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https://www.readbyqxmd.com/read/29766749/enhanced-sternal-healing-via-platelet-rich-plasma-and-biodegradable-gelatin-hydrogel
#1
Masafumi Shibata, Gen Takagi, Mitsuhiro Kudo, Jiro Kurita, Yoko Kawamoto, Yasuo Miyagi, Mikimoto Kanazashi, Takashi Sakatani, Zenya Naito, Yasuhiko Tabata, Masaaki Miyamoto, Takashi Nitta
Platelet-rich plasma (PRP) contains numerous growth factors and promotes bone fracture healing. The aim of this study was to evaluate the effectiveness of the controlled release of PRP from biodegradable gelatin hydrogel for promoting healing in a rabbit ischemic sternal model. PRP was prepared from the whole blood of a Japanese white rabbit. Sixteen rabbits were randomized into four groups (each n = 4) and all underwent median sternotomy and bilateral internal thoracic artery removal. Before the sternum was closed, the following solutions were applied between the sternum incisions in three of the groups: 30 mg of gelatin hydrogel incorporating 300 μL of phosphate-buffered saline, 300 μL of a solution form of PRP, or 30 mg of gelatin hydrogel incorporating 300 μL of PRP (PRP+Gel)...
May 16, 2018: Tissue Engineering. Part A
https://www.readbyqxmd.com/read/29753000/early-enforced-mobilization-after-liver-resection-a-prospective-randomized-controlled-trial
#2
Chun-Yan Ni, Zhi-Hong Wang, Zhi-Ping Huang, Hui Zhou, Li-Juan Fu, Hui Cai, Xuan-Xuan Huang, Yuan Yang, Hui-Fen Li, Wei-Ping Zhou
OBJECTIVE: This randomized controlled study investigated the feasibility of early ambulation after liver resection and the effect of the amount of activity on postoperative recovery. METHODS: A total of 120 patients who underwent liver resection were randomly divided into two groups for the comparative analysis of the following factors: amount of activity, pain control, sleeping state, perioperative gastrointestinal function recovery, incidence of complications and postoperative hospital stay...
May 9, 2018: International Journal of Surgery
https://www.readbyqxmd.com/read/29747562/early-ambulation-in-patients-with-external-ventricular-drains-results-of-a-quality-improvement-project
#3
Syed Omar Shah, Jacqueline Kraft, Nethra Ankam, Paula Bu, Kristen Stout, Sara Melnyk, Fred Rincon, M Kamran Athar
INTRODUCTION: Prolonged immobility in patients in the intensive care unit (ICU) can lead to muscle wasting and weakness, longer hospital stays, increased number of days in restraints, and hospital-acquired infections. Increasing evidence demonstrates the safety and feasibility of early mobilization in the ICU. However, there is a lack of evidence in the safety and feasibility of mobilizing patients with external ventricular drains (EVDs). The purpose of this study was to determine the safety and feasibility of early mobility in this patient population...
June 2018: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29736276/pregnant-women-who-requested-a-108-ambulance-in-two-states-of-india
#4
Samiksha Singh, Pat Doyle, Oona Maeve Renee Campbell, Govindaraju Venkata Ramana Rao, Gudlavalleti V S Murthy
We studied the pregnant women, who requested a '108' ambulance in two Indian states (Andhra Pradesh (AP) and Himachal Pradesh (HP)). We conducted a cross-sectional telephone survey to study the characteristics and outcomes of those who (1) were transported using '108' ambulance, (2) were sent '108' ambulance but did not use it and (3) were not assigned a '108' ambulance. We conducted interviews within 24 hours of clients' call and followed them up at 48 hours, on the 7th and 28th day. 90% of pregnant women callers in AP and only 16% in HP were from poorer socioeconomic circumstances...
2018: BMJ Global Health
https://www.readbyqxmd.com/read/29735230/management-of-multiple-burned-patients-with-inhalation-injuries
#5
Kouhei Ishikawa, Youichi Yanagawa, Yukino Kato, Yoko Nozawa, Hiroki Nagasawa, Ikuto Takeuchi, Kei Jitsuiki, Akihiko Kondo, Hiromichi Ohsaka, Kazuhiko Omori
The fire department in Atami received an emergency call at 6:17 am, with notification of 4 or 5 casualties because of a fire. Because there was only 1 ambulance (O) at the station, an additional ambulance (P) was also requested. Ambulance O transported 2 patients (A and B), and ambulance P transported 2 patients (C and D). These 4 patients were judged to have severe inhalation injuries at the scene and were transported to 2 local hospitals (X and Y). After patients C and D arrived at hospital Y, the medical staff decided to transfer them to the emergency medical service center...
