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https://www.readbyqxmd.com/read/28727576/severe-respiratory-failure-extracorporeal-membrane-oxygenation-and-intracranial-hemorrhage
#1
Christopher J A Lockie, Stuart A Gillon, Nicholas A Barrett, Daniel Taylor, Asif Mazumder, Kaggere Paramesh, Katie Rowland, Kathleen Daly, Luigi Camporota, Christopher I S Meadows, Guy W Glover, Nicholas Ioannou, Christopher J Langrish, Stephen Tricklebank, Andrew Retter, Duncan L A Wyncoll
OBJECTIVES: For patients supported with veno-venous extracorporeal membrane oxygenation, the occurrence of intracranial hemorrhage is associated with a high mortality. It is unclear whether intracranial hemorrhage is a consequence of the extracorporeal intervention or of the underlying severe respiratory pathology. In a cohort of patients transferred to a regional severe respiratory failure center that routinely employs admission brain imaging, we sought 1) the prevalence of intracranial hemorrhage; 2) survival and neurologic outcomes; and 3) factors associated with intracranial hemorrhage...
July 19, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28726539/rethinking-transitions-of-care-an-interprofessional-transfer-triage-protocol-in-post-acute-care
#2
Radha V Patel, Lauri Wright, Brittany Hay
Readmissions to hospitals from post-acute care (PAC) units within long-term care settings have been rapidly increasing over the past decade, and are drivers of increased healthcare costs. With an average of $11,000 per admission, there is a need for strategies to reduce 30-day preventable hospital readmission rates. In 2018, incentives and penalties will be instituted for long-term care facilities failing to meet all-cause, all-condition hospital readmission rate performance measures. An interprofessional team (IPT) developed and implemented a Transfer Triage Protocol used in conjunction with the INTERACT programme to enhance clinical decision-making and assess the potential to reduce the facility's 30-day preventable hospital readmission rates by 10% within 6 weeks of implementation...
July 20, 2017: Journal of Interprofessional Care
https://www.readbyqxmd.com/read/28724333/the-impact-of-acute-management-on-the-occurrence-of-medical-complications-during-the-specialized-spinal-cord-injury-acute-hospitalization-following-motor-complete-cervical-spinal-cord-injury
#3
Andréane Richard-Denis, Debbie Erhmann Feldman, Cynthia Thompson, Jean-Marc Mac-Thiong
CONTEXT/OBJECTIVE: Determine the impact of early admission and complete perioperative management in a specialized spinal cord injury (SCI) trauma center (SCI-center) on the occurrence of medical complications following tetraplegia. DESIGN: A retrospective comparative cohort study of prospectively collected data involving 116 individuals was conducted. Group 1 (N=87) was early managed in a SCI-center promptly after the trauma, whereas Group 2 (N=29) was surgically and preoperatively managed in a non-specialized (NS) center before being transferred to the SCI-center...
July 19, 2017: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/28724143/potentially-avoidable-surgical-intensive-care-unit-admissions-and-disposition-delays
#4
Navpreet K Dhillon, Ara Ko, Eric J T Smith, Mayumi Kharabi, Joseph Castongia, Michael Nurok, Bruce L Gewertz, Eric J Ley
Importance: High health care costs encourage initiatives that avoid overuse of resources and identify opportunities to promote appropriate care. Objective: To investigate the causes of potentially avoidable surgical intensive care unit (SICU) admissions and disposition delays to determine whether targeted interventions could decrease these stays. Design, Setting, and Participants: This prospective, observational study focused on potentially avoidable SICU days, as determined by observers with input from the rounding intensivists at a 24-bed open SICU at an urban, academic hospital...
July 19, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28722579/control-of-human-echinococcosis-in-xinjiang-china-with-2-544-surgeries-in-a-multihospital-network
#5
Xinhua Chen, Xinyu Duan, Yingmei Shao, Jianwen Jiang, Shusen Zheng, Hao Wen
Human echinococcosis is a serious parasitic disease threatening public health worldwide especially in Xinjiang, China, an undeveloped farming and pastoral area. A multihospital surgical network was applied to improve human echinococcosis control. An innovative surgery network connected the 28 designated public hospitals, which distributed in a vast land of 1,600,000 m(2). The surgery network integrated the efficient patient digital information sharing, treatment consulting, patient transfer, and financial support...
