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https://www.readbyqxmd.com/read/29458231/perioperative-complications-of-transanal-pull-through-surgery-for-hirschsprung-s-disease
#1
Mikko Pakarinen
Transanal pull-through is currently one of the most commonly used operation to treat Hirschsprung's disease (HD) worldwide. It has undergone some technical modifications during the last decades and still contains variable surgical practices. As high quality comparative studies between different surgical approaches are missing, debate over the optimal operation for HD still continues. Transanal pull-through is associated with multiple potential complications, which may result in permanently impaired functional outcome, life-long morbidity, and significant social restrictions...
February 19, 2018: European Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29458153/eus-guided-transluminal-interventions
#2
Uzma D Siddiqui, Michael J Levy
The role of endoscopic ultrasound (EUS) has transitioned from a diagnostic to a therapeutic one over the past 40 years. With the advent of curvilinear array echoendoscopes in the 1990's with an accessory channel, multiple tools and devices have been developed and utilized for a variety of transluminal interventions. EUS provides a viable option and is becoming the procedure of choice for many interventions including bile and pancreatic duct drainage, guiding angiotherapy, pancreatic fluid collection management, gallbladder drainage, and creating a gastrojejunostomy...
February 16, 2018: Gastroenterology
https://www.readbyqxmd.com/read/29457984/cardio-oncology-the-role-of-advanced-echocardiography-in-cancer-patients
#3
Lucia Venneri, Giacomo Zoppellaro, Rajdeep S Khattar
Cardio-oncology is a rapidly growing field aimed at improving the quality of care of cancer patients by preventing and monitoring cardiovascular complications resulting from cancer treatment. Cardiac imaging, and in particular, transthoracic echocardiography, plays an essential role in the baseline assessment and serial follow-up of cardio-oncology patients. Areas covered: This review article discusses the role of cardiac imaging with a focus on advanced echocardiography for the detection and management of cancer therapy related cardiovascular complications, in particular, left ventricular dysfunction and heart failure...
February 19, 2018: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/29457945/factors-that-influence-nurses-assessment-of-patient-acuity-and-response-to-acute-deterioration
#4
Mark Dalton, John Harrison, Anitra Malin, Conan Leavey
BACKGROUND: nurses play a crucial role in the early recognition and management of the deteriorating patient. They are responsible for the care they provide to their patients, part of which is the monitoring of vital signs (blood pressure, pulse, respiratory rate and temperature), which are fundamental in the surveillance of deterioration. The aim of this study was to discover what factors influence how nurses assess patient acuity and their response to acute deterioration. METHODS: a generic qualitative approach was used...
February 22, 2018: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/29457942/management-of-chronic-oedema-in-patients-with-multiple-morbidity
#5
Marie Todd
Marie Todd, Lymphoedema Clinical Nurse Specialist, Specialist Lymphoedema Service, Glasgow, discusses the difficulties of caring for people with compounding conditions.
February 22, 2018: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/29457941/the-impact-of-nurse-managers-leadership-styles-on-ward-staff
#6
Usama Saleh, Tom O'Connor, Hattan Al-Subhi, Rana Alkattan, Saad Al-Harbi, Declan Patton
AIM: to explore the nature of leadership styles used by the nursing management team, as perceived by nurses working at the bedside. BACKGROUND: leadership style is related to job satisfaction, staff retention, costs, and quality of care. The leadership styles of managers can be crucial in the healthcare setting, but very few studies have focused on them. METHOD: the study employed qualitative methodology, involving 35 nurses working in different specialties of a medical city in Saudi Arabia...
February 22, 2018: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/29457743/a-framework-for-complexity-in-palliative-care-a-qualitative-study-with-patients-family-carers-and-professionals
#7
Sophie Pask, Cathryn Pinto, Katherine Bristowe, Liesbeth van Vliet, Caroline Nicholson, Catherine J Evans, Rob George, Katharine Bailey, Joanna M Davies, Ping Guo, Barbara A Daveson, Irene J Higginson, Fliss Em Murtagh
BACKGROUND: Palliative care patients are often described as complex but evidence on complexity is limited. We need to understand complexity, including at individual patient-level, to define specialist palliative care, characterise palliative care populations and meaningfully compare interventions/outcomes. AIM: To explore palliative care stakeholders' views on what makes a patient more or less complex and insights on capturing complexity at patient-level. DESIGN: In-depth qualitative interviews, analysed using Framework analysis...
February 1, 2018: Palliative Medicine
https://www.readbyqxmd.com/read/29457585/training-nurses-in-a-competency-framework-to-support-adults-with-epilepsy-and-intellectual-disability-the-epaid-cluster-rct
#8
Howard Ring, James Howlett, Mark Pennington, Christopher Smith, Marcus Redley, Caroline Murphy, Roxanne Hook, Adam Platt, Nakita Gilbert, Elizabeth Jones, Joanna Kelly, Angela Pullen, Adrian Mander, Cam Donaldson, Simon Rowe, James Wason, Fiona Irvine
BACKGROUND: People with an intellectual (learning) disability (ID) and epilepsy have an increased seizure frequency, higher frequencies of multiple antiepileptic drug (AED) use and side effects, higher treatment costs, higher mortality rates and more behavioural problems than the rest of the population with epilepsy. The introduction of nurse-led care may lead to improvements in outcome for those with an ID and epilepsy; however, this has not been tested in a definitive clinical trial...
