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https://www.readbyqxmd.com/read/29775973/safety-model-for-the-introduction-of-robotic-surgery-in-gynecology
#1
Mariano Tamura Vieira Gomes, Beatriz Taliberti da Costa Porto, Jose Pedro Parise Filho, Ana Luiz Vasconcelos, Bruna Fernanda Bottura, Renato Moretti Marques
OBJECTIVE:  To analyze the perioperative results and safety of performing gynecological surgeries using robot-assisted laparoscopy during implementation of the technique in a community hospital over a 6-year period. METHODS:  This was a retrospective observational study in which the medical records of 274 patients who underwent robotic surgery from September 2008 to December 2014 were analyzed. We evaluated age, body mass index (BMI), diagnosis, procedures performed, American Society of Anesthesiologists (ASA) classification, the presence of a proctor (experienced surgeon with at least 20 robotic cases), operative time, transfusion rate, perioperative complications, conversion rate, length of stay, referral to the intensive care unit (ICU), and mortality...
May 18, 2018: Revista Brasileira de Ginecologia e Obstetrícia
https://www.readbyqxmd.com/read/29775692/exploring-canadian-physicians-experiences-providing-medical-assistance-in-dying-a-qualitative-study
#2
Narges Khoshnood, Marie-Clare Hopwood, Bhadra Lokuge, Allison Kurahashi, Anastasia Tobin, Sarina Isenberg, Amna Husain
CONTEXT: MAiD allows a practitioner to administer or prescribe medication for the purpose of ending a patient's life. In 2016, Canada was the latest country, following several European countries and American states, to legalize physician-assisted death. Although some studies report on physician attitudes towards MAiD or describe patient characteristics, there are few that explore the professional challenges faced by physicians who provide MAiD. OBJECTIVES: To explore the professional challenges faced by Canadian physicians who provide MAiD...
May 15, 2018: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29775556/let-s-talk-about-it-supporting-family-communication-during-end-of-life-care-of-pediatric-patients
#3
Meghan L Marsac, Christine Kindler, Danielle Weiss, Lindsay Ragsdale
BACKGROUND: Communication is key in optimizing medical care when a child is approaching end of life (EOL). Research is yet to establish best practices for how medical teams can guide intrafamily communication (including surviving siblings) when EOL care is underway or anticipated for a pediatric patient. While recommendations regarding how medical teams can facilitate communication between the medical team and the family exist, various barriers may prevent the implementation of these recommendations...
May 18, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29775080/mindfulness-meditation-and-interprofessional-cardiopulmonary-resuscitation-a-mixed-methods-pilot-study
#4
Diana J Kelm, Jennifer L Ridgeway, Becca L Gas, Monali Mohan, David A Cook, Darlene R Nelson, Roberto P Benzo
PROBLEM: Mindfulness training includes mindfulness meditation, which has been shown to improve both attention and self-awareness. Medical providers in the intensive care unit often deal with difficult situations with strong emotions, life-and-death decisions, and both interpersonal and interprofessional conflicts. The effect of mindfulness meditation training on healthcare providers during acute care tasks such as cardiopulmonary resuscitation remains unknown. Mindfulness meditation has the potential to improve provider well-being and reduce stress in individuals involved in resuscitation teams, which could then translate into better team communication and delivery of care under stress...
May 18, 2018: Teaching and Learning in Medicine
https://www.readbyqxmd.com/read/29773700/implications-of-involving-pharmacy-technicians-in-obtaining-a-best-possible-medication-history-from-the-perspectives-of-pharmaceutical-medical-and-nursing-staff-a-qualitative-study
#5
Andrea Niederhauser, Chantal Zimmermann, Liat Fishman, David L B Schwappach
OBJECTIVES: In recent years, the involvement of pharmacy technicians in medication reconciliation has increasingly been investigated. The aim of this study was to assess the implications on professional roles and collaboration when a best possible medication history (BPMH) at admission is obtained by pharmacy technicians. DESIGN: Qualitative study with semistructured interviews. Data were analysed using a qualitative content analysis approach. SETTING: Internal medicine units in two mid-sized Swiss hospitals...
