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https://www.readbyqxmd.com/read/28538442/impact-of-moderate-hyperchloremia-on-clinical-outcomes-in-intracerebral-hemorrhage-patients-treated-with-continuous-infusion-hypertonic-saline-a-pilot-study
#1
Heidi M Riha, Michael J Erdman, Joseph E Vandigo, Lauren A Kimmons, Nitin Goyal, K Erin Davidson, Abhi Pandhi, G Morgan Jones
OBJECTIVES: Hyperchloremia has been associated with increased morbidity and mortality in critically ill patients. While previous research has demonstrated an association between hypertonic saline and hyperchloremia, limited data exist in neurocritical care patients. The objective of this study is to determine the impact of moderate hyperchloremia (chloride ≥ 115 mmol/L) on clinical outcomes in intracerebral hemorrhage patients treated with continuous IV infusion 3% hypertonic saline...
May 22, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28533183/dedicated-research-time-during-surgery-residency-leads-to-a-significant-decline-in-self-assessed-clinical-aptitude-and-surgical-skills
#2
Monica M Grova, Anthony D Yang, Misty D Humphries, Joseph M Galante, Edgardo S Salcedo
OBJECTIVE: The surgical community commonly perceives a decline in surgical and patient care skills among residents who take dedicated time away from clinical activity to engage in research. We hypothesize that residents perceive a decline in their skills because of dedicated research time. SETTING: UC Davis Medical Center, Sacramento, CA, an institutional tertiary care center. PARTICIPANTS: General surgery residents and graduates from UC Davis general surgery residency training program, who had completed at least 1 year of research during their training...
May 19, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28531453/protected-time-for-nutrition-support-teams-what-are-the-benefits
#3
Guilherme D Ceniccola, Wilma M C Araújo, Ione de Brito-Ashurst, Henrique B Abreu, Rita de C Akutsu
BACKGROUND & AIMS: Nutrition support teams (NSTs) are important and unique entities in acute care hospitals. Despite their utility, NSTs are lacking in the majority of hospitals worldwide and where they exist, most members only spend a fraction of their time working within that role. We aim to evaluate the effect of protected time on NST performance by assessing the influence of structure and process in NST activities. METHODS: All large public hospitals (>250 beds) in the Brazilian Federal District were evaluated with a structured questionnaire designed to assess NST performance...
December 2016: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/28530252/new-trends-in-rehabilitation-of-children-with-ent-disorders
#4
R Bovo, P Trevisi, E Zanoletti, D Cazzador, T Volo, E Emanuelli, A Martini
In the last 20 years, neonatal survival has progressively increased due to the constant amelioration of neonatal medical treatment and surgical techniques. Thus, the number of children with congenital malformations and severe chronic pathologies who need rehabilitative care has progressively increased. Rehabilitation programs for paediatric patients with disorders of voice, speech and language, communication and hearing, deglutition and breathing are not widely available in hospital settings or in long-term care facilities...
May 22, 2017: Acta Otorhinolaryngologica Italica
https://www.readbyqxmd.com/read/28525830/outpatient-management-of-pulmonary-embolism
#5
REVIEW
P-M Roy, T Moumneh, A Penaloza, O Sanchez
Despite clear potential benefits of outpatient care, most patients suffering from pulmonary embolism (PE) are currently hospitalized due to the fear of possible adverse events. Nevertheless, some teams have increased or envisage to increase outpatient treatment or early discharge. We performed a narrative systematic review of studies published on this topic. We identified three meta-analyses and 23 studies, which involved 3671 patients managed at home (n=3036) or discharged early (n=535). Two main different approaches were applied to select patients eligible for outpatient in recent prospective studies, one based on a list of pragmatic criteria as the HESTIA rule, the other adding severity criteria (i...
