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https://www.readbyqxmd.com/read/28107309/-delay-to-operating-room-fails-to-identify-adverse-outcomes-at-a-level-i-trauma-center
#1
Paul R Lewis, Jayraan Badiee, Michael J Sise, Richard Y Calvo, Jason B Brill, James D Wallace, Steven R Shackford, Casey E Dunne, Vishal Bansal, C Beth Sise
BACKGROUND: The American College of Surgeons Committee on Trauma devised process audit filters to identify opportunities for improvement (OFI), prevent adverse outcomes, and improve quality. Delay to the operating room for primary trauma laparotomy is a process audit filter that has not been definitively associated with improved outcomes. We sought to evaluate the effectiveness of delay to the operating room of greater than 2 hours (DOR) to independently identify an adverse outcome or an OFI at our Level I trauma center...
February 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28107262/suspected-cerebral-edema-in-diabetic-ketoacidosis-is-there-still-a-role-for-head-ct-in-treatment-decisions
#2
Carmen L Soto-Rivera, Lisa A Asaro, Michael S D Agus, Danielle D DeCourcey
OBJECTIVES: Neurologic deterioration associated with cerebral edema in diabetic ketoacidosis is typically sudden in onset, progresses rapidly, and requires emergent treatment. The utility of brain imaging by head CT in decisions to treat for cerebral edema has not been previously studied. The objective of this study was to describe the characteristics of pediatric patients with diabetic ketoacidosis who develop altered mental status and evaluate the role of head CT in this cohort. DESIGN: Retrospective analysis of clinical, biochemical, and radiologic data...
January 19, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28106904/planned-early-delivery-versus-expectant-management-for-hypertensive-disorders-from-34-weeks-gestation-to-term
#3
REVIEW
Catherine Cluver, Natalia Novikova, Corine M Koopmans, Helen M West
BACKGROUND: Hypertensive disorders in pregnancy are significant contributors to maternal and perinatal morbidity and mortality. These disorders include well-controlled chronic hypertension, gestational hypertension (pregnancy-induced hypertension) and mild pre-eclampsia. The definitive treatment for these disorders is planned early delivery and the alternative is to manage the pregnancy expectantly if severe uncontrolled hypertension is not present, with close maternal and fetal monitoring...
January 15, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28106625/long-term-hearing-results-after-ossiculoplasty
#4
Matthew D Cox, Aaron Trinidade, James Shep Russell, John L Dornhoffer
OBJECTIVES: To determine if the OOPS index is predictive of long-term hearing results after ossiculoplasty. STUDY DESIGN: Case series with retrospective chart review. SETTING: Tertiary care otology practice. PATIENTS: Adult and pediatric patients (3-88 years of age). INTERVENTIONS: Ossiculoplasty with cartilage tympanoplasty, with or without mastoidectomy. OUTCOME MEASURES: Primary outcome measures included short-term hearing results (pure-tone average air-bone gap [PTA-ABG] measured between 60 days and 1 year after surgery), long-term hearing results (PTA-ABG measured ≥5 years after surgery), and the rate of successful ABG closure to ≤20 dB...
January 18, 2017: Otology & Neurotology
https://www.readbyqxmd.com/read/28105408/predictors-of-prolonged-mechanical-ventilation-in-pediatric-patients-after-cardiac-surgery-for-congenital-heart-disease
#5
Avisa Tabib, Seyed Ehsan Abrishami, Mohammad Mahdavi, Hojjat Mortezaeian, Ziae Totonchi
BACKGROUND: The duration of mechanical ventilation (MV) is one of the most important clinical factors which predict outcomes in pediatric cardiac surgery. The prolonged mechanical ventilation (PMV) following cardiac surgery is a multifactorial phenomenon and there are conflicts regarding its predictors in pediatric population between different centers. OBJECTIVES: The current study aimed to describe PMV predictors in patients undergoing cardiac surgery for congenital heart disease in a tertiary center for pediatric cardiovascular diseases in Iran...
