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Patient safety and emergency

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https://www.readbyqxmd.com/read/28328728/crew-resource-management-in-the-trauma-room-a-prospective-3-year-cohort-study
#1
Marck H T M Haerkens, Matthijs Kox, Pieter M Noe, Johannes G Van Der Hoeven, Peter Pickkers
OBJECTIVE: Human factors account for the majority of adverse events. Human factors awareness training entitled Crew Resource Management (CRM) is associated with improved safety and reduced complications and mortality in critically ill patients. We determined the effects of CRM implementation in the trauma room of an Emergency Department (ED). PATIENTS AND METHODS: A prospective 3-year cohort study was carried out in a level 1 ED, admitting more than 12 000 patients annually (>1500 trauma related)...
March 21, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28328569/mid-term-follow-up-of-minimally-invasive-multivessel-coronary-artery-bypass-grafting-is-the-early-learning-phase-detrimental
#2
Maria Lorena Rodriguez, Harry R Lapierre, Benjamin Sohmer, David Glineur, Marc Ruel
OBJECTIVE: Minimally invasive coronary artery bypass grafting (MICS CABG) through a small left thoracotomy is a novel technique for surgical coronary revascularization, which is increasingly being adopted around the world. This study aimed to describe the characteristics and mid-term outcomes of a series of MICS CABG to identify areas for improvement. METHODS: A prospective longitudinal study was performed on the 306 MICS CABG patients operated on by a single surgeon from 2005 to 2015...
March 22, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28328511/wireless-power-transfer-strategies-for-implantable-bioelectronics-methodological-review
#3
Kush Agarwal, Rangarajan Jegadeesan, Yong-Xin Guo, Nitish V Thakor
Neural implants have emerged over the last decade as highly effective solutions for the treatment of dysfunctions and disorders of the nervous system. These implants establish a direct, often bidirectional, interface to the nervous system, both sensing neural signals and providing therapeutic treatments. As a result of the technological progress and successful clinical demonstrations, completely implantable solutions have become a reality and are now commercially available for the treatment of various functional disorders...
March 16, 2017: IEEE Reviews in Biomedical Engineering
https://www.readbyqxmd.com/read/28327932/integrated-safety-analysis-of-rolapitant-with-coadministered-drugs-from-phase-ii-iii-trials-an-assessment-of-cyp2d6-or-bcrp-inhibition-by-rolapitant
#4
S Barbour, T Smit, X Wang, D Powers, S Arora, V Kansra, M Aapro, J Herrstedt
Background: Rolapitant, a long-acting neurokinin (NK) 1 receptor antagonist (RA), has demonstrated efficacy in prevention of chemotherapy-induced nausea and vomiting in patients administered moderately or highly emetogenic chemotherapy. Unlike other NK 1 RAs, rolapitant does not inhibit or induce cytochrome P450 (CYP) 3A4, but it does inhibit CYP2D6 and breast cancer resistance protein (BCRP). To analyze potential drug-drug interactions between rolapitant and concomitant medications, this integrated safety analysis of four double-blind, randomized phase II or III studies of rolapitant examined adverse events by use versus non-use of drug substrates of CYP2D6 or BCRP...
February 23, 2017: Annals of Oncology: Official Journal of the European Society for Medical Oncology
https://www.readbyqxmd.com/read/28327484/workplace-violence-against-resident-doctors-in-a-tertiary-care-hospital-in-delhi
#5
Tanu Anand, Shekhar Grover, Rajesh Kumar, Madhan Kumar, Gopal Krishna Ingle
BACKGROUND: Healthcare workers particularly doctors are at high risk of being victims of verbal and physical violence perpetrated by patients or their relatives. There is a paucity of studies on work-related violence against doctors in India. We aimed to assess the exposure of workplace violence among doctors, its consequences among those who experienced it and its perceived risk factors. METHODS: This study was done among doctors working in a tertiary care hospital in Delhi...
