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https://www.readbyqxmd.com/read/29342089/chitosan-gel-to-treat-pressure-ulcers-a-clinical-pilot-study
#1
Virginia Campani, Eliana Pagnozzi, Ilaria Mataro, Laura Mayol, Alessandra Perna, Floriana D'Urso, Antonietta Carillo, Maria Cammarota, Maria Chiara Maiuri, Giuseppe De Rosa
Chitosan is biopolymer with promising properties in wound healing. Chronic wounds represent a significant burden to both the patient and the medical system. Among chronic wounds, pressure ulcers are one of the most common types of complex wound. The efficacy and the tolerability of chitosan gel formulation, prepared into the hospital pharmacy, in the treatment of pressure ulcers of moderate severity were evaluated. The endpoint of this phase II study was the reduction of the area of the lesion by at least 20% after four weeks of treatment...
January 17, 2018: Pharmaceutics
https://www.readbyqxmd.com/read/29342059/patients-living-alone-can-be-safely-discharged-directly-home-after-total-joint-arthroplasty-a-prospective-cohort-study
#2
Andrew N Fleischman, Matthew S Austin, James J Purtill, Javad Parvizi, William J Hozack
BACKGROUND: Despite the expense and potential hazards of inpatient rehabilitation, there is a prevailing belief that patients living alone cannot be safely discharged directly home after total joint arthroplasty. The purpose of this study was to assess the safety and efficacy of direct home discharge for patients living alone during convalescence after primary total joint arthroplasty. METHODS: We prospectively studied 910 consecutive patients undergoing primary, unilateral total hip arthroplasty or total knee arthroplasty over an 8-month period...
January 17, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29342019/hot-spotting-as-a-strategy-to-identify-high-cost-surgical-populations
#3
Sarah P Shubeck, Jyothi R Thumma, Justin B Dimick, Hari Nathan
OBJECTIVE: The aim of this study was to determine the feasibility of "hot spotting" in elective surgical populations. BACKGROUND: Prospective identification of high-cost patients, known as "hot spotting," is well developed in medical populations, but has not been performed in surgical populations. Population-based management of surgical expenditures requires identification of high-cost surgical patients to allow for effective implementation of cost-saving strategies...
January 16, 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29341844/empiric-antibiotics-for-sepsis
#4
Sara A Buckman, Isaiah R Turnbull, John E Mazuski
BACKGROUND: Sepsis is life-threatening organ dysfunction caused by a dysregulated host response to infection. Early recognition and treatment are the cornerstones of management. METHODS: Review of the English-language literature. RESULTS: For both sepsis and septic shock "antimicrobials [should be] be initiated as soon as possible and within one hour" (Surviving Sepsis Campaign). The risk of progression from severe sepsis to septic shock increases 8% for each hour before antibiotics are started...
January 17, 2018: Surgical Infections
https://www.readbyqxmd.com/read/29341529/-when-the-ward-overflows%C3%A2-the-impact-of-outlying-beds-on-patient-care
#5
Valérie Mosimann, Olivier Lamy, Julien Castioni
Due to the chronic lack of beds in hospitals, patients are often hospitalized in other departments (outlier patients), with a responsible physician working in another department. This causes increased thromboembolics risks, nosocomial infections, falls and delirium in the elderly, morbidity and mortality. Outlier patients, compared to standard patients, stay longer in the emergency department and their discharge documents are available later. Outlying is used daily in the CHUV hospital and new strategies are elaborated to manage patient flow, especially during the flu epidemic...
January 17, 2018: Revue Médicale Suisse
https://www.readbyqxmd.com/read/29341514/opportunity-costs-in-paediatric-training-the-specialist-registrars-experience
#6
M B O'Neill, T Nabialek, N Kandamany
In the training process, there is a tension between the work life and home life of trainees. This study explored both the personal impact and the opportunity costs of training from the Specialist Paediatric Registrar (SPR) perspective. The survey explored 1) career progression, 2) perceived functional effectiveness at work, 3) psychological impact of hospital based training, and 4) the personal and social cost of training. Fifty-three (71%) SPRs responded of whom 47 (89%)were married or in long term relationships...
