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https://www.readbyqxmd.com/read/28920524/remotely-supported-prehospital-ultrasound-a-feasibility-study-of-real-time-image-transmission-and-expert-guidance-to-aid-diagnosis-in-remote-and-rural-communities
#1
Leila Eadie, John Mulhern, Luke Regan, Alasdair Mort, Helen Shannon, Ashish Macaden, Philip Wilson
Introduction Our aim is to expedite prehospital assessment of remote and rural patients using remotely-supported ultrasound and satellite/cellular communications. In this paradigm, paramedics are remotely-supported ultrasound operators, guided by hospital-based specialists, to record images before receiving diagnostic advice. Technology can support users in areas with little access to medical imaging and suboptimal communications coverage by connecting to multiple cellular networks and/or satellites to stream live ultrasound and audio-video...
January 1, 2017: Journal of Telemedicine and Telecare
https://www.readbyqxmd.com/read/28918620/conservative-management-of-colonoscopic-perforation-a-case-report
#2
Hossein Parsa, Arash Miroliaee, Zafar Doagoo, Saeed Sina
Colonoscopy is widely used for the diagnosis, treatment and a follow up of colorectal diseases. Perforation of the large bowel during elective colonoscopy is rare but serious life threatening complication. We report a 51-year-old woman who experienced recto sigmoid perforation during diagnostic colonoscopy. During 8 days of total hospitalization, she spent 3 days in ICU with gastrointestinal rest. The patient was hydrated and took intravenous antibiotics. In take-output and temperature were closely monitored...
July 2017: Acta Medica Iranica
https://www.readbyqxmd.com/read/28918118/case-report-aquatic-therapy-and-end-stage-dementia
#3
Bruce E Becker, Stacy Lynch
A 54-year old female, retired due to progressive cognitive decline, was diagnosed with early-onset Alzheimer's dementia. Conventional medication therapy for dementia had proven futile. Initial evaluation revealed a non-verbal female seated in a wheelchair, dependent on 2-person assist for all transfers and activities of daily living (ADLs.) She had been either non-responsive or actively resistive for both ADLs and transfers in the 6 months prior to assessment. Following a total of 17 one hour therapy sessions over 19 weeks in a warm water therapy pool, she achieved ability to tread water for 15 minutes, transfers improved to moderate to-maximum assist from seated, ambulation improved to 1000' with minimum-to-moderate assist of 2 persons...
September 13, 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/28916295/utilization-of-hospice-services-in-a-population-of-patients-with-huntington-s-disease
#4
Margaret O Johnson, Samuel Frank, Matthew Mendlik, David Casarett
CONTEXT: Although the early and middle stages of Huntington's Disease (HD) and its complications have been well described, less is known about the course of late-stage illness. In particular, little is known about the population of patients who enroll in hospice. OBJECTIVES: Our goal is to describe the characteristics of patients with HD who enrolled in hospice. METHODS: Retrospective cohort study of electronic medical record data from 12 not-for-profit hospices in the United States from 2008 to 2012...
September 12, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28904639/a-comparison-of-functional-outcome-between-amputation-and-extension-prosthesis-in-the-treatment-of-congenital-absence-of-the-fibula-with-severe-limb-deformity
#5
P Calder, S Shaw, A Roberts, S Tennant, I Sedki, R Hanspal, D Eastwood
PURPOSE: Complete fibula absence often presents with significant lower-limb deformity. Parental counselling regarding management is paramount in achieving the optimum functional outcome. Amputation offers a single surgical event with minimal complications. This study compares outcomes with an amputation protocol to those using an extension prosthesis. METHOD: Thirty-two patients were identified. Nine patients (2 males, 7 females; median age at assessment of 23...
August 1, 2017: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/28902102/post-traumatic-spinal-hygroma-causing-cord-compression-in-type-iii-odontoid-fracture-with-vertical-atlantoaxial-instability
#6
Salvatore Russo, Antonio Belli, Andy Eynon, Ali Nader-Sepahi
STUDY DESIGN: Case report. OBJECTIVE: To report the first case in the literature of a traumatic cervical spine subdural cerebrospinal fluid (CSF) collection (hygroma) under tension causing cord compression. We suggest etiopathogenesis and modality of treatment. SUMMARY OF BACKGROUND DATA: Hygromas are subdural cranial CSF collection. A literature review showed no previous published case of post-traumatic spinal hygroma. This was a potential life-threatening sequelae of a high cervical injury that warranted early diagnosis and emergency treatment...
