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Patient Safety and Quality

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https://www.readbyqxmd.com/read/28101753/effect-and-safety-of-paroxetine-combined-with-zolpidem-in-treatment-of-primary-insomnia
#1
Z H Yu, X H Xu, S D Wang, M F Song, Y Liu, Y Yin, H J Mao, G Z Tang
PURPOSE: Primary insomnia is a persistent and recurrent disorder as well as a risk factor for depression. The aim of this study was to determine whether the zolpidem combined with paroxetine would be effective in the treatment of patients with primary insomnia. METHODS: Ninety patients meeting DSM-IV criteria for primary insomnia were randomly assigned to 8 weeks of treatment with zolpidem combined with paroxetine (the combined treatment group, n = 45) or zolpidem combined with placebo (the control group, n = 45)...
January 18, 2017: Sleep & Breathing, Schlaf & Atmung
https://www.readbyqxmd.com/read/28101720/enhanced-recovery-after-surgery-programs-for-liver-resection-a-meta-analysis
#2
Cheng Wang, Guoqun Zheng, Wenlong Zhang, Fabiao Zhang, Shangdong Lv, Aidong Wang, Zheping Fang
BACKGROUND AND AIMS: Due to the limited number of high-quality randomized controlled trials on enhanced recovery after surgery for hepatectomy, previous reviews have not been sufficiently comprehensive. Our objectives were to evaluate and compare the safety and efficacy of enhanced recovery after surgery programs and traditional care in patients undergoing open or laparoscopic surgery and to assess the optimized items for hepatectomy. METHODS: We searched the PubMed, Embase, and the Cochrane Library databases for all the relevant studies regardless of study design...
January 18, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28101651/eslicarbazepine-acetate-its-effectiveness-as-adjunctive-therapy-in-clinical-trials-and-open-studies
#3
REVIEW
S D Shorvon, E Trinka, B J Steinhoff, M Holtkamp, V Villanueva, J Peltola, E Ben-Menachem
Eslicarbazepine acetate (ESL) is a once-daily antiepileptic drug that is approved as adjunctive therapy in adults with focal-onset seizures. Following oral administration, ESL is rapidly metabolized to its active metabolite, eslicarbazepine, which acts primarily by enhancing slow inactivation of voltage-gated sodium channels. The efficacy and safety/tolerability of ESL in the adjunctive setting were established in a comprehensive Phase III program (n = 1702 randomized patients) and this evidence has been supported by several open studies (n = 864)...
January 18, 2017: Journal of Neurology
https://www.readbyqxmd.com/read/28101567/influence-of-arm-crank-ergometry-on-development-of-lymphedema-in-breast-cancer-patients-after-axillary-dissection-a-randomized-controlled-trail
#4
Thorsten Schmidt, Jette Berner, Walter Jonat, Burkhard Weisser, Christioph Röcken, Marion van Mackelenbergh, Christoph Mundhenke
OBJECTIVE: To investigate the safety and efficacy of arm crank ergometry in breast cancer patients after axillary lymph node dissection, with regard to changes in bioelectrical impedance analysis, arm circumference, muscular strength, quality of life and fatigue. DESIGN: Randomized controlled clinical intervention trial. SUBJECTS: Forty-nine patients with breast cancer after axillary lymph node dissection. METHODS: Arm crank ergometer training twice-weekly was compared with usual care over 12 weeks...
January 19, 2017: Journal of Rehabilitation Medicine
https://www.readbyqxmd.com/read/28100544/oscillatory-whole-body-vibration-improves-exercise-capacity-and-physical-performance-in-pulmonary-arterial-hypertension-a-randomised-clinical-study
#5
Felix Gerhardt, Daniel Dumitrescu, Carina Gärtner, Ralf Beccard, Thomas Viethen, Tilmann Kramer, Stephan Baldus, Martin Hellmich, Eckhard Schönau, Stephan Rosenkranz
OBJECTIVE: In patients with pulmonary arterial hypertension (PAH), supportive therapies may be beneficial in addition to targeted medical treatment. Here, we evaluated the effectiveness and safety of oscillatory whole-body vibration (WBV) in patients on stable PAH therapy. METHODS: Twenty-two patients with PAH (mean PAP≥25 mm Hg and pulmonary arterial wedge pressure (PAWP)≤15 mm Hg) who were in world health organization (WHO)-Functional Class II or III and on stable PAH therapy for≥3 months, were randomised to receive WBV (16 sessions of 1-hour duration within 4 weeks) or to a control group, that subsequently received WBV...
