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https://www.readbyqxmd.com/read/28822403/inpatient-peripherally-inserted-central-venous-catheter-complications-should-peripherally-inserted-central-catheter-lines-be-placed-in-the-intensive-care-unit-setting
#1
Michael Martyak, Ishraq Kabir, Rebecca Britt
Peripherally inserted central venous catheters (PICCs) are now commonly used for central access in the intensive care unit (ICU) setting; however, there is a paucity of data evaluating the complication rates associated with these lines. We performed a retrospective review of all PICCs placed in the inpatient setting at our institution during a 1-year period from January 2013 to December 2013. These were divided into two groups: those placed at the bedside in the ICU and those placed by interventional radiology in non-ICU patients...
August 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28820700/rapid-detection-of-plasmodium-knowlesi-by-isothermal-recombinase-polymerase-amplification-assay
#2
Meng-Yee Lai, Choo-Huck Ooi, Yee-Ling Lau
In this study, we developed a recombinase polymerase amplification (RPA) assay for specific diagnosis of Plasmodium knowlesi. Genomic DNA was extracted from whole blood samples using a commercial kit. With incubation at 37°C, the samples were successfully amplified within 20 minutes. The end product of RPA was further examined by loading onto agarose gel and a specific band was observed with a size of 128 bp. The RPA assay exhibited high sensitivity with limits of detection down to one copy of the plasmid...
August 14, 2017: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/28820620/care-providers-integration-of-family-requests-in-end-of-life-communication-understanding-what-to-do-and-why-to-do-it
#3
Paula Hopeck
End-of-life situations are fraught with challenges for patients, family members, and individuals working at the patient's bedside. Care workers must address needs of the patient, as well as his or her distressed family members. This article is an inductive investigation of care workers' (nurses, patient advocates, and clergy) experiences with end-of-life discussions when the family asks to "do everything." Participants also noted resistance to hospice in some of these encounters based on pre-existing connotations of hospice held by the family members...
August 18, 2017: Health Communication
https://www.readbyqxmd.com/read/28818149/cerebellar-infarction-presenting-with-acute-vestibular-syndrome-in-two-u-s-air-force-pilots
#4
Roger R Hesselbrock
BACKGROUND: Cerebellar infarction is an uncommon but serious cause of isolated acute vestibular symptoms, particularly in young, healthy individuals, and can easily be overlooked. We present two cases of cerebellar infarction in U.S. Air Force pilots, one of which occurred during flight. CASE REPORTS: A 41-yr-old man developed acute vertigo, disequilibrium, nausea, and headache, with progressive slow symptomatic improvement, and presented to medical attention 4 d after symptom onset...
September 1, 2017: Aerospace Medicine and Human Performance
https://www.readbyqxmd.com/read/28817942/-the-current-status-of-diagnostic-tools-for-leptospirosis
#5
Mitsumasa Saito, Yasuhiko Nikaido, Masahiro Matsumoto, Midori Ogawa, Sharon Y A M Villanueva
Leptospirosis is a worldwide zoonosis caused by pathogenic Leptospira spp. The severity of leptospirosis vary from mild, flu-like disease to a more severe form, Weil's disease causing jaundice, hemorrhage, renal failure, and even death. Every year, 300,000‒500,000 cases of severe leptospirosis are reported around the world, with the case fatality rate being 10‒30%. The usual diagnostic tools for leptospirosis are 1) direct observation of leptospires in blood and urine under dark-field microscope, 2) isolation of leptospires from blood, cerebrospinal fluid (CSF), or urine samples by culture, 3) microscopic agglutination test (MAT) to detect anti-Leptospira antibodies in serum, and 4) PCR to detect Leptospira DNA...
August 15, 2017: JARMAM: Journal of the Association for Rapid Method and Automation in Microbiology
https://www.readbyqxmd.com/read/28817216/functional-neuroimaging-after-severe-anoxic-brain-injury-in-children-may-reveal-preserved-yet-covert-cognitive-function
#6
Adrian M Owen
A growing body of evidence has confirmed that, after severe brain injury in adults, motoric and task-dependent factors that are essential for reliable communication, frequently interfere with an accurate assessment of cognitive status. In the current study, resting state functional magnetic resonance imaging (fMRI) in children who have sustained an anoxic brain injury following a near drowning incident suggests a similar pattern; preserved cognition amidst severe motoric impairment that effectively precludes accurate clinical diagnosis at the bedside...
August 17, 2017: Human Brain Mapping
https://www.readbyqxmd.com/read/28816054/animal-models-how-a-mechanistic-approach-can-reduce-suffering-and-improve-translatability
#7
Elliot Lilley
Poorly predictive animal models of disease cause avoidable suffering and hamper the discovery of new treatments for patients. A focus on mechanistic modelling has the potential to reduce animal suffering as well as improving translation from the bench to the bedside.