September 15, 2017: Spine
https://www.readbyqxmd.com/read/28902101/early-ambulation-decreases-length-of-hospital-stay-perioperative-complications-and-improves-functional-outcomes-in-elderly-patients-undergoing-surgery-for-correction-of-adult-degenerative-scoliosis
#7
Owoicho Adogwa, Aladine A Elsamadicy, Jared Fialkoff, Joseph Cheng, Isaac O Karikari, Carlos Bagley
STUDY DESIGN: Ambispective cohort review. OBJECTIVE: To examine the effects of early mobilization on patient outcomes, complications profile, and 30-day readmission rates. SUMMARY OF BACKGROUND DATA: Prolonged immobilization after surgery can result in functional decline and an increased risk of hospital-associated complications. METHODS: We conducted an ambispective study of 125 elderly patients (>65 years) undergoing elective spinal surgery for correction of adult degenerative scoliosis...
September 15, 2017: Spine
https://www.readbyqxmd.com/read/28888468/effect-of-visual-biofeedback-cycling-training-on-gait-in-patients-with-multiple-sclerosis
#8
A Hochsprung, A Granja Domínguez, E Magni, S Escudero Uribe, A Moreno García
INTRODUCTION: Gait alterations are present in a high percentage of patients with multiple sclerosis (MS). They appear from early stages of the disease and can limit patients' capacity to perform basic activities of daily living, affecting their quality of life. Visual biofeedback cycling training appears to be a useful tool in treating these impairments. This study aims to evaluate the short-term effect of visual biofeedback cycling training on gait in patients with MS. MATERIAL AND METHODS: A total of 61 patients with mild to moderate MS were randomly assigned to a control group and an intervention group...
September 6, 2017: Neurología: Publicación Oficial de la Sociedad Española de Neurología
https://www.readbyqxmd.com/read/28882580/lotus-birth-a-holistic-approach-on-physiological-cord-clamping
#9
Laura A Zinsser
BACKGROUND: The positive effects of delayed cord clamping (DCC) has been extensively researched. DCC means: waiting at least one minute after birth before clamping and cutting the cord or till the pulsation has stopped. With physiological clamping and cutting (PCC) the clamping and cutting can happen at the earliest after the pulsation has stopped. With a Lotus birth, no clamping and cutting of the cord is done. A woman called Clair Lotus Day imitated the holistic approach of PCC from an anthropoid ape in 1974...
September 4, 2017: Women and Birth: Journal of the Australian College of Midwives
https://www.readbyqxmd.com/read/28869145/the-early-diagnosis-and-management-of-mixed-delirium-in-a-patient-placed-on-ecmo-and-with-difficult-sedation-a-case-report
#10
María Acevedo-Nuevo, Maria Teresa González-Gil, Miguel Ángel Romera-Ortega, Ignacio Latorre-Marco, Maria Dolores Rodríguez-Huerta
Delirium represents a serious problem that impacts the physical and cognitive prognosis of patients admitted to intensive care units and requires prompt diagnosis and management. This article describes the case and progress of a patient placed on Extracorporeal Membrane Oxygenation with difficult sedation criteria and an early diagnosis of mixed delirium. During the case report, we reflect on the pharmacological and non-pharmacological strategies employed to cope with delirium paying special attention to the non-use of physical restraint measures in order to preserve vital support devices (endotracheal tube or Extracorporeal Membrane Oxygenation cannula)...
