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https://www.readbyqxmd.com/read/28534558/-proposing-a-physiological-model-for-emergency-department-operating-principles-classification-of-overcrowding-and-guidelines-for-redesign
#1
M Herrera Carranza, F Aguado Correa, N Padilla Garrido, F López Camacho
The operation of Emergency Departments (ED) is determined by demand, their own organizational structures and the connection to other medical care levels. When these elements are not simultaneous, it hinders patient flow and decreases capacity, making it necessary to employ a systemic approach to the chain of emergency care as a single operational entity. With this theoretical orientation, we suggest a conceptual model similar to the physiological cardiac output, in which the preload is the demand, the contractile or flow pump is the organizational structure, the afterload is the hospital, the pre-ED valve is primary care and outpatient emergencies, and the post-ED valve is the diagnostic support services and the specialist consultants...
April 30, 2017: Anales del Sistema Sanitario de Navarra
https://www.readbyqxmd.com/read/28511373/prevalence-of-nutritional-deficiency-anaemia-and-its-impact-on-scholastic-performance-among-undergraduate-medical-students
#2
Ningappa Asha Rani, Rajeshwari Arasegowda, Pramit Mukherjee, Shilpashree Yeliyur Dhananjay
INTRODUCTION: Nutritional deficiency anaemia can lead to development of headache, fatigue, lethargy, apathy, exertional dyspnoea, palpitations and tinnitus and thereby decrease the quality of everyday life to a great extent. Such symptoms may pose a hindrance for students in their academic life and have a negative impact on their career. AIM: To determine prevalence of nutritional deficiency anaemia and its correlation with academic performance among medical students...
March 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28490560/nursing-home-team-care-deprescribing-study-a-stepped-wedge-randomised-controlled-trial-protocol
#3
Chong-Han Kua, Cindy Ying Ying Yeo, Cheryl Wai Teng Char, Cheryl Wei Yan Tan, Poh Ching Tan, Vivienne Sl Mak, Shaun Wen Huey Lee, Ian Yi-Onn Leong
INTRODUCTION: An ageing population has become an urgent concern for Asia in recent times. In nursing homes, polypharmacy has also become a compounding issue. Deprescribing practice is an evidence-based strategy to provide a better outcome in this group of patients; however, its implementation in nursing homes is often challenging, and prospective outcome data on deprescribing practice in the elderly is lacking. Our study assesses the implementation of team-care deprescribing to understand the benefits of this practice in geriatric setting and to explore the factors affecting deprescribing practice...
May 9, 2017: BMJ Open
https://www.readbyqxmd.com/read/28485255/a-system-based-intervention-to-improve-access-to-hyperacute-stroke-care
#4
Richard H Swartz, Elizabeth Linkewich, Shelley Sharp, Jacqueline Willems, Chris Olynyk, Nicola Tahair, Megan L Cayley, Mark T Bayley
BACKGROUND: Hyperacute stroke is a time-sensitive emergency for which outcomes improve with faster treatment. When stroke systems are accessed via emergency medical services (EMS), patients are routed to hyperacute stroke centres and are treated faster. But over a third of patients with strokes do not come to the hospital by EMS, and may inadvertently arrive at centres that do not provide acute stroke services. We developed and studied the impact of protocols to quickly identify and move "walk-in" patients from non-hyperacute hospitals to regional stroke centres (RSCs)...
May 9, 2017: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
https://www.readbyqxmd.com/read/28477070/rates-and-predictors-of-18-months-remission-in-an-epidemiological-cohort-of-661-patients-with-first-episode-psychosis
#5
Philippe Conus, Sue Cotton, Benno G Schimmelmann, Patrick D McGorry, Martin Lambert
OBJECTIVES: Most first episode psychosis (FEP) outcome studies are based on patient samples enrolled through an informed consent procedure, which may induce important biases. Our aim was to study the 18-month outcome of FEP in an epidemiological sample of patients treated at the Early Psychosis Prevention and Intervention Centre (EPPIC). METHODS: The files of 661 FEP patients treated for up to 18 months between 1998 and 2000 were assessed. Symptomatic remission was defined as receiving a score ≤3 on the Clinical Global Impressions (CGI) scales, and functional remission as concurrent fulfillment of occupation/employment and independent living...
