality evidence, and many of the current therapies in use have not shown benefit in randomized control trials...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28186833/the-use-of-a-brief-5-item-measure-of-family-satisfaction-as-a-critical-quality-indicator-in-advanced-cancer-care-a-multisite-comparison
#7
Katherine A Ornstein, Joan Penrod, Julie B Schnur, Cardinale B Smith, Jeanne A Teresi, Melissa M Garrido, Karen McKendrick, Albert L Siu, Diane E Meier, R Sean Morrison
BACKGROUND: Although family satisfaction is recognized as a critical indicator of quality for patients with advanced cancer, it is rarely assessed as part of routine clinical care. Measurement burden may be one barrier to widespread use of family satisfaction measures. OBJECTIVE: The goal of this study was to test the ability of a new, brief 5-item measure of family satisfaction with care to accurately capture differences across hospital settings. DESIGN: Using data from the Palliative Care for Cancer Patients study, a prospective study of 1979 patients and caregivers, we used multivariate regression analysis to detect significant differences across five sites...
February 10, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28183852/incarceration-and-exposure-to-internally-displaced-persons-camps-associated-with-reproductive-rights-abuses-among-sex-workers-in-northern-uganda
#8
Margaret Erickson, Shira M Goldenberg, Monica Akello, Godfrey Muzaaya, Paul Nguyen, Josephine Birungi, Kate Shannon
BACKGROUND: While female sex workers (FSWs) face a high burden of violence and criminalisation, coupled with low access to safe, non-coercive care, little is known about such experiences among FSWs in conflict-affected settings, particularly as they relate to sexual and reproductive health (SRH) and rights. We explored factors associated with lifetime abortions among FSWs in northern Uganda; and separately modelled the independent effect of lifetime exposures to incarceration and living in internally displaced persons (IDP) camps on coerced and unsafe abortions...
February 9, 2017: Journal of Family Planning and Reproductive Health Care
https://www.readbyqxmd.com/read/28179154/managing-the-patient-identification-crisis-in-healthcare-and-laboratory-medicine
#9
REVIEW
Giuseppe Lippi, Camilla Mattiuzzi, Chiara Bovo, Emmanuel J Favaloro
Identification errors have emerged as a critical issue in health care, as testified by the ample scientific literature on this argument. Despite available evidence suggesting that the frequency of misidentification in vitro laboratory diagnostic testing may be relatively low compared to that of other laboratory errors (i.e., usually comprised between 0.01 and 0.1% of all specimens received), the potential adverse consequences remain particularly worrying, wherein 10-20% of these errors not only would translate into serious harm for the patient, but may also erode considerable human and economic resources, so that the entire healthcare system should be re-engineered to act proactively and limiting the burden of this important problem...
February 5, 2017: Clinical Biochemistry
https://www.readbyqxmd.com/read/28171734/imiquimod-injection-to-rabbit-vocal-folds
#10
Stephanie E Teng, Gregory R Dion, Danielle N Sin, Nao Hiwatashi, Peter A Benedict, Milan R Amin, Ryan C Branski
Objective Given the recalcitrant nature of recurrent respiratory papillomatosis, targeted therapies to reduce disease burden are fundamental to improved patient care paradigms. We seek to demonstrate the safety of imiquimod injection into vocal fold mucosa by evaluating the degree of laryngeal edema, histopathologic changes to vocal fold structure, and serologic interferon α (IFNα) levels following injection. Study Design Preclinical. Setting Academic institution. Subjects and Methods Six New Zealand White rabbits underwent unilateral injection of 100 µg of sterile imiquimod (1 µg/µL), with 100 µL of normal saline injected into the contralateral vocal fold...
February 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28166640/what-matters-most-a-mixed-methods-study-of-critical-aspects-of-a-home-based-palliative-program
#11
Claire K Ankuda, Kaileen Kersting, Timothy C Guetterman, Jessica Haefner, Evan Fonger, Michael Paletta, Faith Hopp
BACKGROUND: Home-based palliative care programs have shown value in improving quality of care and lowering costs for seriously ill patients. It is unknown what specific elements of these programs matter most to patients and caregivers. AIM: To identify what services are critical and why they matter to patients in a home-based palliative program. SETTING/PARTICIPANTS: A mixed methods study of 18 participants in the At Home Support (AHS) program in Southeast Michigan...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28166165/automated-variable-aortic-control-vs-complete-aortic-occlusion-in-a-swine-model-of-hemorrhage
#12
Timothy K Williams, Lucas P Neff, M Austin Johnson, Rachel M Russo, Sarah-Ashley Ferencz, Anders J Davidson, Nathan F Clement, J Kevin Grayson, Todd E Rasmussen
BACKGROUND: Future endovascular hemorrhage control devices will require features that mitigate the adverse effects of vessel occlusion. Permissive regional hypoperfusion (PRH) with variable aortic control (VAC) is a novel strategy to minimize hemorrhage and reduce the ischemic burden of complete aortic occlusion (AO). The objective of this study was to compare PRH with VAC to AO in a lethal model of hemorrhage. METHODS: Twenty-five swine underwent cannulation of the supraceliac aorta, with diversion of aortic flow through an automated extracorporeal circuit...
