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https://www.readbyqxmd.com/read/29334495/the-ethics-of-interventional-procedures-for-patients-too-ill-for-surgery
#1
Caroline G Kan, Michael Nurok
PURPOSE OF REVIEW: Minimally invasive interventional procedures are increasingly popular options for patients who are high-risk candidates for open surgical procedures. It is unclear how to proceed in the rare circumstance of a complication during an interventional procedure, where addressing the complication would require exposing the patient to the full risk that was being avoided with the minimally invasive technique. This review provides recommendations on how to approach this paradoxical scenario...
January 12, 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29333577/prostate-cancer-patients-understanding-of-the-gleason-scoring-system-implications-for-shared-decision-making
#2
Erin K Tagai, Suzanne M Miller, Alexander Kutikov, Michael A Diefenbach, Ronak A Gor, Tahseen Al-Saleem, David Y T Chen, Sara Fleszar, Gem Roy
The Gleason scoring system is a key component of a prostate cancer diagnosis, since it indicates disease aggressiveness. It also serves as a risk communication tool that facilitates shared treatment decision-making. However, the system is highly complex and therefore difficult to communicate: factors which have been shown to undermine well-informed and high-quality shared treatment decision-making. To systematically explore prostate cancer patients' understanding of the Gleason scoring system (GSS), we assessed knowledge and perceived importance among men who had completed treatment (N = 50)...
January 15, 2018: Journal of Cancer Education: the Official Journal of the American Association for Cancer Education
https://www.readbyqxmd.com/read/29332187/human-bite-injuries-to-the-head-and-neck-current-trends-and-management-protocols-in-england-and-wales
#3
Glyndwr W Jenkins, Robert Isaac, Shakir Mustafa
INTRODUCTION: Human bite injuries can be challenging in their presentation to the examining physician. In a study by Merchant et al., 18% of patients presenting with a human bite injury had suffered wounds to the head and neck region. Current trends in their initial management at presentation to emergency departments throughout England and Wales will be discussed in this paper. MATERIALS AND METHOD: A postal survey was sent out to 100 A&E lead clinicians. This was followed up by telephone enquiries to improve the response rate...
January 14, 2018: Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29331871/rupture-during-coiling-of-intracranial-aneurysms-predictors-and-clinical-outcome
#4
Damian Kocur, Nikodem Przybyłko, Piotr Bażowski, Jan Baron
INTRODUCTION: The intraprocedural aneurysm rupture (IPR) is one of the most feared adverse effect associated with the coil embolization therapy. The aim of the study was to identify predisposing factors for IPR, as well as to define patient groups with worse clinical outcome following IPR. PATIENTS AND METHODS: From February 2008 to March 2015, 273 consecutive patients were treated at our institution via endovascular coil embolization. Patient medical records were reviewed with emphasis on procedure description, potential risk factors and clinical outcomes related to IPR...
January 8, 2018: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/29331164/adherence-to-the-danish-food-based-dietary-guidelines-and-risk-of-myocardial-infarction-a-cohort-study
#5
Camilla Plambeck Hansen, Kim Overvad, Inge Tetens, Anne Tjønneland, Erik Thorlund Parner, Marianne Uhre Jakobsen, Christina Catherine Dahm
OBJECTIVE: A direct way to evaluate food-based dietary guidelines is to assess if adherence is associated with development of non-communicable diseases. Thus, the objective was to develop an index to assess adherence to the 2013 Danish food-based dietary guidelines and to investigate the association between adherence to the index and risk of myocardial infarction (MI). DESIGN: Population-based cohort study with recruitment of participants in 1993-1997. Information on dietary intake was collected at baseline using an FFQ and an index ranging from 0 to 6 points was created to assess adherence to the 2013 Danish food-based dietary guidelines...