May 5, 2017: Social Psychiatry and Psychiatric Epidemiology
https://www.readbyqxmd.com/read/28474253/prevalence-and-burden-of-headache-disorders-in-lithuania-and-their-public-health-and-policy-implications-a-population-based-study-within-the-eurolight-project
#6
Daiva Rastenytė, Dalia Mickevičienė, Lars Jacob Stovner, Hallie Thomas, Colette Andrée, Timothy J Steiner
BACKGROUND: The Eurolight project assessed the impact of headache disorders in ten EU countries, using the same structured questionnaire but varying sampling methods. In Lithuania, sample selection employed methods in line with consensus recommendations for population-based burden-of-headache studies. METHODS: The survey was cross-sectional. We identified, from the Residents' Register Service, a sample of inhabitants of Kaunas city and surrounding Kaunas region reflecting age (in the range 18-65 years), gender and rural/urban distributions of Lithuania...
December 2017: Journal of Headache and Pain
https://www.readbyqxmd.com/read/28468332/neuroprotective-role-of-atractylenolide-i-in-an-in-vitro-and-in-vivo-model-of-parkinson-s-disease
#7
Sandeep More, Dong-Kug Choi
Parkinson's disease (PD) is an age-related neurological disorder characterized by a loss of dopaminergic neurons within the midbrain. Neuroinflammation has been nominated as one of the key pathogenic features of PD. Recently, the inadequate pharmacotherapy and adverse effects of conventional drugs have spurred the development of unconventional medications in the treatment of PD. The purpose of this study is to investigate the anti-neuroinflammatory mechanisms of Atractylenolide-I (ATR-I) in in vivo and in vitro models of PD...
May 2, 2017: Nutrients
https://www.readbyqxmd.com/read/28468272/clinical-correlates-and-prognostic-value-of-plasma-galectin-3-levels-in-degenerative-aortic-stenosis-a-single-center-prospective-study-of-patients-referred-for-invasive-treatment
#8
Beata Bobrowska, Ewa Wieczorek-Surdacka, Olga Kruszelnicka, Bernadeta Chyrchel, Andrzej Surdacki, Dariusz Dudek
Galectin-3 (Gal-3), a β-galactoside-binding lectin, has been implicated in myocardial fibrosis, development of left ventricular (LV) dysfunction and transition from compensated LV hypertrophy to overt heart failure (HF), being a novel prognostic marker in HF. Risk stratification is crucial for the choice of the optimal therapy in degenerative aortic stenosis (AS), affecting elderly subjects with coexistent diseases. Our aim was to assess correlates and prognostic value of circulating Gal-3 in real-world patients with degenerative AS referred for invasive treatment...
April 29, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28463539/treatment-of-neurogenic-cough-with-tramadol-a-pilot-study
#9
Gregory R Dion, Stephanie E Teng, Efstratios Achlatis, Yixin Fang, Milan R Amin
This study employs validated cough assessment tools to prospectively determine the impact of tramadol on cough severity and quality of life in subjects with neurogenic cough. The study was a prospective case series with planned data collection at a tertiary care academic medical center laryngology practice. Sixteen consecutive collected subjects with neurogenic cough prospectively completed pre- and posttreatment validated cough assessment tools, the cough severity index (CSI) and Leicester Cough Questionnaire (LCQ)...
April 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28460127/effects-of-combining-a-brief-cognitive-intervention-with-transcranial-direct-current-stimulation-on-pain-tolerance-a-randomized-controlled-pilot-study
#10
Abigail Powers, Alok Madan, Megan Hilbert, Scott T Reeves, Mark George, Michael R Nash, Jeffrey J Borckardt
Objective.:  Cognitive behavioral therapy has been shown to be effective for treating chronic pain, and a growing literature shows the potential analgesic effects of minimally invasive brain stimulation. However, few studies have systematically investigated the potential benefits associated with combining approaches. The goal of this pilot laboratory study was to investigate the combination of a brief cognitive restructuring intervention and transcranial direct current stimulation (tDCS) over the left dorsolateral prefrontal cortex in affecting pain tolerance...