June 12, 2017: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/28721569/management-of-enterocutaneous-fistula-outcomes-in-276-patients
#6
Martha Quinn, Stuart Falconer, Ruth F McKee
OBJECTIVE: To assess the outcomes of patients with type II intestinal failure due to enterocutaneous fistulae in a tertiary referral centre over a 15 year period. Intestinal failure secondary to enterocutaneous fistula (ECF) requires multidisciplinary management at significant cost. Mortality and morbidity are high. METHODS: Patients were identified from a prospectively collected database of patients requiring inpatient parenteral nutrition (1998-2013). Data collected included: demographics, mode of admission, pathological grouping and outcome...
July 18, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28720746/-a-rare-case-of-ruptured-internal-carotid-posterior-communicating-artery-aneurysm-associated-with-contralateral-delayed-oculomotor-nerve-palsy
#7
Chika Somagawa, Yutaka Fukuda, Shota Yoshimura, Kei Satoh, Takeshi Hiu, Tomonori Ono, Ryujirou Ushijima, Keisuke Toda, Keisuke Tsutsumi
A 55-year-old man presented with difficulty breathing, chest pain, and disturbance of consciousness, and was transferred to our hospital. Initial whole body CT revealed a diffuse subarachnoid hemorrhage(SAH)with severe pulmonary edema that was considered neurogenic in origin. He received controlled ventilation under sedation and conservative care for the SAH. One day after the onset of the SAH, his left pupil suddenly became dilated to 6mm, with no reaction to light. Head CT showed no new bleeding. Subsequent CT angiogram revealed a right internal carotid-posterior communicating artery aneurysm(IC-PC AN)with a posterior-lateral projection; however, no vessel abnormality was observed in the left anterior or posterior circulations...
July 2017: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/28720234/effect-of-music-therapy-on-the-anxiety-levels-and-pregnancy-rate-of-women-undergoing-in-vitro-fertilization-embryo-transfer-a-randomized-controlled-trial
#8
Yilda Arzu Aba, Dilek Avci, Yilmaz Guzel, Semanur Kumral Ozcelik, Basak Gurtekin
PURPOSE: The aim of this study was to determine the effect of music therapy on the anxiety levels and pregnancy rates of women who underwent in vitro fertilization-embryo transfer. METHODS: This prospective randomized controlled trial was conducted with 186 infertile women who presented to the In Vitro Fertilization Unit at the American Hospital in Turkey between April 2015 and April 2016. The infertile women who met the inclusion criteria were assigned to the music therapy group or the standard therapy group through block randomization...
August 2017: Applied Nursing Research: ANR
https://www.readbyqxmd.com/read/28720000/differentiation-between-pyogenic-flexor-tenosynovitis-and-other-finger-infections
#9
Colin D Kennedy, Alexander S Lauder, Jonathan R Pribaz, Stephen A Kennedy
BACKGROUND: Hospital transfer decisions regarding pyogenic flexor tenosynovitis (PFT) are made difficult by emergency department presentations similar to other finger infections, with pain, redness, and functional limitation. Our objectives were to: (1) determine diagnostic sensitivity and specificity of Kanavel signs; and (2) identify existing factors most predictive of PFT during initial presentation. METHODS: Adult patients who underwent surgical consultation for concern of PFT over a 5-year period were identified retrospectively...
February 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28718494/the-hiv-care-cascade-in-buenos-aires-argentina-results-in-a-tertiary-referral-hospital
#10
Carina Cesar, Gabriela Blugerman, José Antonio Valiente, Peter Rebeiro, Omar Sued, Valeria Fink, Mariana Romero Soto, Roberto Cillis, Cleyton Yamamoto, Carlos Falistocco, Pedro Cahn, Héctor Pérez
Objective: To determine rates of retention, antiretroviral therapy (ART) use, and viral suppression in an adult cohort from a public tertiary referral hospital in the city of Buenos Aires, Argentina. Methods: HIV-positive ART-naïve patients ≥ 18 years old starting care 2011-2013 contributed data until the end of 2014. Three outcomes were assessed in 2014: retention in care, ART use, and viral suppression. Patient characteristics associated with each outcome were assessed through logistic regression...
