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https://www.readbyqxmd.com/read/28230581/a-handoffs-software-led-to-fewer-errors-of-omission-and-better-provider-satisfaction-a-randomized-control-trial
#1
Markos G Kashiouris, Christos Stefanou, Deepankar Sharma, Cecilia Yshii-Tamashiro, Ryan Vega, Sarah Hartingan, Charles Albrecht, Robert H Brown
BACKGROUND: Computer-assisted communication is shown to prevent critical omissions ("errors") in the handoff process. OBJECTIVE: The aim of the study was to study this effect and related provider satisfaction, using a standardized software. METHODS: Fourteen internal medicine house officers staffed 6 days and 1 cross-covering teams were randomized to either the intervention group or control, employing usual handoff, so that handoff information was exchanged only between same-group subjects (daily, for 28 days)...
February 22, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28229483/venous-hemodialysis-catheters-and-cardiac-implantable-electronic-devices-avoiding-a-high-risk-combination
#2
EDITORIAL
Theodore F Saad, Henry L Weiner
End-stage renal disease is frequently accompanied by cardiac comorbidity that warrants treatment with a cardiovascular implantable electronic device (permanent pacemaker or implantable cardioverter-defibrillator). In the United States, chronic hemodialysis (HD) population, cardiac implantable devices are present in up to 10.5% of patients; a venous HD catheter is utilized for blood access in 18% of prevalent patients. The concomitant presence of a venous HD catheter and cardiovascular implantable device creates a high-risk circumstance, with potential for causing symptomatic central venous stenosis, and for developing complicated endovascular infection...
February 23, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28226474/estimation-of-arterio-venous-access-blood-flow-in-hemodialysis-patients-using-video-image-processing-technique
#3
Fansan Zhu, Schantel Williams, Hannah Putnam, Israel Campos, Jie Ma, Camille Johnson, Franz Kappel, Peter Kotanko, Fansan Zhu, Schantel Williams, Hannah Putnam, Israel Campos, Jie Ma, Camille Johnson, Franz Kappel, Peter Kotanko, Jie Ma, Israel Campos, Peter Kotanko, Schantel Williams, Franz Kappel, Fansan Zhu, Hannah Putnam, Camille Johnson
Assessment of arterio-venous fistula (AVF) blood flow (ABF) is vital in hemodialysis (HD) patients. Currently, no non-invasive and contact-free technique is available to accurately measure ABF in routine clinical practice. In this study, we developed a novel approach using video image processing (VIP) to measure the change in optic flow in the skin. We the tested the hypothesis that the change in optical flow, expressed as the change in pixels between consecutive frames, is related to ABF. We recorded AVF videos in 40 HD patients using a digital camera and processed them by VIP technique...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28224103/management-of-parenteral-nutrition-in-critically-ill-patients
#4
REVIEW
Paolo Cotogni
Artificial nutrition (AN) is necessary to meet the nutritional requirements of critically ill patients at nutrition risk because undernutrition determines a poorer prognosis in these patients. There is debate over which route of delivery of AN provides better outcomes and lesser complications. This review describes the management of parenteral nutrition (PN) in critically ill patients. The first aim is to discuss what should be done in order that the PN is safe. The second aim is to dispel "myths" about PN-related complications and show how prevention and monitoring are able to reach the goal of "near zero" PN complications...
February 4, 2017: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28223086/long-term-10-year-outcomes-after-laparoscopic-roux-en-y-gastric-bypass
#5
Shanu N Kothari, Andrew J Borgert, Kara J Kallies, Matthew T Baker, Brandon T Grover
BACKGROUND: Laparoscopic Roux-en-Y gastric bypass (LRYGB) has been the "gold standard" for weight loss surgery. Long-term data are limited, and reporting methods for LRYGB outcomes vary in the literature. In addition, follow-up compliance within bariatric centers is poor due to insurance and access to care issues, making long-term follow-up evaluation difficult. OBJECTIVE: Evaluate long-term LRYGB outcomes using standard outcome reporting definitions. SETTING: Integrated multispecialty health system...
