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Christina Schumann, Michael Faust
BACKGROUND:  Diabetic ketoacidosis and the hyperosmolar hyperglycemic state are the most serious diabetic emergencies. Before the discovery of insulin in 1921 by Banting and Best the diagnosis of type 1 diabetes was fatal ending in diabetic ketoacidosis equivalent to a torturous death. Today, mortality from diabetic ketoacidosis is low at approximately 2 %. But each death from these two acute metabolic complications of diabetes is potentially avoidable by improved patient and healthcare professional education...
March 2018: Deutsche Medizinische Wochenschrift
Bernardo Costa-Pinel, Santiago Mestre-Miravet, Francisco Barrio-Torrell, Joan-Josep Cabré-Vila, Xavier Cos-Claramunt, Sofía Aguilar-Sanz, Claustre Solé-Brichs, Conxa Castell-Abat, Victoria Arija-Val, Jaana Lindström
BACKGROUND: The DE-PLAN-CAT project (Diabetes in Europe-Prevention using lifestyle, physical activity and nutritional intervention-Catalonia) has shown that an intensive lifestyle intervention is feasible in the primary care setting and substantially reduces the incidence of diabetes among high-risk Mediterranean participants. The DP-TRANSFERS project (Diabetes Prevention-Transferring findings from European research to society) is a large-scale national programme aimed at implementing this intervention in primary care centres whenever feasible...
2018: PloS One
Jaime Fernández-Sarmiento, Joseph A Carcillo, Claudia M Salinas, Edgar F Galvis, Paula A López, Andrés Jagua-Gualdrón
OBJECTIVES: To evaluate adherence to the sepsis bundle before and after an educational strategy and its impact on hospital stay. DESIGN: A prospective, analytic, before-and-after study of children with severe sepsis and septic shock who presented to the emergency department. SETTING: Carried out from January to December 2014 in the emergency department of a quaternary care hospital. PATIENTS: Of a total of 19,836 children who presented to the emergency department, 4,383 had an infectious pathology, with 203 of these showing severe sepsis and septic shock (124 pre intervention, and 79 post intervention)...
March 14, 2018: Pediatric Critical Care Medicine
Kenzie A Cameron, Elaine R Cohen, Joelle R Hertz, Diane B Wayne, Debi Mitra, Jeffrey H Barsuk
OBJECTIVES: The aims of the study were to identify perceived barriers and facilitators to central venous catheter (CVC) insertion among healthcare providers and to understand the extent to which an existing Simulation-Based Mastery Learning (SBML) program may address barriers and leverage facilitators. METHODS: Providers participating in a CVC insertion SBML train-the-trainer program, in addition to intensive care unit nurse managers, were purposively sampled from Veterans Administration Medical Centers located in geographically diverse areas...
March 14, 2018: Journal of Patient Safety
Oksoo Kim, Mi Sun Kim, Hee Jung Jang, Hyangkyu Lee, Younhee Kang, Yanghee Pang, Heeja Jung
AIM AND OBJECTIVES: To examine the current state of radiation safety education and its influence on nurses' compliance with safety procedures. BACKGROUND: Use of radiation in therapy and diagnosis has prolonged and improved millions of lives, but it presents potential hazards for healthcare professionals. DESIGN: A cross-sectional design. METHODS: Participants included 1,672 female nurses of childbearing age who had recently been exposed to radiation emitting generators or radiation...
March 15, 2018: Journal of Clinical Nursing
Paul J Choi, Joe Iwanaga, R Shane Tubbs, Emre Yilmaz
Owing to its rarity, rhabdomyosarcoma of the head and neck (HNRMS) has seldom been discussed in the literature. As most of the data is based only on the retrospective experiences of tertiary healthcare centers, there are difficulties in formulating a standard treatment protocol. Moreover, the disease is poorly understood at its pathological, genetic, and molecular levels. For instance, 20% of all histological assessment is inaccurate; even an experienced pathologist can confuse rhabdomyosarcoma (RMS) with neuroblastoma, Ewing's sarcoma, and lymphoma...
January 9, 2018: Curēus
Beatriz Paulina Ayala Quintanilla, Wendy E Pollock, Susan J McDonald, Angela J Taft
INTRODUCTION: Preventing and reducing violence against women (VAW) and maternal mortality are Sustainable Development Goals. Worldwide, the maternal mortality ratio has fallen about 44% in the last 25 years, and for one maternal death there are many women affected by severe acute maternal morbidity (SAMM) requiring management in the intensive care unit (ICU). These women represent the most critically ill obstetric patients of the maternal morbidity spectrum and should be studied to complement the review of maternal mortality...