January 18, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28100522/intraoperative-dexamethasone-does-not-increase-the-risk-of-postoperative-wound-infection-a-propensity-score-matched-post-hoc-analysis-of-the-enigma-ii-trial-endex
#6
T Corcoran, J Kasza, T G Short, E O'Loughlin, M T V Chan, K Leslie, A Forbes, M Paech, P Myles
BACKGROUND: In a post hoc analysis of the ENIGMA-II trial, we sought to determine whether intraoperative dexamethasone was associated with adverse safety outcomes. METHODS: Inverse probability weighting with estimated propensity scores was used to determine the association of dexamethasone administration with postoperative infection, quality of recovery, and adverse safety outcomes for 5499 of the 7112 non-cardiac surgery subjects enrolled in ENIGMA-II. RESULTS: Dexamethasone was administered to 2178 (40%) of the 5499 subjects included in this analysis and was not associated with wound infection [189 (8...
February 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28100176/effect-of-training-and-structured-medication-review-on-medication-appropriateness-in-nursing-home-residents-and-on-cooperation-between-health-care-professionals-the-intherakt-study-protocol
#7
Angelika Mahlknecht, Nadja Nestler, Ulrike Bauer, Nadine Schüßler, Jochen Schuler, Sebastian Scharer, Ralf Becker, Isabel Waltering, Georg Hempel, Oliver Schwalbe, Maria Flamm, Jürgen Osterbrink
BACKGROUND: Pharmacotherapy in residents of nursing homes is critical due to the special vulnerability of this population. Medical care and interprofessional communication in nursing homes are often uncoordinated. As a consequence, polypharmacy and inappropriate medication use are common and may lead to hospitalizations and health hazards. The aim of this study is to optimize communication between the involved professional groups by specific training and by establishing a structured medication review process, and to improve medication appropriateness and patient-relevant health outcomes for residents of nursing homes...
January 18, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28099689/effectiveness-and-safety-of-procalcitonin-evaluation-for-reducing-mortality-in-adults-with-sepsis-severe-sepsis-or-septic-shock
#8
REVIEW
Brenda Ng Andriolo, Regis B Andriolo, Reinaldo Salomão, Álvaro N Atallah
BACKGROUND: Serum procalcitonin (PCT) evaluation has been proposed for early diagnosis and accurate staging and to guide decisions regarding patients with sepsis, severe sepsis and septic shock, with possible reduction in mortality. OBJECTIVES: To assess the effectiveness and safety of serum PCT evaluation for reducing mortality and duration of antimicrobial therapy in adults with sepsis, severe sepsis or septic shock. SEARCH METHODS: We searched the Central Register of Controlled Trials (CENTRAL; 2015, Issue 7); MEDLINE (1950 to July 2015); Embase (Ovid SP, 1980 to July 2015); Latin American Caribbean Health Sciences Literature (LILACS via BIREME, 1982 to July 2015); and the Cumulative Index to Nursing and Allied Health Literature (CINAHL; EBSCO host, 1982 to July 2015), and trial registers (ISRCTN registry, ClinicalTrials...
