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https://www.readbyqxmd.com/read/27926784/preoperative-characteristics-and-cytological-features-of-136-histologically-confirmed-pancreatic-mucinous-cystic-neoplasms
#1
Aristana Scourtas, Jonathan C Dudley, William R Brugge, Abdurrahman Kadayifci, Mari Mino-Kenudson, Martha B Pitman
BACKGROUND: Mucinous cystic neoplasms (MCNs) of the pancreas present a management conundrum. The majority are benign but all are resected due to their malignant potential. Recent studies have recommended nonsurgical management. In the current study, the authors analyzed the preoperative imaging, cytology, and cyst fluid characteristics of 136 histologically confirmed MCNs to assess predictors of a high-risk (HR) cyst for surgical triage. METHODS: MCNs resected at the Massachusetts General Hospital between 1990 and 2014 formed the study cohort...
December 7, 2016: Cancer
https://www.readbyqxmd.com/read/27926663/the-impact-of-value-based-healthcare-for-inflammatory-bowel-diseases-on-healthcare-utilization-a-pilot-study
#2
Welmoed K van Deen, Arlen Spiro, A Burak Ozbay, Martha Skup, Adriana Centeno, Natalie E Duran, Precious N Lacey, Darius Jatulis, Eric Esrailian, Martijn G H van Oijen, Daniel W Hommes
BACKGROUND AND OBJECTIVES: Value-based healthcare (VBHC) is considered to be the solution that will improve quality and decrease costs in healthcare. Many hospitals are implementing programs on the basis of this strategy, but rigorous scientific reports are still lacking. In this pilot study, we present the first-year outcomes of a VBHC program for inflammatory bowel disease (IBD) management that focuses on highly coordinated care, task differentiation of providers, and continuous home monitoring...
December 6, 2016: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/27926583/evaluation-of-the-financial-and-health-burden-of-infants-at-risk-for-respiratory-syncytial-virus
#3
Stephanie McCallum Blake, David Tanaka, Lisa M Bendz, Suzanne Staebler, Debra Brandon
BACKGROUND: Respiratory syncytial virus (RSV) is the leading viral cause of death in infants younger than 1 year. In July 2014, the American Academy of Pediatrics (AAP) Committee on Infectious Diseases concluded that the "limited clinical benefit" for infants born at more than 29 weeks' gestation, together with the associated high cost of the immunoprophylaxis, no longer supported the routine use of palivizumab (Synagis). PURPOSE: To evaluate the impact of the newly adopted AAP palivizumab prophylaxis administration on health and subsequent hospital costs of infants born between 29 and less than 32 weeks' gestation...
December 6, 2016: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
https://www.readbyqxmd.com/read/27926560/using-modified-frailty-index-to-predict-safe-discharge-within-48-hours-of-ileostomy-closure
#4
Yuxiang Wen, Murad A Jabir, Eslam M G Dosokey, Dongjin Choi, Clayton C Petro, Justin T Brady, Scott R Steele, Conor P Delaney
BACKGROUND: Enhanced recovery pathways allow for safe discharge and optimal outcomes within 48 hours after ileostomy closure. Unfortunately, some patients undergoing ileostomy closure have prolonged hospital stays. We have shown previously that the Modified Frailty Index can help predict patients who will fail early discharge after laparoscopic colorectal surgery. OBJECTIVE: The purpose of this study was to use the Modified Frailty Index to identify patients who were safe for early discharge after ileostomy closure...
January 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/27926556/natural-orifice-specimen-extraction-with-single-stapling-colorectal-anastomosis-for-laparoscopic-anterior-resection-feasibility-outcomes-and-technical-considerations
#5
Bansal Saurabh, Sheng-Chi Chang, Tao-Wei Ke, Yu-Chun Huang, Takashi Kato, Hwei-Ming Wang, William Tzu-Liang Chen, Abe Fingerhut
BACKGROUND: Double and triple stapling techniques to close the rectal stump in laparoscopic anterior resection are fraught with technical drawbacks that could possibly be avoided with the use of the single stapling technique. However, little is known of its safety in laparoscopic surgery or outcomes when combined with natural orifice specimen extraction. OBJECTIVE: This study aims to analyze the feasibility and the operative and immediate postoperative outcomes of single-stapled anastomosis and natural orifice specimen extraction with conventional techniques...
