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https://www.readbyqxmd.com/read/29150972/patient-level-factors-and-the-quality-of-care-delivered-in-pediatric-emergency-departments
#1
James P Marcin, Patrick S Romano, Parul Dayal, Madan Dharmar, James M Chamberlain, Nanette Dudley, Charles G Macias, Lise E Nigrovic, Elizabeth C Powell, Alexander J Rogers, Meridith Sonnett, Leah Tzimenatos, Elizabeth R Alpern, Rebecca Andrews-Dickert, Dominic A Borgialli, Erika Sidney, T Charles Casper, J Michael Dean, Nathan Kuppermann
OBJECTIVE: Quality of care delivered to adult patients in the emergency department (ED) is often associated with demographic and clinical factors such as a patient's race/ethnicity and insurance status. We sought to determine whether the quality of care delivered to children in the ED was associated with a variety of patient-level factors. METHODS: This was a retrospective, observational cohort study. Pediatric patients (<18 years) who received care between January 2011 and December 2011 at one of twelve EDs participating in the Pediatric Emergency Care Applied Research Network (PECARN) were included...
November 18, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29142842/prevention-and-management-of-bleeding-in-thyroid-surgery
#2
REVIEW
Gabriele Materazzi, Carlo Enrico Ambrosini, Lorenzo Fregoli, Luigi De Napoli, Gianluca Frustaci, Valeria Matteucci, Piermarco Papini, Sohail Bakkar, Paolo Miccoli
Post-thyroidectomy neck hematoma represents a major concern for surgeons because it can result in severe and even life-threatening complications. In fact, postoperative hemorrhage may result in airway compression and respiratory distress, and therefore, effective hemostasis is an important goal in thyroid surgery. Postoperative hematoma occurs at a rate of approximately 0.1% to 1.1%. Almost all cases occur in the first 6 h after surgery and can be the result of several surgeon or patient factors. For many years the clamp-and-tie technique has been the most common way to divide the main vascular pedicles of the thyroid gland...
October 2017: Gland Surgery
https://www.readbyqxmd.com/read/29135485/update-on-questionnaires-for-assessing-adherence-to-inhaler-devices-in-respiratory-patients
#3
Vicente Plaza
PURPOSE OF REVIEW: It has been estimated that adherence to inhaled medications in patients with asthma and chronic obstructive pulmonary disease (COPD) is around 50%. This low adherence rate increases morbidity and mortality of these disorders. The objective of this review was to update information on main questionnaires used in daily for assessing adherence to inhalers of patients with chronic respiratory diseases. RECENT FINDINGS: The test of the adherence to inhalers (TAI) is a recently developed and validated 12-item questionnaire to assess adherence to inhalers of aerosolized drugs in patients with asthma or COPD...
November 11, 2017: Current Opinion in Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/29119961/-the-effectiveness-of-the-improvement-of-health-in-the-schoolchildren-staying-in-a-country-summer-camp
#4
D N Lir, A Ya Perevalov
Organization of recreational activities in the children's camps is inseparable from the assessment of their effectiveness. AIM: The objective of the present study was to estimate the influence of the pastime of the children in a summer camp under the habitual climatic conditions and the resulting improvement of their health status including the body component composition and the functional state of the organism. MATERIAL AND METHODS: The study included 44 schoolchildren at the age from 9 to12 years...
2017: Voprosy Kurortologii, Fizioterapii, i Lechebnoĭ Fizicheskoĭ Kultury
https://www.readbyqxmd.com/read/29119568/unchanged-mitochondrial-phenotype-but-accumulation-of-lipids-in-the-myometrium-in-obese-pregnant-women
#5
Christiane Marie Bourgin Folke Gam, Lea Hüche Larsen, Ole Hartvig Mortensen, Line Engelbrechtsen, Steen Seier Poulsen, Klaus Qvortrup, Elisabeth Reinhart Mathiesen, Peter Damm, Bjørn Quistorff
KEY POINTS: Obesity during pregnancy and childbirth is associated with labour dystocia leading to instrumental or operative delivery, but the underlying pathophysiological mechanisms remain unclear and insufficient uterine contractility has been suggested. This study examined whether reduced myometrial mitochondrial capacity or quantity could contribute as a pathophysiological mechanism to labour dystocia. Data did not support reduced myometrial mitochondrial capacity or quantity in the myometrium at term in obese women, but a reduced myocyte density with increased triglyceride content was demonstrated, which could lead to poorer uterine contractility...
