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https://www.readbyqxmd.com/read/28902042/performance-of-a-quick-pregnancy-test-on-whole-blood-in-early-pregnancy-units-a-prospective-cohort-study
#1
Caroline Legoupil, Isabelle Enderle, Flore-Anne Le Baccon, Claude Bendavid, Lucas Peltier, Estelle Bauville, Jean Leveque, Vincent Lavoue, Maela Le Lous
OBJECTIVE: To assess the diagnostic performance of the NG-Test human chorionic gonadotropin (hCG) WB, which is a new point-of-care (POC) hCG whole-blood test. MATERIALS AND METHODS: This prospective study included women consulted in early pregnancy units for vaginal bleeding and/or pelvic pain with unknown pregnancy status after medical consultation including a pelvic ultrasound scan. A new POC test (the NG-Test hCG WB) and the usual laboratory serum test (considered the gold standard) were performed in patients...
September 8, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28890987/impact-of-patient-specific-inflow-velocity-profile-on-hemodynamics-of-the-thoracic-aorta
#2
Pouya Youssefi, Alberto Gomez, Christopher Arthurs, Rajan Sharma, Marjan Jahangiri, Alberto Figueroa
Background-Computational fluid dynamics (CFD) provides a non-invasive method to functionally assess aortic hemodynamics. The thoracic aorta has an anatomically complex inlet comprising of the aortic valve, which is highly prone to different morphologies and pathologies. We investigated the effect of using patient-specific inflow velocity profiles compared to idealised profiles based on the patient's flow waveform. Methods-A healthy 31yo with a normally functioning tricuspid aortic valve (subject A), and a 52yo with a bicuspid aortic valve, aortic valvular stenosis and dilated ascending aorta (subject B) were studied...
September 11, 2017: Journal of Biomechanical Engineering
https://www.readbyqxmd.com/read/28890870/treg-th17-cell-balance-and-phytohaemagglutinin-activation-of-t-lymphocytes-in-peripheral-blood-of-systemic-sclerosis-patients
#3
Ekaterina Krasimirova, Tsvetelina Velikova, Ekaterina Ivanova-Todorova, Kalina Tumangelova-Yuzeir, Desislava Kalinova, Vladimira Boyadzhieva, Nikolay Stoilov, Tsvetelina Yoneva, Rasho Rashkov, Dobroslav Kyurkchiev
AIM: To investigate T-cell activation, the percentage of peripheral T regulatory cells (Tregs), Th17 cells and the circulating cytokine profile in systemic sclerosis (SSc). METHODS: We enrolled a total of 24 SSc patients and 16 healthy controls in the study and divided the patients as having diffuse cutaneous SSc (dcSSc, n = 13) or limited cutaneous SSc (lcSSc, n = 11). We performed a further subdivision of the patients regarding the stage of the disease - early, intermediate or late...
August 20, 2017: World Journal of Experimental Medicine
https://www.readbyqxmd.com/read/28871456/queueing-theoretic-analysis-of-labor-and-delivery-understanding-management-styles-and-c-section-rates
#4
Matthew Gombolay, Toni Golen, Neel Shah, Julie Shah
Childbirth is a complex clinical service requiring the coordinated support of highly trained healthcare professionals as well as management of a finite set of critical resources (such as staff and beds) to provide safe care. The mode of delivery (vaginal delivery or cesarean section) has a significant effect on labor and delivery resource needs. Further, resource management decisions may impact the amount of time a physician or nurse is able to spend with any given patient. In this work, we employ queueing theory to model one year of transactional patient information at a tertiary care center in Boston, Massachusetts...