May 2018: Air Medical Journal
https://www.readbyqxmd.com/read/29728525/increasing-early-ambulation-disability-in-spontaneous-intracerebral-hemorrhage-survivors
#6
Yannick Béjot, Christelle Blanc, Benoit Delpont, Pierre Thouant, Cécile Chazalon, Anaïs Daumas, Guy-Victor Osseby, Marie Hervieu-Bègue, Frédéric Ricolfi, Maurice Giroud, Charlotte Cordonnier
OBJECTIVE: To evaluate temporal trends in early ambulatory status in patients with spontaneous intracerebral hemorrhage (ICH). METHODS: All patients with ICH between 1985 and 2011 were prospectively registered in a population-based registry in Dijon, France, and included in the study. Outcomes of ICH survivors were assessed at discharge from their stay in an acute care ward with the use of a 4-grade ambulation scale. Time trends in ambulation disability and place of discharge were analyzed in 3 periods (1985-1993, 1994-2002, and 2003-2011)...
May 4, 2018: Neurology
https://www.readbyqxmd.com/read/29725506/comparison-of-adductor-canal-block-versus-local-infiltration-analgesia-on-postoperative-pain-and-functional-outcome-after-total-knee-arthroplasty-a-randomized-controlled-trial
#7
W Kampitak, A Tanavalee, S Ngarmukos, C Amarase, B Songthamwat, A Boonshua
Introduction: Total knee arthroplasty (TKA) is associated with intense postoperative pain for which effective analgesia is essential to facilitate early postoperative recovery. Adductor canal block (ACB) and local infiltration analgesia (LIA) have become increasingly involved in postoperative pain management after TKA. We aimed to compare their efficacy and outcomes in patients undergoing TKA. Materials and Methods: Sixty patients undergoing unilateral TKA were randomized to receive either postoperative single-injection ACB (Group A) or LIA (Group L) during the operation...
March 2018: Malaysian Orthopaedic Journal
https://www.readbyqxmd.com/read/29698341/early-hospital-discharge-after-helicopter-transport-of-pediatric-trauma-patients-analysis-of-rates-of-over-and-undertriage
#8
Aodhnait S Fahy, Stephanie F Polites, Cornelius A Thiels, Maile Parker, Michael B Ishitani, Christopher R Moir, Kathleen Berns, Scott P Zietlow, Donald H Jenkins, Martin D Zielinski
OBJECTIVES: Helicopter air ambulance (HAA) of pediatric trauma patients is a life-saving intervention. Triage remains a challenge for both scene transport and interhospital transfer of injured children. We aimed to understand whether overtriage or undertriage was a feature of scene or interhospital transfer and how in or out of state transfers affected these rates. METHODS: Children (<18 years) who underwent trauma activation at a level I trauma center between 2011 and 2013 were identified and reviewed...
April 24, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29691180/multimodal-clinical-pathway-with-adductor-canal-block-decreases-hospital-length-of-stay-improves-pain-control-and-reduces-opioid-consumption-in-total-knee-arthroplasty-patients-a-retrospective-review
#9
Terry A Ellis, Hassan Hammoud, Philip Dela Merced, Nishankkumar P Nooli, Farhad Ghoddoussi, Joshua Kong, Sandeep H Krishnan
BACKGROUND: Total knee arthroplasty volume is increasing significantly in the United States. Reducing hospital length of stay may represent the best method for accommodating expanding volume and reducing costs. We hypothesized that tailoring a clinical pathway to facilitate early ambulation would decrease costs and resource utilization. METHODS: We conducted a sequential before-and-after study of total knee arthroplasty patients after a phased implementation of a clinical pathway that includes multimodal oral analgesic protocols, adductor canal nerve block, and standardized day of surgery ambulation protocols...
