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https://www.readbyqxmd.com/read/29165160/a-review-of-vietnam-s-healthcare-reform-through-the-direction-of-healthcare-activities-doha
#1
REVIEW
Kyoko Takashima, Koji Wada, Ton Thanh Tra, Derek R Smith
OBJECTIVE: This article provides a comprehensive review of the healthcare reform process driven by the Vietnamese Ministry of Health's Direction of Healthcare Activities (DOHA) scheme. METHODS: We reviewed policy documents relating to DOHA, along with historical literature and background information describing its formation. RESULTS: DOHA (Chỉ đạo tuyến in Vietnamese) literally means guidance line or level in English. It requires healthcare facilities at higher government administration levels to support those at lower levels (the four levels being central, provincial, district, and commune), to help lower level hospitals to provide medical services for local communities in primary care settings and reduce the number of patients in higher level (central and provincial) hospitals...
October 30, 2017: Environmental Health and Preventive Medicine
https://www.readbyqxmd.com/read/29163800/end-of-life-care-in-children-with-hematologic-malignancies
#2
Jessica I Hoell, Jens Warfsmann, Stefan Balzer, Arndt Borkhardt, Gisela Janssen, Michaela Kuhlen
Introduction: Hematologic malignancies (HM) represent the most common neoplasms in childhood. Despite improved overall survival rates, they are still a major contributor to cancer death in children. Aims: To determine the proportion of children with HM in pediatric palliative care (PPC) and to identify the clinical characteristics and symptoms in comparison to children with extracranial solid tumors (non HM patients). Patients and Methods: This study was conducted as a single-center retrospective cohort study of patients in the care of a large specialized PPC team...
October 27, 2017: Oncotarget
https://www.readbyqxmd.com/read/29163659/automated-quality-control-of-ultrasound-based-on-in-air-reverberation-patterns
#3
Pepijn van Horssen, Arnold Schilham, Dennis Dickerscheid, Niels van der Werf, Han Keijzers, Ronald van Almere, Joost Kuijer, Rob Peters, Mark Hofman
Ultrasound image degradation originates primarily from transducer defects and potentially undermines reliable image interpretation. Systematic quantitative quality control is often neglected due to the limited resources available for this task. We propose a quantitative quality control based on in-air reverberation images. These images serve as an initial indication of image degradation. They are easily generated for any (curvi-)linear transducer independent of the level of expertise of the operator. Automated analysis is presented to extract quality parameters based on the in-air reverberation pattern...
November 2017: Ultrasound: Journal of the British Medical Ultrasound Society
https://www.readbyqxmd.com/read/29163422/a-novel-inca-c1-group-conjugative-plasmid-encoding-vim-1-metallo-beta-lactamase-mediates-the-acquisition-of-carbapenem-resistance-in-st104-klebsiella-pneumoniae-isolates-from-neonates-in-the-intensive-care-unit-of-v-monaldi-hospital-in-naples
#4
Eliana P Esposito, Stefano Gaiarsa, Mariateresa Del Franco, Valeria Crivaro, Mariano Bernardo, Susanna Cuccurullo, Francesca Pennino, Maria Triassi, Piero Marone, Davide Sassera, Raffaele Zarrilli
The emergence of carbapenemase producing Enterobacteriaceae has raised major public health concern. The aim of this study was to investigate the molecular epidemiology and the mechanism of carbapenem resistance acquisition of multidrug-resistant Klebsiella pneumoniae isolates from 20 neonates in the neonatal intensive care unit (NICU) of the V. Monaldi Hospital in Naples, Italy, from April 2015 to March 2016. Genotype analysis by pulsed-field gel electrophoresis (PFGE) and multi-locus sequence typing (MLST) identified PFGE type A and subtypes A1 and A2 in 17, 2, and 1 isolates, respectively, and assigned all isolates to sequence type (ST) 104...
2017: Frontiers in Microbiology
https://www.readbyqxmd.com/read/29163416/diagnostic-evasion-of-highly-resistant-microorganisms-a-critical-factor-in-nosocomial-outbreaks
#5
Xuewei Zhou, Alexander W Friedrich, Erik Bathoorn
Highly resistant microorganisms (HRMOs) may evade screening strategies used in routine diagnostics. Bacteria that have evolved to evade diagnostic tests may have a selective advantage in the nosocomial environment. Evasion of resistance detection can result from the following mechanisms: low-level expression of resistance genes not resulting in detectable resistance, slow growing variants, mimicry of wild-type-resistance, and resistance mechanisms that are only detected if induced by antibiotic pressure. We reviewed reports on hospital outbreaks in the Netherlands over the past 5 years...