September 4, 2017: Health Care Management Science
https://www.readbyqxmd.com/read/28865753/developing-an-emergency-department-crowding-dashboard-a-design-science-approach
#5
Niels Martin, Jochen Bergs, Dorien Eerdekens, Benoît Depaire, Sandra Verelst
BACKGROUND: As an emergency department (ED) is a complex adaptive system, the analysis of continuously gathered data is valuable to gain insight in the real-time patient flow. To support the analysis and management of ED operations, relevant data should be provided in an intuitive way. AIM: Within this context, this paper outlines the development of a dashboard which provides real-time information regarding ED crowding. METHODS: The research project underlying this paper follows the principles of design science research, which involves the development and study of artifacts which aim to solve a generic problem...
August 30, 2017: International Emergency Nursing
https://www.readbyqxmd.com/read/28852873/barriers-and-enablers-to-implementing-scalp-cooling-in-australia-a-qualitative-study-of-health-professionals-attitudes-to-and-experience-with-scalp-cooling
#6
Joanne M Shaw, Jane O'Brien, Susan Chua, Richard De Boer, Rachel Dear, Nicholas Murray, Fran Boyle
BACKGROUND: Chemotherapy-induced alopecia is a common and distressing adverse event for patients. Scalp cooling to reduce this alopecia has been available in Europe for more than a decade, but only recently introduced in Australia. The aim of this study was to qualitatively explore health professionals' perceptions of the barriers and enablers to the implementation of scalp cooling in Australian cancer centres. METHODS: Using a qualitative methodology, telephone interviews were conducted with 21 health professionals working in a tumour stream where chemotherapy-induced alopecia is an adverse event of treatment...
August 29, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28852789/a-multi-center-prospective-cohort-study-of-patient-transfers-from-the-intensive-care-unit-to-the-hospital-ward
#7
Henry T Stelfox, Jeanna Parsons Leigh, Peter M Dodek, Alexis F Turgeon, Alan J Forster, Francois Lamontagne, Rob A Fowler, Andrea Soo, Sean M Bagshaw
PURPOSE: To provide a 360-degree description of ICU-to-ward transfers. METHODS: Prospective cohort study of 451 adults transferred from a medical-surgical ICU to a hospital ward in 10 Canadian hospitals July 2014-January 2016. Transfer processes documented in the medical record. Patient (or delegate) and provider (ICU/ward physician/nurse) perspectives solicited by survey 24-72 h after transfer. RESULTS: Medical records (100%) and survey responses (ICU physicians-80%, ICU nurses-80%, ward physicians-46%, ward nurses-64%, patients-74%) were available for most transfers...
August 29, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28841814/the-impact-of-commercial-rapid-respiratory-virus-diagnostic-tests-on-patient-outcomes-and-health-system-utilization
#8
Fiona Ko, Steven J Drews
Acute respiratory tract infections due to influenza A/B and respiratory syncytial virus (RSV) are major causes of morbidity and mortality globally. Rapid tests for detection of these pathogens include antigen detection point of care tests (POC) and newer easy to use molecular tests. From experience, these assays improve both laboratory workflow and assay interpretation issues. However, the question of the benefits of using rapid test technology compared to routine laboratory testing for respiratory viral pathogens is still often asked...
September 4, 2017: Expert Review of Molecular Diagnostics
https://www.readbyqxmd.com/read/28839885/emergency-general-surgery-hot-clinics-reduce-admission-rates-and-duration-of-inpatient-stay
#9
Francesca Th'ng, Christos Skouras, Alice Paterson-Brown, Rajan Ravindran, Peter Lamb, Andrew de Beaux, Simon Paterson-Brown, Damian J Mole
OBJECTIVE: To determine the impact of a 'Hot Clinic' (HC) on emergency general surgery patient flow-through. DESIGN: Prospective service evaluation study. SETTING: HC is a four-bedded area coordinated by a specialist nurse. The HC consultant sees emergency patients referred from the emergency department, general practitioners or those in preceding 24 h considered suitable for interim discharge while awaiting investigations and HC reassessment...
