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https://www.readbyqxmd.com/read/27903076/the-potential-of-optimizing-prehospital-triage-of-patients-with-suspected-acute-myocardial-infarction-using-high-sensitivity-cardiac-troponin-t-and-copeptin
#1
Carsten Stengaard, Jacob T Sørensen, Søren A Ladefoged, Jens F Lassen, Martin B Rasmussnen, Claus Kjær Pedersen, Antoine Ayer, Hans Erik Bøtker, Christian J Terkelsen, Kristian Thygesen
PURPOSE: In patients with a suspected acute myocardial infarction (AMI), to evaluate the potential for early triage based on measurement of high-sensitivity cardiac troponin T (hs-cTnT) and copeptin in blood samples collected in the prehospital phase. MATERIALS AND METHODS: In this retrospective study, we measured hs-cTnT and copeptin in blood samples collected in the ambulance form 962 patients with suspected AMI. The diagnostic accuracy was estimated by receiver-operating characteristics curve area under the curve (AUC) for both biomarkers and a combined model...
December 1, 2016: Biomarkers: Biochemical Indicators of Exposure, Response, and Susceptibility to Chemicals
https://www.readbyqxmd.com/read/27897380/lived-experience-of-involuntary-transport-under-mental-health-legislation
#2
Joanne Bradbury, Marie Hutchinson, John Hurley, Helen Stasa
Police have historically been responsible for transporting people during a mental health crisis in Australia. A major change to the New South Wales (NSW) Mental Health Act (MHA) in 2007 expanded the range of coercive transportation agencies to include NSW Ambulance (paramedics) and NSW Health (mental health nurses). Anecdotal reports, however, describe a lack of clarity around how these changes should be implemented in practice. This research aims to explore this lack of clarity through qualitative analysis of interviews with people with the lived experience of involuntary transport under the MHA...
November 29, 2016: International Journal of Mental Health Nursing
https://www.readbyqxmd.com/read/27896461/transversus-abdominis-plane-block-for-postoperative-pain-relief-after-hand-assisted-laparoscopic-colon-surgery-a-randomized-placebo-controlled-clinical-trial
#3
R Tikuisis, P Miliauskas, V Lukoseviciene, N Samalavicius, A Dulskas, L Zabuliene, V Zabulis, J Urboniene
BACKGROUND: Although hand-assisted laparoscopic surgery (HALS) offers patients smaller surgical incisions, they still experience pain. Currently, there is no consensus on the optimal analgesic package for patients undergoing HALS. The aim of this prospective, randomized, double-blinded, placebo-controlled clinical trial was to evaluate the effect of transversus abdominis plane (TAP) block on postoperative pain control (pain score and analgesic use) and other outcomes in colon cancer patients undergoing hand-assisted laparoscopic left hemicolectomy...
November 28, 2016: Techniques in Coloproctology
https://www.readbyqxmd.com/read/27889724/phenotype-of-dent-disease-in-a-cohort-of-indian-children
#4
Swati Bhardwaj, Ranjeet Thergaonkar, Aditi Sinha, Pankaj Hari, Cheong Hi, Arvind Bagga
OBJECTIVE: To describe the clinical and genotypic features of Dent disease in children diagnosed at our center over a period of 10 years. DESIGN: Case series. SETTING: Pediatric Nephrology Clinic at a referral center in Northern India. METHODS: The medical records of patients with Dent disease diagnosed and followed up at this hospital from June 2005 to April 2015 were reviewed. The diagnosis of Dent disease was based on presence of all three of the following: (i) low molecular weight proteinuria, (ii) hypercalciuria and (iii) one of the following: nephrolithiasis, hematuria, hypophosphatemia or renal insufficiency, with or without mutation in CLCN5 or OCRL1 genes...
November 15, 2016: Indian Pediatrics
https://www.readbyqxmd.com/read/27878902/a-retrospective-comparison-of-intrathecal-morphine-and-epidural-hydromorphone-for-analgesia-following-posterior-spinal-fusion-in-adolescents-with-idiopathic-scoliosis
#5
Rebecca A Hong, Kathleen M Gibbons, G Ying Li, Ashlee Holman, Terri Voepel-Lewis
BACKGROUND: Posterior spinal fusion to correct idiopathic scoliosis is associated with severe postoperative pain. Intrathecal morphine is commonly used for analgesia after adolescent posterior spinal fusion; however, anticipating and managing the increase in pain scores after resolution of analgesic effect of intrathecal morphine analgesia is challenging. In 2014, we developed a clinical protocol detailing both the administration of intrathecal morphine intraoperatively and the transition to routine, scheduled oral analgesics at 18 h postoperatively...
