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https://www.readbyqxmd.com/read/28548315/aapm-medical-physics-practice-guideline-8-a-linear-accelerator-performance-tests
#1
Koren Smith, Peter Balter, John Duhon, Gerald A White, David L Vassy, Robin A Miller, Christopher F Serago, Lynne A Fairobent
PURPOSE: The purpose of this guideline is to provide a list of critical performance tests in order to assist the Qualified Medical Physicist (QMP) in establishing and maintaining a safe and effective quality assurance (QA) program. The performance tests on a linear accelerator (linac) should be selected to fit the clinical patterns of use of the accelerator and care should be given to perform tests which are relevant to detecting errors related to the specific use of the accelerator. METHODS: A risk assessment was performed on tests from current task group reports on linac QA to highlight those tests that are most effective at maintaining safety and quality for the patient...
May 26, 2017: Journal of Applied Clinical Medical Physics
https://www.readbyqxmd.com/read/28540552/application-of-ruo2-ni-foam-electrodes-for-remediation-of-ibuprofen-in-soil-matrix-the-effect-of-electrokinetic-parameters
#2
Ching Yuan, Chung-Hsuang Hung, Tzu-Yuan Huang
Pharmaceuticals and personal care products (PPCPs) are an extraordinary and diverse group of chemicals used in veterinary medicine, agriculture, and for human health and cosmetics care. They are considered emerging contaminants and have raised great concern in recent years. Among the PPCPs, ibuprofen (IBP) is one of the most known non-steroidal anti-inflammatory drugs, which has been found at a high concentration in irrigation water in the USA and showed harmful effect for organisms. This study examined IBP degradation performance by an electrokinetic process coupled with 24-96 cm(2) of RuO2/Ni foam (RN) electrodes applied 1-3 V cm(-1) potential gradient for 5-9 days...
May 24, 2017: Environmental Science and Pollution Research International
https://www.readbyqxmd.com/read/28539083/patient-length-of-stay-and-mortality-prediction-a-survey
#3
Aya Awad, Mohamed Bader-El-Den, James McNicholas
Over the past few years, there has been increased interest in data mining and machine learning methods to improve hospital performance, in particular hospitals want to improve their intensive care unit statistics by reducing the number of patients dying inside the intensive care unit. Research has focused on prediction of measurable outcomes, including risk of complications, mortality and length of hospital stay. The length of stay is an important metric both for healthcare providers and patients, influenced by numerous factors...
May 2017: Health Services Management Research
https://www.readbyqxmd.com/read/28538056/engaging-all-employees-in-efforts-to-achieve-high-reliability
#4
Anne Marie Benedicto
DRAMATIC AND NUMEROUS advances in science, technology, and medicine provide new opportunities to keep people healthy as well as to diagnose, treat, and cure disease. Unfortunately, increasing complexity increases opportunities for mistakes and errors, particularly in healthcare organizations as they struggle to prevent patient harm (). Safety problems persist and harm to patients continues despite widespread attention to the need for improvement ().An engaged and empowered workforce is critical to improving the patient experience, improving health outcomes, and correcting unsafe conditions ()...
July 2017: Frontiers of Health Services Management
https://www.readbyqxmd.com/read/28536932/thromboprophylaxis-in-extracorporeal-circuits-current-pharmacological-strategies-and-future-directions
#5
REVIEW
Gail M Annich, Oshri Zaulan, Megan Neufeld, Deborah Wagner, Melissa M Reynolds
The development of extracorporeal devices for organ support has been a part of medical history and progression since the late 1900s. These types of technology are primarily used and developed in the field of critical care medicine. Unfractionated heparin, discovered in 1916, has really been the only consistent form of thromboprophylaxis for attenuating or even preventing the blood-biomaterial reaction that occurs when such technologies are initiated. The advent of regional anticoagulation for procedures such as continuous renal replacement therapy and plasmapheresis have certainly removed the risks of systemic heparinization and heparin effect, but the challenges of the blood-biomaterial reaction and downstream effects remain...
