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https://www.readbyqxmd.com/read/28815416/what-is-the-evidence-for-paediatric-adolescent-bariatric-surgery
#1
REVIEW
Natalie Durkin, Ashish P Desai
PURPOSE OF REVIEW: In spite of the increasing prevalence of severe and complex obesity in children, surgery as a potential management option is still not widely accepted. The purpose of this review is to examine the evidence for surgical options in the severely obese paediatric population. Increasing evidence supports early rather than later use of bariatric surgery in the treatment of extreme obesity. RECENT FINDINGS: Prior to 2007, the feasibility and safety of surgery have been reported by predominantly small, sporadic single-centre retrospective case series...
August 16, 2017: Current Obesity Reports
https://www.readbyqxmd.com/read/28814576/children-s-hospitals-solutions-for-patient-safety-collaborative-impact-on-hospital-acquired-harm
#2
Anne Lyren, Richard J Brilli, Karen Zieker, Miguel Marino, Stephen Muething, Paul J Sharek
OBJECTIVES: To determine if an improvement collaborative of 33 children's hospitals focused on reliable best practice implementation and culture of safety improvements can reduce hospital-acquired conditions (HACs) and serious safety events (SSEs). METHODS: A 3-year prospective cohort study design with a 12-month historical control population was completed by the Children's Hospitals' Solutions for Patient Safety collaborative. Identification and dissemination of best practices related to 9 HACs and SSE reduction focused on key process and culture of safety improvements...
August 16, 2017: Pediatrics
https://www.readbyqxmd.com/read/28814328/building-capacity-for-dissemination-and-implementation-research-one-university-s-experience
#3
Ross C Brownson, Enola K Proctor, Douglas A Luke, Ana A Baumann, Mackenzie Staub, Matthew T Brown, Mallory Johnson
BACKGROUND: While dissemination and implementation (D&I) science has grown rapidly, there is an ongoing need to understand how to build and sustain capacity in individuals and institutions conducting research. There are three inter-related domains for capacity building: people, settings, and activities. Since 2008, Washington University in St. Louis has dedicated significant attention and resources toward building D&I research capacity. This paper describes our process, challenges, and lessons with the goal of informing others who may have similar aims at their own institution...
August 16, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28811131/assessment-of-translational-risk-in-drug-research-role-of-biomarker-classification-and-mechanism-based-pkpd-concepts
#4
Sandra A G Visser, Tjerk J H Bueters
In 2005, Danhof and coauthors proposed a new biomarker classification in the context of the application of mechanism-based PKPD modeling. They defined the term 'biomarker' as a measure that characterizes a drug-induced response, which is on the causal path between drug administration and clinical outcome. The biomarker classification identified seven categories that provide different insights into the kinetics of drug action, such as target site distribution, target engagement, or into the impact of the drug on physiology or disease...
August 12, 2017: European Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/28781898/suicide-by-ingestion-of-caffeine
#5
Frédéric Aknouche, Emilie Guibert, Alison Tessier, Aude Eibel, Pascal Kintz
BACKGROUND: Mr K, aged 48, was found sweating by his partner at home at 11.50 pm. He claimed to have attempted suicide. She immediately called the Emergency Unit to ask for support. At the phone, the physician on duty indicated her to give a pill of Lysanxia (prazepam) to decrease the level of stress of the victim. However, the clinical situation worsened and he was taken to the hospital at 1.00 am. At his arrival at 1.28 am he was in cardiac arrest. Despite intensive resuscitation manoeuvres, death was pronounced at 2...
2017: Egyptian journal of forensic sciences
https://www.readbyqxmd.com/read/28777998/is-faculty-practice-valuable-the-experience-of-western-australian-nursing-and-midwifery-academics-undertaking-faculty-clinical-practice-a-discussion-paper
#6
Amanda C Fowler, Melanie Baker, Sadie Geraghty
The faculty clinical practice model provides dedicated time for nursing lecturers and educators in a university school of nursing to work with supervision in the clinical environments for an agreed amount of time each year. Allowing academics to partake in faculty clinical practice this way has been shown to update skills and retain clinical competency. Some nursing and midwifery academics believe it is essential to remain clinically current and up-to-date with professional issues in the clinical environments, whereas other academics believe reading current research maintains clinical competency...
July 27, 2017: Nurse Education in Practice
https://www.readbyqxmd.com/read/28764688/developing-a-patient-decision-aid-for-the-treatment-of-women-with-early-stage-breast-cancer-the-struggle-between-simplicity-and-complexity
#7
W Savelberg, T van der Weijden, L Boersma, M Smidt, C Willekens, A Moser
BACKGROUND: A patient decision aid (PtDA) can support shared decision making (SDM) in preference-sensitive care, with more than one clinically applicable treatment option. The development of a PtDA is a complex process, involving several steps, such as designing, developing and testing the draft with all the stakeholders, known as alpha testing. This is followed by testing in 'real life' situations, known as beta testing, and then finalising the definite version. Our aim was developing and alpha testing a PtDA for primary treatment of early stage breast cancer, ensuring that the tool is considered relevant, valid and feasible by patients and professionals...