May 4, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28521019/a-whole-system-approach-to-improving-mortality-associated-with-acute-kidney-injury
#6
Thangavelu Chandrasekar, Asheesh Sharma, Lucinda Tennent, Christopher Wong, Peter Chamberlain, Kottarathil A Abraham
BACKGROUND: Acute kidney injury (AKI) is in the main managed by non-nephrologists, many who feel challenged by or lack awareness of the complexity that the renal element adds to their patients' care. National reports have raised major concerns about the quality of care and have predicted that mortality reductions of 30% are achievable with good medical practice. AIM: This quality improvement project evaluated whether a whole system approach could improve outcomes for patients with AKI...
May 18, 2017: QJM: Monthly Journal of the Association of Physicians
https://www.readbyqxmd.com/read/28514471/addressing-the-communication-and-other-needs-of-persons-with-severe-disabilities-through-engaged-interprofessional-teams-introduction-to-a-clinical-forum
#7
Billy T Ogletree
Purpose: Interprofessional collaborative practice (IPCP) is introduced as a viable and preferred clinical methodology for speech-language pathologists and others serving persons with severe disabilities. Contributions to this clinical forum dedicated to IPCP and severe disabilities are described. Method: This clinical focus article introduces IPCP and reviews literature specific to its origins and effectiveness, defines severe disabilities, and proposes IPCP as a vital tenet in effective communication-related and other service delivery for this population...
May 17, 2017: American Journal of Speech-language Pathology
https://www.readbyqxmd.com/read/28509706/length-of-stay-mortality-cost-and-perceptions-of-care-associated-with-transition-from-an-open-to-closed-staffing-model-in-the-cardiac-intensive-care-unit
#8
Jason N Katz, Anton Lishmanov, Sean van Diepen, Dongqing Yu, Haipeng Shen, Eric Pauley, Jatin Bhatia, Adam Buntaine, Arun Das, Cristie Dangerfield, Brooke McLaughlin, George A Stouffer, Prashant Kaul
BACKGROUND: Organizational models in the intensive care unit (ICU) have classically been described as either closed or open, depending on the presence or absence of a dedicated ICU team. Although a closed model has been shown to improve patient outcomes in medical and surgical ICUs, the merits of various care models have not been previously explored in the cardiac ICU (CICU) setting. METHODS: From November 2012 to March 2014, data were prospectively collected on all admissions before and after transition from an open to closed CICU at our institution...
June 2017: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/28507916/past-present-and-future-of-kidney-paired-donation-transplantation-in-india
#9
REVIEW
Vivek B Kute, Himanshu V Patel, Pankaj R Shah, Pranjal R Modi, Veena R Shah, Sayyed J Rizvi, Bipin C Pal, Manisha P Modi, Priya S Shah, Umesh T Varyani, Pavan S Wakhare, Saiprasad G Shinde, Vijay A Ghodela, Minaxi H Patel, Varsha B Trivedi, Hargovind L Trivedi
One third of healthy willing living kidney donors are rejected due to ABO blood group incompatibility and donor specific antibody. This increases pre-transplant dialysis duration leading to increased morbidity and mortality on the kidney transplantation waiting list. Over the last decade kidney paired donation is most rapidly increased source of living kidney donors. In a kidney transplantation program dominated by living donor kidney transplantation, kidney paired donation is a legal and valid alternative strategy to increase living donor kidney transplantation...
April 24, 2017: World Journal of Transplantation
https://www.readbyqxmd.com/read/28504231/poland-coronary-and-structural-heart-interventions-from-2010-to-2015
#10
Jacek Legutko, Zbigniew Siudak, Radosław Parma, Andrzej Ochała, Dariusz Dudek
For the last five years, invasive cardiology in Poland has developed extensively. Currently, 98% of the 161 Polish cathlabs operate in 24/7 mode, 37 of them supported by cardiac surgery departments on-site. A certification curriculum for interventional cardiology operators is supported by dedicated workshops and scientific meetings during national conferences. The rise in the number of coronary angiographies and PCIs was paralleled by an increased use of drug-eluting stents, bioresorbable vascular scaffolds and physiologic assessment of coronary arteries...