May 23, 2017: American Journal of Cardiovascular Drugs: Drugs, Devices, and Other Interventions
https://www.readbyqxmd.com/read/28532628/milestones-barriers-and-beacons-shared-decision-making-in-canada-inches-ahead
#6
France Légaré, Dawn Stacey, Pierre-Gerlier Forest, Marie-France Coutu, Patrick Archambault, Laura Boland, Holly O Witteman, Annie LeBlanc, Krystina B Lewis, Anik M C Giguere
Canada's approach to shared decision making (SDM) remains as disparate as its healthcare system; a conglomerate of 14 public plans - ten provincial, three territorial and one federal. The healthcare research funding environment has been largely positive for SDM because there was funding for knowledge translation research which also encompassed SDM. The funding climate currently places new emphasis on patient involvement in research and on patient empowerment in healthcare. SDM fields have expanded from primary care to elder care, paediatrics, emergency and critical care medicine, cardiology, nutrition, occupational therapy and workplace rehabilitation...
May 19, 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/28532613/the-practice-of-evidence-based-medicine-involves-the-care-of-whole-persons
#7
W Scott Richardson
In this issue of the Journal, Dr. Fava posits that evidence-based medicine (EBM) was bound to fail. I share some of the concerns he expresses, yet I see more reasons for optimism. Having been on rounds with both Drs. Engel and Sackett, I reckon they would have agreed more than they disagreed. Their central teaching was the compassionate and well-informed care of sick persons. The model that emerged from these rounds was that patient care could be both person-centered and evidence-based, that clinical judgment was essential to both, and the decisions could and should be shared...
April 2017: Journal of Clinical Epidemiology
https://www.readbyqxmd.com/read/28532611/hijacked-evidence-based-medicine-stay-the-course-and-throw-the-pirates-overboard
#8
John P A Ioannidis
The article discusses a number of criticisms that have been raised against evidence-based medicine, such as focusing on benefits and ignoring adverse events; being interested in averages and ignoring the wide variability in individual risks and responsiveness; ignoring clinician-patient interaction and clinical judgement; leading to some sort of reductionism; and falling prey to corruption from conflicts of interest. I argue that none of these deficiencies are necessarily inherent to evidence-based medicine...
April 2017: Journal of Clinical Epidemiology
https://www.readbyqxmd.com/read/28531789/do-picu-patients-meet-technical-criteria-for-performing-indirect-calorimetry
#9
Megan R Beggs, Gonzalo Garcia Guerra, Bodil M K Larsen
BACKGROUND & AIMS: Indirect calorimetry (IC) is considered gold standard for assessing energy needs of critically ill children as predictive equations and clinical status indicators are often unreliable. Accurate assessment of energy requirements in this vulnerable population is essential given the high risk of over or underfeeding and the consequences thereof. The proportion of patients and patient days in pediatric intensive care (PICU) for which energy expenditure (EE) can be measured using IC is currently unknown...
October 2016: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/28530851/chondral-injuries-and-irreparable-meniscal-tears-among-adolescents-with-anterior-cruciate-ligament-or-meniscal-tears-are-more-common-in-patients-with-public-insurance
#10
Ariel A Williams, Nickolas S Mancini, Matthew J Solomito, Carl W Nissen, Matthew D Milewski
BACKGROUND: Access to health care services is a critical component of health care reform and may differ among patients with different types of insurance. Hypothesis/Purpose: The purpose was to compare adolescents with private and public insurance undergoing surgery for anterior cruciate ligament (ACL) and/or meniscal tears. We hypothesized that patients with public insurance would have a delayed presentation from the time of injury and therefore would have a higher incidence of chondral injuries and irreparable meniscal tears and lower preoperative International Knee Documentation Committee (IKDC) scores than patients with private insurance...