May 17, 2018: BMJ Open
https://www.readbyqxmd.com/read/29773698/protocol-for-the-validation-of-sensitivity-and-specificity-of-the-cow-s-milk-related-symptom-score-comiss-against-open-food-challenge-in-a-single-blinded-prospective-multicentre-trial-in-infants
#6
Yvan Vandenplas, Rajat Mukherjee, Christophe Dupont, Philippe Eigenmann, Arne Høst, Mikael Kuitunen, Carmen Ribes-Koninkx, Neil Shah, Hania Szajewska, Andrea von Berg, Ralf G Heine, Zheng-Yan Zhao
INTRODUCTION: The symptoms of cow's milk protein allergy (CMPA) in infancy can be non-specific which may delay a correct diagnosis and cause adverse clinical outcomes. The diagnosis of non-IgE-mediated CMPA is particularly complex as it involves a 2 to 4 week elimination diet followed by oral food challenge (OFC). The Cow's Milk-related Symptom Score (CoMiSS) is a clinical resource for primary healthcare providers which aims to increase awareness of CMPA symptoms to facilitate an earlier diagnosis...
May 17, 2018: BMJ Open
https://www.readbyqxmd.com/read/29773605/using-patient-whiteboards-to-engage-families-in-harm-prevention-and-care-planning-a-quality-improvement-study
#7
Katherine Nowacki, Tondeleyo Gonzalez, Jennifer Mehnert, Amy Jacquemard, Amy Tyler
OBJECTIVES: Whiteboards are a valuable tool used to facilitate communication between families and the care team, but they were underused in our institution. Our aim was to increase families' knowledge of their child's plan of care, safety plan, and medical care team names by increasing the use of patient whiteboards with inpatient populations at a freestanding quaternary care children's hospital. METHODS: With this quality improvement study, we redesigned the whiteboard template to address the following 4 main barriers to use: (1) not having enough space to explain concepts to families, (2) having too much information to complete, (3) unclear roles of who completes the whiteboard, and (4) forgetting to update the whiteboard...
May 17, 2018: Hospital Pediatrics
https://www.readbyqxmd.com/read/29771976/skin-disease-prevalence-study-in-schoolchildren-in-rural-c%C3%A3-te-d-ivoire-implications-for-integration-of-neglected-skin-diseases-skin-ntds
#8
Rie Roselyne Yotsu, Kouamé Kouadio, Bamba Vagamon, Konan N'guessan, Amari Jules Akpa, Aubin Yao, Julien Aké, Rigobert Abbet Abbet, Barbine Tchamba Agbor Agbor, Roger Bedimo, Norihisa Ishii, L Claire Fuller, Roderick Hay, Oriol Mitjà, Henning Drechsler, Kingsley Asiedu
BACKGROUND: Early detection of several skin-related neglected tropical diseases (skin NTDs)-including leprosy, Buruli ulcer, yaws, and scabies- may be achieved through school surveys, but such an approach has seldom been tested systematically on a large scale in endemic countries. Additionally, a better understanding of the spectrum of skin diseases and the at-risk populations to be encountered during such surveys is necessary to facilitate the process. METHODS: We performed a school skin survey for selected NTDs and the spectrum of skin diseases, among primary schoolchildren aged 5 to 15 in Côte d'Ivoire, West Africa...
May 17, 2018: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/29771887/-new-visual-field-testing-possibilities-a-preliminary-report
#9
V P Erichev, A P Ermolaev, A A Antonov, G L Grigoryan, D V Kosova
There are currently no portable mobile perimeters that allow visual field testing outside ophthalmologist's examination rooms. PURPOSE: To develop a mobile perimetry technique based on use of a virtual reality headset (VR). MATERIAL AND METHODS: The study involved 26 patients (30 eyes) with II-III stage primary open-angle glaucoma (POAG) with compensated IOP. Perimetry was performed for each patient twice - on Humphrey analyzer (test 30-2, 76 points) and employing similar strategy on a perimeter integrated into VR headset (Total Vision, Russia)...