January 14, 2018: Public Health Nutrition
https://www.readbyqxmd.com/read/29330753/transfer-of-critically-ill-adults-assessing-the-need-for-training
#6
Ruth-Aoibheann O'Leary, Brian Marsh, Paul O'Connor
BACKGROUND: Transfer of critically ill patients within the hospital is commonly associated with adverse incidents, but, despite this, no standardised training exists on how to carry out this task. Very little information is published in the literature on the learning needs of staff undertaking these transfers, and this limits our ability to provide a focused and appropriate educational intervention. AIMS: This study aimed to explore the organisational, environmental and individual issues that increase risk to patients during intrahospital transport (IHT) and to explore the potential educational solutions to these issues as articulated by these practitioners...
January 12, 2018: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/29325786/a-proactive-outreach-intervention-that-decreases-readmission-after-hepatectomy
#7
Nisha Narula, Bradford J Kim, Catherine H Davis, Whitney L Dewhurst, Leigh A Samp, Thomas A Aloia
BACKGROUND: After hepatectomy, 7%-19% of patients are readmitted within 30 days, accounting for substantial cost and poor patient experience. The purpose of this study was to analyze the impact of a proactive outreach intervention on readmissions. METHODS: Consecutive patients undergoing hepatectomy by a single surgeon 2012-2016 were identified in a prospectively maintained database. In August 2013 a postoperative intervention was implemented; an advanced practice provider called each patient within 72 hours of discharge...
January 9, 2018: Surgery
https://www.readbyqxmd.com/read/29318430/an-eight-year-prospective-controlled-study-about-the-safety-and-diagnostic-value-of-cardiac-and-non-cardiac-1-5-t-mri-in-patients-with-a-conventional-pacemaker-or-a-conventional-implantable-cardioverter-defibrillator
#8
Pierpaolo Lupo, Riccardo Cappato, Giovanni Di Leo, Francesco Secchi, Giacomo D E Papini, Sara Foresti, Hussam Ali, Guido M G De Ambroggi, Antonio Sorgente, Gianluca Epicoco, Paola M Cannaò, Francesco Sardanelli
OBJECTIVES: To investigate safety and diagnostic value of 1.5-T MRI in carriers of conventional pacemaker (cPM) or conventional implantable defibrillator (cICD). METHODS: We prospectively compared cPM/cICD-carriers undergoing MRI (study group, SG), excluding those device-dependent or implanted <6 weeks before enrolment or prior to 01/01/2000, with cPM/cICD-carriers undergoing chest x-ray, CT or follow-up (reference group, RG). RESULTS: 142 MRI (55 cardiac) were performed in 120 patients with cPM (n=71) or cICD (n=71)...
January 9, 2018: European Radiology
https://www.readbyqxmd.com/read/29316150/proper-use-of-social-media-by-health-operators-in-the-pediatric-oncohematological-setting-consensus-statement-from-the-italian-pediatric-hematology-and-oncology-association-aieop
#9
Carlo Alfredo Clerici, Paola Quarello, Anna Bergadano, Laura Veneroni, Marina Bertolotti, Paola Guadagna, Angelo Ricci, Andrea Galdi, Franca Fagioli, Andrea Ferrari
Social media are powerful means of communication that can also have an important role in the healthcare sector. They are sometimes seen with diffidence in the healthcare setting, partly because they risk blurring professional boundaries. This issue is particularly relevant to relations between caregivers and adolescent patients. The Italian Pediatric Hematology and Oncology Association created a multidisciplinary working group to develop some shared recommendations on this issue. After reviewing the literature, the working group prepared a consensus statement in an effort to suggest an analytical approach rather than restrictive rules...
January 9, 2018: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/29315392/redefining-diabetes-and-the-concept-of-self-management-from-a-patient-s-perspective-implications-for-disease-risk-factor-management
#10
T K Masupe, K Ndayi, L Tsolekile, P Delobelle, T Puoane
The colliding epidemics of non-communicable diseases including diabetes with chronic infectious diseases in Sub-Saharan Africa requires contextualized innovative disease management strategies. This qualitative study conducted in a peri-urban township near Cape Town, South Africa aimed to identify and gain in-depth understanding of contextual and environmental issues pertinent to the patient that could influence Type 2-diabetes mellitus (T2DM) care and self-management. Participants included purposively sampled diabetics or pre-diabetics from the community, PURE study database, facility health club and health care providers...