December 22, 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28222688/vascular-access-conversion-and-patient-outcome-after-hemodialysis-initiation-with-a-nonfunctional-arteriovenous-access-a-prospective-registry-based-study
#6
Natalia Alencar de Pinho, Raphael Coscas, Marie Metzger, Michel Labeeuw, Carole Ayav, Christian Jacquelinet, Ziad A Massy, Bénédicte Stengel
BACKGROUND: Little is known about vascular access conversion and outcomes for patients starting hemodialysis with nonfunctional arteriovenous (AV) access. We assessed mortality risk associated with nonfunctional AV access at hemodialysis initiation, taking subsequent changes in vascular access into account. METHODS: We studied the 53,092 incident adult hemodialysis patients included in the French REIN registry from 2005 through 2012. AV access placed predialysis was considered nonfunctional when dialysis began with a central venous catheter...
February 22, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28219324/non-anti-coagulant-factors-associated-with-filter-life-in-continuous-renal-replacement-therapy-crrt-a-systematic-review-and-meta-analysis
#7
Matthew Brain, Elizabeth Winson, Owen Roodenburg, John McNeil
BACKGROUND: Optimising filter life and performance efficiency in continuous renal replacement therapy has been a focus of considerable recent research. Larger high quality studies have predominantly focussed on optimal anticoagulation however CRRT is complex and filter life is also affected by vascular access, circuit and management factors. We performed a systematic search of the literature to identify and quantify the effect of vascular access, circuit and patient factors that affect filter life and presented the results as a meta-analysis...
February 20, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28218362/mechanical-recanalization-for-clot-occlusion-of-venous-access-ports-experimental-study-using-ports-with-clot-occlusion
#8
Myung Gyu Song, Tae-Seok Seo, Baek-Hui Kim, Jeong Ho Kim
PURPOSE: To test the hypothesis that mechanical injection of saline is safe and effective in restoring patency of totally implantable venous access ports (TIVAPs) with clot occlusion. We devised an experimental port model for the evaluation of mechanical TIVAP recanalization prior to its clinical application. MATERIALS AND METHODS: The clot TIVAP occlusion model was constructed by filling the catheter with swine blood and incubating it at 37.5°C. The model was incubated for different lengths of time ranging from 1 day to 7 days...
February 8, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28218354/dialysis-access-infections-and-hospitalisations-in-unplanned-dialysis-start-patients-results-from-the-options-study
#9
Anna Machowska, Mark D Alscher, Satyanarayana Reddy Vanga, Michael Koch, Michael Aarup, Abdul R Qureshi, Bengt Lindholm, Peter Rutherford
INTRODUCTION: Unplanned dialysis start (UPS) associates with worse clinical outcomes, higher utilisation of healthcare resources, lower chances to select dialysis modality and UPS patients typically commenced in-centre haemodialysis (HD) with central venous catheter (CVC). We evaluated patient outcomes and healthcare utilisation depending on initial dialysis access (CVC or PD catheter) and subsequent pathway of UPS patients. METHODS: In this study patient demographics, access procedures, hospitalisations, and major infectious complications were analysed over 12 months in 270 UPS patients...
February 11, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/28217223/long-term-reliability-of-sweet-tip-type-screw-in-leads
#10
Asuka Takano, Gaku Sekita, Minako Watanabe, Hiroshi Mukaida, Sayaka Komatsu, Haruna Tabuchi, Hidemori Hayashi, Takashi Tokano, Masataka Sumiyoshi, Yuji Nakazato, Hiroyuki Daida
BACKGROUND: Active fixation leads have provided stable atrial and ventricular pacing; however, long-term follow-up data have not been satisfactory. The purpose of this study was to investigate the long-term reliability of active fixation leads and their electrical characteristic stability. METHODS: A total of 1196 pacing leads were implanted in 830 patients consecutively between 2002 and 2013. In this retrospective study, we were able to trace 1092 leads in 750 patients to investigate the prognosis of implanted leads...
February 2017: Journal of Arrhythmia
https://www.readbyqxmd.com/read/28217064/a-simple-technique-to-achieve-vascular-access-for-continuous-venous-venous-ultrafiltration-in-a-toddler
#11
Joseph Drew Tobias
Acute renal failure is associated with increased mortality in the Pediatric Intensive Care Unit. When anuric or oliguric renal failure occurs, the associated fluid overload may compromise respiratory function and has been shown to be associated with worse outcomes. Renal replacement therapy using continuous venous-venous hemofiltration (CVVH) allows for fluid, solute, and nitrogenous waste removal. However, large bore vascular access with placement of a double-lumen dialysis catheter is necessary to ensure effective flow rates to allow for CVVH...
