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https://www.readbyqxmd.com/read/28228178/the-state-of-emergency-medical-services-ems-systems-in-africa
#1
Nee-Kofi Mould-Millman, Julia M Dixon, Nana Sefa, Arthur Yancey, Bonaventure G Hollong, Mohamed Hagahmed, Adit A Ginde, Lee A Wallis
: Introduction Little is known about the existence, distribution, and characteristics of Emergency Medical Services (EMS) systems in Africa, or the corresponding epidemiology of prehospital illness and injury. METHODS: A survey was conducted between 2013 and 2014 by distributing a detailed EMS system questionnaire to experts in paper and electronic versions. The questionnaire ascertained EMS systems' jurisdiction, operations, finance, clinical care, resources, and regulatory environment...
February 23, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28228127/a-review-of-enhanced-paramedic-roles-during-and-after-hospital-handover-of-stroke-myocardial-infarction-and-trauma-patients
#2
Darren Flynn, Richard Francis, Shannon Robalino, Joanne Lally, Helen Snooks, Helen Rodgers, Graham McClelland, Gary A Ford, Christopher Price
BACKGROUND: Ambulance paramedics play a critical role expediting patient access to emergency treatments. Standardised handover communication frameworks have led to improvements in accuracy and speed of information transfer but their impact upon time-critical scenarios is unclear. Patient outcomes might be improved by paramedics staying for a limited time after handover to assist with shared patient care. We aimed to categorize and synthesise data from studies describing development/extension of the ambulance-based paramedic role during and after handover for time-critical conditions (trauma, stroke and myocardial infarction)...
February 23, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/28214239/feasibility-and-factor-structure-of-the-frail-scale-in-older-adults
#3
Ivan Aprahamian, Sumika Mori Lin, Claudia Kimie Suemoto, Daniel Apolinario, Natália Oiring de Castro Cezar, Serpui Marie Elmadjian, Wilson Jacob Filho, Mônica Sanches Yassuda
OBJECTIVES: The aim of the present study was to (1) evaluate a geriatric outpatient sample with the FRAIL scale; (2) investigate the psychometric properties of the scale; and (3) characterize different associations of the subdimensions of the scale with demographic and clinical data. DESIGN: Cross-sectional observational study. SETTING: Geriatric outpatient center a university-based hospital in São Paulo, Brazil. PARTICIPANTS: A total of 811 men and women aged 60 years or older evaluated between March 2015 and September 2015...
February 14, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28190499/proportion-recovery-and-times-to-ambulation-for-non-ambulatory-dogs-with-thoracolumbar-disc-extrusions-treated-with-hemilaminectomy-or-conservative-treatment-a-systematic-review-and-meta-analysis-of-case-series-studies
#4
L Langerhuus, J Miles
Thoracolumbar intervertebral disc extrusion is a common cause of spinal cord dysfunction in dogs. Peer-reviewed studies reporting treatment of predominantly chondrodystrophic dogs with disc extrusion with loss of ambulation with either hemilaminectomy or conservative treatment (rest, analgesics and anti-inflammatories) were evaluated in a systematic review of the literature. Generally, the level of evidence available was low with no controlled studies and only case series available. In the meta-analysis, there was a clear trend to a greater proportion of dogs recovering and returning faster to ambulation for dogs treated with hemilaminectomy than for conservatively treated dogs...
February 2017: Veterinary Journal
https://www.readbyqxmd.com/read/28188187/electronic-rapid-fitness-assessment-a-novel-tool-for-preoperative-evaluation-of-the-geriatric-oncology-patient
#5
Armin Shahrokni, Amy Tin, Robert J Downey, Vivian Strong, Sanam Mahmoudzadeh, Manpreet K Boparai, Sincere McMillan, Andrew Vickers, Beatriz Korc-Grodzicki
Background: The American College of Surgeons and American Geriatrics Society recommend performing a geriatric assessment (GA) in the preoperative evaluation of older patients. To address this, we developed an electronic GA, the Electronic Rapid Fitness Assessment (eRFA). We reviewed the feasibility and clinical utility of the eRFA in the preoperative evaluation of geriatric patients. Methods: We performed a retrospective review of our experience using the eRFA in the preoperative assessment of geriatric patients...
