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https://www.readbyqxmd.com/read/28817942/-the-current-status-of-diagnostic-tools-for-leptospirosis
#1
Mitsumasa Saito, Yasuhiko Nikaido, Masahiro Matsumoto, Midori Ogawa, Sharon Y A M Villanueva
Leptospirosis is a worldwide zoonosis caused by pathogenic Leptospira spp. The severity of leptospirosis vary from mild, flu-like disease to a more severe form, Weil's disease causing jaundice, hemorrhage, renal failure, and even death. Every year, 300,000‒500,000 cases of severe leptospirosis are reported around the world, with the case fatality rate being 10‒30%. The usual diagnostic tools for leptospirosis are 1) direct observation of leptospires in blood and urine under dark-field microscope, 2) isolation of leptospires from blood, cerebrospinal fluid (CSF), or urine samples by culture, 3) microscopic agglutination test (MAT) to detect anti-Leptospira antibodies in serum, and 4) PCR to detect Leptospira DNA...
August 15, 2017: JARMAM: Journal of the Association for Rapid Method and Automation in Microbiology
https://www.readbyqxmd.com/read/28813425/effectiveness-of-two-distinct-web-based-education-tools-for-bedside-nurses-on-medication-administration-practice-for-venous-thromboembolism-prevention-a-randomized-clinical-trial
#2
Brandyn D Lau, Dauryne L Shaffer, Deborah B Hobson, Gayane Yenokyan, Jiangxia Wang, Elizabeth A Sugar, Joseph K Canner, David Bongiovanni, Peggy S Kraus, Victor O Popoola, Hasan M Shihab, Norma E Farrow, Jonathan K Aboagye, Peter J Pronovost, Michael B Streiff, Elliott R Haut
BACKGROUND: Venous thromboembolism (VTE) is a common cause of preventable harm in hospitalized patients. While numerous successful interventions have been implemented to improve prescription of VTE prophylaxis, a substantial proportion of doses of prescribed preventive medications are not administered to hospitalized patients. The purpose of this trial was to evaluate the effectiveness of nurse education on medication administration practice. METHODS: This was a double-blinded, cluster randomized trial in 21 medical or surgical floors of 933 nurses at The Johns Hopkins Hospital, an academic medical center, from April 1, 2014 -March 31, 2015...
2017: PloS One
https://www.readbyqxmd.com/read/28806902/monitoring-documenting-and-reporting-the-quality-of-antibiotic-use-in-the-netherlands-a-pilot-study-to-establish-a-national-antimicrobial-stewardship-registry
#3
Marvin Ah Berrevoets, Jaap Ten Oever, Tom Sprong, Reinier M van Hest, Ingeborg Groothuis, Inger van Heijl, Jeroen A Schouten, Marlies E Hulscher, Bart-Jan Kullberg
BACKGROUND: The Dutch Working Party on Antibiotic Policy is developing a national antimicrobial stewardship registry. This registry will report both the quality of antibiotic use in hospitals in the Netherlands and the stewardship activities employed. It is currently unclear which aspects of the quality of antibiotic use are monitored by antimicrobial stewardship teams (A-teams) and can be used as indicators for the stewardship registry. In this pilot study we aimed to determine which stewardship objectives are eligible for the envisioned registry...
August 15, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28806028/treatment-of-peritonsillar-abscess-in-immunosuppressed-patients
#4
Jed H Assam, William C Spanos
Peritonsillar abscess (PTA) is a common pathology in otolaryngology emergency. The treatment of PTA is usually bedside drainage or surgical removal of the tonsils (Quincy tonsillectomy) in combination with antibiotic treatment. However, patients with immune suppression might have a more difficult treatment course. Such difficulties may be further magnified within older patients. This case report will describe successful multi-modality treatment of two separate incidents of PTA developing in the context of immunosuppression...