November 9, 2017: Journal of Physiology
https://www.readbyqxmd.com/read/29117092/the-development-and-validation-of-a-concise-instrument-for-formative-assessment-of-team-leader-performance-during-simulated-pediatric-resuscitations
#6
Lindsay D Nadkarni, Cindy G Roskind, Marc A Auerbach, Aaron W Calhoun, Mark D Adler, David O Kessler
AIM: The aim of this study was to assess the validity of a formative feedback instrument for leaders of simulated resuscitations. METHODS: This is a prospective validation study with a fully crossed (person × scenario × rater) study design. The Concise Assessment of Leader Management (CALM) instrument was designed by pediatric emergency medicine and graduate medical education experts to be used off the shelf to evaluate and provide formative feedback to resuscitation leaders...
November 8, 2017: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
https://www.readbyqxmd.com/read/29098288/hypoglossal-nerve-stimulation-in-adolescents-with-down-syndrome-and-obstructive-sleep-apnea
#7
Gillian R Diercks, Carissa Wentland, Donald Keamy, Thomas Bernard Kinane, Brian Skotko, Vanessa de Guzman, Ellen Grealish, John Dobrowski, Ryan Soose, Christopher J Hartnick
Importance: Obstructive sleep apnea (OSA) affects up to 60% of children with Down syndrome (DS) and may persist in half of patients after adenotonsillectomy. Children with DS who have persistent OSA often do not tolerate treatment with positive pressure airway support devices or tracheotomy for their residual moderate to severe OSA. The hypoglossal nerve stimulator is an implantable device that delivers an electrical impulse to anterior branches of the hypoglossal nerve in response to respiratory variation, resulting in tongue base protrusion that alleviates upper airway obstruction in adults...
November 2, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/29078756/effects-of-lung-protective-mechanical-ventilation-associated-with-permissive-respiratory-acidosis-on-regional-extra-pulmonary-blood-flow-in-experimental-ards
#8
Rudolf Hering, Stefan Kreyer, Christian Putensen
BACKGROUND: Lung protective mechanical ventilation with limited peak inspiratory pressure has been shown to affect cardiac output in patients with ARDS. However, little is known about the impact of lung protective mechanical ventilation on regional perfusion, especially when associated with moderate permissive respiratory acidosis. We hypothesized that lung protective mechanical ventilation with limited peak inspiratory pressure and moderate respiratory acidosis results in an increased cardiac output but unequal distribution of blood flow to the different organs of pigs with oleic-acid induced ARDS...
October 27, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/29068595/computational-fluid-dynamics-in-the-assessment-of-patients-postoperative-status-after-glottis-widening-surgery
#9
Magdalena Marków, Daniel Janecki, Bogusława Orecka, Maciej Misiołek, Krzysztof Warmuziński
BACKGROUND: Computational fluid dynamics (CFD), a rapidly developing instrument with a number of practical applications, allows calculation and visualization of the changing parameters of airflow in the upper respiratory tract. OBJECTIVES: The aim of this study was to demonstrate the advantages of CFD as an instrument for noninvasive tests of the larynx in patients who had undergone surgical treatment due to bilateral vocal fold paralysis. MATERIAL AND METHODS: Surface measurements of the glottic space were made during maximum adduction of the vocal folds...
September 2017: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
https://www.readbyqxmd.com/read/29068269/prone-position-for-acute-respiratory-distress-syndrome-a-systematic-review-and-meta-analysis
#10
Laveena Munshi, Lorenzo Del Sorbo, Neill K J Adhikari, Carol L Hodgson, Hannah Wunsch, Maureen O Meade, Elizabeth Uleryk, Jordi Mancebo, Antonio Pesenti, V Marco Ranieri, Eddy Fan
RATIONALE: The application of prone positioning for acute respiratory distress syndrome (ARDS) has evolved, with recent trials focusing on patients with more severe ARDS, and applying prone ventilation for more prolonged periods. OBJECTIVES: This review evaluates the effect of prone positioning on 28-day mortality (primary outcome) compared with conventional mechanical ventilation in the supine position for adults with ARDS. METHODS: We updated the literature search from a systematic review published in 2010, searching MEDLINE, EMBASE, and CENTRAL (through to August 2016)...
