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Sylvina Alvarado, Ernesto Paya, María Teresa Valenzuela, Rodolfo Villena
INTRODUCTION: Special vaccines recommendation patients are a growing population. The Ministry of Health has developed a special vaccination program for these cases, through which our hospital manages vaccine forms by an established flowchart. OBJECTIVE: To describe the special vaccines model of management results in the period between March 2015 and September 2016, and the clinical and demographics characterization of the pediatric population benefited with this program in Dr...
December 2017: Revista Chilena de Pediatría
Jesús Escrivá Muñoz, Y Pan, S Ge, E W Jensen, M Vallverdú
The purpose of this document is to describe a methodology to select the most adequate time-frequency distribution (TFD) kernel for the characterization of impedance cardiography signals (ICG). The predominant ICG beat was extracted from a patient and was synthetized using time-frequency variant Fourier approximations. These synthetized signals were used to optimize several TFD kernels according to a performance maximization. The optimized kernels were tested for noise resistance on a clinical database. The resulting optimized TFD kernels are presented with their performance calculated using newly proposed methods...
March 16, 2018: Medical & Biological Engineering & Computing
Paulo Pereira, Jerard Seghatchian, Beatriz Caldeira, Sandra Xavier, Gracinda de Sousa
General quality control good practices require the control of the production of blood components using statistical techniques, such as mandatory by the European Commission Directives and the American Association of Blood Banks standards. Sometimes, the control procedure is exclusively in favor of the compliance verification with specifications per individual component or to compute the number of defective parts usually on a monthly basis. However, this is a critical restriction to detect unnatural patterns such as to guarantee that the production has a non-significance chance to manufacturing nonconforming components...
February 20, 2018: Transfusion and Apheresis Science
Bart W Driesen, Evangeline G Warmerdam, Gert-Jan T Sieswerda, Paul H Schoof, Folkert J Meijboom, Felix Haas, Pieter R Stella, Adriaan O Kraaijeveld, Fabiola C M Evens, Pieter A F M Doevendans, Gregor J Krings, Arie P J van Dijk, Michiel Voskuil
OBJECTIVES: To describe the use of fractional flow reserve (FFR) and intravascular ultrasound (IVUS) in the evaluation of patients with anomalous coronary arteries originating from the opposite sinus of Valsalva (ACAOS). BACKGROUND: ACAOS of the right and left coronary are rare, but may lead to symptoms and impose a risk for sudden cardiac death, depending on several anatomical features. Assessment and risk estimation is challenging in (nonathlete) adults, especially if they present without symptoms or with atypical complaints...
March 9, 2018: Catheterization and Cardiovascular Interventions
Lori-Anne P Schillaci, Suzanne D DeBrosse, Shawn E McCandless
When a child presents with high-anion gap metabolic acidosis, the pediatrician can proceed with confidence by recalling some basic principles. Defects of organic acid, pyruvate, and ketone body metabolism that present with acute acidosis are reviewed. Flowcharts for identifying the underlying cause and initiating life-saving therapy are provided. By evaluating electrolytes, blood sugar, lactate, ammonia, and urine ketones, the provider can determine the likelihood of an inborn error of metabolism. Freezing serum, plasma, and urine samples during the acute presentation for definitive diagnostic testing at the provider's convenience aids in the differential diagnosis...
April 2018: Pediatric Clinics of North America
Liam A Toohey, Michael K Drew, Lauren V Fortington, Caroline F Finch, Jill L Cook
BACKGROUND: Accounting for subsequent injuries is critical for sports injury epidemiology. The subsequent injury categorisation (SIC-1.0) model was developed to create a framework for accurate categorisation of subsequent injuries but its operationalisation has been challenging. OBJECTIVES: The objective of this study was to update the subsequent injury categorisation (SIC-1.0 to SIC-2.0) model to improve its utility and application to sports injury datasets, and to test its applicability to a sports injury dataset...
March 3, 2018: Sports Medicine
B Loomans, N Opdam
This paper explains a conservative, pragmatic and minimally invasive intervention concept for the treatment of severe tooth wear patients based on the Radboud Tooth Wear Project in the Netherlands. Guidelines and flowcharts for management of severe tooth wear patients and rehabilitation in increased vertical dimension of occlusion are presented. We concluded that: (a) Restorative treatment is not always indicated, even for patients with severe tooth wear. (b) If the patient has no complaints, counselling and monitoring is probably the best option...
