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https://www.readbyqxmd.com/read/28721569/management-of-enterocutaneous-fistula-outcomes-in-276-patients
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
https://www.readbyqxmd.com/read/28690893/blood-culture-contaminants-in-a-paediatric-population-retrospective-study-from-a-tertiary-hospital-in-oman
#9
Mohamed A El-Naggari, Sharef W Al-Mulaabed, Zakaria Al-Muharrmi, Renjith Mani, Rana Abdelrahim, Reem Abdwani
OBJECTIVES: Most children presenting with febrile illness require a blood culture to determine the causative organism as well as its sensitivity to antibiotics. However, false-positive results lead to unnecessary hospitalisations, prescriptions and tests. This study aimed to evaluate the impact of false-positive blood cultures among a paediatric population at a tertiary hospital in Oman. METHODS: This retrospective study included all 225 children <13 years old with positive blood cultures who presented to the Sultan Qaboos University Hospital, Muscat, Oman, between July 2011 and December 2013...
May 2017: Sultan Qaboos University Medical Journal
https://www.readbyqxmd.com/read/28690088/a-cluster-randomized-trial-to-estimate-the-effect-of-mobile-screening-and-treatment-feedback-on-hba1c-and-diabetes-related-complications-in-tshwane-primary-health-care-clinics-south-africa
#10
Elizabeth Melanie Webb, Paul Rheeder
AIM AND OBJECTIVES: Our study had two primary objectives. The first was to evaluate the effect of an expert review with an individualised patient management plan on change in HbA1c. The second was to determine whether a mobile screening unit would increase the proportion of patients screened for glycaemic and lipid control, as well as diabetic complications as compared to the standard guideline-driven clinic care. METHODS: We conducted a cluster-randomised trial and enrolled 599 diabetic patients from twelve primary health care clinics in the Tshwane district of South Africa...
July 6, 2017: Primary Care Diabetes
https://www.readbyqxmd.com/read/28689974/endoscopic-surgery-for-sinonasal-tumors-the-transcribriform-approach
#11
R Thomas, P Martin, D Patrick, M Justin
Over the past 10 to 20 years, endoscopic endonasal surgery has become for many teams the preferred treatment for sinonasal tumors. Technical advances in the field of surgical instrumentation (good visualization, hemostasis…) and the progress of imaging guidance (to avoid neurovascular complication) has made those procedures simpler and safer. Nevertheless, endonasal endoscopic procedures require a trained surgical team of ENT specialist and neurosurgeon. Endoscopic endonasal surgery has been reported to be feasible for all types of sinonasal tumors whether benign tumors such as inverted papillomas, or malignant tumors...
July 8, 2017: Journal of Stomatology, Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28688794/transition-of-care-in-patients-with-anorectal-malformations-consensus-by-the-arm-net-consortium
#12
REVIEW
Stefano Giuliani, Caterina Grano, Dalia Aminoff, Nicole Schwarzer, Mariette Van De Vorle, Celia Cretolle, Michel Haanen, Giulia Brisighelli, Stefanie Marzheuser, Martin Connor
OBJECTIVES: To develop the first consensus to standardize the management of patients with Anorectal Malformations (ARMs) transitioning from childhood to adulthood. METHODS: A dedicated task force of experts performed an extensive literature review and multiple meetings to define the most important aspects of transition of care. The findings were discussed with all ARM-net consortium members and a set of practical recommendations agreed upon at the annual meeting in 2016...
