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https://www.readbyqxmd.com/read/28064245/conservative-management-of-migrated-percutaneous-endoscopic-colostomy-tube
#1
Thomas J G Chase, Joshua Luck, Lauren S Harris, Gareth Bashir
A 68-year-old male nursing home resident presented following dislodgement of a percutaneous endoscopic colostomy (PEC) tube originally sited to prevent recurrent sigmoid volvulus. Computed tomography demonstrated tube migration into the lumen of the recto-sigmoid junction, where it remained for 12 days before passing spontaneously. During this period, the patient remained asymptomatic; the residual colocutaneous fistula functioned as a decompressive valve. Originally, the patient was due to be discharged with early flexible sigmoidoscopy follow-up...
January 6, 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28056819/quality-of-care-assessment-and-improvement-in-aortic-stenosis-rationale-and-design-of-a-multicentre-registry-impulse
#2
Norbert Frey, Richard P Steeds, Antonio Serra, Eberhard Schulz, Stephan Baldus, Matthias Lutz, Christiane Pohlmann, Jana Kurucova, Peter Bramlage, David Messika-Zeitoun
BACKGROUND: Severe aortic stenosis (AS) is a common, serious valve disease in which no effective medical therapy is available and, if not treated by intervention, has a 5-year survival of only 40-60%. Despite the availability of guidelines supporting the effective use of surgical aortic valve replacement (SAVR) or transcatheter aortic valve implantation (TAVI) to treat the majority of these patients, adherence to these guidelines in clinical practice is still unsatisfactory. Several recent studies have emphasised the necessity for improved communication between multidisciplinary teams, with the aim to ensure that severe AS patients receive appropriate treatment...
January 5, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28043434/aortic-root-surgery-does-high-surgical-volume-and-a-consistent-perioperative-approach-improve-outcome
#3
Rajdeep Bilkhu, Pouya Youssefi, Gopal Soppa, Rajan Sharma, Anne Child, Mark Edsell, Jean-Pierre van Besouw, Marjan Jahangiri
There is evidence that high surgical volume and team consistency improve outcomes. Mortality of 4%-12% for aortic root surgery has been reported in the United States and UK. We aim to assess outcomes of patients undergoing aortic root surgery by a consistent, high-volume team. Data on patients undergoing elective or urgent aortic root replacement (ARR) were collected prospectively. Patients undergoing emergency surgery were excluded. A standardized perioperative approach was maintained and was achieved by delivering training to team members, including surgical trainees, anesthetic, nursing, and perfusion staff, whenever there was a change of team...
July 2016: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28034845/thirty-day-readmissions-after-transcatheter-aortic-valve-replacement-in-the-united-states-insights-from-the-nationwide-readmissions-database
#4
Dhaval Kolte, Sahil Khera, M Rizwan Sardar, Neil Gheewala, Tanush Gupta, Saurav Chatterjee, Andrew Goldsweig, Wilbert S Aronow, Gregg C Fonarow, Deepak L Bhatt, Adam B Greenbaum, Paul C Gordon, Barry Sharaf, J Dawn Abbott
BACKGROUND: Readmissions after cardiac procedures are common and contribute to increased healthcare utilization and costs. Data on 30-day readmissions after transcatheter aortic valve replacement (TAVR) are limited. METHODS AND RESULTS: Patients undergoing TAVR (International Classification of Diseases-Ninth Revision-CM codes 35.05 and 35.06) between January and November 2013 who survived the index hospitalization were identified in the Nationwide Readmissions Database...
January 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/27890544/persistent-hydrocephalus-due-to-postural-activation-of-a-ventricular-shunt-anti-gravity-device
#5
Claudia L Craven, Ahmed K Toma, Laurence D Watkins
The ever present need to balance over drainage with under drainage in hydrocephalus has required innovations including adjustable valves with antigravity devices. These are activated in the vertical position to prevent siphoning. We describe a group of bedridden patients who presented with unexplained under drainage caused by activation of antigravity shunt components produced by peculiar head/body position. Retrospective single centre case series of hydrocephalus patients, treated with ventriculo-peritoneal (VP) shunt insertion between April 2014 - February 2016...
March 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/27803362/toward-optimal-decision-making-among-vulnerable-patients-referred-for-cardiac-surgery-a-qualitative-analysis-of-patient-and-provider-perspectives
#6
Ryan A Gainer, Janet Curran, Karen J Buth, Jennie G David, Jean-Francois Légaré, Gregory M Hirsch
OBJECTIVES: Comprehension of risks, benefits, and alternative treatment options has been shown to be poor among patients referred for cardiac interventions. Patients' values and preferences are rarely explicitly sought. An increasing proportion of frail and older patients are undergoing complex cardiac surgical procedures with increased risk of both mortality and prolonged institutional care. We sought input from patients and caregivers to determine the optimal approach to decision making in this vulnerable patient population...
