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https://www.readbyqxmd.com/read/27920568/reduced-butyrylcholinesterase-activity-is-an-early-indicator-of-trauma-induced-acute-systemic-inflammatory-response
#1
Aleksandar R Zivkovic, Jochen Bender, Thorsten Brenner, Stefan Hofer, Karsten Schmidt
PURPOSE: Early diagnosis of systemic inflammatory response syndrome is fundamentally important for an effective and a goal-directed therapy. Various inflammation biomarkers have been used in clinical and experimental practice. However, a definitive diagnostic tool for an early detection of systemic inflammation remains to be identified. Acetylcholine (Ach) has been shown to play an important role in the inflammatory response. Serum cholinesterase (butyrylcholinesterase [BChE]) is the major Ach hydrolyzing enzyme in blood...
2016: Journal of Inflammation Research
https://www.readbyqxmd.com/read/27919400/a-novel-concept-for-integrating-and-delivering-health-information-using-a-comprehensive-digital-dashboard-an-analysis-of-healthcare-professionals-intention-to-adopt-a-new-system-and-the-trend-of-its-real-usage
#2
Keehyuck Lee, Se Young Jung, Hee Hwang, Sooyoung Yoo, Hyun Young Baek, Rong-Min Baek, Seok Kim
OBJECTIVE: To introduce a new concept of medical dashboard system called BESTBoard. Such a system was implemented in all wards in a tertiary academic hospital to explore the development process, core designs, functions, usability and feasibility. METHODS: The task-force team made user interface designs for 6 months based on a need analysis. Hardware configuration and software development was carried out for 3 months. We conducted a survey of 383 physicians and nurses to determine the usability and feasibility of the system...
January 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/27919281/incidence-causes-and-consequences-of-preventable-adverse-drug-events-protocol-for-an-overview-of-reviews
#3
Brian Hutton, Salmaan Kanji, Erika McDonald, Fatemeh Yazdi, Dianna Wolfe, Kednapa Thavorn, Sally Pepper, Laurie Chapman, Becky Skidmore, David Moher
BACKGROUND: Medication errors represent a noteworthy source of harm to patients. In recent years, several systematic reviews have assessed the frequency and causes of these events, as well as other factors such as commonly associated drugs, their incidence in different specialties, and their consequences to patients. Despite this past literature, there remains a need to study discrepancies between these reviews and establish the current state of the evidence. The planned review will bring together, compare, and contract existing evidence related to the occurrence of medication errors in acute and continuing/long-term care settings...
December 5, 2016: Systematic Reviews
https://www.readbyqxmd.com/read/27916415/hospital-discharges-and-patient-activity-associated-with-chronic-pancreatitis-in-ireland-2009-2013
#4
Hazel M Ní Chonchubhair, Yasir Bashir, David McNaughton, Joseph M Barry, Sinead N Duggan, Kevin C Conlon
OBJECTIVE: To investigate trends in acute public hospital patient discharges in Ireland, to analyse hospital discharge activity for geographical variations, aetiological differences, and to estimate a national prevalence for chronic pancreatitis. METHOD: We performed a nationwide retrospective study of all in-patient discharges from acute public hospitals in Ireland, participating in the Hospital In-Patient Enquiry (HIPE) reporting system. We searched for International Classification of Disease, Tenth Revision, Australian Modification (ICD-10-AM) codes K86...
November 25, 2016: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/27914889/ventricular-tachycardia-and-prolonged-qt-interval-presenting-as-seizure-like-activity-a-case-report
#5
Max Wentlandt, Stephen C Morris, Steven H Mitchell
Seizures can be difficult to distinguish from other causes of transient cerebral hypoxia in the emergency room. We present a case of seizure activity in a woman in whom EKG led to a diagnosis of intermittent monomorphic and polymorphic ventricular tachycardia (torsades de pointes), highlighting the need for careful consideration of alternative causes of seizures, even in patients with known epilepsy.
