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https://www.readbyqxmd.com/read/27914350/phosphorus-flows-in-a-peri-urban-region-with-intensive-food-production-a-case-study
#1
S Bittman, S C Sheppard, D Poon, D E Hunt
Excess phosphorus (P) in peri-urban regions is an emerging issue, whereas there is global depletion of quality mined supplies of P. The flow of P across the landscape leading to regional surpluses and deficits is not well understood. We computed a regional P budget with internal P flows in a fairly discreet peri-urban region (Lower Fraser Valley, BC) with closely juxtaposed agricultural and non-agricultural urban ecosystems, in order to clarify the relationship between food production, food consumption and other activities involving use of P (e...
November 30, 2016: Journal of Environmental Management
https://www.readbyqxmd.com/read/27914259/city-scale-analysis-of-water-related-energy-identifies-more-cost-effective-solutions
#2
Ka Leung Lam, Steven J Kenway, Paul A Lant
Energy and greenhouse gas management in urban water systems typically focus on optimising within the direct system boundary of water utilities that covers the centralised water supply and wastewater treatment systems, despite a greater energy influence by the water end use. This work develops a cost curve of water-related energy management options from a city perspective for a hypothetical Australian city. It is compared with that from the water utility perspective. The curves are based on 18 water-related energy management options that have been implemented or evaluated in Australia...
November 26, 2016: Water Research
https://www.readbyqxmd.com/read/27914194/illness-narratives-of-people-who-are-homeless
#3
Cecilia Håkanson, Joakim Öhlén
Multiple illnesses are common in all homeless populations. While most previous studies have focused on experiences of mental illness, there is a scarcity of studies about experiences of bodily illness among people who are homeless. This study aimed to explore illness narratives of people who are homeless, and how homelessness as a social context shapes the experience of multiple and/or advancing somatic conditions. The design was a qualitative single-case study, using interpretive description. Data were generated through interviews, with nine participants who were homeless rough sleepers in Stockholm, Sweden, recruited while receiving care in a support home for homeless people with complex care needs...
2016: International Journal of Qualitative Studies on Health and Well-being
https://www.readbyqxmd.com/read/27913802/combined-use-of-a-pconus-and-a-solitaire-stent-report-of-two-cases
#4
Pervinder Bhogal, Marta Aguilar Pérez, Rosa Martinez Moreno, Marcin Miś, Maciej Miś, Hans Henkes
OBJECTIVE: The aim of this study was to report our initial experience of the use of the pCONus neck protection device in conjunction with the Solitaire AB stent to assist in the endovascular management of complex intracranial aneurysms with arteries arising from both the neck and the dome of the aneurysm. METHODS: Two patients with unruptured aneurysms underwent elective endovascular management of their aneurysms, one arising from the middle cerebral artery bifurcation and one from the anterior communicating artery...
December 2, 2016: Interventional Neuroradiology
https://www.readbyqxmd.com/read/27913724/novel-application-of-steroid-eluting-stents-in-choanal-atresia-repair-a-case-series
#5
John N Bangiyev, Nandini Govil, Anthony Sheyn, Michael Haupert, Prasad John Thottam
PURPOSE: To describe the application of mometasone furoate eluting sinus stent technology in the treatment of choanal atresia (CA) in the hopes of preventing postsurgical stenosis. METHODS: We analyzed 3 consecutive patients aged 4 days to 16 years undergoing repair of CA at a tertiary pediatric hospital. Mometasone furoate eluting sinus stents were placed intraoperatively. Postoperative need for revision surgery as well as routine surveillance endoscopy were used to determine success of surgery...
