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https://www.readbyqxmd.com/read/28538650/consequences-of-pediatric-undertriage-and-overtriage-in-a-statewide-trauma-system
#1
Hilary A Hewes, Mathew Christensen, Peter P Taillac, N Clay Mann, Kammy K Jacobsen, Stephen J Fenton
BACKGROUND: With increasing attention to the quality of health care delivery, evaluating trauma triage decisions in a large system of emergency care can help decision makers reduce mortality, morbidity, unnecessary transfers, and healthcare costs. OBJECTIVES: To quantify the magnitude of pediatric traumatic injury undertriage (hospital mortality risk) and overtriage (early trauma center discharge after transfer) in a statewide trauma system. METHODS: A statewide population-based evaluation of pediatric trauma outcomes and secondary triage (interfacility transfers) patterns from 2001-2013 among 45 hospitals in Utah's statewide trauma system...
May 22, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28532508/is-it-possible-for-knowledge-based-planning-to-improve-intensity-modulated-radiation-therapy-plan-quality-for-planners-with-different-planning-experiences-in-left-sided-breast-cancer-patients
#2
Juanqi Wang, Weigang Hu, Zhaozhi Yang, Xiaohui Chen, Zhiqiang Wu, Xiaoli Yu, Xiaomao Guo, Saiquan Lu, Kaixuan Li, Gongyi Yu
BACKGROUND: Knowledge-based planning (KBP) is a promising technique that can improve plan quality and increase planning efficiency. However, no attempts have been made to extend the domain of KBP for planners with different planning experiences so far. The purpose of this study was to quantify the potential gains for planners with different planning experiences after implementing KBP in intensity modulated radiation therapy (IMRT) plans for left-sided breast cancer patients. METHODS: The model libraries were populated with 80 expert clinical plans from treated patients who previously received left-sided breast-conserving surgery and IMRT with simultaneously integrated boost...
May 22, 2017: Radiation Oncology
https://www.readbyqxmd.com/read/28531553/hiv-1-viral-load-measurement-in-venous-blood-and-fingerprick-blood-using-abbott-realtime-hiv-1-dbs-assay
#3
Ning Tang, Vihanga Pahalawatta, Andrea Frank, Zowie Bagley, Raquel Viana, John Lampinen, Gregor Leckie, Shihai Huang, Klara Abravaya, Carole L Wallis
BACKGROUND: HIV RNA suppression is a key indicator for monitoring success of antiretroviral therapy. From a logistical perspective, viral load (VL) testing using Dried Blood Spots (DBS) is a promising alternative to plasma based VL testing in resource-limited settings. OBJECTIVES: To evaluate the analytical and clinical performance of the Abbott RealTime HIV-1 assay using a fully automated one-spot DBS sample protocol. STUDY DESIGN: Limit of detection (LOD), linearity, lower limit of quantitation (LLQ), upper limit of quantitation (ULQ), and precision were determined using serial dilutions of HIV-1 Virology Quality Assurance stock (VQA Rush University), or HIV-1-containing armored RNA, made in venous blood...
May 13, 2017: Journal of Clinical Virology: the Official Publication of the Pan American Society for Clinical Virology
https://www.readbyqxmd.com/read/28526633/facial-skin-rejuvenation-by-autologous-dermal-microfat-transfer-in-photoaged-patients-clinical-evaluation-and-skin-surface-digital-profilometry-analysis
#4
Angelo Trivisonno, Alfredo Rossi, Massimo Monti, Donato Di Nunno, Christophe Desouches, Claudio Cannistra, Gabriele Toietta
Cumulative long-term exposure to solar ultraviolet radiation promotes premature skin aging characterized by wrinkle formation and reduced skin elasticity. In this study, we assessed whether microfat transfer could improve dermal and subcutaneous tissue thickness loss associated with photoaging. Twenty-one patients affected by facial photoaging (photodamage grade II-IV; age range 35-62 years; 19 females, 2 males; all of Caucasian origin) were treated using minimally invasive autologous dermal white fat transfer harvested with a recently designed microcannula...
