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https://www.readbyqxmd.com/read/28100274/using-medical-specialty-and-selection-criteria-clusters-to-study-specialty-selection-by-israeli-medical-students
#1
Yoram G Weiss, Rachel Yaffa Zisk-Rony, Howard Tandeter, Uriel Elchalal, Alex Avidan, Josh E Schroeder, Charles Weissman
BACKGROUND: During their final year of medical school, Israeli students must consider which specialty to choose for residency. Based on the vocational counseling literature we presumed that choices are made by selecting from a cluster of related specialties while considering professional and socio-economic issues. METHODS: Questionnaires distributed to final-year medical students at two Israeli medical schools ascertained inclinations toward various medical specialties and the importance of various selection criteria...
January 18, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/28077509/the-basic-approach-a-single-centre-experience-with-a-cost-reducing-model-for-paediatric-cardiac-extracorporeal-membrane-oxygenation
#2
Massimo A Padalino, Chiara Tessari, Alvise Guariento, Anna C Frigo, Vladimiro L Vida, Andrea Marcolongo, Fabio Zanella, Michael J Harvey, Ravi R Thiagarajan, Giovanni Stellin
OBJECTIVES: Extracorporeal membrane oxygenation (ECMO) is a lifesaving but expensive therapy in terms of financial, technical and human resources. We report our experience with a 'basic' ECMO support model, consisting of ECMO initiated and managed without the constant presence of a bedside specialist, to assess safety, clinical outcomes and financial impact on our health system. METHODS: We did a retrospective single-centre study of paediatric cardiac ECMO between January 2001 and March 2014...
January 10, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28073176/parental-perceptions-of-clown-care-in-paediatric-intensive-care-units
#3
Guillaume Mortamet, Audrey Merckx, Nadia Roumeliotis, Caroline Simonds, Sylvain Renolleau, Philippe Hubert
AIM: The objective of this study was to report family satisfaction with regards to the presence of clowns in the paediatric intensive care unit (PICU). METHODS: This is a single-centre survey-based study, conducted over 4 months in a 12-bed third level PICU in a university hospital. All parents present at the bedside of their child during clowning were considered as potential participants. Eligible parents were approached by one of the two intensivists as investigators and asked to complete a survey within the 48 h following the clowns' intervention...
January 10, 2017: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/28069418/splenic-artery-aneurysm-rupture-in-pregnancy
#4
Joshua Jacobson, Chad Gorbatkin, Stacey Good, Scott Sullivan
CASE PRESENTATION: A pregnant woman at 22+5/7weeks gestation presented to the emergency department (ED) from an outpatient clinic, hypotensive after experiencing a syncopal episode. On arrival to the ER she was tachycardic, tachypneic and complaining of abdominal pain. A bedside FAST was performed and noted free fluid in the abdomen. Subsequent CT obtained noted the rare but life-threatening diagnosis of ruptured splenic artery aneurysm that resulted in emergent transfer to the operating room with OB/GYN and general surgery...
December 15, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28069417/standing-shock-index-an-alternative-to-orthostatic-vital-signs
#5
Michael D Witting
: Objective The lack of a sensitive, practical bedside test for hypovolemia has rekindled interest in the shock index (heart rate divided by systolic blood pressure). Here, we compare the effect of blood donation on standing shock index values with its effect on values for the supine shock index and orthostatic change in shock indicies (OCSI). METHODS: This is a re-analysis of data collected for an earlier report. Data were available from 292 adults below age 65 and 44 adults ages 65 and over, donating 450mL of blood...
December 23, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28069269/clinical-considerations-for-blunt-laryngotracheal-trauma-in-children
#6
REVIEW
Jeffrey Cheng, Matthew Cooper, Elisabeth Tracy
OBJECTIVE: Systematic review of blunt pediatric laryngeal and tracheal trauma and development of proposed evaluation and management strategy. STUDY DESIGN: Systematic review and proposed clinical consideration algorithm. DATA SOURCES: PubMed, EMBASE, Web of Science, and Cochrane Central Register of Controlled Trials. REVIEW METHODS: A medical librarian was utilized. RESULTS: 329 titles and abstracts were identified, and 50 reports were included...
