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https://www.readbyqxmd.com/read/28449017/a-multifaceted-intervention-to-improve-primary-care-radiology-referral-quality-and-value-in-canterbury
#1
Kieran Holland, Graham McGeoch, Carolyn Gullery
AIMS: This article describes a seven-year multifaceted intervention leading to sustained improvement in primary care radiology referral quality and value in Canterbury, New Zealand, and discusses the transferability to other health systems. METHODS: Access criteria were developed with input from general practitioners and hospital-based specialists, and embedded in locally developed clinical pathways. A referral management service was created to streamline referral processes...
April 28, 2017: New Zealand Medical Journal
https://www.readbyqxmd.com/read/28448605/vasopressor-use-following-traumatic-injury-a-single-center-retrospective-study
#2
Mathieu Hylands, Marie-Pier Godbout, Sandeep K Mayer, William D Fraser, Alain Vanasse, Marc-André Leclair, Alexis F Turgeon, François Lauzier, Emmanuel Charbonney, Vincent Trottier, Tarek S Razek, André Roy, Frédérick D'Aragon, Emilie Belley-Côté, Andrew G Day, Soazig Le Guillan, Robert Sabbagh, François Lamontagne
OBJECTIVES: Vasopressors are not recommended by current trauma guidelines, but recent reports indicate that they are commonly used. We aimed to describe the early hemodynamic management of trauma patients outside densely populated urban centers. METHODS: We conducted a single-center retrospective cohort study in a Canadian regional trauma center. All adult patients treated for traumatic injury in 2013 who died within 24 hours of admission or were transferred to the intensive care unit were included...
2017: PloS One
https://www.readbyqxmd.com/read/28447444/maternal-thyroid-function-in-women-undergoing-controlled-ovarian-hyperstimulation-during-in-vitro-fertilization-and-its-relation-to-reproductive-outcome
#3
Abdul K Abdul Karim, Muhammad Azrai Abu, Buvanes Chelliah, Zainul R Mohd Razi, Mohd H Omar, Hanita Othman, Zuraidah C Man
BACKGROUND: We conducted a study to evaluate the changes in thyroid function during Controlled Ovarian Hyperstimulation (COH) and its association with the outcome of assisted reproductive technique (ART). METHODS: This is a prospective cohort study done in University Hospital Fertility clinic for one year duration. A total of eighty eight euthyroid women who underwent COH as part of planned in vitro fertilization were invited to participate in this study. Serum thyroid function of each women will be monitored before stimulation (T1), day 10 -13 of cycle (T2), during oocyte retrieval (T3), one week following embryo transfer (T4) and at four weeks post embryo transfer(T5)...
April 26, 2017: Minerva Ginecologica
https://www.readbyqxmd.com/read/28447372/rapid-thermal-adaptation-in-photosymbionts-of-reef-building-corals
#4
Leela J Chakravarti, Victor H Beltran, Madeleine J H van Oppen
Climate warming is occurring at a rate not experienced by life on Earth for 10 s of millions of years, and it is unknown whether the coral-dinoflagellate (Symbiodinium spp.) symbiosis can evolve fast enough to ensure coral reef persistence. Coral thermal tolerance is partly dependent on the Symbiodinium hosted. Therefore, directed laboratory evolution in Symbiodinium has been proposed as a strategy to enhance coral holobiont thermal tolerance. Using a reciprocal transplant design, we show that the upper temperature tolerance and temperature tolerance range of Symbiodinium C1 increased after ~80 asexual generations (2...
April 27, 2017: Global Change Biology
https://www.readbyqxmd.com/read/28447201/teleophthalmology-image-based-navigated-retinal-laser-therapy-for-diabetic-macular-edema-a-concept-of-retinal-telephotocoagulation
#5
Igor Kozak, John F Payne, Patrik Schatz, Eman Al-Kahtani, Moritz Winkler
BACKGROUND: To determine the feasibility and efficacy of a retinal telephotocoagulation treatment plan for diabetic macular edema. METHODS: Prospective, interventional cohort study at two clinical sites. Sixteen eyes of ten subjects with diabetic macular edema underwent navigated focal laser photocoagulation using a novel teleretinal treatment plan. Clinic 1 (King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia) collected retinal images and fundus fluorescein angiogram...