February 2018: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/29457521/relationships-between-race-ethnicity-and-health-care-utilization-among-older-post-acute-home-health-care-patients
#9
Jo-Ana D Chase, David Russell, Liming Huang, Alexandra Hanlon, Melissa O'Connor, Kathryn H Bowles
Few studies have explored racial/ethnic differences in health care outcomes among patients receiving home health care (HHC), despite known differences in other care settings. We conducted a retrospective cohort study examining racial/ethnic disparities in rehospitalization and emergency room (ER) use among post-acute patients served by a large northeastern HHC agency between 2013 and 2014 ( N = 22,722). We used multivariable binomial logistic regression to describe the relationship between race/ethnicity and health care utilization outcomes, adjusting for individual-level factors that are conceptually related to health service use...
February 1, 2018: Journal of Applied Gerontology: the Official Journal of the Southern Gerontological Society
https://www.readbyqxmd.com/read/29457514/relapse-of-bullous-pemphigoid-an-update-on-this-stubborn-clinical-problem
#10
Yiman Wang, Xuming Mao, Yanhong Wang, Yueping Zeng, Yidi Liu, Hongzhong Jin, Li Li
Bullous Pemphigoid (BP) is a chronic autoimmune blistering disorder that has a predilection for the elderly. It is characterized by a poor prognosis due to its high mortality rate and the tendency to relapse. The relapse rate of BP ranges from 27.87% to 53% after disease remission, while the majority of relapses occur early (within 6 months) during remission. Clinical interventions aimed to prevent early relapses could reduce potential complications from first-line treatment and make follow-up care easier for clinicians in practice, thus improving the prognosis of BP and the quality of patients' lives...
February 19, 2018: Annals of Medicine
https://www.readbyqxmd.com/read/29457491/critical-care-pharmacists-and-medication-management-in-an-icu-recovery-center
#11
Joanna L Stollings, Sarah L Bloom, Li Wang, E Wesley Ely, James C Jackson, Carla M Sevin
BACKGROUND: Many patients experience complications following critical illness; these are now widely referred to as post-intensive care syndrome (PICS). An interprofessional intensive care unit (ICU) recovery center (ICU-RC), also known as a PICS clinic, is one potential approach to promoting patient and family recovery following critical illness. OBJECTIVES: To describe the role of an ICU-RC critical care pharmacist in identifying and treating medication-related problems among ICU survivors...
February 1, 2018: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/29457487/dementia-management-strategies-associated-with-neuropsychiatric-symptoms-of-elderly-people-with-alzheimer-s-disease
#12
Lais Lopes Delfino, Ricardo Shoiti Komatsu, Caroline Komatsu, Anita Liberalesso Neri, Meire Cachioni
This study aims to investigate the association between management and communication strategies and the presence of neuropsychiatric symptoms presented by elderly people with Alzheimer's disease. One hundred and thirty-four family caregivers answered a questionnaire with socio-demographic data and questions regarding the care context, the Small Communication Strategies Scale, the Dementia Management Strategy Scale, and the Neuropsychiatric Inventory. Caregivers used the criticism management strategy more when the elderly presented hallucination, agitation, depression, anxiety, irritability, nighttime behavior, and appetite abnormalities...
January 1, 2018: Dementia
https://www.readbyqxmd.com/read/29457258/quality-of-prescribing-by-physicians-nurse-practitioners-and-physician-assistants-in-the-united-states
#13
Shiyin Jiao, Irene B Murimi, Randall S Stafford, Ramin Mojtabai, G Caleb Alexander
OBJECTIVE: Nurse practitioners (NPs) and physician assistants (PAs) have increasingly broad prescribing authority in the United States, yet little is known regarding how the quality of their prescribing practices compares to that of physicians. The objective of this study was to compare the quality of prescribing practices of physicians and non-physician providers. METHODS: A serial cross-sectional analysis of the 2006-2012 National Ambulatory Medical Care Survey (NAMCS) and National Hospital Ambulatory Medical Care Survey (NHAMCS) was performed...
February 19, 2018: Pharmacotherapy
https://www.readbyqxmd.com/read/29457112/anesthetic-management-during-a-cesarean-section-in-a-patient-with-cleidocranial-dysplasia-a-case-report
#14
Yumiko Nishio, Teruyuki Hiraki, Hiroko Taniguchi, Kazuo Ushijima
Background: Cleidocranial dysplasia is a type of skeletal dysplasia, which is primarily characterized by delayed ossification of skeletal structures. It causes facial and oral abnormalities, resulting in difficult airway management and neuraxial anesthesia. Case presentation: The patient was a 24-year-old primipara (height 138 cm, weight 42 kg) with a hypoplastic right clavicle, patent fontanelles, dental malalignment, and a high palate. She was diagnosed with cleidocranial dysplasia at birth, although gene examination has not been performed...