November 2016: National Medical Journal of India
https://www.readbyqxmd.com/read/28326800/safety-feasibility-and-efficacy-of-bilateral-synchronous-percutaneous-nephrolithotomy-for-bilateral-stone-disease-evidence-from-a-systematic-review
#6
Patrick Jones, Blessing Dhliwayo, Bhavan Prasad Rai, Moeketsi Mokete, Ramachandran Amitharaj, Omar M Aboumarzouk, Bhaskar K Somani
INTRODUCTION: With the evolution of endourologic technology, bilateral synchronous percutaneous nephrolithotomy (BS-PCNL) has emerged as a potentially practical intervention for patients with bilateral lithiasis. Although tradition has favored a staged approach, an increasing number of original studies have reported their experiences with the synchronous approach. MATERIALS AND METHODS: A Cochrane style search was performed after development of a sensitive and predefined search strategy...
March 22, 2017: Journal of Endourology
https://www.readbyqxmd.com/read/28326468/day-case-laparoscopic-cholecystectomy-analysis-of-the-factors-allowing-early-discharge
#7
Giovanni Domenico Tebala, Angela Belvedere, Sean Keane, Abdul Qayyum Khan, Abdelsalam Osman
Despite a number of studies have already demonstrated that majority of patients can be safely discharged early after laparoscopic cholecystectomy, this approach did not gain widespread diffusion yet. The present study was set up to assess safety and feasibility of 24 h or same-day discharge after laparoscopic cholecystectomy and to identify the prognostic factors. Perioperative variables of 229 patients undergoing cholecystectomy have been analyzed. Primary endpoints were: postoperative length of stay, rate of patients discharged within 24 h, and rate of those discharged on the same day...
March 21, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28325679/children-treated-for-lawn-mower-related-injuries-in-us-emergency-departments-1990-2014
#8
Karen S Ren, Thiphalak Chounthirath, Jingzhen Yang, Laura Friedenberg, Gary A Smith
OBJECTIVE: Investigate the epidemiology of lawn mower-related injuries to children in the US. METHODS: A retrospective analysis was conducted of children younger than 18years of age treated in US emergency departments for a lawn mower-related injury from 1990 through 2014 using data from the National Electronic Injury Surveillance System. RESULTS: An estimated 212,258 children <18years of age received emergency treatment for lawn mower-related injuries from 1990 through 2014, equaling an average annual rate of 11...
March 14, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28325264/role-of-ketogenic-metabolic-therapy-in-malignant-glioma-a-systematic-review
#9
REVIEW
Sebastian F Winter, Franziska Loebel, Jorg Dietrich
BACKGROUND: Coined as the "Warburg effect" and a recognized hallmark of cancer, energy metabolism is aberrantly geared towards aerobic glycolysis in most human cancers, including malignant glioma. Ketogenic metabolic therapy (KMT), i.e. nutritional intervention with ketogenic or low-glycemic diets, has been proposed as an anti-neoplastic strategy in glioma patients. MATERIALS AND METHODS: We here review the rationale and existing data investigating KMT in management of patients with malignant glioma and discuss the promise and potential challenges of this novel strategy...
April 2017: Critical Reviews in Oncology/hematology
https://www.readbyqxmd.com/read/28325207/using-a-systematic-framework-of-interventions-to-improve-early-discharges
#10
Hemali Patel, Sasha Morduchowicz, Michelle Mourad
BACKGROUND: Late-afternoon hospital discharges can lead to admission bottlenecks and negatively affect the flow of patients needing hospital admission. Delays in discharge are a prevalent health care problem and have been linked to increased length of stay, lower patient satisfaction scores, and adverse outcomes. As a result, hospitals are placing a renewed emphasis on early discharge as a way to reduce admission delays and achieve optimal patient flow. This study shows that the Model for Improvement (MFI) is an effective approach for complex improvement efforts...
April 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28325090/using-stents-in-the-management-of-malignant-bowel-obstruction-the-current-situation-and-future-progress
#11
Alessandro Fugazza, Piera Alessia Galtieri, Alessandro Repici
The use of self-expanding metal stents (SEMS) has been considered an effective and safe alternative to emergency surgery as bridge to surgery or for palliation in advanced colorectal cancer even though more recent data have raised concerns on both early and long-term outcomes when patients are treated with bridge to surgery indications. Areas covered: A comprehensive literature review of articles on endoscopic management of malignant bowel obstruction was performed. Indication, technique, outcomes, benefits and risks of these treatments in acute malignant colonic obstruction were reviewed...