January 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/27926380/out-of-hours-workload-management-bayesian-inference-for-decision-support-in-secondary-care
#6
Iker Perez, Michael Brown, James Pinchin, Sarah Martindale, Sarah Sharples, Dominick Shaw, John Blakey
OBJECTIVE: In this paper, we aim to evaluate the use of electronic technologies in out of hours (OoH) task-management for assisting the design of effective support systems in health care; targeting local facilities, wards or specific working groups. In addition, we seek to draw and validate conclusions with relevance to a frequently revised service, subject to increasing pressures. METHODS AND MATERIAL: We have analysed 4 years of digitised demand-data extracted from a recently deployed electronic task-management system, within the Hospital at Night setting in two jointly coordinated hospitals in the United Kingdom...
October 2016: Artificial Intelligence in Medicine
https://www.readbyqxmd.com/read/27925784/management-of-adults-with-hospital-acquired-and-ventilator-associated-pneumonia
#7
Christopher T Erb, Bela Patel, Jeremy E Orr, Thomas Bice, Jeremy B Richards, Mark L Metersky, Kevin C Wilson, Carey C Thomson
No abstract text is available yet for this article.
December 2016: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/27925556/assessing-and-documenting-fluid-balance
#8
Sarah Pinnington, Sarah Ingleby, Prasanna Hanumapura, Deryn Waring
Concerns about inadequate patient hydration and suboptimal monitoring of fluid balance have been documented in recent reports. The Fluid Balance Improvement Project at Central Manchester University Hospitals NHS Foundation Trust was undertaken to identify risk factors influencing hydration and to implement a revised process to manage these risks, resulting in the development of a hydration pathway. This new approach to monitoring patient hydration, together with staff education and support, has resulted in improved compliance with fluid balance monitoring standards, as well as significant improvements in identifying patients at risk of dehydration, and an increase in patients with acute kidney injury commencing appropriate fluid balance monitoring...
December 7, 2016: Nursing Standard
https://www.readbyqxmd.com/read/27925534/plans-to-train-more-clinician-managers
#9
(no author information available yet)
More nurses and doctors will be encouraged to run hospitals in England, under new training schemes announced by the government.
December 7, 2016: Nursing Standard
https://www.readbyqxmd.com/read/27925414/a-qualitative-study-of-healthcare-providers-perceptions-and-suggestions-for-developing-cancer-survivorship-care-models-in-south-korea
#10
J W Lim, E J Shon, E J Yang
This study aimed to explore healthcare providers' perceptions of the issues and problems as well as suggestions regarding the development of cancer survivorship care models in South Korea. An exploratory, descriptive, qualitative study was conducted with eight Korean healthcare providers using individual interviews. Purposive sampling was performed in a university hospital in Gyeonggi-do, Korea. Three concepts of the Chronic Care Model (CCM) were employed to identify the issues and problems with developing a survivorship care model for Korean cancer survivors...
December 7, 2016: European Journal of Cancer Care
https://www.readbyqxmd.com/read/27925086/multidisciplinary-team-of-intensive-therapy-humanization-and-fragmentation-of-the-work-process
#11
Viviane Canhizares Evangelista, Thiago da Silva Domingos, Fernanda Paula Cerântola Siqueira, Eliana Mara Braga
Objective: to understand the meaning of humanized care in intensive care units considering the experience of the multidisciplinary team. Method: descriptive and exploratory qualitative research. For this purpose, we conducted semi-structured interviews with 24 professionals of the heath-care team, and, after transcription, we organized the qualitative data according to content analysis. Results: from two main categories, we were able to understand that humanized care is characterized in the actions of health-care: effective communication, team work, empathy, singularity, and integrality; and mischaracterized in the management processes, specifically in the fragmentation of the work process and health-care, in the precarious work conditions, and in differing conceptual aspects of the political proposal of humanization...