January 2017: Annals of Otology, Rhinology, and Laryngology
https://www.readbyqxmd.com/read/27913722/impact-of-a-multidisciplinary-round-visit-for-the-management-of-dysphagia-utilizing-a-wi-fi-based-wireless-flexible-endoscopic-evaluation-of-swallowing
#6
Koichi Sakakura, Masayuki Tazawa, Natsuko Otani, Masato Takagi, Mariko Morita, Minori Kurosaki, Tomoko Chiyoda, Yuri Kanai, Ayaka Endo, Takaaki Murata, Masato Shino, Yuki Yokobori, Kenji Shirakura, Naoki Wada, Kazuaki Chikamatsu
OBJECTIVES: The management of dysphagia requires a multidisciplinary approach, especially in large-scale hospitals. We introduce a novel protocol using a Wi-Fi-based flexible endoscopic evaluation of swallowing (FEES) system and aim to verify its effectiveness in evaluation and rehabilitation of inpatients with dysphagia. METHOD: We conducted novel Wi-Fi-based FEES at the bedside using 3 iPads as monitors and recorders. Functional outcomes of swallowing in 2 different hospitals for acute care with conventional wired or wireless FEES were compared retrospectively...
January 2017: Annals of Otology, Rhinology, and Laryngology
https://www.readbyqxmd.com/read/27913720/presentation-and-management-of-giant-fibrovascular-polyps-of-the-hypopharynx-and-esophagus
#7
Julina Ongkasuwan, C Lane Anzalone, Esperanza Salazar, Donald T Donovan
OBJECTIVE: Fibrovascular polyps of the hypopharynx and esophagus are rare, with few case reports in the literature. In this article, we present our institutional experience with a focus on airway and surgical management. STUDY DESIGN: Case series. SETTING: Tertiary academic institution. METHODS: A retrospective review was conducted of 4 patients that presented to a tertiary medical center with fibrovascular polyps between 1990 and 2012...
January 2017: Annals of Otology, Rhinology, and Laryngology
https://www.readbyqxmd.com/read/27913596/facilitators-and-barriers-for-the-adoption-implementation-and-monitoring-of-child-safety-interventions-a-multinational-qualitative-analysis
#8
REVIEW
Beatrice Scholtes, Peter Schröder-Bäck, J Morag MacKay, Joanne Vincenten, Katharina Förster, Helmut Brand
The efficiency and effectiveness of child safety interventions are determined by the quality of the implementation process. This multinational European study aimed to identify facilitators and barriers for the three phases of implementation: adoption, implementation and monitoring (AIM process). Twenty-seven participants from across the WHO European Region were invited to provide case studies of child safety interventions from their country. Cases were selected by the authors to ensure broad coverage of injury issues, age groups and governance level of implementation (eg, national, regional or local)...
December 2, 2016: Injury Prevention: Journal of the International Society for Child and Adolescent Injury Prevention
https://www.readbyqxmd.com/read/27913556/how-does-age-related-macular-degeneration-affect-real-world-visual-ability-and-quality-of-life-a-systematic-review
#9
Deanna J Taylor, Angharad E Hobby, Alison M Binns, David P Crabb
OBJECTIVES: To review systematically the evidence of age-related macular degeneration (AMD) affecting real-world visual ability and quality of life (QoL). To explore trends in specific topics within this body of the literature. DESIGN: Systematic review. METHODS: A systematic literature search was carried out using MEDLINE, EMBASE, CINAHL, PsycINFO, PsychARTICLES and Health and Psychosocial Instruments for articles published up to January 2015 for studies including people diagnosed with AMD, assessing real-world visual ability or QoL as an outcome...
December 2, 2016: BMJ Open
https://www.readbyqxmd.com/read/27913548/warm-antibody-autoimmune-hemolytic-anemia
#10
Theodosia A Kalfa
Autoimmune hemolytic anemia (AIHA) is a rare and heterogeneous disease that affects 1 to 3/100 000 patients per year. AIHA caused by warm autoantibodies (w-AIHA), ie, antibodies that react with their antigens on the red blood cell optimally at 37°C, is the most common type, comprising ∼70% to 80% of all adult cases and ∼50% of pediatric cases. About half of the w-AIHA cases are called primary because no specific etiology can be found, whereas the rest are secondary to other recognizable underlying disorders...