March 22, 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28324167/efficacy-and-safety-of-golimumab-52-week-maintenance-therapy-in-japanese-patients-with-moderate-to-severely-active-ulcerative-colitis-a-phase-3-double-blind-randomized-placebo-controlled-study-pursuit-j-study
#12
Toshifumi Hibi, Yuya Imai, Asako Senoo, Kentaro Ohta, Yoshifumi Ukyo
BACKGROUND: The global phase 3 studies of golimumab [PURSUIT-SC and PURSUIT-maintenance (M)], an anti-tumor necrosis factor-α (anti-TNFα) antibody, have demonstrated clinical efficacy and safety as induction and maintenance therapies in patients with moderate to severely active ulcerative colitis (UC). This study aimed to evaluate the efficacy and safety of golimumab as maintenance therapy in the Japanese population. METHODS: In this phase 3, double-blind (DB), placebo-controlled, parallel group, randomized withdrawal study, 144 Japanese patients with moderately to severely active UC received golimumab doses of 200 mg (at week 0) and 100 mg (at week 2) subcutaneously during the 6-week open-label induction phase...
March 21, 2017: Journal of Gastroenterology
https://www.readbyqxmd.com/read/28321512/four-year-maintenance-treatment-with-adalimumab-in-japanese-patients-with-moderately-to-severely-active-ulcerative-colitis
#13
Yasuo Suzuki, Satoshi Motoya, Hiroyuki Hanai, Toshifumi Hibi, Shiro Nakamura, Andreas Lazar, Anne Martin Robinson, Martha Skup, Nael Mohamed Mostafa, Bidan Huang, Roopal Thakkar, Mamoru Watanabe
BACKGROUND: The 52-week safety and efficacy of adalimumab in Japanese patients with moderately to severely active ulcerative colitis were demonstrated in a placebo-controlled phase 2/3 trial. Data from patients who enrolled in the open-label extension study are presented. METHODS: Remission and response per the full Mayo score (FMS) and the partial Mayo score (PMS), remission per the Inflammatory Bowel Disease Questionnaire (IBDQ) score, corticosteroid-free remission, and mucosal healing were assessed up to week 196 (week 208 for remission/response per PMS) of adalimumab treatment in patients who received one or more doses of adalimumab with use of a hybrid nonresponder imputation (hNRI) method...
March 20, 2017: Journal of Gastroenterology
https://www.readbyqxmd.com/read/28320635/safety-and-efficacy-of-multipotent-adult-progenitor-cells-in-acute-ischaemic-stroke-masters-a-randomised-double-blind-placebo-controlled-phase-2-trial
#14
David C Hess, Lawrence R Wechsler, Wayne M Clark, Sean I Savitz, Gary A Ford, David Chiu, Dileep R Yavagal, Ken Uchino, David S Liebeskind, Alexander P Auchus, Souvik Sen, Cathy A Sila, Jeffrey D Vest, Robert W Mays
BACKGROUND: Multipotent adult progenitor cells are a bone marrow-derived, allogeneic, cell therapy product that modulates the immune system, and represents a promising therapy for acute stroke. We aimed to identify the highest, well-tolerated, and safest single dose of multipotent adult progenitor cells, and if they were efficacious as a treatment for stroke recovery. METHODS: We did a phase 2, randomised, double-blind, placebo-controlled, dose-escalation trial of intravenous multipotent adult progenitor cells in 33 centres in the UK and the USA...
March 17, 2017: Lancet Neurology
https://www.readbyqxmd.com/read/28320139/10-year-outcomes-after-rituximab-for-myasthenia-gravis-efficacy-safety-costs-of-inhospital-care-and-impact-on-childbearing-potential
#15
Karl Stieglbauer, Robert Pichler, Raffi Topakian
Rituximab (RTX) has emerged as an attractive off-label treatment option for patients with myasthenia gravis (MG) refractory to other immune therapies. However, data on long-term outcome after RTX for MG are still scarce. Here we present the 10-year outcomes [median (range) 10.1 (6.7-11.2) years] with respect to efficacy, safety, costs of inhospital care, and impact on childbearing potential in all four MG patients treated by one of the authors with RTX. In all patients, RTX led to sustained clinical improvement and eventual tapering of other immune therapies...
