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https://www.readbyqxmd.com/read/28918202/implementation-of-a-risk-stratified-opioid-weaning-protocol-in-a-pediatric-intensive-care-unit
#1
L Nelson Sanchez-Pinto, Lara P Nelson, Phuong Lieu, Joyce Y Koh, John W Rodgers, Krichelle A Larson, Jennifer M Huson, Rambod Amirnovin
PURPOSE: Opioids are important in the care of critically ill children. However, their use is associated with complications including delirium, dependence, withdrawal, and bowel dysfunction. Our aim was to implement a risk-stratified opioid weaning protocol to reduce the duration of opioids without increasing the incidence of withdrawal. METHODS: A pre- and post-interventional prospective study was undertaken in a large children's hospital pediatric ICU where we implemented a risk-stratified opioid weaning protocol...
September 7, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28915919/project-lifeskills-a-randomized-controlled-efficacy-trial-of-a-culturally-tailored-empowerment-based-and-group-delivered-hiv-prevention-intervention-for-young-transgender-women-study-protocol
#2
Lisa M Kuhns, Matthew J Mimiaga, Sari L Reisner, Katie Biello, Robert Garofalo
BACKGROUND: Transgender women in the U.S. have an alarmingly high incidence rate of HIV infection; condomless anal and vaginal sex is the primary risk behavior driving transmission. Young transgender women are the subpopulation at the highest risk for HIV. Despite this, there are no published randomized controlled efficacy trials testing interventions to reduce sexual risk for HIV among this group. This paper describes the design of a group-based intervention trial to reduce sexual risk for HIV acquisition and transmission in young transgender women...
September 16, 2017: BMC Public Health
https://www.readbyqxmd.com/read/28894838/recurrent-respiratory-papillomatosis-rrp-time-for-a-reckoning
#3
Peter Kin Cho Goon, Lars-Uwe Scholtz, Holger Sudhoff
OBJECTIVES: Recurrent respiratory papillomatosis (RRP) is a rare disease, but one with severe morbidity and occasional mortality. The aetiological agent is human papillomavirus (HPV), and HPV types 6 and 11 account for over 90% of all cases. In the active phase of the disease, patients require multiple hospital admissions for surgical removal or ablation of these benign tumors, which are likely to obstruct the airways if left unchecked. Long-term sequelae include scarring of the vocal cords, change in voice timbre, or even muteness if a tracheostomy is required...
August 2017: Laryngoscope Investigative Otolaryngology
https://www.readbyqxmd.com/read/28893299/risk-for-surgical-complications-after-previous-stereotactic-body-radiotherapy-of-the-spine
#4
Johannes Roesch, John B C Cho, Daniel K Fahim, Peter C Gerszten, John C Flickinger, Inga S Grills, Maha Jawad, Ronald Kersh, Daniel Letourneau, Frederick Mantel, Arjun Sahgal, John H Shin, Brian Winey, Matthias Guckenberger
OBJECT: Stereotactic body radiotherapy (SBRT) for vertebral metastases has emerged as a promising technique, offering high rates of symptom relief and local control combined with low risk of toxicity. Nonetheless, local failure or vertebral instability may occur after spine SBRT, generating the need for subsequent surgery in the irradiated region. This study evaluated whether there is an increased incidence of surgical complications in patients previously treated with SBRT at the index level...
September 11, 2017: Radiation Oncology
https://www.readbyqxmd.com/read/28889167/does-simulation-based-training-increase-athletic-training-students-clinical-confidence-and-competence-in-performing-a-cardiovascular-screening
#5
Jennifer L Doherty-Restrepo, K Erin Harrelson, Tazjanne Swinnie, Alicia M Montalvo
CONTEXT: The incidence of sudden cardiac death (SCD) in athletes is higher than previously estimated. The need for increased screening to detect cardiac diseases in preparticipation physical examinations (PPE) has become a focus in athletic training. The use of simulation-based training in healthcare professionals' education has increased clinical confidence and competence, but research is limited. OBJECTIVE: To examine if a simulation-based educational intervention can increase athletic training students' self-reported confidence and clinical competence in conducting a cardiovascular screening...