November 22, 2016: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/27849462/functional-outcomes-of-service-members-with-bilateral-transfemoral-and-knee-disarticulation-amputations-resulting-from-trauma
#6
Barri L Schnall, Yin-Ting Chen, Elizabeth M Bell, Erik J Wolf, Jason M Wilken
As longitudinal studies for those with bilateral transfemoral amputation (BTFA) or knee disarticulation (KD) are lacking, it is important to quantify performance measures during rehabilitation in an effort to determine reasonable expectations and trends that may influence the rehabilitation process. At initial evaluation (date of first independent ambulation) and follow up (median 135 [range = 47-300] days later), 10 participants with BTFA/KD completed 6 minute walk testing and Activity Specific Balance Confidence and Lower Extremity Functional Scale questionnaires...
November 2016: Military Medicine
https://www.readbyqxmd.com/read/27848255/prognostic-predictors-for-ambulation-in-children-with-cerebral-palsy-a-systematic-review-and-meta-analysis-of-observational-studies
#7
Orawan Keeratisiroj, Nuanlaor Thawinchai, Wantana Siritaratiwat, Montana Buntragulpoontawee, Chayanin Pratoomsoot
PURPOSE: The purpose of this study is to investigate the prognostic predictors for ambulation in children with cerebral palsy using meta-analysis of observational studies. METHOD: Electronic searches were conducted in PubMed, SCOPUS, CINAHL, ProQuest, Ovid, Wiley InterScience, and ScienceDirect databases from their start dates to December 2015. RESULTS: Of the 1123 identified articles, 12 met the inclusion criteria for qualitative synthesis, eight of which were deemed appropriate for meta-analysis...
November 16, 2016: Disability and Rehabilitation
https://www.readbyqxmd.com/read/27842564/heel-pressure-ulcer-prevention-and-predictors-during-the-care-delivery-chain-when-and-where-to-take-action-a-descriptive-and-explorative-study
#8
Åsa Muntlin Athlin, Maria Engström, Lena Gunningberg, Carina Bååth
BACKGROUND: Hazardous healthcare settings, for example acute care, need to focus more on preventing adverse events and preventive actions across the care delivery chain (i.e pre-hospital and emergency care, and further at the hospital ward) should be more studied. Pressure ulcer prevalence is still at unreasonably high levels, causing increased healthcare costs and suffering for patients. Recent biomedical research reveals that the first signs of cell damage could arise within minutes...
November 14, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/27823597/frequency-of-deep-vein-thrombosis-and-or-pulmonary-embolism-after-coronary-artery-bypass-grafting-investigation-regardless-of-clinical-suspicion
#9
Vitor B Viana, Emanoel R Melo, Mario Terra-Filho, Luis A Dallan, Maria M Gonzalez, Ludhmila A Hajjar, Fabio B Jatene, Luiz A Cesar, Caio B Vianna
Venous thromboembolism (VTE) includes deep vein thrombosis (DVT) and/or pulmonary embolism (PE). Many surgeons and clinicians believe that VTE after coronary artery bypass grafting (CABG) has little clinical significance because it is seldom diagnosed. This study aimed to identify VTE after CABG, independent of clinical suspicion. In this prospective, observational, single-center study, 100 patients underwent computed tomographic pulmonary angiography (multidetector-64) and lower extremity venous compressive ultrasound after elective CABG...
October 8, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/27815810/ankle-foot-orthosis-in-duchenne-muscular-dystrophy-a-4%C3%A2-year-experience-in-a-multidisciplinary-neuromuscular-disorders-clinic
#10
Anupam Gupta, Atchayaram Nalini, Shanti Prakash Arya, Seena Vengalil, Meeka Khanna, Rashmi Krishnan, Arun B Taly
OBJECTIVE: To assess Ankle-Foot-Orthosis (AFO) requirement and ambulation in Duchenne Muscular Dystrophy (DMD) patients seen over a period of 4 y at a multi-disciplinary Neuromuscular disorders clinic (NMD). METHODS: A study was conducted in university quaternary research hospital with DMD patients confirmed by MLPA (multiplex ligation - dependent probe amplification) method and were evaluated between January 2012 and December 2015. Their ambulatory status, detailed neurological and functional status were recorded...