December 30, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28067682/utilizing-a-human-factors-nursing-worksystem-improvement-framework-to-increase-nurses-time-at-the-bedside-and-enhance-safety
#7
C Adam Probst, Megan Carter, Caton Cadigan, Cortney Dalcour, Cindy Cassity, Penny Quinn, Tiana Williams, Donna Cook Montgomery, Claudia Wilder, Yan Xiao
OBJECTIVE: The aim of this study is to increase nurses' time for direct patient care and improve safety via a novel human factors framework for nursing worksystem improvement. BACKGROUND: Time available for direct patient care influences outcomes, yet worksystem barriers prevent nurses adequate time at the bedside. METHODS: A novel human factors framework was developed for worksystem improvement in 3 units at 2 facilities. Objectives included improving nurse efficiency as measured by time-and-motion studies, reducing missing medications and subsequent trips to medication rooms and improving medication safety...
January 7, 2017: Journal of Nursing Administration
https://www.readbyqxmd.com/read/28065330/impact-of-personalized-report-cards-on-nurses-managing-central-lines
#8
Theresa Morrison, Jacqueline Raffaele, Laura Brennaman
BACKGROUND: The purpose of this quality improvement project was to determine the effect of providing feedback to managers and bedside nurses on the nurses' central line-associated bloodstream infection (CLABSI) contributing factors, found on visual and documentation audits. METHODS: This nonexperimental, quality improvement project was conducted in a 715-bed, 2-campus acute care community hospital health care system in Southwest Florida. The intervention consisted of providing confidential feedback on central line audits deviations, through the systematic delivery of unit case reports and personalized nurse report cards...
January 1, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28063724/pressure-injury-prevalence-in-intensive-care-versus-non-intensive-care-patients-a-state-wide-comparison
#9
Fiona Coyer, Sandra Miles, Sandra Gosley, Paul Fulbrook, Kirstine Sketcher-Baker, Jane-Louise Cook, Jacqueline Whitmore
BACKGROUND: Hospital-acquired pressure injury is associated with increased morbidity and mortality and considered to be largely preventable. Pressure injury prevalence is regarded as a marker of health care quality. OBJECTIVE: To compare the state-wide prevalence, severity and location of pressure injuries of intensive care unit patients compared to patients in non-intensive care wards. METHOD: The study employed a secondary data analysis design to extract and analyse de-identified pressure injury data from all Queensland Health hospitals with level I-III intensive care facilities that participated in Queensland Bedside Audits between 2012-2014...
January 4, 2017: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/28060192/imaging-of-the-lungs-in-organ-donors-and-its-clinical-relevance-a-retrospective-analysis
#10
Gracijela Bozovic, Catharina Adlercreutz, Peter Höglund, Isabella Björkman-Burtscher, Peter Reinstrup, Richard Ingemansson, Cornelia Schaefer-Prokop, Roger Siemund, Mats Geijer
PURPOSE: The aim of the study was to retrospectively evaluate the diagnostic imaging that potential lung donors undergo, the reader variability of image interpretation and its relevance for donation, and the potential information gained from imaging studies not primarily intended for lung evaluation but partially including them. MATERIALS AND METHODS: Bedside chest radiography and computed tomography (CT), completely or incompletely including the lungs, of 110 brain-dead potential organ donors in a single institution during 2007 to 2014 were reviewed from a donation perspective...
