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https://www.readbyqxmd.com/read/28922710/paediatric-mild-head-injury-is-routine-admission-to-a-tertiary-trauma-hospital-necessary
#1
Krishna Tallapragada, Ratna Soundarya Peddada, Mark Dexter
BACKGROUND: Previous studies have shown that children with isolated linear skull fractures have excellent clinical outcomes and low risk of surgery. We wish to identify other injury patterns within the spectrum of paediatric mild head injury, which need only conservative management. Children with low risk of evolving neurosurgical lesions could be safely managed in primary hospitals. METHODS: We retrospectively analysed all children with mild head injury (i.e. admission Glasgow coma score 13-15) and skull fracture or haematoma on a head computed tomography scan admitted to Westmead Children's Hospital, Sydney over the years 2009-2014...
September 18, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28922271/the-impact-of-telemedicine-on-pediatric-critical-care-triage
#2
Jillian B Harvey, Brooke E Yeager, Christina Cramer, David Wheeler, S David McSwain
OBJECTIVE: To examine the relationship between pediatric critical care telemedicine consultation to rural emergency departments and triage decisions. We compare the triage location and provider rating of the accuracy of remote assessment for a cohort of patients who receive critical care telemedicine consultations and a similar group of patients receiving telephone consultations. DESIGN: Retrospective evaluation of consultations occurring between April 2012 and March 2016...
September 15, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28921673/safety-of-back-transfer-to-local-hospitals-during-an-acute-care-hospitalization
#3
Leah F Nelson, Karisa K Harland, Dan M Shane, Azeemuddin Ahmed, Nicholas M Mohr
PURPOSE: This paper investigates patient outcomes including length of stay (LOS), cost of hospitalization, bounce-back rates, transition to hospice care, and mortality, following back-transfer. METHODS: This study was an observational case-control study of adults hospitalized in Iowa between 2005 and 2013 to identify back-transferred patients. Back-transfer was defined as the transfer of rural patients near the end of their acute hospitalization in a comprehensive medical center back to a local community hospital for the completion of their medical care...
September 18, 2017: Journal of Rural Health
https://www.readbyqxmd.com/read/28920034/the-use-of-intraoperative-transesophageal-echocardiography-in-thoracic-aortic-dissection-due-to-chronic-cocaine-abuse
#4
Ali Dabbagh, Mohammad Kazem Arabnia, Mahnoosh Foroughi, Mehran Shahzamani, Hassan Rahmian
INTRODUCTION: Aortic dissection is a life threatening disease and is usually accompanied by a high rate of mortality and morbidity. Here we present a case report in which intraoperative tranesophageal echocardiography was used for intraoperative assessments of thoracic aortic dissection due to cocaine abuse. CASE PRESENTATION: A 45- year- old male was admitted to a university hospital due to severe chest pain. He was suffering from severe excruciating chest pain that had started after a psychological stress, leading to heavy cocaine abuse...
February 2017: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/28919071/validation-of-the-retrieve-reverse-triage-events-criteria-for-same-day-return-of-non-st-elevation-acute-coronary-syndrome-patients-to-referring-non-pci-centres
#5
Sonya N Burgess, Vu Huynh Nguyen, James Xu, Yoshio Hinde, Anoop Dharmadmajan, Xavier Brennan, Karen Owen, Karen Lintern, Craig Juergens, Sidney Lo, Phong Nguyen, Krishna K Kadappu, John K French, Rohan Rajaratnam
BACKGROUND: There are continuing bed constraints in percutaneous coronary intervention centres (PCI) so efficient patient triage from referral hospitals is pivotal. To evaluate a strategy of PCI centre (PCIC) bed-sparing we examined return of patients to referral hospitals screened by the RETRIEVE (REverse TRIage EVEnts) criteria and validated its use as a tool for screening suitability for same day transfer of non-ST-elevation acute coronary syndrome (NSTEACS) patients post PCI to their referring non-PCI centre (NPCIC)...
