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https://www.readbyqxmd.com/read/29664759/characteristics-of-medical-professional-liability-claims-in-pediatric-orthopedics
#1
Jessica Burns, M Wade Shrader, Carla Boan, Mohan Belthur
OBJECTIVES: Medical malpractice is burdensome to the U.S. healthcare system. The following is an epidemiological analysis of the closed medical professional liability (MPL) claims in pediatric orthopedics using data maintained by the Physician Insurers Association of America. METHODS: The Physician Insurers Association of America registry of MPL claims from 1985 to 2013 for all specialties included 286,021 closed claims in the United States. All closed MPL claims for orthopedic surgery in patients younger than 18 years were retrospectively reviewed (N = 2,671)...
April 16, 2018: Journal of Patient Safety
https://www.readbyqxmd.com/read/29661552/skin-banking-at-a-regional-burns-centre-the-way-forward
#2
Sunil Manohar Keswani, Mukesh Gopinath Mishra, Shilpa Karnik, Shruti Dutta, Mamata Mishra, Sangita Panda, Reshmi Varghese, Tanvi Virkar, Vaishna Upendran
In India approximately 1 million people get burnt every year and most of them are from the lower or middle income strata. Therefore it is obligatory to find out an economic way of treatment for the affected populace. Since use of human skin allograft is the gold standard for the treatment of burn wound, in-house skin banking for a burn unit hospital is prerequisite to make the treatment procedure affordable. Although, there was one skin bank at India till 2009, but it was difficult for a single bank to cover the entire country's need...
April 13, 2018: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/29660009/critical-care-in-the-military-health-system-a-24-h-point-prevalence-study
#3
Raymond Fisher, Christopher J Colombo, Cristin A Mount, Elizabeth A Mann-Salinas, Adam W Bostick, Konrad Davis, James K Aden, Kevin K Chung, Mary S McCarthy, Jeremy C Pamplin
Background: Healthcare expenditures are a significant economic cost with critical care services constituting one of its largest components. The Military Health System (MHS) is the largest, global healthcare system of its kind. In this project, we sought to describe critical care services and the patients who receive them in the MHS. Methods: We surveyed 26 military treatment facilities (MTFs) representing 38 critical care services or intensive care units (ICUs)...
April 11, 2018: Military Medicine
https://www.readbyqxmd.com/read/29656835/trauma-quality-improvement-reducing-triage-errors-by-automating-the-level-assignment-process
#4
David P Stonko, Dillon C O Neill, Bradley M Dennis, Melissa Smith, Jeffrey Gray, Oscar D Guillamondegui
BACKGROUND: Trauma patients are triaged by the severity of their injury or need for intervention while en route to the trauma center according to trauma activation protocols that are institution specific. Significant research has been aimed at improving these protocols in order to optimize patient outcomes while striving for efficiency in care. However, it is known that patients are often undertriaged or overtriaged because protocol adherence remains imperfect. The goal of this quality improvement (QI) project was to improve this adherence, and thereby reduce the triage error...
April 12, 2018: Journal of Surgical Education
https://www.readbyqxmd.com/read/29651952/special-traumatized-populations-burns-and-hypothermia
#5
Shruti Mehrotra, Amita Misir
It is important for physicians treating children to be aware of unique presentation that require expertise and knowledge. Two areas of importance when caring for traumatized children are Thermal Burn Injuries, and Hypothermia. Burns commonly result in morbidity in children; as such, the appropriate identification of the severity of the burn and appropriate management are integral to minimize the complications of burns during the acute phase. Attention to proper fluid management is paramount. Knowledge of types of solutions to use during Burn treatment is important...
