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https://www.readbyqxmd.com/read/29156481/-why-and-how-should-i-assess-frailty-a-guide-for-the-preoperative-anesthesia-clinic
#1
Oliver Birkelbach, Rudolf Mörgeli, Felix Balzer, Maria Olbert, Sascha Treskatsch, Rainer Kiefmann, Ursula Müller-Werdan, Anett Reisshauer, Christine Schwedtke, Bruno Neuner, Claudia Spies
Introduction: Frailty is a condition of decreased physiological reserves seen in approx. one third of elderly anesthesiological patients, and affecting many aspects of treatment as well as outcome. Although there are over 60 measurement instruments, frailty assessment is still poorly implemented. Understanding why and how to assess frailty is key to its implementation in preoperative anesthesia clinics. Method: After presenting the impact of perioperative frailty and the benefits of an early diagnosis on health related quality of life, we present an overview of the most important tools that can be used in the preoperative frailty assessment...
November 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/29156298/european-research-on-electrochemotherapy-in-head-and-neck-cancer-eureca-project-results-from-the-treatment-of-mucosal-cancers
#2
Christina Caroline Plaschke, Giulia Bertino, James A McCaul, Juan J Grau, Remco de Bree, Gregor Sersa, Antonio Occhini, Ales Groselj, Cristobal Langdon, Derrek A Heuveling, Maja Cemazar, Primoz Strojan, C Rene Leemans, Marco Benazzo, Francesca De Terlizzi, Irene Wessel, Julie Gehl
AIM: Electrochemotherapy is an effective local treatment for cutaneous tumours and metastases. In this prospective trial, six European institutions investigated electrochemotherapy in recurrent, mucosal head and neck tumours. PATIENT AND METHODS: Forty-three patients with recurrent mucosal head and neck tumours and no further curative or reasonably effective palliative treatment options were enrolled and treated with electrochemotherapy. Patients were treated in general anaesthesia using intravenous or local injection of bleomycin followed by delivery of electric pulses to the tumour area...
November 16, 2017: European Journal of Cancer
https://www.readbyqxmd.com/read/29156249/changing-experience-of-adverse-medical-events-in-the-national-health-service-comparison-of-two-population-surveys-in-2001-and-2013
#3
Alastair M Gray, Paul Fenn, Neil Rickman, Dev Vencappa
Care quality is important to patients and providers, but is hard to measure. This study aimed to examine changes in the frequency and severity of one quality measure - adverse events associated with medical care - in Great Britain over a 12-year period when available resources initially expanded and were subsequently constrained. Data on perceived adverse events, collected from two representative population surveys in 2001 and 2013, were analysed and compared. The samples consisted of 8202 adults aged 15 and over in 2001 and 19,746 adults aged 15 and over in 2013...
November 11, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/29155884/the-importance-of-mean-time-in-therapeutic-range-for-complication-rates-in-warfarin-therapy-of-patients-with-atrial-fibrillation-a-systematic-review-and-meta-regression-analysis
#4
Anne Sig Vestergaard, Flemming Skjøth, Torben Bjerregaard Larsen, Lars Holger Ehlers
BACKGROUND: \Anticoagulation is used for stroke prophylaxis in non-valvular atrial fibrillation, amongst other by use of the vitamin K antagonist, warfarin. Quality in warfarin therapy is often summarized by the time patients spend within the therapeutic range (percent time in therapeutic range, TTR). The correlation between TTR and the occurrence of complications during warfarin therapy has been established, but the influence of patient characteristics in that respect remains undetermined...
2017: PloS One
https://www.readbyqxmd.com/read/29154427/design-of-a-multicentre-randomized-controlled-trial-to-assess-the-safety-and-efficacy-of-dose-titration-by-specialized-nurses-in-patients-with-heart-failure-etific-study-protocol
#5
Juana Oyanguren, LLuisa García-Garrido, Magdalena Nebot Margalef, Iñaki Lekuona, Josep Comin-Colet, Nicolás Manito, Julia Roure, Pilar Ruiz Rodriguez, Cristina Enjuanes, Pedro Latorre, Jesús Torcal Laguna, Susana García-Gutiérrez
AIMS: Heart failure (HF) is associated with many hospital admissions and relatively high mortality, rates decreasing with administration of beta-blockers (BBs), angiotensin-converting-enzyme inhibitors, angiotensin II receptor blockers, and mineralocorticoid receptor antagonists. The effect is dose dependent, suboptimal doses being common in clinical practice. The 2012 European guidelines recommend close monitoring and dose titration by HF nurses. Our main aim is to compare BB doses achieved by patients after 4 months in intervention (HF nurse-managed) and control (cardiologist-managed) groups...