July 2017: South Dakota Medicine: the Journal of the South Dakota State Medical Association
https://www.readbyqxmd.com/read/28803440/electrical-impedance-tomography-for-diagnosis-and-monitoring-of-pulmonary-function-disorders-in-the-intensive-care-unit-case-report-and-review-of-literature
#5
Szymon Białka, Maja Copik, Katarzyna Rybczyk, Hanna Misiołek
The aim of this paper is to describe the possibility of using Electrical Impedance Tomography (EIT) as a treatment monitoring tool in the ICU. It was based on case report and literature review. A 19-year-old female was admitted to ICU due to severe acute respiratory distress syndrome. Despite aggressive treatment there was no improvement. We decided to use EIT in the monitoring of treatment because of difficulties in transporting the patient to the radiology department in order to perform a control CT scan...
2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/28800888/clinical-classification-of-post-anoxic-myoclonic-status
#6
Yara Mikhaeil-Demo, Jay R Gavvala, Irena I Bellinski, Micheal P Macken, Aditi Narechania, Jessica W Templer, Stephen VanHaerents, Stephan U Schuele, Elizabeth E Gerard
INTRODUCTION: Despite decades of research into the prognostic significance of post anoxic myoclonic status (MS), no consistent definition has been used to describe its clinical appearance. We set out to characterize the clinical features of MS and hypothesized that there are distinct clinical subtypes that may have prognostic implications. METHODS: Video EEG reports from 2008 to 2016 were searched to identify adult patients with post anoxic MS defined as persistent myoclonus for >30min beginning within 3days of cardiac arrest in a comatose patient...
August 8, 2017: Resuscitation
https://www.readbyqxmd.com/read/28798246/extramedullary-haematopoiesis-presenting-with-cardiac-tamponade-in-a-patient-with-polycythaemia-vera
#7
Faysal Haroun, Viktoria Elkis, Anne Chen, Elsie Lee
A 71-year-old man with a history of polycythaemia vera, diagnosed 4 years ago, presented to the emergency room with shortness of breath. A bedside echocardiogram revealed a large pericardial effusion with features concerning for pericardial tamponade. A left anterior thoracotomy and a pericardial window were emergently performed in the operating room and relieved the patient's symptoms. Histology evaluation of the pericardial fragments and pericardial fluid revealed the presence of trilineage haematopoietic elements without any increase in the blasts...
August 10, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28780540/the-postoperative-handover-a-focus-group-interview-study-with-nurse-anaesthetists-anaesthesiologists-and-pacu-nurses
#8
Maria Randmaa, Maria Engström, Christine Leo Swenne, Gunilla Mårtensson
OBJECTIVES: To investigate different professionals' (nurse anaesthetists', anaesthesiologists', and postanaesthesia care unit nurses') descriptions of and reflections on the postoperative handover. DESIGN: A focus group interview study with a descriptive design using qualitative content analysis of transcripts. SETTING: One anaesthetic clinic at two hospitals in Sweden. PARTICIPANTS: Six focus groups with 23 healthcare professionals involved in postoperative handovers...
August 4, 2017: BMJ Open
https://www.readbyqxmd.com/read/28780235/dilated-right-coronary-sinus-identified-on-point-of-care-ultrasound
#9
Damali Nakitende, Michael Gottlieb
Point-of-care cardiac ultrasound (POCUS) is a common application in Emergency Medicine. Here we present a case of an incidentally discovered dilated right coronary sinus on ultrasound. This case involved a 55-year-old female who presented with chest pain, shortness of breath, and lightheadedness. Her initial presentation was concerning for congestive heart failure (CHF) exacerbation. A bedside ultrasound was performed to assess cardiac function, where a dilated right coronary sinus was discovered. The right coronary sinus is the vein that serves as the venous return for the coronary system...
July 29, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28776144/-validation-of-medical-ethical-decisions-at-the-bedside-by-the-autopsy-experience-of-the-ethics-committee-at-the-stuttgart-clinic
#10
REVIEW
A Bosse, C Schupp
BACKGROUND: Ethics consultations in a clinical setting can be challenging, specifically with respect to limiting therapeutic interventions in terminally ill patients. Some decisions will even be controversial. OBJECTIVE: Can a clinical autopsy be used to confirm the recommendations given by the ethics committee, i. e. limitation of therapy to palliative care? MATERIAL AND METHODS: We report an exemplary case of a patient with endocarditis and subsequent septic cerebral infarction...