May 15, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28496361/improved-immediate-breast-reconstruction-as-a-result-of-oncoplastic-multidisciplinary-meeting
#11
Mohsen M El Gammal, Maria Lim, Rajan Uppal, Richard Sainsbury
INTRODUCTION: The National Institute for Health and Clinical Excellence guidelines recommend that breast reconstruction should be available to all women undergoing mastectomy and discussed at the initial surgical consultation (2002, and updated 2009). The National Mastectomy and Breast Reconstruction Audit (2009) showed that 21% of mastectomy patients underwent immediate breast reconstruction (IBR) and 11% had delayed breast reconstruction (DBR). Breast reconstruction has been shown to have a positive effect on quality of life postmastectomy...
2017: Breast Cancer: Targets and Therapy
https://www.readbyqxmd.com/read/28477319/transition-of-care-in-congenital-heart-disease-ensuring-the-proper-handoff
#12
REVIEW
Angela Lee, Barbara Bailey, Geraldine Cullen-Dean, Sandra Aiello, Joanne Morin, Erwin Oechslin
BACKGROUND: With great advances in medical and surgical care, most congenital heart disease patients are living in to adulthood and require lifelong surveillance and expert care for adult onset complications. Care lapse and lack of successful transfer from pediatric to adult care put young adults at risk for increased morbidity and premature death. Hence, transition and transfer from pediatric to adult care is a crucial and critical process to provide access to specialized care and lifelong surveillance...
June 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/28473673/feasibility-of-implementing-chronic-care-model-in-the-malaysian-public-primary-care-setting
#13
F Ariffin, A S Ramli, M H Daud, J Haniff, S Abdul-Razak, S Selvarajah, V K Lee, S F Tong, M A Bujang
INTRODUCTION: Non-communicable diseases (NCD) is a global health threat. the Chronic Care Model (CCM) was proven effective in improving NCD management and outcomes in developed countries. Evidence from developing countries including Malaysia is limited and feasibility of CCM implementation has not been assessed. this study intends to assess the feasibility of public primary health care clinics (PHC) in providing care according to the CCM. METHODOLOGY: A cross-sectional survey was conducted to assess the public PHC ability to implement the components of CCM...
April 2017: Medical Journal of Malaysia
https://www.readbyqxmd.com/read/28472313/implementing-evidence-based-palliative-care-programs-and-policy-for-cancer-patients-epidemiologic-and-policy-implications-of-the-2016-american-society-of-clinical-oncology-clinical-practice-guideline-update
#14
Sarina R Isenberg, Rebecca A Aslakson, Thomas J Smith
The American Society of Clinical Oncology (ASCO) recently convened an Ad Hoc Palliative Care Expert Panel to update a 2012 provisional clinical opinion by conducting a systematic review of clinical trials in palliative care in oncology. The key takeaways from the updated ASCO clinical practice guidelines (CPGs) are that more people should be referred to interdisciplinary palliative care teams and that more palliative care specialists and palliative care-trained oncologists are needed to meet this demand. The following summary statement is based on multiple randomized clinical trials: "Inpatients and outpatients with advanced cancer should receive dedicated palliative care services, early in the disease course, concurrent with active treatment...
January 1, 2017: Epidemiologic Reviews
https://www.readbyqxmd.com/read/28471619/role-of-emergency-magnetic-resonance-imaging-for-the-workup-of-suspected-appendicitis-in-pregnant-women
#15
Michal M Amitai, Eldad Katorza, Larisa Guranda, Sara Apter, Orith Portnoy, Yael Inbar, Eli Konen, Eyal Klang, Yael Eshet
BACKGROUND: Pregnant women with acute abdominal pain pose a diagnostic challenge. Delay in diagnosis may result in significant risk to the fetus. The preferred diagnostic modality is magnetic resonance imaging (MRI), since ultrasonography is often inconclusive, and computed tomography (CT) would expose the fetus to ionizing radiation. OBJECTIVES: To describe the process in setting up an around-the-clock MRI service for diagnosing appendicitis in pregnant women and to evaluate the contribution of abdominal MR in the diagnosis of acute appendicitis...