January 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28214161/human-factors-related-to-time-dependent-infection-control-measures-scrub-the-hub-for-venous-catheters-and-feeding-tubes
#12
Lindsay Caspari, Elizabeth Epstein, Amy Blackman, Li Jin, David A Kaufman
BACKGROUND: The use of catheter hub decontamination protocols is a common practice to reduce central line-associated bloodstream infections. However, few data exist on the most effective disinfection procedure prior to hub access accounting for human factors and time-dependent practices in real time in the clinical setting. METHODS: An observational design with a multimodal intervention was used in this study in a neonatal intensive care unit. Direct observations on nurse compliance of scrub times with decontamination when accessing of venous catheter and feeding tube hubs were conducted during 3 phases: (1) baseline period prior to any interventions; (2) during an educational intervention phase; and (3) during a timer intervention period when using a timing device, either an actual timer or music button...
February 15, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28206886/guideline-for-monitoring-and-management-of-pediatric-patients-before-during-and-after-sedation-for-diagnostic-and-therapeutic-procedures-update-2016
#13
(no author information available yet)
The safe sedation of children for procedures requires a systematic approach that includes the following: no administration of sedating medication without the safety net of medical/dental supervision, careful presedation evaluation for underlying medical or surgical conditions that would place the child at increased risk from sedating medications, appropriate fasting for elective procedures and a balance between the depth of sedation and risk for those who are unable to fast because of the urgent nature of the procedure, a focused airway examination for large (kissing) tonsils or anatomic airway abnormalities that might increase thepotential for airway obstruction, a clear understanding of the medication's pharmacokinetic and pharmacodynamic effects and drug interactions, appropriate training and skills in airway management to allow rescue of the patient, age- and size-appropriate equipment for airway management and venous access, appropriate medications and reversal agents, sufficient numbers of staff to both carry out the procedure and monitor the patient, appropriate physiologic monitoring during and after the procedure, a properly equipped and staffed recovery area, recovery to the presedation level of consciousness before discharge from medical/dental supervision, and appropriate discharge instructions...
October 15, 2016: Pediatric Dentistry
https://www.readbyqxmd.com/read/28203338/the-predictive-value-of-pulse-oximeters-for-pulse-improvement-after-angiography-in-infants-and-children
#14
Mohammad-Reza Alipour, Mazyar Rastegar, Mehdi Ghaderian, Seyedeh-Mahdieh Namayandeh, Reza Faraji, Zohreh Pezeshkpour
BACKGROUND: Information from pulse oximeter waves confirms the presence of a pulse and helps obtain waves from tissue when the supplying artery is not readily accessible. OBJECTIVES: This study determined the predictive value of pulse oximeters for detecting improved arterial pulses after angiography. PATIENTS AND METHODS: This cross-sectional, multi-center study included 467 4-day-old to 12-year-old patients and was conducted from January 2012 to January 2016...
October 2016: Iranian Journal of Pediatrics
https://www.readbyqxmd.com/read/28197790/surgical-treatment-of-anterior-cranial-fossa-dural-arterio-venous-fistulas-davfs-a-two-centre-experience
#15
Pietro Meneghelli, Alberto Pasqualin, Luigi Andrea Lanterna, Claudio Bernucci, Roberto Spinelli, Gianluigi Dorelli, Piergiuseppe Zampieri
BACKGROUND: Anterior cranial fossa dural arterio-venous fistulas (DAVFs) represent 6% of all intracranial DAVFs; characteristically they show an aggressive behaviour with high risk of intracranial haemorrhage. Peculiar anatomical features, such as feeding by the ethmoidal arteries and the pattern of venous drainage (frequently with varices that mimic aneurysmal dilatation), can be evaluated in detail only by digital subtraction angiography (DSA), which represents the "gold standard" in the diagnosis of such cranial fistulas...