November 2017: ESC Heart Failure
https://www.readbyqxmd.com/read/29154396/nurses-experiences-of-unprofessional-behaviors-in-the-emergency-department-a-qualitative-study
#6
Naser Parizad, Hadi Hassankhani, Azad Rahmani, Eesa Mohammadi, Violeta Lopez, Michelle Cleary
The nursing profession is focused on serving others and has high expectations that each member behaves professionally and ethically, as articulated in nursing codes of practice and conduct. Where these are not upheld, inappropriate and unprofessional workplace behaviors follow. Regrettably, unprofessional behavior is neither new nor constrained to the nursing profession, but is known to negatively impact staff and workplace relationships, and importantly, patient safety and care. The aim of this qualitative study was to explore Iranian nurses' experiences of professional communication between colleagues in the emergency department...
November 20, 2017: Nursing & Health Sciences
https://www.readbyqxmd.com/read/29154382/review-of-strategies-to-reduce-central-line-associated-bloodstream-infection-clabsi-and-catheter-associated-urinary-tract-infection-cauti-in-adult-icus
#7
Payal K Patel, Ashwin Gupta, Valerie M Vaughn, Jason D Mann, Jessica M Ameling, Jennifer Meddings
Central line-associated bloodstream infection (CLABSI) and catheter-associated urinary tract infection (CAUTI) are costly and morbid. Despite evidence-based guidelines, Some intensive care units (ICUs) continue to have elevated infection rates. In October 2015, we performed a systematic search of the peer-reviewed literature within the PubMed and Cochrane databases for interventions to reduce CLABSI and/or CAUTI in adult ICUs and synthesized findings using a narrative review process. The interventions were categorized using a conceptual model, with stages applicable to both CAUTI and CLABSI prevention: (stage 0) avoid catheter if possible, (stage 1) ensure aseptic placement, (stage 2) maintain awareness and proper care of catheters in place, and (stage 3) promptly remove unnecessary catheters...
November 8, 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29153787/the-society-of-thoracic-surgeons-national-database-2017-annual-report
#8
Jeffrey P Jacobs, David M Shahian, Richard S D'Agostino, Marshall L Jacobs, Benjamin D Kozower, Vinay Badhwar, Vinod H Thourani, Henning A Gaissert, Felix G Fernandez, Richard L Prager
The Society of Thoracic Surgeons (STS) National Database has three major component databases: the STS Adult Cardiac Surgery Database (ACSD), the STS Congenital Heart Surgery Database (CHSD), and the STS General Thoracic Surgery Database (GTSD). Beginning in January 2016, The Annals of Thoracic Surgery began publishing a monthly series of scholarly articles on outcomes analysis, quality improvement, and patient safety. This article summarizes the status of the STS National Database as of October 2017 and summarizes the articles about the STS National Database that appeared in The Annals of Thoracic Surgery 2017 series "Outcomes Analysis, Quality Improvement, and Patient Safety...
December 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29153462/health-related-quality-of-life-and-toxicity-after-single-fraction-19%C3%A2-gy-high-dose-rate-prostate-brachytherapy-phase-ii-trial
#9
Alfonso Gomez-Iturriaga, Francisco Casquero, Jose Ignacio Pijoan, Pablo Minguez, Jose Maria Espinosa, Ana Irasarri, Andrea Bueso, Jon Cacicedo, David Buchser, Pedro Bilbao
PURPOSE: To evaluate the safety, tolerance and impact on health-related-quality-of-life (HRQoL) of the high-dose-rate brachytherapy of 19 Gy (BRT-HDR-19 Gy) single fraction in prostate cancer. METHODS: From January 2014 to July 2016, 43 patients with low/intermediate risk were treated with BRT-HDR-19 Gy. The patients were monitored prospectively for toxicity and HRQoL. RESULTS: The median age, initial PSA and the International Prostate Symptom Score (IPSS) were 71 years (55-78), 7...