2017: Frontiers in Microbiology
https://www.readbyqxmd.com/read/29162573/data-quality-and-30-day-survival-for-out-of-hospital-cardiac-arrest-in-the-uk-out-of-hospital-cardiac-arrest-registry-a-data-linkage-study
#6
Sangeerthana Rajagopal, Scott J Booth, Terry P Brown, Chen Ji, Claire Hawkes, A Niroshan Siriwardena, Kim Kirby, Sarah Black, Robert Spaight, Imogen Gunson, Samantha J Brace-McDonnell, Gavin D Perkins
OBJECTIVES: The Out-of-Hospital Cardiac Arrest Outcomes (OHCAO) project aims to understand the epidemiology and outcomes of out-of-hospital cardiac arrest (OHCA) across the UK. This data linkage study is a subproject of OHCAO. The aim was to establish the feasibility of linking OHCAO data to National Health Service (NHS) patient demographic data and Office for National Statistics (ONS) date of death data held on the NHS Personal Demographics Service (PDS) database to improve OHCAO demographic data quality and enable analysis of 30-day survival from OHCA...
November 20, 2017: BMJ Open
https://www.readbyqxmd.com/read/29162345/postacute-care-after-pediatric-hospitalizations-for-a-primary-mental-health-condition
#7
James C Gay, Bonnie T Zima, Tumaini R Coker, Stephanie K Doupnik, Matthew Hall, Jonathan Rodean, Margaret O'Neill, Rustin Morse, Kris P Rehm, Jay G Berry, Naomi S Bardach
OBJECTIVES: To determine the proportion of US children hospitalized for a primary mental health condition who are discharged to postacute care (PAC); whether PAC discharge is associated with demographic, clinical, and hospital characteristics; and whether PAC use varies by state. STUDY DESIGN: Retrospective cohort study of a nationally representative sample of US acute care hospitalizations for children ages 2-20 years with a primary mental health diagnosis, using the 2009 and 2012 Kids' Inpatient Databases...
November 18, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/29160424/effect-of-prophylactic-non-invasive-mechanical-ventilation-on-functional-capacity-after-heart-valve-replacement-a-clinical-trial
#8
Amaro Afrânio de Araújo-Filho, Manoel Luiz de Cerqueira-Neto, Lucas de Assis Pereira Cacau, Géssica Uruga Oliveira, Telma Cristina Fontes Cerqueira, Valter Joviniano de Santana-Filho
OBJECTIVE: During cardiac surgery, several factors contribute to the development of postoperative pulmonary complications. Non-invasive ventilation is a promising therapeutic tool for improving the functionality of this type of patient. The aim of this study is to evaluate the functional capacity and length of stay of patients in a nosocomial intensive care unit who underwent prophylactic non-invasive ventilation after heart valve replacement. METHOD: The study was a controlled clinical trial, comprising 50 individuals of both sexes who were allocated by randomization into two groups with 25 patients in each group: the control group and experimental group...
October 2017: Clinics
https://www.readbyqxmd.com/read/29159719/effect-of-a-real-time-electronic-dashboard-on-a-rapid-response-system
#9
Grant S Fletcher, Barry A Aaronson, Andrew A White, Reena Julka
A rapid response system (RRS) may have limited effectiveness when inpatient providers fail to recognize signs of early patient decompensation. We evaluated the impact of an electronic medical record (EMR)-based alerting dashboard on outcomes associated with RRS activation. We used a repeated treatment study in which the dashboard display was successively turned on and off each week for ten 2-week cycles over a 20-week period on the inpatient acute care wards of an academic medical center. The Rapid Response Team (RRT) dashboard displayed all hospital patients in a single view ranked by severity score, updated in real time...