October 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/29059880/evaluation-of-indirect-measures-of-neural-inspiratory-time-from-invasive-and-noninvasive-recordings-of-respiratory-activity
#11
Daniel Garcia-Castellote, Abel Torres, Luis Estrada, Leonardo Sarlabous, Raimon Jane
Measuring diaphragmatic electromyography (EMGdi) provides an indirect quantification of neural respiratory drive and allows the delimitation of diaphragm neural activation and deactivation during inspiration. EMGdi recordings have been incorporated in novel modes of assisted mechanical ventilation, such as neurally adjusted ventilatory assist (NAVA), to trigger and cycle-off the ventilator. The EMGdi signal improves the assistance delivered by more conventional ventilatory modes, in which the ventilator is synchronized with the patient employing a pneumatic triggering...
July 2017: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/29059648/determine-the-effectiveness-of-lipid-lowering-therapy-in-patients-with-chronic-obstructive-pulmonary-disease-combined-with-coronary-heart-disease
#12
Vyacheslav Zhdan, Galina Khaymenova, Lyudmila Shilkina, Daria Martynyuk, Marina Babanina, Tatyana Mamontova
INTRODUCTION: In complex treatment of chronic obstructive pulmonary disease (COPD) combined with ischemic heart disease (IHD) more and more attention is drawn to pleiotropic effect of statins. The aim of our researches became determining the effectivity of utilization of rosuvastatin (CRESTOR®, IPR PHARMACEUTICALS, Inc.) in complex treatment of COPD combined with IHD. MATERIALS AND METHODS: Basing on pulmonology department of Poltava regional clinical hospital, 30 patients with COPD combined with IHD have been examined (stable effort angina FC II) aged from 51 to 67 y...
2017: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/29056418/hemodynamic-effects-of-dexmedetomidine-with-and-without-mk-467-following-intramuscular-administration-in-cats-anesthetized-with-isoflurane
#13
Kristine T Siao, Bruno H Pypendop, Juhana Honkavaara, Jan E Ilkiw
OBJECTIVE: To characterize the hemodynamic effects of dexmedetomidine, with or without MK-467, following intramuscular (IM) administration in cats. STUDY DESIGN: Randomized, crossover, experimental study. ANIMALS: Six healthy adult male castrated purpose-bred cats. METHODS: Cats were anesthetized with isoflurane in oxygen and instrumented. Cats were administered dexmedetomidine (25 μg kg(-1)), with (DM) or without (D) MK-467 (600 μg kg(-1)), IM in the epaxial muscles...
May 4, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/29049254/one-stage-posterior-approaches-for-treatment-of-thoracic-spinal-infection-transforaminal-and-costotransversectomy-compared-with-anterior-approach-with-posterior-instrumentation
#14
Fu-Cheng Kao, Tsung-Ting Tsai, Chi-Chien Niu, Po-Liang Lai, Lih-Huei Chen, Wen-Jer Chen
Treating thoracic infective spondylodiscitis with anterior surgical approaches carry a relatively high risk of perioperative and postoperative complications. Posterior approaches have been reported to result in lower complication rates than anterior procedures, but more evidence is needed to demonstrate the safety and efficacy of 1-stage posterior approaches for treating infectious thoracic spondylodiscitis.Preoperative and postoperative clinical data, of 18 patients who underwent 2 types of 1-stage posterior procedures, costotransversectomy and transforaminal thoracic interbody debridement and fusion and 7 patients who underwent anterior debridement and reconstruction with posterior instrumentation, were retrospectively assessed...
October 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29039228/evaluation-of-the-respiratory-tract-toxicity-of-ortho-phthalaldehyde-a-proposed-alternative-for-the-chemical-disinfectant-glutaraldehyde
#15
Natasha R Catlin, Cynthia J Willson, Matthew Stout, Grace E Kissling, Suramya Waidyanatha, Gregory L Baker, Barry K Hayden, Michael Wyde
ortho-Phthalaldehyde (OPA) is a high-level chemical disinfectant that is commonly used for chemical sterilization of dental and medical instruments as an alternative to glutaraldehyde, a known skin and respiratory sensitizer. Concern for safe levels of human exposure remains due to a lack of toxicity data as well as human case reports of skin and respiratory sensitization following OPA exposure. The present study evaluated the inhalational toxicity of OPA in Harlan Sprague-Dawley rats and B6C3F1/N mice. Groups of 10 male and female rats and mice were exposed to OPA by whole-body inhalation for 3 months at concentrations of 0 (control), 0...