August 2016: Research in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28104711/m%C3%A4-ori-patients-experiences-and-perspectives-of-chronic-kidney-disease-a-new-zealand-qualitative-interview-study
#6
Rachael C Walker, Shayne Walker, Rachael L Morton, Allison Tong, Kirsten Howard, Suetonia C Palmer
OBJECTIVES: To explore and describe Māori (the indigenous people of New Zealand) patients' experiences and perspectives of chronic kidney disease (CKD), as these are largely unknown for indigenous groups with CKD. DESIGN: Face-to-face, semistructured interviews with purposive sampling and thematic analysis. SETTING: 3 dialysis centres in New Zealand (NZ), all of which offered all forms of dialysis modalities. PARTICIPANTS: 13 Māori patients with CKD and who were either nearing the need for dialysis or had started dialysis within the previous 12 months...
January 19, 2017: BMJ Open
https://www.readbyqxmd.com/read/28104698/periconceptional-maternal-one-carbon-biomarkers-are-associated-with-embryonic-development-according-to-the-carnegie-stages
#7
F Parisi, M Rousian, A H J Koning, S P Willemsen, I Cetin, R P M Steegers-Theunissen
STUDY QUESTION: Is periconceptional maternal one-carbon (I-C) metabolism associated with embryonic morphological development in non-malformed ongoing pregnancies? SUMMARY ANSWER: Serum vitamin B12, red blood cell (RBC) folate and plasma total homocysteine (tHcy) are associated with embryonic development according to the Carnegie stages. WHAT IS KNOWN ALREADY: Derangements in maternal I-C metabolism affect reproductive and pregnancy outcomes, as well as future health of the offspring...
January 18, 2017: Human Reproduction
https://www.readbyqxmd.com/read/28104496/risk-factors-clinical-presentation-and-outcomes-for-abdominal-wall-endometriosis
#8
Zaraq Khan, Valentina Zanfagnin, Sherif A El-Nashar, Bimbola O Famuyide, Gaurang S Daftary, Matthew R Hopkins
STUDY OBJECTIVE: To evaluate risk factors, presentation and outcomes in cases of abdominal wall endometriosis. DESIGN: This is a case control study. DESIGN CLASSIFICATION: Canadian Task Force classification II-2 SETTING: Academic medical center PATIENTS: Total of 102 (34 cases and 68 controls) were included. INTERVENTION(S): Surgical resection of abdominal wall endometriosis. MAIN OUTCOME MEASURE(S): Cases underwent surgical excision for abdominal wall endometriosis at Mayo Clinic from January 1, 2000 through December 31, 2013...
January 16, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28104300/challenges-and-opportunities-in-primary-cns-lymphoma-a-systematic-review
#9
REVIEW
Mariana N Kerbauy, Fabio Y Moraes, Benjamin H Lok, Jennifer Ma, Lucila N Kerbauy, Daniel E Spratt, Fabio P S Santos, Guilherme F Perini, Alejandro Berlin, Caroline Chung, Nelson Hamerschlak, Joachim Yahalom
BACKGROUND: Historically, high-dose methotrexate (HD-MTX) plus consolidation chemotherapy and/or whole brain radiotherapy (WBRT) has been the gold standard on Primary Central Nervous System Lymphoma (PCNSL) management. We sought to examine and summarize the data, on clinical trial (CT) setting, investigating multi-modality treatment to PCNSL. METHODS: We performed a systematic review of electronic databases (Medline, EMBASE, Cochrane Database and clinicaltrials...
January 16, 2017: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
https://www.readbyqxmd.com/read/28103836/rapid-reduction-of-maternal-mortality-in-uganda-and-zambia-through-the-saving-mothers-giving-life-initiative-results-of-year-1-evaluation
#10
Florina Serbanescu, Howard I Goldberg, Isabella Danel, Tadesse Wuhib, Lawrence Marum, Walter Obiero, James McAuley, Jane Aceng, Ewlyn Chomba, Paul W Stupp, Claudia Morrissey Conlon
BACKGROUND: Achieving maternal mortality reduction as a development goal remains a major challenge in most low-resource countries. Saving Mothers, Giving Life (SMGL) is a multi-partner initiative designed to reduce maternal mortality rapidly in high mortality settings through community and facility evidence-based interventions and district-wide health systems strengthening that could reduce delays to appropriate obstetric care. METHODS: An evaluation employing multiple studies and data collection methods was used to compare baseline maternal outcomes to those during Year 1 in SMGL pilot districts in Uganda and Zambia...