April 22, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28525596/antiretroviral-therapy-containing-hiv-protease-inhibitors-enhances-fracture-risk-by-impairing-osteoblast-differentiation-and-bone-quality
#5
Hiroyuki Hirakawa, Hiroyuki Gatanaga, Hiroki Ochi, Toru Fukuda, Satoko Sunamura, Shinichi Oka, Shu Takeda, Shingo Sato
Long-term ART is associated with increased fracture risk, but the mechanism remains elusive. We measured serum undercarboxylated osteocalcin and pentosidine (markers of poor bone quality) in HIV-infected patients treated with protease inhibitors (PIs) or an integrase strand transfer inhibitor (INSTI)-containing regimens. The results demonstrated significantly higher undercarboxylated osteocalcin and pentosidine in PIs-treated patients. Switching to INSTI resulted in significant decrease in these markers. We also showed impaired bone mechanical properties with higher undercarboxylated osteocalcin level in PIs-treated mice and inhibited osteoblast differentiation in PIs-treated osteogenic cells...
May 19, 2017: Journal of Infectious Diseases
https://www.readbyqxmd.com/read/28524382/an-observational-study-of-patient-care-outcomes-sensitive-to-handover-quality-in-the-post-anaesthetic-care-unit
#6
Nichole Lillibridge, Mari Botti, Beverley Wood, Bernice Redley
AIMS AND OBJECTIVES: To identify patient care outcome indicators sensitive to the quality of interprofessional handover between the anaesthetist and the Post-Anaesthetic Care Unit nurse. BACKGROUND: The relationship between interprofessional clinical handover when patients are transferred from the operating theatre to the Post-Anaesthetic Care Unit and patient outcomes of subsequent patient care delivery is not well understood. DESIGN: Naturalistic, exploratory descriptive design using observation...
May 19, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28523364/-structured-patient-handovers-in-perioperative-medicine-rationale-and-implementation-in-clinical-practice
#7
M J Merkel, V von Dossow, B Zwißler
Clear and consistent communication is pivotal for well-functioning teamwork, in operating theatres as well as intensive care units. However, patient handovers significantly vary between specialties and locations. If communication is not well structured, it might increase the risk for mishaps and malpractice. Therefore, implementing structured handover protocols is pivotal. The perioperative setting is a high-risk environment that is prone to communication failures due to operational design (frequent change of shift due to working time restrictions) and a high work load and multitasking (operating room management, short surgery times, concurrent emergencies)...
May 18, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28520729/top-quality-blastocyst-formation-rates-in-relation-to-progesterone-levels-on-the-day-of-oocyte-maturation-in-gnrh-antagonist-ivf-icsi-cycles
#8
V S Vanni, E Somigliana, M Reschini, L Pagliardini, E Marotta, S Faulisi, A Paffoni, P Vigano', W Vegetti, M Candiani, E Papaleo
Cycles with progesterone elevation during controlled ovarian stimulation (COS) for IVF/ICSI are commonly managed with a "freeze-all" strategy, due to a well-recognized detrimental effect of high progesterone levels on endometrial receptivity. However, also a detrimental effect of elevated progesterone on day-3 embryo quality has recently been found with regards to top quality embryo formation rate. Because blastocyst culture and cryopreservation are largely adopted, we deemed relevant to determine whether this detrimental effect is also seen on blastocyst quality on day 5-6...
2017: PloS One
https://www.readbyqxmd.com/read/28511712/what-we-learned-from-extended-culture-of-rejected-day-3-cleavage-stage-embryos-a-prospective-cohort-study
#9
Anat Hershko Klement, Michal Ovadia, Amir Wiser, Arie Berkovitz, Tal Shavit, Luba Nemerovsky, Yehudith Ghetler, Ilan Cohen, Adrian Shulman
BACKGROUND: To test whether poor quality day-3 embryos can undergo successful blastulation and implantation. METHODS: A prospective cohort study was conducted. Whether or not a good quality embryo was transferred on day-3, poor quality (rejected) embryos were further cultured and followed. The clinical outcome of each embryo was assessed. RESULTS: A total of 694 rejected embryos (from 205 patients) were included, with a blastulation rate of 21...
