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https://www.readbyqxmd.com/read/28644930/trends-in-open-and-endoscopic-cubital-tunnel-release-in-the-medicare-patient-population
#1
Tsun Yee Law, Zachary S Hubbard, Lee Onn Chieng, Harvey W Chim
BACKGROUND: Cubital tunnel syndrome (CUT) is the second most common peripheral neuropathy with an annual incidence of 24.7 per 100 000, affecting nearly twice as many men as women. With increasing focus on cost-effectiveness and cost-containment in medicine, a critical understanding of utilization of health care resources for open and endoscopic approaches for cubital tunnel release is of value. The purpose of this study was to evaluate the costs and utilization trends of open and endoscopic cubital tunnel release...
July 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28641321/identifying-and-acting-on-potentially-inappropriate-care-inadequacy-of-current-hospital-coding-for-this-task
#2
P David Cooper, David R Smart
INTRODUCTION: Recent Australian attempts to facilitate disinvestment in healthcare, by identifying instances of 'inappropriate' care from large Government datasets, are subject to significant methodological flaws. Amongst other criticisms has been the fact that the Government datasets utilized for this purpose correlate poorly with datasets collected by relevant professional bodies. Government data derive from official hospital coding, collected retrospectively by clerical personnel, whilst professional body data derive from unit-specific databases, collected contemporaneously with care by clinical personnel...
June 2017: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/28638515/use-of-fellow-as-clinical-teacher-fact-curriculum-for-teaching-during-consultation-effect-on-subspecialty-fellow-teaching-skills
#3
Eli M Miloslavsky, Kathleen Degnan, Jenna McNeill, Jakob I McSparron
BACKGROUND: Subspecialty consultation in inpatient care is increasing. Teaching by subspecialty fellows in a consultation setting may be an important source of work-based learning for students and residents. However, teaching and evaluation of learners in this context may be challenging due to personal and systems-based barriers. OBJECTIVE: We developed and evaluated a framework designed to overcome barriers to teaching and to improve fellow teaching skills during inpatient consultation...
June 2017: Journal of Graduate Medical Education
https://www.readbyqxmd.com/read/28637683/an-environmental-scan-of-quality-indicators-in-critical-care
#4
Sabira Valiani, Romain Rigal, Henry T Stelfox, John Muscedere, Claudio M Martin, Peter Dodek, François Lamontagne, Robert Fowler, Afshan Gheshmy, Deborah J Cook, Alan J Forster, Paul C Hébert
BACKGROUND: We performed a directed environmental scan to identify and categorize quality indicators unique to critical care that are reported by key stakeholder organizations. METHODS: We convened a panel of experts (n = 9) to identify key organizations that are focused on quality improvement or critical care, and reviewed their online publications and website content for quality indicators. We identified quality indicators specific to the care of critically ill adult patients and then categorized them according to the Donabedian and the Institute of Medicine frameworks...
June 21, 2017: CMAJ Open
https://www.readbyqxmd.com/read/28633904/clinical-characteristics-of-type-a-acute-aortic-dissection-with-symptom-of-the-central-nervous-system
#5
Yuji Shono, Tomohiko Akahoshi, Satomi Mezuki, Kenta Momii, Noriyuki Kaku, Jun Maki, Kentaro Tokuda, Tetsuro Ago, Takanari Kitazono, Yoshihiko Maehara
BACKGROUND AND PURPOSE: Accurate diagnosis of acute aortic dissection (AAD) is sometimes difficult because of accompanying central nervous system (CNS) symptoms. The purpose of this study was to investigate the clinical characteristics of Type A AAD (TAAAD) with CNS symptoms. METHODS: We retrospectively reviewed the medical records of 8403 patients ambulanced to our emergency and critical care center between April 2009 and May 2014. RESULTS: We identified 59 TAAAD patients for the analysis (mean age, 67...