February 2017: Journal of the National Comprehensive Cancer Network: JNCCN
https://www.readbyqxmd.com/read/28186453/effects-of-distance-and-transport-method-on-intervention-and-mortality-in-aneurysmal-subarachnoid-hemorrhage
#6
Jonathan Weyhenmeyer, Cristian F Guandique, Adam Leibold, Stephen Lehnert, Jonathan Parish, Woody Han, Chad Tuchek, Janit Pandya, Thomas Leipzig, Troy Payner, Andrew DeNardo, John Scott, Aaron A Cohen-Gadol
OBJECTIVE Most patients suffering from aneurysmal subarachnoid hemorrhage (aSAH) initially present to a hospital that lacks a neurosurgical unit. These patients require interhospital transfer (IHT) to tertiary facilities capable of multidisciplinary neurosurgical intervention. Yet, little is known about the effects of IHT on the outcomes of patients suffering from aSAH. In this study, the authors examined the effects of IHT and transport method on the timing of treatment, rebleed rates, and overall outcomes of patients who have experienced aSAH...
February 10, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28185289/effect-of-epidural-compared-to-patient-controlled-intravenous-analgesia-on-outcomes-for-patients-undergoing-liver-resection-for-neoplastic-disease
#7
Shelby Allen, Amy DeRoche, Lu Adams, Karen Valerie Slocum, Clancy J Clark, Nora F Fino, Perry Shen
BACKGROUND: Epidural analgesia is routinely used for postoperative pain control following abdominal surgeries, yet data regarding the safety and efficacy of epidural analgesia is controversial. METHODS: Pain-related and clinical perioperative data were extracted and correlated with baseline clinicopathologic data and method of analgesia (epidural vs. intravenous patient-controlled analgesia) in patients who underwent hepatectomy from 2012 to 2014. Chronic pain was defined by specific narcotic requirements preoperatively...
February 10, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28184033/extracorporeal-membrane-oxygenation-outcomes-in-acute-respiratory-distress-treatment-case-study-in-a-chinese-referral-center
#8
Lei Huang, Tong Li, Lei Xu, Xiao-Min Hu, Da-Wei Duan, Zhi-Bo Li, Xin-Jing Gao, Jun Li, Peng Wu, Ying-Wu Liu
BACKGROUND No definitive conclusions have been drawn from the available data about the utilization of extracorporeal membrane oxygenation (ECMO) to treat severe acute respiratory distress syndrome (ARDS). The aim of this study was to review our center's experience with ECMO and determine predictors of outcome from our Chinese center. MATERIAL AND METHODS We retrospectively analyzed a total of 23 consecutive candidates who fulfilled the study entry criteria between January 2009 and December 2015. Detailed clinical data, ECMO flow, and respiratory parameters before and after the introduction of ECMO were compared among in-hospital survivors and nonsurvivors; factors associated with mortality were investigated...
February 10, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28162215/-clinical-values-of-multimodal-preventive-analgesia-in-patients-with-partial-hepatectomy-for-liver-cancer
#9
H Zhou, W D Jia, X F Qiao, F P Liu, L Chen, C L Hu
Objective: To investigate the clinical values of multimodal preventive analgesia in patients with partial hepatectomy for liver cancer. Methods: A perspective study was conducted to collect data of patients with liver cancer who underwent partial hepatectomy from March 2014 to March 2015.The 90 patients involved in the study were randomly divided into two groups as multimodal analgesia and control groups, and each group had 45 cases. In multimodal analgesia group, 40 mg parecoxib sodium was injected intravenously 30 minutes before anesthetic induction, and 0...
