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https://www.readbyqxmd.com/read/28538464/decreasing-peripherally-inserted-central-catheter-use-with-ultrasound-guided-peripheral-intravenous-lines-a-quality-improvement-project-in-the-acute-care-setting
#1
Lauren Morata, Carrie Ogilvie, Jackie Yon, Allison Johnson
An ultrasound-guided peripheral intravenous (UGPIV) quality improvement project occurred in an 849-bed tertiary care hospital with a goal to reduce the use of central lines, in particular, peripherally inserted central catheters (PICCs). Since implementation, PICCs have decreased by 46.7% overall, and 59 nurses in-hospital are competent in placing UGPIVs. Placement of UGPIVs by the bedside nurse is a key initiative in decreasing PICC use and, potentially, infections.
June 2017: Journal of Nursing Administration
https://www.readbyqxmd.com/read/28524786/variation-in-management-of-in-hospital-newborn-falls-a-single-center-experience
#2
Doron J Kahn, Paul D Fisher, Dean A Hertzler
OBJECTIVE There are only 3 small case series in the literature that report on the management of in-hospital newborn falls (NFs), and recommendations are unclear. The authors performed a retrospective review to determine outcome and differences in management and to understand why management of NFs varies at their institution. METHODS All NFs occurring within the authors' institution over a 3.5-year period were reviewed. Post-fall management and outcomes of each incident were compared. RESULTS There were 24 NFs out of 40,349 deliveries (5...
May 19, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28516829/factors-associated-with-failure-of-emergency-wait-time-targets-for-high-acuity-discharges-and-intensive-care-unit-admissions
#3
Ivy Cheng, Merrick Zwarenstein, Alex Kiss, Maaret Castren, Mats Brommels, Michael Schull
OBJECTIVE: Ontario established emergency department length-of-stay (EDLOS) targets but has difficulty achieving them. We sought to determine predictors of target time failure for discharged high acuity patients and intensive care unit (ICU) admissions. METHODS: This was a retrospective, observational study of 2012 Sunnybrook Hospital emergency department data. The main outcome measure was failing to meet government EDLOS targets for high acuity discharges and ICU emergency admissions...
May 18, 2017: CJEM
https://www.readbyqxmd.com/read/28489809/cannabis-induced-bullous-lung-disease-leading-to-pneumothorax-case-report-and-literature-review
#4
Rashmi Mishra, Ravi Patel, Misbahuddin Khaja
RATIONALE: Marijuana use has been increasing in the United States among college students and young adults. Marijuana use has been associated with bullous lung disease which can lead to pneumothorax. There are other recreational drugs like methylphenidate, cocaine and heroin which have been associated with pneumothorax. PATIENT CONCERNS: We present a case of a 30-year-old man with spontaneous pneumothorax associated with marijuana use. The patient had no medical conditions and presented to the emergency room with chest pain...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28485316/left-ventricular-longitudinal-systolic-function-in-septic-shock-patients-with-normal-ejection-fraction-a-case-control-study
#5
Hong-Min Zhang, Xiao-Ting Wang, Li-Na Zhang, Wei He, Qing Zhang, Da-Wei Liu
BACKGROUND: Septic cardiomyopathy is a common finding in septic shock patients. The accepted definition of septic cardiomyopathy is often based on the left ventricular ejection fraction (LVEF). The aim of this study was to determine whether the left ventricular longitudinal systolic function was more sensitive than the LVEF in heart function appraisal of septic shock patients. METHODS: This was a case-control study conducted at a 40-bed Intensive Care Unit (ICU) of Peking Union Medical College Hospital...
May 20, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28474273/outpatient-appendectomy-in-an-emergency-outpatient-surgery-unit-24%C3%A2-h-a-day-an-intention-to-treat-analysis-of-194-patients
#6
Adeline Aubry, Arnaud Saget, Gilles Manceau, Matthieu Faron, Mathilde Wagner, Christophe Tresallet, Bruno Riou, Olivier Lucidarme, Frédéric le Saché, Mehdi Karoui
OBJECTIVE: To evaluate the feasibility and outcomes of patients operated on for uncomplicated acute appendicitis (UAA) in our 24-h emergency outpatient surgery unit. METHODS: This was a prospective observational study with intention-to-treat (ITT) analysis. From 12/2013 to 03/2015, all consecutive patients admitted for acute appendicitis (AA) were prospectively screened. A computed tomography or abdominal ultrasound confirmed the diagnosis of AA. Eligibility criteria for outpatient appendectomy were: UAA, no comorbidity, no physical or mental condition preventing participation in the study, absence of pregnancy, age older than 15 years, an accompanying adult person available for the hospital discharge and place of residence within 1 h of our hospital...