April 11, 2018: Current Pediatric Reviews
https://www.readbyqxmd.com/read/29648477/acute-intensive-care-unit-management-of-mustard-gas-victims-the-turkish-experience
#6
Ertugrul Kilic, Mesut Ortatatli, Sermet Sezigen, Rusen Koray Eyison, Levent Kenar
Sulfur mustard (SM) is an highly toxic and vesicant chemical weapon that was used in various military conflicts several times in the history. The severity of ocular, dermal, and pulmonary symptoms that may appear following a characteristic asymptomatic period are depending on the SM concentration and exposure duration. The aim of this study is to present the clinical features and share the intensive care unit (ICU) experiences for the medical management of mustard gas victims. Thirteen Free Syrian Army soldiers near Al-Bab region of North Syria were reportedly exposed to oily blackish smoke with garlic smell due to the explosion of a trapped bomb without causing any blast or thermal effect on 26th November 2016...
April 12, 2018: Cutaneous and Ocular Toxicology
https://www.readbyqxmd.com/read/29629853/-determining-depth-of-burns-using-laser-doppler-imaging
#7
C M Legemate, M J Hop, M K Nieuwenhuis, E Middelkoop, M E van Baar, C H van der Vlies
Early accurate assessment of burn depth is important to determine the optimal treatment of burns (conservative versus surgery). Laser Doppler imaging (LDI) is a technique that allows accurate measurement of burn depth by measuring dermal perfusion. Although it has been demonstrated that LDI led to faster decisions as to whether or not to operate, this has not lead to shorter wound healing time or cost savings in Dutch burn care. LDI is used in all Dutch burn centres. In case of doubt about the depth of a burn in primary or secondary care, referral to a burn centre is advisable...
2018: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/29629651/designing-a-brief-behaviour-change-intervention-to-reduce-sexually-transmitted-infections-a-discrete-choice-experiment
#8
Alec Miners, Carrie Llewellyn, Carina King, Alex Pollard, Anupama Roy, Richard Gilson, Alison Rodger, Fiona Burns, Maryam Shahmanesh
To understand whether people attending sexual health (SH) clinics are willing to participate in a brief behavioural change intervention (BBCI) to reduce the likelihood of future sexually transmitted infections (STIs) and to understand their preferences for different service designs, we conducted a discrete choice experiment (DCE) with young heterosexual adults (aged 16-25 years), and men who have sex with men (MSM) aged 16 or above, attending SH clinics in England. Data from 368 participants showed that people particularly valued BBCIs that involved talking (OR 1...
January 1, 2018: International Journal of STD & AIDS
https://www.readbyqxmd.com/read/29628217/development-and-characterization-of-a-point-of-care-rate-based-transcutaneous-respiratory-status-monitor
#9
Xudong Ge, Prosper Adangwa, Ja Young Lim, Yordan Kostov, Leah Tolosa, Richard Pierson, Daniel Herr, Govind Rao
Blood gas measurements provide vital clinical information in critical care. The current "gold standard" for blood gas measurements involves obtaining blood samples, which can be painful and can lead to bleeding, thrombus formation, or infection. Mass transfer equilibrium-based transcutaneous blood gas monitors have been used since the 1970s, but they require heating the skin to ≥42 °C to speed up the transcutaneous gas diffusion. Thus, these devices have a potential risk for skin burns. Here we report a new generation of noninvasive device for respiratory status assessment...
April 5, 2018: Medical Engineering & Physics
https://www.readbyqxmd.com/read/29624408/patient-and-family-engagement-in-the-icu-untapped-opportunities-and-under-recognized-challenges
#10
Karen E A Burns, Cheryl Misak, Margaret Herridge, Maureen O Meade, Simon Oczkowski
The call for meaningful patient and family engagement in healthcare and research is gaining impetus. Healthcare institutions and research funding agencies increasingly encourage clinicians and researchers to work actively with patients and their families to advance clinical care and research. Engagement is increasingly mandated by healthcare organizations and is becoming a prerequisite for research funding. In this article, we review the rationale and the current state of patient and family engagement in patient care and research in the intensive care unit (ICU)...
April 6, 2018: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29622333/emergency-care-of-pediatric-burns
#11
REVIEW
Ashley M Strobel, Ryan Fey
Although the overall incidence of and mortality rate associated with burn injury have decreased in recent decades, burns remain a significant source of morbidity and mortality in children. Children with major burns require emergent resuscitation. Resuscitation is similar to that for adults, including pain control, airway management, and administration of intravenous fluid. However, in pediatrics, fluid resuscitation is needed for burns greater than or equal to 15% of total body surface area (TBSA) compared with burns greater than or equal to 20% TBSA for adults...
