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https://www.readbyqxmd.com/read/28422890/an-unusual-location-of-gouty-panniculitis-a-case-report
#1
David Martin, Gaëtan-Romain Joliat, Pierre Fournier, Christophe Brunel, Nicolas Demartines, Olivier Gié
RATIONALE: Gouty panniculitis, characterised by the deposition of monosodium urate crystals in subcutaneous tissue, is a rare clinical manifestation of gout. PATIENT CONCERNS: The case of a 67-year-old man is reported, who presented an erythematous nodule on the upper part of the right buttock suspicious for an abscess. This was in the context of chemotherapy for non-Hodgkin's lymphoma. DIAGNOSES: Histopathologic examination demonstrated gouty panniculitis...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28419032/formal-physical-therapy-after-total-hip-arthroplasty-is-not-required-a-randomized-controlled-trial
#2
Matthew S Austin, Brian T Urbani, Andrew N Fleischman, Navin D Fernando, James J Purtill, William J Hozack, Javad Parvizi, Richard H Rothman
BACKGROUND: The value of formal physical therapy after total hip arthroplasty is unknown. With substantial changes that have occurred in surgical and anesthesia techniques, self-directed therapy may be efficacious in restoring function to patients undergoing total hip arthroplasty. METHODS: We conducted a single-center, randomized trial of 120 patients undergoing primary, unilateral total hip arthroplasty who were eligible for direct home discharge. The experimental group followed a self-directed home exercise program for 10 weeks...
April 19, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28416177/restoring-how-older-adults-manage-their-recovery-from-hip-fracture
#3
David J Healee, Antoinette McCallin, Marion Jones
AIMS AND OBJECTIVES: To generate a substantive theory that explained recovery from hip fracture from the perspective of older adults and find out how they managed it. BACKGROUND: Hip fracture is a well-researched phenomenon. The perspective of how older adults recover from hip fracture has been examined least of all. Patients spend less time in hospital following injury and generally recover in their home setting. DESIGN: A Glaserian grounded theory approach was used for this study...
March 9, 2017: International Journal of Orthopaedic and Trauma Nursing
https://www.readbyqxmd.com/read/28398938/pediatric-anaphylaxis-in-the-emergency-department-clinical-presentation-quality-of-care-and-reliability-of-consensus-criteria
#4
Viginia L Goetz, Kelly Kim, Antonia S Stang
OBJECTIVES: The objective of this study was to describe the quality of emergency department (ED) care for pediatric patients with anaphylaxis. The secondary objectives were to describe (1) the clinical presentation of pediatric patients with anaphylaxis including the proportion of patients meeting each of the National Institute of Allergy and Infectious Diseases (NIAID) consensus criteria and subcriteria and (2) the Interrater reliability (IRR) for applying the NIAID criteria. METHODS: We conducted a retrospective cross-sectional chart review of patients seen in a pediatric ED during a 2-year period...
April 11, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28385940/the-evolution-of-fracture-clinic-design-the-activity-and-safety-of-the-edinburgh-trauma-triage-clinic-with-one-year-follow-up
#5
T O White, S P Mackenzie, T H Carter, J G Jefferies, O R Prescott, A D Duckworth, J F Keating
AIMS: Fracture clinics are often characterised by the referral of large numbers of unselected patients with minor injuries not requiring investigation or intervention, long waiting times and recurrent unnecessary reviews. Our experience had been of an unsustainable system and we implemented a 'Trauma Triage Clinic' (TTC) in order to rationalise and regulate access to our fracture service. The British Orthopaedic Association's guidelines have required a prospective evaluation of this change of practice, and we report our experience and results...
April 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28378083/minor-laparoscopic-liver-resection-toward-1-day-surgery
#6
Nicola de'Angelis, Benjamin Menahem, Philippe Compagnon, Jean Claude Merle, Francesco Brunetti, Alain Luciani, Daniel Cherqui, Alexis Laurent
BACKGROUND: Technical advances in laparoscopy and enhanced recovery after surgery programs have progressively decreased the need for hospitalization. The present study aimed to explore the feasibility and safety of an early discharge protocol after minor laparoscopic liver resection (LLR). METHODS: The study sample consisted of patients with both benign and malignant hepatic lesions involving no more than two hepatic segments who underwent minor LLR and were discharged within 24 h...