January 5, 2018: Health Education Research
https://www.readbyqxmd.com/read/29314628/perceptions-of-hyperbaric-oxygen-therapy-among-podiatrists-practicing-in-high-risk-foot-clinics
#11
Frances R Henshaw, Lauren Brennan, Freya MacMillan
Foot ulceration is a devastating and costly consequence of diabetes. Hyperbaric oxygen therapy is recognised as an adjunctive therapy to treat diabetes-related foot ulceration, yet uptake is low. Semi-structured interviews were conducted with 16 podiatrists who manage patients with foot ulcers related to diabetes to explore their perceptions of, and the barriers/facilitators to, referral for hyperbaric oxygen. Podiatrists cited logistical issues such as location of facilities as well as poor communication pathways, lack of delegation and lack of follow up when patients presented for hyperbaric treatment...
January 3, 2018: International Wound Journal
https://www.readbyqxmd.com/read/29314332/portuguese-oncologists-practices-regarding-female-fertility-preservation-which-barriers-most-relate-to-these-practices
#12
Cláudia Melo, Ana Fonseca, Cristina Silva, Teresa Almeida-Santos, Maria Cristina Canavarro
This study aims to investigate the current practice patterns of Portuguese oncologists with different clinical specialties regarding female fertility preservation (FP) and to determine the relative endorsement of different barriers to these practices. A total of 111 doctors with different clinical specialties assisting female cancer patients of childbearing age at Portuguese clinical institutions completed a self-report questionnaire to assess their current practice patterns regarding female FP and their perceptions of the barriers to these practices...
January 4, 2018: European Journal of Cancer Care
https://www.readbyqxmd.com/read/29314264/a-practical-guide-for-the-care-of-patients-with-end-stage-renal-disease-near-the-end-of-life
#13
Amar D Bansal, Jane O Schell
Most patients who rely on dialysis for treatment of end-stage renal disease (ESRD) never receive a kidney transplant. Therefore, it is important for nephrology providers to feel comfortable discussing the role of dialysis near the end of life (EOL). Advance care planning (ACP) is an ongoing process of learning patient values and goals in an effort to outline preferences for current and future care. This review presents a framework for how to incorporate ACP in the care of dialysis patients throughout the kidney disease course and at the EOL...
January 3, 2018: Seminars in Dialysis
https://www.readbyqxmd.com/read/29313293/management-of-care-transition-and-hospital-discharge
#14
Amedeo Zurlo, Giovanni Zuliani
Current demographic and epidemiological trends highlight a growing task in surgical departments by elderly patients, characterized by high prevalence of comorbidity, complexity, and functional disability. Of consequence, discharge of an elderly patient must be considered in a new cultural perspective and should be imagined as a well-structured process starting from admission to surgical department and finishing with the patient discharge in a setting able to support her/him in the best possible way. The lack of a suitable discharge planning and of a proper transition program in the elderly subjects increases the risk of quick re-admission and may negatively affect the functional and the status quality of life of patients and caregivers...
January 8, 2018: Aging Clinical and Experimental Research
https://www.readbyqxmd.com/read/29307094/diet-and-exercise-changes-following-bone-densitometry-in-the-patient-activation-after-dxa-result-notification-paadrn-study
#15
Douglas W Roblin, Peter Cram, Yiyue Lou, Stephanie W Edmonds, Sylvie F Hall, Michael P Jones, Kenneth G Saag, Nicole C Wright, Fredric D Wolinsky
Calcium and vitamin D intake and exercise are suboptimal among older adults. Following bone densitometry, a letter communicating individualized fracture risk accompanied by an educational brochure improved participants' lifestyle-but no more than existing communication strategies-over 52 weeks. Simple communication strategies are insufficient for achieving optimal levels of bone health behaviors. PURPOSE: The Patient Activation After DXA Result Notification (PAADRN) study was designed to evaluate whether a letter with individualized fracture risk and an educational brochure mailed to patients soon after their DXA might improve bone health behaviors (daily calcium intake, vitamin D supplementation, and weekly exercise sessions) compared to slower, less individualized communication characterizing usual care...