April 26, 2017: Graefe's Archive for Clinical and Experimental Ophthalmology
https://www.readbyqxmd.com/read/28446899/clonal-spread-of-16s-rrna-methyltransferase-producing-klebsiella-pneumoniae-st37-with-high-prevalence-of-esbls-from-companion-animals-in-china
#6
Jing Xia, Liang-Xing Fang, Ke Cheng, Guo-Hao Xu, Xi-Ran Wang, Xiao-Ping Liao, Ya-Hong Liu, Jian Sun
We screened 30 Klebsiella pneumoniae isolates from dogs and cats at a single animal hospital in Guangdong Province, China. Among them, 12 K. pneumoniae strains possessed high-level resistance to amikacin and gentamicin and these were screened for 16S rRNA methyltransferase (16S-RMTase) genes. And then the genes positive isolates were detected for ESBLs (extended spectrum β-lactamases) and analyzed by pulsed-field gel electrophoresis, multilocus sequence typing, PCR-based replicon typing and plasmid analysis...
2017: Frontiers in Microbiology
https://www.readbyqxmd.com/read/28446535/direct-transfer-to-angiosuite-to-reduce-door-to-puncture-time-in-thrombectomy-for-acute-stroke
#7
Marc Ribo, Sandra Boned, Marta Rubiera, Alejandro Tomasello, Pilar Coscojuela, David Hernández, Jorge Pagola, Jesús Juega, Noelia Rodriguez, Marian Muchada, David Rodriguez-Luna, Carlos A Molina
OBJECTIVE: To evaluate direct transfer to the angiosuite protocol of patients with acute stroke, candidates for endovascular treatment (EVT). METHODS: We studied workflow metrics of all patients with stroke who had undergone EVT in the past 12 months. Patients followed three protocols: direct transfer to emergency room (DTER), CT room (DTCT) or angiosuite (DTAS, only last 6 months if admission National Institute of Health Stroke Scale (NIHSS) score >9 and time from onset <4...
April 26, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28446169/the-relative-importance-of-large-problems-far-away-versus-small-problems-closer-to-home-insights-into-limiting-the-spread-of-antimicrobial-resistance-in-england
#8
Tjibbe Donker, Katherine L Henderson, Katie L Hopkins, Andrew R Dodgson, Stephanie Thomas, Derrick W Crook, Tim E A Peto, Alan P Johnson, Neil Woodford, A Sarah Walker, Julie V Robotham
BACKGROUND: To combat the spread of antimicrobial resistance (AMR), hospitals are advised to screen high-risk patients for carriage of antibiotic-resistant bacteria on admission. This often includes patients previously admitted to hospitals with a high AMR prevalence. However, the ability of such a strategy to identify introductions (and hence prevent onward transmission) is unclear, as it depends on AMR prevalence in each hospital, the number of patients moving between hospitals, and the number of hospitals considered 'high risk'...
April 27, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28445240/evaluation-of-a-pediatric-early-warning-score-across-different-subspecialty-patients
#9
Nathan P Dean, J B Fenix, Michael Spaeder, Amanda Levin
OBJECTIVE: To evaluate the ability of a Pediatric Early Warning Score to predict deterioration in different subspecialty patient populations. DESIGN: Single center, retrospective cohort study. Patients were classified into five groups: 1) cardiac; 2) hematology/oncology/bone marrow transplant; 3) surgical; 4) neurologic; and 5) general medical. The relationship between the Pediatric Early Warning Score and unplanned ICU transfer requiring initiation of specific ICU therapies (intubation, high-flow nasal cannula, noninvasive ventilation, inotropes, or aggressive fluid hydration within 12 hr of transfer) was evaluated...
April 25, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28444458/the-potential-of-ehealth-in-otorhinolaryngology-head-and-neck-surgery-patients-perspectives
#10
Martin Holderried, C Ernst, F Holderried, M Rieger, G Blumenstock, A Tropitzsch
The use of modern information and communication technologies (ICT) in daily life has significantly increased during the last several years. These essential online technologies have also found their way into the healthcare system. The use of modern ICT for health reasons can be summarized by the term 'eHealth'. Despite the potential importance of eHealth in the field of otorhinolaryngology (ORL), there is little understanding of patients' attitudes towards the deeper integration of these technologies into intersectoral care...