December 2, 2016: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/27913544/treatment-of-rare-factor-deficiencies-in-2016
#11
Flora Peyvandi, Marzia Menegatti
Rare bleeding disorders (RBDs) are a heterogeneous group of coagulation disorders characterized by fibrinogen, prothrombin, factors V, VII, X, XI, or XIII (FV, FVII, FX, FXI, or FXIII, respectively), and the combined factor V + VIII and vitamin K-dependent proteins deficiencies, representing roughly 5% of all bleeding disorders. They are usually transmitted as autosomal, recessive disorders, and the prevalence of the severe forms could range from 1 case in 500 000 for FVII up to 1 in 2-3 million for FXIII in the general population...
December 2, 2016: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/27913539/prevention-of-central-nervous-system-sequelae-in-sickle-cell-disease-without-evidence-from-randomized-controlled-trials-the-case-for-a-team-based-learning-collaborative
#12
Michael R DeBaun, Allison A King
Since 1998, the National Institutes of Health has funded 5 randomized controlled trials (RCTs) for primary and secondary prevention of strokes in children with sickle cell anemia (SCA). In a systematic fashion, these trials have significantly advanced the care of children with SCA. In the absence of an RCT, clinicians are often compelled to make decisions at the bedside, based on experience, observational studies, and principles of hematology. We will provide an initial example that describes how a team-based, learning collaborative developed a multisite standard care protocol with a low budget (<$10 000 per year) to overcome the intrinsic limitations of advancing the care of neurologic complications in sickle cell disease (SCD)...
December 2, 2016: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/27913535/reversing-vitamin-k-antagonists-making-the-old-new-again
#13
Sabine Eichinger
Vitamin K antagonists (VKAs) are commonly used for the prevention and treatment of thrombotic disorders. The response to VKAs is highly variable due to their specific interaction with the vitamin K cycle, and hence interference with hepatic synthesis of vitamin K-dependent coagulation factors. Monitoring the anticoagulant effect of VKAs by assessing the patient's international normalized ratio (INR) is essential because complications are closely related to the intensity of anticoagulation. Treatment with VKAs contains a substantial risk of bleeding with a high case fatality rate...
December 2, 2016: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/27913534/myelodysplastic-and-myeloproliferative-disorders-of-childhood
#14
Henrik Hasle
Myelodysplastic syndrome (MDS) and myeloproliferative disorders are rare in children; they are divided into low-grade MDS (refractory cytopenia of childhood [RCC]), advanced MDS (refractory anemia with excess blasts in transformation), and juvenile myelomonocytic leukemia (JMML), each with different characteristics and management strategies. Underlying genetic predisposition is recognized in an increasing number of patients. Germ line GATA2 mutation is found in 70% of adolescents with MDS and monosomy 7. It is challenging to distinguish RCC from aplastic anemia, inherited bone marrow failure, and reactive conditions...
December 2, 2016: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/27913509/the-post-thrombotic-syndrome
#15
Susan R Kahn
The post-thrombotic syndrome (PTS) is a frequent, sometimes disabling complication of deep vein thrombosis (DVT) that reduces quality of life and is costly. This article discusses risk factors for PTS after DVT and available means to prevent and treat PTS, with a focus on new information in the field. After DVT, PTS will develop in 20% to 50% of patients, and severe PTS, including venous ulcers, will develop in 5% to 10%. The principal risk factors for PTS are anatomically extensive DVT, recurrent ipsilateral DVT, persistent leg symptoms 1 month after acute DVT, obesity, and older age...