May 16, 2017: Journal of Ovarian Research
https://www.readbyqxmd.com/read/28508791/rehabilitation-risk-management-enabling-data-analytics-with-quantified-self-and-smart-home-data
#10
Andreas Hamper, Isabella Eigner, Nilmini Wickramasinghe, Freimut Bodendorf
A variety of acute and chronic diseases require rehabilitation at home after treatment. Outpatient rehabilitation is crucial for the quality of the medical outcome but is mainly performed without medical supervision. Non-Compliance can lead to severe health risks and readmission to the hospital. While the patient is closely monitored in the hospital, methods and technologies to identify risks at home have to be developed. We analyze state-of-the-art monitoring systems and technologies and show possibilities to transfer these technologies into rehabilitation monitoring...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28507869/superficial-circumflex-iliac-artery-perforator-flap-for-dorsalis-pedis-reconstruction
#11
Kensuke Tashiro, Shuji Yamashita
Reconstruction of dorsalis pedis with soft tissue is challenging because it needs to preserve thin structure to ensure that the patient will be able to wear shoes. Here, we report the use of a thin superficial circumflex iliac artery perforator (SCIP) flap in dorsalis pedis reconstruction. A 67-year-old man presented with a third-degree burn, which exposed his extensor tendons. A thin SCIP flap from the left inguinal region measuring 15 × 4 cm was transferred to the dorsalis pedis region. Postoperatively, no major cosmetic or functional problems were observed...
April 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28500681/comparison-of-time-to-first-dose-of-oral-morphine-in-the-treatment-of-neonatal-abstinence-syndrome
#12
Sarah T Mitchell, Tracy J Costello, Kara M Nedderman
OBJECTIVE: To compare time to first dose of oral morphine used in the treatment of neonatal abstinence syndrome (NAS) in a neonatal intensive care unit (NICU) versus a special care nursery (SCN) setting. METHODS: A retrospective chart review was completed of patient data from two community hospitals in a single health network. Infants born at either facility between January 2013 and August 2015 were eligible for inclusion in the study if treated for NAS with a course of oral morphine...
May 13, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28499377/calculating-hospital-length-of-stay-using-the-hospital-episode-statistics-a-comparison-of-methodologies
#13
John Busby, Sarah Purdy, William Hollingworth
BACKGROUND: Accurate calculation of hospital length of stay (LOS) from the English Hospital Episode Statistics (HES) is important for a wide range of audit and research purposes. The two methodologies which are commonly used to achieve this differ in their accuracy and complexity. We compare these methods and make recommendations on when each is most appropriate. METHODS: We calculated LOS using continuous inpatient spells (CIPS), which link care spanning across multiple hospitals, and spells, which do not, for six conditions with short (dyspepsia or other stomach function, ENT infection), medium (dehydration and gastroenteritis, perforated or bleeding ulcer), and long (stroke, fractured proximal femur) average LOS...
May 12, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28494624/an-overview-of-the-performance-improvement-initiatives-by-the-ministry-of-health-in-the-kingdom-of-saudi-arabia
#14
Mazen Hassanain
Saudi Arabia's Ministry of Health (MOH) use corporate performance improvement methodologies to develop and implement performance improvement initiatives designed to continue building on the Ministry's vision of transforming hospital operations and instituting a culture of quality and performance focused on the "patient first" principle. We evaluated the feasibility of setting up a performance improvement unit (PIU) within the MOH to apply the principles of Lean Six Sigma and to change management methodologies...
January 1, 2017: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/28488303/a-systematic-review-of-the-effectiveness-of-flipped-classrooms-in-medical-education
#15
REVIEW
Fei Chen, Angela M Lui, Susan M Martinelli
CONTEXT: There are inconsistent claims made about the effectiveness of the flipped classroom (FC) in medical education; however, the quality of the empirical evidence used to back up these claims is not evident. The aims of this review are to examine the scope and quality of studies on the FC teaching approach in medical education and to assess the effects of FCs on medical learning. METHODS: A literature search was conducted using the major electronic databases in 2016...