November 15, 2017: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
https://www.readbyqxmd.com/read/29151784/molecular-targeted-treatment-of-metastatic-colorectal-cancer-the-cardiovascular-adverse-effects-of-bevacizumab-and-cetuximab
#10
REVIEW
Alexandra Gherman, Călin Căinap, Anne-Marie Constantin, Sînziana Cetean, Simona Sorana Căinap
Novel emerging therapies have changed paradigms in metastatic colorectal cancer. The advantages of molecular targeted treatments, either the anti-angiogenic or the anti-epidermal growth factor receptor drugs, reside in the fact that while their specificity for the cancer cell is higher, their toxicity on normal tissues is significantly lower when compared to chemotherapy. But when it comes to their safety, especially from a cardiovascular point of view, they still need to pass the test of time and further prospective studies are needed...
2017: Clujul Medical (1957)
https://www.readbyqxmd.com/read/29150478/early-versus-late-application-of-subthalamic-deep-brain-stimulation-to-parkinson-s-disease-patients-with-motor-complications-elass-protocol-of-a-multicentre-prospective-and-observational-study
#11
Lulu Jiang, Wai Sang Poon, Elena Moro, Wenbiao Xian, Chao Yang, Xian Lun Zhu, Jing Gu, Xiaodong Cai, Jinlong Liu, Vincent Mok, Yanmei Liu, Shaohua Xu, Qiyu Guo, Wanru Chen, Ling Chen
INTRODUCTION: Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is a well-established surgical treatment for Parkinson's disease (PD). However, there is currently no consensus on the best timing for this surgery. The aim of our study is to compare the therapeutic efficacy of bilateral STN DBS in patients with PD with early and late motor complications. METHODS AND ANALYSIS: 200 patients with PD will be enrolled in this multicentre, prospective, observational study, and will be followed up for 4 years...
November 16, 2017: BMJ Open
https://www.readbyqxmd.com/read/29150418/immune-enhancing-formulas-for-patients-with-cancer-undergoing-esophagectomy-systematic-review-protocol
#12
Astrid Naranjo, Elizabeth Isenring, Laisa Teleni
BACKGROUND: Adult patients with an esophageal cancer can potentially be compromised with postoperative leaks or fistulae if patients' nutritional status is in a vulnerable stage. Currently in Australia, there is a growing need for clinicians to know whether use of immune-enhancing formulas (IEFs) containing Arg, omega-3, and RNA are a cost-effective approach compared with isonitrogenous-isocaloric formulas to reduce postoperative infectious complications in esophagectomy patients. Since IEFs may carry higher costs, this has led to inconsistencies in practice among clinicians and hospitals...
November 17, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/29150394/efficacy-of-prostatic-artery-embolization-for-catheter-dependent-patients-with-large-prostate-sizes-and-high-comorbidity-scores
#13
Shivank Bhatia, Vishal K Sinha, Bruce R Kava, Christopher Gomez, Sardis Harward, Sanoj Punnen, Issam Kably, Jeffrey Miller, Dipen J Parekh
PURPOSE: To evaluate efficacy and safety of prostate artery embolization (PAE) in urinary catheter-dependent patients with large prostate volumes and high comorbidity scores. MATERIALS AND METHODS: A retrospective single-center review was conducted of 30 patients with urinary retention at time of PAE from November 2014 through February 2017. Mean (range) age was 73.1 years (48-94 y), age-adjusted Charlson comorbidity index was 4.5 (0-10), duration of urinary retention was 63...
November 15, 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/29150313/safety-practices-perceptions-and-behaviors-in-radiation-oncology-a-national-survey-of-radiation-therapists
#14
Kristina Demas Woodhouse, David Hashemi, Kathryn Betcher, Abigail Doucette, Allison Weaver, Brian Monzon, Seth A Rosenthal, Neha Vapiwala
PURPOSE: Radiation therapy is complex and demands high vigilance and precise coordination. Radiation therapists (RTTs) directly deliver radiation and are often the first to discover an error. Yet, few studies have examined the practices of RTTs regarding patient safety. We conducted a national survey to explore the perspectives of RTTs related to quality and safety. METHODS AND MATERIALS: In 2016, an electronic survey was sent to a random sample of 1500 RTTs in the United States...
June 15, 2017: Practical Radiation Oncology
https://www.readbyqxmd.com/read/29150102/evaluation-of-criteria-of-manual-blood-smear-review-following-automated-complete-blood-counts-in-a-large-university-hospital
#15
Samuel Ricardo Comar, Mariester Malvezzi, Ricardo Pasquini
BACKGROUND: There is great interest in reducing the number of automated complete blood counts requiring manual blood smear reviews without sacrificing the quality of patient care. This study was aimed at evaluating and establishing appropriate screening criteria for manual blood smear reviews to improve the performance in a hematology laboratory. METHOD: A total of 1977 consecutive samples from the daily workload were used to evaluate four sets of screening criteria for manual blood smear reviews to identify samples with positive smear findings...