August 8, 2017: Irish Medical Journal
https://www.readbyqxmd.com/read/29341131/a-retrospective-study-of-feline-trauma-patients-admitted-to-a-referral-centre
#7
T Hernon, M Gurney, S Gibson
OBJECTIVE: To identify prognostic information and provide recommendations for management of feline trauma patients. METHODS: Retrospective analysis of case records for 185 cats presented as emergency trauma cases to a referral hospital between February 2009 and December 2013. Each case was assigned a severity score from 1 (very minor injuries) to 6 (moribund, dying). The data were analysed using Mann-Whitney U and Spearman's rank correlation tests. Logistic regression was used to calculate odds ratios...
January 17, 2018: Journal of Small Animal Practice
https://www.readbyqxmd.com/read/29341032/-epidemiology-diagnosis-and-treatment-of-adult-patients-with-nosocomial-pneumonia-update-2017-s3-guideline-of-the-german-society-for-anaesthesiology-and-intensive-care-medicine-the-german-society-for-infectious-diseases-the-german-society-for-hygiene-and-microbiology
#8
K Dalhoff, M Abele-Horn, S Andreas, M Deja, S Ewig, P Gastmeier, S Gatermann, H Gerlach, B Grabein, C P Heußel, G Höffken, M Kolditz, E Kramme, H Kühl, C Lange, K Mayer, I Nachtigall, M Panning, M Pletz, P-M Rath, G Rohde, S Rosseau, B Schaaf, D Schreiter, H Schütte, H Seifert, C Spies, T Welte
Nosocomial pneumonia (HAP) is a frequent complication of hospital care. Most data are available on ventilator-associated pneumonia. However, infections on general wards are increasing. A central issue are infections with multidrug resistant (MDR) pathogens which are difficult to treat in the empirical setting potentially leading to inappropriate use of antimicrobial therapy.This guideline update was compiled by an interdisciplinary group on the basis of a systematic literature review. Recommendations are made according to GRADE giving guidance for the diagnosis and treatment of HAP on the basis of quality of evidence and benefit/risk ratio...
January 2018: Pneumologie
https://www.readbyqxmd.com/read/29340855/the-relationship-between-target-joints-and-direct-resource-use-in-severe-haemophilia
#9
Jamie O'Hara, Shaun Walsh, Charlotte Camp, Giuseppe Mazza, Liz Carroll, Christina Hoxer, Lars Wilkinson
OBJECTIVES: Target joints are a common complication of severe haemophilia. While factor replacement therapy constitutes the majority of costs in haemophilia, the relationship between target joints and non drug-related direct costs (NDDCs) has not been studied. METHODS: Data on haemophilia patients without inhibitors was drawn from the 'Cost of Haemophilia across Europe - a Socioeconomic Survey' (CHESS) study, a cost assessment in severe haemophilia A and B across five European countries (France, Germany, Italy, Spain, and the United Kingdom) in which 139 haemophilia specialists provided demographic and clinical information for 1285 adult patients...
January 16, 2018: Health Economics Review
https://www.readbyqxmd.com/read/29340826/single-port-laparoscopic-surgery-in-uncomplicated-acute-appendicitis-a-randomized-controlled-trial
#10
Byung Mo Kang, Sung Il Choi, Bum-Soo Kim, Suk-Hwan Lee
BACKGROUND: Single-port laparoscopic surgery (SPLS) is an alternative, minimally invasive surgical approach for managing appendicitis. The aim of this randomized trial was to evaluate the safety and efficacy of SPLS in uncomplicated appendicitis. METHODS: Between December 2009 and November 2010, 194 patients with radiologically diagnosed acute appendicitis were randomly allocated to undergo either SPLS or multiport laparoscopic surgery (MPLS). Patients with intraoperative findings of perforated appendicitis were excluded from the analysis...