November 22, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27914661/statin-discontinuation-and-mortality-in-an-older-adult-population-with-traumatic-brain-injury-a-four-year-multi-centre-observational-cohort-study
#6
Alessandro Orlando, Christine Thomas, Matthew Carrick, D Sue Slone, Charles W Mains, David Bar-Or
INTRODUCTION: Statin discontinuation has been investigated in a wide range of diseases and injuries, but there is a paucity of data in the older adult population with traumatic brain injury (TBI). The purpose of this study was to re-examine the extent to which early discontinuation of pre-injury statin (PIS) therapy increases the risk of poor patient outcomes in older adult patients suffering a TBI. METHODS: This was a retrospective observational cohort study of adult trauma patients with a blunt TBI across three trauma centres over four years...
November 25, 2016: Injury
https://www.readbyqxmd.com/read/27914125/having-a-physician-rather-than-a-place-as-a-usual-source-of-care-would-be-better-from-2012-korea-health-panel-data
#7
Kyeong Min Kim, Hyunsoo Jeon, Jae Ho Lee
A usual source of care (USC) in primary care improves health care quality and can result in improved health. However, current research about the type of USC (place only vs. physician with a place) is insufficient as an evidence to support the value of primary care. We analyzed data from the 2012 Korea Health Panel survey of adults aged 18 years or older (n = 11,873) who reported whether having a USC or not to compare the effects by type of USC on medical care use and out-of-pocket costs. Descriptive analysis showed significant differences in the distributions of sociodemographic and health status factors except frequency of outpatient visit by type of USC...
January 2017: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/27912923/predictors-of-30-day-mortality-in-patients-admitted-to-emergency-departments-for-acute-heart-failure
#8
Matthieu Marchetti, Antoine Benedetti, Olivier Mimoz, Jean-Yves Lardeur, Jérémy Guenezan, Nicolas Marjanovic
OBJECTIVES: Acute heart failure (AHF) is a leading cause of admission in emergency departments (ED). It is associated with significant in-hospital mortality, suggesting that there is room for improvement of care. Our aims were to investigate clinical patterns, biological characteristics and determinants of 30-day mortality. METHODS: We conducted a single site, retrospective review of adult patients (≥18years) admitted to ED for AHF over a 12-month period. Data collected included demographics, clinical, biological and outcomes data...
November 22, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27912248/mean-arterial-blood-pressure-management-of-acute-spinal-cord-injured-patients-during-the-pre-hospital-and-early-admission-period
#9
Jin Wee Tee, Farhaan Altaf, Lise M Belanger, Tamir Ailon, John Street, Scott J Paquette, Michael C Boyd, Charles G Fisher, Marcel F Dvorak, Brian K Kwon
The optimization and maintenance of mean arterial blood pressure (MAP) and the general avoidance of systemic hypotension for the first 5 to 7 days following acute traumatic SCI is considered to be important for minimizing secondary spinal cord ischemic damage. The characterization of hemodynamic parameters in the immediate post-injury stage prior to admission to a specialized spine unit has not been previously reported. Here we describe the blood pressure management of 40 acute tSCI patients in the early post-injury phases of care prior to their arrival in a specialized spinal injury high dependency unit (HDU), intensive care unit (ICU) or operating room (OR)...
December 2, 2016: Journal of Neurotrauma
https://www.readbyqxmd.com/read/27909958/using-group-medical-visits-with-those-who-have-diabetes-examining-the-evidence
#10
REVIEW
Laura M Housden, Sabrina T Wong
The number of people with diabetes is expected to rise to over 592 million by the year 2035. Past work provides evidence that the conventional method of primary care delivery may not meet many patients' needs. An alternative to the conventional one-on-one appointment is care offered to a group of patients through group medical visits (GMVs). Group medical visits for diabetes have a positive impact on physiologic and self-care outcomes including improved HbA1c, blood pressure control and self-management skills...
