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https://www.readbyqxmd.com/read/28922228/anesthesia-capacity-in-ghana-a-teaching-hospital-s-resources-and-the-national-workforce-and-education
#1
Mark A Brouillette, Alfred J Aidoo, Maria A Hondras, Nana A Boateng, Akwasi Antwi-Kusi, William Addison, Alec R Hermanson
BACKGROUND: Quality anesthetic care is lacking in low- and middle-income countries (LMICs). Global health leaders call for perioperative capacity reports in limited-resource settings to guide improved health care initiatives. We describe a teaching hospital's resources and the national workforce and education in this LMIC capacity report. METHODS: A prospective observational study was conducted at Komfo Anokye Teaching Hospital (KATH) in Kumasi, Ghana, during 4 weeks in August 2016...
September 14, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28918297/a-rare-case-of-spontaneous-rupture-of-an-aneurysm-of-the-right-gastric-artery
#2
Yu-Ki Takemoto, Nobuaki Fujikuni, Kazuaki Tanabe, Hironobu Amano, Toshio Noriyuki, Masahiro Nakahara
BACKGROUND: Visceral artery aneurysms at the origin of the gastric and gastroepiploic artery are uncommon. Raptured visceral aneurysms cause high mortality and require urgent and adequate intervention and treatment. PRESENTATION OF CASE: A 65-year-old woman was transferred to the emergency department with sudden abdominal and back pain. Radiographically, we diagnosed intra-abdominal bleeding due to a ruptured aneurysm of the right gastric artery. Although her vital signs were relatively stable, transcatheter arterial embolization (TAE) could not be performed due to thrombotic occlusion of her abdominal aorta, and bilateral axillary arteries...
September 1, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28916436/treating-overactive-bladder-in-older-patients-with-a-combination-of-mirabegron-and-solifenacin-a-prespecified-analysis-from-the-beside-study
#3
William Gibson, Scott MacDiarmid, Moses Huang, Emad Siddiqui, Matthias Stölzel, Nurul Choudhury, Marcus J Drake
BACKGROUND: The BESIDE study demonstrated that combination therapy (mirabegron and solifenacin 5mg) improved overactive bladder symptoms versus solifenacin 5mg or 10mg, and was well tolerated. OBJECTIVE: To ensure efficacy and safety is maintained in older patients (>65 yr), who usually experience greater symptom severity and comorbidities, a prespecified subanalysis stratified by age group was conducted. DESIGN, SETTING, AND PARTICIPANTS: Patients remaining incontinent (≥1 episode during 3-d diary) following 4-wk single-blind daily solifenacin 5mg were randomized 1:1:1 to a daily double-blind combination (solifenacin 5mg and mirabegron 25mg, increased to 50mg at wk 4), solifenacin 5mg or 10mg for 12 wk...
September 12, 2017: European Urology Focus
https://www.readbyqxmd.com/read/28916175/early-sepsis-detection-in-critical-care-patients-using-multiscale-blood-pressure-and-heart-rate-dynamics
#4
Supreeth P Shashikumar, Matthew D Stanley, Ismail Sadiq, Qiao Li, Andre Holder, Gari D Clifford, Shamim Nemati
Sepsis remains a leading cause of morbidity and mortality among intensive care unit (ICU) patients. For each hour treatment initiation is delayed after diagnosis, sepsis-related mortality increases by approximately 8%. Therefore, maximizing effective care requires early recognition and initiation of treatment protocols. Antecedent signs and symptoms of sepsis can be subtle and unrecognizable (e.g., loss of autonomic regulation of vital signs), causing treatment delays and harm to the patient. In this work we investigated the utility of high-resolution blood pressure (BP) and heart rate (HR) times series dynamics for the early prediction of sepsis in patients from an urban, academic hospital, meeting the third international consensus definition of sepsis (sepsis-III) during their ICU admission...
August 16, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/28915898/physician-staffed-helicopter-emergency-medical-service-has-a-beneficial-impact-on-the-incidence-of-prehospital-hypoxia-and-secured-airways-on-patients-with-severe-traumatic-brain-injury
#5
Toni Pakkanen, Antti Kämäräinen, Heini Huhtala, Tom Silfvast, Jouni Nurmi, Ilkka Virkkunen, Arvi Yli-Hankala
BACKGROUND: After traumatic brain injury (TBI), hypotension, hypoxia and hypercapnia have been shown to result in secondary brain injury that can lead to increased mortality and disability. Effective prehospital assessment and treatment by emergency medical service (EMS) is considered essential for favourable outcome. The aim of this study was to evaluate the effect of a physician-staffed helicopter emergency medical service (HEMS) in the treatment of TBI patients. METHODS: This was a retrospective cohort study...