August 2017: Inhalation Toxicology
https://www.readbyqxmd.com/read/29028763/effects-of-hyperoxia-during-resuscitation-from-hemorrhagic-shock-in-swine-with-preexisting-coronary-artery-disease
#16
Clair Hartmann, Maurizio Loconte, Elena Antonucci, Michael Holzhauser, Tobias Hölle, David Katzsch, Tamara Merz, Oscar McCook, Ulrich Wachter, Josef A Vogt, Andrea Hoffmann, Martin Wepler, Michael Gröger, Martin Matejovic, Enrico Calzia, Michael Georgieff, Pierre Asfar, Peter Radermacher, Benedikt L Nussbaum
OBJECTIVES: Investigation of the effects of hyperoxia during resuscitation from hemorrhagic shock in swine with preexisting coronary artery disease. DESIGN: Prospective, controlled, randomized trial. SETTING: University animal research laboratory. SUBJECTS: Nineteen hypercholesterolemic pigs with preexisting coronary artery disease. INTERVENTIONS: Anesthetized, mechanically ventilated, and surgically instrumented pigs underwent 3 hours of hemorrhagic shock (removal of 30% of the calculated blood volume and subsequent titration of mean arterial blood pressure ≈40 mm Hg)...
December 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29020996/quality-of-life-profile-of-general-vietnamese-population-using-eq-5d-5l
#17
Long Hoang Nguyen, Bach Xuan Tran, Quynh Ngoc Hoang Le, Tung Thanh Tran, Carl A Latkin
BACKGROUND: Health-related quality of life (HRQOL) is a vital benchmark to assess the effects of health interventions and policies. Measuring HRQOL of the general population is essential to establish a reference for health outcomes evaluations. However, evidence on HRQOL of general populations in low and middle income countries is very limited. This study aimed to measure HRQOL of the Vietnamese population by using the EuroQol-5 dimensions-5 levels (EQ-5D-5L) instrument and determine its associated factors...
October 11, 2017: Health and Quality of Life Outcomes
https://www.readbyqxmd.com/read/28982772/occupational-exposure-to-disinfectants-and-asthma-control-in-us-nurses
#18
Orianne Dumas, Aleta S Wiley, Catherine Quinot, Raphaëlle Varraso, Jan-Paul Zock, Paul K Henneberger, Frank E Speizer, Nicole Le Moual, Carlos A Camargo
Disinfectant use has been associated with adverse respiratory effects among healthcare workers. However, the specific harmful agents have not been elucidated. We examined the association between occupational exposure to disinfectants and asthma control in the Nurses' Health Study II, a large cohort of female nurses.Nurses with asthma were invited in 2014 to complete two questionnaires on their current occupation and asthma (response rate 80%). Asthma control was defined by the Asthma Control Test (ACT). Exposure to major disinfectants was evaluated by a job-task-exposure matrix (JTEM)...
October 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/28977471/variations-in-gene-expression-of-lung-macromolecules-after-induction-chemotherapy-for-lung-cancer
#19
Lucio Cagini, Stefania Balloni, Vienna Ludovini, Marco Andolfi, Alberto Matricardi, Rossella Potenza, Jacopo Vannucci, Annamaria Siggillino, Francesca Romana Tofanetti, Guido Bellezza, Maria Bodo, Francesco Puma, Lorella Marinucci
OBJECTIVES: Preoperative chemotherapy may play a role in postoperative respiratory complications due to subclinical parenchymal damage. We investigated the gene expression of lung tissue components after neoadjuvant chemotherapy of alveolar-capillary membrane, extracellular matrix and membrane proteins. METHODS: The study group included 14 patients submitted to pulmonary resection for lung cancer after 3 cycles of gemcitabine-cisplatin, while the control group included 14 naive-treatment patients...
June 19, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28977300/analysis-of-daytime-sleepiniess-in-adolescents-by-the-pediatric-daytime-sleepiness-scale-a-systematic-review
#20
Carolina Meyer, Geraldo Jose Ferrari, Diego Grasel Barbosa, Rubian Diego Andrade, Andreia Pelegrini, Érico Pereira Gomes Felden
OBJECTIVE: To systematically review the use of the Pediatric Daytime Sleepiness Scale (PDSS) in the analysis of daytime sleepiness in children and adolescents. DATA SOURCE: The electronic databases PubMed and SciELO were consulted between 2003 and 2015. As inclusion criterion, studies were considered in English, Spanish and Portuguese, original articles of any type of design, articles with a sample of children and/or adolescents, articles that used the PDSS. Duplicate articles, articles with no relation to the theme, articles with another investigated population, and articles that the parents answered the instrument for their children were excluded...
July 2017: Revista Paulista de Pediatria: Orgão Oficial da Sociedade de Pediatria de São Paulo
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