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https://www.readbyqxmd.com/read/28741278/italian-intersociety-consensus-on-prevention-diagnosis-and-treatment-of-delirium-in-hospitalized-older-persons
#1
Giuseppe Bellelli, Alessandro Morandi, Marco Trabucchi, Guido Caironi, Daniele Coen, Carlo Fraticelli, Ciro Paolillo, Carolina Prevaldi, Angela Riccardi, Gianfranco Cervellin, Corrado Carabellese, Salvatore Putignano, Stefania Maggi, Antonio Cherubini, Paola Gnerre, Andrea Fontanella, Nicola Latronico, Concezione Tommasino, Antonio Corcione, Giovanni Ricevuti, Nicola Ferrara, Francesco De Filippi, Alberto Ferrari, Mario Guarino, Maria Pia Ruggieri, Pietro Amedeo Modesti, Carlo Locatelli, Patrizia Hrelia, Marco Otto Toscano, Emi Bondi, Antonio Tarasconi, Luca Ansaloni, Francesco Perticone
Delirium is a severe neuropsychiatric syndrome characterized by inattention and global cognitive dysfunction in the setting of an acute medical illness, medical complication, drug intoxication, or drug withdrawal. The most important risk factors are advanced age and dementia, whereas pain, dehydration, infections, stroke, metabolic disturbances, and surgery are the most common triggering factors. Although delirium is a common clinical syndrome in different settings of care (acute care hospitals, inpatient rehabilitation facilities, nursing homes, and hospices), it often remains under-recognized, poorly understood, and inadequately managed...
July 24, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28722615/assessing-the-short-term-global-health-experience-a-cross-sectional-study-of-demographics-socioeconomic-factors-and-disease-prevalence
#2
Olivia Geen, Allison Pumputis, Cristina Kochi, Andrew Costa, Karl Stobbe
Interest in short-term global health experiences to underserviced populations has grown rapidly in the last few decades. However, there remains very little research on what participants can expect to encounter. At the same time, it has been suggested that in order for physicians and workers to provide safe and effective care, volunteers should have a basic understanding of local culture, health systems, epidemiology, and socioeconomic needs of the community before arriving. Our objective was to add to the limited literature on what short-term global health trips can expect to encounter through a cross-sectional study of patient demographics, socioeconomic markers, and the prevalence of diseases encountered on a short-term medical service trip to Lima, Peru...
June 12, 2017: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/28699379/what-dilemmas-do-healthcare-workers-face-looking-after-children-with-acute-pain
#3
Glyn Williams
There have been significant advances in the treatment of acute pain in children alongside increased academic interest in the field. This has led to improvements in both efficacy and safety alongside the development of multidisciplinary pain services. Despite this, however, there are still high rates of acute pain reported in children in both inpatient and outpatient settings. In this article, we discuss some of the challenges faced by healthcare workers in designing effective multidisciplinary treatment regimens, understanding the implications for long-term pain and pain processing of acute pain and analgesic interventions as well as ongoing issues around research, education and resource...
July 12, 2017: Pain Management
https://www.readbyqxmd.com/read/28663360/public-knowledge-of-cardiovascular-disease-and-response-to-acute-cardiac-events-in-three-cities-in-china-and-india
#4
Herbert C Duber, Claire R McNellan, Alexandra Wollum, Bryan Phillips, Kate Allen, Jonathan C Brown, Miranda Bryant, R B Guptam, Yichong Li, Piyusha Majumdar, Gregory A Roth, Blake Thomson, Shelley Wilson, Alexander Woldeab, Maigeng Zhou, Marie Ng
OBJECTIVE: To inform interventions targeted towards reducing mortality from acute myocardial infarction (AMI) and sudden cardiac arrest in three megacities in China and India, a baseline assessment of public knowledge, attitudes and practices was performed. METHODS: A household survey, supplemented by focus group and individual interviews, was used to assess public understanding of cardiovascular disease (CVD) risk factors, AMI symptoms, cardiopulmonary resuscitation (CPR) and automated external defibrillators (AEDs)...
June 29, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28655309/the-effectiveness-of-emergency-nurse-practitioner-service-in-the-management-of-patients-presenting-to-rural-hospitals-with-chest-pain-a-multisite-prospective-longitudinal-nested-cohort-study
#5
Tina E Roche, Glenn Gardner, Leanne Jack
BACKGROUND: Health reforms in service improvement have included the use of nurse practitioners. In rural emergency departments, nurse practitioners work to the full scope of their expanded role across all patient acuities including those presenting with undifferentiated chest pain. Currently, there is a paucity of evidence regarding the effectiveness of emergency nurse practitioner service in rural emergency departments. Inquiry into the safety and quality of the service, particularly regarding the management of complex conditions is a priority to ensure that this service improvement model meets health care needs of rural communities...