June 6, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28627845/efficacy-of-interprofessionnality-evidence-and-challenges
#6
Valérie Santschi, Philippe Germanier, Joëlle Tischhauser, Nicolas Senn, Alain Pecoud
Skillmix is often proposed as a measure to address the growing needs of an aging population with its expected increase in chronic diseases. This article reports on a symposium on interprofessional collaboration which took place in the canton of Valais in Switzerland. Reviews of the literature on interprofessional collaboration show evidence in favor of the effectiveness of having interactions between physicians, nurses, pharmacists and physiotherapists. A critical analysis of different forms of coordinated care within family medicine supports the effectiveness of these approaches...
May 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28625250/-fulminant-clostridium-difficile-colitis-new-challenges-in-critical-care-medicine
#7
Bin Liu
Fulminant Clostridium difficile colitis (FCDC) means severe Clostridium difficile colitis (CDC), which often manifested with severe diarrhea, fever, abdominal distention, electrolyte disorder, hypoalbuminemia, and it can lead to pseudo membrane colonitis, toxic megacolon, bowel perforation, septic shock, and multiple organ dysfunction. Now Clostridium difficile (CD) becomes one of the most important medical institutions related infectious pathogens. In particular, the recently discovered mutant CD strain NAP1/BI/ribotype 027 has high pathogenicity in the global epidemic and its outbreak...
June 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28620467/recent-advances-in-understanding-lung-function-development
#8
REVIEW
Erik Melén, Stefano Guerra
Recent years have witnessed critical contributions to our understanding of the determinants and long-term implications of lung function development. In this article, we review studies that have contributed to advances in understanding lung function development and its critical importance for lung health into adult life. In particular, we have focused on early life determinants that include genetic factors, perinatal events, environmental exposures, lifestyle, infancy lower respiratory tract infections, and persistent asthma phenotypes...
2017: F1000Research
https://www.readbyqxmd.com/read/28612089/the-intensive-care-delirium-research-agenda-a-multinational-interprofessional-perspective
#9
REVIEW
Pratik P Pandharipande, E Wesley Ely, Rakesh C Arora, Michele C Balas, Malaz A Boustani, Gabriel Heras La Calle, Colm Cunningham, John W Devlin, Julius Elefante, Jin H Han, Alasdair M MacLullich, José R Maldonado, Alessandro Morandi, Dale M Needham, Valerie J Page, Louise Rose, Jorge I F Salluh, Tarek Sharshar, Yahya Shehabi, Yoanna Skrobik, Arjen J C Slooter, Heidi A B Smith
Delirium, a prevalent organ dysfunction in critically ill patients, is independently associated with increased morbidity. This last decade has witnessed an exponential growth in delirium research in hospitalized patients, including those critically ill, and this research has highlighted that delirium needs to be better understood mechanistically to help foster research that will ultimately lead to its prevention and treatment. In this invited, evidence-based paper, a multinational and interprofessional group of clinicians and researchers from within the fields of critical care medicine, psychiatry, pediatrics, anesthesiology, geriatrics, surgery, neurology, nursing, pharmacy, and the neurosciences sought to address five questions: (1) What is the current standard of care in managing ICU delirium? (2) What have been the major recent advances in delirium research and care? (3) What are the common delirium beliefs that have been challenged by recent trials? (4) What are the remaining areas of uncertainty in delirium research? (5) What are some of the top study areas/trials to be done in the next 10 years? Herein, we briefly review the epidemiology of delirium, the current best practices for management of critically ill patients at risk for delirium or experiencing delirium, identify recent advances in our understanding of delirium as well as gaps in knowledge, and discuss research opportunities and barriers to implementation, with the goal of promoting an integrated research agenda...
June 13, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28604159/spiritual-care-in-the-intensive-care-unit-a-narrative-review
#10
Jim Q Ho, Christopher D Nguyen, Richard Lopes, Stephen C Ezeji-Okoye, Ware G Kuschner
Spiritual care is an important component of high-quality health care, especially for critically ill patients and their families. Despite evidence of benefits from spiritual care, physicians and other health-care providers commonly fail to assess and address their patients' spiritual care needs in the intensive care unit (ICU). In addition, it is common that spiritual care resources that can improve both patient outcomes and family member experiences are underutilized. In this review, we provide an overview of spiritual care and its role in the ICU...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28602557/recurrent-failings-of-medical-humanitarianism-intractable-ignored-or-just-exaggerated
#11
REVIEW
Sandro Colombo, Enrico Pavignani
Humanitarian health workers operate in dangerous and uncertain contexts, in which mistakes and failures are common, often have severe consequences, and are regularly repeated, despite being documented by many reviews. This Series paper aims to discuss the failures of medical humanitarianism. We describe why some of these recurrent failings, which are often not identified until much later, seem intractable: they are so entrenched in humanitarian action that they cannot be addressed by simple technical fixes...
