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https://www.readbyqxmd.com/read/28743054/continuity-for-children-after-guardianship-versus-adoption-with-kin-approximating-the-right-counterfactual
#1
Nancy Rolock, Kevin R White
Over the past two decades there has been a rapid increase in the number of children and youth living in guardianship and adoptive homes who were previously in foster care. Further, previous studies compared outcomes for children in guardianship homes to those for children in adoptive homes, despite the fact that many factors likely affect the selection of foster youth into different types of permanent placements. This study examined two counterfactuals for guardianship as a permanent placement type: adoption only and adoption or long-term-fostercare (A+LTFC)...
July 22, 2017: Child Abuse & Neglect
https://www.readbyqxmd.com/read/28742783/end-expiratory-occlusion-test-predicts-fluid-responsiveness-in-patients-with-protective-ventilation-in-the-operating-room
#2
Matthieu Biais, Mathilde Larghi, Jeremy Henriot, Hugues de Courson, Musa Sesay, Karine Nouette-Gaulain
BACKGROUND: End-expiratory occlusion test (EEOT) has been proposed to predict fluid responsiveness in mechanically ventilated intensive care unit patients. The utility of this test during low-tidal-volume ventilation remains uncertain. This study aimed to determine whether hemodynamic variations induced by EEOT could predict the effect of volume expansion in patients with protective ventilation in the operating room. METHODS: Forty-one patients undergoing neurosurgery were included...
July 21, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28742770/role-of-the-perioperative-surgical-home-in-optimizing-the-perioperative-use-of-opioids
#3
Thomas R Vetter, Zeev N Kain
Several federal agencies have recently noted that the United States is in the midst of an unprecedented "opioid epidemic," with an increasing number of opioid-related overdoses and deaths. Providers currently face 3 population-level, public health challenges in providing optimal perioperative pain care: (1) the continued lack of overall improvement in the excessive incidence of inadequately treated postoperative pain, (2) minimizing or preventing postoperative opioid-related side effects, and (3) addressing current opioid prescribing patterns, and the accompanying problematic surge in prescription opioid diversion, misuse, abuse, addiction, and overdose...
July 24, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28742762/kdigo-clinical-practice-guideline-on-the-evaluation-and-care-of-living-kidney-donors
#4
Krista L Lentine, Bertram L Kasiske, Andrew S Levey, Patricia L Adams, Josefina Alberú, Mohamed A Bakr, Lorenzo Gallon, Catherine A Garvey, Sandeep Guleria, Philip Kam-Tao Li, Dorry L Segev, Sandra J Taler, Kazunari Tanabe, Linda Wright, Martin G Zeier, Michael Cheung, Amit X Garg
The 2017 Kidney Disease: Improving Global Outcomes (KDIGO) Clinical Practice Guideline on the Evaluation and Care of Living Kidney Donors is intended to assist medical professionals who evaluate living kidney donor candidates and provide care before, during and after donation. The guideline development process followed the Grades of Recommendation Assessment, Development, and Evaluation (GRADE) approach and guideline recommendations are based on systematic reviews of relevant studies that included critical appraisal of the quality of the evidence and the strength of recommendations...
August 2017: Transplantation
https://www.readbyqxmd.com/read/28742738/necrotizing-enterocolitis-current-concepts-in-practice
#5
Alysia Agnoni, Christine Lazaros Amendola
Necrotizing enterocolitis (NEC) is the most common gastrointestinal emergency in preterm infants and continues to be a major cause of morbidity and mortality. The incidence of NEC as well as mortality from the disease has persisted at unacceptably high levels for decades as current understanding of the cause remains incomplete. Identifying infants at risk and preventing NEC are mainstays of care. This article briefly examines disease presentation and treatment, identifies gaps in current understanding of disease pathology, and highlights new research that may lead to a decrease in the incidence of NEC in the future...
