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https://www.readbyqxmd.com/read/28637222/risk-factors-for-the-development-of-delayed-tsh-elevation-in-neonatal-intensive-care-unit-nicu-newborns
#1
Amnon Zung, Rachel Bier Palmon, Agneta Golan, Mara Troitzky, Smadar Eventov-Friedman, Ronella Marom, Rimona Keidar, Neri Kats, Shlomo Almashanu, Orna Flidel-Rimon
Context: Delayed TSH elevation (dTSH) is defined as elevated TSH in the second neonatal screen (following normal TSH in the initial screen) in premature, low-birth-weight and sick newborns, mostly in the neonatal intensive care unit (NICU) setting. The pathogenesis of dTSH is elusive. Objective: To identify risk factors for dTSH development among newborns in the NICU. Design: setting and patients: A retrospective chart review of neonates with dTSH was conducted in eight university-affiliated NICUs...
June 20, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28637185/a-novel-method-of-open-reduction-and-internal-fixation-of-a-displaced-manubrial-fracture-using-distal-clavicle-locking-plates
#2
Daniel Miller, M Adeel Akhtar, Jonathan Fergusson, James L McVie
A 52-year-old man sustained a sternal fracture after a blunt traumatic chest injury. He was in severe pain in the intensive care unit, which resulted in difficulty breathing and increased analgesic requirement, and a decision was made to stabilize his manubrial fracture. Orthopaedic and thoracic surgeons jointly performed open reduction and internal fixation of the displaced manubrial fracture using 2 distal clavicle locking plates. This resulted in improvement in patient's pain and helped with his subsequent recovery and discharge from the hospital...
June 20, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28637096/uncovering-the-decision-making-work-of-transferring-dying-patients-home-from-critical-care-units-an-integrative-review
#3
REVIEW
Yanxia Lin, Michelle Myall, Nikki Jarrett
AIMS: To understand how decisions are made to transfer dying patients home from critical care units. BACKGROUND: Many people prefer a home death, but a high proportion die in critical care units. Transferring dying patients home is recognized to be complex but transfer decision-making itself remains unclear. DESIGN: Integrative review. DATA SOURCES: Seven bibliographic databases (origin - 2015), grey literature and reference lists were searched...
June 21, 2017: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/28636702/analysis-of-survival-after-initiation-of-continuous-renal-replacement-therapy-in-a-surgical-intensive-care-unit
#4
James M Tatum, Galinos Barmparas, Ara Ko, Navpreet Dhillon, Eric Smith, Daniel R Margulies, Eric J Ley
Importance: Continuous renal replacement therapy (CRRT) benefits patients with renal failure who are too hemodynamically unstable for intermittent hemodialysis. The duration of therapy beyond which continued use is futile, particularly in a population of patients admitted to and primarily cared for by a surgical service (hereinafter referred to as surgical patients), is unclear. Objective: To analyze proportions of and independent risk factors for survival to discharge after initiation of CRRT among patients in a surgical intensive care unit (SICU)...
June 21, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28636648/cost-effectiveness-of-pazopanib-versus-sunitinib-for-metastatic-renal-cell-carcinoma-in-the-united-kingdom
#5
Jordan Amdahl, Jose Diaz, Arati Sharma, Jinhee Park, David Chandiwana, Thomas E Delea
BACKGROUND: Sunitinib and pazopanib are the only two targeted therapies for the first-line treatment of locally advanced or metastatic renal cell carcinoma (mRCC) recommended by the United Kingdom's National Institute for Health and Care Excellence. Pazopanib demonstrated non-inferior efficacy and a differentiated safety profile versus sunitinib in the phase III COMPARZ trial. The current analysis provides a direct comparison of the cost-effectiveness of pazopanib versus sunitinib from the perspective of the United Kingdom's National Health Service based on data from COMPARZ and other sources...