January 18, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28099344/laparoscopic-total-pancreatectomy-case-report-and-literature-review
#9
Xin Wang, Yongbin Li, Yunqiang Cai, Xubao Liu, Bing Peng
RATIONALE: Laparoscopic total pancreatectomy is a complicated surgical procedure and rarely been reported. This study was conducted to investigate the safety and feasibility of laparoscopic total pancreatectomy. PATIENTS AND METHODS: Three patients underwent laparoscopic total pancreatectomy between May 2014 and August 2015. We reviewed their general demographic data, perioperative details, and short-term outcomes. General morbidity was assessed using Clavien-Dindo classification and delayed gastric emptying (DGE) was evaluated by International Study Group of Pancreatic Surgery (ISGPS) definition...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28099343/efficacy-and-safety-of-bisphosphonates-in-management-of-low-bone-density-in-inflammatory-bowel-disease-a-meta-analysis
#10
Liwei Yao, Haiqing Wang, Wenwei Dong, Zhenxin Liu, Haijiao Mao
This study aims to determine whether bisphosphonates are safe, as well as effective against bone mineral loss in inflammatory bowel disease (IBD). A computerized search of electronic databases from 1966 to 2016 was performed. Randomized controlled trials (RCTs) were included in this review to evaluate the role of bisphosphonates in the management of osteoporosis in IBD patients. A revised 7-point Jadad scale was used to evaluate the quality of each study. Overall, 13 RCTs and 923 patients met the inclusion criteria of this meta-analysis...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28099325/intraoperative-clinical-decision-support-for-anesthesia-a-narrative-review-of-available-systems
#11
Bala G Nair, Eilon Gabel, Ira Hofer, Howard A Schwid, Maxime Cannesson
With increasing adoption of anesthesia information management systems (AIMS), there is growing interest in utilizing AIMS data for intraoperative clinical decision support (CDS). CDS for anesthesia has the potential for improving quality of care, patient safety, billing, and compliance. Intraoperative CDS can range from passive and post hoc systems to active real-time systems that can detect ongoing clinical issues and deviations from best practice care. Real-time CDS holds the most promise because real-time alerts and guidance can drive provider behavior toward evidence-based standardized care during the ongoing case...
February 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28099276/factors-in-the-efficacy-safety-and-impact-on-quality-of-life-for-treatment-of-drooling-with-botulinum-toxin-type-a-in-patients-with-cerebral-palsy
#12
Maria D Gonzalez-L, Carmen Martinez, Inma Bori Y Fortuny, Santiago Suso-Vergara
OBJECTIVE: To assess the efficacy and safety of botulinum toxin A (BoNT-A) injected in both submandibular and parotid versus only in parotid glands as a treatment for drooling in patients with spastic and dyskinetic cerebral palsy (CP), including an assessment of impact on quality of life (QoL) based on items from the International Classification of Functioning, Disability, and Health (ICF) core set. DESIGN: Forty patients with CP 18 years or older (mean, 21.8 years) participated in a prospective, single-center, randomized controlled interventional study...
February 2017: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/28097941/telemedicine-support-shortens-length-of-stay-after-fast-track-hip-replacement
#13
Martin Svoldgaard Vesterby, Preben Ulrich Pedersen, Malene Laursen, Søren Mikkelsen, Jens Larsen, Kjeld Søballe, Lene Bastrup Jørgensen
Background and purpose - Telemedicine could allow patients to be discharged more quickly after surgery and contribute to improve fast-track procedures without compromising quality, patient safety, functionality, anxiety, or other patient-perceived parameters. We investigated whether using telemedicine support (TMS) would permit hospital discharge after 1 day without loss of self-assessed quality of life, loss of functionality, increased anxiety, increased rates of re-admission, or increased rates of complications after hip replacement...
February 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28097858/-the-current-status-of-patient-safety-in-argentina-cross-sectional-study
#14
Lucrecia Arpí, Néstor D Panattieri, Cristina Godio, Verónica Sabio Paz, Nora Dackiewicz
BACKGROUND: Patient safety is a priority for healthcare organizations. For the PRONAP´s 2013 final exam, the Quality & Patient Safety Subcommittee and the PRONAP managers designed a survey to be answered by pediatrician students nationwide. It was destined to evaluate attitudes, practices and safety conditions in which they worked. AIM: To assess the current state of practices in patient safety. MATERIAL AND METHODS: Setting and sample: PRONAP students (7,438 pediatrician nationwide) who answered 2013 final exam...
1, 2017: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/28096194/autologous-cell-therapy-for-peripheral-arterial-disease-systematic-review-and-meta-analysis-of-randomized-non-randomized-and-non-controlled-studies
#15
Mauro Rigato, Matteo Monami, Gian Paolo Fadini
RATIONALE: Critical limb ischemia (CLI) is a life-threatening complication of peripheral arterial disease (PAD). In patients who are ineligible for revascularization procedures, there are few therapeutic alternatives, leading to amputations and death. OBJECTIVE: To provide a systematic review of the literature and a meta-analysis of studies evaluating safety and efficacy of autologous cell therapy for intractable PAD/CLI. METHODS AND RESULTS: We retrieved 19 randomized controlled trials (RCTs; 837 patients), 7 non-randomized trials (338 patients), and 41 non-controlled studies (1,177 patients)...