November 5, 2016: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/27815374/treatment-with-tpa-in-the-golden-hour-and-the-shape-of-the-4-5-hour-time-benefit-curve-in-the-national-us-get-with-the-guidelines-stroke-population
#11
Joon-Tae Kim, Gregg C Fonarow, Eric E Smith, Mathew J Reeves, Digvijaya D Navalkele, James C Grotta, Maria V Grau-Sepulveda, Adrian F Hernandez, Eric D Peterson, Lee H Schwamm, Jeffrey L Saver
BACKGROUND: -Earlier tissue plasminogen activator (tPA) treatment improves ischemic stroke outcome, but aspects of the time-benefit relationship still not well delineated are: 1) the degree of additional benefit accrued with treatment in the first 60 minutes after onset, and 2) the shape of the time-benefit curve through 4.5 hours. METHODS: -We analyzed acute ischemic stroke patients treated with intravenous tPA within 4.5 hours of onset from the Get With The Guidelines-Stroke US national program...
November 4, 2016: Circulation
https://www.readbyqxmd.com/read/27811526/prospective-double-blind-randomized-study-to-evaluate-single-injection-adductor-canal-nerve-block-versus-femoral-nerve-block-postoperative-functional-outcomes-after-total-knee-arthroplasty
#12
George I Macrinici, Carol Murphy, Lori Christman, Michelle Drescher, Brittany Hughes, Victor Macrinici, Gloria Diab
BACKGROUND AND OBJECTIVES: Despite multiple clinical trials comparing the adductor canal block (ACB) with femoral nerve block (FNB) for total knee arthroplasty, none looked at the aforementioned nerve blocks from early functional results to up to 6 months after surgery. METHODS: For this prospective, double-blind, randomized, single-center trial, we enrolled 98 patients set to undergo total knee arthroplasty. The patients were randomized, with 93 patients included in the intention-to-treat analysis...
November 2, 2016: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/27793206/mog-igg-in-nmo-and-related-disorders-a-multicenter-study-of-50-patients-part-2-epidemiology-clinical-presentation-radiological-and-laboratory-features-treatment-responses-and-long-term-outcome
#13
Sven Jarius, Klemens Ruprecht, Ingo Kleiter, Nadja Borisow, Nasrin Asgari, Kalliopi Pitarokoili, Florence Pache, Oliver Stich, Lena-Alexandra Beume, Martin W Hümmert, Marius Ringelstein, Corinna Trebst, Alexander Winkelmann, Alexander Schwarz, Mathias Buttmann, Hanna Zimmermann, Joseph Kuchling, Diego Franciotta, Marco Capobianco, Eberhard Siebert, Carsten Lukas, Mirjam Korporal-Kuhnke, Jürgen Haas, Kai Fechner, Alexander U Brandt, Kathrin Schanda, Orhan Aktas, Friedemann Paul, Markus Reindl, Brigitte Wildemann
BACKGROUND: A subset of patients with neuromyelitis optica spectrum disorders (NMOSD) has been shown to be seropositive for myelin oligodendrocyte glycoprotein antibodies (MOG-IgG). OBJECTIVE: To describe the epidemiological, clinical, radiological, cerebrospinal fluid (CSF), and electrophysiological features of a large cohort of MOG-IgG-positive patients with optic neuritis (ON) and/or myelitis (n = 50) as well as attack and long-term treatment outcomes. METHODS: Retrospective multicenter study...
September 27, 2016: Journal of Neuroinflammation
https://www.readbyqxmd.com/read/27789567/variables-associated-with-administration-of-analgesia-nurse-initiated-analgesia-and-early-analgesia-in-the-emergency-department
#14
David McD Taylor, Jessie Chen, Munad Khan, Marina Lee, Mani Rajee, Michael Yeoh, Joanna R Richardson, Antony M Ugoni
OBJECTIVE: To determine the patient and clinical variables associated with administration of any analgesia, nurse-initiated analgesia (NIA, prescribed and administered by a nurse) and early analgesia (within 30 min of presentation). METHODS: We undertook a retrospective cohort study of patients who presented to a metropolitan ED in Melbourne, Australia, during July and August, 2013. The ED has an established NIA programme. Patients were included if they were aged 18 years or more and presented with a painful complaint...
October 27, 2016: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/27789264/early-ambulation-and-prevention-of-post-operative-thrombo-embolic-risk
#15
P Talec, S Gaujoux, C M Samama
The prevention of post-operative risk of venous thrombo-embolism (VTE) is of fundamental importance, but preventive methods have progressed with the introduction of direct oral anticoagulants (DOAC), the development of ambulatory surgery and enhanced recovery programs (ERP) after surgery. Surgery is, inherently a trigger for venous thrombo-embolic disease, as is prolonged immobilization. However, the risk of VTE is very low following ambulatory surgery, especially in this selected population. ERP, consists of a set of measures to optimize the patient's peri-operative management while reducing length of stay, costs and morbidity and mortality; one measure is the encouragement of early ambulation...
