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https://www.readbyqxmd.com/read/29678896/outcomes-for-patients-with-rheumatic-heart-disease-after-cardiac-surgery-followed-at-rural-district-hospitals-in-rwanda
#1
Emmanuel K Rusingiza, Ziad El-Khatib, Bethany Hedt-Gauthier, Gedeon Ngoga, Symaque Dusabeyezu, Neo Tapela, Cadet Mutumbira, Francis Mutabazi, Emmanuel Harelimana, Joseph Mucumbitsi, Gene F Kwan, Gene Bukhman
BACKGROUND: In sub-Saharan Africa, continued clinical follow-up, after cardiac surgery, is only available at urban referral centres. We implemented a decentralised, integrated care model to provide longitudinal care for patients with advanced rheumatic heart disease (RHD) at district hospitals in rural Rwanda before and after heart surgery. METHODS: We collected data from charts at non-communicable disease (NCD) clinics at three rural district hospitals in Rwanda to describe the outcomes of 54 patients with RHD who received cardiac valve surgery during 2007-2015...
April 20, 2018: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29655553/transitional-care-post-tavi-a-pilot-initiative-focused-on-bridging-gaps-and-improving-outcomes
#2
Sandra Wong, Lorraine Montoya, Bonnie Quinlan
Interventions focused on ensuring safe transitions for patients from hospital to home can assist in providing continuity of care, preventing readmissions, and reducing duplication of services. Patients undergoing a Transcatheter Aortic Valve Implantation (TAVI) procedure are often frail, elderly, and have multiple co-morbidities. A pilot initiative evaluating transitional care strategies through telephone follow up was implemented in a tertiary centre with the aim to identify gaps and intervene, preventing re-admission and improving patient outcomes...
April 11, 2018: Geriatric Nursing
https://www.readbyqxmd.com/read/29576902/maladjustment-of-programmable-ventricular-shunt-valves-by-inadvertent-exposure-to-a-common-hospital-device
#3
R Fujimura, R Lober, K Kamian, L Kleiner
Background: Programmable ventricular shunt valves are commonly used to treat hydrocephalus. They can be adjusted to allow for varying amounts of cerebrospinal fluid (CSF) flow using an external magnetic programming device, and are susceptible to maladjustment from inadvertent exposure to magnetic fields. Case Description: We describe the case of a 3-month-old girl treated for hydrocephalus with a programmable StrataTM II valve found at the incorrect setting on multiple occasions during her hospitalization despite frequent reprogramming and surveillance...
2018: Surgical Neurology International
https://www.readbyqxmd.com/read/29499865/ten-year-clinical-experience-of-humanitarian-cardiothoracic-surgery-in-rwanda-building-a-platform-for-ultimate-sustainability-in-a-resource-limited-setting
#4
JaBaris D Swain, Colleen Sinnott, Suellen Breakey, Rian Hasson Charles, Gita Mody, Napthal Nyirimanzi, Ceeya Patton-Bolman, Patricia Come, Gapira Ganza, Emmanuel Rusingiza, Nathan Ruhamya, Joseph Mucumbitsi, Jorge Borges, Martin Zammert, Jochen D Muehlschlegel, Robert Oakes, Bruce Leavitt, R Morton Bolman
OBJECTIVE: Despite its near complete eradication in resource-rich countries, rheumatic heart disease remains the most common acquired cardiovascular disease in sub-Saharan Africa. With a ratio of physicians/population of 1 per 10,500, including only 4 cardiologists for a population of 11.4 million, Rwanda represents a resource-limited setting lacking the local capacity to detect and treat early cases of strep throat and perform lifesaving operations for advanced rheumatic heart disease...
February 27, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29464459/a-diaper-pad-for-diaper-based-urine-collection-and-colorimetric-screening-of-urinary-biomarkers
#5
Haakon Karlsen, Tao Dong, Zhenhe Suo
The high prevalence of urinary tract infection in aging adults is a challenging aspect of geriatric care. Incontinence and cognitive/functional impairment make collection of urine samples difficult and often require either catheterization for sample collection, which is a risk factor for infections, or more lenient criteria for initiating antibiotic treatment. We report the development of a diaper inlay with absorbent materials, superabsorbent polymer-based valve and chemical reaction pads for rapid screening of urinary tract infection of incontinent diaper-wearing elderly receivers of home care services...