June 7, 2017: Lancet
https://www.readbyqxmd.com/read/28599300/cancer-and-the-kidney-dangereoux-liasons-or-price-paid-for-the-progress-in-medicine
#12
REVIEW
Jolanta Małyszko, Leszek Kozlowski, Klaudia Kozłowska, Maciej Małyszko, Jacek Małyszko
A long time ago, the links between renal disease and malignancy were observed, however, quite recently, their importance was recognized and 'new' subspecialty in nephrology, namely 'onconephrology' was established. In the XXI century, patients with malignancy make up the most growing number of the subjects seen for nephrology consult and/or critical care nephrology services. A plethora of renal problems may be found in patients with malignancy. They may influence not only their short-term outcomes but also the adequate therapy of the underlying oncological problem...
May 23, 2017: Oncotarget
https://www.readbyqxmd.com/read/28598866/using-qualitative-research-to-inform-development-of-professional-guidelines-a-case-study-of-the-society-of-critical-care-medicine-family-centered-care-guidelines
#13
Maureen A Coombs, Judy E Davidson, Mark E Nunnally, Mary A Wickline, J Randall Curtis
OBJECTIVES: To explore the importance, challenges, and opportunities using qualitative research to enhance development of clinical practice guidelines, using recent guidelines for family-centered care in the ICU as an example. METHODS: In developing the Society of Critical Care Medicine guidelines for family-centered care in the neonatal ICU, PICU, and adult ICU, we developed an innovative adaptation of the Grading of Recommendations, Assessments, Development and Evaluations approach to explicitly incorporate qualitative research...
June 8, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28597121/current-research-priorities-in-perioperative-intensive-care-medicine
#14
REVIEW
Michael A Gillies, Michael Sander, Andrew Shaw, Duminda N Wijeysundera, John Myburgh, Cesar Aldecoa, Ib Jammer, Suzana M Lobo, Naomi Pritchard, Michael P W Grocott, Marcus J Schultz, Rupert M Pearse
INTRODUCTION: Surgical treatments are offered to more patients than ever before, and increasingly to older patients with chronic disease. High-risk patients frequently require critical care either in the immediate postoperative period or after developing complications. The purpose of this review was to identify and prioritise themes for future research in perioperative intensive care medicine. METHODS: We undertook a priority setting process (PSP). A panel was convened, drawn from experts representing a wide geographical area, plus a patient representative...
June 8, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28595818/do-not-resuscitate-orders-and-high-risk-pediatric%C3%A2-surgery-professional-nuisance-or%C3%A2-medical%C3%A2-necessity
#15
Lauren M Baumann, Kibileri Williams, Fizan Abdullah, Richard J Hendrickson, Tolulope A Oyetunji
BACKGROUND: There is a paucity of data in the literature regarding end-of-life care and do-not-resuscitate (DNR) status of the pediatric surgical patient, although invasive procedures are frequently performed in very high risk and critically ill children. Despite significant efforts in adult medicine to enhance discussions around end-of-life care, little is known about similar endeavors in the pediatric population. METHODS: A retrospective review of the National Surgical Quality Improvement Program Pediatric database was performed...
May 11, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28588969/it-is-time-to-revise-the-international-good-clinical-practices-guidelines-recommendations-from-non-commercial-north-south-collaborative-trials
#16
Raffaella Ravinetto, Halidou Tinto, Ermias Diro, Joseph Okebe, Yodi Mahendradhata, Suman Rijal, Eduardo Gotuzzo, Pascal Lutumba, Alain Nahum, Katelijne De Nys, Minne Casteels, Marleen Boelaert
The Good Clinical Practices (GCP) codes of the WHO and the International Conference of Harmonization set international standards for clinical research. But critics argue that they were written without consideration for the challenges faced in low and middle income countries (LMICs). Based on our field experience in LMICs, we developed a non-exhaustive set of recommendations for the improvement of GCP. These cover 3 domains: ethical, legal and operational, and 8 specific issues: the double ethical review of 'externally sponsored' trials; the informed consent procedure in minors and in illiterate people; post-trial access to newly-developed products for the trial communities; the role of communities as key research actors; the definition of sponsor; and the guidance for contractual agreements, laboratory quality management systems, and quality assurance of investigational medicinal products...