April 25, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28444049/healthcare-financing-decentralization-and-regional-health-planning-federal-transfers-and-the-healthcare-networks-in-minas-gerais-brazil
#11
Laura Monteiro de Castro Moreira, Felipe Ferré, Eli Iola Gurgel Andrade
The Decrees 4279/10 and 7508/11 established norms to guide health politics, with impacts on funding of the Middle and High Complexity Hospital and Outpatient. To verify the effects on the consolidation of care networks in Minas Gerais, we performed an analytical-descriptive study of the National Health Fund from 2006 to 2014. We observed decentralization of responsibilities, accompanied of resources and innovative financing mechanisms, resulting expansion of the network care model. The federal government definitions suggest reduction of the autonomy and limitation of regional solutions...
April 2017: Ciência & Saúde Coletiva
https://www.readbyqxmd.com/read/28443808/-10-tips-for-improving-patient-handovers-from-hospital-to-other-health-care-settings
#12
R van Seben, S E Geerlings, B M Buurman
When patients are transferred from the hospital to other health care settings, responsibility for the patient is transferred from the treating physician, nurse, paramedic or pharmacist at the hospital to the next health care provider. Good patient handovers from hospital to other healthcare settings are essential to ensure continuity of care. However, handovers are often delayed or incomplete and the patient is barely involved in her or his own transfer. Risks related to an incomplete handover may be considerable...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28441928/canadian-stroke-best-practice-recommendations-telestroke-best-practice-guidelines-update-2017
#13
Dylan Blacquiere, M Patrice Lindsay, Norine Foley, Colleen Taralson, Susan Alcock, Catherine Balg, Sanjit Bhogal, Julie Cole, Marsha Eustace, Patricia Gallagher, Antoinette Ghanem, Alexander Hoechsmann, Gary Hunter, Khurshid Khan, Alier Marrero, Brian Moses, Kelley Rayner, Andrew Samis, Elisabeth Smitko, Marilyn Vibe, Gord Gubitz, Dariush Dowlatshahi, Stephen Phillips, Frank L Silver
Every year, approximately 62,000 people with stroke and transient ischemic attack are treated in Canadian hospitals. The 2016 update of the Canadian Stroke Best Practice Recommendations Telestroke guideline is a comprehensive summary of current evidence-based and consensus-based recommendations appropriate for use by all healthcare providers and system planners who organize and provide care to patients following stroke across a broad range of settings. These recommendations focus on the use of telemedicine technologies to rapidly identify and treat appropriate patients with acute thrombolytic therapies in hospitals without stroke specialized expertise; select patients who require to immediate transfer to stroke centers for Endovascular Therapy; and for the patients who remain in community hospitals to facilitate their care on a stroke unit and provide remote access to stroke prevention and rehabilitation services...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28441676/transitioning-from-volume-to-value-one-academic-medical-center-s-approach-to-improving-population-health
#14
Stephanie A C Halvorson, Mary E Tanski, Thomas R Yackel
PROBLEM: The U.S. health care system is undergoing a major transformation. Clinical delivery systems are now being paid according to the value of the care they provide, in accordance with the Triple Aim, which incorporates improving the quality and cost of care and the patient experience. Increasingly, financial risk is being transferred from insurers to clinical delivery systems that become responsible for both episode-based clinical care and the longitudinal care of patients. Thus, these delivery systems need to develop strategies to manage the health of populations...
May 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28440868/improved-outcomes-after-successful-implementation-of-a-pediatric-early-warning-system-pews-in-a-resource-limited-pediatric-oncology-hospital
#15
Asya Agulnik, Lupe Nataly Mora Robles, Peter W Forbes, Doris Judith Soberanis Vasquez, Ricardo Mack, Federico Antillon-Klussmann, Monica Kleinman, Carlos Rodriguez-Galindo
BACKGROUND: Hospitalized pediatric oncology patients are at high risk of clinical decline and mortality, particularly in resource-limited settings. Pediatric early warning systems (PEWS) aid in the early identification of clinical deterioration; however, there are limited data regarding their feasibility or impact in low-resource settings. This study describes the successful implementation of PEWS at the Unidad Nacional de Oncología Pediátrica (UNOP), a pediatric oncology hospital in Guatemala, resulting in improved inpatient outcomes...