March 14, 2018: BMJ Open
Eva Cepova, Martina Cicvakova, Peter Kolarcik, Neda Markovska, Andrea Madarasova Geckova
BACKGROUND: Modification of health literacy (HL) is an important factor for improving and maintaining oral health. The aim of the study is to examine the association of HL with oral health-promoting behaviour (OHPB) and assess possible mediating effects of HL on the impact of socioeconomic status on OHPB. METHODS: A cross-sectional questionnaire survey on the Slovak general adult population (N = 360, mean age 39) was conducted in 2014 and 2015. The association of HL (9 domains of the Health Literacy Questionnaire) and OHPB was analysed using logistic regression models adjusted for gender, age and educational level...
March 14, 2018: BMC Oral Health
Jennifer Kranz, Stefanie Schmidt, Cordula Lebert, Laila Schneidewind, Falitsa Mandraka, Mirjam Kunze, Sina Helbig, Winfried Vahlensieck, Kurt Naber, Guido Schmiemann, Florian M Wagenlehner
BACKGROUND: We aimed to update the 2010 evidence- and consensus-based national clinical guideline on the diagnosis and management of uncomplicated urinary tract infections (UTIs) in adult patients. Results are published in 2 parts. Part 1 covers methods, the definition of patient groups, and diagnostics. This second publication focuses on treatment of acute episodes of cystitis and pyelonephritis as well as on prophylaxis of recurrent UTIs. MATERIALS AND METHODS: An interdisciplinary group consisting of 17 representatives of 12 medical societies and a patient representative was formed...
March 14, 2018: Urologia Internationalis
Rangarirai Matima, Katherine Murphy, Naomi S Levitt, Rhonda BeLue, Tolu Oni
BACKGROUND: Current South African health policy for chronic disease management proposes integration of chronic services for better outcomes for chronic conditions; that is based on the Integrated Chronic Disease Model (ICDM). However, scant data exist on how patients with chronic multimorbidities currently experience the (re)-organisation of health services and what their perceived needs are in order to enhance the management of their conditions. METHODS: A qualitative study was conducted in a community health centre treating both HIV and diabetes patients in Cape Town...
2018: PloS One
Michael Jones, John Morris, Frank Deruyter
Significant health disparities exist between the general population and people with disabilities, particularly with respect to chronic health conditions. Mobile healthcare-the delivery of healthcare via mobile communication devices-is witnessing tremendous growth and has been touted as an important new approach for management of chronic health conditions. At present, little is known about the current state of mobile healthcare for people with disabilities. Early evidence suggests they are not well represented in the growth of mobile healthcare, and particularly the proliferation of mobile health software applications (mHealth apps) for smartphones...
March 14, 2018: International Journal of Environmental Research and Public Health
Jong-In Kim, Hee-Jung Kim, Jung Ju Lee, Ji Hee Jun, Tae-Young Choi, Myeong Soo Lee
BACKGROUND: The ability of acupuncture to successfully control pain has been reported in the past. However, currently no systematic reviews exist regarding the effect of acupuncture on trigeminal neuralgia (TN). This proposed review aims to evaluate the current evidence on the efficacy of acupuncture for the management of pain in TN. METHODS: A total of 11 databases were searched from their inception. These include MEDLINE, AMED, EMBASE, the Cochrane Library, 6 Korean medical databases, and 1 Chinese Medical Database...
March 2018: Medicine (Baltimore)
Tyler Sheetz, Cheryl T Lee
PURPOSE OF REVIEW: As the population ages, urologic oncologists are caring for older and more vulnerable patients that must withstand complex surgical treatments. Our healthcare environment emphasizes surgical quality, reductions in length of hospital stay, reduced readmission rates, and high patient satisfaction. So those who manage urologic malignancies must be able to optimize their patients. Understanding the concept of frailty, how to diagnose it in a timely and reliable manner, appreciate its perioperative impact, and consider interventions to reduce its effects may improve surgical outcomes...
March 13, 2018: Current Opinion in Urology
Edwin Tapiwa Chamanga
Chronic wounds are defined as those that have failed to heal after three months. There are various intrinsic and extrinsic factors that may result in the development of chronic wounds, including comorbidities such as diabetes mellitus and venous insufficiency, and lifestyle factors such as obesity, alcohol consumption and smoking. Chronic wounds represent a significant burden on healthcare resources and can have a negative effect on patients' quality of life. This article discusses the assessment and treatment of non-healing chronic wounds...
