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https://www.readbyqxmd.com/read/29775556/let-s-talk-about-it-supporting-family-communication-during-end-of-life-care-of-pediatric-patients
#1
Meghan L Marsac, Christine Kindler, Danielle Weiss, Lindsay Ragsdale
BACKGROUND: Communication is key in optimizing medical care when a child is approaching end of life (EOL). Research is yet to establish best practices for how medical teams can guide intrafamily communication (including surviving siblings) when EOL care is underway or anticipated for a pediatric patient. While recommendations regarding how medical teams can facilitate communication between the medical team and the family exist, various barriers may prevent the implementation of these recommendations...
May 18, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29774497/safety-of-commercial-airflight-in-patients-with-brain-tumors-a-case-series
#2
Michelle Phillips, Marlon Saria, Amy Eisenberg, Daniel F Kelly, Garni Barkhoudarian
INTRODUCTION: Patients with intracranial masses are often advised to avoid airflight due to concerns of worsening neurological symptoms or deterioration. However, many patients often travel cross-country or internationally to tertiary care centers for definitive care. This study assesses the safety of commercial airflight for brain and skull base tumor patients without severe or progressive neurological deficits. METHODS: Patients that had traveled to our institution for surgery via commercial airflight from 2014 to 2017 were identified...
May 17, 2018: Journal of Neuro-oncology
https://www.readbyqxmd.com/read/29773688/understanding-patients-perceptions-of-asthma-control-a-qualitative-study
#3
Natalie Bidad, Neil Barnes, Chris Griffiths, Rob Horne
Asthma control is suboptimal for many sufferers despite the existence of effective treatments. Patients' self-management is influenced by their perceptions of asthma and its treatment. This study explored sufferers' perceptions of asthma control and their influence on self-management behaviours.Participants (n=42) recruited from primary and secondary care asthma clinics in London each underwent a qualitative interview exploring perceptions and experiences of asthma control. Purposive sampling ensured variation in disease severity, degree of asthma control, age and socioeconomic status...
May 17, 2018: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/29769074/delay-in-reviewing-test-results-prolongs-hospital-length-of-stay-a-retrospective-cohort-study
#4
Mei-Sing Ong, Farah Magrabi, Enrico Coiera
BACKGROUND: Failure in the timely follow-up of test results has been widely documented, contributing to delayed medical care. Yet, the impact of delay in reviewing test results on hospital length of stay (LOS) has not been studied. We examine the relationship between laboratory tests review time and hospital LOS. METHODS: A retrospective cohort study of inpatients admitted to a metropolitan teaching hospital in Sydney, Australia, between 2011 and 2012 (n = 5804)...
May 16, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29768294/a-pilot-study-to-reduce-computed-tomography-utilization-for-pediatric-mild-head-injury-in-the-emergency-department-using-a-clinical-decision-support-tool-and-a-structured-parent-discussion-tool
#5
Rakesh S Engineer, Seth R Podolsky, Baruch S Fertel, Purva Grover, Heather Jimenez, Erin L Simon, Courtney M Smalley
INTRODUCTION: The American College of Emergency Physicians embarked on the "Choosing Wisely" campaign to avoid computed tomographic (CT) scans in patients with minor head injury who are at low risk based on validated decision rules. We hypothesized that a Pediatric Mild Head Injury Care Path could be developed and implemented to reduce inappropriate CT utilization with support of a clinical decision support tool (CDST) and a structured parent discussion tool. METHODS: A quality improvement project was initiated for 9 weeks to reduce inappropriate CT utilization through 5 interventions: (1) engagement of leadership, (2) provider education, (3) incorporation of a parent discussion tool to guide discussion during the emergency department (ED) visit between the parent and the provider, (4) CDST embedded in the electronic medical record, and (5) importation of data into the note to drive compliance...
