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https://www.readbyqxmd.com/read/28546005/fast-epithermal-and-thermal-photoneutron-dosimetry-in-air-and-in-tissue-equivalent-phantom-for-a-high-energy-x-ray-medical-accelerator
#1
Mehdi Sohrabi, Amir Hakimi
Photoneutron (PN) dosimetry in fast, epithermal and thermal energy ranges originated from the beam and albedo neutrons in high-energy X-ray medical accelerators is highly important from scientific, technical, radiation protection and medical physics points of view. Detailed dose equivalents in the fast, epithermal and thermal PN energy ranges in air up to 2m as well as at 35 positions from the central axis of 12 cross sections of the phantom at different depths were determined in 18MV X-ray beams of a Siemens ONCOR accelerator...
May 22, 2017: Zeitschrift Für Medizinische Physik
https://www.readbyqxmd.com/read/28543090/association-of-pulse-pressure-with-left-ventricular-geometry-and-function-in-elderly-nonhypertensive-patients-with-diabetes-a-3d-speckle-tracking-echocardiography-study
#2
Qingqing Wang, Kaibin Tan, Hongmei Xia, Yunhua Gao
PURPOSE: The aims of this study were to investigate and compare the left ventricular (LV) geometry and function in elderly nonhypertensive type 2 diabetic patients with normal (NPP, <60 mm Hg) and with high (HPP, ≥60 mmHg) 24-hour pulse pressure, and to explore the independent predictors of LV strain values in these patients. METHODS: A total of 76 elderly nonhypertensive type 2 diabetic patients with normal (≥55%) LV ejection fraction (LVEF) were included, 36 of whom had HPP...
May 22, 2017: Journal of Clinical Ultrasound: JCU
https://www.readbyqxmd.com/read/28537346/does-length-of-stay-influence-how-patients-rate-their-hospitalization-after-total-hip-arthroplasty
#3
Ronald E Delanois, Chukwuweike Gwam, Jaydev B Mistry, Anton Khlopas, Morad Chughtai, Prem Ramkumar, Nicolas Piuzzi, Ryan Berger, Peter M Bonutti, Arthur L Malkani, Michael A Mont
BACKGROUND: The reimbursement for medical services by Medicare and Medicaid (CMS) has recently changed from fee-for-service to quality-based payments. This is being implemented through the use of patient administered surveys, most commonly Press Ganey. With a recent strive for fast-track total hip arthroplasty (THA), it is important to ascertain whether length-of-stay (LOS) in post-THA patients influences the Press Ganey scores and overall hospital ratings. Therefore, we looked at: 1) Which Press Ganey survey factors affect overall hospital rating in patients who have a short (=2) or longer (>2) length of stay; and 2) whether hospital satisfaction is different between patients who have varied lengths of stay...
May 24, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28521787/robot-assisted-thoracoscopic-lobectomy-as-treatment-of-a-giant-bulla
#4
Rosa Roemers, Kornelis Patberg, Caroline van de Wauwer, Tam Nguyen, Ghada Shahin
BACKGROUND: A bulla is a marked enlarged space within the parenchyma of the lung. Bullae may cause dyspnea by compressing healthy lung parenchyma and can cause a pneumothorax. Also, bullae are associated with malignancy, therefore surgical bullectomy is indicated on preventive basis. This case is unique and therefore valuable because of the remarkable presentation, innovative treatment and the spectacular improvement of lung function and socio-economic performance of the patient. CASE PRESENTATION: In this case report we describe the presentation, minimally invasive surgical treatment by means of a robot-assisted lobectomy and postoperative outcome of a young patient with a giant congenital bulla of the left upper lobe...
May 18, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28511195/safety-aspects-of-postanesthesia-care-unit-discharge-without-motor-function-assessment-after-spinal-anesthesia-a-randomized-multicenter-semiblinded-noninferiority-controlled-trial
#5
Eske Kvanner Aasvang, Christoffer Calov Jørgensen, Mogens Berg Laursen, Jacob Madsen, Søren Solgaard, Mogens Krøigaard, Per Kjærsgaard-Andersen, Hans Mandøe, Torben Bæk Hansen, Jørgen Ulrich Nielsen, Niels Krarup, Annette Elisabeth Skøtt, Henrik Kehlet
BACKGROUND: Postanesthesia care unit (PACU) discharge without observation of lower limb motor function after spinal anesthesia has been suggested to significantly reduce PACU stay and enhance resource optimization and early rehabilitation but without enough data to allow clinical recommendations. METHODS: A multicenter, semiblinded, noninferiority randomized controlled trial of discharge from the PACU with or without assessment of lower limb motor function after elective total hip or knee arthroplasty under spinal anesthesia was undertaken...