November 1, 2016: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/27616189/fast-track-cardiac-care-for-adult-cardiac-surgical-patients
#7
REVIEW
Wai-Tat Wong, Veronica Kw Lai, Yee Eot Chee, Anna Lee
BACKGROUND: Fast-track cardiac care is a complex intervention involving several components of care during cardiac anaesthesia and in the postoperative period, with the ultimate aim of early extubation after surgery, to reduce length of stay in the intensive care unit and in the hospital. Safe and effective fast-track cardiac care may reduce hospital costs. This is an update of a Cochrane review first published in 2003, updated in 2012 and updated now in 2016. OBJECTIVES: To determine the safety and effectiveness of fast-track cardiac care compared with conventional (not fast-track) care in adult patients undergoing cardiac surgery...
September 12, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27604617/12th-winfocus-world-congress-on-ultrasound-in-emergency-and-critical-care
#8
Yahya Acar, Onur Tezel, Necati Salman, Erdem Cevik, Margarita Algaba-Montes, Alberto Oviedo-García, Mayra Patricio-Bordomás, Mustafa Z Mahmoud, Abdelmoneim Sulieman, Abbas Ali, Alrayah Mustafa, Ihab Abdelrahman, Mustafa Bahar, Osama Ali, H Lester Kirchner, Gregor Prosen, Ajda Anzic, Paul Leeson, Maryam Bahreini, Fatemeh Rasooli, Houman Hosseinnejad, Gabriel Blecher, Robert Meek, Diana Egerton-Warburton, Edina Ćatić Ćuti, Stanko Belina, Tihomir Vančina, Idriz Kovačević, Nadan Rustemović, Ikwan Chang, Jin Hee Lee, Young Ho Kwak, Do Kyun Kim, Chi-Yung Cheng, Hsiu-Yung Pan, Chia-Te Kung, Ela Ćurčić, Ena Pritišanac, Ivo Planinc, Marijana Grgić Medić, Radovan Radonić, Abiola Fasina, Anthony J Dean, Nova L Panebianco, Patricia S Henwood, Oliviero Fochi, Moreno Favarato, Ezio Bonanomi, Ivan Tomić, Youngrock Ha, Hongchuen Toh, Elizabeth Harmon, Wilma Chan, Cameron Baston, Gail Morrison, Frances Shofer, Angela Hua, Sharon Kim, James Tsung, Isa Gunaydin, Zeynep Kekec, Mehmet Oguzhan Ay, Jinjoo Kim, Jinhyun Kim, Gyoosung Choi, Dowon Shim, Ji-Han Lee, Jana Ambrozic, Katja Prokselj, Miha Lucovnik, Gabrijela Brzan Simenc, Asta Mačiulienė, Almantas Maleckas, Algimantas Kriščiukaitis, Vytautas Mačiulis, Andrius Macas, Sharad Mohite, Zoltan Narancsik, Hugon Možina, Sara Nikolić, Jan Hansel, Rok Petrovčič, Una Mršić, Simon Orlob, Markus Lerchbaumer, Niklas Schönegger, Reinhard Kaufmann, Chun-I Pan, Chien-Hung Wu, Sarah Pasquale, Stephanie J Doniger, Sharon Yellin, Gerardo Chiricolo, Maja Potisek, Borut Drnovšek, Boštjan Leskovar, Kristine Robinson, Clara Kraft, Benjamin Moser, Stephen Davis, Shelley Layman, Yusef Sayeed, Joseph Minardi, Irmina Sefic Pasic, Amra Dzananovic, Anes Pasic, Sandra Vegar Zubovic, Ana Godan Hauptman, Ana Vujaklija Brajkovic, Jaksa Babel, Marina Peklic, Vedran Radonic, Luka Bielen, Peh Wee Ming, Nur Hafiza Yezid, Fatahul Laham Mohammed, Zainal Abidin Huda, Wan Nasarudin Wan Ismail, W Yus Haniff W Isa, Hashairi Fauzi, Praveena Seeva, Mohd Zulfakar Mazlan
A1 Point-of-care ultrasound examination of cervical spine in emergency departmentYahya Acar, Onur Tezel, Necati SalmanA2 A new technique in verifying the placement of a nasogastric tube: obtaining the longitudinal view of nasogastric tube in addition to transverse view with ultrasoundYahya Acar, Necati Salman, Onur Tezel, Erdem CevikA3 Pseudoaneurysm of the femoral artery after cannulation of a central venous line. Should we always use ultrasound in these procedures?Margarita Algaba-Montes, Alberto Oviedo-García, Mayra Patricio-BordomásA4 Ultrasound-guided supraclavicular subclavian vein catheterization...