May 15, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29767338/-beginners-operations-and-medical-specialist-standards-avoidance-of-criminal-liability-and-civil-liability
#6
REVIEW
H Schneider
BACKGROUND: In all phases, patients are entitled to receive medical treatment according to medical specialist standards. This does not mean that patients necessarily have to be treated by a medical specialist. Operations performed by "beginners", e. g. assistant physicians, are permitted. However, there are increased liability risks, both for the specialist and the assistant physician. Furthermore, there are risks of criminal responsibility for causing bodily harm by negligence or negligent manslaughter...
May 16, 2018: Der Urologe. Ausg. A
https://www.readbyqxmd.com/read/29766320/weaning-from-prolonged-veno-venous-extracorporeal-membrane-oxygenation-ecmo-after-transfer-to-a-specialized-center-a-retrospective-study
#7
Frederik Seiler, Franziska C Trudzinski, Sabrina I Hörsch, Annegret Kamp, Carlos Metz, Monika Flaig, Mohammad Alqudrah, Holger Wehrfritz, Markus Kredel, Ralf M Muellenbach, Hendrik Haake, Robert Bals, Philipp M Lepper
Veno-venous extracorporeal membrane oxygenation (vvECMO) is increasingly used as rescue therapy in severe respiratory failure. In patients with pre-existent lung diseases or persistent lung injury weaning from vvECMO can be challenging. This study sought to investigate outcomes of patients transferred to a specialized ECMO center after prolonged ECMO therapy. We performed a retrospective analysis of all patients admitted to our medical intensive care unit (ICU) between 01/2013 and 12/2016 who were transferred from an external ICU after > 8 days on vvECMO...
May 15, 2018: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/29765208/primary-nonadherence-to-chronic-disease-medications-a-meta-analysis
#8
REVIEW
Mark Lemstra, Chijioke Nwankwo, Yelena Bird, John Moraros
Background: Medication nonadherence is a global problem that requires urgent attention. Primary nonadherence occurs when a patient consults with a medical doctor, receives a referral for medical therapy but never fills the first dispensation for the prescription medication. Nonadherence to chronic disease medications costs the USA ~$290 billion (USD) every year in avoidable health care costs. In Canada, it is estimated that 5.4% of all hospitalizations are due to medication nonadherence...
2018: Patient Preference and Adherence
https://www.readbyqxmd.com/read/29764554/-efficacy-and-safety-of-nalbuphine-on-analgesia-of-patients-in-intensive-care-unit
#9
Shaohua Liu, Youdong Wan, Yonggang Luo, Li Wan, Wenjing Yun, Haixu Wang, Zhenhua Wang, Xiaoguang Duan, Ruifang Zhang, Yingying Zhao, Hongwei Cui, Tongwen Sun
OBJECTIVE: To analyze the efficacy and safety of nalbuphine in patients with sedative analgesia in intensive care unit (ICU). METHODS: A prospective observation was conducted. The adult patients with mild and moderate analgesia in general ICU of the First Affiliated Hospital of Zhengzhou University from January to November in 2017 were enrolled, and they were divided into nalbuphine group and sufentanil group in proper order. The nabobrown group was given 40 mg nabobrown, the sufentanil group was given 0...
May 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29763388/how-should-trauma-patients-informed-consent-or-refusal-be-regarded-in-a-trauma-bay-or-other-emergency-settings
#10
Ashley Suah, Peter Angelos
The precipitous and unexpected nature of trauma requires training health care practitioners to think and act quickly, according to the best medical interest of the patient. The urgency of treatment for trauma patients, who frequently have temporary alterations in their abilities to make autonomous and competent decisions, often results in presumed consent for medically necessary treatment. Academic trauma centers use protocol-based management of injuries to facilitate their simultaneous evaluation by multiple clinicians and to avoid delays in treatment, ensuring that trauma patients receive the best possible care...