December 2, 2016: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/27913504/primary-central-nervous-system-lymphoma
#16
Tracy T Batchelor
Primary central nervous system lymphoma (PCNSL) is an extranodal non-Hodgkin lymphoma (NHL) confined to the brain, leptomeninges, eyes, or spinal cord. The majority of PCNSL cases occur in the immunocompetent host, the focus of this review. The prognosis of PCNSL is inferior to that of other NHL subtypes including other organ-specific subtypes of extranodal NHL. The 5- and 10-year survival proportions for PCNSL are 29.3% and 21.6%, respectively. The diagnosis and management of PCNSL differs from that of other primary brain cancers and NHL in other parts of the body...
December 2, 2016: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/27913486/heavy-menstrual-bleeding-work-up-and-management
#17
Andra H James
Heavy menstrual bleeding (HMB), which is the preferred term for menorrhagia, affects ∼90% of women with an underlying bleeding disorder and ∼70% of women on anticoagulation. HMB can be predicted on the basis of clots of ≥1 inch diameter, low ferritin, and "flooding" (a change of pad or tampon more frequently than hourly). The goal of the work-up is to determine whether there is a uterine/endometrial cause, a disorder of ovulation, or a disorder of coagulation. HMB manifest by flooding and/or prolonged menses, or HMB accompanied by a personal or family history of bleeding is very suggestive of a bleeding disorder and should prompt a referral to a hematologist...
December 2, 2016: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/27913383/traumatic-haemopneumothorax-and-whole-body-subcutaneous-emphysema-successful-use-of-a-small-bore-chest-drain
#18
Benjamin Hardy, Nicholas Sunderland, Mevan Perera, Kathryn Channing
A 56-year-old man presented having had two falls at home. He had a background of multiple sclerosis. After his second fall, during which he had fallen onto the toilet injuring his right chest, he was brought into the emergency department reporting pleuritic chest discomfort. Immediately evident was extensive swelling from his forehead to his thighs, which on palpation was found to be subcutaneous emphysema. A chest X-ray showed a large right-sided pneumothorax for which a chest drain was inserted. A CT revealed extensive surgical emphysema, pneumomediastinum, pneumoperitoneum and gas within the spinal canal...
December 2, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27913125/apomorphine-therapy-in-parkinson-s-and-future-directions
#19
Nataliya Titova, K Ray Chaudhuri
Apomorphine infusion or injection is an important dopamine agonist non-oral therapy usually used in advanced Parkinson's disease (PD) with refractory motor fluctuations. The drug also has appreciable efficacy for nonmotor fluctuations and is the quickest to reverse predictable "off" periods. Current subcutaneous administration, however, is complicated by problems associated with needle-based therapies, such as skin nodule formation, skin irritation, and avoidance of this treatment option by needle-phobic subjects...
November 30, 2016: Parkinsonism & related Disorders
https://www.readbyqxmd.com/read/27913098/succinyl-coa-synthetase-sucla2-deficiency-in-two-siblings-with-impaired-activity-of-other-mitochondrial-oxidative-enzymes-in-skeletal-muscle-without-mitochondrial-dna-depletion
#20
Xiaoping Huang, Jirair K Bedoyan, Didem Demirbas, David J Harris, Alexander Miron, Simone Edelheit, George Grahame, Suzanne D DeBrosse, Lee-Jun Wong, Charles L Hoppel, Douglas S Kerr, Irina Anselm, Gerard T Berry
Mutations in SUCLA2 result in succinyl-CoA ligase (ATP-forming) or succinyl-CoA synthetase (ADP-forming) (A-SCS) deficiency, a mitochondrial tricarboxylic acid cycle disorder. The phenotype associated with this gene defect is largely encephalomyopathy. We describe two siblings compound heterozygous for SUCLA2 mutations, c.985A>G (p.M329V) and c.920C>T (p.A307V), with parents confirmed as carriers of each mutation. We developed a new LC-MS/MS based enzyme assay to demonstrate the decreased SCS activity in the siblings with this unique genotype...
November 12, 2016: Molecular Genetics and Metabolism
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