January 6, 2018: Archives of Osteoporosis
https://www.readbyqxmd.com/read/29306621/association-between-non-communicable-disease-multimorbidity-and-health-care-utilization-in-a-middle-income-country-population-based-study
#16
J Jankovic, M Mirkovic, A Jovic-Vranes, M Santric-Milicevic, Z Terzic-Supic
OBJECTIVE: The objective was to analyze possible inequalities by gender in the utilization of health services (general practitioner [GP] and hospital), among people with non-communicable diseases (NCDs) in the Republic of Serbia, with special reference to multimorbidity. In addition, we examined the prevalence patterns of NCDs by sociodemographic characteristics of the population. STUDY DESIGN: This study is a population-based, cross-sectional survey. METHODS: A secondary analysis from the 2013 Serbian National Health Survey included 13,765 adults aged ≥20 years...
January 4, 2018: Public Health
https://www.readbyqxmd.com/read/29306373/benefit-risk-communication-in-paediatric-imaging-what-do-referring-physicians-radiographers-and-radiologists-think-say-and-do
#17
J L Portelli, J P McNulty, P Bezzina, L Rainford
INTRODUCTION: To assess how referrers and practitioners disclose benefit-risk information about medical imaging examinations to paediatric patients and their parents/guardians; to gauge their confidence in doing so; and to seek their opinion about who is responsible for disclosing such information. METHODS: This study followed on from a previously published study, with a questionnaire distributed in staggered phases to 146 radiographers, 22 radiology practitioners, 55 emergency physicians and 43 paediatricians at a primary paediatric referral centre in Malta...
February 2018: Radiography
https://www.readbyqxmd.com/read/29304857/a-qualitative-exploration-of-the-discharge-process-and-factors-predisposing-to-readmissions-to-the-intensive-care-unit
#18
Uchenna R Ofoma, Yue Dong, Ognjen Gajic, Brian W Pickering
BACKGROUND: Quantitative studies have demonstrated several factors predictive of readmissions to intensive care. Clinical decision tools, derived from these factors have failed to reduce readmission rates. The purpose of this study was to qualitatively explore the experiences and perceptions of physicians and nurses to gain more insight into intensive care readmissions. METHODS: Semi-structured interviews of intensive care unit (ICU) and general medicine care providers explored work routines, understanding and perceptions of the discharge process, and readmissions to intensive care...
January 5, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29303921/blood-loss-management-in-spine-surgery
#19
Jesse E Bible, Muhammad Mirza, Mark A Knaub
Substantial blood loss during spine surgery can result in increased patient morbidity and mortality. Proper preoperative planning and communication with the patient, anesthesia team, and operating room staff can lessen perioperative blood loss. Advances in intraoperative antifibrinolytic agents and modified anesthesia techniques have shown promising results in safely reducing blood loss. The surgeon's attention to intraoperative hemostasis and the concurrent use of local hemostatic agents also can lessen intraoperative bleeding...
January 15, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/29302150/the-forgotten-plague-psychiatric-manifestations-of-ebola-zika-and-emerging-infectious-diseases
#20
REVIEW
Veronica Tucci, Nidal Moukaddam, Jonathan Meadows, Suhal Shah, Sagar C Galwankar, G Bobby Kapur
The media and public health generally focus on the biological and physical ramifications of epidemics. Mental health issues that coincide with emerging diseases and epidemics are rarely examined and sometimes, even eschewed due to cultural considerations. Psychiatric manifestations of various infectious diseases, especially with a focus on Ebola Virus disease (EVD) and Zika Virus, are discussed in this commentary to illustrate the continued need of care after the resolution of the actual illness. Various infectious diseases have associations with mental illness, such as an increased risk of obsessive-compulsive disorders and Tourette syndrome in children with Group B streptococcal infection...
October 2017: Journal of Global Infectious Diseases
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