May 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28530771/macrophage-migration-inhibitory-factor-levels-correlate-with-an-infection-in-trauma-patients
#11
Young Duck Cho, Sung Hyuk Choi, Jung Youn Kim, Sung Jun Park, Young Hoon Yoon, Han Jin Cho, Ji Won Yeom
BACKGROUND: The role of migration inhibitory factor (MIF) is best understood in septic shock and septic disease; however, the role of MIF in a secondary infection after trauma has not yet been completely studied. This study aimed to evaluate the role of MIF in trauma patients. METHODS: The patients in the study population were divided into two groups according to the results of their MIF levels. The initial MIF levels, trauma mechanism, revised trauma score, survival rate, length of stay (LOS) in the intensive care unit (ICU), level of leukocytes, and level of C-reactive protein (CRP) were compared between the groups...
May 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/28530457/-patient-turnover-in-a-multidisciplinary-emergency-department
#12
Csaba Varga, Zsuzsanna Lelovics, Viktor Soós, Tibor Oláh
INTRODUCTION: More than twenty emergency departments were opened across Hungary in the past years. Data deficiency on patient flow, trends and lack of knowledge of indicators could raise numerous logistical and organisational problems. AIM: Collection, analysis and provision of data to facilitate successful operations of emergency medical care services. METHOD: During a three-year period investigated, at the multidisciplinary Emergency Department of "Moritz Kaposi" Teaching Hospital, data on patient flow (n = 106,203), epidemiology, triage and international classification of diseases were analysed...
May 2017: Orvosi Hetilap
https://www.readbyqxmd.com/read/28529913/critical-care-management-and-intensive-care-unit-outcomes-following-cytoreductive-surgery-with-hyperthermic-intraperitoneal-chemotherapy
#13
Sumit Kapoor, Adel Bassily-Marcus, Rafael Alba Yunen, Parissa Tabrizian, Sabrine Semoin, Joseph Blankush, Daniel Labow, John Oropello, Anthony Manasia, Roopa Kohli-Seth
AIM: To study the early postoperative intensive care unit (ICU) management and complications in the first 2 wk of patients undergoing cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). METHODS: Our study is a retrospective, observational study performed at Icahn School of Medicine at Mount Sinai, quaternary care hospital in New York City. All adult patients who underwent CRS and HIPEC between January 1, 2007 and December 31, 2012 and admitted to ICU postoperatively were studied...
May 4, 2017: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28526079/patient-needs-and-preferences-for-herb-drug-disease-interaction-alerts-a-structured-interview-study
#14
Carrie M Christensen, Rebecca S Morris, Seraphine Chepkemoi Kapsandoy, Melissa Archer, Jinqiu Kuang, Laura Shane-McWhorter, Bruce E Bray, Qing Zeng-Treitler
BACKGROUND: While complementary and alternative medicine (CAM) is commonly used in the United States and elsewhere, and hazardous interactions with prescription drugs can occur, patients do not regularly communicate with physicians about their CAM use. The objective of this study was to discover patient information needs and preferences for herb-drug-disease interaction alerts. METHODS: We recruited 50 people from several locations within the University of Utah Hospital to participate in this structured interview study...
May 19, 2017: BMC Complementary and Alternative Medicine
https://www.readbyqxmd.com/read/28524025/-effect-of-esmolol-on-hemodynamics-and-clinical-outcomes-in-patients-with-septic-shock
#15
Shupeng Wang, Min Li, Jun Duan, Li Yi, Xu Huang, Desheng Chen, Gang Li
OBJECTIVE: To evaluate the effect of heart rate control with esmolol on hemodynamics, inflammatory cytokines and clinical outcomes in patients with septic shock. METHODS: A prospective randomized controlled trial was conducted. The patients with septic shock admitted to Department of Critical Care Medicine of China-Japan Friendship Hospital from August 2014 to October 2016 were enrolled. After 24 hours of resuscitation and other therapy, they were randomly divided into two groups by sealed envelope...