November 20, 2017: Journal of Medical Systems
https://www.readbyqxmd.com/read/29159569/determinants-of-short-and-long-door-to-balloon-time-in-current-primary-percutaneous-coronary-interventions
#10
Takunori Tsukui, Kenichi Sakakura, Yousuke Taniguchi, Kei Yamamoto, Hiroshi Wada, Shin-Ichi Momomura, Hideo Fujita
Primary percutaneous coronary interventions (PCI) have been developed to improve clinical outcomes in patients with ST-segment elevation myocardial infarction (STEMI). In primary PCI, the door-to-balloon time (DTBT) is closely associated with mortality and morbidity. The purpose of this study was to find determinants of short and long DTBT. From our hospital record, we included 214 STEMI patients, and divided into the short DTBT group (DTBT < 60 min, n = 60), the intermediate DTBT group (60 min ≤ DTBT ≤ 120 min, n = 121) and the long DTBT group (DTBT > 120 min, n = 33)...
November 20, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/29158764/fetal-and-preterm-infant-microbiomes-a-new-perspective-of-necrotizing-enterocolitis
#11
REVIEW
Yong-Sung Choi, In Gyu Song
Necrotizing enterocolitis (NEC) is a devastating condition of hospitalized preterm infants. Numerous studies have attempted to identify the cause of NEC by examining the immunological features associated with pathogenic microorganisms. No single organism has proven responsible for the disease; however, immunological studies are now focused on the microbiome. Recent research has investigated the numerous bacterial species residing in the body and their role in diseases in preterm infants. The timing of initial microbial colonization is a subject of interest...
October 2017: Korean Journal of Pediatrics
https://www.readbyqxmd.com/read/29158075/intermediate-care-unit-after-cardiac-surgery-impact-on-length-of-stay-and-outcomes
#12
Carlos Labata, Teresa Oliveras, Elisabet Berastegui, Xavier Ruyra, Bernat Romero, Maria-Luisa Camara, Maria-Soledad Just, Jordi Serra, Ferran Rueda, Marc Ferrer, Cosme García-García, Antoni Bayes-Genis
INTRODUCTION AND OBJECTIVES: Current postoperative management of adult cardiac surgery often comprises transfer from the intensive care unit (ICU) to a conventional ward. Intermediate care units (IMCU) permit hospital resource optimization. We analyzed the impact of an IMCU on length of stay (both ICU and in-hospital) and outcomes (in-hospital mortality and 30-day readmissions) after adult cardiac surgery (IMCU-CS). METHODS: From November 2012 to April 2015, 1324 consecutive patients were admitted to a university hospital for cardiac surgery...
November 17, 2017: Revista Española de Cardiología
https://www.readbyqxmd.com/read/29155982/economic-and-survival-burden-of-dysphagia-among-inpatients-in-the-united-states
#13
D A Patel, S Krishnaswami, E Steger, E Conover, M F Vaezi, M R Ciucci, D O Francis
The inpatient burden of dysphagia has primarily been evaluated in patients with stroke. It is unclear whether dysphagia, irrespective of cause, is associated with worse clinical outcomes and higher costs compared to inpatients with similar demographic, hospital, and clinical characteristics without dysphagia. The aim of this study is to assess how a dysphagia diagnosis affects length of hospital stay (LOS), costs, discharge disposition, and in-hospital mortality among adult US inpatients. Annual and overall dysphagia prevalence, LOS, hospital charges, inpatient care costs, discharge disposition, and in-hospital mortality were measured using the AHRQ Healthcare Cost and Utilization Project (HCUP) National Inpatient Sample (2009-2013)...
November 16, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/29154381/interhospital-transfer-and-receipt-of-specialty-procedures
#14
Stephanie K Mueller, Jie Zheng, John Orav, Jeffrey L Schnipper
The practice of transferring patients between acute care hospitals is variable and largely nonstandardized. Although often-cited reasons for transfer include providing patients access to specialty services only available at the receiving institution, little is known about whether and when patients receive such specialty care during the transfer continuum. We performed a retrospective analysis using 2013 100% Master Beneficiary Summary and Inpatient claims files from Centers for Medicare and Medicaid Services...
November 8, 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29153941/the-impact-of-readmission-hospital-on-failure-to-rescue-rates-following-major-urologic-cancer-surgery
#15
Jasmir G Nayak, Sarah K Holt, Jonathan L Wright, Matthew Mossanen, Atreya Dash, John L Gore
PURPOSE: Patients readmitted to secondary hospitals rather than the primary hospital where their surgery took place may be at risk for poorer outcomes. We sought to evaluate the effect of site of readmission on failure-to-rescue complication rates following urologic cancer surgery. MATERIALS AND METHODS: Retrospective review of major urologic cancer surgeries in the Washington State Comprehensive Hospital Abstract Reporting System between 1998 and 2013. Failure-to-rescue (FTR) rates, defined as inpatient death after a complication requiring hospital readmission, were compared between patients readmitted to their primary hospital with those readmitted to a secondary hospital...