June 27, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28652226/a-hybrid-web-based-and-in-person-self-management-intervention-to-prevent-acute-to-chronic-pain-transition-after-major-lower-extremity-trauma-ipact-e-trauma-protocol-for-a-pilot-single-blind-randomized-controlled-trial
#6
Mélanie Bérubé, Céline Gélinas, Géraldine Martorella, José Côté, Nancy Feeley, George-Yves Laflamme, Dominique Rouleau, Manon Choinière
BACKGROUND: Acute pain frequently transitions to chronic pain after major lower extremity trauma (ET). Several modifiable psychological risk and protective factors have been found to contribute to, or prevent, chronic pain development. Some empirical evidence has shown that interventions, including cognitive and behavioral strategies that promote pain self-management, could prevent chronic pain. However, the efficacy of such interventions has never been demonstrated in ET patients. We have designed a self-management intervention to prevent acute to chronic pain transition after major lower extremity trauma (iPACT-E-Trauma)...
June 26, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28645963/effectiveness-and-safety-of-moxibustion-treatment-for-non-specific-lower-back-pain-protocol-for-a-systematic-review
#7
Jungtae Leem, Seunghoon Lee, Yeoncheol Park, Byung-Kwan Seo, Yeeun Cho, Jung Won Kang, Yoon Jae Lee, In-Hyuk Ha, Hyun-Jong Lee, Eun-Jung Kim, Sanghoon Lee, Dongwoo Nam
INTRODUCTION: Many patients experience acute lower back pain that becomes chronic pain. The proportion of patients using complementary and alternative medicine to treat lower back is increasing. Even though several moxibustion clinical trials for lower back pain have been conducted, the effectiveness and safety of moxibustion intervention is controversial. The purpose of this study protocol for a systematic review is to evaluate the effectiveness and safety of moxibustion treatment for non-specific lower back pain patients...
June 23, 2017: BMJ Open
https://www.readbyqxmd.com/read/28639937/a-multicentre-randomised-controlled-trial-of-intravenous-immunoglobulin-compared-with-standard-therapy-for-the-treatment-of-transverse-myelitis-in-adults-and-children-strive
#8
Michael Absoud, Peter Brex, Olga Ciccarelli, Onyinye Diribe, Gavin Giovannoni, Jennifer Hellier, Rosemary Howe, Rachel Holland, Joanna Kelly, Paul McCrone, Caroline Murphy, Jackie Palace, Andrew Pickles, Michael Pike, Neil Robertson, Anu Jacob, Ming Lim
BACKGROUND: Transverse myelitis (TM) is an immune-mediated disorder of the spinal cord that affects adults and children and that causes motor, sensory and autonomic dysfunction. There is a prolonged recovery phase, which may continue for many years. Neuromyelitis optica (NMO) is an uncommon relapsing inflammatory central nervous system condition in which TM can be the first presenting symptom. As TM and NMO affect many patients in the prime of their working life, the disorder can impose a significant demand on health resources...
May 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28639551/facet-joint-injections-for-people-with-persistent-non-specific-low-back-pain-facet-injection-study-a-feasibility-study-for-a-randomised-controlled-trial
#9
David R Ellard, Martin Underwood, Felix Achana, James Hl Antrobus, Shyam Balasubramanian, Sally Brown, Melinda Cairns, James Griffin, Frances Griffiths, Kirstie Haywood, Charles Hutchinson, Ranjit Lall, Stavros Petrou, Nigel Stallard, Colin Tysall, David A Walsh, Harbinder Sandhu
BACKGROUND: The National Institute for Health and Care Excellence (NICE) 2009 guidelines for persistent low back pain (LBP) do not recommend the injection of therapeutic substances into the back as a treatment for LBP because of the absence of evidence for their effectiveness. This feasibility study aimed to provide a stable platform that could be used to evaluate a randomised controlled trial (RCT) on the clinical effectiveness and cost-effectiveness of intra-articular facet joint injections (FJIs) when added to normal care...
May 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28615959/severe-forms-of-fibromyalgia-with-acute-exacerbation-of-pain-costs-comorbidities-and-length-of-stay-in-inpatient-care
#10
Tobias Romeyke, Elisabeth Noehammer, Hans Christoph Scheuer, Harald Stummer
BACKGROUND AND PURPOSE: As a disease of the musculoskeletal system, fibromyalgia is becoming increasingly important, because of the direct and indirect costs to health systems. The purpose of this study of health economics was to obtain information about staff costs differentiated by service provider, and staff and material costs of the nonmedical infrastructure in inpatient care. PATIENTS AND METHODS: This study looked at 263 patients who received interdisciplinary inpatient treatment for severe forms of fibromyalgia with acute exacerbation of pain between 2011 and 2014...