March 2, 2018: British Dental Journal
Matej David, Stephan Gollasch
The ballast water management convention incorporates principles of risk assessment. A new ballast water management risk assessment model was developed to support the implementation of most efficient management measures, which we also present as a flowchart decision support system model. The risk assessment model was tested using data from port baseline surveys where available, and real shipping and ballast water discharges data. The here presented ballast water management risk assessment and possible management options are applicable elsewhere to support and improve complex decision making in the implementation of management requirements according to the ballast water management convention...
February 14, 2018: Marine Pollution Bulletin
Guillaume Hébert, Florence Netzer, Sylvain Landry Kouakou, François Lemare, Etienne Minvielle
Background Adverse drug events (ADEs) occur frequently in oncology and justify continuous assessment and monitoring. There are several methods for detecting them, but the trigger tool method seems the most appropriate. Although a generic tool exists, its use for ADEs in oncology has not been convincing. The development of a focused version is therefore necessary. Objective To provide an oncology-focused trigger tool that evaluates the prevalence, harm, and preventability in a standardised method for pragmatic use in ADE surveillance...
February 14, 2018: International Journal of Clinical Pharmacy
Anat Milman, Gad Keren
Electrocardiography abnormalities are a common finding in athletes. To facilitate the differentiation of physiological adaptation versus pathological remodeling, a series of guidelines has emerged in the past decade that attempt to improve specificity while maintaining a high sensitivity. Recently, T wave inversion in the athletic population gained more attention, resulting in accelerated research leading to novel findings not yet integrated into clinical practice. We aim to simplify the knowledge to date and integrate it into one easy to use practical flowchart...
February 2018: Israel Medical Association Journal: IMAJ
Sally F Kelty, Roberta Julian, Eva Bruenisholz, Linzi Wilson-Wilde
Forensic science is increasingly used to help exonerate the innocent and establishing links between individuals and criminal activities. With increased reliance on scientific services provided by multi-disciplinary (police, medicine, law, forensic science), and multi-organisational in the private and government sectors (health, justice, legal, police) practitioners, the potential for miscommunication resulting unjust outcomes increases. The importance of identifying effective multi-organisational information sharing is to prevent the 'justice silo effect'; where practitioners from different organisations operate in isolation with minimal or no interaction...
January 31, 2018: Forensic Science International
Laura Ferreira Cortes, Stela Maris de Mello Padoin, Neusi Aparecida Navas Berbel
OBJECTIVE: Presenting theoretical subsidies for the nursing care practice based on the possibility of convergence between research practice and educational practice. METHOD: The Convergent Healthcare Research was developed from February to August 2015, with an intersectoral working group formed by 32 participants, including health, social services and public safety professionals. Ten group meetings were organized, based on the Problematization Methodology with Maguerez's Arch...
March 2018: Revista Brasileira de Enfermagem
J J Willeumier, Y M van der Linden, C W P G van der Wal, P C Jutte, J M van der Velden, M A Smolle, P van der Zwaal, P Koper, L Bakri, I de Pree, A Leithner, M Fiocco, P D S Dijkstra
BACKGROUND: A survival estimation for patients with symptomatic long bone metastases (LBM) is crucial to prevent overtreatment and undertreatment. This study analyzed prognostic factors for overall survival and developed a simple, easy-to-use prognostic model. METHODS: A multicenter retrospective study of 1,520 patients treated for symptomatic LBM between 2000 and 2013 at the radiation therapy and/or orthopaedic departments was performed. Primary tumors were categorized into 3 clinical profiles (favorable, moderate, or unfavorable) according to an existing classification system...
February 7, 2018: Journal of Bone and Joint Surgery. American Volume
Susan M Cormier, Lei Zheng, Ryan A Hill, Rachael M Novak, Colleen M Flaherty
Field-based methods increase relevance and realism when setting water quality criteria. They also pose challenges. To enable a consistent process, a flow chart was developed for choosing between two field-based methods and then selecting among candidate results. The two field-based methods estimated specific conductivity (SC) levels likely to extirpate 5% of benthic invertebrate genera: an extirpation concentration distribution (XCD) method and a background-to-criterion (B-C) model developed by the U.S. Environmental Protection Agency...