November 2016: BMJ Global Health
https://www.readbyqxmd.com/read/28583149/effect-sizes-in-ongoing-randomized-controlled-critical-care-trials
#17
Elliott E Ridgeon, Rinaldo Bellomo, Scott K Aberegg, Rob Mac Sweeney, Rachel S Varughese, Giovanni Landoni, Paul J Young
BACKGROUND: An important limitation of many critical care trial designs is that they hypothesize large, and potentially implausible, reductions in mortality. Interpretation of trial results could be improved by systematic assessment of the plausibility of trial hypotheses; however, such assessment has not been attempted in the field of critical care medicine. The purpose of this study was to determine clinicians' views about prior probabilities and plausible effect sizes for ongoing critical care trials where the primary endpoint is landmark mortality...
June 5, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28576416/tools-for-predicting-clinical-and-patient-reported-outcomes-in-prostate-cancer-patients-undergoing-androgen-deprivation-therapy-a-systematic-review-of-prognostic-accuracy-and-validity
#18
REVIEW
Jared M Campbell, Michael E O'Callaghan, Elspeth Raymond, Andrew D Vincent, Kerri R Beckmann, David Roder, Sue Evans, John McNeil, Jeremy Millar, John Zalcberg, Martin Borg, Kim L Moretti
Androgen deprivation therapy (ADT) can result in a range of adverse symptoms that reduce patients' quality of life. Careful patient counseling on the likely clinical outcomes and adverse effects is therefore vital. The present systematic review was undertaken to identify and characterize all the tools used for the prediction of clinical and patient-reported outcome measures (PROMs) in patients with prostate cancer undergoing ADT. PubMed and EMBASE were systematically searched from 2007 to 2016. Search terms related to the inclusion criteria were: prostate cancer, clinical outcomes, PROMs, ADT, and prognosis...
March 30, 2017: Clinical Genitourinary Cancer
https://www.readbyqxmd.com/read/28574294/guidelines-for-the-provision-and-assessment-of-nutrition-support-therapy-in-the-pediatric-critically-ill-patient-society-of-critical-care-medicine-and-american-society-for-parenteral-and-enteral-nutrition
#19
Nilesh M Mehta, Heather E Skillman, Sharon Y Irving, Jorge A Coss-Bu, Sarah Vermilyea, Elizabeth Anne Farrington, Liam McKeever, Amber M Hall, Praveen S Goday, Carol Braunschweig
This document represents the first collaboration between 2 organizations-the American Society for Parenteral and Enteral Nutrition and the Society of Critical Care Medicine-to describe best practices in nutrition therapy in critically ill children. The target of these guidelines is intended to be the pediatric critically ill patient (>1 month and <18 years) expected to require a length of stay >2-3 days in a PICU admitting medical, surgical, and cardiac patients. In total, 2032 citations were scanned for relevance...
May 1, 2017: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28556570/what-families-have-in-the-emergency-tracheostomy-kits-identifying-gaps-to-improve-patient-safety
#20
Reshma Amin, Weeda Zabih, Faiza Syed, Joanna Polyviou, Tuyen Tran, Evan J Propst, Theresa Holler
OBJECTIVE: To evaluate the contents of parent-created emergency tracheostomy kits and identify deficiencies. METHODS: This was an observational study. Data on emergency tracheostomy kits were abstracted for 30 consecutive children who had a tracheostomy tube in situ during an outpatient clinic visit with the Division of Respiratory Medicine and/or the Department of Otolaryngology-Head and Neck Surgery at the Hospital for Sick Children between February 1 and October 30, 2016...
May 29, 2017: Pediatric Pulmonology
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