December 2016: Current Diabetes Reports
https://www.readbyqxmd.com/read/27907969/neuroprotection-in-critical-care-neurology
#11
Menno R Germans, Hieronymus D Boogaarts, R Loch Macdonald
Ischemic stroke, intracerebral hemorrhage, subarachnoid hemorrhage, and traumatic brain injury-all have in common early brain injury due to brain tissue destruction, reduced cerebral blood flow and oxygen delivery, and overall substantial morbidity and mortality. The pathophysiology of brain tissue damage likely includes common cellular mechanisms. Neuroprotection has seldom, if ever, been shown to reduce early brain injury. Secondary brain injury develops after these conditions due to macroscopic events such as increased intracranial pressure and reduced cerebral blood flow, as well as cellular processes including vascular damage, inflammation, and apoptotic/necrotic cell death...
December 2016: Seminars in Neurology
https://www.readbyqxmd.com/read/27906086/massive-adrenal-vein-aneurysm-mimicking-an-adrenal-tumor-in-a-patient-with-hemophilia-a-a-case-report-and-review-of-the-literature
#12
Richard Sleightholm, Steven Wahlmeier, Jeffrey S Carson, Andjela Drincic, Audrey Lazenby, Jason M Foster
BACKGROUND: Visceral venous aneurysms are exceedingly rare, and until now, there have been no reports of this phenomenon in the adrenal vasculature. This report details the first adrenal venous aneurysm reported in the literature. The aneurysm presented as an 18-cm mass that was initially suspected to be a hematoma or tumor on the basis of the complex medical history of the patient, which included hemophilia A and testicular cancer. After surgical excision, pathologic examination confirmed this mass to be a 15...
December 1, 2016: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/27905910/is-standardized-care-feasible-in-the-emergency-setting-a-case-matched-analysis-of-patients-undergoing-laparoscopic-cholecystectomy
#13
Fabian Grass, Matthieu Cachemaille, Catherine Blanc, Nicolas Fournier, Nermin Halkic, Nicolas Demartines, Martin Hübner
BACKGROUND: Immediate laparoscopic cholecystectomy is the accepted standard for the treatment of acute cholecystitis. The aim of the present study was to evaluate the feasibility of a standardized approach with tailored care maps for pre- and postoperative care by comparing pain, nausea and patient satisfaction after elective and emergent laparoscopic cholecystectomy. METHODS: From January 2014 until April 2015, data on pain and nausea management were prospectively recorded for all elective and emergency procedures in the department of visceral surgery...
December 1, 2016: BMC Surgery
https://www.readbyqxmd.com/read/27904168/care-situation-for-female-victims-of-sexual-violence-in-metropolitan-emergency-departments-with-charit%C3%A3-berlin-as-an-example
#14
H Hoffmann-Walbeck, M Möckel, S Etzold, M David
of the perpetrators were friends or relations; 17 % were (ex-)partners. The waiting time in the Charité emergency departments amounted to 58 minutes on average, the medical treatment time 55 minutes. About 80 % of the personnel evaluated the "stuprum kit" as being altogether good or very good. More than ⅓ considered the time and room conditions as being unsuitable or rather unsuitable for the situation. Two thirds expressed the desire for further training and supervision. Conclusion: The structured procedure by means of the "stuprum kit" has proved its value...
November 2016: Geburtshilfe und Frauenheilkunde
https://www.readbyqxmd.com/read/27903142/systematic-literature-review-of-general-health-care-interventions-within-programs-of-assertive-community-treatment
#15
Erik R Vanderlip, Benjamin F Henwood, Debra R Hrouda, Piper S Meyer, Maria Monroe-DeVita, Lynette M Studer, April J Schweikhard, Lorna L Moser
OBJECTIVE: Assertive community treatment (ACT) is one of the few evidence-based practices for adults with severe mental illness. Interest has slowly waned for ACT implementation. Yet ACT remains an appealing services platform to achieve the triple aim of health care reform (improved health outcomes, reduced cost, and improved satisfaction) through integration of primary care and behavioral health services. This review highlights the evidence for ACT to improve general medical outcomes, reduce treatment costs, and increase access to treatment...