May 2018: Annals of Biomedical Engineering
https://www.readbyqxmd.com/read/29437076/transcatheter-pulmonary-valve-replacement-in-patients-with-congenital-heart-disease
#6
Shantelle Bartra
Transcatheter pulmonary valve replacement is now a feasible alternative to surgical pulmonary valve replacement in children and adults with dysfunctional right ventricular outflow conduits. Currently, 2 types of valves can be used for this application. This article provides an overview of the procedure and how it is performed, indications and contraindications for transcatheter pulmonary valve replacement, and short- and long-term outcomes. Nursing considerations mainly focus on educating patients, preventing bleeding and infection, monitoring renal function, and preventing injury to the catheter insertion site...
February 2018: Critical Care Nurse
https://www.readbyqxmd.com/read/29429863/-ventilation-during-cardiopulmonary-resuscitation-in-the-infant-mouth-to-mouth-and-nose-or-bag-valve-mask-a-quasi-experimental-study
#7
Myriam Santos-Folgar, Martín Otero-Agra, Felipe Fernández-Méndez, María Teresa Hermo-Gonzalo, Roberto Barcala-Furelos, Antonio Rodríguez-Núñez
INTRODUCTION: It has been observed that health professionals have difficulty performing quality cardiopulmonary resuscitation (CPR). The aim of this study was to compare the quality of ventilations performed by Nursing students on an infant model using different methods (mouth-to-mouth-and-nose or bag-valve-mask). MATERIAL AND METHODS: A quasi-experimental cross-sectional study was performed that included 46 second-year Nursing students. Two quantitative 4-minute tests of paediatric CPR were performed: a) mouth-to-mouth-and-nose ventilations, and b) ventilations with bag-valve-mask...
February 8, 2018: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/29412299/spiritual-well-being-and-hope-in-the-preoperative-period-of-cardiac-surgery
#8
Simone Maria Muniz da Silva Bezerra, Eduardo Tavares Gomes, Paulo César da Costa Galvão, Karolayne Vieira de Souza
OBJECTIVE: To characterize relations between spiritual well-being and hope of patients in the preoperative period of cardiac surgery. METHOD: Exploratory cross-sectional study with quantitative approach, performed in the infirmaries of a reference hospital in cardiology. We evaluated 69 patients hospitalized in preoperative period of myocardial revascularization, valve repair or replacement. RESULTS: We verified that patients hold relevant scores of hope and welfare in all areas, being the existential well-being significantly lower than the religious one...
March 2018: Revista Brasileira de Enfermagem
https://www.readbyqxmd.com/read/29284341/cerebral-perfusion-monitoring-in-adult-patients-following-cardiac-surgery-an-observational-study
#9
Tammy Slater, Julie Stanik-Hutt, Patricia Davidson
BACKGROUND: Following adult cardiac surgery, often difficult to detect fluctuations in regional cerebral perfusion can contribute to strokes. Optimal cerebral perfusion remains elusive and traditional monitoring strategies do not consistently identify acute changes. Non-invasive cerebral oximetry may detect perfusion variations. OBJECTIVE: To assess the feasibility of postoperative non-invasive cerebral oximetry monitoring. METHODS: Non-invasive cerebral oximetry was performed on adult aortic valve surgery patients in a cardiac surgical intensive care unit...
December 2017: Contemporary Nurse
https://www.readbyqxmd.com/read/29275990/octogenarians-post-acute-care-use-after-cardiac-valve-surgery-and-recovery-clinical-implications
#10
Elizabeth Edmiston, Mary A Dolansky, Melissa Zullo, Daniel E Forman
Octogenarians receiving cardiac valve surgery is increasing and recovery is challenging. Post-acute care (PAC) services assist with recovery, yet services provided in facilities do not provide adequate cardiac-focused care or long-term self-management support. The purpose of the paper was to report post-acute care discharge rates in octogenarians and propose clinical implications to improve PAC services. Using a 2003 Medicare Part A database, we studied post-acute care service use in octogenarians after cardiac valve surgery...