May 2018: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/29618862/acetic-acid-dressings-finding-the-holy-grail-for-infected-wound-management
#12
Kapil S Agrawal, Anup Vidyadhar Sarda, Raghav Shrotriya, Manoj Bachhav, Vinita Puri, Gita Nataraj
Background: Wounds have since long, contributed majorly to the health-care burden. Infected long-standing non-healing wounds place many demands on the treating surgeon and are devastating for the patients physically, nutritionally, vocationally, financially, psychologically and socially. Acetic acid has long been included among agents used in the treatment of infected wounds. In this study, we have evaluated the use of acetic acid for topical application in the treatment of infected wounds...
September 2017: Indian Journal of Plastic Surgery: Official Publication of the Association of Plastic Surgeons of India
https://www.readbyqxmd.com/read/29615833/patient-and-physician-perspectives-on-the-use-of-cyclosporine-ophthalmic-emulsion-0-05-for-the-management-of-chronic-dry-eye
#13
REVIEW
Tatiana Deveney, Penny A Asbell
Dry eye disease (DED) is a multifactorial disease of the ocular surface and is one of the most common reasons for patients to visit an eye care provider. Cyclosporine A (CsA) is an immune modulating drug that was approved in the US for topical use in the treatment of DED in 2003, which led to a paradigm change in our understanding and treatment of DED, turning attention to control of inflammation for treatment. This review summarizes the literature to date regarding the impact of CsA on the treatment of DED...
2018: Clinical Ophthalmology
https://www.readbyqxmd.com/read/29615134/improving-outcomes-after-pediatric-cardiac-arrest-the-icu-resuscitation-project-study-protocol-for-a-randomized-controlled-trial
#14
Ron W Reeder, Alan Girling, Heather Wolfe, Richard Holubkov, Robert A Berg, Maryam Y Naim, Kathleen L Meert, Bradley Tilford, Joseph A Carcillo, Melinda Hamilton, Matthew Bochkoris, Mark Hall, Tensing Maa, Andrew R Yates, Anil Sapru, Robert Kelly, Myke Federman, J Michael Dean, Patrick S McQuillen, Deborah Franzon, Murray M Pollack, Ashley Siems, John Diddle, David L Wessel, Peter M Mourani, Carleen Zebuhr, Robert Bishop, Stuart Friess, Candice Burns, Shirley Viteri, David A Hehir, R Whitney Coleman, Tammara L Jenkins, Daniel A Notterman, Robert F Tamburro, Robert M Sutton
BACKGROUND: Quality of cardiopulmonary resuscitation (CPR) is associated with survival, but recommended guidelines are often not met, and less than half the children with an in-hospital arrest will survive to discharge. A single-center before-and-after study demonstrated that outcomes may be improved with a novel training program in which all pediatric intensive care unit staff are encouraged to participate in frequent CPR refresher training and regular, structured resuscitation debriefings focused on patient-centric physiology...
April 3, 2018: Trials
https://www.readbyqxmd.com/read/29615112/where-to-from-here-a-quality-improvement-project-investigating-burns-treatment-and-rehabilitation-practices-in-india
#15
J Jagnoor, C Lukaszyk, A Christou, T Potokar, S Chamania, R Ivers
OBJECTIVE: To describe the capacity of the Indian healthcare system in providing appropriate and effective burns treatment and rehabilitation services. RESULTS: Health professionals involved in burns treatment or rehabilitation at seven hospitals from four states in India were invited to participate in consultative meetings. Existing treatment and rehabilitation strategies, barriers and enablers to patient flow across the continuum of care and details on inpatient and outpatient rehabilitation were discussed during the meetings...
