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https://www.readbyqxmd.com/read/28102025/the-direct-referral-to-endovascular-center-criteria-a-proposal-for-pre-hospital-evaluation-of-acute-stroke-in-the-madrid-stroke-network
#1
J Rodríguez-Pardo, B Fuentes, M Alonso de Leciñana, Á Ximénez-Carrillo, G Zapata-Wainberg, J Álvarez-Fraga, F J Barriga, L Castillo, J Carneado-Ruiz, J Díaz-Guzman, J Egido-Herrero, A de Felipe, J Fernández-Ferro, L Frade-Pardo, Á García-Gallardo, A García-Pastor, A Gil-Núñez, C Gómez-Escalonilla, M Guillán, Y Herrero-Infante, J Masjuan-Vallejo, M Á Ortega-Casarrubios, J Vivancos-Mora, E Díez-Tejedor
BACKGROUND AND PURPOSE: For patients with acute ischaemic stroke due to large-vessel occlusion, it has recently been shown that mechanical thrombectomy (MT) with stent retrievers is better than medical treatment alone. However, few hospitals can provide MT 24 h/day 365 days/year, and it remains unclear whether selected patients with acute stroke should be directly transferred to the nearest MT-providing hospital to prevent treatment delays. Clinical scales such as Rapid Arterial Occlusion Evaluation (RACE) have been developed to predict large-vessel occlusion at a pre-hospital level, but their predictive value for MT is low...
January 19, 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/28101937/methods-of-anorectal-manometry-vary-widely-in-clinical-practice-results-from-an-international-survey
#2
E V Carrington, H Heinrich, C H Knowles, S S Rao, M Fox, S M Scott
BACKGROUND: Ano-rectal manometry (ARM) is the most commonly performed investigation for assessment of anorectal dysfunction. Its use is supported by expert consensus documents and international guidelines. Variation in technology, data acquisition, and analysis affect results and clinical interpretation. This study examined variation in ARM between institutions to establish the status of current practice. METHODS: A 50-item web-based questionnaire assessing analysis and interpretation of ARM was distributed by the International Anorectal Physiology Working Group via societies representing practitioners that perform ARM...
January 18, 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/28101232/feasibility-and-application-of-single-hole-video-assisted-thoracoscope-in-pulmonary-peripheral-tumors
#3
Xin Wang, Lei Wang, Hao Zhang, Ke Li, Xiangnan Gong
The feasibility and clinical application of single-hole video-assisted thoracoscope in pulmonary peripheral tumors was examined. From March, 2011 to March, 2015, we retrospectively analyzed the clinical data obtained from 32 patients with pulmonary peripheral tumor that received single-hole thoracoscopic surgery. We completed the surgery via a 1.5-cm incision on the seventh or eighth rib in midaxillary line as the observation hole, and a 4.0-5.0-cm incision in the lateral margin of pectoralis major in the fourth or fifth rib in midaxillary line as the operation hole...
December 2016: Oncology Letters
https://www.readbyqxmd.com/read/28100142/reduction-in-jail-emergency-department-visits-and-closure-after-implementation-of-on-site-urgent-care
#4
Erick Eiting, Carrie S Korn, Erin Wilkes, Glenn Ault, Sean O Henderson
This descriptive study evaluates the impact of implementation of full service on-site urgent care services at the Los Angeles County Jail (LACJ) by examining the number of patients seen at the referral hospital, Los Angeles County + University of Southern California Medical Center (LAC+USC), and the number of hours that the referral hospital was closed to transfers in the periods before and after the development of the LACJ Urgent Care. The appropriate utilization of public resources is a critical priority for an overburdened county medical health care system...
January 2017: Journal of Correctional Health Care
https://www.readbyqxmd.com/read/28099760/clinical-behavioural-and-social-indicators-for-poor-glycaemic-control-around-the-time-of-transfer-to-adult-care-a-longitudinal-study-of-126-young-people-with-diabetes
#5
P Castensøe-Seidenfaden, A Kryger Jensen, H Smedegaard, E Hommel, G Reventlov Husted, U Pedersen-Bjergaard, G Teilmann
AIMS: To describe and compare changes in glycaemic control in young people with Type 1 diabetes over time between the last 2 years in paediatric care and the first 2 years in adult care and to identify risk factors for poor glycaemic control. METHODS: Our retrospective cohort study followed participants aged 14-22 years from 2 years before to 2 years after transfer from paediatric to adult care. Changes in glycaemic control were calculated using repeated measurements...
