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https://www.readbyqxmd.com/read/28213837/brief-report-meeting-the-needs-of-medically-hospitalized-adults-with-autism-a-provider-and-patient-toolkit
#1
Jocelyn Carter, Sarabeth Broder-Fingert, Ann Neumeyer, Ann Giauque, Ann Kao, Christiana Iyasere
In an effort to meet the needs of adults with autism spectrum disorder (ASD) while hospitalized, a team of experts and providers from Massachusetts General Hospital (MGH), MGH for Children as well as parents of individuals with ASD was sparked in 2013. This became a multidisciplinary collaborative, the MGH Autism Care Collaborative, to improve adult care for inpatients with ASD. The collaborative was created with three goals in mind: (1) to educate internal medicine adult inpatient providers and staff on the unique needs of adults with ASD when hospitalized; (2) to create ASD specific resources for internal medicine adult inpatient providers; (3) to optimize patient care from admission to discharge among adults with ASD admitted to internal medicine services...
February 17, 2017: Journal of Autism and Developmental Disorders
https://www.readbyqxmd.com/read/28213377/interventional-treatment-of-pulmonary-embolism
#2
David M Dudzinski, Jay Giri, Kenneth Rosenfield
Pulmonary embolism (PE) is a serious and prevalent cause of vascular disease. Nevertheless, optimal treatment for many phenotypes of PE remains uncertain. Treating PE requires appropriate risk stratification as a first step. For the highest-risk PE, presenting as shock or arrest, emergent systemic thrombolysis or embolectomy is reasonable, while for low-risk PE, anticoagulation alone is often chosen. Normotensive patients with PE but with indicia of right heart dysfunction (by biomarkers or imaging) constitute an intermediate-risk group for whom there is controversy on therapeutic strategy...
February 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28213059/multidisciplinary-team-learning-in-the-management-of-the-morbidly-adherent-placenta-outcome-improvements-over-time
#3
Alireza A Shamshirsaz, Karin A Fox, Hadi Erfani, Steven L Clark, Bahram Salmanian, B Wycke Baker, Michael Coburn, Amir A Shamshirsaz, Zhoobin H Bateni, Jimmy Espinoza, Ahmed A Nassr, Edwina J Popek, Shiu-Ki Hui, Jun Teruya, Celestine Shauching Tung, Jeffery A Jones, Martha Rac, Gary A Dildy, Michael A Belfort
BACKGROUND: Morbidly adherent placenta (MAP) is a serious obstetric complication causing mortality and morbidity. OBJECTIVE: To evaluate whether outcomes of patients with morbidly adherent placenta improve with increasing experience within a well-established multidisciplinary team at a single referral center. STUDY DESIGN: All singleton pregnancies with pathology-confirmed MAP (including placenta accreta, increta or percreta) managed by a multidisciplinary team between January 2011 and August 2016 were included in this retrospective study...
February 14, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28211351/quality-indicators-of-asthma-care-derived-from-the-spanish-guidelines-for-asthma-management-gema-4-0-a-multidisciplinary-team-report
#4
S Quirce, J Delgado, L M Entrenas, M Grande, C Llorente, A López Viña, E Martínez Moragón, E Mascarós, J Molina, J M Olaguibel, L A Pérez de Llano, M Perpiñá Tordera, J A Quintano, M Rodríguez, M Román-Rodriguez, J Sastre, J A Trigueros, A L Valero, A C Zoni, V Plaza
No abstract text is available yet for this article.
2017: Journal of Investigational Allergology & Clinical Immunology
https://www.readbyqxmd.com/read/28211248/anesthetic-considerations-for-pediatric-electroconvulsive-therapy
#5
REVIEW
Andrew D Franklin, Jenna H Sobey, Eric T Stickles
Electroconvulsive therapy is being used more frequently in the treatment of many chronic and acute psychiatric illnesses in children. The most common psychiatric indications for pediatric electroconvulsive therapy are refractory depression, bipolar disorder, schizophrenia, catatonia, and autism. In addition, a relatively new indication is the treatment of pediatric refractory status epilepticus. The anesthesiologist may be called upon to assist in the care of this challenging and vulnerable patient population...
February 17, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28211140/anesthesia-for-fetal-surgery
#6
REVIEW
Monica A Hoagland, Debnath Chatterjee
Fetal therapy is an exciting and growing field of medicine. Advances in prenatal imaging and continued innovations in surgical and anesthetic techniques have resulted in a wide range of fetal interventions including minimally invasive, open mid-gestation, and ex-utero intrapartum treatment procedures. The potential for maternal morbidity is significant and must be carefully weighed against claimed benefits to the fetus. Appropriate patient selection is critical, and a multidisciplinary team-based approach is strongly recommended...