January 2, 2017: Journal of Thoracic Imaging
https://www.readbyqxmd.com/read/28057565/development-and-validation-of-a-continuously-age-adjusted-measure-of-patient-condition-for-hospitalized-children-using-the-electronic-medical-record
#11
Michael J Rothman, Joseph J Tepas, Andrew J Nowalk, James E Levin, Joan M Rimar, Albert Marchetti, Allen L Hsiao
Awareness of a patient's clinical status during hospitalization is a primary responsibility for hospital providers. One tool to assess status is the Rothman Index (RI), a validated measure of patient condition for adults, based on empirically derived relationships between 1-year post-discharge mortality and each of 26 clinical measurements available in the electronic medical record. However, such an approach cannot be used for pediatrics, where the relationships between risk and clinical variables are distinct functions of patient age, and sufficient 1-year mortality data for each age group simply does not exist...
January 2, 2017: Journal of Biomedical Informatics
https://www.readbyqxmd.com/read/28056150/trends-in-otolaryngology-consultation-patterns-at-an-academic-quaternary-care-center
#12
Kevin J Choi, Russel R Kahmke, Matthew G Crowson, Liana Puscas, Richard L Scher, Seth M Cohen
Importance: The consultation patterns of an otolaryngology-head and neck surgery service have not previously been reported. The time, resources, and attention required to operate such a consultation service are unknown. Objective: To assess trends in otolaryngology-head and neck surgery consultations conducted in emergency departments (EDs) and inpatient services. Design, Setting, and Participants: A retrospective analysis was conducted of the medical records of patients at a quaternary care center receiving inpatient otolaryngology consultations from January 1 to December 31, 2014...
January 5, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28045699/agenda-for-sleep-research-in-older-adults-with-cancer-a-conference-report
#13
Ellyn E Matthews, Eileen Danaher Hacker, Julie L Otte, Grace E Dean
BACKGROUND: Sleep problems are common but often neglected in older adults, particularly in the context of cancer. Underlying mechanisms are poorly understood and interventions frequently lack a clear scientific basis. OBJECTIVE: The objective of this report was to examine scientific content presented at a National Institutes of Health-sponsored U13 "Bedside to Bench" conference using a qualitative and iterative review procedure. Analysis of current scientific issues regarding sleep in older adults with cancer is needed to direct nurse scientists and clinicians toward research opportunities...
December 30, 2016: Cancer Nursing
https://www.readbyqxmd.com/read/28031086/respiratory-and-cardiac-characteristics-of-icu-patients-aged-90-years-and-older-a-report-of-12-cases
#14
Hong-Min Zhang, Da-Wei Liu, Xiao-Ting Wang, Yun Long, Quan-Hui Yang
Objective To investigate the respiratory and cardiac characteristics of elderly Intensive Care Unit (ICU) patients.Methods Twelve senior ICU patients aged 90 years and older were enrolled in this study. We retrospectively collected all patients' clinical data through medical record review. The basic demographics, primary cause for admission, the condition of respiratory and circulatory support, as well as prognosis were recorded. Shock patients and pneumonia patients were specifically analyzed in terms of clinical manifestations, laboratory variables, echocardiography, and lung ultrasound Results...
March 20, 2016: Chinese Medical Sciences Journal, Chung-kuo i Hsüeh K'o Hsüeh Tsa Chih
https://www.readbyqxmd.com/read/28030366/nicu-nurses-and-lactation-based-support-and-care
#15
Elizabeth Froh, Katherine Dahlmeier, Diane L Spatz
BACKGROUND: The provision of human milk and breastfeeding is essential in the neonatal intensive care unit (NICU) population. However, recent national research has demonstrated very low percentages of NICU nurses providing lactation-based support and care to patients and families, and less than half of all NICUs have an International Board Certified Lactation Consultant (IBCLC) on staff. PURPOSE: The purpose of this study was to describe how NICU bedside nurses are providing lactation-based support and care during their shifts and the frequency of that support...