January 2017: Frontline Gastroenterology
https://www.readbyqxmd.com/read/28837555/spread-of-hospital-acquired-infections-a-comparison-of-healthcare-networks
#10
Narimane Nekkab, Pascal Astagneau, Laura Temime, Pascal Crépey
Hospital-acquired infections (HAIs), including emerging multi-drug resistant organisms, threaten healthcare systems worldwide. Efficient containment measures of HAIs must mobilize the entire healthcare network. Thus, to best understand how to reduce the potential scale of HAI epidemic spread, we explore patient transfer patterns in the French healthcare system. Using an exhaustive database of all hospital discharge summaries in France in 2014, we construct and analyze three patient networks based on the following: transfers of patients with HAI (HAI-specific network); patients with suspected HAI (suspected-HAI network); and all patients (general network)...
August 2017: PLoS Computational Biology
https://www.readbyqxmd.com/read/28794660/a-renal-colic-fast-track-pathway-to-improve-waiting-times-and-outcomes-for-patients-presenting-to-the-emergency-department
#11
Omar Al Kadhi, Kate Manley, Madhavi Natarajan, Valmiki Lutchmedial, Abbi Forsyth, Kate Tabrett, Jonathan Betteridge, William Finch, Heinrich Hollis
INTRODUCTION: Renal colic is commonly encountered in the emergency department (ED). We validated a fast track renal colic (FTRC) initiative to decrease patient waiting times and streamline patient flow. METHOD: The FTRC pathway was devised according to the National Institute for Health and Care Excellence clinical summary criteria for the management of patients with suspected renal colic. ED triage nurses use the pathway to identify patients with likely renal colic suitable for fast track to analgesia, investigation and management...
2017: Open Access Emergency Medicine: OAEM
https://www.readbyqxmd.com/read/28790024/hierarchical-medical-system-based-on-big-data-and-mobile-internet-a-new-strategic-choice-in-health-care
#12
Yaogang Wang, Li Sun, Jie Hou
China is setting up a hierarchical medical system to solve the problems of biased resource allocation and high patient flows to large hospitals. The development of big data and mobile Internet technology provides a new perspective for the establishment of hierarchical medical system. This viewpoint discusses the challenges with the hierarchical medical system in China and how big data and mobile Internet can be used to mitigate these challenges.
August 8, 2017: JMIR Medical Informatics
https://www.readbyqxmd.com/read/28755763/reliability-of-triage-nurses-and-emergency-physicians-for-the-interpretation-of-the-c-3po-rule-for-head-trauma-in-children
#13
Jocelyn Gravel, Serge Gouin, Annie Canuel, Benoît Mâsse
INTRODUCTION: The C-3PO rule has been validated for use by emergency physicians to identify young children at risk of skull fracture following head trauma. The use of the rule by triage nurses could improve patient flow in the emergency department. OBJECTIVES: To evaluate the interobserver agreement of triage nurses and emergency physicians in the interpretation of the C-3PO rule in a pediatric emergency department. METHODS: This was a prospective observational study performed in a consecutive sample of children visiting a single emergency department...
July 26, 2017: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
https://www.readbyqxmd.com/read/28750906/quantitative-metrics-for-evaluating-the-phased-roll-out-of-clinical-information-systems
#14
David Wong, Nicolas Wu, Peter Watkinson
OBJECTIVES: We introduce a novel quantitative approach for evaluating the order of roll-out during phased introduction of clinical information systems. Such roll-outs are associated with unavoidable risk due to patients transferring between clinical areas using both the old and new systems. METHODS: We proposed a simple graphical model of patient flow through a hospital. Using a simple instance of the model, we showed how a roll-out order can be generated by minimising the flow of patients from the new system to the old system...