February 17, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28209334/pregnancy-in-chronic-kidney-disease-and-kidney-transplantation
#7
REVIEW
Philip Webster, Liz Lightstone, Dianne B McKay, Michelle A Josephson
Chronic kidney disease (CKD) affects up to 6% of women of childbearing age in high income countries, and is estimated to affect 3% of pregnant women. Advanced renal dysfunction, proteinuria, hypertension, and poorly controlled underlying primary renal disease are all significant risks for adverse maternal, fetal, and renal outcomes. In order to achieve the best outcomes, it is therefore of paramount importance that these pregnancies are planned, where possible, to allow the opportunity to counsel women and their partners in advance and to optimize these risks...
February 13, 2017: Kidney International
https://www.readbyqxmd.com/read/28209176/infective-endocarditis-causing-mitral-valve-stenosis-a-rare-but-deadly-complication-a-case-report
#8
Michael A Hart, Gautam R Shroff
BACKGROUND: Infective endocarditis rarely causes mitral valve stenosis. When present, it has the potential to cause severe hemodynamic decompensation and death. There are only 15 reported cases in the literature of mitral prosthetic valve bacterial endocarditis causing stenosis by obstruction. This case is even more unusual due to the mechanism by which functional mitral stenosis occurred. CASE PRESENTATION: We report a case of a 23-year-old white woman with a history of intravenous drug abuse who presented with acute heart failure...
February 17, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28209144/modified-enhanced-recovery-after-surgery-eras-protocols-for-patients-with-obstructive-colorectal-cancer
#9
Dai Shida, Kyoko Tagawa, Kentaro Inada, Keiichi Nasu, Yasuji Seyama, Tsuyoshi Maeshiro, Sachio Miyamoto, Satoru Inoue, Nobutaka Umekita
BACKGROUND: Enhanced recovery after surgery (ERAS) protocols are now well-known to be useful for elective colorectal surgery, as they result in shorter hospital stays without adversely affecting morbidity. However, the efficacy and safety of ERAS protocols for patients with obstructive colorectal cancer have yet to be clarified. METHODS: We evaluated 122 consecutive resections for obstructive colorectal cancer performed between July 2008 and November 2012 at Tokyo Metropolitan Bokutoh Hospital...
February 16, 2017: BMC Surgery
https://www.readbyqxmd.com/read/28208198/the-pulmonary-embolism-response-team-what-is-the-ideal-model
#10
Josanna Rodriguez-Lopez, Richard Channick
Treatment of patients with intermediate- and high-risk pulmonary embolism (PE) is a controversial area. Many therapeutic options exist, and deciding on appropriate treatment can be difficult. In addition, multiple specialties are often involved in the care of PE patients. To better organize the response to serious PE patients, several hospitals and academic centers across the United States, spearheaded by Massachusetts General Hospital, have created pulmonary embolism response teams (PERTs). The goal of a PERT is to have a single multidisciplinary team of experts in thromboembolic disease, who can respond rapidly to patients with acute PE, and offer consultation with the full spectrum of therapeutic options...
February 2017: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28205734/p-32-the-development-of-a-multidisciplinary-team-to-evaluate-early-developmental-outcomes-of-infants-with-tof-oa
#11
K Walker, J Karpelowsky, D Fitzgerald, A Loughran-Fowlds, N Badawi
No abstract text is available yet for this article.
April 1, 2016: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/28205710/p-39-endoscopic-multidisciplinary-team-for-ea-tef-patients-a-pilot-study
#12
D Lévesque, D Zielinski, S J Daniel
No abstract text is available yet for this article.
April 1, 2016: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/28204986/validation-workflow-for-a-clinical-bayesian-network-model-in-multidisciplinary-decision-making-in-head-and-neck-oncology-treatment
#13
Mario A Cypko, Matthaeus Stoehr, Marcin Kozniewski, Marek J Druzdzel, Andreas Dietz, Leonard Berliner, Heinz U Lemke
PURPOSE: Oncological treatment is being increasingly complex, and therefore, decision making in multidisciplinary teams is becoming the key activity in the clinical pathways. The increased complexity is related to the number and variability of possible treatment decisions that may be relevant to a patient. In this paper, we describe validation of a multidisciplinary cancer treatment decision in the clinical domain of head and neck oncology. METHOD: Probabilistic graphical models and corresponding inference algorithms, in the form of Bayesian networks, can support complex decision-making processes by providing a mathematically reproducible and transparent advice...
February 15, 2017: International Journal of Computer Assisted Radiology and Surgery
https://www.readbyqxmd.com/read/28199030/lessons-learned-from-the-science-of-caring-extending-the-reach-of-psychosocial-oncology-the-international-psycho-oncology-society-2016-sutherland-award-lecture
#14
Barry D Bultz
In medicine, referral to a medical oncology specialty is based on recent history, physical examination, pathology, surgery reports, imaging, blood work and the patient's vital signs. By contrast, referral to a psychosocial specialist has typically been based on the patients expressed request for psychosocial support or the health care team's observation of the patient's limited adjustment or poor coping with the diagnosis, treatment or end of life distress. These observations are usually based on clinical acumen not on metrics...