January 19, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28103460/-pneumocystis-pneumonia-in-107-hiv-infected-patients-admitted-to-the-department-of-infectious-diseases-at-santa-maria-hospital-lisbon-2002-2013
#11
Vilma Grilo, Aida Pereira
INTRODUCTION: Pneumocystis jirovecii pneumonia remains one of the most common opportunistic illnesses in patients infected with the human immunodeficiency virus. It is currently the most reported AIDS-defining infection in Portugal. The aims of this study were to analyze the features of a human immunodeficiency virus /Pneumocystis jirovecii pneumonia coinfected population, to compare it with the current literature, and to evaluate comparatively subpopulations of patients based on the previous knowledge of the human immunodeficiency virus infection, Pneumocystis jirovecii pneumonia diagnostic method and discharge results...
October 2016: Acta Médica Portuguesa
https://www.readbyqxmd.com/read/28103455/-epidemiological-and-demographic-characteristics-of-patients-with-head-and-neck-tumours-in-the-northern-portugal-impact-on-survival
#12
Roberto Estêvão, Tiago Santos, Ana Ferreira, Anabela Machado, João Fernandes, Eurico Monteiro
INTRODUCTION: In Portugal there are still no epidemiological and demographic studies conducted in patients with of the head and neck tumors. The objectives of this analysis are to describe the epidemiological and demographics of patients with malignant tumors of the head and neck referred to an Ear, Nose and Throat department of an oncology center in the North of Portugal and also assess the impact of these characteristics on survival. MATERIAL AND METHODS: Retrospective study of patients referred between January 2011 and December 2013 to the Ear, Nose and Throat Department of an oncology center (Instituto Português de Oncologia do Porto),...
October 2016: Acta Médica Portuguesa
https://www.readbyqxmd.com/read/28103121/comparison-of-helicopter-emergency-medical-services-transport-types-and-delays-on-patient-outcomes-at-two-level-i-trauma-centers
#13
Brodie Nolan, Homer Tien, Bruce Sawadsky, Sandro Rizoli, Amanda McFarlan, Andrea Phillips, Alun Ackery
BACKGROUND: Helicopter emergency medical services (HEMS) have become an engrained component of trauma systems. In Ontario, transportation for trauma patients is through one of three ways: scene call, modified scene call, or interfacility transfer. We hypothesize that differences exist between these types of transports in both patient demographics and patient outcomes. This study compares the characteristics of patients transported by each of these methods to two level 1 trauma centers and assesses for any impact on morbidity or mortality...
January 19, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28102909/the-effects-of-hospital-characteristics-on-delays-in-breast-cancer-diagnosis-in-appalachian-communities-a-population-based-study
#14
Christopher J Louis, Jonathan R Clark, Marianne M Hillemeier, Fabian Camacho, Nengliang Yao, Roger T Anderson
PURPOSE: Despite being generally accepted that delays in diagnosing breast cancer are of prognostic and psychological concern, the influence of hospital characteristics on such delays remains poorly understood, especially in rural and underserved areas. However, hospital characteristics have been tied to greater efficiency and warrant further investigation as they may have implications for breast cancer care in these areas. METHODS: Study data were derived from the Kentucky, North Carolina, Ohio, and Pennsylvania state central cancer registries (2006-2008)...
January 19, 2017: Journal of Rural Health
https://www.readbyqxmd.com/read/28102598/novel-findings-of-left-ventricular-non-compaction-cardiomyopathy-microform-cleft-lip-and-poor-vision-in-patient-with-smc1a-associated-cornelia-de-lange-syndrome
#15
Tara L Wenger, Penny Chow, Stephanie C Randle, Anna Rosen, Craig Birgfeld, Joanna Wrede, Patrick Javid, Darcy King, Vivian Manh, Anne V Hing, Erin Albers
Relatively few patients with Cornelia de Lange syndrome (CdLS) due to SMC1A mutation have been reported, limiting understanding of the full extent of the phenotype. Compared to children with classic NIPBL-associated CdLS, patients with SMC1A-associated CdLS have a milder physical phenotype with prominent intellectual disability, high rate of cleft palate and absence of limb reductions. We present a patient with SMC1A-associated CdLS who had typical features including developmental delay, seizure disorder, feeding difficulties, hirsutism, and cleft palate...