September 15, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28915163/do-prehospital-providers-and-emergency-nurses-agree-on-triage-assignment-an-efficacy-study
#6
Helene Skjøt-Arkil, Louise L Pontoppidan, Jens O Laursen, Matthias Giebner, Jesper D Andersen, Christian B Mogensen
OBJECTIVES: The aim of this study was to investigate the agreement on triage level between prehospital providers and emergency department (ED) nurses in clinical practice when using the same triage system. The objectives were as follows: (a) What is the agreement of triage between prehospital providers and ED nurses, when using Danish Emergency Process Triage (DEPT) correctly? (b) Which part of the triage process yields the highest agreement regarding the final triage? METHODS: The study was a prospective and observational efficacy study...
September 14, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28913951/rapid-response-team-patients-triaged-to-remain-on-ward-despite-deranged-vital-signs-missed-opportunities
#7
J Tirkkonen, T Kontula, S Hoppu
BACKGROUND: Rapid response teams (RRTs) triage most patients to stay on ward, even though some of them have deranged vital signs according to RRTs themselves. We investigated the prevalence and outcome of this RRT patient cohort. METHODS: A prospective observational study was conducted in a Finnish tertiary referral centre, Tampere University Hospital. Data on RRT activations were collected between 1 May 2012 and 30 April 2015. Vital signs of patients triaged to stay on ward without treatment limitations were classified according to objective RRT trigger criteria observed during the reviews...
September 15, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28912927/the-sixth-vital-sign-body-mass-index-in-patients-with-sickle-cell-disease
#8
Samir K Ballas
No abstract text is available yet for this article.
October 2017: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/28912083/nasogastric-decompression-not-associated-with-a-reduction-in-surgery-or-bowel-ischemia-for-acute-small-bowel-obstruction
#9
Daniel J Berman, Hamza Ijaz, Mohammad Alkhunaizi, Paige E Kulie, Khashayar Vaziri, Lorna M Richards, Andrew C Meltzer
OBJECTIVES: Small bowel obstructions (SBOs) occur 300,000 times annually leading to $1.3 billion in cost. Approximately 20% of patients require a laparotomy to manage the obstruction and either prevent or treat intestinal ischemia. Early management may play a role in reducing these complications. Nasogastric decompression is commonly used for early management. Our primary objective was to determine if NGD was associated with lower rates of surgery, bowel ischemia or length of stay. METHODS: We retrospectively enrolled 181 ED patients with SBO from 9/2013 to 9/2015 in order to determine if nasogastric decompression was associated with a reduction in rates of surgery, bowel ischemia or hospital length of stay...
August 15, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28911048/what-can-different-motor-circuits-tell-us-about-psychosis-an-rdoc-perspective
#10
Vijay A Mittal, Jessica A Bernard, Georg Northoff
Signs of motor dysfunction are evidenced across a range of psychiatric disorders including schizophrenia. Historically, these features have been neglected but emerging theoretical and methodological advancements have shed new light on the utility of considering movement abnormalities. Indeed, the National Institute of Mental Health Research Domain Criteria initiative has recently met to develop a Motor Systems Domain. This reflects a growing appreciation for the enhanced reliability and validity that can come along with evaluating disturbances relevant to psychiatric illnesses from multiple levels of analysis, and conceptualizing these domains with respect to the complexity of their role in a broader integrated system (ie, weighing contributions and interactions between the cognitive, affective, and motor domains)...