May 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28523476/impact-of-a-patient-navigator-program-on-hospital-based-and-outpatient-utilization-over-180%C3%A2-days-in-a-safety-net-health-system
#16
Richard B Balaban, Fang Zhang, Catherine E Vialle-Valentin, Alison A Galbraith, Marguerite E Burns, Marc R Larochelle, Dennis Ross-Degnan
BACKGROUND: With emerging global payment structures, medical systems need to understand longer-term impacts of care transition strategies. OBJECTIVE: To determine the effect of a care transition program using patient navigators (PNs) on health service utilization among high-risk safety-net patients over a 180-day period. DESIGN: Randomized controlled trial conducted October 2011 through April 2013. PARTICIPANTS: Patients admitted to the general medicine service with ≥1 readmission risk factor: (1) age ≥ 60; (2) in-network inpatient admission within prior 6 months; (3) index length of stay ≥ 3 days; or (4) admission diagnosis of heart failure or (5) chronic obstructive pulmonary disease...
May 18, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28522349/respiratory-medicine-and-critical-care-a-call-for-papers-for-ers
#17
Laura Feetham, Sabine Kleinert
No abstract text is available yet for this article.
May 15, 2017: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/28521810/estimation-of-the-burden-of-varicella-in-europe-before-the-introduction-of-universal-childhood-immunization
#18
Margarita Riera-Montes, Kaatje Bollaerts, Ulrich Heininger, Niel Hens, Giovanni Gabutti, Angel Gil, Bayad Nozad, Grazina Mirinaviciute, Elmira Flem, Audrey Souverain, Thomas Verstraeten, Susanne Hartwig
BACKGROUND: Varicella is generally considered a mild disease. Disease burden is not well known and country-level estimation is challenging. As varicella disease is not notifiable, notification criteria and rates vary between countries. In general, existing surveillance systems do not capture cases that do not seek medical care, and most are affected by underreporting and underascertainment. We aimed to estimate the overall varicella disease burden in Europe to provide critical information to support decision-making regarding varicella vaccination...
May 18, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28515341/bet-bromodomain-inhibition-suppresses-innate-inflammatory-and-profibrotic-transcriptional-networks-in-heart-failure
#19
Qiming Duan, Sarah McMahon, Priti Anand, Hirsh Shah, Sean Thomas, Hazel T Salunga, Yu Huang, Rongli Zhang, Aarathi Sahadevan, Madeleine E Lemieux, Jonathan D Brown, Deepak Srivastava, James E Bradner, Timothy A McKinsey, Saptarsi M Haldar
Despite current standard of care, the average 5-year mortality after an initial diagnosis of heart failure (HF) is about 40%, reflecting an urgent need for new therapeutic approaches. Previous studies demonstrated that the epigenetic reader protein bromodomain-containing protein 4 (BRD4), an emerging therapeutic target in cancer, functions as a critical coactivator of pathologic gene transactivation during cardiomyocyte hypertrophy. However, the therapeutic relevance of these findings to human disease remained unknown...
May 17, 2017: Science Translational Medicine
https://www.readbyqxmd.com/read/28514888/seeing-is-believing-healthcare-professionals-perceptions-of-a-complex-intervention-to-improve-care-towards-the-end-of-life-a-qualitative-interview-study
#20
Katherine Bristowe, Irene Carey, Adrian Hopper, Susanna Shouls, Wendy Prentice, Irene J Higginson, Jonathan Koffman
BACKGROUND: Methods to improve care, trust and communication are important in acute hospitals. Complex interventions aimed at improving care of patients approaching the end of life are increasingly common. While evaluating outcomes of complex interventions is essential, exploring healthcare professionals' perceptions is also required to understand how they are interpreted; this can inform training, education and implementation strategies to ensure fidelity and consistency in use. AIM: To explore healthcare professionals' perceptions of using a complex intervention (AMBER care bundle) to improve care for people approaching the end of life and their understandings of its purpose within clinical practice...
May 1, 2017: Palliative Medicine
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