April 4, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28377171/benefits-of-subspecialty-adherence-after-asthma-hospitalization-and-patient-perceived-barriers-to-care
#7
Neema Izadi, Jonathan S Tam
BACKGROUND: Comparative studies have demonstrated that asthma education to pediatric patients decreases average hospital usage and that allergy specialists provide stronger asthma education and more improved outcomes. OBJECTIVE: To evaluate the real-world benefits of allergy subspecialty involvement outside inpatient consultation and the impediments for patients in establishing allergy subspecialty care. METHODS: The study population was composed mostly of minority children 0 to 18 years old seen at a large university-affiliated stand-alone children's hospital who had a hospital discharge diagnosis of asthma from 2009 to 2013...
April 1, 2017: Annals of Allergy, Asthma & Immunology
https://www.readbyqxmd.com/read/28359707/evidence-based-practice-video-discharge-instructions-in-the-pediatric-emergency-department
#8
Elyssa B Wood, Gina Harrison, Amber Trickey, Mary Ann Friesen, Sarah Stinson, Erin Rovelli, Serena McReynolds, Kristina Presgrave
While a high quality discharge from a Pediatric Emergency Department helps caregivers feel informed and prepared to care for their sick child at home, poor adherence to discharge instructions leads to unnecessary return visits, negative health outcomes, and decreased patient satisfaction. Nurses at the Inova Loudoun Pediatric ED utilized the Johns Hopkins Model of Evidence Based Practice to answer the following question: Among caregivers who have children discharged from the ED, does the addition of video discharge instructions (VDI) to standard written/verbal discharge instructions (SDI) result in improved knowledge about the child's diagnosis, treatment, illness duration, and when to seek further medical care? METHODS: A multidisciplinary team reviewed available evidence and created VDI for three common pediatric diagnoses: gastroenteritis, bronchiolitis, and fever...
March 28, 2017: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
https://www.readbyqxmd.com/read/28349529/continuous-chest-compression-versus-interrupted-chest-compression-for-cardiopulmonary-resuscitation-of-non-asphyxial-out-of-hospital-cardiac-arrest
#9
REVIEW
Lei Zhan, Li J Yang, Yu Huang, Qing He, Guan J Liu
BACKGROUND: Out-of-hospital cardiac arrest (OHCA) is a major cause of death worldwide. Cardiac arrest can be subdivided into asphyxial and non asphyxial etiologies. An asphyxia arrest is caused by lack of oxygen in the blood and occurs in drowning and choking victims and in other circumstances. A non asphyxial arrest is usually a loss of functioning cardiac electrical activity. Cardiopulmonary resuscitation (CPR) is a well-established treatment for cardiac arrest. Conventional CPR includes both chest compressions and 'rescue breathing' such as mouth-to-mouth breathing...
March 27, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28348936/ciprofloxacin-induced-hepatotoxicity-in-a-healthy-young-adult
#10
Zulfiqar Qutrio Baloch, Muhammad Ali Raza, Shabber A Abbas, Sumera Bukhari
Ciprofloxacin is a broad-spectrum fluoroquinolone antibiotic that is widely used in the treatment of many common infections, including urinary tract infections (UTIs). Despite the increase in Escherichia coli resistance to ciprofloxacin, especially in the United States (US), clinicians continue to utilize the high bioavailability of this drug in urine to counter UTIs. A rare adverse effect following use of ciprofloxacin is drug-induced hepatitis. In this case report, we describe a young 29-year-old female with a previous medical history significant for pyelonephritis and ovarian cyst who presented to the emergency room with signs and symptoms suggestive of progressive liver injury for two weeks that started two days after a complete course of ciprofloxacin therapy for a UTI...