August 3, 2017: Der Pathologe
https://www.readbyqxmd.com/read/28774652/hospital-discharge-preparedness-for-patients-with-limited-english-proficiency-a-mixed-methods-study-of-bedside-interpreter-phones
#11
Jonathan S Lee, Anna Nápoles, Sunita Mutha, Eliseo J Pérez-Stable, Steven E Gregorich, Jennifer Livaudais-Toman, Leah S Karliner
OBJECTIVE: Assess effects of a bedside interpreter-phone intervention on hospital discharge preparedness among patients with limited English proficiency (LEP). METHODS: Mixed-methods study compared patient-reported discharge preparedness and knowledge of medications and follow-up appointments among 189 Chinese- and Spanish-speakers before (n=94) and after (n=95) bedside interpreter-phone implementation, and examined nurse and resident-physician interpreter-phone utilization through focus groups...
July 24, 2017: Patient Education and Counseling
https://www.readbyqxmd.com/read/28774267/two-confirmed-cases-of-severe-fever-with-thrombocytopenia-syndrome-with-pneumonia-implication-for-a-family-cluster-in-east-china
#12
Yiyi Zhu, Huanyu Wu, Jie Gao, Xin Zhou, Renyi Zhu, Chunzhe Zhang, Hongling Bai, Abu S Abdullah, Hao Pan
BACKGROUND: Severe fever with thrombocytopenia syndrome (SFTS) was first reported in China in 2011. Human-to-human transmission of the virus occurred occasionally in family clusters. However, pneumonia as an onset syndrome was not common in most SFTS cases. Our aim is to report a family cluster of SFTS with clinical manifestation of pneumonia in Shanghai. METHODS: Epidemiologic investigations were conducted when a family cluster of severe fever with thrombocytopenia syndrome virus (SFTSV) infection was identified in Shanghai in June 2016...
August 3, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28774239/a-stepwise-approach-to-management-of-open-radiocarpal-fracture-dislocations-a-case-report
#13
Colin Yi-Loong Woon, Taizoon Baxamusa
Radiocarpal dislocations are uncommon and occur after significant trauma. We describe a unique case of open radiocarpal fracture-dislocation presenting with progressive neurovascular compromise. Staged management was necessary. As a first stage, emergent provisional bedside reduction in the emergency room with manual pressure through the open wounds was performed. The second stage then involved formal open reduction and internal fixation as soon as operating room staff and resources became available.
September 2017: Journal of Hand Surgery Asian-Pacific Volume
https://www.readbyqxmd.com/read/28771651/bedside-rounds-valued-but-not-preferred-perceptions-of-internal-medicine-residents-and-attending-physicians-in-a-diverse-academic-training-program
#14
Naseema B Merchant, Daniel G Federman
OBJECTIVES: Bedside rounds/rounding (BDR) is an important tool for patient-centered care and trainee education. This study aimed at understanding the attitudes toward BDR among residents and attending physicians. METHODS: A survey was conducted using the Qualtrics survey tool. Responses were measured using a five-point Likert scale. RESULTS: The survey was sent to 301 attending physicians and 195 residents. Attending physicians conducted BDR 19% of the time...
August 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28768601/translating-cognitive-behavioral-interventions-from-bench-to-bedside-the-feasibility-and-acceptability-of-cognitive-remediation-in-research-as-compared-to-clinical-settings
#15
Alice Medalia, Matthew D Erlich, Charlotte Soumet-Leman, Alice M Saperstein
Cognitive remediation (CR) research typically addresses internal validity, and few studies consider CR in a real-world context. This study evaluated the fit between the program conditions and treatment model in research and clinical settings, with the goal of informing future research on the contextual challenges associated with the implementation of CR. Data was drawn from an initiative by New York State's Office of Mental Health (OMH), to implement CR programs for adults with Serious Mental Illness (SMI) in 16 state operated outpatient clinics...