December 1, 2016: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/27900417/definition-of-hemodynamic-stability-in-blunt-trauma-patients-a-systematic-review-and-assessment-amongst-dutch-trauma-team-members
#16
S A I Loggers, T W A Koedam, G F Giannakopoulos, E Vandewalle, M Erwteman, W P Zuidema
INTRODUCTION: Trauma is a great contributor to mortality worldwide. One of the challenges in trauma care is early identification and management of bleeding. The circulatory status of blunt trauma patients in the emergency room is evaluated using hemodynamic (HD) parameters. However, there is no consensus on which parameters to use. In this study, we evaluate the used terms and definitions in the literature for HD stability and compare those to the opinion of Dutch trauma team members...
November 30, 2016: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/27900413/recommendations-of-the-german-association-of-anesthesiology-and-intensive-care-medicine-dgai-on-structured-patient-handover-in-the-perioperative-setting-the-sbar-concept
#17
V von Dossow, B Zwissler
Teamwork in the operating room and in the intensive care unit necessitates clear and precise communication; however, interruptions in communication frequently occur, especially in the perioperative phase. Patients are particularly susceptible to deficits in communication, e.g. due to higher stress peaks, simultaneous admission of several patients and concomitant treatment of emergency cases. The German Society of Anesthesiology and Intensive Care Medicine (DGAI) therefore recommends the implementation of the so-called SBAR concept (S situation, B background, A assessment, R recommendation) for standardization of patient handover...
November 29, 2016: Der Anaesthesist
https://www.readbyqxmd.com/read/27899469/emergency-surgical-airways-following-activation-of-a-difficult-airway-management-team-in-hospitalized-critically-ill-patients-a-case-series
#18
REVIEW
Joseph M Darby, Gregory Halenda, Courtney Chou, Joseph J Quinlan, Louis H Alarcon, Richard L Simmons
INTRODUCTION: An emergency surgical airway (ESA) is widely recommended for securing the airway in critically ill patients who cannot be intubated or ventilated. Little is known of the frequency, clinical circumstances, management methods, and outcomes of hospitalized critically ill patients in whom ESA is performed outside the emergency department or operating room environments. METHODS: We retrospectively reviewed all adult patients undergoing ESA in our intensive care units (ICUs) and other hospital units from 2008 to 2012 following activation of our difficult airway management team (DAMT)...
November 28, 2016: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/27894560/analysis-of-temperature-variability-in-medication-storage-compartments-in-emergency-transport-helicopters
#19
Margaret A O'Donnell, Justin Whitfield
The purpose of this study was to determine whether the temperature in medication storage compartments in air medical helicopters was within United States Pharmacopeia (USP)-defined limits for controlled room temperature. This was a prospective study using data obtained from a continuous temperature monitoring device. A total of 4 monitors were placed within 2 medication storage locations in 2 identical helicopters. The data collection period lasted 2 weeks during the summer and winter seasons. Data retrieved from monitors were compared against USP parameters for proper medication storage...
November 2016: Air Medical Journal
https://www.readbyqxmd.com/read/27894008/common-or-multiple-futures-for-end-of-life-care-around-the-world-ideas-from-the-waiting-room-of-history
#20
REVIEW
Shahaduz Zaman, Hamilton Inbadas, Alexander Whitelaw, David Clark
Around the world there is growing interest in the manner in which care is delivered to people at the end of life. However, there is little unanimity on what constitutes a 'good death' and the appropriate societal responses to the issue of delivering culturally relevant and sustainable forms of end of life care in different settings are not subjects of broad agreement. In this critical conceptual paper we focus on the emerging narratives of global palliative care and offer an assessment of their implications...
November 9, 2016: Social Science & Medicine
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