February 8, 2017: Curēus
https://www.readbyqxmd.com/read/28346312/using-technology-to-enhance-discharge-teaching-and-improve-coping-for-patients-after-stroke
#11
Melissa A Schneider, Katrina A Howard
BACKGROUND: A diagnosis of stroke is a life-changing event. Effective discharge teaching after a stroke is crucial for recovery, but the overload of information can be overwhelming for patients and caregivers. PURPOSE: The purpose of this study was to examine differences in discharge readiness and postdischarge coping in patients admitted for stroke after the use of individualized postdischarge information/education provided via a technology package (including patient online portal access, e-mail/secure messaging) compared with current standard discharge teaching methods (verbal/written instructions)...
March 24, 2017: Journal of Neuroscience Nursing: Journal of the American Association of Neuroscience Nurses
https://www.readbyqxmd.com/read/28345803/an-evolving-approach-to-delirium-a-mixed-methods-process-evaluation-of-a-hospital-wide-delirium-program-in-new-zealand
#12
Abdullah Ao Alhaidari, Rosalind Ac Allen-Narker
OBJECTIVE: A process evaluation was carried out to assess and potentially improve the design and implementation of a hospital-wide delirium program. METHODS: A mixed-methods sequential-explanatory design was used; retrospective chart reviews for 100 older (75+) medical inpatients were conducted to measure nurses', doctors' and coders' adherence to key program processes following which interviews were conducted to identify potential barriers to implementation. RESULTS: Delirium occurred in 49% of patients...
March 27, 2017: Australasian Journal on Ageing
https://www.readbyqxmd.com/read/28341086/recurrent-priapism-gone-wrong-st-elevation-myocardial-infarction-and-cardiogenic-shock-after-penile-corporal-phenylephrine-irrigation
#13
S Tyler Constantine, Anand Gopalsami, Gregg Helland
BACKGROUND: Recurrent priapism secondary to sickle cell trait in an African-American male has been reported in the literature. A common treatment for these low-flow priapism cases is aspiration and injection of the corpus cavernosum with a sympathomimetic agent. We report a rare complication not described previously in the literature of ST-elevation myocardial infarction (STEMI) and cardiogenic shock in a 29-year-old male with sickle cell trait undergoing a routine detumescence procedure...
March 21, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28329748/extensive-multilevel-split-laminotomy-for-debulking-a-cervicothoracolumbar-nondysraphic-intramedullary-spinal-cord-lipoma-in-a-2-month-old-infant
#14
Ha Son Nguyen, Sean Lew
INTRODUCTION: Laminectomy is the traditional approach for posterior exposure of the spinal canal for tumor resection. Another technique is split laminotomy, which entails the division and retraction of the spinous processes and laminae to access the thecal sac. This technique has been employed for small-segment exposures, but not extensively explored for long-segment exposures. CASE: A 2-month-old male presented with progressive right-leg plegia. MRI of the spine revealed a large, intramedullary spinal-cord lipoma extending from C6 to L5...
March 23, 2017: Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28315495/legumain-cleavable-4-arm-poly-ethylene-glycol-doxorubicin-conjugate-for-tumor-specific-delivery-and-release
#15
Huicong Zhou, Huanjiao Sun, Shixian Lv, Dawei Zhang, Xuefei Zhang, Zhaohui Tang, Xuesi Chen
Traditional chemotherapy strategy exists undesirable toxic side-effects to normal tissues due to the low selectively to cancer cells of micromolecule cytotoxic drugs. One considered method to realizing the targeted delivery and increasing the specificity to tumor tissues of the cytotoxic drug is to transporting and discharging it through an environment-sensitive mechanism. In this study, a novel enzyme-sensitive polymer-doxorubicin conjugate was designed to delivery chemotherapeutic drug in a tumor-specific behavior and selectively activated in tumor tissue...
March 14, 2017: Acta Biomaterialia
https://www.readbyqxmd.com/read/28296227/health-literacy-in-the-urgent-care-setting-what-factors-impact-consumer-comprehension-of-health-information
#16
Traci L Alberti, Nancy J Morris
BACKGROUND: An increasing number of Americans are using urgent care (UC) clinics due to: improved health insurance coverage, the need to decrease cost, primary care offices with limited appointment availability, and a desire for convenient care. Patients are treated by providers they may not know for episodic illness or injuries while in pain or not feeling well. Treatment instructions and follow-up directions are provided quickly. PURPOSE: To examine health literacy in the adult UC population and identify patient characteristics associated with health literacy risk...