May 4, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28469898/the-value-of-a-surgical-assessment-unit-ultrasound-facility
#7
Wesley Lai, Catherine Gutteridge, Alicia Regan, Anthony Lambert
Ultrasound scan (USS) is a common and important mode of investigation for emergency surgical admissions. Delay in investigation often leads to delayed diagnosis and treatment, and possible extended length of stay (LOS), which has clinical, cost and service provision implications. We aim to investigate the clinical impact on patient care and the cost-effectiveness of a pilot Surgical Assessment Unit (SAU) USS facility. We performed a retrospective data collection on 100 consecutive SAU inpatients who had an USS investigation on the ward since the introduction of the facility, matched by 100 consecutive SAU inpatients who had an USS in the radiology department before the pilot study...
2017: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/28410848/improving-access-to-image-guided-procedures-at-an-integrated-rural-critical-access-hospital-ultrasound-guided-thyroid-biopsy-program
#8
Thang Q Le, Yadiel Sánchez, Alexander S Misono, Sanjay Saini, Anand M Prabhakar
PURPOSE: Critical access hospitals face difficulty providing all services locally and may need to refer patients off-site for additional care. Providing on-site minimally invasive biopsies, may obviate visits to tertiary or quaternary care centers. This study aims to assess feasibility and outcomes of an ultrasound-guided thyroid biopsy program in a critical access hospital. METHODS: In this HIPAA compliant, IRB approved study, the Interventional Radiology (IR) database of a 19-bed, island, rural, critical access hospital without onsite pathology services affiliated with our quaternary care institution was retrospectively reviewed to identify all thyroid biopsies that were performed on site since inception of the service in April 2014 through August 2016...
February 16, 2017: Current Problems in Diagnostic Radiology
https://www.readbyqxmd.com/read/28378733/-prognostic-factors-in-patients-with-non-st-segment-elevation-acute-coronary-syndrome-concurrent-with-type-2-diabetes-mellitus-according-to-the-results-of-the-registry
#9
A P Golikov, S A Berns, R I Stryuk, E A Shmidt, A A Golikova, O L Barbarash
AIM: To investigate factors that influence annual prognosis in patients with non-ST-segment elevation acute coronary syndrome ((NSTEACS) concurrent with type 2 diabetes mellitus (DM2). SUBJECTS AND METHODS: The registry of patients with NSTEACS (non-ST-segment elevation myocardial infarction (NSTEMI), unstable angina) included 415 patients, of them 335 had no carbohydrate metabolic disorders, 80 had DM2. The follow-up period, during which the prognosis was evaluated in the patients, was one year after hospital discharge following the index NSTEACS event...
2017: Terapevticheskiĭ Arkhiv
https://www.readbyqxmd.com/read/28369985/nongalenic-pial-arteriovenous-fistula-prenatal-diagnosis
#10
Cristina Martínez-Payo, Javier Sancho Saúco, Maria Miralles, Tirso Pérez Medina
Pial arteriovenous (AV) fistulae have rarely been diagnosed in utero. They are characterized by one or more pial arteries flowing directly into a cortical vein without any shunt or interposed capillary bed. In the fetus and the newborn up to 2 years of age, the most common clinical manifestation is heart failure resulting from fistula overload. Later on, hydrocephalus, focal neurologic deficits, headaches, seizures, and cerebral hemorrhage are the most common manifestations. We present a case of nongalenic pial AV fistula diagnosed in the 25th week of pregnancy, which resulted in intrauterine fetal death due to congestive heart failure...
