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https://www.readbyqxmd.com/read/28522232/efficacy-of-new-measures-saving-time-in-acute-stroke-management-a-quantified-analysis
#1
Ana María Iglesias Mohedano, Andrés García Pastor, Fernando Díaz Otero, Pilar Vázquez Alen, Marta Vales Montero, Elisa Luque Buzo, Nuria Redondo Ráfales, Beatriz Chavarria Cano, Yolanda Fernández Bullido, Jose Antonio Villanueva Osorio, Antonio Gil Núñez
BACKGROUND: Time to treatment remains the most important factor in acute ischemic stroke prognosis. We quantified the effect of new interventions reducing in-hospital delays in acute stroke management and assessed its repercussion on door-to-imaging (DTI), imaging-to-needle (ITN), and door-to-needle (DTN) times. METHODS: Prospective registry of consecutive stroke patients who were candidates for reperfusion therapy attended in a tertiary care hospital from February 1 to December 31, 2014...
May 15, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28521838/does-the-use-of-the-informed-healthcare-choices-ihc-primary-school-resources-improve-the-ability-of-grade-5-children-in-uganda-to-assess-the-trustworthiness-of-claims-about-the-effects-of-treatments-protocol-for-a-cluster-randomised-trial
#2
Allen Nsangi, Daniel Semakula, Andrew D Oxman, Matthew Oxman, Sarah Rosenbaum, Astrid Austvoll-Dahlgren, Laetitia Nyirazinyoye, Margaret Kaseje, Iain Chalmers, Atle Fretheim, Nelson K Sewankambo
BACKGROUND: The ability to appraise claims about the benefits and harms of treatments is crucial for informed health care decision-making. This research aims to enable children in East African primary schools (the clusters) to acquire and retain skills that can help them make informed health care choices by improving their ability to obtain, process and understand health information. The trial will evaluate (at the individual participant level) whether specially designed learning resources can teach children some of the key concepts relevant to appraising claims about the benefits and harms of health care interventions (treatments)...
May 18, 2017: Trials
https://www.readbyqxmd.com/read/28521751/an-integrated-intervention-to-reduce-intimate-partner-violence-and-psychological-distress-with-refugees-in-low-resource-settings-study-protocol-for-the-nguvu-cluster-randomized-trial
#3
Wietse A Tol, M Claire Greene, Samuel Likindikoki, Lusia Misinzo, Peter Ventevogel, Ann G Bonz, Judith K Bass, Jessie K K Mbwambo
BACKGROUND: Intimate partner violence (IPV) is a critical public health and human rights concern globally, including for refugee women in low-resource settings. Little is known about effective interventions for this population. IPV and psychological distress have a bi-directional relationship, indicating the potential benefit of a structured psychological component as part of efforts to reduce IPV for women currently in violent relationships. METHODS: This protocol describes a cluster randomized controlled trial aimed at evaluating an 8-session integrated psychological and advocacy intervention (Nguvu) with female adult survivors of past-year IPV displaying moderate to severe psychological distress...
May 18, 2017: BMC Psychiatry
https://www.readbyqxmd.com/read/28518095/use-of-a-central-venous-line-for-fluids-drugs-and-nutrient-administration-in-a-mouse-model-of-critical-illness
#4
Sarah Derde, Steven Thiessen, Chloë Goossens, Thomas Dufour, Greet Van den Berghe, Lies Langouche
This protocol describes a centrally catheterized mouse model of prolonged critical illness. We combine the cecal ligation and puncture method to induce sepsis with the use of a central venous line for fluids, drugs and nutrient administration to mimic the human clinical setting. Critically ill patients require intensive medical support in order to survive. While the majority of patients will recover within a few days, about a quarter of the patients need prolonged intensive care and are at high risk of dying from non-resolving multiple organ failure...
May 2, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/28515947/the-impact-of-body-armor-on-physical-performance-of-law-enforcement-personnel-a-systematic-review
#5
Colin Tomes, Robin Marc Orr, Rodney Pope
BACKGROUND: The law enforcement officer profession requires performance of arduous occupational tasks while carrying an external load, consisting of, at minimum, a chest rig, a communication system, weaponry, handcuffs, personal protective equipment and a torch. The aim of this systematic review of the literature was to identify and critically appraise the methodological quality of published studies that have investigated the impacts of body armour on task performance and to synthesize and report key findings from these studies to inform law enforcement organizations...