October 2017: Revista Brasileira de Hematologia e Hemoterapia
https://www.readbyqxmd.com/read/29149880/analytical-performance-of-envisia-a-genomic-classifier-for-usual-interstitial-pneumonia
#16
Yoonha Choi, Jiayi Lu, Zhanzhi Hu, Daniel G Pankratz, Huimin Jiang, Manqiu Cao, Cristina Marchisano, Jennifer Huiras, Grazyna Fedorowicz, Mei G Wong, Jessica R Anderson, Edward Y Tom, Joshua Babiarz, Urooj Imtiaz, Neil M Barth, P Sean Walsh, Giulia C Kennedy, Jing Huang
BACKGROUND: Clinical guidelines specify that diagnosis of interstitial pulmonary fibrosis (IPF) requires identification of usual interstitial pneumonia (UIP) pattern. While UIP can be identified by high resolution CT of the chest, the results are often inconclusive, making surgical lung biopsy necessary to reach a definitive diagnosis (Raghu et al., Am J Respir Crit Care Med 183(6):788-824, 2011). The Envisia genomic classifier differentiates UIP from non-UIP pathology in transbronchial biopsies (TBB), potentially allowing patients to avoid an invasive procedure (Brown et al...
November 17, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/29149634/patient-participation-in-nursing-bedside-handover-a-systematic-mixed-methods-review
#17
REVIEW
Georgia Tobiano, Tracey Bucknall, Ishtar Sladdin, Jennifer A Whitty, Wendy Chaboyer
BACKGROUND: Numerous reviews of nursing handover have been undertaken, but none have focused on the patients' role. OBJECTIVES: To explore how patient participation in nursing shift-to-shift bedside handover can be enacted. DESIGN: Systematic mixed- methods review. DATA SOURCES: Three search strategies were undertaken in July-August 2016: database searching, backwards citation searching and forward citation searching...
October 24, 2017: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/29149483/factors-influencing-the-quality-of-vital-signs-data-in-electronic-health-records-a-qualitative-study
#18
Jean E Stevenson, Johan Israelsson, Goran Petersson, Peter A Bath
AIMS AND OBJECTIVES: The purpose of this study was to investigate reasons for inadequate documentation of vital signs in an electronic health record. BACKGROUND: Monitoring vital signs is crucial to detecting and responding to patient deterioration. The ways in which vital signs are documented in electronic health records have received limited attention in the research literature. A previous study revealed that vital signs in an electronic health record were incomplete and inconsistent...
November 17, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29149150/the-hopeless-case-palliative-cryoablation-and-cementoplasty-procedures-for-palliation-of-large-pelvic-bone-metastases
#19
Tyler M Coupal, Kevin Pennycooke, Paul I Mallinson, Hugue A Ouellette, Paul W Clarkson, Pippa Hawley, Peter L Munk
BACKGROUND: Metastases to the bone are common in cancer patients, and it has been estimated that up to 50% of patients with pelvic bone metastases will not achieve adequate pain control with medications alone. This has led to a paradigm shift over recent years towards the use and development of minimally invasive image-guided treatment options for palliation of bony metastases. Despite these developments, large metastatic lesions are still often considered to be "hopeless cases" that would garner little to no benefit from image-guided intervention...
November 2017: Pain Physician
https://www.readbyqxmd.com/read/29149140/optimization-of-postoperative-intravenous-patient-controlled-analgesia-with-opioid-dexmedetomidine-combinations-an-updated-meta-analysis-with-trial-sequential-analysis-of-randomized-controlled-trials
#20
Ke Peng, Juan Zhang, Xiao-Wen Meng, Hua-Yue Liu, Fu-Hai Ji
BACKGROUND: It is still a challenge to optimize postoperative pain management. The effects of adding dexmedetomidine (DEX) to opioid-based postoperative intravenous patient-controlled analgesia (PCA) are not fully understood. OBJECTIVES: The aim of this study is to assess the efficacy and safety of opioid-DEX combinations for postoperative PCA, and a trial sequential analysis (TSA) is utilized to evaluate the robustness of the current evidence. STUDY DESIGN: A systematic review and meta-analysis...
November 2017: Pain Physician
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