April 3, 2017: Journal of Clinical Ultrasound: JCU
https://www.readbyqxmd.com/read/28348360/an-uncommon-case-of-lower-limb-deep-vein-thrombosis-with-multiple-etiological-causes
#11
Jing Miao, Geetha Naik, Sivakumar Muddana, Xiaohuan Li, Supriya Bhimasani, Ronald Alvin Mitchell, Dariush Alaie, Richard L Petrillo
BACKGROUND Deep vein thrombosis (DVT) is a type of venous thromboembolism with diverse clinical and environmental risk factors. Very few cases of DVT with multiple high risk factors have been reported. Here, we report an uncommon DVT case with multiple etiological causes, including appendicitis/appendectomy, morbid obesity, immobilization, positive phosphatidylserine IgG, and heterozygous factor V Leiden mutation. CASE REPORT A 43-year-old female was brought to the emergency room because of 2-week history of pain and swelling and ultrasound revealing evidence of DVT in the right leg...
March 28, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28346955/nonischemic-priapism-in-childhood-a-case-series-and-review-of-literature
#12
Hans-Walter Hacker, Marcus G Schwoebel, Philipp O Szavay
Introduction Nonischemic priapism (NIP) in childhood is a very rare affection. In the literature, patients with NIP are described mainly incidental after perineal trauma. Many of them underwent embolization of either internal pudendal artery or bulbocavernosal arteries. Patients and Methods We report on six boys between 4 and 13 years of age with NIP, treated at our institution between 2008 and 2014. Color Doppler ultrasound (CDU) was performed in all patients as emergency diagnostic evaluation. Patients were treated conservatively, including bed rest, local cooling, and perineal compression...
March 27, 2017: European Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28338811/interventions-for-the-prevention-and-treatment-of-disability-due-to-acquired-joint-contractures-in-older-people-a-systematic-review
#13
Susanne Saal, Katrin Beutner, Julia Bogunski, Kathrin Obermüller, Martin Müller, Eva Grill, Gabriele Meyer
Background: acquired joint contractures have significant effects on quality of life and functioning. Objective: to determine the effects of interventions to prevent and treat disabilities in older people with acquired joint contractures. Methods: systematic search (last 8/2016) via Cochrane Library, PubMed, EMBASE, PEDro, CINAHL, trial registries, reference lists of retrieved articles and scientific congress pamphlets. Controlled and randomised controlled trials in English or German comparing an intervention with another intervention or standard care were included...
February 25, 2017: Age and Ageing
https://www.readbyqxmd.com/read/28303659/invasive-characterization-of-atherosclerotic-plaque-in-patients-with-peripheral-arterial-disease-using-near-infrared-spectroscopy-intravascular-ultrasound
#14
Amr E Abbas, Sibin K Zacharias, James A Goldstein, Ivan D Hanson, Robert D Safian
OBJECTIVES: We describe the characteristics of atherosclerotic plaque in patients with peripheral arterial disease (PAD) using near-infrared spectroscopy-intravascular ultrasound (NIRS-IVUS) BACKGROUND: Imaging and autopsy studies have described atherosclerotic plaque in different vascular beds, including varying degrees of lipid, fibrosis, and calcification. Recently, NIRS has been validated as an accurate method for detecting lipid-core plaque (LCP) in the coronary circulation. Invasive evaluation of plaque composition using NIRS-IVUS has not been reported in different peripheral arterial circulations...
March 17, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28301803/injectable-and-thermally-contractible-hydroxypropyl-methyl-cellulose-fe3o4-for-magnetic-hyperthermia-ablation-of-tumors
#15
Fengjuan Wang, Yang Yang, Yi Ling, Jianxin Liu, Xiaojun Cai, Xiaohan Zhou, Xiuzhen Tang, Bing Liang, Yini Chen, Hangrong Chen, Dengming Chen, Chunhong Li, Zhigang Wang, Bing Hu, Yuanyi Zheng
The development of efficient strategies for the magnetic hyperthermia ablation of tumors remains challenging. To overcome the significant safety limitations, we developed a thermally contractible, injectable and biodegradable material for the minimally invasive and highly efficient magnetic hyperthermia ablation of tumors. This material was composed of hydroxypropyl methyl cellulose (HPMC), polyvinyl alcohol (PVA) and Fe3O4. The thermal contractibility of HPMC/Fe3O4 was designed to avoid damaging the surrounding normal tissue upon heating, which was confirmed by visual inspection, ultrasound imaging and computed tomography (CT)...