September 1, 2017: Schizophrenia Bulletin
https://www.readbyqxmd.com/read/28906367/predicting-the-mortality-in-geriatric-patients-with-dengue-fever
#11
Hung-Sheng Huang, Chien-Chin Hsu, Je-Chiuan Ye, Shih-Bin Su, Chien-Cheng Huang, Hung-Jung Lin
Geriatric patients have high mortality for dengue fever (DF); however, there is no adequate method to predict mortality in geriatric patients. Therefore, we conducted this study to develop a tool in an attempt to address this issue.We conducted a retrospective case-control study in a tertiary medical center during the DF outbreak in Taiwan in 2015. All the geriatric patients (aged ≥65 years) who visited the study hospital between September 1, 2015, and December 31, 2015, were recruited into this study. Variables included demographic data, vital signs, symptoms and signs, comorbidities, living status, laboratory data, and 30-day mortality...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28905271/pharmacokinetics-of-a-new-oral-vitamin-d-receptor-activator-2-methylene-19-nor-20s-1%C3%AE-25-dihydroxyvitamin-d3-in-patients-with-chronic-kidney-disease-and-secondary-hyperparathyroidism-on-hemodialysis
#12
Richa Pandey, Julia B Zella, Jinge G Zhu, Lori A Plum, Margaret Clagett-Dame, William J Blaser, Wendy Bedale, Hector F DeLuca, Daniel W Coyne
BACKGROUND: 2-Methylene-19-nor-(20S)-1α,25-dihydroxyvitamin D3 (DP001 or 2MD) is a novel, potent 1α-hydroxylated vitamin D analog that binds to the vitamin D receptor and suppresses parathyroid hormone synthesis and secretion with potential for an improved safety profile compared to existing active vitamin D analogs. The purpose of this study was to evaluate the pharmacokinetics of DP001 given orally after hemodialysis. METHODS: DP001 (550 ng) was given orally to 11 hemodialysis patients with secondary hyperparathyroidism after each dialysis session (3 times/week) for 4 weeks...
September 13, 2017: Drugs in R&D
https://www.readbyqxmd.com/read/28904876/heart-rate-is-associated-with-mortality-in-patients-undergoing-continuous-renal-replacement-therapy
#13
Soojin Lee, Yeonhee Lee, Heejoon Jang, Hongran Moon, Dong Ki Kim, Seung Seok Han
BACKGROUND: Heart rate (HR) is an essential vital sign based on the finding that HR beyond its normal range is associated with several conditions or diseases, including high mortality in several clinical settings. Nevertheless, the clinical implications of HR remain unresolved in patients undergoing continuous renal replacement therapy (CRRT). METHODS: This retrospective cohort study included 828 patients who underwent CRRT due to acute kidney injury between 2010 and 2014...
September 2017: Kidney Research and Clinical Practice
https://www.readbyqxmd.com/read/28900525/a-case-of-legionella-pneumophila-evaluated-with-ct-and-ultrasound
#14
Alessio D'Angelo, Chiara De Simone, Marco Pagnottella, Stefano Rossi, Raffaele Pepe, Giacomo Ruggieri, Giulio Cocco, Cosima Schiavone
A 36-year-old man was admitted to the emergency department of "SS Annunziata" hospital in Chieti complaining of a sharp chest pain arisen some hours before admission. On examination, the patient looked sweaty; his vital signs showed tachycardia and augmented breath rate; sinus tachycardia and normal ventricular repolarization were observed on ECG, and no abnormalities were observed in the echoscan of the hearth. According to the clinical and electrocardiographic findings, and to previous episode of DVT in anamnesis, a thorax CT scan was performed in order to rule out pulmonary embolism...
September 2017: Journal of Ultrasound
https://www.readbyqxmd.com/read/28898557/improved-survival-for-rural-trauma-patients-transported-by-helicopter-to-a-verified-trauma-center-a-propensity-score-analysis
#15
Thein Hlaing Zhu, Lisa Hollister, Dazar Opoku, Samuel M Galvagno
OBJECTIVES: Recent studies using advanced statistical methods to control for confounders have demonstrated an association between helicopter transport (HT) vs. ground ambulance transport (GT) in terms of improved survival for adult trauma patients. The aim of this study was to apply a methodologically vigorous approach to determine if HT is associated with a survival benefit for when trauma patients are transported to a verified trauma center in a rural setting. METHODS: The ascertainment of trauma patients age ≥15 years (n=469 cases) by HT and (n=580 cases) by GT between 1999 and 2012 was restricted to the scene of injury in a rural area of 10 to 35 miles from the trauma center...