2018: JA Clin Rep
https://www.readbyqxmd.com/read/29456901/awake-craniotomy-for-the-treatment-of-a-cortical-pseudoaneurysm-in-a-pregnant-patient
#15
Hirad Hedayat, Daniel R Felbaum, John E Reynolds, Rashid M Janjua
Neurosurgical pathologies presenting during pregnancy are uncommon. If present, the situation creates a unique diagnostic, observational, and therapeutic challenge as both lives are placed at potential risk. Surgical procedures during pregnancy are approached carefully as physiological stressors associated with surgery and anesthesia may cause fetal or maternal compromise. We present the only known case of a pseudoaneurysm treated with an awake craniotomy, allowing us to abate the risks associated with general anesthesia in pregnancy...
December 7, 2017: Curēus
https://www.readbyqxmd.com/read/29456871/gestational-obesity-weight-management-implementation-of-national-guidelines-glowing-a-pilot-cluster-randomised-controlled-trial-of-a-guideline-implementation-intervention-for-the-management-of-maternal-obesity-by-midwives
#16
Nicola Heslehurst, Judith Rankin, Catherine McParlin, Falko F Sniehotta, Denise Howel, Stephen Rice, Elaine McColl
Background: Weight management in pregnancy guidelines exist, although dissemination alone is an ineffective means of implementation. Midwives identify the need for support to overcome complex barriers to practice. An evaluation of an intervention to support midwives' guideline implementation would require a large-scale cluster randomised controlled trial. A pilot study is necessary to explore the feasibility of delivery and evaluation prior to a definitive trial. The GestationaL Obesity Weight management: Implementation of National Guidelines (GLOWING) trial aims to test whether it is feasible and acceptable to deliver a behaviour change intervention to support midwives' implementation of weight management guidelines...
2018: Pilot and Feasibility Studies
https://www.readbyqxmd.com/read/29456865/a-real-world-example-of-coverage-with-evidence-development-in-australia-ipilimumab-for-the-treatment-of-metastatic-melanoma
#17
Hansoo Kim, Samantha Comey, Karl Hausler, Greg Cook
Background: Australian Government subsidisation of ipilimumab for the treatment of patients with metastatic melanoma was conditional on the sponsor entering a 'managed entry scheme' to assess the 2-year overall survival rate in metastatic melanoma patients who received ipilimumab in the first year of Pharmaceutical Benefits Scheme listing. Methods: All unresectable stage IIIc / IV metastatic melanoma patients treated with at least one dose of ipilimumab therapy in Australia from the PBS listing date to a time point 12 months later (i...
2018: Journal of Pharmaceutical Policy and Practice
https://www.readbyqxmd.com/read/29456606/sudden-cardiac-arrest-in-hypertrophic-cardiomyopathy-with-dynamic-cavity-obstruction-the-case-for-a-decatecholaminisation-strategy
#18
Cosmin Balan, Adrian View-Kim Wong
Catecholamines are entrenched in the management of shock states. A paradigm shift has pervaded the critical care arena in recent years acknowledging their propensity to cause harm and fuel a 'death-spiral'. We present the case of a 21-year-old male following a witnessed out-of-hospital cardiac arrest who received high-quality cardiopulmonary resuscitation and standard advanced life support for refractory ventricular fibrillation until return of spontaneous circulation after 70 min. Early post-admission echocardiography revealed severe diffuse sub-basal left ventricular hypertrophy with dynamic mid-cavity obstruction and akinetic apical pouching...
February 2018: Journal of the Intensive Care Society
https://www.readbyqxmd.com/read/29456603/successful-management-of-70-acetic-acid-ingestion-on-the-intensive-care-unit-a-case-report
#19
Andrew Ratcliffe, Andrew Baker, Daniel Smith
Acetic acid is an organic acid available in concentrations from 2 to 80%. Whilst lower concentrations of 2-6% are more commonly used as the table top condiment, vinegar, much stronger solutions are regularly used in Eastern Europe as food preservatives and cleaning solutions. Oral ingestion of greater than 12% has been reported to cause haemolysis, renal failure, shock and death. Most reported cases of deliberate or accidental poisoning are from Russia and Eastern Europe in the 1980s, with very little currently in western publications...
February 2018: Journal of the Intensive Care Society
https://www.readbyqxmd.com/read/29456602/review-of-management-in-cardiotoxic-overdose-and-efficacy-of-delayed-intralipid-use
#20
Edward Walter, James McKinlay, Jade Corbett, Justin Kirk-Bayley
We present the case of a 51-year-old woman admitted to our intensive care unit following an intentional overdose of a calcium channel antagonist and a beta blocker. The resultant hypotension was reversed with glucagon, noradrenaline, calcium and high-dose insulin. Despite these interventions, she remained vasoplegic and received a delayed, standard dose of intralipid. Subsequently, the vasoplegia resolved rapidly, and the vasopressor was stopped. Here, we review the management of overdose of calcium channel and beta-adrenergic receptor blockers, concentrating on the pharmacology of lipid emulsion therapy...
February 2018: Journal of the Intensive Care Society
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