May 1, 2018: AMA Journal of Ethics
https://www.readbyqxmd.com/read/29760877/an-eaaci-task-force-report-recognising-the-potential-of-the-primary-care-physician-in-the-diagnosis-and-management-of-drug-hypersensitivity
#11
REVIEW
I Doña, J C Caubet, K Brockow, M Doyle, E Moreno, I Terreehorst, M J Torres
Adverse drug reactions include drug hypersensitivity reactions (DHRs), which can be immunologically mediated (allergy) or non-immunologically mediated. The high number of DHRs that are unconfirmed and often self-reported is a frequent problem in daily clinical practice, with considerable impact on future prescription choices and patient health. It is important to distinguish between hypersensitivity and non-hypersensitivity reactions by adopting a structured diagnostic approach to confirm or discard the suspected drug, not only to avoid life-threatening reactions, but also to reduce the frequent over-diagnosis of DHRs...
2018: Clinical and Translational Allergy
https://www.readbyqxmd.com/read/29757778/a-contemporary-analysis-of-medicolegal-issues-in-obstetric-anesthesia-between-2005-and-2015
#12
Vesela P Kovacheva, Ethan Y Brovman, Penny Greenberg, Ellen Song, Arvind Palanisamy, Richard D Urman
BACKGROUND: Detailed reviews of closed malpractice claims have provided insights into the most common events resulting in litigation and helped improve anesthesia care. In the past 10 years, there have been multiple safety advancements in the practice of obstetric anesthesia. We investigated the relationship among contributing factors, patient injuries, and legal outcome by analyzing a contemporary cohort of closed malpractice claims where obstetric anesthesiology was the principal defendant...
May 10, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29757209/immunization-offer-targeting-migrants-policies-and-practices-in-italy
#13
Teresa Dalla Zuanna, Martina Del Manso, Cristina Giambi, Flavia Riccardo, Antonino Bella, Maria Grazia Caporali, Maria Grazia Dente, Silvia Declich
The unprecedented flow of migrants over the last three years places Italy in front of new issues regarding medical care from the rescue phase up to the integration into the national health services, including preventive actions. We used online questionnaires to investigate the Italian national and regional policies for immunization offer targeting asylum seekers, refugees, irregular migrants and unaccompanied minors. Another questionnaire was used to assess how these policies are translated into practice in migrant reception centres and community health services...
May 12, 2018: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/29755756/treatment-choice-medication-adherence-and-glycemic-efficacy-in-people-with-type-2-diabetes-a-uk-clinical-practice-database-study
#14
Jason Gordon, Phil McEwan, Iskandar Idris, Marc Evans, Jorge Puelles
Objective: Using primary care data obtained from the UK Clinical Practice Research Datalink, this retrospective cohort study examined the relationships between medication adherence and clinical outcomes in patients with type 2 diabetes. Research design and methods: Data were extracted for patients treated between 2008 and 2016, and stratified by oral antihyperglycemic agent (OHA) line of therapy (mono, dual or triple therapy). Patients were monitored for up to 365 days; associations between medication possession ratio (MPR) and outcomes at 1 year (glycated hemoglobin A1c (HbA1c), weight and hypoglycemia incidence) were assessed using linear regression modeling and descriptive analyses...
2018: BMJ Open Diabetes Research & Care
https://www.readbyqxmd.com/read/29755048/school-based-interprofessional-asthma-self-management-education-program-for-middle-school-students-a-feasibility-trial
#15
Ellen B Buckner, Donna J Copeland, Kristina S Miller, Timothy Op Holt
BACKGROUND: Asthma is the most common chronic disease among school-aged children under 18 years of age and is a major cause of morbidity, loss of school days, and increased hospitalizations. Asthma disproportionately affects low-income, minority youth in Alabama. The benefits of improving asthma control and self-management have significance for improving health, preventing disease, and reducing health disparities by addressing social, behavioral, environmental, economic, and medical determinants of health...
2018: Progress in Community Health Partnerships: Research, Education, and Action
https://www.readbyqxmd.com/read/29753831/medical-and-dietary-management-of-eosinophilic-esophagitis
#16
REVIEW
Quan M Nhu, Seema S Aceves
OBJECTIVE: Eosinophilic esophagitis (EoE) is a disease of chronic, allergen-driven, T-helper 2 (Th2) immune-mediated inflammation that progresses to fibrostenosis of the esophagus if left untreated. There are currently no FDA-approved drugs for the treatment of EoE. This review focuses on medical and dietary management of EoE. DATA SOURCES: Manuscripts on EoE treatments are identified on PubMed. STUDY SELECTIONS: Original research, randomized control trials, retrospective studies, meta-analyses, case series, and on occasions, case reports of high relevance, are selected and reviewed...