August 19, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28918620/conservative-management-of-colonoscopic-perforation-a-case-report
#6
Hossein Parsa, Arash Miroliaee, Zafar Doagoo, Saeed Sina
Colonoscopy is widely used for the diagnosis, treatment and a follow up of colorectal diseases. Perforation of the large bowel during elective colonoscopy is rare but serious life threatening complication. We report a 51-year-old woman who experienced recto sigmoid perforation during diagnostic colonoscopy. During 8 days of total hospitalization, she spent 3 days in ICU with gastrointestinal rest. The patient was hydrated and took intravenous antibiotics. In take-output and temperature were closely monitored...
July 2017: Acta Medica Iranica
https://www.readbyqxmd.com/read/28918412/prediction-of-early-unplanned-intensive-care-unit-readmission-in-a-uk-tertiary-care-hospital-a-cross-sectional-machine-learning-approach
#7
Thomas Desautels, Ritankar Das, Jacob Calvert, Monica Trivedi, Charlotte Summers, David J Wales, Ari Ercole
OBJECTIVES: Unplanned readmissions to the intensive care unit (ICU) are highly undesirable, increasing variance in care, making resource planning difficult and potentially increasing length of stay and mortality in some settings. Identifying patients who are likely to suffer unplanned ICU readmission could reduce the frequency of this adverse event. SETTING: A single academic, tertiary care hospital in the UK. PARTICIPANTS: A set of 3326 ICU episodes collected between October 2014 and August 2016...
September 15, 2017: BMJ Open
https://www.readbyqxmd.com/read/28917584/pneumatoceles-in-pediatric-blunt-trauma-common-and-benign
#8
Lindsey B Armstrong, David P Mooney
INTRODUCTION: Traumatic pneumatoceles are reported to be rare in children and to have an uncertain clinical significance. We report a single institution series of traumatic pneumatoceles to better define their frequency and clinical significance. METHODS: After obtaining approval from the IRB, data were extracted from the trauma registry of a level 1 pediatric trauma center on children diagnosed with a pulmonary contusion (International Classification of Diseases-9th edition diagnosis codes: 861...
August 7, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28917026/venous-thromboembolism-rates-in-transferred-patients-a-cross-sectional-study
#9
Samuel Lai, Eric Ton, Marianne Lovejoy, William Graham, Alpesh Amin
BACKGROUND: Patients undergoing a transfer during a hospitalization may be more likely to be diagnosed with a venous thromboembolism (VTE) than patients who are not transferred. OBJECTIVE: To determine whether transferred patients have an increased prevalence of VTE diagnosis. DESIGN: This was a cross-sectional study comparing VTE diagnosis rates between transferred patients and non-transferred patients. For the years 2012-2014, the University HealthSystem Consortium database of multiple community and academic medical centers throughout the United States was parsed using ICD-9 VTE diagnosis codes and patient's point of origin...
September 15, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28916485/moderate-intravenous-sedation-for-first-trimester-surgical-abortion-a-comparison-of-adverse-outcomes-between-obese-and-normal-weight-women
#10
Gillian Horwitz, Danielle Roncari, Kari Braaten, Rie Maurer, Jennifer Fortin, Alisa B Goldberg
OBJECTIVE: To determine if obese women experience increased rates of adverse outcomes with moderate intravenous sedation during first trimester surgical abortion compared to normal weight women. STUDY DESIGN: We performed a retrospective cohort study of all first trimester surgical abortions with moderate intravenous sedation at an outpatient facility between September 2010 and June 2015. The primary outcome was supplemental oxygen administration. Secondary outcomes included reversal agent administration, anesthesia-related adverse events, and intraoperative lowest level of consciousness (LLOC)...
September 13, 2017: Contraception
https://www.readbyqxmd.com/read/28913141/outcome-of-intracytoplasmic-sperm-injection-after-preinstillation-of-a-gonadotropin-releasing-hormone-agonist-in-the-uterine-cavity-just-before-embryo-transfer
#11
Pınar Çağlar Aytaç, Bülent Haydardedeoğlu, Halis Özdemir, Esra Bulgan Kılıçdağ
OBJECTIVE: To evaluate the effects of a gonadotropin releasing hormone agonist (GnRHa) injection prior to embryo transfer on implantation and pregnancy rate. MATERIALS AND METHODS: We performed a retrospective analysis of patients undergoing in vitro fertilization (IVF) therapy with and without GnRHa preinstallation into the uterine cavity just before embryo transfer between January 2012 and March 2013 in a single IVF center of a university hospital. Patients were evaluated based upon implantation, pregnancy, live birth, and miscarriage rates...