June 2017: Anesthesiology
https://www.readbyqxmd.com/read/28495690/intensive-care-in-thoracic-oncology
#6
Anne-Pascale Meert, Bogdan Grigoriu, Marc Licker, Paul E Van Schil, Thierry Berghmans
The admission of lung cancer patients to intensive care is related to postprocedural/postoperative care and medical complications due to cancer or its treatment, but is also related to acute organ failure not directly related to cancer.Despite careful preoperative risk management and the use of modern surgical and anaesthetic techniques, thoracic surgery remains associated with high morbidity, related to the extent of resection and specific comorbidities. Fast-tracking processes with timely recognition and treatment of complications favourably influence patient outcome...
May 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/28494481/enhanced-hip-fracture-management-use-of-statistical-methods-and-dataset-to-evaluate-a-fractured-neck-of-femur-fast-track-pathway-pilot-study
#7
Nigel Gilchrist, Kristian Dalzell, Scott Pearson, Gary Hooper, Kit Hoeben, Jeremy Hickling, John McKie, Ma Yi, Sandra Chamberlain, Caroline McCullough, Marc Gutenstein
The increasing elderly population and subsequent rise in total hip fracture(s) in this group means more effective management strategies are necessary to improve efficiency. We have changed our patient care strategy from the emergency department (ED), acute orthopaedic wards, operating theatre, post-operation and rehabilitation, and called it Fracture Neck of Femur Fast Track Pathway. All clinical data and actions were captured, integrated and displayed on a weekly basis using 'signalfromnoise' (SFN) software...
May 12, 2017: New Zealand Medical Journal
https://www.readbyqxmd.com/read/28493526/real-time-mri-guidance-of-cardiac-interventions
#8
Adrienne E Campbell-Washburn, Mohammad A Tavallaei, Mihaela Pop, Elena K Grant, Henry Chubb, Kawal Rhode, Graham A Wright
Cardiac magnetic resonance imaging (MRI) is appealing to guide complex cardiac procedures because it is ionizing radiation-free and offers flexible soft-tissue contrast. Interventional cardiac MR promises to improve existing procedures and enable new ones for complex arrhythmias, as well as congenital and structural heart disease. Guiding invasive procedures demands faster image acquisition, reconstruction and analysis, as well as intuitive intraprocedural display of imaging data. Standard cardiac MR techniques such as 3D anatomical imaging, cardiac function and flow, parameter mapping, and late-gadolinium enhancement can be used to gather valuable clinical data at various procedural stages...
May 11, 2017: Journal of Magnetic Resonance Imaging: JMRI
https://www.readbyqxmd.com/read/28483313/immediate-hypersensitivity-reaction-to-chemotherapeutic-agents
#9
Pedro Giavina-Bianchi, Sarita U Patil, Aleena Banerji
An increase by 70% in new cases of cancer is expected over the next 2 decades, with more than 8 million people dying each year from the disease, an estimated 13% of all deaths worldwide. Several new chemotherapeutic agents have been rapidly developed and many of them approved through a fast-track process. In parallel, adverse reactions to chemotherapy have increased dramatically worldwide, frequently preventing the use of first-line therapy for cancer and jeopardizing patients' treatment outcomes. The present review focuses on immediate hypersensitivity reactions (IHRs) induced by chemotherapeutic agents...
May 2017: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/28477230/a-matched-case-control-comparison-of-hospital-costs-and-outcomes-for-knee-replacement-patients-admitted-postoperatively-to-acute-care-versus-rehabilitation
#10
Brian K Tse, Tessa L Walters, Steven K Howard, T Edward Kim, Stavros G Memtsoudis, Eric C Sun, Alex Kou, Lorrie Graham, Robert King, Edward R Mariano
For select total knee arthroplasty (TKA) patients, we have established an alternative pathway to bypass the acute care surgical ward and directly admit patients from the post-anesthesia care unit to on-campus rehabilitation. We retrospectively examined whether this 'fast track' pathway decreased costs and improved patient outcomes. After reviewing records of consecutive primary unilateral TKA patients over a 15-month period, each patient admitted to rehabilitation was matched with a control admitted to the acute care ward...