March 27, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29681432/a-systematic-review-evaluating-the-role-of-nurses-and-processes-for-delivering-early-mobility-interventions-in-the-intensive-care-unit
#10
REVIEW
Anna Krupp, Linsey Steege, Barbara King
OBJECTIVES: To investigate processes for delivering early mobility interventions in adult intensive care unit patients used in research and quality improvement studies and the role of nurses in early mobility interventions. METHODS: A systematic review was conducted. Electronic databases PubMED, CINAHL, PEDro, and Cochrane were searched for studies published from 2000 to June 2017 that implemented an early mobility intervention in adult intensive care units. Included studies involved progression to ambulation as a component of the intervention, included the role of the nurse in preparing for or delivering the intervention, and reported at least one patient or organisational outcome measure...
April 19, 2018: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/29678650/femoseal%C3%A2-device-use-for-femoral-artery-closure-by-different-techniques
#11
Roberto Gabrielli, Maria Sofia Rosati, Massiliano Millarelli, Angelica Dante, Maurizio Maiorano, Aldo Musilli, Roberto Chiappa, Marco Ventura
BACKGROUND: Common femoral artery is still the most frequently site used for vascular access, mostly for peripheral arterial interventions and its puncture remains a significant source of patient's morbidity. Manual compression (MC) has been the gold standard for hemostasis after femoral catheterization until recently, but only in the last few years, vascular closure devices (VCDs) are replacing MC due to their rapid development. Nowadays also vascular surgeons are becoming familiar with VCDs...
April 17, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29658187/overview-of-intensive-care-unit-related-physical-and-functional-impairments-and-rehabilitation-related-devices
#12
REVIEW
Katie Koester, Heidi Troeller, Sara Panter, Emily Winter, Jayshil J Patel
Rehabilitation after critical illness requires a multidisciplinary effort. Nutrition support of critically ill patients aims to correct the imbalance between protein synthesis and protein degradation to maximize strengthening and muscle mass, whereas physical and occupational therapists focus on optimizing strength and mobility through functional activity to help intensive care (ICU) patients return to their precritical illness level of function and improve quality of life. Early mobility has become the new standard of care for ICU patients...
April 2018: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/29657376/smoke-inhalation-injury-etiopathogenesis-diagnosis-and-management
#13
REVIEW
Kapil Gupta, Mayank Mehrotra, Parul Kumar, Anoop Raj Gogia, Arun Prasad, Joseph Arnold Fisher
Smoke inhalation injury is a major determinant of morbidity and mortality in fire victims. It is a complex multifaceted injury affecting initially the airway; however, in short time, it can become a complex life-threatening systemic disease affecting every organ in the body. In this review, we provide a summary of the underlying pathophysiology of organ dysfunction and provide an up-to-date survey of the various critical care modalities that have been found beneficial in caring for these patients. Major pathophysiological change is development of edema in the respiratory tract...
March 2018: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29652166/ambulance-use-distance-and-outcomes-in-patients-with-suspected-cardiovascular-disease-a-registry-based-geographic-information-system-study
#14
Nariman Sepehrvand, Wendimagegn Alemayehu, Padma Kaul, Rick Pelletier, Aminu K Bello, Robert C Welsh, Paul W Armstrong, Justin A Ezekowitz
BACKGROUND: Despite guideline recommendations, the majority of patients with symptoms suggestive of acute coronary syndrome do not use emergency medical services to reach the emergency department (ED). The aim of this study was to investigate the factors associated with EMS utilisation and subsequent patient outcomes. METHODS: Using administrative data, all patients who presented to an ED in the metropolitan areas of Edmonton and Calgary in the years of 2007-2013 with main ED diagnosis of acute coronary syndrome, stable angina or chest pain were included...
April 1, 2018: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/29650034/complex-fracture-orthopedic-rehabilitation-comfort-real-time-visual-biofeedback-on-weight-bearing-versus-standard-training-methods-in-the-treatment-of-proximal-femur-fractures-in-the-elderly-study-protocol-for-a-multicenter-randomized-controlled-trial
#15
Marco Raaben, Syaiful Redzwan, Robin Augustine, Taco Johan Blokhuis
BACKGROUND: Proximal femur fractures are a common injury after low energy trauma in the elderly. Most rehabilitation programs are based on restoring mobility and early resumption of weight-bearing. However, therapy compliance is low in patients following lower extremity fractures. Moreover, little is known about the relevance of gait parameters and how to steer the rehabilitation after proximal femur fractures in the elderly. Therefore, the aim of this prospective, randomized controlled trial is to gain insight in gait parameters and evaluate if real-time visual biofeedback can improve therapy compliance after proximal femur fractures in the elderly...