June 2017: Turk J Obstet Gynecol
https://www.readbyqxmd.com/read/28911337/postings-and-transfers-in-the-ghanaian-health-system-a-study-of-health-workforce-governance
#12
Aku Kwamie, Miriam Asiamah, Marta Schaaf, Irene Akua Agyepong
BACKGROUND: Decision-making on postings and transfers - that is, the geographic deployment of the health workforce - is a key element of health workforce governance. When poorly managed, postings and transfers result in maldistribution, absenteeism, and low morale. At stake is managing the balance between organisational (i.e., health system) and individual (i.e., staff preference) needs. The negotiation of this potential convergence or divergence of interests provides a window on practices of postings and transfers, and on the micro-practices of governance in health systems more generally...
September 15, 2017: International Journal for Equity in Health
https://www.readbyqxmd.com/read/28911290/outcomes-of-telemedicine-intervention-in-a-regional-intensive-care-unit-a-before-and-after-study
#13
O M Panlaqui, E Broadfield, R Champion, J P Edington, S Kennedy
Telemedicine consultations in remote intensive care units (ICUs) overseas were found to be effective in reducing mortality and hospital length of stay (LOS). In Australia, there were anecdotal reports of these clinical outcomes. This retrospective before and after study assessed the improvement in patient outcomes with the implementation of a telemedicine program in a regional high dependency unit. Daily virtual consultations were conducted between the rural facility and the intensivists at the regional centre...
September 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28910461/exertional-heat-illness-resulting-in-acute-liver-failure-and-liver-transplantation
#14
Benjamin Boni, Christopher Amann Amann
Heat illness remains a large medical burden for militaries around the world. Mitigating the incidence as well as the complications of heat illness must remain on the forefront of operational planning when operating in hot environments. We report the case of a 27-year-old male U.S. Marine who sustained a heat-related illness resulting in fulminant liver failure and permanent disability. The patient was transferred from the field to a civilian hospital. On hospital day 5, liver failure was identified. The patient was transferred to a transplant center, where he successfully received a liver transplant...
2017: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/28910379/a-one-year-prospective-study-of-colonization-with-antimicrobial-resistant-organisms-on-admission-to-a-vietnamese-intensive-care-unit
#15
Duong Bich Thuy, James Campbell, Nguyen Van Minh Hoang, Truong Thi Thuy Trinh, Ha Thi Hai Duong, Nguyen Chi Hieu, Nguyen Hoang Anh Duy, Nguyen Van Hao, Stephen Baker, Guy E Thwaites, Nguyen Van Vinh Chau, C Louise Thwaites
There is a paucity of data regarding initial bacterial colonization on admission to Intensive Care Units (ICUs) in low and middle-income countries (LMICs). Patients admitted to ICUs in LMICs are at high-risk of subsequent infection with antimicrobial-resistant organisms (AROs). We conducted a prospective, observational study at the Hospital for Tropical Diseases in Ho Chi Minh City, Vietnam from November 2014 to January 2016 to assess the colonization and antimicrobial susceptibility of Staphylococcus aureus, Escherichia coli, Klebsiella spp...
2017: PloS One
https://www.readbyqxmd.com/read/28904501/patient-experience-with-conscious-sedation-as-a-method-of-pain-relief-for-transvaginal-oocyte-retrieval-a-cross-sectional-study
#16
Himanshu Singhal, Prasanna S Premkumar, Achamma Chandy, Aleyamma T Kunjummen, Mohan S Kamath
AIM: The aim of the study was to measure patient's satisfaction level and acceptance of conscious sedation as a method of pain relief following transvaginal oocyte retrieval (TVOR) during assisted reproduction technology treatment. We also evaluated the factors that may influence the efficacy of conscious sedation method. SETTING AND DESIGN: A prospective cross-sectional study. MATERIALS AND METHODS: Prospective study was conducted from October 2015 to January 2016 at a university-level hospital and 100 women were recruited...