December 2016: Revista Panamericana de Salud Pública, Pan American Journal of Public Health
https://www.readbyqxmd.com/read/28717089/an-autopsy-case-of-fulminant-hepatitis-in-a-patient-with-multiple-sclerosis-treated-by-interferon-beta-1a
#11
Yuichi Yamazaki, Aya Suzuki, Kimitoshi Hirayanagi, Yusuke Tsukagoshi, Ryota Uehara, Kazuhiko Horiguchi, Tatsuya Ohyama, Takuya Tomaru, Norio Horiguchi, Sumihito Nobusawa, Hayato Ikota, Ken Sato, Satoru Kakizaki, Motoyasu Kusano, Yoshio Ikeda, Hideaki Yokoo, Masanobu Yamada
A 44-year-old woman with multiple sclerosis (MS) receiving interferon (IFN)-beta-1a treatment was admitted to a local hospital for severe icterus and liver injury. She was transferred to our university hospital because fulminant hepatitis (FH) was suspected. She was diagnosed with acute-type FH based on hepatic coma, severe liver injury and liver failure, and she received plasma exchange and continuous hemodiafiltration therapy. On hospital day 6, she died from liver failure despite intensive care. An autopsy revealed histological findings consistent with FH...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28716291/similarities-between-large-animal-related-and-motor-vehicle-crash-related-injuries
#12
Abigail M Tremelling, Robert A Marley, Mackenzie B Marley, Christina M Woofter, Courtney Docherty, Ann E Salvator, Farid F Muakkassa
OBJECTIVE: Many Americans sustain large animal-related injuries (LARIs) from blunt trauma. We compare the injuries and management of LARI in our region of the United States with those of motor vehicle crashes (MVCs). METHODS: A 15-year retrospective study of trauma patients with LARI matched to MVC controls by Injury Severity Score (ISS), age, and sex was conducted. Values were statistically compared, and differences were considered statistically significant at P < ...
July 14, 2017: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/28716152/development-of-a-theory-informed-implementation-intervention-to-improve-the-triage-treatment-and-transfer-of-stroke-patients-in-emergency-departments-using-the-theoretical-domains-framework-tdf-the-t-3-trial
#13
Louise E Craig, Natalie Taylor, Rohan Grimley, Dominique A Cadilhac, Elizabeth McInnes, Rosemary Phillips, Simeon Dale, Denise O'Connor, Chris Levi, Mark Fitzgerald, Julie Considine, Jeremy M Grimshaw, Richard Gerraty, N Wah Cheung, Jeanette Ward, Sandy Middleton
BACKGROUND: Theoretical frameworks and models based on behaviour change theories are increasingly used in the development of implementation interventions. Development of an implementation intervention is often based on the available evidence base and practical issues, i.e. feasibility and acceptability. The aim of this study was to describe the development of an implementation intervention for the T(3) Trial (Triage, Treatment and Transfer of patients with stroke in emergency departments (EDs)) using theory to recommend behaviour change techniques (BCTs) and drawing on the research evidence base and practical issues of feasibility and acceptability...
July 17, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28715136/underweight-and-hypoalbuminemia-as-risk-indicators-for-mortality-among-psychiatric-patients-with-medical-comorbidities
#14
Takahiro Haga, Kae Ito, Masahiro Ono, Jiro Maruyama, Mari Iguchi, Hitoe Suzuki, Eiji Hayashi, Kentaro Sakashita, Tomoko Nagao, Shohei Ikemoto, Asuka Okaniwa, Makiko Kitami, Eriko Inuo, Koichiro Tatsumi
AIM: Medical comorbidities are a major cause of death among patients with mental illness. The purpose of this study was to clarify the risk factors for mortality among psychiatric patients with medical comorbidities. METHODS: We retrospectively reviewed the clinical files of patients transferred to Tokyo Metropolitan Matsuzawa Hospital from a psychiatric hospital to treat medical comorbidities during the three-year period from January 2014 to December 2016. We analyzed the clinical differences between the expired and alive patients...
July 17, 2017: Psychiatry and Clinical Neurosciences
https://www.readbyqxmd.com/read/28714427/discrepancy-between-information-provided-and-information-required-by-emergency-physicians-for-long-term-care-patients
#15
Richa Parashar, Shelley McLeod, Don Melady
OBJECTIVES: The primary objective of this study was to identify information included in long-term care (LTC) transfer documentation and to compare it to the information required by local emergency department (ED) physicians to provide optimal care and make decisions for LTC patients. METHODS: A retrospective chart review was conducted for a sample of LTC residents transferred by ambulance to the ED of an academic, tertiary care hospital over a 1-year period. All emergency physicians working at the institution were invited to complete an online questionnaire about information included in LTC transfer documentation and information required by emergency physicians to provide care for LTC patients...