2017: PloS One
https://www.readbyqxmd.com/read/28636444/a-highly-infectious-disease-care-network-in-the-us-healthcare-system
#6
Aurora B Le, Paul D Biddinger, Philip W Smith, Jocelyn J Herstein, Deborah A Levy, Shawn G Gibbs, John J Lowe
During the 2014-15 Ebola outbreak in West Africa, the United States responded by stratifying hospitals into 1 of 3 Centers for Disease Control and Prevention (CDC)-designated categories-based on the hospital's ability to identify, isolate, assess, and provide care to patients with suspected or confirmed Ebola virus disease (EVD)-in an attempt to position the US healthcare system to safely isolate and care for potential patients. Now, with the Ebola epidemic quelled, it is crucial that we act on the lessons learned from the EVD response to broaden our national perspective on infectious disease mitigation and management, build on our newly enhanced healthcare capabilities to respond to infectious disease threats, develop a more cost-effective and sustainable model of infectious disease prevention, and continue to foster training so that the nation is not in a vulnerable position once more...
May 2017: Health Security
https://www.readbyqxmd.com/read/28636443/personal-protective-equipment-supply-chain-lessons-learned-from-recent-public-health-emergency-responses
#7
Anita Patel, Maryann M D'Alessandro, Karen J Ireland, W Greg Burel, Elaine B Wencil, Sonja A Rasmussen
Personal protective equipment (PPE) that protects healthcare workers from infection is a critical component of infection control strategies in healthcare settings. During a public health emergency response, protecting healthcare workers from infectious disease is essential, given that they provide clinical care to those who fall ill, have a high risk of exposure, and need to be assured of occupational safety. Like most goods in the United States, the PPE market supply is based on demand. The US PPE supply chain has minimal ability to rapidly surge production, resulting in challenges to meeting large unexpected increases in demand that might occur during a public health emergency...
May 2017: Health Security
https://www.readbyqxmd.com/read/28636442/the-national-ebola-training-and-education-center-preparing-the-united-states-for-ebola-and-other-special-pathogens
#8
Christopher J Kratochvil, Laura Evans, Bruce S Ribner, John J Lowe, Melissa Cole Harvey, Richard C Hunt, Abbigail J Tumpey, Ryan P Fagan, Michelle M Schwedhelm, Sonia Bell, John Maher, Colleen S Kraft, Nicholas V Cagliuso, Sharon Vanairsdale, Angela Vasa, Philip W Smith
The National Ebola Training and Education Center (NETEC) was established in 2015 in response to the 2014-2016 Ebola virus disease outbreak in West Africa. The US Department of Health and Human Services office of the Assistant Secretary for Preparedness and Response and the US Centers for Disease Control and Prevention sought to increase the competency of healthcare and public health workers, as well as the capability of healthcare facilities in the United States, to deliver safe, efficient, and effective care to patients infected with Ebola and other special pathogens nationwide...
May 2017: Health Security
https://www.readbyqxmd.com/read/28636421/analysis-of-origins-of-admission-for-solid-tumor-oncology-inpatients-disease-severity-and-outcomes
#9
Christopher E Wee, Lindsey M Goodman, Leticia Varella, Lisa A Rybicki, Alberto J Montero, Bassam N Estfan, Carolyn H Best, James P Stevenson
PURPOSE: Hospital transfers may affect clinical outcomes. Evaluation of admission by source of transfer, time of admission, and provider type may identify opportunities to improve inpatient outcomes. METHODS: We reviewed charts of patients admitted to the solid tumor oncology service between July and December 2014 from the Cleveland Clinic Foundation (CCF) Main Campus emergency department (ED), CCF Regional EDs, outside hospital (OSH) ED, OSH inpatient services, and CCF outpatient clinics...
June 21, 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28636297/-supportive-care-in-oncology-a-real-change-for-patients
#10
Alex Friedlaender, Samuel Blaser, Christophe Luthy, Angela Pugliesi Rinaldi
With the increased incidence of cancers due to an aging population, and a prolonged survival thanks to advances in cancer treatments, new therapeutic challenges have arisen. The management of symptoms, the tolerance of increasingly effective oncologic treatments and, finally, quality of life are central concerns of patients and their loved ones. Supportive care in oncology has helped meet these challenges, offering a holistic approach, encompassing somatic, psychiatric and social aid. Inaugurated in 2005, the oncologic supportive care unit of the Geneva University Hospitals allows many cancer patients access to a team of multidisciplinary care-givers to help meet their needs...