July 2017: Alternatives to Laboratory Animals: ATLA
https://www.readbyqxmd.com/read/28813425/effectiveness-of-two-distinct-web-based-education-tools-for-bedside-nurses-on-medication-administration-practice-for-venous-thromboembolism-prevention-a-randomized-clinical-trial
#8
Brandyn D Lau, Dauryne L Shaffer, Deborah B Hobson, Gayane Yenokyan, Jiangxia Wang, Elizabeth A Sugar, Joseph K Canner, David Bongiovanni, Peggy S Kraus, Victor O Popoola, Hasan M Shihab, Norma E Farrow, Jonathan K Aboagye, Peter J Pronovost, Michael B Streiff, Elliott R Haut
BACKGROUND: Venous thromboembolism (VTE) is a common cause of preventable harm in hospitalized patients. While numerous successful interventions have been implemented to improve prescription of VTE prophylaxis, a substantial proportion of doses of prescribed preventive medications are not administered to hospitalized patients. The purpose of this trial was to evaluate the effectiveness of nurse education on medication administration practice. METHODS: This was a double-blinded, cluster randomized trial in 21 medical or surgical floors of 933 nurses at The Johns Hopkins Hospital, an academic medical center, from April 1, 2014 -March 31, 2015...
2017: PloS One
https://www.readbyqxmd.com/read/28812473/implementation-of-a-pathway-for-the-treatment-of-fever-and-neutropenia-in-pediatric-patients-with-cancer
#9
Joy Vanderway, Catherine Vincent, Susan M Walsh, Jennifer Obrecht
Fever and neutropenia is an oncologic emergency. Time-to-antibiotics (TTA) refers to the amount of time from initial provider evaluation for fever and neutropenia to intravenous antibiotic administration. Research supports that rapid time-to-antibiotics (RTTA) is associated with improved patient outcomes. This quality improvement project evaluated the success of implementing an RTTA pathway in pediatric oncology patients with fever and neutropenia. The setting was an advanced practice nurse-managed pediatric ambulatory infusion center where patients with fever and neutropenia were often evaluated and treated...
September 2017: Journal of Pediatric Oncology Nursing: Official Journal of the Association of Pediatric Oncology Nurses
https://www.readbyqxmd.com/read/28812428/microvascular-perfusion-in-cardiac-arrest-a-review-of-microcirculatory-imaging-studies
#10
Petra Krupičková, Zuzana Mormanová, Tomáš Bouček, Tomáš Belza, Jana Šmalcová, Jan Bělohlávek
Cardiac arrest represents a leading cause of mortality and morbidity in developed countries. Extracorporeal cardiopulmonary resuscitation (ECPR) increases the chances for a beneficial outcome in victims of refractory cardiac arrest. However, ECPR and post-cardiac arrest care are affected by high mortality rates due to multi-organ failure syndrome, which is closely related to microcirculatory disorders. Therefore, microcirculation represents a key target for therapeutic interventions in post-cardiac arrest patients...
August 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28810808/advances-and-challenges-in-cardiovascular-gene-therapy
#11
Seppo Ylä-Herttuala, Johanna Lähteenvuo
25 years of gene therapy have not yet yielded standard therapeutic solutions for clinical use in cardiovascular medicine, but several therapeutic targets have been identified and foundations for future therapies have been set. The safety of viral gene therapy has been established with a wide variety of vectors and transgenes. Adenoviruses and adeno-associated viruses have established their role as vectors of choice for many cardiovascular applications and appropriate viral doses have been established for several tissues and applications...
August 16, 2017: Human Gene Therapy
https://www.readbyqxmd.com/read/28809203/clinical-simulation-a-protocol-for-evaluation-of-mobile-technology
#12
Carey Mather, Sanne Jensen, Elizabeth Cummings
For mobile technology to be accepted at point of care in healthcare environments there is a need to demonstrate benefits whilst ameliorating the risks and challenges. To provide a standardised approach to evaluation of mobile technology a simulation protocol was developed to provide guidance for its use in healthcare environments. Simulated conditions provide the opportunity to assess intended and unintended consequences and identify potential workarounds when using technology. The protocol can also be used to demonstrate the importance of the development of digital professionalism by end-users prior to students entering the clinical practice setting...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28808863/warm-handoffs-a-novel-strategy-to-improve-end-of-rotation-care-transitions
#13
Harry S Saag, Jingjing Chen, Joshua L Denson, Simon Jones, Leora Horwitz, Patrick M Cocks
BACKGROUND: Hospitalized medical patients undergoing transition of care by house staff teams at the end of a ward rotation are associated with an increased risk of mortality, yet best practices surrounding this transition are lacking. AIM: To assess the impact of a warm handoff protocol for end-of-rotation care transitions. SETTING: A large, university-based internal medicine residency using three different training sites. PARTICIPANTS: PGY-2 and PGY-3 internal medicine residents...