January 18, 2017: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/28099054/association-between-do-not-resuscitate-do-not-intubate-status-and-resident-physician-decision-making-a-national-survey
#6
Elizabeth K Stevenson, Hashim M Mehter, Allan J Walkey, Renda Soylemez Wiener
RATIONALE: Compared to their Full Code counterparts, patients with Do Not Resuscitate/Do Not Intubate (DNR/DNI) status receive fewer interventions and have higher mortality than predicted by clinical characteristics. OBJECTIVES: To assess whether internal medicine residents, the front-line providers for many hospitalized patients, would manage hypothetical patients differently based on code status. We hypothesized respondents would be less likely to provide a variety of interventions to DNR/DNI patients than Full Code patients...
January 18, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28098920/-too-long-in-tbs-a-study-on-patients-receiving-forensic-psychiatric-tbs-treatment-for-15-years-or-longer
#7
H Nijman, S Lammers, M Vrinten, E Bulten
In 2013 in the Netherlands about 100 forensic psychiatric patients were treated in tbs-hospitals for 15 years or more.<br/> AIM: To investigate the variables that characterise patients who have been receiving forensic psychiatric treatment (tbs) for 15 years or more, and to obtain insight in which actions might be helpful to facilitate discharge or transfer of such patients to other (mental health care) facilities, according to their caregivers and experts.<br/> METHOD: The group of long-term tbs-patients (n = 97) was compared with regard to diagnostic characteristics, 'basic historical risks' (as assessed by risk assessment instruments), and behaviour  to three other groups of forensic patients: a...
2017: Tijdschrift Voor Psychiatrie
https://www.readbyqxmd.com/read/28097180/the-role-of-nurses-in-coping-process-of-family-caregivers-of-vegetative-patients-a-qualitative-study
#8
Zahra Imanigoghary, Hamid Peyrovi, Esmat Nouhi, Majid Kazemi
BACKGROUND: Vegetative state (VS) occurs through return of the brain stem after coma state. After hospital discharge, responsibility of caring for VS patients is transferred to their families, which causes a high burden on them. Nurses have an important role in helping the family caregivers to meet their needs and cope with difficulties. To explore the role of nurses during coping process of family caregivers of VS patients. METHODS: This study is a part of a larger qualitative study which was performed in Kerman province, Iran during 2014- 2015...
January 2017: International Journal of Community Based Nursing and Midwifery
https://www.readbyqxmd.com/read/28096867/nasal-nosocomial-myiasis-infection-caused-by-chrysomya-bezziana-diptera-calliphoridae-following-the-septicemia-a-case-report
#9
Seyed Farzin Mircheraghi, Seyed Farzam Mircheraghi, Hamed Ramezani Awal Riabi, Arezoo Parsapour
A 74 yr old woman from Gonabad, southern part of Khorasan Razavi Province of Iran was admitted to a Hospital of Gonabad, because of respiratory distress, exertional dyspnea and fever. Close contact with domestic animals, history of chronic obstructive pulmonary disease (COPD), and completely resolved pulmonary tuberculosis (TB) in remote past, were notable parts of her past medical history. Due to clinical, paraclinical and radiographic findings and because of recent hospitalization, she was admitted to internal medicine ward with the diagnosis of health care associated pneumonia (HCAP)...