2017: Annals of Occupational and Environmental Medicine
https://www.readbyqxmd.com/read/28513820/intra-abdominal-hypertension-and-abdominal-compartment-syndrome-in-acute-pancreatitis-hepato-pancreato-biliary-operations-and-liver-transplantation
#6
Alexsander K Bressan, Chad G Ball
Intra-abdominal hypertension, even preceding the onset of abdominal compartment syndrome, is still recognized as an adverse prognostic factor. Unfortunately, most of the current supporting evidence within the critical care environment remains observational in nature. In acute pancreatitis, an active role for intra-abdominal hypertension early in the disease process follows a strong intuitive basis, and it is corroborated by preliminary evidence from animal models. Additional studies are needed to better characterize the optimal fluid resuscitation strategy, as well as the importance of intra-abdominal hypertension as an early therapeutic target...
May 17, 2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/28512551/consensus-statements-and-clinical-recommendations-on-treatment-indications-surgical-procedures-prosthetic-protocols-and-complications-following-all-on-4-standard-treatment-9th-mozo-grau-ticare-conference-in-quintanilla-spain
#7
REVIEW
Miguel Penarrocha-Diago, María Penarrocha-Diago, Regino Zaragozí-Alonso, David Soto-Penaloza, Meeting On Behalf Of The Ticare Consensus
OBJECTIVES: The present consensus report critically evaluates the scientific evidence based on a comprehensive systematic review of the All-On-4 treatment concept, focusing primarily on the treatment indications, surgical procedures and prosthetic protocols, and secondarily on the mechanical and biological complications involved. MATERIAL AND METHODS: A systematic review was made in advance of the meeting. Consensus statements, treatment guidelines and recommendations for future research were based on within-group as well as plenary debates and discussions of the systematic review...
May 2017: Journal of Clinical and Experimental Dentistry
https://www.readbyqxmd.com/read/28511720/identifying-models-of-delivery-care-domains-and-quality-indicators-relevant-to-palliative-day-services-a-scoping-review-protocol
#8
Seán R O'Connor, Martin Dempster, Noleen K McCorry
BACKGROUND: With an ageing population and increasing numbers of people with life-limiting illness, there is a growing demand for palliative day services. There is a need to measure and demonstrate the quality of these services, but there is currently little agreement on which aspects of care should be used to do this. The aim of the scoping review will be to map the extent, range and nature of the evidence around models of delivery, care domains and existing quality indicators used to evaluate palliative day services...
May 16, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/28506711/screening-for-sepsis-in-general-hospitalised-patients-a-systematic-review
#9
REVIEW
Laura Alberto, Andrea P Marshall, Rachel Walker, Leanne M Aitken
INTRODUCTION: Sepsis is a common condition observed outside critical care areas. The purpose of this review was to examine the application of sepsis screening tools for early recognition of sepsis in general hospitalised patients to: (i) identify the accuracy of these tools; (ii) determine the outcomes associated with their implementation and; (iii) describe the implementation process. METHOD: A systematic review method was used. PubMed, CINAHL, COCHRANE, SCOPUS, Web of Science and EMBASE databases were systematically searched for primary articles, published from January 1990 to June 2016, that investigated screening tools or alert mechanisms for early identification of sepsis in adult general hospitalized patients...
May 12, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28506702/cognitive-and-adaptive-measurement-endpoints-for-clinical-trials-in-mucopolysaccharidoses-types-i-ii-and-iii-a-review-of-the-literature
#10
REVIEW
Darren Janzen, Kathleen A Delaney, Elsa G Shapiro
Sensitive, reliable measurement instruments are critical for the evaluation of disease progression and new treatments that affect the brain in the mucopolysaccharidoses (MPS). MPS I, II, and III have early onset clinical phenotypes that affect the brain during development and result in devastating cognitive decline and ultimately death without treatment. Comparisons of outcomes are hindered by diverse protocols and approaches to assessment including applicability to international trials necessary in rare diseases...