January 17, 2017: Circulation Research
https://www.readbyqxmd.com/read/28095408/patient-safety-incidents-involving-sick-children-in-primary-care-in-england-and-wales-a-mixed-methods-analysis
#16
Philippa Rees, Adrian Edwards, Colin Powell, Peter Hibbert, Huw Williams, Meredith Makeham, Ben Carter, Donna Luff, Gareth Parry, Anthony Avery, Aziz Sheikh, Liam Donaldson, Andrew Carson-Stevens
BACKGROUND: The UK performs poorly relative to other economically developed countries on numerous indicators of care quality for children. The contribution of iatrogenic harm to these outcomes is unclear. As primary care is the first point of healthcare contact for most children, we sought to investigate the safety of care provided to children in this setting. METHODS AND FINDINGS: We undertook a mixed methods investigation of reports of primary care patient safety incidents involving sick children from England and Wales' National Reporting and Learning System between 1 January 2005 and 1 December 2013...
January 2017: PLoS Medicine
https://www.readbyqxmd.com/read/28095173/performance-of-a-trigger-tool-for-identifying-adverse-events-in-oncology
#17
Allison Lipitz-Snyderman, David Classen, David Pfister, Aileen Killen, Coral L Atoria, Elizabeth Fortier, Andrew S Epstein, Christopher Anderson, Saul N Weingart
PURPOSE: Although patient safety is a priority in oncology, few tools measure adverse events (AEs) beyond treatment-related toxicities. The study objective was to assemble a set of clinical triggers in the medical record and assess the extent to which triggered events identified AEs. METHODS: We performed a retrospective cohort study to assess the performance of an oncology medical record screening tool at a comprehensive cancer center. The study cohort included 400 patients age 18 years or older diagnosed with breast (n = 128), colorectal (n = 136), or lung cancer (n = 136), observed as in- and outpatients for up to 1 year...
January 17, 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28094908/improving-utilization-of-the-family-history-in-the-electronic-health-record
#18
Kathleen T Hickey, Maria C Katapodi, Bernice Coleman, Karin Reuter-Rice, Angela R Starkweather
PURPOSE: The purpose of this article is to provide an overview of Family History in the Electronic Health Record and to identify opportunities to advance the contributions of nurses in obtaining, updating and assessing family history in order to improve the health of all individuals and populations. ORGANIZING CONSTRUCT: The article presents an overview of the obstacles to charting Family History within the Electronic Health Record and recommendations for using specific Family History tools and core Family History data sets...
January 2017: Journal of Nursing Scholarship
https://www.readbyqxmd.com/read/28094628/-staff-want-to-address-cultural-issues-but-don-t-know-how
#19
Elaine Cole
Katie de Freitas believes a greater awareness of cultures is crucial if clinicians are to meet the needs of patients and families. 'Cultural competency is a matter of quality and safety,' says the quality improvement lead at Great Ormond Street Hospital for Children NHS Foundation Trust (GOSH). 'It can help to bridge the gap between those providing care and those accessing services.
January 4, 2017: Nursing Standard
https://www.readbyqxmd.com/read/28093681/quantifying-the-benefits-of-dimethyl-fumarate-over-%C3%AE-interferon-and-glatiramer-acetate-therapies-on-work-productivity-outcomes-in-ms-patients
#20
Andrew Lee, James Pike, Michael R Edwards, Jennifer Petrillo, John Waller, Eddie Jones
INTRODUCTION: Dimethyl fumarate (DMF) is a novel oral therapy used for the treatment of relapse-remitting multiple sclerosis (RRMS). In two 2-year pivotal Phase 3 trials in patients with RRMS, DMF significantly reduced disease activity based on both clinical and magnetic resonance imaging (MRI) findings and demonstrated an acceptable safety profile. However, there is currently a lack of comparative data which explore the relationship between work productivity and health-related quality of life (HRQoL) outcomes in RRMS and how these differ among RRMS therapies, including DMF...
January 16, 2017: Neurology and Therapy
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