June 23, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28681381/epilepsy-transition-from-pediatric-to-adult-care-recommendations-of-the-ontario-epilepsy-implementation-task-force
#13
REVIEW
Danielle M Andrade, Anne S Bassett, Eduard Bercovici, Felippe Borlot, Esther Bui, Peter Camfield, Guida Quaglia Clozza, Eyal Cohen, Timothy Gofine, Lisa Graves, Jon Greenaway, Beverly Guttman, Maya Guttman-Slater, Ayman Hassan, Megan Henze, Miriam Kaufman, Bernard Lawless, Hannah Lee, Lezlee Lindzon, Lysa Boissé Lomax, Mary Pat McAndrews, Dolly Menna-Dack, Berge A Minassian, Janice Mulligan, Rima Nabbout, Tracy Nejm, Mary Secco, Laurene Sellers, Michelle Shapiro, Marie Slegr, Rosie Smith, Peter Szatmari, Leeping Tao, Anastasia Vogt, Sharon Whiting, O Carter Snead
The transition from a pediatric to adult health care system is challenging for many youths with epilepsy and their families. Recently, the Ministry of Health and Long-Term Care of the Province of Ontario, Canada, created a transition working group (TWG) to develop recommendations for the transition process for patients with epilepsy in the Province of Ontario. Herein we present an executive summary of this work. The TWG was composed of a multidisciplinary group of pediatric and adult epileptologists, psychiatrists, and family doctors from academia and from the community; neurologists from the community; nurses and social workers from pediatric and adult epilepsy programs; adolescent medicine physician specialists; a team of physicians, nurses, and social workers dedicated to patients with complex care needs; a lawyer; an occupational therapist; representatives from community epilepsy agencies; patients with epilepsy; parents of patients with epilepsy and severe intellectual disability; and project managers...
July 6, 2017: Epilepsia
https://www.readbyqxmd.com/read/28680819/middle-east-respiratory-syndrome-clinical-practice-guideline-for-hemodialysis-facilities
#14
Hayne Cho Park, Young-Ki Lee, Sang-Ho Lee, Kyung Don Yoo, Hee Jung Jeon, Dong-Ryeol Ryu, Seong Nam Kim, Seung Hwan Sohn, Rho Won Chun, Kyu Bok Choi
The Korean Society of Nephrology participated in the task force team consisting of government authorities and civilian experts to prevent and control the spread of Middle East respiratory syndrome (MERS) in 2015. The Korean Society of Nephrology MERS Task Force Team took an immediate action and drafted 'the clinical recommendation for hemodialysis facilities' to follow when the first and the only confirmed case was reported in the hemodialysis unit. Owing to the dedicated support from medical doctors, dialysis nurses, and related medical companies, we could prevent further transmission of MERS infection successfully in hemodialysis units...
June 2017: Kidney Research and Clinical Practice
https://www.readbyqxmd.com/read/28669873/endoscopic-endonasal-surgery-for-pituitary-apoplexy-evidences-from-a-75-cases-series-from-a-tertiary-care-center
#15
Matteo Zoli, Laura Milanese, Marco Faustini-Fustini, Federica Guaraldi, Sofia Asioli, Corrado Zenesini, Alberto Righi, Giorgio Frank, Maria Pia Foschini, Carmelo Sturiale, Ernesto Pasquini, Diego Mazzatenta
BACKGROUND: The optimal management of PA remains debated. The aim of this study was to assess the outcome of TA in PA in a large surgical experience. MATERIALS: Each consecutive case of PA consecutively operated by EEA from our tertiary care center, from 1998 to 2015, were was included in this series. RESULTS: Seventy-five patients (47 males; mean age 52.4 ± 16.2 years, SD:16.2) were included. Mean follow-up was 69.3 ± 46.7 months. On admission, all patients presented with abrupt onset severe headache (100%), associated with nterior hypopituitarism in 51 patients (68%), visual disturbances in 55 (73...
June 29, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28666336/health-systems-facilitators-and-barriers-to-the-integration-of-hiv-and-chronic-disease-services-a-systematic-review
#16
Nicola Watt, Louise Sigfrid, Helena Legido-Quigley, Sue Hogarth, Will Maimaris, Laura Otero-García, Pablo Perel, Kent Buse, Martin McKee, Peter Piot, Dina Balabanova
Integration of services for patients with more than one diagnosed condition has intuitive appeal but it has been argued that the empirical evidence to support it is limited. We report the findings of a systematic review that sought to identify health system factors, extrinsic to the integration process, which either facilitated or hindered the integration of services for two common disorders, HIV and chronic non-communicable diseases. Findings were initially extracted and organized around a health system framework, followed by a thematic cross-cutting analysis and validation steps...