September 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/28750022/determinants-of-operative-time-in-thyroid-surgery-a-prospective-multicenter-study-of-3454-thyroidectomies
#15
Arnaud Patoir, Cécile Payet, Jean-Louis Peix, Cyrille Colin, Léa Pascal, Jean-Louis Kraimps, Fabrice Menegaux, François Pattou, Frédéric Sebag, Sandrine Touzet, Stéphanie Bourdy, Jean-Christophe Lifante, Antoine Duclos
OBJECTIVE: To identify the determinants of operative time for thyroidectomy and quantify the relative influence of preoperative and intra-operative factors. BACKGROUND: Anticipation of operative time is key to avoid both waste of hospital resources and dissatisfaction of the surgical staff. Having an accurate and anticipated planning would allow a rationalized operating room use and may improve patient flow and staffing level. METHODS: We conducted a prospective, cross-sectional study between April 2008 and December 2009...
2017: PloS One
https://www.readbyqxmd.com/read/28748771/acute-care-referral-systems-in-liberia-transfer-and-referral-capabilities-in-a-low-income-country
#16
Jimin Kim, Maria Barreix, Christine Babcock, Corey B Bills
Introduction Following two decades of armed conflict in Liberia, over 95% of health care facilities were partially or completely destroyed. Although the Liberian health system has undergone significant rehabilitation, one particular weakness is the lack of organized systems for referral and prehospital care. Acute care referral systems are a critical component of effective health care delivery and have led to improved quality of care and patient outcomes. Problem This study aimed to characterize the referral and transfer systems in the largest county of Liberia...
July 27, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28738050/intralesional-therapy-consensus-statements-for-best-practices-in-administration-from-the-melanoma-nursing-initiative%C3%A2
#17
Virginia Seery
BACKGROUND: Talimogene laherparepvec (T-VEC) is the first intralesional therapy for melanoma approved by the U.S. Food and Drug Administration. This oncolytic viral immunotherapy has improved outcomes for patients with locoregional recurrent melanoma and is showing promise in combination with systemic therapies. 
. OBJECTIVES: This article aims to provide oncology nurses with expert guidance on best practices in incorporating intralesional therapy for patients diagnosed with melanoma in practice...
August 1, 2017: Clinical Journal of Oncology Nursing
https://www.readbyqxmd.com/read/28734583/kidney-transplantation-from-hla-incompatible-live-donors-efficiency-and-outcome-of-32-patients-after-desensitisation
#18
Constantino Fernández, María Calvo, Natacha Leite, Andrés López, Tamara Ferreiro, Roi Ribera, Rocío Seijo, Ángel Alonso
Desensitisation is a procedure undergone by the recipient of a kidney transplant from a donor who is cross-match positive. The aim of this study was to present the outcomes from our hospital of kidney transplant recipients from HLA-incompatible live donors after desensitisation. We studied 32 patients aged 46±14 years with a mean fluorescence intensity (MFI) versus class I HLA of 7979±4089 and 6825±4182 MFI versus class II and relative intensity scale (RIS) of 8.9±7.6. The complement-dependent cytotoxicity (CDC) cross-matching test was positive in 18 patients, flow cytometry was positive in 7 patients and donor-specific antibodies (DEA) were detected in 7...
July 19, 2017: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
https://www.readbyqxmd.com/read/28726594/crowding-karenina-and-complexity-patient-flow-in-evolving-health-care-ecosystems
#19
David A Petrie
No abstract text is available yet for this article.
July 20, 2017: CJEM
https://www.readbyqxmd.com/read/28723845/lean-six-sigma-techniques-to-improve-ophthalmology-clinic-efficiency
#20
Thomas A Ciulla, Mohan V Tatikonda, Yehya A ElMaraghi, Rehan M Hussain, Amanda L Hill, Julie M Clary, Eyas Hattab
PURPOSE: Ophthalmologists serve an increasing volume of a growing elderly population undergoing increasingly complex outpatient medical care, including extensive diagnostic testing and treatment. The resulting prolonged patient visit times ("patient flow times") limit quality, patient and employee satisfaction, and represent waste. Lean Six Sigma process improvement was used in a vitreoretinal practice to decrease patient flow time, demonstrating that this approach can yield significant improvement in health care...
July 18, 2017: Retina
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