May 5, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28437313/enhanced-recovery-after-surgery-for-noncolorectal-surgery-a-systematic-review-and-meta-analysis-of-major-abdominal-surgery
#11
Anthony Visioni, Rupen Shah, Emmanuel Gabriel, Kristopher Attwood, Moshim Kukar, Steven Nurkin
OBJECTIVE: To evaluate the impact of enhanced recovery after surgery (ERAS) protocols across noncolorectal abdominal surgical procedures. BACKGROUND: ERAS programs have been studied extensively in colorectal surgery and adopted at many centers. Several studies testing such protocols have shown promising results in improving postoperative outcomes across various surgical procedures. However, surgeons performing major abdominal procedures have been slower to adopt these ERAS protocols...
April 21, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28435128/randomized-trial-on-fast-track-care-in-colorectal-surgery-for-deep-infiltrating-endometriosis
#12
Marco Scioscia, Marcello Ceccaroni, Irene Gentile, Roberto Rossini, Roberto Clarizia, Davide Brunelli, Giacomo Ruffo
STUDY OBJECT: To study the application of a fast-track care protocol in colorectal surgery for deep infiltrating endometriosis. Bowel endometriosis is an infrequent but not rare condition that often needs intestinal surgery and imposes a high economic burden on society. DESIGN: Prospective randomized trial (Canadian Task Force I). SETTING: Tertiary referral center. PATIENTS: We randomly assigned 227 patients with preoperative evidence of bowel endometriosis to a fast-track (no preoperative bowel preparation, early restoration of diet, no postoperative antibiotics, and early post-operative mobilization) or conventional care for laparoscopic intestinal surgery...
April 18, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28431106/ultrasound-cut-off-values-for-intima-media-thickness-of-temporal-facial-and-axillary-arteries-in-giant-cell-arteritis
#13
Valentin S Schäfer, Aaron Juche, Sofia Ramiro, Andreas Krause, Wolfgang A Schmidt
Objective.: To evaluate the intima-media thickness (IMT) of arteries involved in GCA for determining cut-off values. Methods.: Forty newly diagnosed GCA patients in a fast-track GCA clinic and 40 age- and sex-matched controls were included. IMT measurement was performed at or within 24 h after diagnosis. The common superficial temporal arteries with their frontal and parietal branches and the facial arteries were bilaterally examined with a 10-22 MHz probe and the axillary artery with a 6-18 MHz probe...
April 20, 2017: Rheumatology
https://www.readbyqxmd.com/read/28418710/lung-cancer-guidelines-in-sweden-denmark-norway-and-finland-a-comparison
#14
Niels Lyhne Christensen, Antti Jekunen, Sebastian Heinonen, Susanne Oksbjerg Dalton, Torben Riis Rasmussen
BACKGROUND: The Nordic countries are similar in terms of demographics and health care organization. Yet there are marked differences in lung cancer mortality, for which Denmark historically has had the poorest outcome. One of several possible reasons for these differences could have to do with how lung cancer is diagnosed and treated in the different Nordic countries. However, among the four most populous Nordic countries: Sweden, Denmark, Norway and Finland, there is a paucity of knowledge about differences and similarities in recommendations in the national guidelines for non-small cell lung cancer (NSCLC) and the methodology by which the guidelines are developed...