April 3, 2018: BMC Research Notes
https://www.readbyqxmd.com/read/29614247/pseudomonas-aeruginosa-adapts-to-octenidine-in-the-laboratory-and-a-simulated-clinical-setting-leading-to-increased-tolerance-to-chlorhexidine-and-other-biocides
#16
Matthew J Shepherd, Ginny Moore, Matthew E Wand, J Mark Sutton, Lucy J Bock
BACKGROUND: Octenidine is frequently used for infection prevention in neonatal and burn intensive care units, where Pseudomonas aeruginosa has caused nosocomial outbreaks. AIM: To investigate the efficacy and impact of using octenidine against P. aeruginosa. METHODS: Seven clinical isolates of P. aeruginosa were exposed to increasing concentrations of octenidine over several days. Fitness, minimum bactericidal concentrations after 1 minute, 5 minutes and 24 hours, and minimum inhibitory concentrations of a variety of antimicrobials were measured for the parental and octenidine-adapted P...
March 31, 2018: Journal of Hospital Infection
https://www.readbyqxmd.com/read/29610766/checking-procalcitonin-suitability-for-prognosis-and-antimicrobial-therapy-monitoring-in-burn-patients
#17
Luís Cabral, Vera Afreixo, Rita Meireles, Miguel Vaz, Catarina Chaves, Marisa Caetano, Luís Almeida, José Artur Paiva
Background: Due to greater infection susceptibility, sepsis is the main cause of death in burn patients. Quick diagnosis and patient stratification, early and appropriated antimicrobial therapy, and focus control are crucial for patients' survival. On the other hand, superfluous extension of therapy is associated with adverse events and arousal of microbial resistance. The use of biomarkers, necessarily coupled with close clinical examination, may predict outcomes, stratifying patients who need more intensive care, and monitor the efficacy of antimicrobial therapy, allowing faster de-escalation or stop, reducing the development of resistance and possibly the financial burden, without increasing mortality...
2018: Burns and Trauma
https://www.readbyqxmd.com/read/29609856/a-polymicrobial-fungal-outbreak-in-a-regional-burn-center-after-hurricane-sandy
#18
Geeta Sood, Dhananjay Vaidya, Lisa Dam, Lisa M Grubb, Jonathan Zenilman, Kelly Krout, Zeina Khouri-Stevens, Richard Bennett, Renee Blanding, Stefan Riedel, Stephen Milner, Leigh Ann Price, Trish M Perl
OBJECTIVE: To describe a polymicrobial fungal outbreak after Hurricane Sandy. DESIGN: An observational concurrent outbreak investigation and retrospective descriptive review. SETTING: A regional burn intensive care unit that serves the greater Baltimore area, admitting 350-450 burn patients annually. PATIENTS: Patients with burn injuries and significant dermatologic diseases such as toxic epidermal necrolysis who were admitted to the burn intensive care unit...
March 30, 2018: American Journal of Infection Control
https://www.readbyqxmd.com/read/29609274/-practice-and-thinking-about-the-establishment-and-management-of-burn-intensive-care-unit
#19
X J Li
The treatment of critically burned patients has benefited from the development of knowledge and technologies that we got in critical care medicine of our country in the past ten years. The close-ended management model of general intensive care unit (ICU) and the idea of general ICU doctors who treat the monitoring of organ function and alternative therapy of organs as their primary tasks would affect the treatments for special critical patients hospitalized in general ICU, especially for those patients who were severely burned...
March 20, 2018: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
https://www.readbyqxmd.com/read/29606978/my-burning-issues-in-the-neoadjuvant-treatment-for-breast-cancer
#20
REVIEW
Elisabeth S Bergen, Rupert Bartsch
A combination of anthracyclines and taxanes remains the standard of care for neoadjuvant chemotherapy (NACT) resulting in increased breast conservation rate (BCR) and decreased recurrence rate [1]. Whether pathological complete response (pCR) could be an appropriate surrogate parameter for long-term survival is still a matter of debate. In patients with triple-negative breast cancer (TNBC) and HER2-positive breast cancer (BC), a six to nine times higher risk for relapse has been reported if no pCR was achieved [2, 3]...
2018: Memo
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