October 24, 2016: Journal of Visceral Surgery
https://www.readbyqxmd.com/read/27759596/picu-up-impact-of-a-quality-improvement-intervention-to-promote-early-mobilization-in-critically-ill-children
#16
Beth Wieczorek, Judith Ascenzi, Yun Kim, Hallie Lenker, Caroline Potter, Nehal J Shata, Lauren Mitchell, Catherine Haut, Ivor Berkowitz, Frank Pidcock, Jeannine Hoch, Connie Malamed, Tamara Kravitz, Sapna R Kudchadkar
OBJECTIVE: To determine the safety and feasibility of an early mobilization program in a PICU. DESIGN: Observational, pre-post design. SETTING: PICU in a tertiary academic hospital in the United States. PATIENTS: Critically ill pediatric patients admitted to the PICU. INTERVENTION: This quality improvement project involved a usual-care baseline phase, followed by a quality improvement phase that implemented a multicomponent, interdisciplinary, and tiered activity plan to promote early mobilization of critically ill children...
October 10, 2016: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/27755488/quadratus-lumborum-block-versus-transversus-abdominis-plane-block-for-postoperative-pain-after-cesarean-delivery-a-randomized-controlled-trial
#17
Rafael Blanco, Tarek Ansari, Waleed Riad, Nanda Shetty
BACKGROUND AND OBJECTIVES: Effective postoperative analgesia after cesarean delivery enhances early recovery, ambulation, and breastfeeding. In a previous study, we established the effectiveness of the quadratus lumborum block in providing pain relief after cesarean delivery compared with patient-controlled analgesia (morphine). In the current study, we hypothesized that this method would be equal to or better than the transversus abdominis plane block with regard to pain relief and its duration of action after cesarean delivery...
October 11, 2016: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/27754758/sex-and-age-interactions-and-differences-in-outcomes-after-intracerebral-hemorrhage
#18
Michael L James, Margueritte Cox, Ying Xian, Eric E Smith, Deepak L Bhatt, Phillip J Schulte, Adrian Hernandez, Gregg C Fonarow, Lee H Schwamm
BACKGROUND: Compared to ischemic stroke, sex differences in response to intracerebral hemorrhage (ICH) are largely unexplored, and their potential interactions with patient age have not been examined. This study hypothesized that risk for poor outcome is greater in women with increasing age. METHODS AND RESULTS: The Get With The Guidelines(®)-Stroke database was used to assess differences between men and women with ICH. Data from 192,826 ICH patients admitted from January 1, 2009 through March 31, 2014 to 1,728 fully participating sites were analyzed using logistic regression to test interactions between age/sex and outcome...
October 18, 2016: Journal of Women's Health
https://www.readbyqxmd.com/read/27752318/a-collaborative-improvement-project-by-an-nhs-emergency-department-and-scottish-ambulance-paramedics-to-improve-the-identification-and-delivery-of-sepsis-6
#19
Martin Carberry, John Harden
Early identification of patients with sepsis is key to the delivery of the sepsis 6 bundle including antibiotic therapy within an hour.[1-3] Demand versus capacity challenges in the Emergency Department (ED) led to delays in antibiotic and sepsis 6 delivery. An alerting tool was developed that provided criteria for Scottish Ambulance Service (SAS) Paramedics to alert the ED of potential sepsis patients. Data from patients presenting to the ED prior to the alerting process commencing (n=50) and during alerting (n=50) were analysed, a questionnaire was used to ascertain feedback from all staff groups; nurses doctors, and paramedics (n=38)...
2016: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/27747217/dnajb6-myopathies-focused-review-on-an-emerging-and-expanding-group-of-myopathies
#20
Alessandra Ruggieri, Simona Saredi, Simona Zanotti, Maria Barbara Pasanisi, Lorenzo Maggi, Marina Mora
Mutations in the DNAJB6 gene have been associated with the autosomal dominant limb girdle muscular dystrophy type 1D (LGMD1D), a disorder characterized by abnormal protein aggregates and rimmed vacuoles in muscle fibers. DNAJB6 is a ubiquitously expressed Hsp40 co-chaperone characterized by a J domain that specifies Hsp70 functions in the cellular environment. DNAJB6 is also a potent inhibitor of expanded polyglutamine (polyQ) aggregation preventing aggregate toxicity in cells. In DNAJB6-mutated patients this anti-aggregation property is significantly reduced, albeit not completely lost...
2016: Frontiers in Molecular Biosciences
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