April 18, 2017: Acta Oncologica
https://www.readbyqxmd.com/read/28414681/what-can-erode-through-lungs-bone-and-skin
#15
J M Manalac, D Shankaranayanan, J Paul-Olivier, L Guidry, N R Sells
CASE: A 51 year old African American Man without significant past history presented with three weeks of persistent cough productive of copious yellow sputum. He denied fevers, chills, hemoptysis, dyspnea, weight or appetite changes, sick contacts, recent travel. On physical examination, the patient was afebrile and appeared comfortable. He had decreased air entry of the left lower lobe with dullness to percussion. A 5x3 cm fluctuant mass was incidentally found on the left anterior chest wall at the level of the 11th rib with yellow expressible exudate at which time the patient reported a minor trauma sustained 3 weeks prior...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28413420/overcrowding-in-emergency-departments-a-review-of-strategies-to-decrease-future-challenges
#16
REVIEW
Mohammad H Yarmohammadian, Fatemeh Rezaei, Abbas Haghshenas, Nahid Tavakoli
Emergency departments (EDs) are the most challenging ward with respect to patient delay. The goal of this study is to present strategies that have proven to reduce delay and overcrowding in EDs. In this review article, initial electronic database search resulted in a total of 1006 articles. Thirty articles were included after reviewing full texts. Inclusion criteria were assessments of real patient flows and implementing strategies inside the hospitals. In this study, we discussed strategies of team triage, point-of-care testing, ideal ED patient journey models, streaming, and fast track...
2017: Journal of Research in Medical Sciences: the Official Journal of Isfahan University of Medical Sciences
https://www.readbyqxmd.com/read/28409282/motor-neuron-vulnerability-and-resistance-in-amyotrophic-lateral-sclerosis
#17
REVIEW
Jik Nijssen, Laura H Comley, Eva Hedlund
In the fatal disease-amyotrophic lateral sclerosis (ALS)-upper (corticospinal) motor neurons (MNs) and lower somatic MNs, which innervate voluntary muscles, degenerate. Importantly, certain lower MN subgroups are relatively resistant to degeneration, even though pathogenic proteins are typically ubiquitously expressed. Ocular MNs (OMNs), including the oculomotor, trochlear and abducens nuclei (CNIII, IV and VI), which regulate eye movement, persist throughout the disease. Consequently, eye-tracking devices are used to enable paralysed ALS patients (who can no longer speak) to communicate...
June 2017: Acta Neuropathologica
https://www.readbyqxmd.com/read/28403839/transfer-between-hospitals-as-a-predictor-of-delay-in-diagnosis-and-treatment-of-patients-with-non-small-cell-lung-cancer-a-register-based-cohort-study
#18
Maria Iachina, Erik Jakobsen, Anne Kudsk Fallesen, Anders Green
BACKGROUND: Lung cancer is the second most frequent cancer diagnosis in Denmark. Although improved during the last decade, the prognosis of lung cancer is still poor with an overall 5-year survival rate of approximately 12%. Delay in diagnosis and treatment of lung cancer has been suggested as a potential cause of the poor prognosis and as consequence, fast track cancer care pathways were implemented describing maximum acceptable time thresholds from referral to treatment. In Denmark, patients with lung cancer are often transferred between hospitals with diagnostic facilities to hospitals with treatment facilities during the care pathway...
April 12, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28401873/-fast-diagnostic-track-for-suspected-lung-cancer-a-patient-centered-approach
#19
Hronn Hardardottir, Unnur A Valdimarsdottir, Tomas Gudbjartsson, Andres Sigvaldason, Sigrun Helga Lund, Thor Aspelund, Sif Hansdottir, Steinn Jonsson
INTRODUCTION: The aim of this study is to describe the characteristics of patients who underwent a fast diagnostic track (FDT) due to suspected lung cancer at Landspitali University Hospital, Iceland. MATERIAL AND METHODS: Hospital records were reviewed on background characteristics, diagnosis, staging, waiting times and survival of all 550 patients (mean age 68.1 years, 57% female) that participated in the FDT from February 1, 2008 to January 31, 2015. Adjusting for clinical characteristics in a multivariate analysis, overall survival was compared for patients diagnosed with lung cancer within or outside the FDT in Iceland in 2014 (n=167, mean age 69...
April 2017: Læknablađiđ
https://www.readbyqxmd.com/read/28400940/early-diagnosis-of-penetrating-cardiac-and-pleural-injury-by-extended-focused-assessment-with-sonography-for-trauma
#20
K P Singaravelu, Rama Prakasha Saya, Vinay R Pandit
In India, stab injury is not uncommon, but identifying potential life threatening conditions in the emergency room (ER) and initiating prompt treatment are challenging. This is a case report of a young patient who presented to the ER with assault injury to the chest and shock; timely extended focused assessment with sonography for trauma helped to fast-track the patient to the operating room. A brief review of diagnosis and management of penetrating cardiac injury is presented herewith.
October 2016: Heart Views: the Official Journal of the Gulf Heart Association
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