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https://www.readbyqxmd.com/read/28817428/interprofessional-qi-training-enhances-competency-and-qi-productivity-among-graduates-findings-from-nationwide-children-s-hospital
#1
Thomas Bartman, Karen Heiser, Andrew Bethune, Wallace Crandall, Richard McClead, J Terrance Davis, Richard J Brilli
PURPOSE: Significant resources are expended on quality improvement (QI) training courses. The authors sought to determine whether education provided in QI course training improves self-assessed QI content competence and QI-related productivity among course graduates. METHOD: "Quality Improvement Essentials" is a four-month didactic and experiential course designed to prepare multidisciplinary professionals to participate in and lead QI efforts at Nationwide Children's Hospital (NCH)...
August 16, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28817317/living-outside-the-gender-box-in-mexico-testimony-of-transgender-mexican-asylum-seekers
#2
Marshall K Cheney, Mary J Gowin, E Laurette Taylor, Melissa Frey, Jamie Dunnington, Ghadah Alshuwaiyer, J Kathleen Huber, Mary Camero Garcia, Grady C Wray
OBJECTIVES: To explore preimmigration experiences of violence and postimmigration health status in male-to-female transgender individuals (n = 45) from Mexico applying for asylum in the United States. METHODS: We used a document review process to examine asylum declarations and psychological evaluations of transgender Mexican asylum seekers in the United States from 2012. We coded documents in 2013 and 2014 using NVivo, a multidisciplinary team reviewed them, and then we analyzed them for themes...
August 17, 2017: American Journal of Public Health
https://www.readbyqxmd.com/read/28816890/improving-timeliness-of-%C3%AE-agonist-and-corticosteroid-administration-in-patients-with-acute-wheezing
#3
Mandisa McIver, William Stoudemire, Cherrelle Smith-Ramsey, Mousumee Panigrahi, Christine Walsh-Kelly
OBJECTIVE: Timely delivery of β-agonists and steroids to patients with acute recurrent wheezing is a key component of the National Heart, Lung, and Blood Institute recommended emergency department (ED) asthma care. We conducted an ED improvement initiative to standardize asthma care and improve time to treatments. METHODS: Our multidisciplinary team identified key contributing factors to timeliness, developed key driver diagrams, implemented and refined a management pathway, designed and executed rapid cycle improvements, and implemented interventions...
August 14, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28815418/availability-of-angiography-and-therapeutic-embolization-for-the-treatment-of-acute-bleeding-in-patients-with-hemophilia
#4
Mi Jin Kim, Ji Young Oh, Young Shil Park
Clotting factor replacement therapy alone is often inadequate for acute bleeding in hemophilia patients, and surgery for such patients poses significant clinical challenges. Arterial angiographic intervention is used to control bleeding in local blood vessels. In the present study, we examined the clinical course and prognosis of hemophilia patients with bleeding who had undergone angiography, and evaluated the validity of diagnostic angiography and therapeutic embolization in these patients. Angiography was performed in five hemophilia patients, who experienced bleeding that was difficult to control even after treatment with clotting factor replacement or bypassing agent therapy...
August 16, 2017: International Journal of Hematology
https://www.readbyqxmd.com/read/28814999/centralization-of-liver-cancer-surgery-and-impact-on-multidisciplinary-teams-working-on-stage-iv-colorectal-cancer
#5
REVIEW
Elroy Patrick Weledji
Surgical resection is the most effective treatment approach for colorectal liver metastases but only a minority of patients is suitable for upfront surgery. The treatment strategies of stage IV colorectal cancer have shifted towards a continuum of care in which medical and surgical treatment combinations are tailored to the clinical setting of the individual patient. The optimization of treatment through appropriate decision-making and multimodal therapy for stage IV colorectal cancer require a joint multidisciplinary meeting in a centralized liver cancer unit...
June 14, 2017: Oncology Reviews
https://www.readbyqxmd.com/read/28814172/novel-endovascular-management-of-proximal-type-a-debakey-ii-aortic-dissection-with-a-patent-foramen-ovale-occluder
#6
Xun Yuan, Andreas Mitsis, David Mozalbat, Christoph A Nienaber
PURPOSE: To present a novel endovascular management option that avoids open surgery in selected patients with subacute type A aortic dissection (DeBakey II). CASE REPORT: A 75-year-old woman with previous infrarenal abdominal aortic aneurysm repaired in 2006 and multiple comorbidities (EURO score II 20.5%) was admitted with chest pain; computed tomography angiography (CTA) showed a new dissection in the ascending aorta just above the right coronary ostium. As the patient was considered unfit to undergo surgery, an endovascular solution was suggested after multidisciplinary team discussion...
August 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28809786/octopus-a-design-methodology-for-motion-capture-wearables
#7
Javier Marin, Teresa Blanco, Jose J Marin
Human motion capture (MoCap) is widely recognised for its usefulness and application in different fields, such as health, sports, and leisure; therefore, its inclusion in current wearables (MoCap-wearables) is increasing, and it may be very useful in a context of intelligent objects interconnected with each other and to the cloud in the Internet of Things (IoT). However, capturing human movement adequately requires addressing difficult-to-satisfy requirements, which means that the applications that are possible with this technology are held back by a series of accessibility barriers, some technological and some regarding usability...