February 2017: American Journal of Medical Genetics. Part A
https://www.readbyqxmd.com/read/28100439/considerations-for-an-access-centered-design-of-the-fever-thermometer-in-low-resource-settings-a-literature-review
#16
REVIEW
Rikako Iwamoto, Ana Laura Rodrigues Santos, Niels Chavannes, Ria Reis, Jan Carel Diehl
BACKGROUND: The lack of adequate information about fever in low-resource settings, its unreliable self-assessment, and poor diagnostic practices may result in delayed care and under-or-overdiagnosis of diseases such as malaria. The mismatches of existing fever thermometers in the context of use imply that the diagnostic tools and connected services need to be studied further to address the challenges of fever-related illnesses and their diagnostics. OBJECTIVE: This study aims to inform a product-service system approach to design a reliable and accessible fever thermometer and connected services, as well as contribute to the identification of innovative opportunities to improve health care in low-resource settings...
January 18, 2017: JMIR Human Factors
https://www.readbyqxmd.com/read/28100251/consensus-guideline-for-the-diagnosis-and-treatment-of-aromatic-l-amino-acid-decarboxylase-aadc-deficiency
#17
REVIEW
Tessa Wassenberg, Marta Molero-Luis, Kathrin Jeltsch, Georg F Hoffmann, Birgit Assmann, Nenad Blau, Angeles Garcia-Cazorla, Rafael Artuch, Roser Pons, Toni S Pearson, Vincenco Leuzzi, Mario Mastrangelo, Phillip L Pearl, Wang Tso Lee, Manju A Kurian, Simon Heales, Lisa Flint, Marcel Verbeek, Michèl Willemsen, Thomas Opladen
Aromatic L-amino acid decarboxylase deficiency (AADCD) is a rare, autosomal recessive neurometabolic disorder that leads to a severe combined deficiency of serotonin, dopamine, norepinephrine and epinephrine. Onset is early in life, and key clinical symptoms are hypotonia, movement disorders (oculogyric crisis, dystonia, and hypokinesia), developmental delay, and autonomic symptoms.In this consensus guideline, representatives of the International Working Group on Neurotransmitter Related Disorders (iNTD) and patient representatives evaluated all available evidence for diagnosis and treatment of AADCD and made recommendations using SIGN and GRADE methodology...
January 18, 2017: Orphanet Journal of Rare Diseases
https://www.readbyqxmd.com/read/28099713/systematic-review-of-obstetric-care-from-a-women-centered-perspective-in-nigeria-since-2000
#18
REVIEW
Atsumi Hirose, Oluwatoyin Owolabi, Mari Imamura, Friday Okonofua, Julia Hussein
BACKGROUND: A women-centered approach can improve the quality of patient care. OBJECTIVE: To review issues in the provision of obstetric care from a patient-centered care perspective in Nigeria. SEARCH STRATEGY: Using terms related to maternal and perinatal mortality, in combination with "Nigeria", MEDLINE, Embase, CINAHL, Web of Knowledge, and African Journal Online were searched, between December 1, 2013 and January 31, 2014, for articles in any language...
January 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28099640/cardiopulmonary-resuscitation-of-adults-with-in-hospital-cardiac-arrest-using-the-utstein-style
#19
Rose Mary Ferreira Lisboa da Silva, Bruna Adriene Gomes de Lima E Silva, Fábio Junior Modesto E Silva, Carlos Faria Santos Amaral
Objective: The objective of this study was to analyze the clinical profile of patients with in-hospital cardiac arrest using the Utstein style. Methods: This study is an observational, prospective, longitudinal study of patients with cardiac arrest treated in intensive care units over a period of 1 year. Results: The study included 89 patients who underwent cardiopulmonary resuscitation maneuvers. The cohort was 51.6% male with a mean age 59...
October 2016: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/28099522/anodal-transcranial-direct-current-stimulation-shows-minimal-measure-specific-effects-on-dynamic-postural-control-in-young-and-older-adults-a-double-blind-sham-controlled-study
#20
Chesney E Craig, Michail Doumas
We investigated whether stimulating the cerebellum and primary motor cortex (M1) using transcranial direct current stimulation (tDCS) could affect postural control in young and older adults. tDCS was employed using a double-blind, sham-controlled design, in which young (aged 18-35) and older adults (aged 65+) were assessed over three sessions, one for each stimulatory condition-M1, cerebellar and sham. The effect of tDCS on postural control was assessed using a sway-referencing paradigm, which induced platform rotations in proportion to the participant's body sway, thus assessing sensory reweighting processes...
2017: PloS One
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