September 12, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28895436/evaluation-of-normative-data-of-a-widely-used-computerized-neuropsychological-battery-applicability-and-effects-of-sociodemographic-variables-in-a-dutch-sample
#16
Sophie J M Rijnen, Ikram Meskal, Wilco H M Emons, Carlijn A M Campman, Sophie D van der Linden, Karin Gehring, Margriet M Sitskoorn
INTRODUCTION: Central Nervous System Vital Signs (CNS VS) is a computerized neuropsychological battery that is translated into many languages. However, published CNS VS' normative data were established over a decade ago, are solely age-corrected, and collected in an American population only. METHOD: Mean performance of healthy Dutch participants on CNS VS was compared with the original CNS VS norms ( N = 1,069), and effects of sociodemographic variables were examined...
September 1, 2017: Assessment
https://www.readbyqxmd.com/read/28895021/k-band-doppler-radar-for-contact-less-overnight-sleep-marker-assessment-a-pilot-validation-study
#17
Rakesh Vasireddy, Corinne Roth, Johannes Mathis, Josef Goette, Marcel Jacomet, Andreas Vogt
An estimated 45 million persons in Europe are annually subjected to sleep-wake disorders. State-of-the-art polysomnography provides sophisticated insights into sleep (patho)physiology. A drawback of the method, however, is the obtrusive setting dependent on a clinical-based sleep laboratory with high operational costs. A contact-less prototype was developed to monitor limb movements and vital signs during sleep. A dual channel K-band Doppler radar transceiver captured limb movements and periodic chest wall motion due to respiration and heart activity...
September 11, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28894538/the-effect-of-music-on-pain-and-vital-signs-of-children-before-and-after-endoscopy
#18
Alireza Sabzevari, Hamidreza Kianifar, Seyed Ali Jafari, Masumeh Saeidi, Hamid Ahanchian, Mohammad Ali Kiani, Lida Jarahi
BACKGROUND AND AIM: Gentle music has relaxing and pain reducing effects. In this study, the effect of music on patients' vital signs and pain was investigated before and after endoscopy. METHODS: This clinical trial study was conducted on 100 children from seven to fourteen years of age in Gha'em Hospital, Mashhad in 2015. Children were divided into two equal groups (case group=50 and control group=50). The control group received endoscopy according to the standards, without any other procedure...
July 2017: Electronic Physician
https://www.readbyqxmd.com/read/28893209/preliminary-experience-in-laparoscopic-resection-of-hepatic-hydatidectocyst-with-the-da-vinci-surgical-system-dvss-a-case-report
#19
Haibo Zou, Lanyun Luo, Hua Xue, Guan Wang, Xiankui Wang, Le Luo, Yutong Yao, Guangming Xiang, Xiaolun Huang
BACKGROUND: At present, Da Vinci robotic assisted hepatectomy has been routinely carried out in conditional units. But there is no report concerning the use of Da Vinci robots for hepatic hydatid cystectomy and experience on this aspect is seldom mentioned before. This study was to summarize the preliminary experience in laparoscopic resection of hepatic hydatidectocyst with the Da Vinci Surgical System (DVSS). CASE PRESENTATION: A 29-year-old female diagnosed as hepatic hydatid in the right anterior lobe of liver was treated with laparoscopic resection by the DVSS under general anesthesia...
September 11, 2017: BMC Surgery
https://www.readbyqxmd.com/read/28891198/targeted-medical-nutrition-for-cachexia-in-chronic-obstructive-pulmonary-disease-a-randomized-controlled-trial
#20
Philip C Calder, Alessandro Laviano, Fredrik Lonnqvist, Maurizio Muscaritoli, Maria Öhlander, Annemie Schols
BACKGROUND: Cachectic patients with chronic obstructive pulmonary disease (COPD) may benefit from nutritional support. This double-blind, randomized, controlled trial evaluated the safety and efficacy of targeted medical nutrition (TMN) vs. an isocaloric comparator in pre-cachectic and cachectic patients with COPD. METHODS: Patients aged ≥50 years with moderate-to-severe COPD and involuntary weight loss or low body mass index (16-18 kg/m(2) ) were randomized 1:1 to receive TMN (~230 kcal; 2 g omega-3 fatty acids; 10 μg 25-hydroxy-vitamin D3) or isocaloric comparator twice daily for 12 weeks (ClinicalTrials...
September 10, 2017: Journal of Cachexia, Sarcopenia and Muscle
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