February 15, 2017: Psycho-oncology
https://www.readbyqxmd.com/read/28196811/the-heart-failure-epidemic-a-uk-perspective
#15
REVIEW
Martin R Cowie
Heart failure is appropriately described as an epidemic, with 1-2% of healthcare expenditure being directed at its management. In England, the National Institute for Health and Care Excellence (NICE) has issued guidance on best practice for the diagnosis and treatment of acute and chronic heart failure. Echocardiography is key to the diagnosis of the underlying cardiac abnormalities, and access to this (with our without biochemical testing using natriuretic peptides) is key to high quality and speedy diagnosis...
February 14, 2017: Echo Research and Practice
https://www.readbyqxmd.com/read/28196486/integrated-care-at-home-reduces-unnecessary-hospitalizations-of-community-dwelling-frail-older-adults-a-prospective-controlled-trial
#16
Laura Di Pollina, Idris Guessous, Véronique Petoud, Christophe Combescure, Bertrand Buchs, Philippe Schaller, Michel Kossovsky, Jean-Michel Gaspoz
BACKGROUND: Care of frail and dependent older adults with multiple chronic conditions is a major challenge for health care systems. The study objective was to test the efficacy of providing integrated care at home to reduce unnecessary hospitalizations, emergency room visits, institutionalization, and mortality in community dwelling frail and dependent older adults. METHODS: A prospective controlled trial was conducted, in real-life clinical practice settings, in a suburban region in Geneva, Switzerland, served by two home visiting nursing service centers...
February 14, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28195939/care-for-vulnerable-elderly-in-cardiology-a-program-for-daily-practice
#17
Mirjam A M Wit, Annet J C M Bos-Schaap, Victor A W M Umans
BACKGROUND: The percentage of cardiac patients aged ≥75 has increased considerably over the past decades. To optimize multidisciplinary care for these frail elderly, a program of intensive medical and nursing care was started at Noord West Ziekenhuisgroep department of cardiology. METHODS: Patients over 70 years of age, admitted to the department of cardiology, were included and treated by the advanced practice nurse according to a redesigned care process that focused on expedite mobilization and care by an advanced practice nurse-headed team including the first outpatient visit...
March 2017: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/28195885/eisenmenger-syndrome-and-pregnancy-novel-ecmo-configuration-as-a-bridge-to-delivery-and-recovery-utilizing-a-multidisciplinary-team
#18
Erika B Rosenzweig, Darryl Abrams, Mauer Biscotti, Diane Kerstein, Daphnie Drassinower, Daniel Brodie, Matthew Bacchetta
Pregnancy is typically contraindicated in Eisenmenger syndrome because of its association with excessively high maternal and fetal morbidity and mortality. We report on our novel approach to successfully managing a 29 year-old pregnant woman with an unrepaired patent ductus arteriosus (PDA) with Eisenmenger syndrome through delivery and recovery. Venovenous ECMO was utilized during induction of labor to stabilize maternal hemodynamics and optimize fetal oxygenation by creating an oxygenated right-to-left shunt through the PDA...
February 9, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28195452/practical-indications-for-the-management-of-non-melanoma-skin-cancer-patients
#19
Alessandro DI Stefani, Laura Del Regno, Alfredo Piccerillo, Ketty Peris
Basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), together encompassed in the term non--melanoma skin cancers (NMSC), are the most common cancers among fair--skinned populations. Individuating accurate risk stratification of NMSC patients is crucial to select different options among various treatment strategies. The majority of low risk NMSCs are easily treated with surgery, offering excellent cure rates and cosmetic results. Other treatment modalities include physical destruction (curettage, cautery and cryotherapy), chemical destruction (photodynamic therapy and topical 5--flurouracil) and immunomodulatory therapy (topical imiquimod)...
February 14, 2017: Giornale Italiano di Dermatologia e Venereologia: Organo Ufficiale, Società Italiana di Dermatologia e Sifilografia
https://www.readbyqxmd.com/read/28193800/cardiovascular-and-ventilatory-consequences-of-laparoscopic-surgery
#20
Tamara M Atkinson, George D Giraud, Brandon M Togioka, Daniel B Jones, Joaquin E Cigarroa
Although laparoscopic surgery accounts for >2 million surgical procedures every year, the current preoperative risk scores and guidelines do not adequately assess the risks of laparoscopy. In general, laparoscopic procedures have a lower risk of morbidity and mortality compared with operations requiring a midline laparotomy. During laparoscopic surgery, carbon dioxide insufflation may produce significant hemodynamic and ventilatory consequences such as increased intraabdominal pressure and hypercarbia. Hemodynamic insults secondary to increased intraabdominal pressure include increased afterload and preload and decreased cardiac output, whereas ventilatory consequences include increased airway pressures, hypercarbia, and decreased pulmonary compliance...
February 14, 2017: Circulation
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