November 2016: Revista Brasileira de Enfermagem
https://www.readbyqxmd.com/read/27925047/a-pioneering-healthcare-model-applying-large-scale-production-concepts-principles-and-performance-after-more-than-11-000-transplants-at-hospital-do-rim
#12
José Medina Pestana
The kidney transplant program at Hospital do Rim (hrim) is a unique healthcare model that applies the same principles of repetition of processes used in industrial production. This model, devised by Frederick Taylor, is founded on principles of scientific management that involve planning, rational execution of work, and distribution of responsibilities. The expected result is increased efficiency, improvement of results and optimization of resources. This model, almost completely subsidized by the Unified Health System (SUS, in the Portuguese acronym), has been used at the hrim in more than 11,000 transplants over the last 18 years...
October 2016: Revista da Associação Médica Brasileira
https://www.readbyqxmd.com/read/27925026/reliability-and-validity-of-the-brazilian-version-of-the-hospital-survey-on-patient-safety-culture-hsopsc-a-pilot-study
#13
Cláudia Tartaglia Reis, Josué Laguardia, Ana Glória Godoi Vasconcelos, Mônica Martins
The evaluation of the culture of patient safety in hospitals is nowadays considered as a management too, since it helps to identify problem areas and provide valuable information for planning improvements. This study explored the reliability and validity of the Brazilian version of the Hospital Survey on Patient Safety Culture, an instrument that evaluates characteristics of patient safety culture among hospital staff. The reliability of the instrument was evaluated by analyzing the internal consistency of each dimension...
December 1, 2016: Cadernos de Saúde Pública
https://www.readbyqxmd.com/read/27924792/a-cost-effective-approach-to-the-diagnosis-and-management-of-acute-infectious-encephalitis
#14
Usha Kant Misra, Vinita Elizabeth Mani, Jayantee Kalita
SETTING: A tertiary care teaching hospital in India. OBJECTIVE: To report a syndromic approach to acute encephalitis syndrome (AES) and propose a cost-effective model. STUDY DESIGN: AES patients were categorized by the presence or absence of myalgia/rash into systemic and neurological AES. The patients with systemic AES were investigated for dengue, scrub typhus, leptospira, chikungunya, and malaria, and those with neurological AES were investigated for herpes and Japanese encephalitis (JE)...
December 8, 2016: European Neurology
https://www.readbyqxmd.com/read/27924759/sudden-cardiac-death-in-south-india-incidence-risk-factors-and-pathology
#15
Uma N Srivatsa, K Swaminathan, K Sithy Athiya Munavarah, Ezra Amsterdam, K Shantaraman
BACKGROUND: Sudden cardiac death (SCD) is a major cause of mortality secondary to coronary artery disease (CAD) in the industrialized societies. Although South Asians have a high prevalence of CAD, the frequency and underlying pathology of SCD among this population are unknown. METHODS: Medical records of consecutive patients presenting with unexplained sudden death (USD) in a tertiary care center were reviewed. Patients with trauma, violent deaths, positive toxicology and non-cardiac pathology were excluded to determine sudden cardiac death (SCD)...
July 2016: Indian Pacing and Electrophysiology Journal
https://www.readbyqxmd.com/read/27924740/so-let-me-find-my-way-whatever-it-will-cost-me-rather-than-leaving-myself-in-darkness-experiences-of-glaucoma-in-nigeria
#16
Fatima Kyari, Clare I Chandler, Martha Martin, Clare E Gilbert
BACKGROUND: Blindness from glaucoma is associated with socio-economic deprivation, presumed to reflect poor access to care and poor adherence to treatment. OBJECTIVES: To determine why people with glaucoma are presenting late for treatment and to understand access to glaucoma care. Additionally, we sought to identify what patients and the community know, do and think about the condition and why the poor are the most affected with glaucoma blindness. DESIGN: Study participants were from four communities and two hospitals in Abuja-FCT and Kaduna State, Nigeria...