December 21, 2017: Geriatric Nursing
https://www.readbyqxmd.com/read/29239751/feasibility-of-single-vs-two-physician-procedural-sedation-in-a-small-community-emergency-department
#11
Clayton P Josephy, David R Vinson
OBJECTIVE: Sedation is commonly required for painful procedures in the emergency department (ED). Some facilities mandate two physicians be present for deep sedation cases. Evidence is lacking, however, that a two-physician approach improves safety outcomes. We report our experience on the feasibility of replacing a two-physician ED procedural sedation policy with a single-physician policy in a small, single-coverage community ED. METHODS: This is a retrospective, before/after, single-center observational study of prospectively collected data from January 2013 through December 2016...
November 3, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29170877/oral-anticoagulant-dosing-administration-and-storage-a-cross-sectional-survey-of-canadian-health-care-providers
#12
Siavash Piran, Sam Schulman, Mohamed Panju, Menaka Pai
Direct oral anticoagulant (DOAC) use is increasing worldwide. However, if not taken or prescribed correctly, DOACs have serious side effects. It is crucial that healthcare providers (HCPs) offer patients accurate information and counselling around DOACs, to optimize safe and effective use. To assess knowledge around oral anticoagulant indication, dosing, storage, and administration, an electronic survey was distributed to HCPs across Canada from June to August 2017, with 18 questions on the practical use of oral anticoagulants...
January 2018: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/29148592/use-of-oral-anticoagulants-in-german-nursing-home-residents-drug-use-patterns-and-predictors-for-treatment-choice
#13
Kathrin Jobski, Falk Hoffmann, Stefan Herget-Rosenthal, Michael Dörks
AIMS: Information on utilization of oral anticoagulants (OACs) in nursing homes is scarce. This study aimed to (i) describe OAC use in German nursing home residents, (ii) examine factors influencing whether treatment is initiated with vitamin K antagonists (VKAs) or non-VKA oral anticoagulants (NOACs) and (iii) assess which conditions predict switching to NOAC instead of continuing VKA. METHODS: Using claims data (2010-2014), we studied a cohort of new nursing home residents aged ≥65 years receiving OAC...
March 2018: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29084068/can-providers-use-clinical-skills-to-assess-the-adequacy-of-ventilation-in-children-during-bag-valve-mask-ventilation
#14
Heather J Becker, Melissa L Langhan
OBJECTIVE: Bag-valve mask (BVM) ventilation requires both manual skill and clinical assessment of minute ventilation. Subjective factors can make supplying appropriate ventilation difficult. Capnography is not routinely used when ventilating nonintubated patients. Our objective was to determine if providers were able to maintain normal capnography values with BVM ventilation in pediatric patients based on clinical skills alone. METHODS: Providers (nurses, residents, and fellows) delivered 2 minutes of BVM respiratory support to healthy children during induction of anesthesia for elective surgery...
October 27, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28986731/successful-management-of-prolonged-venovenous-extracorporeal-membrane-oxygenation-in-an-octogenarian
#15
Masami Takagaki, Hiroki Yamaguchi, Shinichi Mitsuyama, Tasuku Kadowaki, Takeshi Ando
Venovenous extracorporeal membrane oxygenation is now an established treatment for acute respiratory distress syndrome. However, this treatment remains rare in octogenarians and is associated with poor outcomes. An 81-year-old man with a history of chronic obstructive pulmonary disease and heavy smoking underwent mitral and tricuspid valve repair and the Maze procedure for mitral and tricuspid regurgitation and paroxysmal atrial fibrillation. Although he was extubated the following day, his postoperative course was complicated with pneumonia followed by acute respiratory distress syndrome...