January 29, 2018: Science of the Total Environment
Kiswendsida Abel Ouedraogo, Julie Beugin, El-Miloudi El-Koursi, Joffrey Clarhaut, Dominique Renaux, Frederic Lisiecki
The work in the article presents the development of an application guide based on feedback and comments stemming from various railway actors on their practices of SIL allocation to railway safety-related functions. The initial generic methodology for SIL allocation has been updated to be applied to railway rolling stock safety-related functions in order to solve the SIL concept application issues. Various actors dealing with railway SIL allocation problems are the intended target of the methodology; its principles will be summarized in this article with a focus on modifications and precisions made in order to establish a practical guide for railway safety authorities...
February 2, 2018: Risk Analysis: An Official Publication of the Society for Risk Analysis
Xiang Zhang, Douglas E Faries, Hu Li, James D Stamey, Guido W Imbens
PURPOSE: Observational pharmacoepidemiological studies can provide valuable information on the effectiveness or safety of interventions in the real world, but one major challenge is the existence of unmeasured confounder(s). While many analytical methods have been developed for dealing with this challenge, they appear under-utilized, perhaps due to the complexity and varied requirements for implementation. Thus, there is an unmet need to improve understanding the appropriate course of action to address unmeasured confounding under a variety of research scenarios...
January 30, 2018: Pharmacoepidemiology and Drug Safety
M V Verschueren, F G A Jansman, D J Touw, C Kramers
- A new guideline: 'Intoxication: initial approach in the hospital' will be published this year. This guideline sets out the latest insights on gastrointestinal decontamination in intoxication; the advice is summarized in a flowchart.- The advice is to generally administer activated charcoal, unless there are indications that the toxin will not bind to activated charcoal or that the amount of toxin that the patient has ingested is too great; in these cases gastric lavage can be considered.- Activated charcoal can be administered up to 2 hours after the ingestion of a toxic substance, unless there are contra-indications...
2018: Nederlands Tijdschrift Voor Geneeskunde
Reem Rachel Abraham, Sharmila Torke, James Gonsalves, Sareesh Naduvil Narayanan, M Ganesh Kamath, Jay Prakash, Kiranmai S Rai
The present study reports perceptions of first-year undergraduate medical students ( n = 120), regarding modified directed self-learning (DSL) sessions in physiology. Students were provided with prereading assignments (faculty developed PowerPoint slides containing diagrams with incomplete labeling/flowcharts with missing steps) pertaining to the DSL topic 1 wk before the scheduled small-group DSL presentations. During DSL presentation sessions, which were facilitated by teachers, a few students individually presented learning objectives in the specified topic...
March 1, 2018: Advances in Physiology Education
Kuang-Chau Tsai, Ray F Lin, Chieh Lee, Ai-Hsien Li
OBJECTIVE: This study aimed to develop a triage tool to more effectively triage possible ACS patients presenting to the emergency department (ED) before admission to a protocol-driven chest pain unit (CPU). METHODS: Seven hundred ninety-three clinical cases, randomly selected from 7962 possible ACS cases, were used to develop and test an ACS triage model using cluster analysis and stepwise logistic regression. RESULTS: The ACS triage model, logit (suspected ACS patient)=-5...
December 13, 2017: American Journal of Emergency Medicine
Syril Keena T Que, Fiona O Zwald, Chrysalyne D Schmults
While the majority of cutaneous squamous cell carcinomas (cSCCs) can be treated surgically, the additional work-up and treatments indicated for high-risk cSCC remain undefined. In recent years, improvements in tumor staging systems have allowed for the more accurate stratification of tumors into high- and low-risk categories. This insight, along with the publication of cSCC guidelines, brings us closer to the development of a consensus approach. The second article in this continuing medical education series addresses in question and answer format the most common questions related to advanced and high-stage cSCCs, with a simplified flowchart...
February 2018: Journal of the American Academy of Dermatology
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