August 15, 2017: Sensors
https://www.readbyqxmd.com/read/28809602/fertility-preservation-and-sexual-health-after-cancer-therapy
#8
Nigel Pereira, Glenn L Schattman
Recent developments in cancer diagnostics and treatments have considerably improved long-term survival rates. Despite improvements in chemotherapy regimens, more focused radiotherapy and diverse surgical options, cancer treatments often have gonadotoxic side-effects that can manifest as loss of fertility or sexual dysfunction, particularly in young cancer survivors. In this review, we focus on two pertinent quality-of-life issues in female cancer survivors of reproductive age-fertility preservation and sexual function...
August 15, 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28808931/robotic-total-pelvic-exenteration-video-illustrated-technique
#9
Ioannis T Konstantinidis, William Chu, Federico Tozzi, Clayton Lau, Mark Wakabayashi, Kevin Chan, Byrne Lee
BACKGROUND: Robotic-assisted total pelvic exenteration (TPE) can offer a minimally invasive approach to a major multi-organ operation. METHODS: In this video, we summarize a stepwise approach to robotic TPE in a 70 year-old female Jehovah's witness with a history of cervical cancer post-chemoradiation and radical hysterectomy who experienced local recurrence at the vaginal cuff involving the rectum and bladder. RESULTS: The patient was placed in the lithotomy position...
August 14, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28807809/paraureteral-endometriosis-with-bilateral-gross-hydroureters-and-left-renal-compromise
#10
Arnaud Wattiez, Razan Nasir
Deep endometriosis is usually defined as endometriosis infiltrating the peritoneum by >5 mm. It sometimes involves the ureter causing hydronephrosis in 5% of cases. The latter is associated with 18% ureteral lesions. Ureteral endometriosis is one of the rare causes of silent Kidney failure. The ureter obstruction can lead to urinary tract obstruction, hydronephrosis and hydroureters. The ureters are usually compressed externally by the endometriotic lesions surrounding it causing extrinsic ureteral endometriosis, and sometimes by pressure from the bulky adenomyotic uterus with paraureteral fibrosis...
August 11, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28807509/-18-f-fdg-pet-ct-angiography-in-the-diagnosis-of-infective-endocarditis-and-cardiac-device-infection-in-adult-patients-with-congenital-heart-disease-and-prosthetic-material
#11
María N Pizzi, L Dos-Subirà, Albert Roque, Nuria Fernández-Hidalgo, Hug Cuéllar-Calabria, Antonia Pijuan Domènech, María T Gonzàlez-Alujas, M T Subirana-Domènech, B Miranda-Barrio, Ignacio Ferreira-González, Juan J González-López, Albert Igual, Olga Maisterra-Santos, David García-Dorado, Joan Castell-Conesa, Benito Almirante, Manuel Escobar Amores, Pilar Tornos, Santiago Aguadé-Bruix
OBJECTIVES: Infective endocarditis (IE) and cardiac device infection (CDI) are a major complication in the growing number of patients with congenital heart disease (CHD) reaching adulthood. We aimed to evaluate the added value of (18)F-FDG-PET/CT angiography (PET/CTA) in the diagnosis of IE-CDI in adults with CHD and intravascular or intracardiac prosthetic material, in whom echocardiography (ECHO) and modified Duke Criteria (DC) have limitations because of the patients' complex anatomy...
August 9, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28807405/initiation-of-a-multidisciplinary-rapid-response-team-to-massive-and-submassive-pulmonary-embolism
#12
Brett J Carroll, Heather Pemberton, Kenneth A Bauer, Louis M Chu, Jeffrey L Weinstein, Barbara L Levarge, Duane S Pinto
Pulmonary embolism (PE) can result in rapid clinical decompensation in many patients. With increasing patient complexity and advanced treatment options for PE, multidisciplinary, rapid response teams can optimize risk stratification and expedite management strategies. The Massive And Submassive Clot On-call Team (MASCOT) was created at our institution, which comprised specialists from cardiology, pulmonology, hematology, interventional radiology, and cardiac surgery. MASCOT offers rapid consultation 24 hours a day with a web-based conference call to review patient data and discuss management of patients with high-risk PE...
July 26, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28806187/pain-is-an-underestimated-symptom-in-cystic-fibrosis
#13
Alexandra Masson, Maya Kirszembaum, Isabelle Sermet-Gaudelus
PURPOSE OF REVIEW: Life expectancy is increasing in cystic fibrosis and new aspects of the disease have to be taken into account in cystic fibrosis care. RECENT FINDINGS: Pain is encountered among 70% of adult and pediatric patients with cystic fibrosis. This symptom is underestimated by the multidisciplinary team. It has been reported as impacting quality of life and adherence to treatments. The location of pain is inconstant among the different studies but the major symptoms are headaches, gastrointestinal, and chest pain...