March 10, 2017: Journal of the American Association of Nurse Practitioners
https://www.readbyqxmd.com/read/28262319/initiation-of-an-inhaled-corticosteroid-during-a-pediatric-emergency-visit-for-asthma-a%C3%A2-randomized-clinical-trial
#17
Esther M Sampayo, Maryann Mazer-Amirshahi, Elizabeth A Camp, Joseph J Zorc
STUDY OBJECTIVE: We determine whether prescribing an inhaled corticosteroid during a pediatric emergency department (ED) asthma visit increases ongoing use and improves outcomes. METHODS: This randomized trial enrolled children aged 1 to 18 years, with persistent asthma not previously prescribed a controller medication, and who were being discharged after ED asthma treatment. Intervention subjects received a 1-month prescription for an inhaled corticosteroid (fluticasone or budesonide by age) in addition to standard asthma therapy and instructions given to all patients...
February 24, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28228448/patient-experience-with-discharge-instructions-in-postdischarge-recovery-a-qualitative-study
#18
Molly J Horstman, Whitney L Mills, Levi I Herman, Cecilia Cai, George Shelton, Tareq Qdaisat, David H Berger, Aanand D Naik
OBJECTIVES: We examined the role of discharge instructions in postoperative recovery for patients undergoing colorectal surgery and report themes related to patient perceptions of discharge instructions and postdischarge experience. DESIGN: Semistructured interviews were conducted as part of a formative evaluation of a Project Re-Engineered Discharge intervention adapted for surgical patients. SETTING: Michael E. DeBakey VA Medical Center, a tertiary referral centre in Houston, Texas...
February 22, 2017: BMJ Open
https://www.readbyqxmd.com/read/28215655/the-caregiver-perspective-on-unscheduled-72-hour-return-visits-to-pediatric-acute-care-sites-a-focus-on-discharge-processes
#19
Nidhya Navanandan, Sarah K Schmidt, Natasha Cabrera, Michael C DiStefano, Rakesh D Mistry
OBJECTIVE: To characterize pediatric caregivers' reasons for 72-hour emergency department (ED) and urgent care (UC) returns. METHODS: A sample of caregivers returning within 72 hours of initial visit to a pediatric ED or affiliated UC site were surveyed from November 2014 to June 2015; patients evaluated at outside ED/UC, scheduled for return, or non-English/Spanish speaking were excluded. Caregiver surveys underwent item generation, validation, and pilot testing...
February 12, 2017: Academic Pediatrics
https://www.readbyqxmd.com/read/28206886/guideline-for-monitoring-and-management-of-pediatric-patients-before-during-and-after-sedation-for-diagnostic-and-therapeutic-procedures-update-2016
#20
(no author information available yet)
The safe sedation of children for procedures requires a systematic approach that includes the following: no administration of sedating medication without the safety net of medical/dental supervision, careful presedation evaluation for underlying medical or surgical conditions that would place the child at increased risk from sedating medications, appropriate fasting for elective procedures and a balance between the depth of sedation and risk for those who are unable to fast because of the urgent nature of the procedure, a focused airway examination for large (kissing) tonsils or anatomic airway abnormalities that might increase thepotential for airway obstruction, a clear understanding of the medication's pharmacokinetic and pharmacodynamic effects and drug interactions, appropriate training and skills in airway management to allow rescue of the patient, age- and size-appropriate equipment for airway management and venous access, appropriate medications and reversal agents, sufficient numbers of staff to both carry out the procedure and monitor the patient, appropriate physiologic monitoring during and after the procedure, a properly equipped and staffed recovery area, recovery to the presedation level of consciousness before discharge from medical/dental supervision, and appropriate discharge instructions...
October 15, 2016: Pediatric Dentistry
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