July 30, 2017: Schizophrenia Research
https://www.readbyqxmd.com/read/28766237/the-toxicology-investigators-consortium-case-registry-the-2016-experience
#16
Lynn A Farrugia, Sean H Rhyee, Diane P Calello, Sharan L Campleman, Anne M Riederer, Hannah R Malashock, Anthony Pizon, Timothy Wiegand, Paul M Wax, Jeffrey Brent
The Toxicology Investigators Consortium (ToxIC) Case Registry was established by the American College of Medical Toxicology in 2010. The Registry contains data from participating sites with the agreement that all bedside medical toxicology consultations will be entered. Currently, 83% of accredited medical toxicology fellowship programs in the USA participate. The Registry continues to grow each year, and as of 31 December 2016, a new milestone was reached, with more than 50,000 cases reported since its inception...
August 1, 2017: Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology
https://www.readbyqxmd.com/read/28765490/incidental-finding-of-persistent-left-superior-vena-cava-after-bubble-study-verification-of-central-venous-catheter
#17
Miguel Agustin Pardinas Gutierrez, Luis A Escobar, Vanessa Blumer, Jorge Luis Cabrera
We report a case of a patient with septic shock who underwent central venous catheter placement in the left internal jugular vein, and a bedside ultrasound 'bubble study' revealed venous cannulation. A chest X-ray postprocedure revealed concern for arterial system catheterisation. However, the possibility of a persistent left superior vena cava was discussed and confirmed with a formal transthoracic echocardiogram and CT. This case demonstrates the importance of ultrasound-guided visualisation of anatomical structures in real time during central venous catheterisation...
July 31, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28765362/driving-organizational-change-from-the-bedside-the-aacn-clinical-scene-investigator-academy
#18
Susan R Lacey, Caryl Goodyear-Bruch, Adrienne Olney, Dave Hanson, Marian S Altman, Natasha S Varn-Davis, Debbie Brinker, Ramón Lavandero, Karen S Cox
BACKGROUND: Staff nurses are pivotal in leading change related to quality improvement efforts, although many lack skills to steer change from the bedside. The American Association of Critical-Care Nurses (AACN) staff nurse leadership program, Clinical Scene Investigator (CSI) Academy, teaches and empowers staff nurses in leadership skills and change concepts to translate evidence into practice affecting patient outcomes. OBJECTIVES: To describe the curriculum of the AACN CSI Academy that provides staff nurses with the leadership skills required to create unit-based change projects that positively impact patient/family outcomes...
August 2017: Critical Care Nurse
https://www.readbyqxmd.com/read/28765352/identification-and-prevention-of-secondary-heart-failure-a-case-study
#19
Vlad Gheorghiu, Thomas W Barkley
Heart failure, a complex clinical syndrome affecting millions of Americans, is associated with high morbidity and mortality and a significant financial burden on the health care system. Recent health care reform efforts have focused on reducing 30-day heart failure hospital readmissions, increasing the cost-effectiveness of care provided to heart failure patients, and improving health outcomes for these patients. This case report describes an acutely ill patient with multiple comorbidities who was not initially admitted for heart failure but who developed acute decompensated heart failure during his hospital stay...
August 2017: Critical Care Nurse
https://www.readbyqxmd.com/read/28765018/takotsubo-cardiomyopathy-triggered-by-venous-air-embolism-during-craniotomy-in-sitting-position-a-case-report
#20
Florian Raimann, Christian Senft, Jörg Honold, Kai Zacharowski, Volker Seifert, Jan Mersmann
BACKGROUND: Here we present a case of a stress induced cardiomyopathy (TakoTsubo cardiomyopathy) caused by a venous air embolism during a craniotomy in sitting position. CASE DESCRIPTION: A 69-year old female patient was admitted to the neurosurgical department and scheduled for elective resection of a cerebellar metastasis in sitting position. After craniotomy and opening of the posterior fossa a venous air embolism was detected via transesophageal echocardiography...
July 29, 2017: World Neurosurgery
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