August 2017: JAAPA: Official Journal of the American Academy of Physician Assistants
https://www.readbyqxmd.com/read/28742691/impact-of-lymph-node-yield-on-overall-survival-in-patients-treated-with-neoadjuvant-chemoradiotherapy-followed-by-esophagectomy-for-cancer-a-population-based-cohort-study-in-the-netherlands
#6
Els Visser, Peter S N van Rossum, Jelle P Ruurda, Richard van Hillegersberg
OBJECTIVE: To evaluate the impact of lymph node yield (LNY) on survival in patients treated with neoadjuvant chemoradiotherapy (nCRT) followed by esophagectomy for cancer. BACKGROUND: The value of an extended lymphadenectomy after nCRT for esophageal cancer is debated. Recent reports demonstrate no association between LNY and survival. This association has not yet been evaluated in larger cohorts. METHODS: All patients who underwent nCRT followed by esophagectomy between 2005 and 2014 were identified from the Netherlands Cancer Registry...
July 24, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28742675/committee-opinion-no-710-counseling-adolescents-about-contraception
#7
(no author information available yet)
Modern contraceptives are very effective when used correctly and, thus, effective counseling regarding contraceptive options and provision of resources to increase access are key components of adolescent health care. Regardless of a patient's age or previous sexual activity, the obstetrician-gynecologist routinely should address her contraceptive needs, expectations, and concerns. Obstetrician-gynecologists should be aware of and be prepared to address the most common misperceptions about contraceptive methods in a way that is age appropriate and compatible with the patient's health literacy...
August 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28742669/committee-opinion-no-710-summary-counseling-adolescents-about-contraception
#8
(no author information available yet)
Modern contraceptives are very effective when used correctly and, thus, effective counseling regarding contraceptive options and provision of resources to increase access are key components of adolescent health care. Regardless of a patient's age or previous sexual activity, the obstetrician-gynecologist routinely should address her contraceptive needs, expectations, and concerns. Obstetrician-gynecologists should be aware of and be prepared to address the most common misperceptions about contraceptive methods in a way that is age appropriate and compatible with the patient's health literacy...
August 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28742637/is-intussusception-a-middle-of-the-night-emergency
#9
Brooke S Lampl, Jonathan Glaab, Rama S Ayyala, Rania Kanchi, Carrie B Ruzal-Shapiro
OBJECTIVES: Intussusception is the most common abdominal emergency in pediatric patients aged 6 months to 3 years. There is often a delay in diagnosis, as the presentation can be confused for viral gastroenteritis. Given this scenario, we questioned the practice of performing emergency reductions in children during the night when minimal support staff are available. Pneumatic reduction is not a benign procedure, with the most significant risk being bowel perforation. We performed this analysis to determine whether it would be safe to delay reduction in these patients until normal working hours when more support staff are available...
July 24, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28742434/use-of-regional-anesthesia-techniques-analysis-of-institutional-enhanced-recovery-after-surgery-protocols-for-colorectal-surgery
#10
Erik M Helander, Michael P Webb, Meghan Bias, Edward E Whang, Alan D Kaye, Richard D Urman
INTRODUCTION: Principles of enhanced recovery after surgery (ERAS(®)) protocols are well established, with the primary goal of optimizing perioperative care and recovery. The use of multimodal analgesia is a key component of these protocols, including regional analgesia techniques such as thoracic epidural analgesia (TEA), transversus abdominis plane (TAP), rectus sheath blocks or continuous wound infiltration (CWI)/catheters, and spinal anesthesia. We compare and contrast regional anesthesia approaches in different institutional colorectal surgery ERAS protocols...
July 25, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28742280/clinical-outcomes-in-patients-with-advanced-egfr-mutated-non-small-cell-lung-cancer-in-south-western-sydney-local-health-district
#11
P N Ding, T L Roberts, W Chua, T M Becker, J Descallar, P Y Yip, V J Bray
AIMS: We aim to describe clinical characteristics, treatment patterns and factors influencing outcomes in patients with EGFR-mutated non-small cell lung cancer (NSCLC) in SWSLHD. METHODS: Retrospective review of patients with EGFR-mutated NSCLC diagnosed between January 2010 and June 2016. RESULTS: A total of 85 EGFR-mutated NSCLC patients were identified; 80 (94%) received first line treatment with EGFR-TKI. The median follow-up was 10.7 months with a median duration of treatment of 9 months...