2017: ClinicoEconomics and Outcomes Research: CEOR
https://www.readbyqxmd.com/read/28601480/the-trajectory-of-postoperative-pain-following-mastectomy-with-and-without-paravertebral-block
#11
Rochelle Wynne, Natalie Lui, Kristen Tytler, Carol Koffsovitz, Victor Kirwa, Bernhard Riedel, Shane Ryan
Evidence to support the argument that general anesthesia (GA) with paravertebral block (PVB) provides better pain relief for mastectomy patients than GA alone is contradictory. The aim of this study was to explore pain and analgesia after mastectomy with or without PVB during acute inpatient recovery. A retrospective study was conducted in a single hospital providing specialist cancer services in metropolitan Melbourne, Australia. We explored pain and concomitant analgesic administration in 80 consecutive women recovering from mastectomy who underwent GA with (n = 40) or without (n = 40) PVB...
June 7, 2017: Pain Management Nursing: Official Journal of the American Society of Pain Management Nurses
https://www.readbyqxmd.com/read/28596802/nursing-diagnoses-in-adult-elderly-patients-undergoing-outpatient-antineoplastic-chemotherapy-a-review
#12
REVIEW
Rafael Tavares Jomar, Rebeca Anselmo Furtado Gomes, Dayana Carvalho Leite, Helena Ferraz Gomes, Ellen Marcia Peres, Eugenio Fuentes Perez Junior
OBJECTIVE: To search in the scientific literature for nursing diagnoses identified in adult/elderly patients undergoing antineoplastic chemotherapy in an outpatient setting. METHODS: Review of studies published in Portuguese, English, or Spanish which were searched in five electronic databases in March 2016, using the descriptors nursing process, nursing diagnosis, neoplasms, drug therapy and hospital outpatient clinic. RESULTS: In the four studies selected for review, 40 nursing diagnoses were identified, namely unbalanced nutrition, less than body requirements, risk of deficient fluid volume, diarrhoea, fatigue, impaired home maintenance, deficient knowledge, disturbed body image, interrupted family processes, ineffective sexuality pattern, anxiety, powerlessness, fear, readiness for enhanced religiosity, risk of infection, impaired dentition, risk of impaired skin integrity, acute pain, and nausea...
2017: Ecancermedicalscience
https://www.readbyqxmd.com/read/28583063/characterization-of-the-development-of-acute-on-chronic-exertional-compartment-syndrome-a-case-report-of-symmetric-compartment-syndromes-and-review-of-the-literature
#13
Andrew Schwartz, Claudette Poole, Charles Schleien
Acute-on-chronic exertional compartment syndrome is a rare and severe progression of the likely common and more benign chronic exertional compartment syndrome. This is a report of one 17-year-old male on a pediatric inpatient service with bilateral anterior leg pain of unknown origin. Because of the nonspecific nature of pain, a high level of suspicion is required for timely diagnosis to avoid compartment ischemia and irreversible soft tissue and nerve damage. While high-energy orthopaedic trauma, orthopaedic surgery, or closed reduction and casting are common preceding events for compartment syndrome, this patient presented with acute-on-chronic exertional compartment syndrome...
April 2017: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/28569654/-unexpected-and-distressing-understanding-and-improving-the-experience-of-transferring-palliative-care-inpatients-to-residential-care
#14
Voula Kallianis, Lynette Joubert, Sue Gorman, Sonia Posenelli, Carolyn Lethborg
The survival of patients with advanced cancer, coupled with the increased presence of end-stage chronic illnesses in an aging population, is leading to a demand in palliative care. Due to the ongoing need for acute-pain and symptom control in hospice/palliative care units, few are able to offer long-stay admission for those whose symptoms have stabilized. When a patient no longer requires specialist palliative care services, transfer from an inpatient palliative care facility may then be necessary. A core component of the role of palliative-care social workers involves working with patients and their families/carers when the care pathway shifts and the option of residential aged care facility (RACF) needs to be considered...