March 8, 2017: Biomaterials
https://www.readbyqxmd.com/read/28290908/-coronary-angioplasty-and-stenting-in-patients-older-than-80-years-immediate-and-long-term-results
#16
A M Babunashvili, D P Dundua, D S Kartashov, A A Bazarnova, A Yu Korenevich, M E Vetluzhskikh
AIM: to assess immediate and long-term results of coronary angioplasty and stenting in patients older than 80 years - a high risk group in view of the severity of concomitant pathology and extent of coronary atherosclerosis. MATERIAL AND METHODS: We conducted retrospective analysis of data from 167 patients older than 80 years (mean age 81.43+/-2.14 years) subjected to percutaneous coronary intervention from 2006 to 2013 (3.2% from total number of patients). Multivessel involvement was present in 128 patients (76...
July 2016: Kardiologiia
https://www.readbyqxmd.com/read/28276672/current-adoption-of-lung-ultrasound-in-intensive-care-units-an-italian-multi-centre-survey
#17
Italo Calamai, Massimiliano Greco, Guido Bertolini, Rosario Spina
BACKGROUND: Lung ultrasound (LUS) is a useful tool for assessing lung status in critically ill patients, but is not widely applied in intensive care units (ICUs). The aim of this study was to investigate the use of LUS in Italian ICUs. METHODS: A questionnaire was distributed to 116 ICU representatives belonging to the Italian GiViTI network, participating in a national project on continuous quality of care assessment. The answers to the questionnaire were analysed with the data collected in the course of said project...
March 7, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28273552/surgeon-performed-continuous-intraoperative-ultrasound-guidance-decreases-re-excisions-and-mastectomy-rates-in-breast-cancer
#18
Guldeniz Karadeniz Cakmak, Ali U Emre, Oge Tascilar, Burak Bahadir, Selcuk Ozkan
BACKGROUND: Intraoperative ultrasound guided (IUG) breast conserving surgery (BCS) is being increasingly embraced by breast surgeons worldwide. We aimed to compare the efficacy of IUG-BCS for palpable and nonpalpable breast cancer with respect to margin status, re-excision rate, tissue sacrifice and cost-time analysis. METHODS: Intraoperative localization protocol includes intraoperative ultrasound prior to excision to localize the lesion and guide the initial resection...
March 2, 2017: Breast: Official Journal of the European Society of Mastology
https://www.readbyqxmd.com/read/28255448/effects-of-different-early-rehabilitation-techniques-on-haemodynamic-and-metabolic-parameters-in-sedated-patients-protocol-for-a-randomised-single-bind-cross-over-trial
#19
Clément Medrinal, Yann Combret, Guillaume Prieur, Aurora Robledo Quesada, Tristan Bonnevie, Francis Edouard Gravier, Éric Frenoy, Olivier Contal, Bouchra Lamia
INTRODUCTION: Early rehabilitation has become widespread practice for patients in intensive care; however, the prevalence of intensive care unit-acquired weakness remains high and the majority of physiotherapy is carried out in bed. Several inbed rehabilitation methods exist, but we hypothesise that techniques that provoke muscle contractions are more effective than passive techniques. METHODS: A randomised, controlled cross-over study will be carried out to evaluate and compare the effectiveness of early rehabilitation techniques on cardiac output (CO) in sedated patients in intensive care...
2017: BMJ Open Respiratory Research
https://www.readbyqxmd.com/read/28190986/algorithms-for-automatically-pointing-ultrasound-imaging-catheters
#20
Paul M Loschak, Laura J Brattain, Robert D Howe
A system for automatically pointing ultrasound (US) imaging catheters will enable clinicians to monitor anatomical structures and track instruments during interventional procedures. Off-the-shelf US catheters provide high quality US images from within the patient. While this method of imaging has been proven to be effective for guiding many interventional treatments, significant training is required to overcome the difficulty in manually steering the imager to point at desired structures. Our system uses closed-form four degree of freedom (DOF) kinematic solutions to automatically position the US catheter and point the imager...
February 2017: IEEE Transactions on Robotics: a Publication of the IEEE Robotics and Automation Society
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