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https://www.readbyqxmd.com/read/28812842/governance-and-capacity-to-manage-resilience-of-health-systems-towards-a-new-conceptual-framework
#1
Karl Blanchet, Sara L Nam, Ben Ramalingam, Francisco Pozo-Martin
The term resilience has dominated the discourse among health systems researchers since 2014 and the onset of the Ebola outbreak in West Africa. There is wide consensus that the global community has to help build more resilient health systems. But do we really know what resilience means, and do we all have the same vision of resilience? The present paper presents a new conceptual framework on governance of resilience based on systems thinking and complexity theories. In this paper, we see resilience of a health system as its capacity to absorb, adapt and transform when exposed to a shock such as a pandemic, natural disaster or armed conflict and still retain the same control over its structure and functions...
April 4, 2017: International Journal of Health Policy and Management
https://www.readbyqxmd.com/read/28812129/-device-based-remote-monitoring-current-evidence
#2
REVIEW
David Duncker, Roman Michalski, Johanna Müller-Leisse, Christos Zormpas, Thorben König, Christian Veltmann
Telemedicine is increasingly used in clinical cardiology. It offers early detection of arrhythmias, technical device follow-up and support of heart failure management. Regarding technical device follow-up, remote monitoring significantly reduces usage of the health care system. Furthermore, remote monitoring is associated with a significantly reduced time from device malfunction to physician's perception of the event. Using remote monitoring, inappropriate ICD (implantable cardioverter defibrillator) shocks can be significantly reduced compared to routine in-office follow-up...
August 15, 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/28809612/a-retrospective-study-evaluating-the-efficacy-of-identification-and-management-of-sepsis-at-a-district-level-hospital-internal-medicine-department-in-the-western-cape-province-south-africa-in-comparison-with-the-guidelines-stipulated-in-the-2012-survivi
#3
Raisa Bhikoo, Sarah Versfeld, M M De V Basson, Almero H Oosthuizen
BACKGROUND: Currently there is little information on the identification, management and outcomes of patients with sepsis in developing countries. Simple cost-effective measures such as accurate identification of patients with sepsis and early antibiotic administration are achievable targets, within reach without having to make use of unsustainable protocols constructed in developed countries. OBJECTIVES: To assess the ability of clinicians at a district-level hospital to identify and manage sepsis, and to assess patient outcome in terms of in-hospital mortality and length of hospital stay given the above management...
July 28, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/28804874/high-frequency-jet-ventilation-for-motion-management-during-ablation-procedures-a-narrative-review
#4
REVIEW
K Galmén, P Harbut, J Freedman, J G Jakobsson
BACKGROUND: High frequency jet ventilation (HFJV) is a method of ventilation that has gained renewed interest over the recent years as it can reduce organ movement to near static conditions, thus enhancing surgical precision in minimal invasive procedures, for example, ablation procedures for atrial fibrillation and solid organ tumours. The aim of this review was to create a summary of the current evidence concerning the clinical use of HFJV for ablative procedures. METHOD: PubMed was searched for the key words high frequency ventilation and ablation January 1990-December 2016...
August 13, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28802985/clinical-analysis-of-48-h-emergency-department-visit-post-outpatient-extracorporeal-shock-wave-lithotripsy-for-urolithiasis
#5
Chin-Heng Lu, Junne-Yih Kuo, Tzu-Ping Lin, Yi-Hsiu Huang, Hsiao-Jen Chung, William J S Huang, Howard H H Wu, Yen-Hwa Chang, Alex T L Lin, Kuang-Kuo Chen
BACKGROUND: Patients suffering from renal or ureteral stones can undergo significant discomfort, even when timely diagnosed and treated. The aim of this study was to assess the risk factors and safety of outpatient Extracorporeal Shock Wave Lithotripsy (ESWL) in the management of patients with renal or ureteral stones. METHODS: In this study, our cohort consisted of 844 outpatients who underwent outpatient ESWL treated between February 2012 and November 2014 at Taipei Veterans General Hospital...