April 2016: Iranian Journal of Parasitology
https://www.readbyqxmd.com/read/28096663/pressure-ulcers-in-palliative-ward-patients-hyponatremia-and-low-blood-pressure-as-indicators-of-risk
#10
Danuta Sternal, Krzysztof Wilczyński, Jan Szewieczek
BACKGROUND: Prevention strategies for pressure ulcer formation remain critical in patients with an advanced illness. We analyzed factors associated with the development of pressure ulcers in patients hospitalized in a palliative care ward setting. PATIENTS AND METHODS: This study was a retrospective analysis of 329 consecutive patients with a mean age (± standard deviation) of 70.4±11.8 years (range: 30-96 years, median 70.0 years; 55.3% women), who were admitted to the Palliative Care Department between July 2012 and May 2014...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/28096418/multi-institute-analysis-of-carbapenem-resistance-reveals-remarkable-diversity-unexplained-mechanisms-and-limited-clonal-outbreaks
#11
Gustavo C Cerqueira, Ashlee M Earl, Christoph M Ernst, Yonatan H Grad, John P Dekker, Michael Feldgarden, Sinéad B Chapman, João L Reis-Cunha, Terrance P Shea, Sarah Young, Qiandong Zeng, Mary L Delaney, Diane Kim, Ellena M Peterson, Thomas F O'Brien, Mary Jane Ferraro, David C Hooper, Susan S Huang, James E Kirby, Andrew B Onderdonk, Bruce W Birren, Deborah T Hung, Lisa A Cosimi, Jennifer R Wortman, Cheryl I Murphy, William P Hanage
Carbapenem-resistant Enterobacteriaceae (CRE) are among the most severe threats to the antibiotic era. Multiple different species can exhibit resistance due to many different mechanisms, and many different mobile elements are capable of transferring resistance between lineages. We prospectively sampled CRE from hospitalized patients from three Boston-area hospitals, together with a collection of CRE from a single California hospital, to define the frequency and characteristics of outbreaks and determine whether there is evidence for transfer of strains within and between hospitals and the frequency with which resistance is transferred between lineages or species...
January 17, 2017: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/28096225/not-so-patchy-story-of-attempted-suicide%C3%A2-leading-to-24%C3%A2-hours-of-deep-sleep-and-survival
#12
Adam Joseph Trist, Hardeep Sahota, Lucy Williams
Here, we present a somewhat unusual suicide attempt where, despite an unbelievable overdose with transdermal fentanyl patches, the patient survived. The patient-a woman aged 70 years, who has suffered from chronic back pain despite starting transdermal fentanyl patches in 2007. The unconventional method of attempted suicide was based on online research into deaths from fentanyl patch toxicity. She had gradually accumulated 100 µg fentanyl patches from repeat prescriptions, applying 14 patches with fatal intent, alongside 2 45 mg mirtazapine tablets, and concurrent therapeutic doses of tramadol and morphine sulfate oral solution...
January 17, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28095787/the-effects-of-habitual-functional-training-on-physical-functioning-in-patients-after-hip-fracture-the-protocol-of-the-hipfrac-study
#13
Kristi Elisabeth Heiberg, Vigdis Bruun-Olsen, Astrid Bergland
BACKGROUND: The survivors after hip fracture often report severe pain and loss of physical functioning. The poor outcomes cause negative impact on the person's physical functioning and quality of life and put a financial burden on society. Rehabilitation is important to improve physical functioning after hip fracture. To maintain the continuity in rehabilitation we have an assumption that it is of utmost importance to continue and progress the functional training that already started at the hospital, while the patients are transferred to short-term stays in a nursing home before they are returning to home...
January 17, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28092235/hospital-cost-and-length-of-stay-in-idiopathic-pulmonary-fibrosis
#14
Joshua J Mooney, Karina Raimundo, Eunice Chang, Michael S Broder
OBJECTIVE: To provide a detailed picture of the economic impact of hospitalization in idiopathic pulmonary fibrosis (IPF) and to identify factors associated with cost and length of stay (LOS). METHODS: In this retrospective cross-sectional study using the Nationwide Inpatient Sample (NIS), we included hospitalizations for IPF (ICD-9-CM 516.3) with a principal diagnosis of respiratory disease (ICD-9-CM 460-519) from 2009-2011; lung transplant admissions were excluded...