December 2017: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/28976398/-nursing-care-in-elderly-patients-with-cardiovascular-disease
#16
Nuray Enç, Havva Öz Alkan
Aging is a process that has biological, physiological, psychological, sociological and chronological dimensions and can be defined from different directions. The incidence of cardiovascular diseases such as hypertension, coronary heart disease, heart failure, dysrhythmia and heart valve diseases is increasing with age. Cardiovascular diseases are the most common cause of death in people over 65 years of age. It also causes serious health problems and poses a significant burden on the health care system. Nurses have important responsibilities in the care of the elderly patients with cardiovascular system disease...
September 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/28928262/the-use-of-speaking-valves-in-children-with-tracheostomy-tubes
#17
REVIEW
Weeda Zabih, Theresa Holler, Faiza Syed, Laurie Russell, Jennifer Allegro, Reshma Amin
One-way speaking valves have been successfully used to restore audible meaningful speech in adult patients after tracheostomy tube placement. One-way speaking valves have also been used in pediatric patients after tracheostomy tube placement with promising results. We conducted a scoping review to synthesize and summarize the current evidence on the use of one-way tracheostomy tube speaking valves in the pediatric population to identify knowledge gaps that could inform future research programs and facilitate evidence-based clinical decision making...
December 2017: Respiratory Care
https://www.readbyqxmd.com/read/28865889/regional-variation-in-utilization-in-hospital-mortality-and-health-care-resource-use-of-transcatheter-aortic-valve-implantation-in-the-united-states
#18
MULTICENTER STUDY
Tanush Gupta, Ankur Kalra, Dhaval Kolte, Sahil Khera, Pedro A Villablanca, Kashish Goel, Anna E Bortnick, Wilbert S Aronow, Julio A Panza, Neal S Kleiman, J Dawn Abbott, David P Slovut, Cynthia C Taub, Gregg C Fonarow, Michael J Reardon, Charanjit S Rihal, Mario J Garcia, Deepak L Bhatt
We queried the National Inpatient Sample database from 2012 to 2014 to identify all patients aged ≥18 years undergoing transcatheter aortic valve implantation (TAVI) in the United States. Regional differences in TAVI utilization, in-hospital mortality, and health-care resource use were analyzed. Of 41,025 TAVI procedures in the United States between 2012 and 2014, 10,390 were performed in the Northeast, 9,090 in the Midwest, 14,095 in the South, and 7,450 in the West. Overall, the number of TAVI implants per million adults increased from 24...
November 15, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28862964/hospital-practice-of-direct-home-discharge-and-30-day-readmission-after-transcatheter-aortic-valve-replacement-in-the-society-of-thoracic-surgeons-american-college-of-cardiology-transcatheter-valve-therapy-sts-acc-tvt-registry
#19
John A Dodson, Mathew R Williams, David J Cohen, Pratik Manandhar, Sreekanth Vemulapalli, Caroline Blaum, Hua Zhong, John S Rumsfeld, Judith S Hochman
BACKGROUND: Nearly 17% of patients are readmitted within 30 days of discharge after transcatheter aortic valve replacement. Selected patients are discharged to skilled nursing facilities, yet the association between a hospital's practice to discharge home versus to skilled nursing facilities, and readmission remains unclear. METHODS AND RESULTS: The Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy (STS/ACC TVT) Registry was used to evaluate readmissions among patients undergoing transcatheter aortic valve replacement (2011-2015)...
August 21, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28828765/fast-track-extubation-in-adult-patients-on-pump-open-heart-surgery-at-a-tertiary-care-hospital
#20
Mohammad Irfan Akhtar, Hasanat Sharif, Mohammad Hamid, Khalid Samad, Fazal Hameed Khan
Background: Fast-track cardiac surgery programs have been established as the standard of cardiac surgical care. Studies have shown that early extubation in elective cardiac surgery patients, including coronary and non-coronary open-heart surgery patients does not increase perioperative morbidity and mortality. The objective of this observational study was to determine the success and failure profile of fast track extubation (FTE) practice in adult open-heart surgical patients. Methods: The study was conducted at cardiac operating room and Cardiac Intensive Care Unit (CICU) of a tertiary care hospital for a period of nine months, i...
October 2016: Journal of Ayub Medical College, Abbottabad: JAMC
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