April 2017: Journal of Human Reproductive Sciences
https://www.readbyqxmd.com/read/28904499/does-first-serum-beta-human-chorionic-gonadotropin-value-prognosticate-the-early-pregnancy-outcome-in-an-in-vitro-fertilisation-cycle
#17
Nikita Naredi, S K Singh, Rajesh Sharma
BACKGROUND: Pregnancies achieved through in-vitro fertilisation (IVF) are associated with adverse first trimester outcomes in comparison to spontaneously achieved pregnancies. In view of this, it is imperative to predict the success as well as prognosticate the pregnancy outcome of an IVF cycle not only for the clinicians but also the couples undergoing IVF. Serum beta-human chorionic gonadotropin (β-hCG) value has, thus, been used as a biomarker for pregnancy outcome after IVF and also an aid in counselling and management of the patient...
April 2017: Journal of Human Reproductive Sciences
https://www.readbyqxmd.com/read/28904006/the-crash-report-emergency-management-dilemmas-facing-acute-physicians-in-patients-with-pulmonary-arterial-hypertension
#18
Laura C Price, Konstantinos Dimopoulos, Philip Marino, Rafael Alonso-Gonzalez, Colm McCabe, Aleksander Kemnpy, Lorna Swan, Maria Boutsikou, Ahmed Al Zahrani, Gerry J Coghlan, Benjamin E Schreiber, Luke S Howard, Rachel Davies, Mark Toshner, Joanna Pepke-Zaba, Alistair C Church, Andrew Peacock, Paul A Corris, James L Lordan, Sean Gaine, Robin Condliffe, David G Kiely, Stephen John Wort
Treatment of acute emergencies in patients with pulmonary arterial hypertension (PAH) can be challenging. In the UK and Ireland, management of adult patients with PAH is centred in eight nationally designated pulmonary hypertension (PH) centres. However, many patients live far from these centres and physicians in local hospitals are often required to manage PAH emergencies. A committee of physicians from nationally designated PH centres identified the 'most common' emergency clinical scenarios encountered in patients with PAH...
September 12, 2017: Thorax
https://www.readbyqxmd.com/read/28902606/an-evaluation-of-patient-risk-factors-to-determine-eligibility-to-undergo-orthopaedic-surgery-in-a-freestanding-ambulatory-center-a-survey-of-4-242-consecutive-patients
#19
Matthew Siow, Germaine Cuff, Jovan Popovic, Joseph Bosco
INTRODUCTION: The value proposition of surgery at freestanding ambulatory surgery centers (FSASCs) in terms of efficiency, safety, and patient satisfaction is well established and has led to increased FSASC utilization. However, there are comorbid conditions that disqualify certain patients from surgery at FSASCs. Understanding the percentage of patients whose comorbid conditions exclude them from FSASCs is important for the proper planning and utilization of operating room assets. We aim to understand the percentage of excluded patients, and we predict that certain procedures have higher rates of disqualification due to the types of patients who undergo them...
May 2017: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/28901229/intraoperative-high-frequency-jet-ventilation-is-equivalent-to-conventional-ventilation-during-patent-ductus-arteriosus-ligation
#20
Mackenzie Noonan, Joseph W Turek, John M Dagle, Steven J McElroy
BACKGROUND: Patent ductus arteriosus (PDA) treatment is typically pharmacologic, but if unsuccessful, surgical ligation is commonly performed. High-frequency jet ventilation (HFJV) is used at the University of Iowa Stead Family Children's Hospital for extremely low birth weight infants. Historically, neonates requiring PDA ligation were temporarily transferred to conventional ventilation (CV) prior to surgery. OBJECTIVE: The objective of this study was to determine whether conversion was necessary...
September 2017: World Journal for Pediatric & Congenital Heart Surgery
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