2017: Journal of Allied Health
https://www.readbyqxmd.com/read/28885957/blunt-scrotal-trauma-in-soldiers-epidemiology-and-outcome
#6
Misgav Rottenstreich, Ofer N Gofrit
INTRODUCTION: Blunt scrotal trauma (BST) is common among soldiers but its incidence and outcome are unknown. The purpose of this study was to estimate the incidence, clinical findings, and outcome of BST in soldiers referred to a primary care field physician. MATERIALS AND METHODS: The medical records of soldiers in their military services who sustained BST and were evaluated by primary care field doctors over a 10-year period were reviewed. Anamnestic data, physical findings, primary care physician decisions, hospitalization, and surgery rates as well as final outcomes were analyzed...
September 2017: Military Medicine
https://www.readbyqxmd.com/read/28880713/sexual-violence-as-a-key-contributor-to-poor-mental-health-among-japanese-women-subjected-to-intimate-partner-violence
#7
Tomoko Honda, Karen Wynter, Jinko Yokota, Thach Tran, Yuri Ujiie, Madoka Niwa, Michi Nakayama, Fumie Ito, Yoshiharu Kim, Jane Fisher, Toshiko Kamo
OBJECTIVES: The aim of this study was to examine the impact of sexual intimate partner violence (IPV) on mental health among Japanese women and to explore to what extent sexual IPV is an important contributor to the severity of mental health problems in comparison with physical and psychological IPV. MATERIALS AND METHODS: A cross-sectional analysis was conducted of the medical records of participants during psychiatric consultation at the Institute of Women's Health, Tokyo Women's Medical University, including 62 women who experienced IPV without sexual violence and 83 women who experienced IPV with sexual violence...
September 7, 2017: Journal of Women's Health
https://www.readbyqxmd.com/read/28876596/endovascular-aortic-aneurysm-repair-at-johannesburg-academic-hospitals
#8
K Thomas, R du Toit, A T O Abdool-Carrim
BACKGROUND: Abdominal aortic aneurysm (AAA) is a common disease seen in vascular units. AAA is defined as transverse diameter greater than 3 cm and affects men more than women. Endovascular aortic aneurysm repair (EVAR) is increasingly being used to treat AAA. Renal dysfunction, graft-related endoleaks, graft limb occlusion, device migration and delayed aneurysm rupture are possible complications that have been encountered after EVAR. METHOD: Changes in renal functions after one month, six months and twelve months...
September 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28871899/psychological-risk-factors-and-outcomes-of-dance-injury-a-systematic-review
#9
Lynda M Mainwaring, Caitlin Finney
Historically, dance medicine and science has focused on the physical aspects rather than the psychological aspects of dance injury. Psychological variables, however, have been shown to influence the occurrence of injury and post-injury outcomes. The purpose of this review was to examine the dance psychology literature and determine the specific psychological factors reported to be associated with the incidence, frequency, and outcome of dance injuries. A systematic literature search was conducted using SPORTDiscus, MEDLINE, CINAHL, and PsycINFO...
September 15, 2017: Journal of Dance Medicine & Science
https://www.readbyqxmd.com/read/28866975/influence-of-changing-endotracheal-tube-cuff-management-on-antibiotic-use-for-ventilator-associated-pneumonia-in-a-tertiary-intensive-care-unit
#10
Jai N Darvall, Irani Thevarajan, Simon Iles, Thomas Rechnitzer, Tim Spelman, Nerina Harley
BACKGROUND: Routine deflation of the endotracheal tube (ETT) cuff of critically ill patients receiving MV is common in Australia and New Zealand. Literature about ventilatorassociated pneumonia (VAP) and antibiotic use rates with different ETT cuff maintenance practices is lacking. OBJECTIVE: To determine the impact of a change in ETT cuff maintenance from a minimal leak technique to pressure manometry on the administration of antibiotics for VAP. DESIGN, SETTING AND PARTICIPANTS: A prospective, pre- post observational study conducted in a metropolitan tertiary referral intensive care unit...