August 9, 2017: Journal of the Chinese Medical Association: JCMA
https://www.readbyqxmd.com/read/28802696/community-acquired-pneumonia-visualized-on-computed-tomography-but-not-chest-x-ray-pathogens-severity-and-clinical-outcomes
#6
Cameron P Upchurch, Carlos G Grijalva, Richard G Wunderink, Derek J Williams, Grant W Waterer, Evan J Anderson, Yuwei Zhu, Eric M Hart, Frank Carroll, Anna M Bramley, Seema Jain, Kathryn M Edwards, Wesley H Self
BACKGROUND: The clinical significance of pneumonia visualized on computed tomography (CT) in the setting of a normal chest x-ray (CXR) is uncertain. METHODS: In a multicenter prospective surveillance study of adults hospitalized with community-acquired pneumonia (CAP), we compared the presenting clinical features, pathogens, and outcomes of patients with pneumonia visualized on CT but not on concurrent CXR (CT-only pneumonia) and those with pneumonia visualized on CXR...
August 9, 2017: Chest
https://www.readbyqxmd.com/read/28801837/blunt-injuries-related-to-equestrian-sports-results-from-an-international-prospective-trauma-database-analysis
#7
Christian D Weber, Anthony R Nguyen, Rolf Lefering, Martijn Hofman, Frank Hildebrand, Hans-Christoph Pape
INTRODUCTION: The objective of this study was to investigate the nature, management, and outcome of major injuries related to equestrian sports and to define the at-risk groups for serious and life-threatening injuries. METHODS: We analyzed demographic, pre-hospital, clinical, and outcome data from an international population-based prospective trauma database (TraumaRegister DGU®). Patients with major injuries (Injury Severity Score [ISS] ≥9 points) related to equestrian sports activities were included (January 1, 1993, to December 31, 2012)...
August 11, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28801782/common-pediatric-medical-emergencies-in-office-practice
#8
Bharat Mehra, Suresh Gupta
General Practitioners frequently see children with medical conditions that may evolve into an emergency if not promptly attended to. The most common emergencies encountered in pediatric office practice are respiratory distress, dehydration, anaphylaxis, seizures and trauma. Assessment of children is sometimes difficult as the signs and symptoms might be subtle and not markedly expressed. Also, normal value of vital signs vary with age, thus their interpretation requires discrete knowledge of age appropriate values...
August 12, 2017: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/28800865/contemporary-reviews-in-critical-care-medicine-anaphylaxis
#9
REVIEW
Daniel LoVerde, Onyinye I Iweala, Ariana Eginli, Guha Krishnaswamy
Anaphylaxis is a systemic, life threatening disorder triggered by mediators released by mast cells and basophils activated via allergic (IgE-mediated) or non-allergic (non-IgE-mediated) mechanisms. It is a rapidly evolving, multisystem process involving the integumentary, pulmonary, gastrointestinal and cardiovascular systems. Anaphylaxis and angioedema are serious disorders that can lead to fatal airway obstruction and culminate in cardiorespiratory arrest resulting in hypoxemia and/or shock. Often, these disorders can be appropriately managed in an outpatient setting...
August 8, 2017: Chest
https://www.readbyqxmd.com/read/28799103/bleeding-recurrence-and-mortality-following-interventional-management-of-spontaneous-hcc-rupture-results-of-a-multicenter-european-study
#10
Lilian Schwarz, Michael Bubenheim, Johanna Zemour, Astrid Herrero, Fabrice Muscari, Ahmet Ayav, Romain Riboud, Christian Ducerf, J-Marc Regimbeau, Hadrien Tranchart, Emilie Lermite, Gheorghe Petrovai, Amal Suhol, Alexandre Doussot, Lorenzo Capussotti, Jean Jacques Tuech, Yves Patrice Le Treut
BACKGROUND: The incidence of spontaneous rupture of hepatocellular carcinoma (HCC) is low in Europe, at less than 3%. HCC rupture remains a life-threatening complication, with mortality reported between 16 and 30%. The risk of bleeding recurrence has never been clearly evaluated in such clinical situation. The objectives of this study were to evaluate the current risk of mortality related to HCC rupture and to focus on the risk of bleeding recurrence following interventional management...