June 29, 2017: Health Policy and Planning
https://www.readbyqxmd.com/read/28655370/antibiotic-stewardship-in-long-term-care-a-call-to-action
#17
Caren McHenry Martin
The Centers for Medicare & Medicaid Services and the Centers for Disease Control and Prevention are focused heavily on curbing the misuse of antibiotics in health care facilities. Regulations governing the management of antibiotics in the nursing facility will likely be changing in the near future, which will put the pharmacist at the forefront of a clinical team that is dedicated to proper antibiotic utilization. Savvy pharmacists are embracing this opportunity to engage long-term care facility staff to improve the care of their residents...
May 1, 2017: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
https://www.readbyqxmd.com/read/28635575/-high-risk-obstetrics-in-tertiary-centres-anaesthetist-hybrid-operating-suite-and-obstetric-critical-care-unit
#18
C D van der Marel, A J Eggink, R J Stolker
The frequency of pregnancy-related morbidity has increased over recent decades, as has the number of patients with complex congenital cardiac anomalies reaching fertile age, resulting in an increasing number of high-risk pregnancies. In order to optimalise maternal and foetal outcome in these patients, not only is the availability of optimal in-hospital facilities (e.g. obstetric critical care unit, hybrid operating suite) important, but also a multidisciplinary approach which is mandatory for successful maternal and foetal outcome...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28634971/impact-of-growing-cohorts-of-adults-with-con-genital-heart-disease-on-clinical-workload-a-20-year-experience-at-a-tertiary-care-centre
#19
Maria Padrutt, Isabelle Bracher, Francesca Bonassin, Bruno Santos Lopes, Christiane Gruner, Simon F Stämpfli, Thomas Wolber, Oliver Kretschmar, Angela Oxenius, Gabriella De Pasquale, Theresa Seeliger, Thomas F Lüscher, Christine Attenhofer Jost, Matthias Greutmann
BACKGROUND: Population based studies show a steady increase in adult patients with congenital heart defects. The aim of this study was to assess the evolution of such a patient cohort and its burden on clinical care at a dedicated tertiary care centre. METHODS: All patients with congenital heart disease followed up by a dedicated multidisciplinary team at our institution were identified (n = 1725). Disease characteristics, the increase in patient numbers and interventions and the increase in selected complications were analysed and compared between the first (1996-2005) and second (2006-2015) decades of the study period...
June 21, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/28628189/-a-statement-the-polish-cardiac-society-working-group-on-pulmonary-circulation-on-screening-for-cteph-patients-after-acute-pulmonary-embolism
#20
Michał Ciurzyński, Marcin Kurzyna, Grzegorz Kopeć, Piotr Błaszczak, Łukasz Chrzanowski, Karol Kamiński, Katarzyna Mizia-Stec, Tatiana Mularek-Kubzdela, Ewa Mroczek, Andrzej Biederman, Piotr Pruszczyk, Adam Torbicki
Both pharmacological and invasive treatment of chronic thromboembolic pulmonary hypertension (CTEPH) is now available in Poland and the awareness of the disease among physicians is growing. Thus, the Polish Cardiac Society's Working Group on Pulmonary Circulation in cooperation with independent experts in this field, have launched the statement on algorithm to guide a CTEPH diagnosis in patients with previous acute pulmonary embolism (APE). In Poland, every year this disease affects about 250 patients. CTEPH should be suspected in individuals after APE with dyspnea, despite at least 3 months period of effective anticoagulation, particularly when specified risk factors are present...
2017: Kardiologia Polska
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