July 25, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28742141/bruton-s-tyrosine-kinase-inhibitor-bms-986142-in-experimental-models-of-rheumatoid-arthritis-enhances-efficacy-of-agents-representing-clinical-standard-of-care
#12
Kathleen M Gillooly, Claudine Pulicicchio, Mark A Pattoli, Lihong Cheng, Stacey Skala, Elizabeth M Heimrich, Kim W McIntyre, Tracy L Taylor, Daniel W Kukral, Shailesh Dudhgaonkar, Jignesh Nagar, Dana Banas, Scott H Watterson, Joseph A Tino, Aberra Fura, James R Burke
Bruton's tyrosine kinase (BTK) regulates critical signal transduction pathways involved in the pathobiology of rheumatoid arthritis (RA) and other autoimmune disorders. BMS-986142 is a potent and highly selective reversible small molecule inhibitor of BTK currently being investigated in clinical trials for the treatment of both RA and primary Sjögren's syndrome. In the present report, we detail the in vitro and in vivo pharmacology of BMS-986142 and show this agent provides potent and selective inhibition of BTK (IC50 = 0...
2017: PloS One
https://www.readbyqxmd.com/read/28741875/depression-and-anxiety-among-emergency-department-patients-utilization-and-barriers-to-care
#13
Beau Abar, Ashley Holub, Joseph Lee, Vincent DeRienzo, Flavia Nobay
BACKGROUND: Anxiety and depression rates among ED patients are substantially higher than in the general population. Additionally, those with mental health issues often have difficulty accessing care. Unfortunately, issues of anxiety and depression are frequently not addressed in the ED due to competing care priorities. This may lead to increased burden and overcrowding in EDs. OBJECTIVE: This study related anxiety and depression with ED utilization and perceived barriers to care...
July 25, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28740999/advanced-cardiac-life-support-2016-singapore-guidelines
#14
Chi Keong Ching, Siew Hon Benjamin Leong, Siang Jin Terrance Chua, Swee Han Lim, Kenneth Heng, Sohil Pothiawala, Venkataraman Anantharaman
The main areas of emphasis in the Advanced Cardiac Life Support (ACLS) guidelines are: early recognition of cardiac arrest and call for help; good-quality chest compressions; early defibrillation when applicable; early administration of drugs; appropriate airway management ensuring normoventilation; and delivery of appropriate post-resuscitation care to enhance survival. Of note, it is important to monitor the quality of the various care procedures. The resuscitation team needs to reduce unnecessary interruptions to chest compressions in order to maintain adequate coronary perfusion pressure during the ACLS drill...
July 2017: Singapore Medical Journal
https://www.readbyqxmd.com/read/28740929/preserving-the-legacy-of-reirradiation-a-narrative-review-of-historical-publications
#15
REVIEW
Carsten Nieder, Johannes A Langendijk, Matthias Guckenberger, Anca L Grosu
PURPOSE: The purpose of this study is to illustrate the historical development of reirradiation during several decades of the 20th century, in particular between 1920 and 1960. METHODS AND MATERIALS: We chose the format of a narrative review because the historical articles are heterogeneous. No systematic extraction of baseline data, treatment details, or follow-up care was possible in many cases. RESULTS: Both hematological malignancies and solid tumors were treated with a second course of radiation therapy, and indications included local relapse, regional nodal recurrence, and second primary tumors developing in a previously treated region...