September 2017: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/28862391/dental-extractions-for-preradiation-dental-clearance-and-incidence-of-osteoradionecrosis-in-patients-with-nasopharyngeal-carcinoma-treated-with-intensity-modulated-radiotherapy
#11
Yoong L See Toh, Yoke L Soong, Yi X Chim, Li T Tan, Weng K Lye, Khim H Teoh
AIM: The aims of the present retrospective study were to evaluate the outcomes of dental extractions in nasopharyngeal carcinoma patients who had undergone dental clearance pre- and post-radiotherapy (RT) with intensity-modulated RT, and to report on the incidence and timing of osteoradionecrosis (ORN) in these patients. METHODS: A total of 231 patients were seen pre-, mid-, and postradiation therapy. Information on patient demographics, smoking history, staging, treatment modalities, dental extraction indications, and number and site of dental extractions was gathered...
September 1, 2017: Journal of Investigative and Clinical Dentistry
https://www.readbyqxmd.com/read/28862375/analysis-of-in-pact-deep-trial-on-the-association-between-changes-in-perfusion-from-pre-to-postrevascularization-and-clinical-outcomes-in-critical-limb-ischemia
#12
Tarek A Hammad, Thomas Zeller, Iris Baumgartner, Dierk Scheinert, Krishna J Rocha-Singh, Mehdi H Shishehbor
OBJECTIVES: To quantify changes in ankle and toe pressure from pre- to post-endovascular revascularization for critical limb ischemia (CLI) and examine their association with major adverse limb events (MALE). BACKGROUND: Despite societal guidelines recommendation of routine hemodynamic surveillance following revascularization, little is known about hemodynamic assessment in CLI. METHODS: Among the 358 patients with CLI from the international multicenter IN...
September 1, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28862112/indications-of-the-magnetic-resonance-method-in-breast-pathology
#13
Adina Chiriţă
The high incidence of breast cancer is a known fact. The 5-year survival rate for women with correctly treated breast cancer is 90% around the world, and 50% in Romania, respectively. Correct diagnostic evaluation of the breasts allows for a competent therapeutic management. The primary diagnosis of breast cancer includes clinical examination of the breasts, breast ultrasound and mammography. Magnetic resonance imaging (MRI) examination is not a first line type of investigation, but targeted to selected patient groups...
July 2017: Chirurgia
https://www.readbyqxmd.com/read/28862069/patient-related-risk-factors-for-requiring-surgical-intervention-following-a-failed-injection-for-the-treatment-of-medial-and-lateral-epicondylitis
#14
Ryan M Degen, Jourdan M Cancienne, Christopher L Camp, David W Altchek, Joshua S Dines, Brian C Werner
OBJECTIVES: To identify risk factors for failure of a therapeutic injection leading to operative management of both medial and lateral epicondylitis. METHODS: A national database was used to query Medicare Standard Analytic Files from 2005-2012 for patients treated with therapeutic injections for medial or lateral epicondylitis using CPT codes for injections associated with corresponding ICD-9 diagnostic codes (726.31 and 726.32, respectively). Those who subsequently underwent surgical treatment following injection were identified...
September 8, 2017: Physician and Sportsmedicine
https://www.readbyqxmd.com/read/28858942/colonoscopy-in-patients-with-postmyocardial-infarction-gastrointestinal-bleeding-a-nationwide-analysis
#15
Rohan M Modi, Feng Li, Khalid Mumtaz, Alice Hinton, Scott M Lilly, Hisham Hussan, Edward Levine, Cheng Zhang, Darwin L Conwell, Somashekar G Krishna, Peter P Stanich
GOALS: The goal of this study was to evaluate outcomes of colonoscopy in the setting of post myocardial infarction (MI) gastrointestinal bleeding (GIB) in a large population-based data set. BACKGROUND: The literature to substantiate the proposed safety of colonoscopy following an acute MI is limited. STUDY: The Nationwide Inpatient Sample (2007 to 2013) was utilized to identify all adult patients (age, 18 y or above) hospitalized with a primary diagnosis of ST-elevation MI and receiving left heart catheterization (STEMI-C)...
