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Rejection of Care

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https://www.readbyqxmd.com/read/28106705/repair-of-orbital-floor-fracture-with-modified-transnasal-endoscopic-approach-through-anterior-space-to-nasolacrimal-duct
#1
Motohiko Suzuki, Yoshihisa Nakamura, Shinya Ozaki, Makoto Yokota, Shingo Murakami
OBJECTIVES: Endoscopic approach provides excellent magnification and visualization, and a purely transnasal approach is minimally invasive method. However, it is very difficult to repair anterior and lateral fractures with the previous transnasal endoscopic approaches, since repair of orbital fractures is managed through the middle meatus and ostium from the posterior side of the nasolacrimal duct with side-viewing endoscope and curved instruments. Therefore, the authors used modified transnasal endoscopic approach as an alternative for repair of orbital floor fractures in order to effectively reach the lateral or anterior fracture of the orbital floor with straight endoscope and instruments endoscopically...
January 18, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28097991/nursing-an-exquisite-obsession-clark-june-nursing-an-exquisite-obsession-220pp-%C3%A2-12-99-quay-books-9781856425094-1856425096-formula-see-text
#2
(no author information available yet)
One of the publishing trends of recent years has been nursing memoirs. Heartwarming anecdotes of the nursing care provided for eccentric patients are generally combined with attacks on supposed developments in nurse education after about 1975, and the whole account is bathed in the light of a golden age that has passed. This memoir emphatically rejects such nostalgia.
January 18, 2017: Nursing Standard
https://www.readbyqxmd.com/read/28092800/effect-of-venepuncture-process-design-on-efficiency-and-failure-rates-a-simulation-model-study-for-secondary-care
#3
Sean Reed, Rasa Remenyte-Prescott, Ben Rees
BACKGROUND: Healthcare aims to deliver good patient outcomes. For many clinical procedures there are multiple alternative task sequences that can be performed. These deviations can influence procedure reliability, efficiency of usage of hospital resources and risk to staff and patient safety. Venepuncture is one of the most common invasive procedures in healthcare. Literature of clinical practice shows evidence of wide variability in the procedure order and the duration of each step, which can depend on attributes, such as patient health, sampling method and staff skills...
December 29, 2016: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/28092777/controlling-the-3d-architecture-of-self-lifting-auto-generated-tissue-equivalents-slates-for-optimized-corneal-graft-composition-and-stability
#4
Ricardo M Gouveia, Elena González-Andrades, Juan C Cardona, Carmen González-Gallardo, Ana M Ionescu, Ingrid Garzon, Miguel Alaminos, Miguel González-Andrades, Che J Connon
Ideally, biomaterials designed to play specific physical and physiological roles in vivo should comprise components and microarchitectures analogous to those of the native tissues they intend to replace. For that, implantable biomaterials need to be carefully designed to have the correct structural and compositional properties, which consequently impart their bio-function. In this study, we showed that the control of such properties can be defined from the bottom-up, using smart surface templates to modulate the structure, composition, and bio-mechanics of human transplantable tissues...
December 23, 2016: Biomaterials
https://www.readbyqxmd.com/read/28088400/hospitalizations-for-respiratory-syncytial-virus-and-vaccine-preventable-infections-in-the-first-2-years-after-pediatric-liver-transplant
#5
Amy G Feldman, Shikha S Sundaram, Brenda L Beaty, Allison Kempe
OBJECTIVES: To examine in liver transplant recipients at centers participating in the Pediatric Health Information System dataset the number of hospitalizations for respiratory syncytial virus (RSV) and vaccine-preventable infections (VPIs) in the first 2 years after transplantation, morbidity and mortality associated with these hospitalizations, and costs associated with these hospitalizations. STUDY DESIGN: A retrospective cohort study of patients <18 years of age who underwent liver transplantation at a Pediatric Health Information System center between January 1, 2004, and December 31, 2012...
January 11, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28078864/human-herpesviruses-6-and-7-encephalitis-in-immunocompetent-infants-are-they-really-so-uncommon
#6
L Marseglia, S Manti, G D Angelo, G Stroscio, D Impollonia, S Arena, C Salpietro, E Gitto
Human herpesviruses-6 and -7 (HHV-6 and 7) are considered uncommon causes of central nervous system infection and may occasionally cause encephalitis in young infants, however, the clinical syndrome and incidence are not well defined. In immunosuppressed hosts, reactivation is associated with a worse outcome such as encephalitis, hepatitis, or graft rejection. In immunocompetent hosts, this persistent infection is generally of no consequence. We report 4 cases of immunocompetent critically ill children, affected by HHV-6 and -7 encephalitis, admitted to our Pediatric Intensive Care Unit...
October 2016: Journal of Biological Regulators and Homeostatic Agents
https://www.readbyqxmd.com/read/28071839/life-after-a-lung-transplant-a-balance-of-joy-and-challenges
#7
Jytte Graarup, Elin Lindberg Mogensen, Malene Missel, Selina Kikkenborg Berg
PURPOSE: To describe patients' experiences throughout the first four months post lung transplant. BACKGROUND: Health professionals are familiar with the fact that patients' average survival after a lung transplant is about seven years and that 74% of these patients reject new organs within the first two years. By contrast, knowledge of these patients' perspectives after lung transplantation is scant. DESIGN/METHOD: A qualitative study was conducted between May, 2013 and May, 2014 in which 26 interviewees participated - four months post-transplant - based on a semi-structured interview guide...