May 10, 2018: Annals of Allergy, Asthma & Immunology
https://www.readbyqxmd.com/read/29753523/testicular-transposition-in-children-undergoing-brachytherapy-for-bladder-and-or-prostate-rhabdomyosarcoma
#17
Guenolee de Lambert, Cyrus Chargari, Véronique Minard-Colin, Christine Haie-Meder, Florent Guérin, Hélène Martelli
BACKGROUND/PURPOSE: Fertility preservation is a major goal in treatment of children with cancer. We describe a new technique of testicular transposition (TT) in patients treated with pulse-dose-rate (PDR) brachytherapy as part of the multimodal conservative treatment of bladder neck and/or prostate rhabdomyosarcoma (BP RMS). METHODS: Medical records of consecutive patients treated between September 2016 and August 2017 were studied. These patients underwent a TT performed during BP RMS surgery by the same suprapubic incision...
April 13, 2018: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29749387/invasive-candidiasis
#18
REVIEW
Peter G Pappas, Michail S Lionakis, Maiken Cavling Arendrup, Luis Ostrosky-Zeichner, Bart Jan Kullberg
Invasive candidiasis is an important health-care-associated fungal infection that can be caused by several Candida spp.; the most common species is Candida albicans, but the prevalence of these organisms varies considerably depending on geographical location. The spectrum of disease of invasive candidiasis ranges from minimally symptomatic candidaemia to fulminant sepsis with an associated mortality exceeding 70%. Candida spp. are common commensal organisms in the skin and gut microbiota, and disruptions in the cutaneous and gastrointestinal barriers (for example, owing to gastrointestinal perforation) promote invasive disease...
May 11, 2018: Nature Reviews. Disease Primers
https://www.readbyqxmd.com/read/29745311/systemic-delays-in-the-initiation-of-antiretroviral-therapy-for-clinically-eligible-hiv-infected-patients-in-houston-texas-the-providers-report-card
#19
Osaro Mgbere, Maria Rodriguez-Barradas, Karen Joan Vigil, Melanie McNeese, Fazal Tabassam, Nadia Barahmani, Jason Wang, Raouf Arafat, Ekere James Essien
BACKGROUND: The current US HIV treatment guidelines support initiation of antiretroviral therapy (ART) for persons with HIV for personal health benefits and prevention of HIV transmission. However, high levels of adherence to ART are critical to maximize individual and public health benefits. We examined the nonclinical barriers to ART initiation for clinically eligible individuals and the provider- and patient-related factors associated with these barriers among HIV-infected patients in Houston/Harris County, Texas...
January 2018: Journal of the International Association of Providers of AIDS Care
https://www.readbyqxmd.com/read/29743156/evaluating-the-impact-of-a-web-based-risk-assessment-system-caresage-and-tailored-interventions-on-health-care-utilization-protocol-for-a-randomized-controlled-trial
#20
Ramya Sita Palacholla, Nils C Fischer, Stephen Agboola, Mariana Nikolova-Simons, Sharon Odametey, Sara Bersche Golas, Jorn Op den Buijs, Linda Schertzer, Joseph Kvedar, Kamal Jethwani
BACKGROUND: Soaring health care costs and a rapidly aging population, with multiple comorbidities, necessitates the development of innovative strategies to deliver high-quality, value-based care. OBJECTIVE: The goal of this study is to evaluate the impact of a risk assessment system (CareSage) and targeted interventions on health care utilization. METHODS: This is a two-arm randomized controlled trial recruiting 370 participants from a pool of high-risk patients receiving care at a home health agency...
May 9, 2018: JMIR Research Protocols
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