December 27, 2016: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
https://www.readbyqxmd.com/read/28018682/bent-metal-in-a-bone-a-rare-complication-of-an-emergent-procedure-or-a-deficiency-in-skill-set
#16
Mridula Krishnan, Katherine Lester, Amber Johnson, Kaye Bardeloza, Peter Edemekong, Ilya Berim
Intraosseous (IO) access is an important consideration in patients with difficult intravenous (IV) access in emergent situations. IO access in adults has become more popular due to the ease of placement and high success rates. The most common sites of access include the proximal tibia and the humeral head. The complications associated are rare but can be catastrophic: subsequent amputation of a limb has been described in the literature. We report a 25-year-old female presenting with diabetic ketoacidosis (DKA) in whom emergent IO access was complicated by needle bending inside the humerus...
2016: Case Reports in Critical Care
https://www.readbyqxmd.com/read/28008417/time-domain-diffuse-correlation-spectroscopy
#17
Jason Sutin, Bernhard Zimmerman, Danil Tyulmankov, Davide Tamborini, Kuan Cheng Wu, Juliette Selb, Angelo Gulinatti, Ivan Rech, Alberto Tosi, David A Boas, Maria Angela Franceschini
Physiological monitoring of oxygen delivery to the brain has great significance for improving the management of patients at risk for brain injury. Diffuse correlation spectroscopy (DCS) is a rapidly growing optical technology able to non-invasively assess the blood flow index (BFi) at the bedside. The current limitations of DCS are the contamination introduced by extracerebral tissue and the need to know the tissue's optical properties to correctly quantify the BFi. To overcome these limitations, we have developed a new technology for time-resolved diffuse correlation spectroscopy...
September 2016: Optica
https://www.readbyqxmd.com/read/28005560/capsaicin-8-patch-repeat-treatment-in-non-diabetic-peripheral-neuropathic-pain-a-52-week-open-label-single-arm-safety-study
#18
Rafael Gálvez, Marie-Louise Navez, Graeme Moyle, Christian Maihöfner, Malcolm Stoker, Etienne Ernault, Turo J Nurmikko, Nadine Attal
OBJECTIVES: To investigate long-term safety and tolerability of capsaicin 8% patch repeat treatment in non-diabetic patients with peripheral neuropathic pain (NP). METHODS: Prospective, open-label, observational study in patients with post-herpetic neuralgia, post-traumatic or post-surgical nerve injury, HIV-associated distal sensory polyneuropathy, or other peripheral NP, and average daily pain score ≥4, received ≤6 capsaicin 8% patch treatments over 52 weeks according to clinical need (retreatment at 9-12 wk intervals)...
December 21, 2016: Clinical Journal of Pain
https://www.readbyqxmd.com/read/28005000/nonsurgically-treated-sigmoid-volvulus-in-a-young-patient-3-days-after-renal-transplant
#19
İsmail Bilgiç, Mehmet Tolga Kafadar, Işılay Nadir, Mukaddes Ayşe Bilgiç, Ali Akçay, Aydın Dalgıç
Sigmoid volvulus is a rare clinical condition in young individuals. It should be accurately diagnosed and treated in a rapid manner. Surgical and nonsurgical conservative methods are used for the treatment of sigmoid volvulus. Patients having no signs of perforation or peritonitis should be primarily treated by colonoscopic detorsion. A delay in the diagnosis and treatment of this condition may cause significant morbidity and mortality in an immunosuppressed patient with newly performed renal transplant and diffuse abdominal pain...
December 22, 2016: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/27998750/clinical-translation-of-polymyxin-based-combination-therapy-facts-challenges-and-future-opportunities
#20
REVIEW
Xueli Zhang, Fengmei Guo, Hua Shao, Xiao Zheng
The emergence and spread of multidrug resistant Gram-negative bacteria has led to a resurgence in the clinical use of polymyxin antibiotics. However, the prevalence of polymyxin resistance is on the rise at an alarming rate, motivating the idea of combination therapy to sustain the revival of these "old" antibiotics. Although ample evidence in favor of combination therapy has emerged, it seems impracticable and confusing to find a promising combination from the diverse reports or gain adequate information on the efficacy and safety profile...
December 18, 2016: Journal of Infection
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