April 12, 2018: Trials
https://www.readbyqxmd.com/read/29643155/femoral-nerve-block-intervention-in-neck-of-femur-fracture-finof-a-randomised-controlled-trial
#16
Martin Rowlands, Gerrie van de Walt, Jim Bradley, Alexa Mannings, Sarah Armstrong, Nigel Bedforth, Iain K Moppett, Opinder Sahota
OBJECTIVE: Fractured neck of femur is a severely painful condition with significant mortality and morbidity. We investigated whether early and continuous use of femoral nerve block can improve pain on movement and mobility after surgery in older participants with fragility neck of femur fracture. DESIGN: Prospective single-centre, randomised controlled pragmatic trial. SETTING: Secondary care, acute National Health Service Trust, UK. PARTICIPANTS: Participants admitted with a history and examination suggesting fractured neck of femur...
April 10, 2018: BMJ Open
https://www.readbyqxmd.com/read/29643066/early-ambulation-among-hospitalized-heart-failure-patients-is-associated-with-reduced-length-of-stay-and-30-day-readmissions
#17
Lisa M Fleming, Xin Zhao, Adam D DeVore, Paul A Heidenreich, Clyde W Yancy, Gregg C Fonarow, Adrian F Hernandez, Robb D Kociol
BACKGROUND: Early ambulation (EA) is associated with improved outcomes for mechanically ventilated and stroke patients. Whether the same association exists for patients hospitalized with acute heart failure is unknown. We sought to determine whether EA among patients hospitalized with heart failure is associated with length of stay, discharge disposition, 30-day post discharge readmissions, and mortality. METHODS AND RESULTS: The study population included 369 hospitals and 285 653 patients with heart failure enrolled in the Get With The Guidelines-Heart Failure registry...
April 2018: Circulation. Heart Failure
https://www.readbyqxmd.com/read/29628577/comparison-of-dexamethasone-and-buprenorphine-as-adjuvant-in-ultrasound-guided-brachial-plexus-blocks-a-randomized-controlled-trial
#18
Prasanna Vadhanan, Narendren Ganesh, M I Hussain Ahmed
Introduction: Effective postoperative analgesia is imperative for orthopedic surgeries to enhance recovery and facilitate early ambulation. Various additives have been used as adjuvants with local anesthetics in peripheral nerve blocks to provide postoperative analgesia. The aim of this study is to compare the duration of postoperative analgesia with buprenorphine and dexamethasone when administered as an adjuvant during ultrasound-guided brachial plexus blocks. Methodology: Sixty adult patients undergoing various upper arm surgeries were recruited for the study after acquiring ethics committee clearance...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29628551/perianal-block-is-it-as-good-as-spinal-anesthesia-for-closed-hemorrhoidectomies
#19
Kavitha Jinjil, Deepak Dwivedi, Vidhu Bhatnagar, Rahul K Ray, Swayam Tara
Background and Aims: This study compared if perianal block using ropivacaine and dexmedetomidine was as good as spinal anesthesia (SA) using bupivacaine (heavy) for closed hemorrhoidectomies. Methods: A prospective randomized study was conducted in sixty patients who underwent closed hemorrhoidectomy. Thirty patients of Group A received SA. Thirty patients in Group B received local perianal block. Patients were evaluated for onset of the block, total pain-free period, and time to ambulation...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29622974/pre-hospital-and-hospital-delay-in-patients-with-non-st-elevation-acute-coronary-syndromes-in-tertiary-care
#20
G S Youssef, H H Kassem, O A Ameen, H S Al Taaban, H H Rizk
Background: Early presentation is desirable in all cases of acute prolonged chest pain. Causes of delayed presentation vary widely across geographic regions because of different patients' profile and different healthcare capabilities. Objectives: To detect causes of delay of Non-ST elevation acute coronary syndrome (NSTE-ACS) patients in our country. Methods: Patients admitted with NSTE-ACS were included. We recorded the time delay between the onsets of acute severe symptoms till their arrival to the hospital (Pre-hospital delay)...
September 2017: The Egyptian heart journal: (EHJ): official bulletin of the Egyptian Society of Cardiology
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