June 1, 2017: Journal of Social Work in End-of-life & Palliative Care
https://www.readbyqxmd.com/read/28554207/provider-type-and-management-of-common-visits-in-primary-care
#15
Douglas W Roblin, Hangsheng Liu, Lee F Cromwell, Michael Robbins, Brandi E Robinson, David Auerbach, Ateev Mehrotra
OBJECTIVES: Debate continues on whether nurse practitioners (NPs) and physician assistants (PAs) are more likely to order ancillary services, or order more costly services among alternatives, than primary care physicians (PCPs). We compared prescription medication and diagnostic service orders associated with NP/PA versus PCP visits for management of neck or back (N/B) pain or acute respiratory infection (ARI). STUDY DESIGN: Retrospective, observational study of visits from January 2006 through March 2008 in the adult primary care practice of Kaiser Permanente in Atlanta, Georgia...
April 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/28538140/comparison-of-policies-for-recognising-and-responding-to-clinical-deterioration-across-five-victorian-health-services
#16
Julie Considine, Anastasia F Hutchison, Helen Rawson, Alison M Hutchinson, Tracey Bucknall, Trisha Dunning, Mari Botti, Maxine M Duke, Maryann Street
Objectives The aim of the present study was to describe and compare organisational guidance documents related to recognising and responding to clinical deterioration across five health services in Victoria, Australia.Methods Guidance documents were obtained from five health services, comprising 13 acute care hospitals, eight subacute care hospitals and approximately 5500 beds. Analysis was guided by a specific policy analysis framework and a priori themes.Results In all, 22 guidance documents and five graphic observation and response charts were reviewed...
May 25, 2017: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/28538139/advanced-musculoskeletal-physiotherapists-are-effective-and-safe-in-managing-patients-with-acute-low-back-pain-presenting-to-emergency-departments
#17
James M Sayer, Rita M Kinsella, Belinda A Cary, Angela T Burge, Lara A Kimmel, Paula Harding
Objective The aim of this study was to compare emergency department (ED) key performance indicators for patients presenting with low back pain and seen by an advanced musculoskeletal physiotherapist (AMP) with those seen by other non-AMP clinicians (ED doctors and nurse practitioners).Methods A retrospective audit (October 2012-September 2013) was performed of data from three metropolitan public hospital EDs to compare patients with low back pain seen by AMP and non-AMP clinicians. Outcome measures included ED length of stay, ED wait time, admission rates and re-presentation to the ED...
May 25, 2017: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/28532506/clinical-evaluation-of-myocardial-involvement-in-acute-myopericarditis-in-young-adults
#18
Ersin Saricam, Yasemin Saglam, Tuncay Hazirolan
BACKGROUND: Myocardial involvement in young adults has various causes. Acute myopericarditis is one of the myocardial involvements in young adults. It is easy to confuse with acute ST-elevation myocardial infarction because of the electrocardiographic features. This study aims to investigate a number of imaging techniques and clinical features for acute myopericarditis in young adults (<30 years of age). METHODS: This retrospective study included 147 patients selected from the 2147 patients at the age of <30 with acute chest pain admitted into emergency service between 2010 and 2016...
May 22, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28527504/telehealth-in-physical-medicine-and-rehabilitation-a-narrative-review
#19
REVIEW
Adam S Tenforde, Jaye E Hefner, Jodi E Kodish-Wachs, Mary A Iaccarino, Sabrina Paganoni
Telehealth refers to health care interactions that leverage telecommunication devices to provide medical care outside the traditional face-to-face, in-person medical encounter. Technology advances and research have expanded use of telehealth in health care delivery. Physical medicine and rehabilitation providers may use telehealth to deliver care to populations with neurologic and musculoskeletal conditions, commonly treated in both acute care and outpatient settings. Patients with impaired mobility and those living in locations with reduced access to care may particularly benefit...
May 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/28527286/-possible-oral-transmission-of-chagas-disease-among-hydrocarbons-sector-workers-in-casanare-colombia-2014
#20
Liliana Patricia Zuleta-Dueñas, Ángela Johana López-Quiroga, Fernando Torres-Torres, Oneida Castañeda-Porras
INTRODUCTION: Trypanosoma cruzi, the etiological agent for Chagas disease, can be transmitted by oral intake of contaminated food or drinks. During epidemiological week 14 of 2014, two cases of acute Chagas disease were notified among hydrocarbons sector workers in Paz de Ariporo, Casanare. OBJECTIVE: To characterize the affected population, to establish control and prevention measures and to confirm the outbreak. MATERIALS AND METHODS: We conducted an outbreak investigation that included the following components: a) Search for symptomatic people compatible with Chagas disease according to the case definition for their referral to medical services; b) entomological survey (192/197 houses); c) sanitary inspection and microbiological analysis of food samples; and d) study of reservoirs...
June 1, 2017: Biomédica: Revista del Instituto Nacional de Salud
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