November 16, 2017: Urologic Oncology
https://www.readbyqxmd.com/read/29153254/facial-reanimation-surgery-in-m%C3%A3-bius-syndrome-experience-from-76-cases-from-a-tertiary-referral-hospital-in-latin-america
#16
A Cardenas-Mejia, D Palafox
INTRODUCTION: Möbius syndrome is defined as a combined congenital bilateral facial and abducens nerve palsies. The main goal of treatment is to provide facial reanimation by means of a dynamic surgical procedure. The microneurovascular transfer of a free muscle transplant is the procedure of choice for facial animation in a child with facial paralysis. OBSERVATION: Between January 2008 and January 2017, 124 patients with the syndrome have been approached at our institution...
November 15, 2017: Annales de Chirurgie Plastique et Esthétique
https://www.readbyqxmd.com/read/29152906/short-term-outcomes-following-implementation-of-a-dedicated-young-adult-congenital-heart-disease-transition-program
#17
Sumeet S Vaikunth, Roberta G Williams, Merujan Y Uzunyan, Han Tun, Cheryl Barton, Philip M Chang
OBJECTIVE: Transition from pediatric to adult care is a critical time for patients with congenital heart disease. Lapses in care can lead to poor outcomes, including increased mortality. Formal transition clinics have been implemented to improve success of transferring care from pediatric to adult providers; however, data regarding outcomes remain limited. We sought to evaluate outcomes of transfer within a dedicated transition clinic for young adult patients with congenital heart disease...
November 20, 2017: Congenital Heart Disease
https://www.readbyqxmd.com/read/29152759/retrieval-of-adult-patients-on-extracorporeal-membrane-oxygenation-by-an-intensive-care-physician-model
#18
Aidan J C Burrell, David V Pilcher, Vincent A Pellegrino, Stephen A Bernard
The optimal staffing model during the inter-hospital transfer of patients on extracorporeal membrane oxygenation (ECMO) is not known. We report the complications and outcomes of patients who were commenced on ECMO at a referring hospital by intensive care physicians and compare these findings with patients who had ECMO established at an ECMO center in Australia. This was a single center, retrospective observational study based on a prospectively collected ECMO database from Melbourne, Australia. Patients with severe cardiac and/or respiratory failure failing conventional supportive treatment between 2007-2013 were placed on ECMO via a physician-led model of ECMO retrieval, including two intensivists in a four person team, using percutaneous ECMO cannulation...
November 19, 2017: Artificial Organs
https://www.readbyqxmd.com/read/29152320/intramuscular-progesterone-gestone-versus-vaginal-progesterone-suppository-cyclogest-for-luteal-phase-support-in-cycles-of-in-vitro-fertilization-embryo-transfer-patient-preference-and-drug-efficacy
#19
Amal Yaseen Zaman, Serdar Coskun, Ahmed Abdullah Alsanie, Khalid Arab Awartani
Background: The requirement for luteal phase support (LPS) in stimulated IVF cycles is well established, however drug choice, and route of administration and duration of use are not. This report evaluates patients' preference and satisfaction by using either vaginal or intramuscular (IM) progesterone (P) supplementation for luteal phase support after in vitro fertilization and embryo transfer (IVF-ET). Methods: It is a prospective cohort study done in a reproductive and infertility unit in a tertiary care hospital from March 2013 through February 2015 for four hundred and nine patients undergoing IVF-ET...
2017: Fertility Research and Practice
https://www.readbyqxmd.com/read/29151460/-evaluation-of-absorbed-dose-by-mri-read-out
#20
Shuji Usui
Three dimensional dose distribution by gel dosimeters is often read out by an MRI scanner, which is readily available in most hospitals. Both the T1 and T2 relaxation rates are used to evaluate the absorbed dose. This paper will describe the principle of the imaging sequences (spin echo, multiple spin echo, and inversion recovery methods) to measure the relaxation rate and the factors to affect the precision (signal noise ratio, temperature during scanning, coil, imaging artefact). Additionally, the magnetization transfer method will be mentioned as an alternative for low-density foam gel dosimeters...
2017: Japanese Journal of Medical Physics
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