April 25, 2017: Cancer
https://www.readbyqxmd.com/read/28440686/severe-ovarian-hyperstimulation-syndrome-after-combined-gnrh-agonist-and-low-dose-human-chorionic-gonadotropin-trigger-in-a-patient-with-a-single-kidney
#16
Nigel Pereira, Jovana P Lekovich, Isaac Kligman, Zev Rosenwaks
Ovarian hyperstimulation syndrome (OHSS) following gonadotropin-releasing hormone agonist (GnRH-a) trigger is rare. Here, we report a case of severe OHSS after combined GnRH-a and low-dose human chorionic gonadotropin (hCG) trigger in a patient with a single kidney. The patient is a 32-year-old women with a two-year history of infertility. The patient's history was significant for a single kidney, that is, she had donated a kidney to a family member three years ago. The patient underwent controlled ovarian stimulation (COS) for in vitro fertilization (IVF) and received a combined 2 mg GnRH-a and 1500 IU hCG ovulatory trigger...
April 25, 2017: Gynecological Endocrinology
https://www.readbyqxmd.com/read/28439956/biologic-treatments-for-elderly-patients-with-psoriasis
#17
Mami Momose, Akihiko Asahina, Mitsuha Hayashi, Koichi Yanaba, Yoshinori Umezawa, Hidemi Nakagawa
The number of elderly patients with psoriasis is increasing in Japan. However, biologic treatment is generally considered to be challenging in elderly patients, due to their increased risk of complications compared with younger patients. Our retrospective study aimed to evaluate the safety profile and efficacy of biologics in senior elderly patients (≥75 years old) with psoriasis. The study involved a cohort of 27 patients aged 75-88 years who were being treated with biologics over a period of more than 1 year...
April 25, 2017: Journal of Dermatology
https://www.readbyqxmd.com/read/28439390/nosocomial-pseudomonas-putida-meningitis-a-case-report-and-literature-review
#18
Fahmi Yousef Khan, Mohammed AbuKamar, Deshmukh Anand
We report a case of Pseudomonas putida meningitis in a 26-year-old Nepalese man who was admitted to Hamad General Hospital with epidermoid cyst for drainage. Ommaya reservoir was placed into the cyst for drainage and externalventricular drainage (EVD) was performed. After four days, the patient was transferred to the ward in stable condition. His weakness resolved partially and headache severity decreased. After three days, the patient developed fever and headache severity increased with deterioration of consciousness level...
March 2017: Oman Medical Journal
https://www.readbyqxmd.com/read/28439262/turn-up-the-heat-food-and-clinical-escherichia-coli-isolates-feature-two-transferrable-loci-of-heat-resistance
#19
Erik J Boll, Roger Marti, Henrik Hasman, Søren Overballe-Petersen, Marc Stegger, Kim Ng, Susanne Knøchel, Karen A Krogfelt, Joerg Hummerjohann, Carsten Struve
Heat treatment is a widely used process to reduce bacterial loads in the food industry or to decontaminate surfaces, e.g., in hospital settings. However, there are situations where lower temperatures must be employed, for instance in case of food production such as raw milk cheese or for decontamination of medical devices such as thermo-labile flexible endoscopes. A recently identified locus of heat resistance (LHR) has been shown to be present in and confer heat resistance to a variety of Enterobacteriaceae, including Escherichia coli isolates from food production settings and clinical ESBL-producing E...
2017: Frontiers in Microbiology
https://www.readbyqxmd.com/read/28439196/clinical-differences-of-influenza-subspecies-among-hospitalized-children
#20
Manolya Acar, Murat Sütçü, Hacer Aktürk, Selda Hançerli Törün, Metin Uysalol, Sevim Meşe, Nuran Salman, Ayper Somer
AIM: Clinical findings, mortality, and morbidity rates differ among influenza subspecies. Awareness of these differences will lead physicians to choose the proper diagnostic and therapeutic strategies and to foresee possible complications. The aim of this study was to evaluate the clinical differences of influenza subspecies among hospitalized children. MATERIAL AND METHODS: Hospitalized children with proven influenza infection by polymerase chain reaction on nasopharyngeal swab specimens in our clinic, between December 2013 and March 2016, were enrolled...
March 2017: Türk Pediatri Arşivi
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