March 14, 2018: Nursing Standard
Carole Therasse, Isabelle Fusier, Anne-Laure Cordonnier, Florence Bérard, Olivier Parent de Curzon, François Bocquet, Pascal Paubel
AIM: Erythropoiesis-stimulating agents (ESAs) are particularly used to treat dialysis patients suffering from anemia due to renal failure. Since March 2014, ESAs have no longer been funded on top-of-diagnosis-related groups (DRGs) in French hospitals and are funded via DRGs. There are two ways to fund dialysis in French hospitals: the 'DRG for dialysis in session' and the 'off-dialysis DRG', which is not a DRG and consists in a supplement tariff specific to dialysis for patients hospitalized for another main reason than dialysis...
March 14, 2018: Journal of Comparative Effectiveness Research
Wei Gong, Aobo Li, Hui Ai, Han Shi, Xiao Wang, Shaoping Nie
Background Early discharge after successful primary angioplasty is common, but the evidence supporting the practice is still lacking. We therefore performed a meta-analysis assessing the safety of early discharge after primary angioplasty in low-risk patients with ST-segment elevation myocardial infarction (STEMI). Methods Randomised controlled trials were identified and extracted from PubMed, Embase, Cochrane Library databases and reference lists of relevant papers. Heterogeneity was analysed using the I2 test...
January 1, 2018: European Journal of Preventive Cardiology
James R Duncan
In medicine, data collection and analysis provide the information needed to reduce diagnostic uncertainty. An examination of how medical imaging data is collected and then transformed into diagnostic information provides testable ideas for better managing this dynamic process. In other fields, process data is systematically assessed for differences between observed and predicted values. For studies that expose patients to the potentially harmful effects of ionizing radiation, monitoring imaging studies/illness, images/imaging study and radiation exposure/image would be steps towards developing radiation dose budgets for the diagnosis and treatment of common conditions...
September 26, 2017: Diagnosis
Caroline Fertleman, Phoebe Aubugeau-Williams, Carmel Sher, Ai-Nee Lim, Sophie Lumley, Sylvie Delacroix, Xueni Pan
Background: Virtual reality technology is an exciting and emerging field with vast applications. Our study sets out the viewpoint that virtual reality software could be a new focus of direction in the development of training tools in medical education. We carried out a panel discussion at the Center for Behavior Change 3rd Annual Conference, prompted by the study, "The Responses of Medical General Practitioners to Unreasonable Patient Demand for Antibiotics--A Study of Medical Ethics Using Immersive Virtual Reality" (1)...
2018: Frontiers in Public Health
Rikinkumar S Patel, Priya Patel, Kaushal Shah, Mandeep Kaur, Zeeshan Mansuri, Ramkrishna Makani
Objective To determine the impact of cannabis use disorder (CUD) on the inpatient outcomes of attention deficit hyperactivity disorder (ADHD) in adolescents Background Previous studies have evaluated the impact of CUD on the health-related quality of life in ADHD patients. Methods We used the nationwide inpatient sample (NIS) from the Healthcare Cost and Utilization Project (HCUP) from years 2010--2014. We identified ADHD and cannabis use (CU) as the primary and the other diagnosis, respectively, using validated International Classification of Diseases, 9th Revision, and Clinical Modification (ICD-9--CM) codes...
January 7, 2018: Curēus
José Martínez-Raga, Mario Amore, Guido Di Sciascio, Radu Ioan Florea, Marina Garriga, Gabriel Gonzalez, Kai G Kahl, Per-Axel Karlsson, Jens Kuhn, Maria Margariti, Bruno Pacciardi, Konstantinos Papageorgiou, Maurizio Pompili, Fabrice Rivollier, Ángel Royuela, Gemma Safont, Joachim Scharfetter, Bo Skagen, Kazuhiro Tajima-Pozo, Pierre Vidailhet
Agitation is a heterogeneous concept without a uniformly accepted definition, however, it is generally considered as a state of cognitive and motor hyperactivity characterized by excessive or inappropriate motor or verbal activity with marked emotional arousal. Not only the definition but also other aspects of agitated patients' care are still unsolved and need consensus and improvement. To help the discussion about agitation among experts and improve the identification, management, and treatment of agitation, the 1st International Experts' Meeting on Agitation was held in October 2016 in Madrid...
2018: Frontiers in Psychiatry
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