April 2017: Advances in Radiation Oncology
https://www.readbyqxmd.com/read/28739534/insurance-coverage-and-well-child-visits-improved-for-youth-under-the-affordable-care-act-but-latino-youth-still-lag-behind
#16
Alexander N Ortega, Ryan M McKenna, Jie Chen, Héctor E Alcalá, Brent A Langellier, Dylan H Roby
OBJECTIVE: To examine whether there have been changes in insurance coverage and health care utilization for youth before and after the national implementation of the Patient Protection and Affordable Care Act (ACA) and to assess whether racial and ethnic inequities have improved. METHODS: Data are from 64,565 youth (ages 0-17) participants in the 2011-2015 National Health Interview Survey (NHIS). We conducted multivariate logistic regression analyses to determine how the period after national implementation of the ACA (years 2011-2013 versus years 2014-2015) was associated with health insurance coverage and utilization of health care services (well-child visits, having visited an emergency department, and having visited a physician, all in the past 12 months), and whether changes over the pre- and post-ACA periods varied by race and Latino ethnicity...
July 21, 2017: Academic Pediatrics
https://www.readbyqxmd.com/read/28739479/emergency-department-visits-after-lumbar-spine-surgery-are-associated-with-lower-hcahps-scores
#17
Jay M Levin, Robert D Winkelman, Gabriel A Smith, Joseph E Tanenbaum, Roy Xiao, Thomas E Mroz, Michael P Steinmetz
BACKGROUND: Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) surveys are used to assess the quality of the patient experience following an inpatient stay. HCAHPS scores are used to determine reimbursement for hospital systems and incentivize spine surgeons nationwide. There are conflicting data detailing whether early readmission or other post-discharge complications are associated with patient responses on the HCAHPS survey. Currently, the association between post-discharge ED visits and HCAHPS scores following lumbar spine surgery is unknown...
July 21, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28739142/radiation-therapy-for-oligorecurrence-in-prostate-cancer-preliminary-results-of-our-centre
#18
C González Ruiz de León, M Ramírez Backhaus, M Sobrón Bustamante, J Casaña, L Arribas, J Rubio-Briones
INTRODUCTION AND OBJECTIVE: There is growing interest in the use of more aggressive therapeutic modalities for treating metastatic prostate cancer. In this study, we examine the use of stereotactic body radiation therapy (SBRT) for patients with oligorecurrent prostate cancer. We analysed the biochemical response and toxicity of patients who underwent this therapy at our centre. MATERIAL AND METHOD: We selected patients who experienced oligorecurrence between January 2015 to December 2016 and were administered SBRT...
July 21, 2017: Actas Urologicas Españolas
https://www.readbyqxmd.com/read/28739114/ethical-and-medical-management-of-a-pregnant-woman-with-brain-stem-death-resulting-in-delivery-of-a-healthy-child-and-organ-donation
#19
A Gopčević, B Rode, M Vučić, A Horvat, M Širanović, Ž Gavranović, V Košec, A Košec
Maternal brain death during pregnancy remains an exceedingly complex situation that requires not only a well-considered medical management plan, but also careful decision-making in a legally and ethically delicate situation. Management of brain dead pregnant patients needs to adhere to special strategies that support the mother in a way that she can deliver a viable and healthy child. Brain death in pregnant women is very rare, with only a few published cases. We present a case of a pregnant woman with previously diagnosed multiple brain cavernomas that led to intracranial hemorrhage and brain stem death during the 21st week of pregnancy...
June 24, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28739067/the-unique-role-of-the-pediatric-clinical-research-nurse-in-anesthesia-an-interdisciplinary-collaboration
#20
Christine Dube, Vanessa Young, Michelle Anderson, Brenda Barton, Izabela Leahy
This article describes the distinctive function of the pediatric clinical research nurse (CRN) in the anesthesia setting. The pediatric CRN in anesthesia acts as a liaison between families and the research team and is the major nexus between the principal investigator or anesthesiologist on a study, and the collaborating surgeons from many different departments. This is unique because the CRNs collaborate with physicians in specialties that can include plastics, urology, neurosurgery, orthopaedics, otolaryngology, cardiology, critical care, and many other departments...
August 2017: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
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