August 1, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/28753376/searching-for-the-qcd-axion-with-gravitational-microlensing
#8
Malcolm Fairbairn, David J E Marsh, Jérémie Quevillon
The phase transition responsible for axion dark matter (DM) production can create large amplitude isocurvature perturbations, which collapse into dense objects known as axion miniclusters. We use microlensing data from the EROS survey and from recent observations with the Subaru Hyper Suprime Cam to place constraints on the minicluster scenario. We compute the microlensing event rate for miniclusters, treating them as spatially extended objects. Using the published bounds on the number of microlensing events, we bound the fraction of DM collapsed into miniclusters f_{MC}...
July 14, 2017: Physical Review Letters
https://www.readbyqxmd.com/read/28752985/considerations-in-minimally-invasive-adrenal-surgery-the-front-or-the-backdoor
#9
Otis M Vrielink, Patrick H Hemmer, Schelto Kruijff
In the last decades, in minimally invasive adrenal surgery, the retroperitoneoscopic adrenalectomy (PRA) has shown favorable results when compared to the laparoscopic transperitoneal adrenalectomy (LTA). However, for many endocrine surgeons it is unclear if, when, and how to transition from LTA to PRA. Although the length of the learning curve for both approaches is comparable, the LTA is a technically more challenging procedure whilst PRA demands an orientation in a new environment in a patient that is positioned upside down...
July 28, 2017: Minerva Chirurgica
https://www.readbyqxmd.com/read/28742820/facilitators-and-barriers-to-physical-activity-in-people-with-chronic-low-back-pain-a-qualitative-study
#10
Laura Boutevillain, Arnaud Dupeyron, Caroline Rouch, Emilie Richard, Emmanuel Coudeyre
BACKGROUND: For medical teams, one of the main objectives of rehabilitation for people with chronic low back pain is adherence to physical activity (PA). OBJECTIVE: The objective of this study was to identify PA barriers and facilitators in this population. METHODS: This qualitative study included 4 discussion groups and 16 semi-structured interviews conducted among people with non-specific chronic low back pain who were involved in a specific rehabilitation program or seen in primary care settings...
2017: PloS One
https://www.readbyqxmd.com/read/28740684/pediatric-airway-surgery
#11
REVIEW
Konrad Hoetzenecker, Thomas Schweiger, Doris Maria Denk-Linnert, Walter Klepetko
The management of pediatric airway pathology can be challenging and requires a dedicated team, consisting of thoracic surgeons, phoniatricians, logopedics, pediatricians and anesthetists. It necessitates a tailored treatment approach for each individual patient in order to address the minor variances that exist between cases. The majority of pediatric airway problems are a sequela of prematurity and prolonged post-partal intubation/tracheostomy. Surgical repair is often complicated by additional malformation or severe comorbidities...
June 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28734630/management-of-an-acinetobacter-baumannii-outbreak-in-an-intensive-care-unit
#12
M Tanguy, A Kouatchet, B Tanguy, É Pichard, S Fanello, M-L Joly-Guillou
INTRODUCTION: Acinetobacter baumannii is a ubiquitous pathogen resistant to desiccation and responsible for healthcare-associated infections (HAI), especially in intensive care units (ICU) where it is responsible for 5-10% of HAIs. An A. baumannii outbreak occurred in the ICU of the University Hospital of Angers, France. OBJECTIVES: To describe the A. baumannii outbreak and to evaluate the control measures taken. The secondary objective was to evaluate the impact of the electronic alert system on the incidence of multidrug resistance to antibiotics...
July 19, 2017: Médecine et Maladies Infectieuses
https://www.readbyqxmd.com/read/28721569/management-of-enterocutaneous-fistula-outcomes-in-276-patients
#13
Martha Quinn, Stuart Falconer, Ruth F McKee
OBJECTIVE: To assess the outcomes of patients with type II intestinal failure due to enterocutaneous fistulae in a tertiary referral centre over a 15 year period. Intestinal failure secondary to enterocutaneous fistula (ECF) requires multidisciplinary management at significant cost. Mortality and morbidity are high. METHODS: Patients were identified from a prospectively collected database of patients requiring inpatient parenteral nutrition (1998-2013). Data collected included: demographics, mode of admission, pathological grouping and outcome...