August 28, 2017: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/28863011/sedation-and-mobilization-during-venovenous-extracorporeal-membrane-oxygenation-for-acute-respiratory-failure-an-international-survey
#11
Jonathan D Marhong, Julian DeBacker, Julien Viau-Lapointe, Laveena Munshi, Lorenzo Del Sorbo, Lisa Burry, Eddy Fan, Sangeeta Mehta
OBJECTIVES: To characterize sedation, analgesia, delirium, and mobilization practices in patients supported with venovenous extracorporeal membrane oxygenation for severe acute respiratory failure. DESIGN: Cross-sectional electronic survey administered January 2016 to March 2016. SETTING: Three-hundred ninety-four extracorporeal membrane oxygenation centers registered with the Extracorporeal Life Support Organization. SUBJECTS: Extracorporeal membrane oxygenation medical directors and program coordinators...
August 31, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28861039/intracerebral-hemorrhage-with-intraventricular-extension-getting-the-prognosis-right-early
#12
Christoph Stretz, Catherine Gao, David M Greer, Caitlin Loomis, Emily J Gilmore, Adam J Kundishora, Charles C Matouk, David Y Hwang
BACKGROUND: Early accurate outcome prognostication for patients with intracerebral hemorrhage (ICH) and accompanying intraventricular hemorrhage (IVH) is often challenging (1). Acute hydrocephalus often contributes to a poor clinical exam (2) and can portend significant morbidity and mortality (3). Accordingly, the inpatient neurologist may feel inclined to recommend limitations of care for an ICH patient admitted with a large IVH burden and poor exam. CASE PRESENTATION: We present a patient with significant IVH and minimal ICH who deteriorated rapidly to coma after presentation...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28856110/the-analgesic-efficiency-of-ultrasound-guided-rectus-sheath-analgesia-compared-with-low-thoracic-epidural-analgesia-after-elective-abdominal-surgery-with-a-midline-incision-a-prospective-randomized-controlled-trial
#13
Hany Mahmoud Yassin, Ahmed Tohamy Abd Elmoneim, Hatem El Moutaz
BACKGROUND: Ultrasound-guided rectus sheath blockade has been described to provide analgesia for midline abdominal incisions. We aimed to compare thoracic epidural analgesia (TEA) and rectus sheath analgesia (RSA) with respect to safety and efficacy. METHODS: Sixty patients who underwent elective laparotomies through a midline incision were assigned randomly to receive either continuous TEA (TEA group, n = 31) or intermittent RSA (RSA group, n = 29). The number of patients who required analgesia, the time to first request analgesia, the interval and the cumulative morphine doses consumption during 72 hours postoperatively, and pain intensity using visual analog score (VAS) at rest and upon coughing were reported in addition to any side effects related to both techniques or administered drugs...
June 2017: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/28841028/clinical-impact-and-predictors-of-complete-st-segment-resolution-after-primary-percutaneous-coronary-intervention-a-subanalysis-of-the-atlantic-trial
#14
Enrico Fabris, Arnoud van 't Hof, Christian W Hamm, Frédéric Lapostolle, Jens F Lassen, Shaun G Goodman, Jurriën M Ten Berg, Leonardo Bolognese, Angel Cequier, Mohamed Chettibi, Christopher J Hammett, Kurt Huber, Magnus Janzon, Béla Merkely, Robert F Storey, Uwe Zeymer, Warren J Cantor, Anne Tsatsaris, Mathieu Kerneis, Abdourahmane Diallo, Eric Vicaut, Gilles Montalescot
BACKGROUND: In the ATLANTIC (Administration of Ticagrelor in the catheterization laboratory or in the Ambulance for New ST elevation myocardial Infarction to open the Coronary artery) trial the early use of aspirin, anticoagulation, and ticagrelor coupled with very short medical contact-to-balloon times represent good indicators of optimal treatment of ST-elevation myocardial infarction and an ideal setting to explore which factors may influence coronary reperfusion beyond a well-established pre-hospital system...
August 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28833266/home-monitoring-after-ambulatory-implanted-primary-cardiac-implantable-electronic-devices-the-home-ambulance-pilot-study
#15
Mariana S Parahuleva, Nedim Soydan, Dimitar Divchev, Ulrich Lüsebrink, Bernhard Schieffer, Ali Erdogan
BACKGROUND: The Home Monitoring (HM) system of cardiac implantable electronic devices (CIEDs) permits early detection of arrhythmias or device system failures. The aim of this pilot study was to examine how the safety and efficacy of the HM system in patients after ambulatory implanted primary CIEDs compare to patients with a standard procedure and hospitalization. HYPOTHESIS: We hypothesized that HM and their modifications would be a useful extension of the present concepts for ambulatory implanted CIEDs...