May 17, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28635585/the-meaning-and-experience-of-bereavement-support-a-qualitative-interview-study-of-bereaved-family-caregivers
#11
Emma Kirby, Katherine Kenny, Alex Broom, John MacArtney, Phillip Good
OBJECTIVE: Experiences of bereavement can be stressful and are frequently complicated by emotional, familial, and financial issues. Some-though not all-caregivers may benefit from bereavement support. While considered standard within palliative care services in Australia, bereavement support is not widely utilized by family caregivers. There is little research focused on the forms of bereavement support desired or required by family caregivers, how such care is viewed, and/or how bereavement support is experienced...
June 21, 2017: Palliative & Supportive Care
https://www.readbyqxmd.com/read/28635575/-high-risk-obstetrics-in-tertiary-centres-anaesthetist-hybrid-operating-suite-and-obstetric-critical-care-unit
#12
C D van der Marel, A J Eggink, R J Stolker
The frequency of pregnancy-related morbidity has increased over recent decades, as has the number of patients with complex congenital cardiac anomalies reaching fertile age, resulting in an increasing number of high-risk pregnancies. In order to optimalise maternal and foetal outcome in these patients, not only is the availability of optimal in-hospital facilities (e.g. obstetric critical care unit, hybrid operating suite) important, but also a multidisciplinary approach which is mandatory for successful maternal and foetal outcome...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28635570/quality-dementia-care-prerequisites-and-relational-ethics-among-multicultural-healthcare-providers
#13
Gerd Sylvi Sellevold, Veslemøy Egede-Nissen, Rita Jakobsen, Venke Sørlie
BACKGROUND: Many nursing homes appear as multicultural workplaces where the majority of healthcare providers have an ethnic minority background. This environment creates challenges linked to communication, interaction and cultural differences. Furthermore, the healthcare providers have varied experiences and understanding of what quality care of patients with dementia involves. PURPOSE: The aim of this study is to illuminate multi-ethnic healthcare providers' lived experiences of their own working relationship, and its importance to quality care for people with dementia...
January 1, 2017: Nursing Ethics
https://www.readbyqxmd.com/read/28635566/stone-size-is-a-predictor-for-residual-stone-and-multiple-procedures-of-endoscopic-combined-intrarenal-surgery
#14
Shimpei Yamashita, Yasuo Kohjimoto, Akinori Iba, Kazuro Kikkawa, Isao Hara
OBJECTIVES: The aim of this study was to identify the predictors of treatment results after endoscopic combined intrarenal surgery (ECIRS). MATERIALS AND METHODS: A retrospective analysis was conducted of 75 patients with renal stones who underwent ECIRS and a preoperative non-contrast computed tomography (NCCT) examination. The stone-free rate (SFR), number of primary procedures and perioperative complications were investigated, and the predictors contributing to these three outcomes were analyzed...
February 13, 2017: Scandinavian Journal of Urology
https://www.readbyqxmd.com/read/28635539/an-old-challenge-with-new-promises-a-systematic-review-on-comprehensive-geriatric-assessment-in-long-term-care-facilities
#15
Francesco Panza, Vincenzo Solfrizzi, Madia Lozupone, Maria Rosaria Barulli, Francesca D'Urso, Roberta Stallone, Vittorio Dibello, Alessia Noia, Cristina Di Dio, Antonio Daniele, Antonello Bellomo, Davide Seripa, Antonio Greco, Giancarlo Logroscino
Comprehensive geriatric assessment (CGA) is a multidimensional and multidisciplinary diagnostic process focused on determining the clinical profile, pathological risk, residual skills, short- and long-term prognosis, and the personalized therapeutic and care plan of the functionally compromised and frail older subjects. Previous evidence suggested that the effectiveness of CGA programs may be influenced by the settings where the CGA is performed [i.e., hospital, post-hospital discharge/ long-term care facilities (LTCF), or community/home] as well as the specific clinical conditions of older frail individuals...