April 26, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28452133/blinded-ultrasonic-fetal-biometry-at-36-weeks-and-the-risk-of-emergency-caesarean-delivery-a-prospective-cohort-study-of-3-047-low-risk-nulliparous-women
#11
Ulla Sovio, Gordon C S Smith
OBJECTIVES: We studied the risk of emergency caesarean delivery (CD) using blinded ultrasonographic estimated fetal weight (EFW) at 36 weeks of gestational age (wkGA): (1) to compare the association for customised and non-customised EFW, (2) to determine whether adding ultrasonic EFW improved prediction based on maternal characteristics alone, and (3) to determine whether women at high predicted risk of emergency CD had higher risks of maternal and perinatal morbidity than other women...
April 28, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28448501/employment-12-months-after-kidney-transplantation-an-in-depth-bio-psycho-social-analysis-of-the-swiss-transplant-cohort
#12
Brigitta Danuser, Amira Simcox, Regina Studer, Michael Koller, Pascal Wild
BACKGROUND: Return to work with or after a chronic disease is a dynamic process influenced by a variety of interactions between personal, work, societal and medical resources or constraints. The aim of this study was to identify predictors for employment 12 months after transplantation in kidney patients, applying a bio-psycho-social model. METHODS: All kidney patients followed in the Swiss Transplant Cohort between May 2008 and December 2012, aged 18 to 65 were assessed before, 6 and 12 months after transplantation...
2017: PloS One
https://www.readbyqxmd.com/read/28444426/investigation-of-altered-microstructure-in-patients-with-drug-refractory-epilepsy-using-diffusion-tensor-imaging
#13
Yuwei Jiang, Lingyan Mao, Xu Yan, Mingxia Fan, Xin Wang, Jing Ding, Dongrong Xu
PURPOSE: The risk of refractory epilepsy can be more dangerous than the adverse effect caused by medical treatment. In this study, we employed voxel-wise analysis (VWA) and tract-based spatial statistics (TBSS) methods to measure microstructural changes using diffusion tensor imaging (DTI) in patients of drug refractory epilepsy (DRE) who had been epileptic for more than 10 years. METHODS: To examine the specific microstructural abnormalities in DRE patients and its difference from medically controlled epilepsy (MCE), we acquired DTI data of 7 DRE patients, 37 MCE patients, and 31 healthy controls (HCs) using a 3 T MRI scanner...
April 25, 2017: Neuroradiology
https://www.readbyqxmd.com/read/28442715/work-disability-before-and-after-a-major-cardiovascular-event-a-ten-year-study-using-nationwide-medical-and-insurance-registers
#14
Marianna Virtanen, Jenni Ervasti, Ellenor Mittendorfer-Rutz, Tea Lallukka, Linnea Kjeldgård, Emilie Friberg, Mika Kivimäki, Erik Lundström, Kristina Alexanderson
We examined the trajectories of work disability before and after IHD and stroke events. New IHD (n = 13521) and stroke (n = 7162) cases in 2006-2008 were retrieved from nationwide Swedish hospital records and their annual work disability days five years before and after the date of diagnosis were retrieved from a nationwide disability register. There was no pre-event differences in disability days between the IHD and stroke cases and five years prior to the event, they were close to those observed in the general population...
April 25, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28435917/effect-of-employment-status-on-length-of-hospital-stay-30-day-readmission-and-patient-reported-outcomes-after-spine-surgery
#15
Owoicho Adogwa, Aladine A Elsamadicy, Jared Fialkoff, Ankit I Mehta, Raul A Vasquez, Joseph Cheng, Isaac O Karikari, Carlos A Bagley
BACKGROUND: Growing scrutiny has placed hospitals at the center of readmission prevention. The relationship between pre-operative employment status, length of hospital stays (LOS) and 30-day readmission rates after elective spine surgery remains unclear. METHODS: The medical records of 360 patients (employed: n=174, unemployed: n=70, retired: n=40, disabled: n=76) undergoing elective spine surgery at a major academic medical center were reviewed. Patient demographics, comorbidities, and post-operative complication rates were recorded...