January 10, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28066918/implementation-of-the-redesigned-community-health-fund-in-the-dodoma-region-of-tanzania-a-qualitative-study-of-views-from-rural-communities
#8
Albino Kalolo, Lara Gautier, Ralf Radermacher, Manfred Stoermer, Albrecht Jahn, Menoris Meshack, Manuela De Allegri
The need to understand how an intervention is received by the beneficiary community is well recognised and particularly neglected in the micro-health insurance (MHI) domain. This study explored the views and reactions of the beneficiary community of the redesigned Community Health Fund (CHF) implemented in the Dodoma region of Tanzania. We collected data from focus group discussions with 24 groups of villagers (CHF members and nonmembers) and in-depth interviews with 12 key informants (enrolment officers and health care workers)...
January 8, 2017: International Journal of Health Planning and Management
https://www.readbyqxmd.com/read/28065646/-what-the-family-doctor-must-know-about-lung-transplantation-complications-health-promotion-and-outcomes-part-2
#9
L Zurbano, F Zurbano
The lung transplantation is a therapeutic procedure indicated for lung diseases that are terminal and irreversible (except lung cancer) despite the best medical current treatment. It is an emergent procedure in medical care. In this review, an analyse is made of the most frequent complications of lung transplant related to the graft (rejection and chronic graft dysfunction), immunosuppression (infections, arterial hypertension, renal dysfunction, and diabetes), as well as others such as gastrointestinal complications, osteoporosis...
January 5, 2017: Semergen
https://www.readbyqxmd.com/read/28062971/cost-equivalence-and-pluralism-in-publicly-funded-health-care-systems
#10
Dominic Wilkinson, Julian Savulescu
Clinical guidelines summarise available evidence on medical treatment, and provide recommendations about the most effective and cost-effective options for patients with a given condition. However, sometimes patients do not desire the best available treatment. Should doctors in a publicly-funded healthcare system ever provide sub-optimal medical treatment? On one view, it would be wrong to do so, since this would violate the ethical principle of beneficence, and predictably lead to harm for patients. It would also, potentially, be a misuse of finite health resources...
January 6, 2017: Health Care Analysis: HCA: Journal of Health Philosophy and Policy
https://www.readbyqxmd.com/read/28062650/euthanasia-embedded-in-palliative-care-responses-to-essentialistic-criticisms-of-the-belgian-model-of-integral-end-of-life-care
#11
Jan L Bernheim, Kasper Raus
The Belgian model of 'integral' end-of-life care consists of universal access to palliative care (PC) and legally regulated euthanasia. As a first worldwide, the Flemish PC organisation has embedded euthanasia in its practice. However, some critics have declared the Belgian-model concepts of 'integral PC' and 'palliative futility' to fundamentally contradict the essence of PC. This article analyses the various essentialistic arguments for the incompatibility of euthanasia and PC. The empirical evidence from the euthanasia-permissive Benelux countries shows that since legalisation, carefulness (of decision making) at the end of life has improved and there have been no significant adverse 'slippery slope' effects...
January 6, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28062570/moving-biomarkers-toward-clinical-implementation-in-kidney-transplantation
#12
Madhav C Menon, Barbara Murphy, Peter S Heeger
Long-term kidney transplant outcomes remain suboptimal, delineating an unmet medical need. Although current immunosuppressive therapy in kidney transplant recipients is effective, dosing is conventionally adjusted empirically on the basis of time after transplant or altered in response to detection of kidney dysfunction, histologic evidence of allograft damage, or infection. Such strategies tend to detect allograft rejection after significant injury has already occurred, fail to detect chronic subclinical inflammation that can negatively affect graft survival, and ignore specific risks and immune mechanisms that differentially contribute to allograft damage among transplant recipients...
January 6, 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/28058228/corticosteroid-minimization-in-renal-transplantation-careful-patient-selection-enables-feasibility
#13
Georgios Vlachopanos, Julie M Bridson, Ajay Sharma, Ahmed Halawa
AIM: To explore the benefits and harms of corticosteroid (CS) minimization following renal transplantation. METHODS: CS minimization attempts to improve cardiovascular risk factors (hypertension, diabetes, dyslipidemia), to enhance growth in children, to ameliorate bone disease and to lead to better compliance with immunosuppressive agents. Nevertheless, any benefit must be carefully weighed against the reduction in net immunosuppression and the potential harm to renal allograft function and survival...