January 16, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29340588/antimicrobial-resistant-klebsiella-pneumoniae-carriage-and-infection-in-specialized-geriatric-care-wards-linked-to-acquisition-in-the-referring-hospital
#11
Claire L Gorrie, Mirjana Mirceta, Ryan R Wick, Louise M Judd, Kelly L Wyres, Nicholas R Thomson, Richard A Strugnell, Nigel F Pratt, Jill S Garlick, Kerrie M Watson, Peter C Hunter, Steve A McGloughlin, Denis W Spelman, Adam W J Jenney, Kathryn E Holt
Background: Klebsiella pneumoniae is a leading cause of extended-spectrum beta-lactamase (ESBL) producing hospital-associated infections, for which elderly patients are at increased risk. Methods: We conducted a 1-year prospective cohort study, in which a third of patients admitted to two geriatric wards in a specialized hospital were recruited and screened for carriage of K. pneumoniae by microbiological culture. Clinical isolates were monitored via the hospital laboratory...
January 11, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29340294/a-comparison-of-endoscopic-and-non-endoscopic-biliary-intervention-outcomes-in-patients-with-prior-bariatric-surgery
#12
Amrit K Kamboj, Victorio Pidlaoan, Mohammad H Shakhatreh, Alice Hinton, Darwin L Conwell, Somashekar G Krishna
Background and study aims : Endoscopic biliary intervention (BI) is often difficult to perform in patients with prior bariatric surgery (BRS). We sought to analyze outcomes of patients with prior BRS undergoing endoscopic and non-endoscopic BI. Patients and methods:  The Nationwide Inpatient Sample (2007 - 2011) was reviewed to identify all adult inpatients (≥ 18 years) with a history of BRS undergoing BI. The clinical outcomes of interest were in-patient mortality, length of stay (LOS), and total hospital charges...
January 2018: Endoscopy International Open
https://www.readbyqxmd.com/read/29339916/pediatric-cataract-surgery-with-hydrophilic-acrylic-intraocular-lens-implantation-in-nepalese-children
#13
Srijana Adhikari, Ujjowala D Shrestha
Purpose: To assess the outcome of cataract surgery with hydrophilic acrylic intraocular lens (IOL) implantation in children with congenital and developmental cataracts. Method: A retrospective review of medical records of children with congenital or developmental cataracts who underwent cataract surgery with hydrophilic IOL implantation, from January 2011 to December 2014 in a tertiary eye hospital in Nepal. Primary posterior capsulotomy, anterior vitrectomy, and IOL implantation was done in children 8 years or younger, while older children underwent only lens aspiration and IOL implantation...
2018: Clinical Ophthalmology
https://www.readbyqxmd.com/read/29339657/the-practical-management-of-chronic-pancreatitis-a-multidisciplinary-symposium-held-at-the-annual-meeting-of-the-pancreatic-society-of-great-britain-and-ireland-manchester-2016
#14
Santhalingam Jegatheeswaran, Joanne M Puleston, Sinead Duggan, Andrew Hart, Kevin C Conlon, Ajith K Siriwardena
AIM: This study is about a questionnaire survey of delegates attending the chronic pancreatitis symposium at the 2016 meeting of the Pancreatic Society of Great Britain and Ireland and seeks a multidisciplinary "snapshot" overview of practice. METHODS: A questionnaire was developed with multidisciplinary input. Questions on access to specialist care, methods of diagnosis and treatment including specific scenarios were incorporated. Eighty-three (66%) of 125 delegates effectively participated in this survey...
January 16, 2018: Digestive Surgery
https://www.readbyqxmd.com/read/29339300/robotic-surgery-in-elderly-and-very-elderly-gynecologic-cancer-patients
#15
Valerio Gallotta, Carmine Conte, Marco D'Indinosante, Alex Federico, Antonella Biscione, Giuseppe Vizzielli, Carolina Bottoni, Maria Vittoria Carbone, Francesco Legge, Stefano Uccella, Pierpaolo Ciocchetti, Andrea Russo, Lorenzo Polidori, Giovanni Scambia, Gabriella Ferrandina
STUDY OBJECTIVE: To investigate feasibility, safety and short-term outcomes of robotic surgery (RS) for gynecological oncologic indications (cervical, endometrial and ovarian cancer) in elderly patients, especially women aged from 65 to 74 (Elderly group - EG), compared to women ≥ 75 (Very Elderly group - VEG). DESIGN: Retrospective cohort study (Canadian Task Force classification II-2). SETTING: Catholic University of the Sacred Hearth, Rome, Italy...