June 2017: Medical Education
https://www.readbyqxmd.com/read/28486977/rapid-cartesian-versus-radial-acquisition-comparison-of-two-sequences-for-hepatobiliary-phase-mri-at-3-tesla-in-patients-with-impaired-breath-hold-capabilities
#16
Johannes Budjan, Philipp Riffel, Melissa M Ong, Stefan O Schoenberg, Ulrike I Attenberger, Daniel Hausmann
BACKGROUND: Hepatocyte-specific gadolinium based contrast agents (HSCA) provide substantial information for the classification of liver lesions in magnetic resonance imaging (MRI). However, breathing artifacts which reduce image quality and diagnostic confidence of hepatobiliary phase acquisitions are regularly observed in clinical routine. The aim of this study was to evaluate two approaches to reduce breathing artifacts for hepatobiliary phase imaging. METHODS: Twenty minutes after administration of a HSCA (gadoxetic acid), a T1-weighted VIBE sequence with radial k-space sampling (radialVIBE, 180 s acquisition time in free breathing) and a highly accelerated Cartesian VIBE with Dixon fat separation (CD-VIBE, CAIPIRINHA acceleration with r = 2 × 2, breath-hold 8-10 s) were acquired in 35 patients (12 female, 57 ± 13 years), who showed breath-holding difficulties in early phases of the examinations...
May 9, 2017: BMC Medical Imaging
https://www.readbyqxmd.com/read/28485490/label-free-relative-quantification-of-secreted-proteins-as-a-non-invasive-method-for-the-quality-control-of-chondrogenesis-in-bioengineered-substitutes-for-cartilage-repair
#17
Christel Henrionnet, Pierre Gillet, Didier Mainard, Jean-Baptiste Vincourt, Astrid Pinzano
Cartilage tissue engineering is making progress but the competing available strategies still leave room for improvement and consensual overviews regarding the best combinations of scaffolds and cell sources are limited by the capacity to compare them directly. In addition, because most strategies involve autologous cell transfer, once these will be optimized, the resulting implants require individual quality control prior to grafting in order to emphasize patient-to-patient differential responsiveness to engineering processes...
May 9, 2017: Journal of Tissue Engineering and Regenerative Medicine
https://www.readbyqxmd.com/read/28484919/medical-image-tamper-detection-based-on-passive-image-authentication
#18
Guzin Ulutas, Arda Ustubioglu, Beste Ustubioglu, Vasif V Nabiyev, Mustafa Ulutas
Telemedicine has gained popularity in recent years. Medical images can be transferred over the Internet to enable the telediagnosis between medical staffs and to make the patient's history accessible to medical staff from anywhere. Therefore, integrity protection of the medical image is a serious concern due to the broadcast nature of the Internet. Some watermarking techniques are proposed to control the integrity of medical images. However, they require embedding of extra information (watermark) into image before transmission...
May 8, 2017: Journal of Digital Imaging: the Official Journal of the Society for Computer Applications in Radiology
https://www.readbyqxmd.com/read/28483037/effect-of-the-4-h-target-on-time-to-ecg
#19
James A Hughes, C J Cabilan, Caitlin Young, Andrew Staib
Objectives The aim of this study was to assess the relationship between compliance with time-based Emergency Department (ED) targets (known as NEAT) and the time taken to collect an electrocardiogram (TTE) in patients presenting with chest pain.Methods This was a pilot descriptive retrospective cohort study completed in a large inner city tertiary ED. Patients who presented with active or recent chest pain between July 2014 and June 2015 were eligible for inclusion. Pregnant patients, inter-hospital transfers, and traumatic chest pain were excluded...
May 9, 2017: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/28482767/the-impact-of-leadership-coaching-in-an-australian-healthcare-setting
#20
Anthony M Grant, Ingrid Studholme, Raj Verma, Lea Kirkwood, Bronwyn Paton, Sean O'Connor
Purpose There is limited empirical literature on the effectiveness of leadership coaching in healthcare settings. The purpose of this paper is to explore the efficacy of leadership coaching for individuals implementing strategic change in the Australian public health system. Design/methodology/approach Using a within-subjects (pre-post) design, participants ( n=31) undertook six one-hour coaching sessions. Coaching was conducted by professional leadership coaches. Both quantitative and qualitative data were collected...
April 10, 2017: Journal of Health Organization and Management
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