February 4, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28166113/using-a-mixed-methods-approach-to-examine-practice-characteristics-associated-with-implementation-of-an-adult-immunization-intervention-using-the-4-pillars-practice-transformation-program
#13
Mary Hawk, Mary Patricia Nowalk, Krissy K Moehling, Valory Pavlik, Jonathan M Raviotta, Anthony E Brown, Richard K Zimmerman, Edmund M Ricci
Adult immunization rates are consistently suboptimal, exacting significant human and financial burden of preventable disease. Practice-level interventions to improve immunization rates have produced mixed results. The context of change critically affects implementation of evidence-based interventions. We conducted a randomized controlled cluster trial of the 4 Pillars Practice Transformation Program to increase adult vaccination rates in primary care practices and used qualitative methods to test intervention effects and understand practice characteristics associated with implementation success...
January 11, 2017: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/28164253/heart-failure-in-the-elderly-ten-peculiar-management-considerations
#14
Feras Bader, Bassam Atallah, Lisa F Brennan, Rola H Rimawi, Mohammed E Khalil
Chronic heart failure (HF) is a disease with significantly higher prevalence in the elderly or patients older than 65 years old. Typically, older patients have more risk factors for HF, more comorbidities, and are more likely to have recurrent admissions for acute decompensations. With HF burden on health care systems primarily related to hospital and nursing home costs, it is critical that elderly patients are approached with a clear understanding of certain unique clinical, laboratory, imaging, and pharmacokinetic differences that can alter their management and outcomes...
February 6, 2017: Heart Failure Reviews
https://www.readbyqxmd.com/read/28161930/electronic-referrals-and-digital-imaging-systems-in-ophthalmology-a-global-perspective
#15
V Swetha E Jeganathan, H Nikki Hall, Roshini Sanders
Ophthalmology departments face intensifying pressure to expedite sight-saving treatments and reduce the global burden of disease. The use of electronic communication systems, digital imaging, and redesigned service care models is imperative for addressing such demands. The recently developed Scottish Eyecare Integration Project involves an electronic referral system from community optometry to the hospital ophthalmology department using National Health Service (NHS) email with digital ophthalmic images attached, via a virtual private network connection...
January 2017: Asia-Pacific Journal of Ophthalmology
https://www.readbyqxmd.com/read/28160952/antibiotic-trends-amid-multidrug-resistant-gram-negative-infections-in-intensive-care-units
#16
REVIEW
Leanne H Fowler, Susan Lee
Isolates from ICUs most commonly find multidrug-resistant (MDR) gram-negative bacteria. The purpose of this article is to discuss the significant impact MDR gram-negative infections are having on ICUs, the threat on health and mortality, and effective and new approaches aimed to combat MDR gram-negative infections in critically ill populations. Inappropriate antibiotic therapies for suspected or documented infections are the leading cause of the emergence of bacterial resistance. A variety of strategies are aimed at combatting this international burden via antibiotic stewardship programs...
March 2017: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/28160353/a-review-on-microbiological-decontamination-of-fresh-produce-with-nonthermal-plasma
#17
REVIEW
C Pignata, D D'Angelo, E Fea, G Gilli
Food safety is a critical public health issue for consumers and the food industry because microbiological contamination of food causes considerable social and economic burdens on health care. Most foodborne illness comes from animal production, but as of the mid-1990s in the United States and more recently in the European Union, the contribution of fresh produce to foodborne outbreaks has rapidly increased. Recent studies have suggested that sterilisation with nonthermal plasma could be a viable alternative to the traditional methods for the decontamination of heat-sensitive materials or food because this technique proves capable of eliminating microorganisms on surfaces without altering the substrate...
February 4, 2017: Journal of Applied Microbiology
https://www.readbyqxmd.com/read/28159645/driven-to-distraction-the-nature-and-apparent-purpose-of-interruptions-in-critical-care-and-implications-for-hit
#18
Lena Mamykina, Eileen J Carter, Barbara Sheehan, R Stanley Hum, Bridget C Twohig, David R Kaufman
OBJECTIVES: To examine the apparent purpose of interruptions in a Pediatric Intensive Care Unit and opportunities to reduce their burden with informatics solutions. MATERIALS AND METHODS: In this prospective observational study, researchers shadowed clinicians in the unit for one hour at a time, recording all interruptions participating clinicians experienced or initiated, their starting time, duration, and a short description that could help to infer their apparent purpose...
January 31, 2017: Journal of Biomedical Informatics
https://www.readbyqxmd.com/read/28156650/organizational-factors-influencing-specialty-palliative-care-utilization-at-academic-cancer-centers
#19
Michael W Rabow, Megan Crowley-Makota, Mallory Marie Waters, Michelle Nkumsah, Douglas B White, Edward Chu, Cardinale B Smith, Robert Arnold
: 109 Background: Rates of early specialty palliative care utilization remain low, despite increasing familiarity and favorable attitudes amongst cancer center oncologists. In this context, understanding organizational barriers to specialty palliative care use becomes critical. METHODS: We conducted a qualitative interview study with 74 medical oncologists practicing at 3 U.S. academic cancer centers with well-established specialty palliative care clinics. The in-depth interview guide elicited experiences and views related to outpatient palliative care...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152826/patient-and-clinician-perspectives-on-treatment-decision-making-for-african-american-men-with-prostate-cancer
#20
Sarah Abramson, Daniel Walker, Lindsey Sova, Jenny J Lin, Kezhen Fei, Rebeca Franco, Ann Scheck McAlearney
: 186 Background: Prostate cancer is the most common cancer for men in the US, yet the burden of this disease falls disproportionately on African Americans (AAs). The disparity's etiology is complex. Surgery and radiotherapy offer similar survival but historically have different rates of performance with younger and white men more likely to undergo surgery and AAs more likely to experience underuse. This study aims to examine treatment decision-making (TDM) processes for AA men from patient and physician perspectives...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
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