August 14, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28808365/intra-and-inter-observer-reliability-of-quadriceps-muscle-thickness-measured-with-bedside-ultrasonography-by-critical-care-physicians
#14
Vijay Hadda, Gopi C Khilnani, Rohit Kumar, Ashesh Dhunguna, Saurabh Mittal, Maroof Ahmad Khan, Karan Madan, Anant Mohan, Randeep Guleria
BACKGROUND: Muscle wasting is common among critically ill patients with sepsis and has a significant effect on clinical outcome. However, appropriate tool for measurement of muscle loss is debatable. Ultrasonography (USG) has been used for objective assessment of quadriceps muscle thickness among these patients; however, there is limited data on its reliability. AIMS AND OBJECTIVE: This study was aimed to assess the reliability of quadriceps muscle thickness as measured by critical care physicians...
July 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28807202/do-acute-care-surgeons-follow-best-practices-for-breast-abscess-management-a-single-institution-analysis-of-325-consecutive-cases
#15
Alison Unzeitig Barron, Stephen Luk, Herb A Phelan, Brian H Williams
BACKGROUND: The breast surgery community has adopted needle aspiration as the standard of care for breast abscesses, which have a size less than 5 cm on ultrasound, no skin changes, and fewer than 5 days of symptoms. Our acute-care surgery (ACS) service manages all breast abscess consults at our urban safety-net hospital. We undertook this descriptive study to identify the rate of operative incisions and drainage performed by ACS surgeons which were not compatible with best practices for breast abscess management...
August 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28807026/circulating-micrornas-in-malaria-infection-bench-to-bedside
#16
REVIEW
Supat Chamnanchanunt, Suthat Fucharoen, Tsukuru Umemura
Severe malaria has a poor prognosis with a morbidity rate of 80% in tropical areas. The early parasite detection is one of the effective means to prevent severe malaria of which specific treatment strategies are limited. Many clinical characteristics and laboratory testings have been used for the early diagnosis and prediction of severe disease. However, a few of these factors could be applied to clinical practice. MicroRNAs (miRNAs) were demonstrated as useful biomarkers in many diseases such as malignant diseases and cardiovascular diseases...
August 15, 2017: Malaria Journal
https://www.readbyqxmd.com/read/28806954/-usability-of-data-integration-and-visualization-software-for-multidisciplinary-pediatric-intensive-care-a-human-factors-approach-to-assessing-technology
#17
Ying Ling Lin, Anne-Marie Guerguerian, Jessica Tomasi, Peter Laussen, Patricia Trbovich
BACKGROUND: Intensive care clinicians use several sources of data in order to inform decision-making. We set out to evaluate a new interactive data integration platform called T3™ made available for pediatric intensive care. Three primary functions are supported: tracking of physiologic signals, displaying trajectory, and triggering decisions, by highlighting data or estimating risk of patient instability. We designed a human factors study to identify interface usability issues, to measure ease of use, and to describe interface features that may enable or hinder clinical tasks...
August 14, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/28806953/a-fast-healthcare-interoperability-resources-fhir-layer-implemented-over-i2b2
#18
Abdelali Boussadi, Eric Zapletal
BACKGROUND: Standards and technical specifications have been developed to define how the information contained in Electronic Health Records (EHRs) should be structured, semantically described, and communicated. Current trends rely on differentiating the representation of data instances from the definition of clinical information models. The dual model approach, which combines a reference model (RM) and a clinical information model (CIM), sets in practice this software design pattern. The most recent initiative, proposed by HL7, is called Fast Health Interoperability Resources (FHIR)...
August 14, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/28806902/monitoring-documenting-and-reporting-the-quality-of-antibiotic-use-in-the-netherlands-a-pilot-study-to-establish-a-national-antimicrobial-stewardship-registry
#19
Marvin Ah Berrevoets, Jaap Ten Oever, Tom Sprong, Reinier M van Hest, Ingeborg Groothuis, Inger van Heijl, Jeroen A Schouten, Marlies E Hulscher, Bart-Jan Kullberg
BACKGROUND: The Dutch Working Party on Antibiotic Policy is developing a national antimicrobial stewardship registry. This registry will report both the quality of antibiotic use in hospitals in the Netherlands and the stewardship activities employed. It is currently unclear which aspects of the quality of antibiotic use are monitored by antimicrobial stewardship teams (A-teams) and can be used as indicators for the stewardship registry. In this pilot study we aimed to determine which stewardship objectives are eligible for the envisioned registry...
August 15, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28806028/treatment-of-peritonsillar-abscess-in-immunosuppressed-patients
#20
Jed H Assam, William C Spanos
Peritonsillar abscess (PTA) is a common pathology in otolaryngology emergency. The treatment of PTA is usually bedside drainage or surgical removal of the tonsils (Quincy tonsillectomy) in combination with antibiotic treatment. However, patients with immune suppression might have a more difficult treatment course. Such difficulties may be further magnified within older patients. This case report will describe successful multi-modality treatment of two separate incidents of PTA developing in the context of immunosuppression...
July 2017: South Dakota Medicine: the Journal of the South Dakota State Medical Association
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