March 2017: Journal of Spine Surgery (Hong Kong)
https://www.readbyqxmd.com/read/28431447/-return-to-work-after-acute-myocardial-infarction
#16
Rona Reibis, Annett Salzwedel, Johannes Falk, Heinz Völler
Vocational reintegration provides a key goal for patients after myocardial infarction both from social as well as from individual perspective. Return to work rate is determined by medical parameters such as left ventricular function, residual ischemia and rhythm stability, as well as by occupational requirement profile such as the blue or white collar work, night shifts and the way capacity. Psycho-social factors including depression, self-assessment of their own situation and pre-existing cognitive impairment to a large extent determine the reintegration...
April 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28422541/evaluation-of-the-implementation-of-the-trauma-triage-and-destination-plan-on-the-field-triage-of-injured-patients-in-north-carolina
#17
Jane H Brice, Frances S Shofer, Christopher Cowden, E Brooke Lerner, Matthew Psioda, Meredith Arasaratanam, N Clay Mann, Antonio R Fernandez, Anna Waller, Chailee Moss, Michael Mian
OBJECTIVE: Timely triage and appropriate destination decision making for injured patients are central challenges faced by emergency medical services (EMS) systems. In 2010, North Carolina (NC) adopted a statewide Trauma Triage and Destination Plan (TTDP) based on the CDC's Field Triage Guidelines to better address these challenges. We sought to characterize the implementation of these guidelines by quantifying their effect on multiple metrics of patient care. METHODS: We employed a retrospective pre-post study design utilizing a statewide EMS medical record database...
April 19, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28422448/the-benefits-of-clinical-facilitators-on-improving-stroke-care-in-acute-hospitals-a-new-program-for-australia
#18
Tara Purvis, Karen Moss, Linda Francis, Karen Borschmann, Monique F Kilkenny, Sonia Denisenko, Christopher F Bladin, Dominique A Cadilhac
BACKGROUND: Care gaps for stroke lead to preventable disability and deaths. The Victorian State Government implemented a program of employing clinical Facilitators on a fixed-term basis for up to three years (2008-2011) in eight hospitals to improve stroke care. The Facilitators were to establish stroke units where absent, implement evidence-based management protocols and provide staff education within an agreed work plan. The aim of this study was to determine if the Facilitator role was associated with improved stroke care, and to describe factors supporting or mitigating enhancements to care...
April 19, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28420374/prevalence-and-associated-factors-of-common-mental-disorders-among-ethiopian-migrant-returnees-from-the-middle-east-and-south-africa
#19
Kassahun Habtamu, Abebaw Minaye, Waganesh A Zeleke
BACKGROUND: Ethiopian migrants to the Middle East and South Africa experience a range of problems at various stages of their migration including overwork, sleep deprivation, denial of food, emotional abuse, difficulty adapting to the host culture, salary denial, sexual abuse, labor exploitation, confiscation of their travel documents, confinement, denial of medication, lack of access to legal service and degrading attitude by employers, traffickers and smugglers. These experiences can be associated with different types of mental disorders...
April 19, 2017: BMC Psychiatry
https://www.readbyqxmd.com/read/28412918/neurological-aspects-of-medical-use-of-cannabidiol
#20
Carmen Mannucci, Michele Navarra, Fabrizio Calapai, Elvira Ventura Spagnolo, Francesco Paolo Busardò, Roberto Da Cas, Francesca Menniti Ippolito, Gioacchino Calapai
BACKGROUND: Cannabidiol (CBD) is among the major secondary metabolites of Cannabis devoid of the delta-9-tetra-hydrocannabinol psychoactive effects. It is a resorcinol-based compound with a broad spectrum of potential therapeutic properties, including neuroprotective effects in numerous pathological conditions. CBD neuroprotection is due to its antioxidant and antiinflammatory activi-ties and the modulation of a large number of brain biological targets (receptors, channels) involved in the development and maintenance of neurodegenerative diseases...
April 13, 2017: CNS & Neurological Disorders Drug Targets
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