December 24, 2016: World Journal of Transplantation
https://www.readbyqxmd.com/read/28058211/organ-transplantation-and-drug-eluting-stents-perioperative-challenges
#14
REVIEW
Aparna Dalal
Patients listed for organ transplant frequently have severe coronary artery disease (CAD), which may be treated with drug eluting stents (DES). Everolimus and zotarolimus eluting stents are commonly used. Newer generation biolimus and novolimus eluting biodegradable stents are becoming increasingly popular. Patients undergoing transplant surgery soon after the placement of DES are at increased risk of stent thrombosis (ST) in the perioperative period. Dual antiplatelet therapy (DAPT) with aspirin and a P2Y12 inhibitor such as clopidogrel, prasugrel and ticagrelor is instated post stenting to decrease the incident of ST...
December 24, 2016: World Journal of Transplantation
https://www.readbyqxmd.com/read/28054208/is-2d-speckle-tracking-echocardiography-useful-for-detecting-and-monitoring-myocardial-dysfunction-in-adult-m-3243a-g-carriers-a-retrospective-pilot-study
#15
S Koene, J Timmermans, G Weijers, P de Laat, C L de Korte, J A M Smeitink, M C H Janssen, L Kapusta
OBJECTIVES: Cardiomyopathy is a common complication of mitochondrial disorders, associated with increased mortality. Two dimensional speckle tracking echocardiography (2DSTE) can be used to quantify myocardial deformation. Here, we aimed to determine the usefulness of 2DSTE in detecting and monitoring subtle changes in myocardial dysfunction in carriers of the 3243A>G mutation in mitochondrial DNA. METHODS: In this retrospective pilot study, 30 symptomatic and asymptomatic carriers of the mitochondrial 3243A>G mutation of whom two subsequent echocardiograms were available were included...
January 4, 2017: Journal of Inherited Metabolic Disease
https://www.readbyqxmd.com/read/28049470/quality-indicators-for-the-referral-process-from-primary-to-specialised-mental-health-care-an-explorative-study-in-accordance-with-the-rand-appropriateness-method
#16
Miriam Hartveit, Kris Vanhaecht, Olav Thorsen, Eva Biringer, Kjell Haug, Aslak Aslaksen
BACKGROUND: Communication between involved parties is essential to ensure coordinated and safe health care delivery. However, existing literature reveals that the information relayed in the referral process is seen as insufficient by the receivers. It is unknown how this insufficiency affects the quality of care, and valid performance measures to explore it are lacking. The aim of the present study was to develop quality indicators to detect the impact that the quality of referral letters from primary care to specialised mental health care has on the quality of mental health services...
January 3, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28043082/a-dialysis-patient-s-choice-and-a-nephrologist-s-obligation-the-need-to-understand-and-value-the-patient-s-perspective
#17
EDITORIAL
Juliya Hemmett, Christopher W McIntyre
Patient-centered care is critical to the successful management of chronic diseases, such as chronic kidney disease. While a course of treatment may prolong life it may come with a reduced quality of life (QOL). For many patients, the decision to prolong life at the expense of lower QOL is not an obvious choice. Dialysis patients make treatment decisions daily, some of which can be life-altering. Therefore, the need for optimal decision-making may be more pressing in dialysis patients than in many other chronic disease states...
January 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28031583/suicide-and-suicidal-behavior-among-transgender-persons
#18
REVIEW
H G Virupaksha, Daliboyina Muralidhar, Jayashree Ramakrishna
BACKGROUND: Suicide rate and suicidal tendencies among transgender persons are considerably high compared to general population. Hence, this review is an attempt to understand the issues around the suicide and suicidal behavior among transgender persons. METHODOLOGY: The literature search conducted using three sources, i.e., electronic databases (PubMed, ProQuest, Google Scholar, PsycInfo), manual search (library catalog), and gray literature (consultation with experts)...
November 2016: Indian Journal of Psychological Medicine
https://www.readbyqxmd.com/read/28004964/patient-safety-under-deep-sedation-for-digestive-endoscopic-procedures
#19
Julián Álvarez, Rafael Cabadas, Manuel de la Matta
Deep sedation with Propofol has become popular in recent years. The safety of this technique when administered by non-anaesthesiologists has created much controversy which at times is masked in a contentious debate on the economic sustainability of the health system. In 2011, the Spanish Society of Anaesthesiology, Resuscitation and Pain Therapy, along with 20 other organisations from European countries, revoked the recommendations of the European Society of Gastrointestinal Endoscopy on the administration of Propofol by non-anaesthesiologists, citing that it is "extremely dangerous for the safety and quality of endoscopic procedures"...
December 22, 2016: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28004607/comparison-of-food-colour-regulations-in-the-eu-and-the-us-a-review-of-current-provisions
#20
Sari Lehto, Maria Buchweitz, Alexandra Klimm, Raphaela Straßburger, Cato Bechtold, Franz Ulberth
This review describes the European Union and the US regulations applicable to food colours. Despite the different regulatory frameworks, the overall approach is similar, based on well-established risk-assessment procedures and risk-management measures. However, differences impacting free movement of goods can be found in the details and implementation of regulations. Using additives approved only in the US or in the EU implies that producers aiming to export need to adjust their product composition to the export market...
January 20, 2017: Food Additives & Contaminants. Part A, Chemistry, Analysis, Control, Exposure & Risk Assessment
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