October 2016: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/28471604/a-dedicated-follow-up-clinic-for-brca-mutation-carriers
#16
Rinat Yerushalmi, Shulamith Rizel, Dalia Zoref, Eran Sharon, Ram Eitan, Gad Sabah, Ahuva Grubstein, Yael Rafson, Maya Cohen, Ada Magen, Iehudit Birenboim, David Margel, Rachel Ozlavo, Aaron Sulkes, Baruch Brenner, Shlomit Perry
Women who carry the BRCA gene mutation have an up to 80% chance of developing cancer, primarily of breast and ovarian origin. Confirmation of carrier status is described by many women as an overwhelming, life-changing event. Healthy individuals harboring a BRCA mutation constitute a high risk population with unique needs, often overlooked by health authorities. As such, we felt the need to create a specialized service dedicated specifically to this high risk population. The clinic staff comprises an experienced multidisciplinary team of health professionals who can support the medical and emotional needs of this population...
September 2016: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/28470637/-antimicrobial-stewardship-in-daily-life-ask-your-doctor-and-your-pharmacist
#17
Anette Friedrichs, Bibiane Steinborn, Swantje Eisend
Antimicrobial Stewardship (AMS) cannot be practised as a one-man show. A well-established AMS-team with formal authority and dedicated time given by the hospital management can manage its tasks also in exceptional situations as for example an outbreak due to a multi-drug-resistant pathogen. Know-how of clinical infectious diseases is mandatory for all members of the AMS-team. The AMS-team plays various roles in an outbreak situation with the rational use of last-resort antibiotics and optimization of the dosage by therapeutic drug monitoring being most important...
April 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/28468272/clinical-correlates-and-prognostic-value-of-plasma-galectin-3-levels-in-degenerative-aortic-stenosis-a-single-center-prospective-study-of-patients-referred-for-invasive-treatment
#18
Beata Bobrowska, Ewa Wieczorek-Surdacka, Olga Kruszelnicka, Bernadeta Chyrchel, Andrzej Surdacki, Dariusz Dudek
Galectin-3 (Gal-3), a β-galactoside-binding lectin, has been implicated in myocardial fibrosis, development of left ventricular (LV) dysfunction and transition from compensated LV hypertrophy to overt heart failure (HF), being a novel prognostic marker in HF. Risk stratification is crucial for the choice of the optimal therapy in degenerative aortic stenosis (AS), affecting elderly subjects with coexistent diseases. Our aim was to assess correlates and prognostic value of circulating Gal-3 in real-world patients with degenerative AS referred for invasive treatment...
April 29, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28467132/interprofessional-team-based-placements-the-importance-of-space-place-and-facilitation
#19
Margo L Brewer, Helen Louise Flavell, Joanne Jordon
Interprofessional education in practice settings typically requires greater resource investment than in the classroom or online. Increased interest in return on investment means research on the outcomes of practice-based interprofessional education is needed. In this article, we report findings from a qualitative study involving a series of focus groups with health sciences' students during their interprofessional placements in three community health settings in Western Australia. An exploratory case study approach was adopted to determine students' perceptions of the placement and their learning...
May 3, 2017: Journal of Interprofessional Care
https://www.readbyqxmd.com/read/28461024/care-management-in-amyotrophic-lateral-sclerosis
#20
REVIEW
M-H Soriani, C Desnuelle
Amyotrophic lateral sclerosis (ALS) is a relentlessly progressive and fatal neurodegenerative disease characterized by progressive weakness of voluntary muscles of movement as well as those for swallowing, speech and respiration. In the absence of curative treatment, care can improve quality of life, prolong survival, and support ALS patients and their families, and also help them to anticipate and prepare for the end of life. Multidisciplinary management in tertiary centers is recommended in close collaboration with general practitioners, home carers and a dedicated health network...
April 28, 2017: Revue Neurologique
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