February 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/28159605/incidence-frequency-and-clinical-characteristics-of-type-3-myocardial-infarction-in-clinical-practice
#10
Nikolaj Jangaard, Laura Sarkisian, Lotte Saaby, Søren Mikkelsen, Anne Marie Lassen, Niels Marcussen, Jørgen L Thomsen, Axel C P Diederichsen, Kristian Thygesen, Hans Mickley
OBJECTIVES: Cardiac death in a patient with symptoms and electrocardiographic changes indicative of myocardial ischemia but without available measurements of cardiac biomarkers is designated a type 3 myocardial infarction. We wanted to investigate the incidence, the frequency and the characteristics of patients diagnosed as type 3 myocardial infarction. METHODS: The occurrence of deaths in a well-defined geographic region was retrieved from the Danish Civil Registration System during a one-year period from 2010 to 2011...
January 31, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28158992/patients-anticipated-actions-following-transient-ischaemic-attack-symptoms-a-qualitative-vignette-based-study
#11
Parker Magin, Terry Joyce, Christopher Levi, Daniel Lasserson
BACKGROUND: Transient Ischaemic Attack (TIA) requires urgent investigation and management. Urgent management reduces the risk of subsequent stroke markedly, but non-presentation or delays in patient presentation to health services have been found to compromise timely management. We aimed to explore general practice patients' anticipated responses to TIA symptoms. METHODS: This was a qualitative study employing semi-structured telephone interviews. Participants were recruited from respondents in an earlier quantitative study based in Australian general practices...
February 3, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28151752/influences-on-emergency-department-length-of-stay-for-older-people
#12
Maryann Street, Mohammadreza Mohebbi, Debra Berry, Anthony Cross, Julie Considine
OBJECTIVE: The aim of this study was to examine the influences on emergency department (ED) length of stay (LOS) for older people and develop a predictive model for an ED LOS more than 4 h. METHODS: This retrospective cohort study used organizational data linkage at the patient level from a major Australian health service. The study population was aged 65 years or older, attending an ED during the 2013/2014 financial year. We developed and internally validated a clinical prediction rule...
February 1, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28122419/factors-influencing-choice-of-pre-hospital-transportation-of-patients-with-potential-acute-coronary-syndrome-an-observational-study
#13
Tim Lavery, Jaimi H Greenslade, William A Parsonage, Tracey Hawkins, Emily Dalton, Christopher Hammett, Louise Cullen
OBJECTIVE: To determine factors associated with ambulance use in patients with confirmed and potential acute coronary syndrome presenting to the ED. METHODS: A convenience sample of patients (n = 247) presenting to the ED from April 2014 to January 2015 with suspected acute coronary syndrome were included in the study. Data on mode of transport and patient demographics were collected from the Emergency Department Information System database. Clinical data were collected from chart records and information systems...
January 25, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28118698/wearable-robotic-exoskeleton-for-over-ground-gait-training-in-sub-acute-and-chronic-hemiparetic-stroke-patients-preliminary-results
#14
Franco Molteni, Giulio Gasperini, Marina Gaffuri, Maria Colombo, Chiara Giovanzana, Chiara Lorenzon, Nico Farina, Giovanni Cannaviello, Stefano Scarano, Davide Proserpio, Davide Liberali, Eleonora Guanziroli
BACKGROUND: Recovery of therapeutic or functional ambulatory capacity in post-stroke patients is a primary goal of rehabilitation. Wearable powered exoskeletons allow patients with gait dysfunctions to perform over-ground gait training, even immediately after the acute event. AIM: To investigate the feasibility and the clinical effects of an over-ground walking training with a wearable powered exoskeleton in sub-acute and chronic stroke patients. DESIGN: Prospective, pilot pre-post, open label, non-randomized experimental study...