July 18, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28720207/thrombotic-microangiopathy-a-multidisciplinary-team%C3%A2-approach
#14
Craig E Gordon, Vipul C Chitalia, J Mark Sloan, David J Salant, David L Coleman, Karen Quillen, Katya Ravid, Jean M Francis
Thrombotic microangiopathy (TMA) is characterized by the presence of microangiopathic hemolytic anemia and thrombocytopenia along with organ dysfunction, and pathologically, by the presence of microthrombi in multiple microvascular beds. Delays in diagnosis and initiation of therapy are common due to the low incidence, variable presentation, and poor awareness of these diseases, underscoring the need for interdisciplinary approaches to clinical care for TMA. We describe a new approach to improve clinical management via a TMA team that originally stemmed from an Affinity Research Collaborative team focused on thrombosis and hemostasis...
July 15, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28719524/establishing-obstetric-anesthesiology-practice-guidelines-in-the-republic-of-armenia-a-global-health-collaboration
#15
Gordon Yuill, Ashot Amroyan, Simon Millar, Emil Vardapetyan, Ashraf S Habib, Medge D Owen
BACKGROUND: Disparity exists in anesthesia practices between high- and low-to-middle income countries, and awareness has been raised within the global health community to improve the standards of anesthesia care and patient safety. The establishment of international collaborations and appropriate practice guidelines may help address clinical care deficiencies. This report's aim was to assess the impact of a multiyear collaboration on obstetric anesthesia practices in the Republic of Armenia...
August 2017: Anesthesiology
https://www.readbyqxmd.com/read/28715361/trauma-systems-around-the-world-a-systematic-overview
#16
Suzan Dijkink, Charlie Nederpelt, Pieta Krijnen, George C Velmahos, Inger B Schipper
BACKGROUND: Implementation of trauma care systems has resulted in improved patient outcomes, but international differences obviously remain. Improvement of care can only be established if we recognize and clarify these differences. The aim of the current review is to provide an overview of the recent literature on the state of trauma systems globally. METHODS: The literature review over the period 2000-2016 was conducted following the PRISMA guidelines. Pre-hospital care, acute hospital care and quality assurance were classified using the WHO Trauma System Maturity Index in four levels from I (least mature) to IV (most mature)...
July 15, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28709439/enhanced-antimicrobial-de-escalation-for-pneumonia-in-mechanically-ventilated-patients-a-cross-over-study
#17
Tracy Trupka, Kristen Fisher, Scott T Micek, Paul Juang, Marin H Kollef
BACKGROUND: Antibiotics are commonly administered to hospitalized patients with infiltrates for possible bacterial pneumonia, often leading to unnecessary treatment and increasing the risk for resistance emergence. Therefore, we performed a study to determine if an enhanced antibiotic de-escalation practice could improve antibiotic utilization in mechanically ventilated patients with suspected pneumonia cared for in an academic closed intensive care unit (ICU). METHODS: This was a prospective cross-over trial comparing routine antibiotic management (RAM) and enhanced antimicrobial de-escalation (EAD) performed within two medical ICUs (total 34 beds) at Barnes-Jewish Hospital, an academic referral center...
July 15, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28707644/going-the-extra-mile-lessons-learned-from-running-coaches-applied-to-medicine
#18
Ryan Graddy, Scott Wright
Master clinicians and successful long-distance runners have a lot in common. Both are dedicated to continuous improvement and are flexible in their approach, allowing for adaptation to meet unplanned challenges. Given these similarities and the important role of coaches in athletics, there is an opportunity for medical educators to learn from excellent running coaching. The authors spent time with three respected running coaches at different levels (high school, college, and postcollegiate online) and identified six principles employed by these coaches that seem to be particularly relevant for promoting skill development in medicine...
January 2017: Education for Health: Change in Training & Practice
https://www.readbyqxmd.com/read/28699274/transplant-center-support-for-infectious-diseases
#19
Joanna M Schaenman, Deepali Kumar, Camille N Kotton, Lara Danziger-Isakov, Michele I Morris
BACKGROUND: Transplant Infectious Diseases (TID) is a rapidly growing subspecialty, which has contributed significantly to improving patient outcomes after transplantation. Obtaining institutional support to implement programs that promote excellence in patient care remains a challenge for many non-surgical transplant-related specialties. METHOD: We surveyed the membership of the American Society of Transplantation Infectious Diseases Community of Practice to assess characteristics of individual transplant programs and delineate current patterns of institutional support of TID, with a goal of facilitating the exchange of innovative funding ideas between transplant programs...
July 12, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28697970/cystic-fibrosis-priorities-and-progress-for-future-therapies
#20
REVIEW
Eitan Kerem
Significant improvement in the survival of patients with CF has been achieved in the last decades. The improved clinical status of the patients is mainly the result of a better understanding of the natural course of infection and inflammation in CF that has led to the implementation of strategies that increase the life expectancy and quality of life of the patients. These strategies include prompt diagnosis, timely and aggressive nutritional support, augmentation of MCC and improved mucous drainage, initiation of antimicrobial and anti-inflammatory therapy as soon as possible, early treatment of acute exacerbations, implementation of effective hygienic measures in and outside CF centers and prompt identification and treatment of CF-related complications...
June 12, 2017: Paediatric Respiratory Reviews
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