August 10, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28795054/sepsis-in-the-burn-patient-a-different-problem-than-sepsis-in-the-general-population
#11
REVIEW
David G Greenhalgh
Sepsis has recently been defined as "life-threatening organ dysfunction caused by a dysregulated host response to infection". A great amount of effort has been made to develop early treatments for sepsis through the Surviving Sepsis Campaign. There are similar but slightly different recommendations for the treatment of sepsis in the pediatric population. These international efforts have led to earlier diagnosis and treatments for sepsis that have led to improvements in survival. Sepsis is also the leading cause of death in the burn patient but most clinical sepsis studies have excluded burns...
2017: Burns and trauma
https://www.readbyqxmd.com/read/28794599/beware-a-simple-renal-cyst-could-be-a-hydatid-cyst
#12
Nidhi Sehgal, Vinod Priyadarshi
Kidney is one of the most common sites for the cyst formation in the body, and the management of simple cysts is required entirely for its symptoms and complications. Surgical decortication is an established treatment for a large and symptomatic simple renal cyst. On the other hand, hydatid cysts of the kidney are usually multiloculated complex or calcified cysts and are quite rare. Their surgical treatment also differs and requires complete excision with pericystectomy or partial/complete nephrectomy depending upon residual functional parenchyma, using extreme caution to avoid spillage, recurrence or development of severe anaphylactic shock...
July 2017: Urology Annals
https://www.readbyqxmd.com/read/28794357/a-rare-case-of-gastric-ulcer-penetrating-the-pancreas-that-was-successfully-managed-by-conservative-therapy
#13
Narihiro Shibukawa, Shohei Ouchi, Shuji Wakamatsu, Yuhei Wakahara, Nobuyuki Tatsumi, Akira Kaneko
A 62-year-old woman was admitted to our hospital with septic shock due to left submandibular osteomyelitis and cellulitis. Her condition improved following tooth extraction, drainage, and the administration of antibiotics. However, on the 4th day of hospitalization, she went into hemorrhagic shock after defecating a massive tarry stool. Emergency esophagogastroduodenoscopy (EGD) was performed. We found a giant ulcer at the antral greater curvature of the stomach. Computed tomography (CT) revealed that the gastric ulcer had penetrated the pancreas...
August 10, 2017: Internal Medicine
https://www.readbyqxmd.com/read/28794159/p63%C3%AE-protein-upregulates-heat-shock-protein-70-expression-via-e2f1-transcription-factor-1-promoting-wasf3-wave3-mmp9-signaling-and-bladder-cancer-invasion
#14
Honglei Jin, Qipeng Xie, Xirui Guo, Jiheng Xu, Annette Wang, Jingxia Li, Junlan Zhu, Xue-Ru Wu, Haishan Huang, Chuanshu Huang
Bladder cancer (BC) is the sixth most common cancer in the United States and is the number one cause of death among patients with urinary system malignancies. This makes the identification of invasive regulator(s)/effector(s) as the potential therapeutic targets for managing BC a high priority. p63 is a member of the p53 family of tumor suppressor genes/proteins, plays a role in the differentiation of epithelial tissues, and is believed to function as a tumor suppressor. However, whether and how p63 functions in BC cell invasion after tumorigenesis remains unclear...
August 9, 2017: Journal of Biological Chemistry
https://www.readbyqxmd.com/read/28793382/transitioning-into-new-clinical-areas-of-practice-an-integrative-review-of-the-literature
#15
REVIEW
Grant R Kinghorn, Elizabeth J Halcomb, Terry Froggatt, Stuart Dm Thomas
AIMS AND OBJECTIVES: This review aims to critically synthesise research related to the transition of Registered Nurses into new areas of clinical practice. BACKGROUND: Global workforce shortages and rising health care demands have encouraged Registered Nurses to move into new clinical settings. While a body of literature reports on the transition of newly qualified nurses, evidence surrounding the transition of more experienced Registered Nurses to new clinical areas remains poorly explored...