24, 2017: European Journal of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/28110861/safety-of-early-ambulation-in-patients-undergoing-ultrasound-guided-femoral-low-angle-arterial-access-technique-flat
#15
P A Shukla, M K Kolber, A Kumar, R I Patel
PURPOSE: To evaluate the safety of early ambulation in patients undergoing transfemoral arterial interventions via ultrasound-guided femoral low angle arterial access technique (FLAT). MATERIALS AND METHODS: A total of 58 patients undergoing 72 transfemoral arterial procedures that underwent an attempt at FLAT for femoral artery cannulation at our institution from November 2014 to July 2015 were retrospectively identified. Technical success was defined as obtaining less than a 35-degree angle of entry through the anterior wall of the common femoral artery...
January 16, 2017: Diagnostic and Interventional Imaging
https://www.readbyqxmd.com/read/28105624/-clinical-research-of-delta-shaped-anastomosis-technology-in-laparoscopic-distal-gastrectomy-and-digestive-tract-reconstruction
#16
Bo Gao, Qingxing Huang, Jianhong Dong
OBJECTIVE: To evaluate the feasibility and safety of the delta-shaped anastomosis in laparoscopic distal gastrectomy and digestive tract reconstruction. METHODS: Clinical data of 34 gastric cancer patients undergoing laparoscopic distal gastrectomy with the delta-shaped anastomosis for digestive tract reconstruction (delta-shaped group) and 83 gastric cancer patients undergoing laparoscopic distal gastrectomy with Billroth I( for digestive tract reconstruction (Billroth group) by same surgeon team from July 2013 to July 2015 at the Department of Digestive Surgery, Affiliated Tumor Hospital of Shanxi Medical University were retrospectively analyzed...
January 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28088757/challenges-in-neonatal-transport-in-jamaica-a-resource-limited-setting
#17
Salome Henry, Helen Trotman
AIM: This study aimed to determine challenges associated with neonatal transport in Jamaica, a resource-limited setting. METHODS: This was a prospective descriptive study of neonates transported to the University Hospital of the West Indies (UHWI) over a 15 month period. Data on the clinical status of the neonates before, during and at the end of transport, as well as on accompanying staff and equipment, were collected. Neonatal demographics, reason for transfer and outcome at 48 h and at discharge were also collected...
January 14, 2017: Journal of Tropical Pediatrics
https://www.readbyqxmd.com/read/28061493/effects-of-percutaneous-sacroplasty-on-pain-and-mobility-in-sacral-insufficiency-fracture
#18
Kyung-Chul Choi, Seung-Ho Shin, Dong Chan Lee, Hyeong-Ki Shim, Choon-Keun Park
OBJECTIVE: Sacral insufficiency fracture (SIF) contributes to severe low back pain. Prolonged immobilization resulting from SIF can cause significant complications in the elderly. Sacroplasty, a treatment similar to vertebroplasty, has recently been introduced for providing pain relief in SIF. The purpose of this study is to investigate the clinical short-term effects of percutaneous sacroplasty on pain and mobility in SIF. METHODS: This study is conducted prospectively with data collection...
January 1, 2017: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/28048739/tu-ab-207a-03-image-quality-dose-and-clinical-applications
#19
F Dong
: Practicing medical physicists are often time charged with the tasks of evaluating and troubleshooting complex image quality issues related to CT scanners. This course will equip them with a solid and practical understanding of common CT imaging chain and its major components with emphasis on acquisition physics and hardware, reconstruction, artifacts, image quality, dose, and advanced clinical applications. The core objective is to explain the effects of these major system components on the image quality...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048020/tu-ab-207a-00-ct-systems-course
#20
Baojun Li
: Practicing medical physicists are often time charged with the tasks of evaluating and troubleshooting complex image quality issues related to CT scanners. This course will equip them with a solid and practical understanding of common CT imaging chain and its major components with emphasis on acquisition physics and hardware, reconstruction, artifacts, image quality, dose, and advanced clinical applications. The core objective is to explain the effects of these major system components on the image quality...
June 2016: Medical Physics
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