June 21, 2017: Rejuvenation Research
https://www.readbyqxmd.com/read/28635494/urea-cycle-disorder-misdiagnosed-as-multiple-sclerosis-a-case-report-and-review-of-the-literature
#16
Hussein Algahtani, Seham Alameer, Yousef Marzouk, Bader Shirah
Urea cycle disorders are a group of inborn errors of metabolism caused by dysfunction of any of the six enzymes or two transport proteins involved in urea biosynthesis. In this paper, we report a patient who presented with neurological dysfunction and coma in the immediate postpartum period. She was misdiagnosed for many years as a case of multiple sclerosis. The importance of reporting this case is to illustrate that the wrong diagnosis of patients as being affected with multiple sclerosis for many years due to magnetic resonance imaging abnormalities rather than the classic relapsing-remitting nature of the disease may lead to catastrophic consequences...
January 1, 2017: Neuroradiology Journal
https://www.readbyqxmd.com/read/28635447/-your-core-nursing-skills-are-vital
#17
(no author information available yet)
After taking up a nursing career in his thirties, Major Rob Instrell qualified in Southampton in 2002. He worked mainly in emergency care, and is now lead practitioner in critical care outreach at Blackpool Teaching Hospitals NHS Foundation Trust. In his military career, he has served as a troop commander and as the unit adjutant for 335 Medical Evacuation, and has been the regiment's clinical lead for the past four years.
June 21, 2017: Nursing Standard
https://www.readbyqxmd.com/read/28635440/adding-an-accredited-exercise-physiologist-role-to-a-new-model-of-care-at-a-secure-extended-care-mental-health-service-a-qualitative-study
#18
Trentham Furness, Jude Hewavasam, Jakqui Barnfield, Brian McKenna, Corey Joseph
BACKGROUND: Accredited exercise physiologists (AEPs) are emerging as essential members of allied health in the management of non-communicable chronic diseases. People diagnosed with severe mental illness (SMI) are at greater risk of cardiovascular diseases. Secure extended care units (SECUs) provide treatment, supervision and support for people with SMI whose needs cannot be met adequately in the community. However, the role of AEPs in SECUs has not been described. AIM: Describe the processes and outcomes of adding an AEP to a new model of care at a SECU...
March 1, 2017: Journal of Mental Health
https://www.readbyqxmd.com/read/28635374/sepsis-favors-high-on-clopidogrel-platelet-reactivity
#19
Karolina Akinosoglou, Angelos Perperis, Spyridoula Theodoraki, Dimitrios Alexopoulos, Charalambos Gogos
High-on-treatment platelet reactivity (HPR) is associated with ischemic events in patients on antiplatelet therapy with a history of cardiovascular disease. On the other hand, recent data have associated sepsis with adverse cardiovascular events in patients admitted with bacteremia or respiratory infection. We aimed to assess P2Y12-mediated platelet reactivity (PR) during sepsis and recovery in patients under clopidogrel. This was a prospective observational study. Incoming patients presenting with signs/symptoms of sepsis already on a maintenance dose of clopidogrel of 75 mg qd for cardiovascular events were included in this study...
June 21, 2017: Platelets
https://www.readbyqxmd.com/read/28635351/assessing-the-quality-of-bereavement-care-after-perinatal-death-development-and-piloting-of-a-questionnaire-to-assess-parents-experiences
#20
Esther Aiyelaagbe, Rebecca E Scott, Victoria Holmes, Emma Lane, Alexander E P Heazell
Understanding parents' experience of care is essential to develop high-quality perinatal bereavement services. This study aimed at developing a questionnaire to identify parents' needs and record their experience of care. The patient experience questionnaire was developed by professionals and parents, and piloted in a tertiary maternity unit. Responses were received from 58 parents. Sensitivity and kindness of staff and time spent with their baby were ranked as 'very important' by 95% of parents. Care in these areas largely met their needs (90%), although 5% of respondents stated that partners could have been more involved...
June 21, 2017: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
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