September 2016: Critical Ultrasound Journal
https://www.readbyqxmd.com/read/27573519/neonatal-ventilation-with-a-manikin-model-and-two-novel-peep-valves-without-an-external-gas-source
#9
Monica Thallinger, Hege Langli Ersdal, Colin Morley, Carolyn Purington, Øystein Gomo, Estomih Mduma, Joar Eilevstjønn, Ketil Størdal
OBJECTIVE: Positive end expiratory pressure (PEEP) is beneficial when ventilating preterm newborns. The aim was to study whether inexperienced providers were able to generate PEEP during simulated neonatal ventilation, using two novel prototype PEEP valves, on a self-inflating bag without an external gas source. DESIGN: Forty-six nursing students in Tanzania were trained in ventilation with a new Laerdal Upright resuscitator and mask on a NeoNatalie manikin with a newborn resuscitation monitor...
August 29, 2016: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/27510178/identifying-the-position-of-the-right-atrium-to-align-pressure-transducer-for-cvp-spirit-level-or-3d-electromagnetic-positioning
#10
S Avellan, I Uhr, D McKelvey, Soren Sondergaard
The central venous pressure, CVP, is an important variable in the management of selected perioperative and intensive care cases and in clinical decision support systems, CDSS. In current routine, when measuring CVP the health care provider may use anatomical landmarks and a spirit level, SL, to adjust the pressure transducer to the level of the tricuspid valve, i.e. the phlebostatic axis. The aim of the study was to assess the agreement in the postoperative setting between the SL method and electromagnetic 3D positioning (EM)...
August 10, 2016: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/27508481/stressors-perceived-by-patients-in-the-immediate-postoperative-of-cardiac-surgery
#11
Carina Aparecida Marosti Dessotte, Hélen Francine Rodrigues, Rejane Kiyomi Furuya, Lidia Aparecida Rossi, Rosana Aparecida Spadoti Dantas
OBJECTIVE: to investigate stressors perceived by patients in the immediate postoperative of cardiac surgery and their association with sociodemographic and clinical characteristics. METHOD: a prospective correlational study conducted in a city in São Paulo, between August 2013 and December 2014. A non-probabilistic sample included patients submitted to their first coronary artery bypass graft or mitral valve surgery. The "Environmental Stressor Questionnaire" adapted to Portuguese was used...
July 2016: Revista Brasileira de Enfermagem
https://www.readbyqxmd.com/read/27500132/prosthetic-aortic-valve-endocarditis-with-left-main-coronary-artery-embolism-a-case-report-and-review-of-the-literature
#12
Hafeez Ul Hassan Virk, Faisal Inayat, Salman Farooq, Ali Raza Ghani, Ghazi A Mirrani, Muhammed Waqas Athar
CONTEXT: Coronary embolization is potentially a fatal sequela of endocarditis. Although the primary cause of acute coronary syndrome is atherosclerotic disease, it is imperative to consider septic embolism as an etiological factor. CASE REPORT: Herein, we report a case of ventricular fibrillation and ST-segment depression myocardial infarction occurring in a patient who initially presented with fever and increased urinary frequency. Coronary angiography revealed new 99% occlusion of the left main coronary artery (LMCA)...
June 2016: North American Journal of Medical Sciences
https://www.readbyqxmd.com/read/27440847/aerococcus-urinae-a-rare-cause-of-infective-endocarditis
#13
Stephen Melnick, Salik Nazir, Rittu Hingorani, Philip Wexler
We present the case of an elderly male who was initially seen in our hospital for a urinary tract infection that was treated with oral ciprofloxacin. He was admitted 2 weeks later with altered mental status and fever, and was found to have bacteraemia with Aerococcus urinae Owing to altered mental status a brain MRI was performed which showed evidence of embolic stroke. Following this, a transesophageal echocardiogram showed severe mitral regurgitation and a vegetation >1 cm involving the mitral valve with associated destruction of posterior valve leaflets...
July 20, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27324945/factors-affecting-difficult-peripheral-intravenous-cannulation-in-adults-a-prospective-observational-study
#14
Michela Piredda, Valentina Biagioli, Beatrice Barrella, Ilaria Carpisassi, Roberta Ghinelli, Diana Giannarelli, Maria Grazia De Marinis
AIMS AND OBJECTIVES: This study aimed to identify risk factors for difficult intravenous cannulation in relation to characteristics of patients, healthcare providers and devices in adult patients accessing a radiology service. BACKGROUND: Early recognition of patients at risk for difficult peripheral intravenous catheterisation is important to adopt strategies able to increase the likelihood of success in intravenous cannulation, as well as to critically evaluate the use of alternative administration routes or venous devices...