August 9, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28791185/use-of-hemadsorption-in-a-case-of-pediatric-toxic-shock-syndrome
#16
Andrea Berkes, Edit Szikszay, János Kappelmayer, Adrienne Kerényi, Tamás Szabó, László Ujhelyi, Krisztina Bari, György Balla, József Balla
BACKGROUND: Toxic shock syndrome is a potentially fatal toxin-mediated disease. The role of toxins in this clinical entity made us hypothesize that extracorporeal blood purification with CytoSorb® could play a beneficial role in the clinical management of toxic shock syndrome. This case report describes the successful treatment of toxic shock syndrome using a combination of renal replacement therapy and hemadsorption in a pediatric patient. CASE PRESENTATION: A 5-year-old girl with Down's syndrome presented with an inflamed area surrounding an insect bite, signs of systemic inflammation, and multiple organ failure...
2017: Case Reports in Critical Care
https://www.readbyqxmd.com/read/28790290/-postoperative-intrathoracic-hemorrhage-perioperative-prevention-and-management
#17
Yoshimasa Maniwa
Postoperative intrathoracic hemorrhage is sometimes diagnosed in the thoracic cavity, while the patient is in the recovery room after undergoing thoracic surgery such as lung resection with thoracotomy or mediastinal surgery with a median sternotomy. The information from the chest tube is important to identify this kind of postoperative complication. When the condition becomes severe, the patient may develop hemorrhagic shock due to hemothorax and re-exploration to assess for bleeding and hemostasis may be required...
July 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28790288/-management-of-pulmonary-thromboembolism
#18
Taijiro Mishina, Masahiro Miyajima, Atsushi Watanabe
Pulmonary thromboembolism is a fatal perioperative complication in general thoracic surgery. There is a report on its incidence of 2.68 cases out of 10,000 general thoracic surgeries. To prevent pulmonary thromboembolism, risk evaluation of an individual case and steady implementation of recommended preventive techiques are required. Because of the prevalence of guidelines for prevention, the incidence of pulmonary thromboembolism in the perioperative period is reducing. However, maximum prevention of deep vein thrombosis(DVT), which can lead to pulmonary thromboembolism, is impossible even if preventive measures are strictly implemented in the perioperative period...
July 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28790011/management-of-septic-shock-in-an-intermediate-care-unit
#19
Eric Meaudre, Cédric Nguyen, Claire Contargyris, Ambroise Montcriol, Erwan d'Aranda, Pierre Esnault, Mourad Bensalah, Bertrand Prunet, Julien Bordes, Philippe Goutorbe
BACKGROUND: While guidelines advocate goal-directed resuscitation based on timed bundles, the management of SS outside an ICU setting has been poorly studied in intermediate care units (IMCU). PATIENTS AND METHOD: We reviewed all cases of septic shock patients admitted to our IMCU between January 2013 and June 2014. The characteristics of sepsis, compliance of bundles, and outcomes were collected. The IMCU population was compared with the SS patients admitted to the ICU during the same period...
August 5, 2017: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/28789803/preliminary-performance-on-the-new-cms-sepsis-1-national-quality-measure-early-insights-from-the-emergency-quality-network-e-qual
#20
Arjun K Venkatesh, Todd Slesinger, Jessica Whittle, Tiffany Osborn, Emily Aaronson, Craig Rothenberg, Nalani Tarrant, Pawan Goyal, Donald M Yealy, Jeremiah D Schuur
STUDY OBJECTIVE: We describe current hospital-level performance for the Centers for Medicare & Medicaid Services' Severe Sepsis/Septic Shock Early Management Bundle (SEP-1) quality measure and qualitatively assess emergency department (ED) sepsis quality improvement best practice implementation. METHODS: Using a standardized Web-based submission portal, we surveyed quality improvement data from volunteer hospital-based EDs participating in the Emergency Quality Network Sepsis Initiative...
August 5, 2017: Annals of Emergency Medicine
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