August 12, 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28805585/understanding-and-treating-pain-syndromes-in-parkinson-s-disease
#14
Marialuisa Gandolfi, Christian Geroin, Angelo Antonini, Nicola Smania, Michele Tinazzi
Pain affects many people with Parkinson's disease (PD) and diminishes their quality of life. Different types of pain have been described, but their related pathophysiological mechanisms remain unclear. The aim of this chapter is to provide movement disorders specialists an update about the pathophysiology of pain and a practical guide for the management of pain syndromes in clinical practice. This chapter reviews current knowledge on the pathophysiological mechanisms of sensory changes and pain in PD, as well as assessment and treatment procedures to manage these symptoms...
2017: International Review of Neurobiology
https://www.readbyqxmd.com/read/28805570/swallowing-dysfunctions-in-parkinson-s-disease
#15
Janine A Simons
Dysphagia is a very frequent and highly relevant symptom in Parkinson's disease (PD) for quality of life, morbidity, and remaining lifetime, which is unfortunately widely underdiagnosed and underestimated regarding patients' centered care. Especially in early stages, the causal association between disease and swallowing disabilities remains unnoticed, which may be accounted for by the inability of caregivers and physicians to detect subtle swallowing problems and by the low self-awareness among PD patients...
2017: International Review of Neurobiology
https://www.readbyqxmd.com/read/28805087/preliminary-investigation-of-the-reliability-and-validity-of-the-birt-independent-living-scale
#16
Sara D S Ramos, Michael Oddy, Lorraine Haye, Anna Goodson
PURPOSE: Neurorehabilitation aims to increase independence and participation in ordinary life. It is argued that the fundamental indices of this are independent living and engagement in occupational or productive activity. The Brain Injury Rehabilitation Trust Independent Living Scale was designed to capture change in levels of participation and independence following neurorehabilitation. With greater use of outcome measures in health care, it becomes necessary to develop tools which are simple to use and that capture the holistic impact of rehabilitation...
August 13, 2017: Disability and Rehabilitation
https://www.readbyqxmd.com/read/28804862/oncological-patients-in-the-intensive-care-unit-prognosis-decision-making-therapies-and-end-of-life-care
#17
Ewelina Biskup, Fengfeng Cai, Marcus Vetter, Stephan Marsch
The effectiveness of intensive care unit (ICU) care for cancer patients remains controversial. Advances in antitumour and supportive care led to major improvements in outcomes of oncological patients in the ICU. Improved cancer therapies and supportive management of organ dysfunctions have contributed to improved survival rates. As a consequence, the number of cancer patients requiring ICU admission is rising. Frequently, cancer patients have a poor performance status and are vulnerable. It is a heterogeneous population, where the nature and curability of the neoplasm and the severity of critical illness cause a plethora of issues about ICU admissions...
August 14, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/28803578/physiotherapy-managers-views-of-musculoskeletal-physiotherapy-service-provision-in-ireland-a-qualitative-study
#18
Helen P French, Rose Galvin
Aim Integrated multidisciplinary primary healthcare is still in a relatively early stage of development in Ireland, with significant restructuring occurring in the past decade. Musculoskeletal physiotherapy services traditionally provided in acute hospital settings have been relocated into the primary care setting where the physiotherapist works as part of the multidisciplinary team. This study aimed to explore physiotherapy managers' experiences of managing musculoskeletal physiotherapy services in primary care to gain an insight into the opportunities and challenges in service delivery, changing roles and ongoing professional development needs of staff...
August 14, 2017: Primary Health Care Research & Development
https://www.readbyqxmd.com/read/28803074/hospice-palliative-care-development-in-hungary
#19
Agnes Csikos, Csilla Busa, Katalin Muszbek
During the past 25 years many developmental steps have occurred in Hungary in palliative care. Further education and service development is needed to provide a quality palliative care for all the Hungarian people. Hungary has a universal health care system with a developed infrastructure. The first Hungarian hospice team started in 1991. At that time the concept of hospice care was unknown. Symptom control and psychosocial support for the dying patient was inadequate. The regulatory framework was based on the 1997 Health Care Act which was followed by significant palliative care legislation including documents on the legal requirements for palliative care (2004)...
August 9, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28802997/prophylactic-use-of-an-intra-aortic-balloon-pump-in-a-high-risk-patient-with-peripartum-cardiomyopathy-requiring-cesarean-delivery
#20
R S Samalavicius, L Puodziukaite, I Radaviciute, I Norkiene, K Urbonas, I Misiuriene, V Janusauskas, A Zorinas, K Rucinskas, P Serpytis
The use of intra-aortic balloon counter-pulsation for circulatory support in pregnant women with cardiac failure is limited to several case reports. Few publications have addressed the use of intra-aortic balloon counter-pulsation during delivery. We report a case using prophylactic intra-aortic counter-pulsation during the management of a cesarean delivery in a patient with peripartum cardiomyopathy. A 28-year-old primigravid female at 37weeks of gestation was admitted with signs of worsening heart failure, and transthoracic echocardiography revealed a decreased left ventricular ejection fraction of 25%...
July 14, 2017: International Journal of Obstetric Anesthesia
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