February 14, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28194196/assessment-of-hemodialysis-adequacy-and-its-relationship-with-individual-and-personal-factors
#16
Ozra Rezaiee, Nahid Shahgholian, Shahrzad Shahidi
BACKGROUND: Hemodialysis is the most common renal replacement therapy in the world, and hemodialysis adequacy is an important and influencial factor in the reduction of various complications experienced by these patients. Multiple factors influence hemodialysis adequacy. This study was conducted to determine hemodialysis adequacy and its relationship with individual and personal factors in patients undergoing hemodialysis in three hemodialysis centers of Isfahan, Iran. MATERIALS AND METHODS: This descriptive, cross-sectional study was conducted in partnership with 202 patients undergoing hemodialysis in three hemodialysis centers of Isfahan...
November 2016: Iranian Journal of Nursing and Midwifery Research
https://www.readbyqxmd.com/read/28194064/therapeutic-plasma-exchange-in-patients-with-neurologic-disorders-review-of-63-cases
#17
Anil Tombak, Mehmet Ali Uçar, Aydan Akdeniz, Arda Yilmaz, Hakan Kaleagası, Mehmet Ali Sungur, Eyup Naci Tiftik
Therapeutic plasma exchange (TPE) is a procedure that reduces circulating autoantibodies of the patients. TPE is commonly used in neurological disorders where autoimmunity plays a major role. We report our experience with regard to the indications, adverse events and outcomes of plasma exchange in neurological disorders. Sixty-three patients were included to this retrospective study. Median age was 48 years (range 1-85), there was a predominance of males. Neurological indications included Guillain-Barrè syndrome (n = 22), myasthenia gravis (n = 21), chronic inflammatory demyelinating polyneuropathy (n = 7), polymyositis (n = 3), multifocal motor neuropathy (n = 2), acute disseminated encephalomyelitis (n = 2), neuromyelitis optica (n = 2), multiple sclerosis (n = 2), limbic encephalitis (n = 1) and transverse myelitis (n = 1)...
March 2017: Indian Journal of Hematology & Blood Transfusion
https://www.readbyqxmd.com/read/28191308/ralstonia-mannitolilytica-infections-in-an-oncologic-day-ward-description-of-a-cluster-among-high-risk-patients
#18
Claudia Lucarelli, Enea Gino Di Domenico, Luigi Toma, Domenico Bracco, Grazia Prignano, Maria Fortunati, Lorella Pelagalli, Fabrizio Ensoli, Patrizio Pezzotti, Aurora García-Fernández, Annalisa Pantosti, Loredana Ingrosso
BACKGROUND: Ralstonia spp, an environmental microorganism, has been occasionally associated with healthcare infections. The aim of this study was to investigate an outbreak caused by Ralstonia mannitolilytica in oncology patients. METHODS: Case definition: Oncology outpatients attending a day ward, with positive blood and/or central venous catheter (CVC) culture for Ralstonia spp from September 2013 - June 2014. We analysed medical records, procedures and environmental samples...
2017: Antimicrobial Resistance and Infection Control
https://www.readbyqxmd.com/read/28188661/idiopathic-epicardial-ventricular-tachycardia-from-the-coronary-venous-system-from-electrocardiographic-recognition-to-appropriate-therapy
#19
Stéphane Boulé, Claire Federspiel, Eric Verbrugge, Didier Klug
Idiopathic epicardial ventricular tachycardias (VTs) account for 9% of idiopathic VTs. The recognition of this entity is important, as a minimally invasive ablation procedure performed exclusively through the coronary sinus branches may be considered, avoiding the potential risks associated with access to the left ventricular endocardium, the aortic root, and the pericardial space. The electrocardiographic features and therapeutic management of this rare form of tachycardia are discussed.
February 11, 2017: Annals of Noninvasive Electrocardiology
https://www.readbyqxmd.com/read/28188038/tunneled-central-venous-catheters-in-children-with-malignant-and-chronic-diseases-a-comparison-of-open-vs-percutaneous-implantation
#20
Lea-Valeska Blum, Ulf Abdel-Rahman, Thomas Klingebiel, Henning Fiegel, Stefan Gfroerer, Udo Rolle
PURPOSE: Tunneled central venous catheters (tCVCs) are routinely used for long-term venous access in children with cancer and chronic diseases. They may be inserted by surgical venous cut-down or percutaneously. The aim of this study was to compare the operative times and intraoperative complications of both techniques. METHODS: This study compared group A (surgical venous cut-down, years 2002-2006) with group B (percutaneous, years 2008-2012). Patient characteristics, operative times, and intraoperative complications were obtained from surgical reports...
January 30, 2017: Journal of Pediatric Surgery
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