August 30, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28852497/risk-factors-for-bleeding-complications-after-nephrologist-performed-native-renal-biopsy
#16
Jennifer S Lees, Emily P McQuarrie, Natalie Mordi, Colin C Geddes, Jonathan G Fox, Bruce Mackinnon
BACKGROUND: Bleeding is a recognized complication of native percutaneous renal biopsy. This study aimed to describe the incidence of major bleeding after biopsy in a single centre over a 15-year period and examine factors associated with major bleeding. METHODS: We identified consecutive adult patients undergoing ultrasound-guided native renal biopsy in the Glasgow Renal and Transplant Unit from 2000 to 2014. From the electronic patient record, we collected data pertaining to biopsy indication, pre- and post-biopsy laboratory measurements, prescribed medication and diagnosis...
August 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/28851373/a-pragmatic-lifestyle-modification-programme-reduces-the-incidence-of-predictors-of-cardio-metabolic-disease-and-dysglycaemia-in-a-young-healthy-urban-south-asian-population-a-randomised-controlled-trial
#17
Mahen Wijesuriya, Nikolaos Fountoulakis, Nicola Guess, Sarath Banneheka, Laksha Vasantharajah, Martin Gulliford, Giancarlo Viberti, Luigi Gnudi, Janaka Karalliedde
BACKGROUND: There is an increasing incidence of type 2 diabetes mellitus (T2DM) in young urban South-Asians. We tested the effect of a pragmatic trimonthly lifestyle modification (LSM) programme (P-LSM) versus a less-intensive 12-monthly control LSM (C-LSM) intervention on a primary composite endpoint of predictors of cardio-metabolic disease (new onset T2DM, hypertension, impaired glucose tolerance (IGT), impaired fasting glycaemia (IFG) and markers of cardio-renal disease) in participants aged 5-40 years with risk factors for T2DM...
August 30, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28851342/ehealth-interventions-for-the-prevention-of-depression-and-anxiety-in-the-general-population-a-systematic-review-and-meta-analysis
#18
M Deady, I Choi, R A Calvo, N Glozier, H Christensen, S B Harvey
BACKGROUND: Anxiety and depression are associated with a range of adverse outcomes and represent a large global burden to individuals and health care systems. Prevention programs are an important way to avert a proportion of the burden associated with such conditions both at a clinical and subclinical level. eHealth interventions provide an opportunity to offer accessible, acceptable, easily disseminated globally low-cost interventions on a wide scale. However, the efficacy of these programs remains unclear...
August 29, 2017: BMC Psychiatry
https://www.readbyqxmd.com/read/28845551/management-of-side-effects-during-and-post-treatment-in-breast-cancer-survivors
#19
Oxana Palesh, Caroline Scheiber, Shelli Kesler, Karen Mustian, Cheryl Koopman, Lidia Schapira
Cancer-related fatigue, insomnia, and cancer-related cognitive impairment are commonly experienced symptoms that share psychological and physical manifestations. One or more of these symptoms will affect nearly all patients at some point during their course of treatment or survivorship. These side effects are burdensome and reduce patients' quality of life well beyond their cancer diagnosis and associated care treatments. Cancer-related fatigue, insomnia, and cancer-related cognitive impairment are likely to have multiple etiologies that make it difficult to identify the most effective method to manage them...
August 27, 2017: Breast Journal
https://www.readbyqxmd.com/read/28843589/hemorrhage-risk-with-transjugular-intrahepatic-portosystemic-shunt-tips-insertion-at-the-main-portal-vein-bifurcation-with-stent-grafts
#20
A S Griffin, S R Preece, J Ronald, T P Smith, P V Suhocki, C Y Kim
PURPOSE: The purpose of this study was to assess the incidence of major hemorrhage after transjugular intrahepatic portosystemic shunt (TIPS) insertion using a stent graft at the main portal vein bifurcation. PATIENTS AND METHODS: TIPS insertion using stent grafts was performed in 215 patients due to non-variceal hemorrhage indications. There were 137 men and 78 women, with a mean age of 57 years±10.6 (SD) (range: 19-90 years). Based on retrospective review of portal venograms, TIPS inserted within 5mm from the portal vein bifurcation were considered "bifurcation TIPS", while those inserted 2cm or greater from the bifurcation were considered intrahepatic...
August 23, 2017: Diagnostic and Interventional Imaging
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