2016: Global Health Action
https://www.readbyqxmd.com/read/27924689/hymenoptera-venom-allergy-in-outdoor-workers-occupational-exposure-clinical-features-and-effects-of-allergen-immunotherapy
#17
Alessandra Toletone, Susanna Voltolini, Giovanni Passalacqua, Guglielmo Dini, Donatella Bignardi, Paola Minale, Emanuela Massa, Alessio Signori, Costantino Troise, Paolo Durando
OBJECTIVES: To describe (i) the clinical characteristics of workers, exposed to hymenoptera stings, with an ascertained diagnosis of Hymenoptera Venom Allergy (HVA), (ii) the specific role of occupational exposure, (iii) the effect of Venom Immunotherapy (VIT) in reducing the severity of allergic episodes in workers exposed to repeated stings of hymenoptera, and (iv) the management of the occupational consequences caused by allergic reactions due to hymenoptera stings. METHODS: Between 2000 and 2013 an observational study, including patients referred to the regional reference hospital of Liguria, Italy, with an ascertained diagnosis of HVA and treated with VIT, was carried out...
December 7, 2016: Human Vaccines & Immunotherapeutics
https://www.readbyqxmd.com/read/27924674/work-load-and-management-in-the-delivery-room-changing-the-direction-of-healthcare-policy
#18
Gianfranco Sfregola, Antonio Simone Laganà, Roberta Granese, Pamela Sfregola, Angela Lopinto, Onofrio Triolo
Nurse staffing, increased workload and unstable nursing unit environments are linked to negative patient outcomes including falls and medication errors on medical/surgical units. Considering this evidence, the aim of our study was to overview midwives' workload and work setting. We created a questionnaire and performed an online survey. We obtained information about the type and level of hospital, workload, the use of standardised procedures, reporting of sentinel and 'near-miss' events. We reported a severe understaffing in midwives' work settings and important underuse of standard protocols according to the international guidelines, especially in the South of Italy...
December 7, 2016: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/27924386/cost-analysis-of-laparoendoscopic-rendezvous-versus-preoperative-ercp-and-laparoscopic-cholecystectomy-in-the-management-of-cholecystocholedocholithiasis
#19
Aldo Garbarini, Dario Reggio, Simone Arolfo, Marco Bruno, Roberto Passera, Giorgia Catalano, Claudio Barletti, Mauro Salizzoni, Mario Morino, Luca Petruzzelli, Alberto Arezzo
BACKGROUND: Evidence from controlled trials and meta-analyses suggests that laparoendoscopic rendezvous (LERV) is preferable to sequential treatment in the management of common bile duct stones. MATERIALS AND METHODS: With this retrospective analysis of a prospective database that included consecutive patients treated for cholecystocholedocholithiasis at our institution between January 2007 and July 2015, we compared LERV with sequential treatment. The primary endpoint was global cost, defined as the cost/patient/hospital stay, and the secondary end points were efficacy and morbidity...
December 6, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/27924251/free-vascularized-fibular-graft-transfer-in-the-reconstruction-of-defects-for-premalignant-and-malignant-musculoskeletal-conditions-of-the-femur-in-a-tertiary-care-setting-in-pakistan-a-series-of-six-cases
#20
Avais Raja, Hana Manzoor, Imad-Ud-Din Saqib, Waqar Jan, Mamoon Rashid
OBJECTIVE: To determine the application, success and complications of the utilization of free vascularized fibular grafts (FVFG) in the reconstruction of lower limb defects after resection of primary lower limb musculoskeletal tumors. METHODOLOGY: This descriptive retrospective case series analysis was conducted at Shifa International Hospital from January 2011 to January 2016. It included patients who had premalignant and malignant conditions of the lower limb and subsequently had the lesion resected followed by FVFG surgery...
November 4, 2016: Curēus
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