January 16, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28091839/impact-of-the-2014-2015-influenza-season-on-the-activity-of-an-academic-emergency-department
#15
Nicolas Beysard, Bertrand Yersin, Pascal Meylan, Olivier Hugli, Pierre-Nicolas Carron
The morbidity and mortality of the 2014-2015 influenza season were more important than those in previous years. We assessed the impact of the 2014-2015 influenza season on the length of stay (LOS) and workload in an academic emergency department (ED). This is a monocentric retrospective study. The database of the microbiology laboratory was used to identify influenza nasal swabs performed during the influenza seasons from 2010 to 2015. Patients admitted to the ED during these periods were identified through the administrative database and cross-checked with patients who underwent an influenza nasal swab in the ED...
January 16, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28089473/box-or-virtual-reality-trainer-which-tool-results-in-better-transfer-of-laparoscopic-basic-skills-a-prospective-randomized-trial
#16
Christian Brinkmann, Mathias Fritz, Ulrich Pankratius, Ralf Bahde, Philipp Neumann, Steffen Schlueter, Norbert Senninger, Emile Rijcken
OBJECTIVE: Simulation training improves laparoscopic performance. Laparoscopic basic skills can be learned in simulators as box- or virtual-reality (VR) trainers. However, there is no clear recommendation for either box or VR trainers as the most appropriate tool for the transfer of acquired laparoscopic basic skills into a surgical procedure. DESIGN: Both training tools were compared, using validated and well-established curricula in the acquirement of basic skills, in a prospective randomized trial in a 5-day structured laparoscopic training course...
January 12, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28088757/challenges-in-neonatal-transport-in-jamaica-a-resource-limited-setting
#17
Salome Henry, Helen Trotman
AIM: This study aimed to determine challenges associated with neonatal transport in Jamaica, a resource-limited setting. METHODS: This was a prospective descriptive study of neonates transported to the University Hospital of the West Indies (UHWI) over a 15 month period. Data on the clinical status of the neonates before, during and at the end of transport, as well as on accompanying staff and equipment, were collected. Neonatal demographics, reason for transfer and outcome at 48 h and at discharge were also collected...
January 14, 2017: Journal of Tropical Pediatrics
https://www.readbyqxmd.com/read/28087902/a-review-of-the-preventability-of-maternal-mortality-in-one-hospital-system-in-louisiana-usa
#18
James J Morong, Jane K Martin, Robert S Ware, Alfred G Robichaux
OBJECTIVE: To determine preventability of in-hospital maternal mortality in the Ochsner Health System (OHS) in the US state of Louisiana. METHODS: A retrospective study was undertaken of all known cases of in-hospital maternal death (during pregnancy or within 42 days of termination) that occurred within OHS facilities in 1995-2013. Associations between characteristics and mortality and preventability were investigated. Incidence rate ratios (IRRs) were calculated in view of varying reference values...
December 9, 2016: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28087288/outcome-of-adult-patients-attended-by-rapid-response-teams-a-systematic-review-of-the-literature
#19
REVIEW
Joonas Tirkkonen, Tero Tamminen, Markus Skrifvars
BACKGROUND: An abundance of studies have investigated the impact of rapid response teams (RRTs) on in-hospital cardiac arrest rates. However, existing RRT data appear highly variable in terms of both study quality and reported uses of limitations of care, patient survival and patient long-term outcome. METHODS: A systematic electronic literature search (January, 1990-March, 2016) of the PubMed and Cochrane databases was performed. Bibliographies of articles included in the full-text review were searched for additional studies...
January 10, 2017: Resuscitation
https://www.readbyqxmd.com/read/28086867/process-evaluation-of-an-integrated-care-pathway-in-geriatric-rehabilitation-for-people-with-complex-health-problems
#20
Irma H J Everink, Jolanda C M van Haastregt, Jose M C Maessen, Jos M G A Schols, Gertrudis I J M Kempen
BACKGROUND: An integrated care pathway in geriatric rehabilitation was developed to improve coordination and continuity of care for community-living older adults in the Netherlands, who go through the process of hospital admission, admission to a geriatric rehabilitation facility and discharge back to the home situation. This pathway is a complex intervention and is focused on improving communication, triage and transfers of patients between the hospital, geriatric rehabilitation facility and primary care organisations...
January 13, 2017: BMC Health Services Research
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