January 12, 2018: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/29339126/addressing-the-impact-and-unmet-needs-of-nonadherence-in-asthma-and-chronic-obstructive-pulmonary-disease-where-do-we-go-from-here
#16
Richard Dekhuijzen, Federico Lavorini, Omar S Usmani, Job F M van Boven
Nonadherence to treatment, and its associated health and economic burden, is particularly problematic in asthma and chronic obstructive pulmonary disease management because of heterogeneous patient populations and the need for an inhaled route of drug administration. Symptom variability, comorbidities, and device switching further add to suboptimal adherence rates. As opposed to controlled clinical trials, real-life studies show consistently low inhaler adherence in daily practice, yet exact adherence rates have long been affected by disagreement on standardized definitions...
January 12, 2018: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/29339125/prevalence-and-outcomes-of-primary-immunodeficiency-in-hospitalized-children-in-the-united-states
#17
Zachary Rubin, Andrea Pappalardo, Alan Schwartz, James W Antoon
BACKGROUND: Primary immunodeficiency diseases (PIDDs) are rare yet life-threatening chronic conditions in children. The prevalence and outcomes of PIDDs in the pediatric population in the United States are not well understood. OBJECTIVE: The objectives of this study were to (1) determine the epidemiology of children hospitalized with PIDD in the United States and (2) characterize the clinical outcomes of hospitalized children with PIDDs. METHODS: Retrospective cohort analysis of the 2003-2012 Kids' Inpatient Database of children aged 2-18 years admitted with a primary or secondary diagnosis code of PIDD was performed...
January 12, 2018: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/29338905/posterior-reversible-encephalopathy-syndrome-a-rare-childhood-case-with-unconsciousness
#18
Akira Komori, Daisuke Mizu, Koichi Ariyoshi
BACKGROUND: Posterior reversible encephalopathy syndrome (PRES) is a condition characterized by seizures, altered consciousness, visual disturbances, and headache. Characteristic findings on neuroimaging include cerebral edema, typically involving the parieto-occipital white matter. PRES has been associated with hypertension, autoimmune disease, and Henoch-Schölein purpura (HSP), but few cases have been reported, and fewer cases of PRES have been reported in children. CASE REPORT: We report the case of a 4-year-old girl who presented with blindness and semi-consciousness...
January 12, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29338852/simulation-based-multidisciplinary-team-training-decreases-time-to-critical-operations-for-trauma-patients
#19
Margaret Murphy, Kate Curtis, Mary K Lam, Cameron S Palmer, Jeremy Hsu, Andrea McCloughen
BACKGROUND: Simulation has been promoted as a platform for training trauma teams. However, it is not clear if this training has an impact on health service delivery and patient outcomes. This study evaluates the association between implementation of a simulation based multidisciplinary trauma team training program at a metropolitan trauma centre and subsequent patient outcomes. METHOD: This was a retrospective review of trauma registry data collected at an 850-bed Level 1 Adult Trauma Centre in Sydney, Australia...
January 8, 2018: Injury
https://www.readbyqxmd.com/read/29338765/infantile-hypertrophic-pyloric-stenosis-a-4-year-experience-from-two-tertiary-care-centres-in-cameroon
#20
Rene Ndongo, Paul Nkemtendong Tolefac, Faustin Félicien Mouafo Tambo, Matin Hongieh Abanda, Marcelin Ngowe Ngowe, Olivier Fola, Bonaventure Dzekem, Patrick Eroyl Weledji, Maurice Aurelien Sosso, Jacqueline Ze Minkande
OBJECTIVE: This study aimed to describe the clinical characteristics of patients with infantile hypertrophic stenosis, management and its outcome in two tertiary care centres in Cameroon. RESULTS: A total of 21 patients were included from the two centres. The mean age at presentation was 5.2 ± 1.2 weeks, predominantly male with a male-to-female ratio of 4.25:1. The triad of vomiting, visible peristalsis and palpable mass was present in only 7 (33.3%) of the participants...
January 16, 2018: BMC Research Notes
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