April 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/27295774/-mitral-valve-repair-with-minimally-invasive-cardiac-surgery-approach-as-routine-practice
#15
Kazuma Okamoto, Mikihiko Kudo, Hideyuki Shimizu
Although minimally invasive cardiac surgery (MICS) via right minithoracotomy is attracting attention as a minimally invasive approach in cardiac surgery, it has not become a standard, routine approach for mitral valve repair. Although it has spread rapidly in Germany (43%) and USA (20.4%), the proportion of MICS in isolated mitral valve repair still comprises only 15.6% of mitral valve repair surgeries in Japan. For safe, assured introduction of MICS as a routine approach under quality control for good surgical and mid- and long-term results, surgeons experienced in mitral valve repair who perform at least 10 mitral valve repairs per year are necessary...
March 2016: Nihon Geka Gakkai Zasshi
https://www.readbyqxmd.com/read/27290685/gender-in-the-access-eu-registry-a-prospective-multicentre-non-randomised-post-market-approval-study-of-mitraclip%C3%A2-therapy-in-europe
#16
Sameer Gafoor, Horst Sievert, Francesco Maisano, Stephan Baldus, Ulrich Schaefer, Joerg Hausleiter, Christian Butter, Gian Paolo Ussia, Volker Geist, Julian D Widder, Tiziano Moccetti, Wolfgang Schillinger, Olaf Franzen
AIMS: Gender has been an important factor in outcomes after mitral valve surgery; however, its effect on percutaneous mitral valve repair is not well known. We aimed to report the effect of gender on outcomes in a large European prospective, multicentre, non-randomised post-approval study of percutaneous mitral valve repair. METHODS AND RESULTS: Two hundred and five female and 362 male patients with significant mitral regurgitation underwent percutaneous repair at 14 European sites from October 2008 to April 2011...
June 12, 2016: EuroIntervention
https://www.readbyqxmd.com/read/27194239/enhancing-asthma-medication-delivery-spacers-and-valved-holding-chambers
#17
Sally Schoessler, Tonya Winders
Asthma is one of the most prevalent chronic diseases managed by school nurses, and its management often includes the administration of bronchodilators delivered via a metered dose inhaler (MDI). The use of an MDI requires coordination and mastery of steps that must be performed correctly and in the proper order. These steps are greatly enhanced, especially in the pediatric population, through the use of medical devices-spacers and valved holding chambers. The purpose of this article is to review the rationale and implications for the use of these devices in the school setting...
July 2016: NASN School Nurse
https://www.readbyqxmd.com/read/27101650/-cpap-generation-by-a-non-mechanical-device-the-bousignac-system
#18
Francisco José Clemente López
CPAP (continuous positive airway pressure) is to establish a supraatmosferica pressure throughout the respiratory cycle on which the patient vent spontaneously. Its use improves the clinical and gasometrics parameters when applied with appropriate selection criteria in the context of respiratory failure acute (IRA) hypoxemic. It has been demonstrated that applying CPAP early, decreases the need for intubation and associated complications, as well as survival, reducing health care costs and hospital stay. The use of valve Boussignac for applying a CPAP is spreading especially in the delivered environment and emergencies as a device not mechanical, simple, easy to use and transport, which can manage enough pressures to manage the patient hypoxemia...
February 2016: Revista de Enfermería
https://www.readbyqxmd.com/read/27060802/nursing-leadership-of-the-transcatheter-aortic-valve-implantation-heart-team-supporting-innovation-excellence-and-sustainability
#19
REVIEW
Sandra B Lauck, Janis McGladrey, Cindy Lawlor, John G Webb
Transcatheter Aortic Valve Implantation (TAVI) is an innovative and resource-intensive treatment of valvular heart disease. Growing evidence and excellent outcomes are contributing to increased patient demand. The Heart Team is foundational to TAVI programs to manage the complexities of case selection and other aspects of care. The competencies and expertise of nurses are well suited to provide administrative and clinical leadership within the TAVI Heart Team to promote efficient, effective, and sustainable program development...
May 2016: Healthcare Management Forum
https://www.readbyqxmd.com/read/26971132/in-hospital-mobility-variations-across-primary-diagnoses-among-older-adults
#20
Vincenzo Valiani, Shiyao Gao, Zhiguo Chen, Sunil Swami, Christopher A Harle, Gigi Lipori, Sandrine Sourdet, Samuel Wu, Susan G Nayfield, Carlo Sabbá, Marco Pahor, Todd M Manini
OBJECTIVES: To examine the relationship between primary diagnoses and mobility impairment and recovery among hospitalized older adults. DESIGN: Prospective cohort study. SETTING: UF Health Shands Hospital, an 852-bed level I trauma center located in Gainesville, Florida. PARTICIPANTS: A total of 18,551 older adults (≥65 years) with 29,148 hospitalizations between January 2009 and April 2014. MEASUREMENTS: Incident and discharge mobility impairment and recovery were assessed using the Braden activity subscale score that was recorded by the nursing staff at every shift change: approximately 3 times per day...
May 1, 2016: Journal of the American Medical Directors Association
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