August 21, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28829221/enhanced-recovery-after-surgery-in-laparoscopic-surgery
#16
Kay B Leissner, Jessica L Shanahan, Peter L Bekker, Houman Amirfarzan
BACKGROUND: As part of an effort to maximize value in the perioperative setting, a paradigm shift is underway in the way that patients are cared for preoperatively, on the day of surgery, and postoperatively-a setting collectively known as the perioperative care. Enhanced Recovery After Surgery (ERAS(®)) is an evidence-based, patient-centered team approach to delivering high-quality perioperative care to surgical patients. METHODS: This review focuses on anesthesiologists, with their unique purview of perioperative setting, who are important drivers of change in the delivery of valuable perioperative care...
September 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28817167/body-mass-index-50-kg-m2-and-beyond-perioperative-care-of-pregnant-women-with-superobesity-undergoing-cesarean-delivery
#17
Marcela Carolina Smid, Sarah K Dotters-Katz, Robert M Silver, Jeffrey A Kuller
Importance: Superobesity, defined as body mass index 50 kg/m(2) or greater, is the fastest-growing obesity group in the United States. Currently, 2% of pregnant women in the United States are superobese, and 50% will deliver via cesarean delivery. Objective: To review evidence of perioperative care during cesarean delivery among superobese women. Evidence Acquisition: We performed an evidence-based review of maternal and neonatal risks of cesarean delivery and of intraoperative management and immediate postpartum care of superobese pregnant women...
August 2017: Obstetrical & Gynecological Survey
https://www.readbyqxmd.com/read/28793852/trust-in-the-early-chain-of-healthcare-lifeworld-hermeneutics-from-the-patient-s-perspective
#18
Gabriella Norberg Boysen, Maria Nyström, Lennart Christensson, Johan Herlitz, Birgitta Wireklint Sundström
PURPOSE: Patients must be able to feel as much trust for caregivers and the healthcare system at the healthcare centre as at the emergency department. The aim of this study is to explain and understand the phenomenon of trust in the early chain of healthcare, when a patient has called an ambulance for a non-urgent condition and been referred to the healthcare centre. METHOD: A lifeworld hermeneutic approach from the perspective of caring science was used. Ten patients participated: seven female and three male...
December 2017: International Journal of Qualitative Studies on Health and Well-being
https://www.readbyqxmd.com/read/28792986/-implementation-of-the-mobile-emergency-medical-service-in-brazil-action-strategies-and-structural-dimension
#19
Gisele O'Dwyer, Mariana Teixeira Konder, Luciano Pereira Reciputti, Cesar Macedo, Monica Guimarães Macau Lopes
The Mobile Emergency Medical Service (SAMU) was the first component of the National Policy for Emergency Care implemented in Brazil in the early 2000. The article analyzed the implementation of mobile pre-hospital emergency care in Brazil. The methods included document analysis, interviews with state emergency care coordinators, and an expert panel. The theoretical reference was the strategic conduct analysis from Giddens' Structuration Theory. The results showed uneven implementation of the SAMU between states and regions of Brazil, identifying six patterns of implementation, considering the states' capacity to expand the population coverage and regionalize the service...
August 7, 2017: Cadernos de Saúde Pública
https://www.readbyqxmd.com/read/28789801/early-ambulation-after-grafting-of-lower-extremity-burns
#20
J P Gawaziuk, B Peters, S Logsetty
OBJECTIVE: Early ambulation of lower extremity burns that undergo a skin graft may help to avoid some of the complications associated with immobilization. Despite recent evidence supporting early ambulation, post-operative immobilization following lower extremity skin grafting is still a common practice. The purpose of this study was to retrospectively assess the outcomes of lower extremity skin graft cases dressed with a multi-layer compression bandage who were ambulated in the immediate post-operative period...
August 5, 2017: Burns: Journal of the International Society for Burn Injuries
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