May 8, 2017: Molecular Genetics and Metabolism
https://www.readbyqxmd.com/read/28499679/aeromedical-ultrasound-the-evaluation-of-point-of-care-ultrasound-during-helicopter-transport
#11
Jeffrey G Yates, Denise Baylous
INTRODUCTION: This study correlated the eFAST findings performed in-flight by the flight crew with the findings obtained by the trauma team upon initial evaluation at a level 1 trauma center and with the subsequent CT scans that were performed or the surgeon's operative note. We hypothesize that aeromedical eFAST examinations are highly correlated with the trauma teams findings. METHODS: This prospective, observational study evaluated 190 traumatically injured patients from June 2014 to December 2015 in Southeast Virginia and Northeast North Carolina...
May 2017: Air Medical Journal
https://www.readbyqxmd.com/read/28497934/cerebral-autoregulation-monitoring-in-acute-traumatic-brain-injury-what-s-the-evidence
#12
Leanne A Calviello, Joseph Donnelly, Frederick A Zeiler, Eric P Thelin, Peter Smielewski, Marek Czosnyka
Cerebral autoregulation is conceptualized as a vascular self-regulatory mechanism within the brain. Controlled by elusive relationships between various biophysical processes, it functions to protect the brain against potential damages caused by sudden changes in cerebral perfusion pressures and flow. Following events such as traumatic brain injuries (TBI), autoregulation may be compromised, potentially leading to an unfavorable outcome. In spite of its complexity, autoregulation has been able to be quantified non-invasively within the neuro-critical care setting with the aid of transcranial Doppler...
May 12, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28495320/comparison-of-2-intravenous-insulin-protocols-glycemia-variability-in-critically-ill-patients
#13
Marta Gómez-Garrido, Ana M Rodilla-Fiz, María Girón-Lacasa, Laura Rodríguez-Rubio, Anselmo Martínez-Blázquez, Fernando Martínez-López, María Dolores Pardo-Ibáñez, Juan M Núñez-Marín
OBJECTIVE: Glycemic variability is an independent predictor of mortality in critically ill patients. The objective of this study was to compare two intravenous insulin protocols in critically ill patients regarding the glycemic variability. MATERIAL AND METHODS: This was a retrospective observational study performed by reviewing clinical records of patients from a Critical Care Unit for 4 consecutive months. First, a simpler Scale-Based Intravenous Insulin Protocol (SBIIP) was reviewed and later it was compared for the same months of the following year with a Sliding Scale-Based Intravenous Insulin Protocol (SSBIIP)...
May 2017: Endocrinol Diabetes Nutr
https://www.readbyqxmd.com/read/28487455/experience-of-living-with-cancer-and-comorbid-illness-protocol-for-a-qualitative-systematic-review
#14
Debbie Cavers, Sarah Cunningham-Burley, Eila Watson, Elspeth Banks, Christine Campbell
INTRODUCTION: There are an increasing number of people living with and beyond cancer, whose experience is further complicated by additional long-term health conditions in the context of an ageing population. The supportive care needs of this growing patient group should be recognised and addressed. There is a need to explore the experience of living with cancer and comorbid illness in order to develop optimal models of patient-centred care. This protocol describes a systematic review that aims to identify the qualitative evidence relating to the experience of cancer and comorbid illness for patients, informal carers and professionals, and to highlight areas where more research is needed...
May 9, 2017: BMJ Open
https://www.readbyqxmd.com/read/28487264/optimizing-protein-intake-and-nitrogen-balance-opinib-in-adult-critically-ill-patients-a-study-protocol-for-a-randomized-controlled-trial
#15
Matteo Danielis, Giulia Lorenzoni, Laura Cavaliere, Mariangela Ruffolo, Luca Peressoni, Amato De Monte, Rodolfo Muzzi, Fabio Beltrame, Dario Gregori
BACKGROUND: Adequate nutrition of critically ill patients plays a key role in the modulation of metabolic response to stress. OBJECTIVE: This paper presents the development of a protocol for a randomized controlled trial (RCT) aimed at comparing clinical outcomes of patients in the intensive care unit (ICU) administered with standard and protein-fortified diet. Together with the RCT study protocol, the results of the observational analysis conducted to assess the feasibility of the RCT are presented...