July 17, 2017: CJEM
https://www.readbyqxmd.com/read/28713659/a-descriptive-report-of-early-mobilization-for-critically-ill-ventilated-patients-with-cancer
#16
Amanda Weeks, Claudine Campbell, Prabalini Rajendram, Weiji Shi, Louis Voigt
BACKGROUND: Early mobilization protocols have been successfully implemented to improve function in critically ill patients; however, no study has focused on the oncology population. OBJECTIVES: To investigate the feasibility of early mobilization and describe the rehabilitation interventions and discharge outcomes in a cohort of critically ill patients with cancer. DESIGN: Retrospective review. METHODS: A retrospective analysis of patients with cancer who participated in occupational and physical therapy while on mechanical ventilation utilizing an institutional early mobilization protocol from June 2010 - July 2011, was completed...
July 2017: Rehabilitation Oncology
https://www.readbyqxmd.com/read/28713440/investigating-the-physical-stability-of-repackaged-medicines-stored-into-commercially-available-multicompartment-compliance-aids-mcas
#17
Bahijja Tolulope Raimi-Abraham, Alba Garcia Del Valle, Carlota Varon Galcera, Susan Anne Barker, Mine Orlu
BACKGROUND: Compliance aids are devices which have been developed and are currently used to assist individuals in their medicines management. The use of compliance aids involves the transfer of medicines from the manufacturers' original packaging and repackaged into an multicompartment compliance aid (MCA). MCAs do not guarantee the same level of protection compared to manufacturer's original packaging. OBJECTIVE: The aim of this study was to investigate the stability profile of atenolol, aspirin and lansoprazole dosage forms repackaged together in two different commercially available MCAs...
June 2017: Journal of Pharmaceutical Health Services Research
https://www.readbyqxmd.com/read/28713357/extensively-drug-resistant-klebsiella-pneumoniae-causing-nosocomial-bloodstream-infections-in-china-molecular-investigation-of-antibiotic-resistance-determinants-informing-therapy-and-clinical-outcomes
#18
Wenzi Bi, Haiyang Liu, Rhys A Dunstan, Bin Li, Von Vergel L Torres, Jianming Cao, Lijiang Chen, Jonathan J Wilksch, Richard A Strugnell, Trevor Lithgow, Tieli Zhou
The rise in diversity of antimicrobial resistance phenotypes seen in Klebsiella pneumoniae is becoming a serious antibiotic management problem. We sought to investigate the molecular characteristics and clinical implications of extensively drug-resistant (XDR) K. pneumoniae isolated from different nosocomial bloodstream infections (BSIs) patients from July 2013 to November 2015. Even in combination treatment, meropenem did not protect against mortality of BSIs patients (P = 0.015). In contrast, tigecycline in combination with other antimicrobial agents significantly protected against mortality (P = 0...
2017: Frontiers in Microbiology
https://www.readbyqxmd.com/read/28712527/clinical-presentation-to-the-emergency-department-predicts-subarachnoid-hemorrhage-associated-myocardial-injury
#19
Khalil M Yousef, Elizabeth Crago, Theodore F Lagattuta, Marilyn Hravnak
INTRODUCTION: Aneurysmal subarachnoid hemorrhage (aSAH) is frequently seen in emergency departments. Secondary injury, such as subarachnoid hemorrhage-associated myocardial injury (SAHMI), affects one third of survivors and contributes to poor outcomes. SAHMI is not attributed to ischemia from myocardial disease but can result in hypotension and arrhythmias. It is important that emergency nurses recognize which clinical presentation characteristics are predictive of SAHMI to initiate proper interventions...
July 13, 2017: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
https://www.readbyqxmd.com/read/28712369/a-hospital-based-matched-case-control-study-to-identify-risk-factors-for-clinical-infection-with-oxa-48-producing-klebsiella-pneumoniae-in-rectal-carriers
#20
A Madueño, J Gonzalez Garcia, A Aguirre-Jaime, M Lecuona
Asymptomatic colonisation of the gastrointestinal tract by carbapenemase-producing Enterobacteriaceae is an important reservoir for transmission, which may precede infection. This retrospective observational case-control study was designed to identify risk factors for developing clinical infection with OXA-48-producing Klebsiella pneumoniae in rectal carriers during hospitalisation. Case patients (n = 76) had carbapenemase-producing K. pneumoniae (CPKP) infection and positive rectal culture for CPKP. Control patients (n = 174) were those with rectal colonisation with CPKP but without CPKP infection...
July 17, 2017: Epidemiology and Infection
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