April 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28318654/safety-and-efficacy-of-drug-eluting-stents-in-patients-with-spontaneous-coronary-artery-dissection
#16
Federico Conrotto, Fabrizio D'Ascenzo, Enrico Cerrato, Antonio Fernandez Ortiz, Nieves Gonzalo, Carlos Macaya, Corrado Tamburino, Marco Barbanti, Martijn van Lavieren, Jan J Piek, Robert J Applegate, Azeem Latib, Maria Teresa Spinnler, Raffaella Marzullo, Mario Iannaccone, Marco Pavani, Gabriele Crimi, Rossella Fattori, Alessandra Chinaglia, Patrizia Presbitero, Ferdinando Varbella, Fiorenzo Gaita, Javier Escaned
AIMS: Given the different pathogenesis, use of drug eluting stent (DES) in patients with Spontaneous Coronary Artery Dissection SCAD may delay the healing of the dissected vessel. Aim of our study was to compare the safety and the efficacy of DES vs. bare metal stent (BMS) in a cohort of patients who underwent stenting for SCAD. METHODS AND RESULTS: Consecutive patients with SCAD between January 1995 and August 2014 were retrospectively identified in 12 centers and included...
March 9, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28318345/novel-agents-in-classical-hodgkin-lymphoma
#17
Sven Borchmann, Bastian von Tresckow
Classical Hodgkin lymphoma (cHL) is the most common hematological malignancy in young adults and can be cured in most cases. However, relapsed and refractory Hodgkin lymphoma, certain patient groups, such as elderly patients, and toxicity of first-line treatment still pose significant challenges. Consequently, new treatment options are needed. Recently, many new treatment concepts have been evaluated in clinical trials. Targeted drug-antibody conjugates and immune checkpoint inhibitors have decisively changed treatment approaches...
March 20, 2017: Leukemia & Lymphoma
https://www.readbyqxmd.com/read/28315722/risk-mitigation-for-children-exposed-to-drugs-during-gestation-a-critical-role-for-animal-preclinical-behavioral-testing
#18
REVIEW
Irving Zucker
Many drugs with unknown safety profiles are administered to pregnant women, placing their offspring at risk. I assessed whether behavioral outcomes for children exposed during gestation to antidepressants, anxiolytics, anti-seizure, anti-nausea and sedative medications can be predicted by more extensive animal studies than are part of the FDA approval process. Human plus rodent data were available for only 8 of 33 CNS-active drugs examined. Similar behavioral and cognitive deficits, including autism and ADHD emerged in human offspring and in animal models of these disorders after exposure to fluoxetine, valproic acid, carbamazepine, phenytoin, phenobarbital, acetaminophen and ibuprofen...
March 15, 2017: Neuroscience and Biobehavioral Reviews
https://www.readbyqxmd.com/read/28315559/immunotherapy-toxicities-%C3%A2-a-new-electronic-documentation-template-to-improve-patient-care
#19
Elizabeth Reimschissel, Buenagracia Dela Cruz, Melissa Gonzalez, Joaquin Buitrago, Cary Goodman, Patricia A Johnston
BACKGROUND: Emerging immunotherapies are associated with numerous toxicities. Although traditional health records allow nurses to document system-based assessments, few offer immunotherapy-based documentation templates to assess and grade toxicities.
. OBJECTIVES: The aim of this article is to present the development of a standardized template for documenting genetically modified cellular product-related toxicities in an electronic health record (EHR).
. METHODS: Through interprofessional collaboration, a documentation template for genetically modified cellular product-related toxicities was developed in an EHR, allowing for standardized documentation, data reporting, and tracking of immune-related toxicities...
April 1, 2017: Clinical Journal of Oncology Nursing
https://www.readbyqxmd.com/read/28315558/toxicity-management-development-of-a-novel-and-immune-mediated-adverse-events-algorithm%C3%A2
#20
Haleigh Mistry, Sheryl G Forbes, Nathan Fowler
BACKGROUND: Novel immunotherapy and biologic agents are being developed with the potential to improve outcomes and reduce long-term toxicities among individuals with hematologic malignancies. These emerging drugs affect neoplastic cells and the surrounding microenvironment, causing unique immune-mediated toxicities.
. OBJECTIVES: The aim was to develop an algorithm for clinical staff to manage unique toxicities associated with next-generation immunotherapies indicated in the hematologic population, using a system-focused approach...
April 1, 2017: Clinical Journal of Oncology Nursing
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