May 9, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28478999/integration-of-tactical-ems-in-the-national-park-service
#16
REVIEW
William Will R Smith
The National Park Service (NPS) has domestic responsibility for emergency medical services (EMS) in remote and sometimes tactical situations in 417 units covering over 34 million hectares (84 million acres). The crossover between conflicting patient care priorities and complex medical decision making in the tactical, technical, and wilderness/remote environments often has many similarities. Patient care in these diverse locations, when compared with military settings, has slightly different variables but often similar corresponding risks to the patients and providers...
May 4, 2017: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/28476098/developing-quality-indicators-for-the-care-of-patients-with-musculoskeletal-injuries-in-the-emergency-department-study-protocol
#17
Kirsten Strudwick, Anthony Bell, Trevor Russell, Melinda Martin-Khan
BACKGROUND: Musculoskeletal injuries are a common presentation to the Emergency Department (ED). The quality of care provided is important to the patients, clinicians, organisations and purchasers of care. In the context of the increasing burden of musculoskeletal disease, quality of care needs to occur despite financial impacts, variations in care, and pressure to reach time-based performance measures. This study aims to develop a suite of evidence-based quality indicators (QI) which will provide a measure of the quality of care for patients with musculoskeletal injuries in the ED...
May 5, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/28475585/acinetobacter-baumannii-strains-isolated-from-patients-in-intensive-care-units-in-goi%C3%A3-nia-brazil-molecular-and-drug-susceptibility-profiles
#18
Suellen Rocha Araújo Castilho, Cássia Silva de Miranda Godoy, Adriana Oliveira Guilarde, Juliana Lamaro Cardoso, Maria Cláudia Porfirio André, Ana Paula Junqueira-Kipnis, André Kipnis
Resistance to antimicrobial agents is increasing worldwide and imposes significant life-threatening risks to several different populations, especially those in intensive care units (ICUs). Bacteria can quickly develop or acquire resistance to antimicrobial drugs, and combined with their intrinsic potential to cause disease in humans, these bacteria can become deadly. Among Gram-negative bacteria, Acinetobacter baumannii is notorious as a frequent opportunistic pathogen associated with critically ill patients, and understanding the genetic basis of A...
2017: PloS One
https://www.readbyqxmd.com/read/28468619/economic-and-quality-of-care-evaluation-of-dialysis-service-models-in-remote-australia-protocol-for-a-mixed-methods-study
#19
Gillian Gorham, Kirsten Howard, Samantha Togni, Paul Lawton, Jaquelyne Hughes, Sandawana William Majoni, Sarah Brown, Sue Barnes, Alan Cass
BACKGROUND: Australia's Northern Territory (NT) has the country's highest incidence and prevalence of kidney disease. Indigenous people from remote areas suffer the heaviest disease burden. Concerns regarding cost and sustainability limit the provision of dialysis treatments in remote areas and most Indigenous people requiring dialysis relocate to urban areas. However, this dislocation of people from their family, community and support networks may prove more costly when the broader health, societal and economic consequences for the individual, family and whole of government are considered...
May 3, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28464935/provision-of-peer-specialist-services-in-va-patient-aligned-care-teams-protocol-for-testing-a-cluster-randomized-implementation-trial
#20
Matthew Chinman, Karin Daniels, Jeff Smith, Sharon McCarthy, Deborah Medoff, Amanda Peeples, Richard Goldberg
BACKGROUND: Over 1100 Veterans work in the Veterans Health Administration (VHA) as peer specialists (PSs). PSs are Veterans with formal training who provide support to other Veterans with similar diagnoses, primarily in mental health settings. A White House Executive Action mandated the pilot reassignment of VHA PSs from mental health to 25 primary care Patient Aligned Care Teams (PACT) in order to broaden the provision of wellness services that can address many chronic illnesses. An evaluation of this initiative was undertaken to assess the impact of outside assistance on the deployment of PS in PACT, as implementation support is often needed to prevent challenges commonly experienced when first deploying PSs in VHA settings...
May 2, 2017: Implementation Science: IS
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