2018: Vestnik Oftalmologii
https://www.readbyqxmd.com/read/29771750/injectable-nonsteroidal-anti-inflammatory-drugs-in-sport
#10
Matthew J Matava
OBJECTIVE: The primary objective of this article is to review the basic science of nonsteroidal anti-inflammatory drugs (NSAIDs), their clinical effects, indications, potential complications, and ethical issues associated with the use of injectable NSAIDs in the treatment of athletes. These objectives are presented taking into consideration the contemporaneous issues associated with the treatment of amateur and professional athletes. DATA SOURCES: A nonformal review of the published medical literature and lay media focusing on the use of injectable NSAIDs in athletes was used for this article...
May 10, 2018: Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine
https://www.readbyqxmd.com/read/29771722/detection-of-deteriorating-patients-on-surgical-wards-outside-the-icu-by-an-automated-mews-based-early-warning-system-with-paging-functionality
#11
Axel R Heller, Sören T Mees, Benjamin Lauterwald, Christian Reeps, Thea Koch, Jürgen Weitz
BACKGROUND: The establishment of early warning systems in hospitals was strongly recommended in recent guidelines to detect deteriorating patients early and direct them to adequate care. Upon reaching predefined trigger criteria, Medical Emergency Teams (MET) should be notified and directed to these patients. The present study analyses the effect of introducing an automated multiparameter early warning score (MEWS)-based early warning system with paging functionality on 2 wards hosting patients recovering from highly complex surgical interventions...
May 16, 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29771695/scheduling-the-nonoperating-room-anesthesia-suite
#12
Mary E Warner, David P Martin
PURPOSE OF REVIEW: Nonoperating room anesthesia (NORA) and procedural services often are associated with dispersed geographic settings and small volumes of cases. These lead to scheduling challenges that, if not managed well, result in decreased patient and healthcare team satisfaction and reduced efficiency. This review describes recent studies and provides examples on how NORA scheduling issues have been addressed. RECENT FINDINGS: Increased use of blocked time for consolidated NORA services can lead to sufficiently large volumes of cases that allow improved scheduling and maintain patient and healthcare team satisfaction and better efficiency of care...
May 15, 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29771227/team-development-among-physician-leaders-at-the-cleveland-clinic
#13
Tracy H Porter, James K Stoller, Scott J Allen
Purpose Since 1990, the Cleveland Clinic has trained physicians in team skills through various iterations of a program called Leading in Healthcare (LHC). In the present study, the authors utilize a case study approach to gain insight into the LHC curriculum, and more specifically, the team project. The purpose of this paper is to better understand the Cleveland Clinic's position on the issue and its approach to education - specifically among physicians. Design/methodology/approach The authors utilized a case study approach with four key program architects...
May 8, 2018: Leadership in Health Services
https://www.readbyqxmd.com/read/29770995/adolescent-and-young-adult-oncology-patients-in-france-heterogeneity-in-pathways-of-care
#14
Emmanuel Desandes, Laurence Brugières, Florence Molinié, Gautier Defossez, Patricia Delafosse, Karine Jehannin-Ligier, Michel Velten, Brigitte Trétarre, Brice Amadéo, Emilie Marrer, Anne-Sophie Woronoff, Olivier Ganry, Alain Monnereau, Tania d'Almeida, Xavier Troussard, Laetitia Daubisse-Marliac, Simona Bara, Anne-Valérie Guizard, Isabelle Baldi, Guy Launoy, Jacqueline Clavel, Brigitte Lacour
BACKGROUND: In order to evaluate at the population level the impact of the actions developed in France since 2004 to organize the care of adolescents and young adults (AYAs) with cancer, we conducted the present study to provide an unbiased view of the pathway of care of these patients. METHODS: Using a population-based registry, we conducted a review of all cases of cancer diagnosed during 2012 and 2013 in 15- to 24-year-old patients living in nineteen French administrative areas...
May 17, 2018: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/29770296/an-overview-of-mechanical-circulatory-support-in-single-ventricle-patients
#15
REVIEW
Jacob R Miller, Timothy S Lancaster, Connor Callahan, Aaron M Abarbanell, Pirooz Eghtesady
The population of people with a single-ventricle is continually increasing due to improvements across the spectrum of medical care. Unfortunately, a proportion of these patients will develop heart failure. Often, for these patients, mechanical circulatory support (MCS) represents the only available treatment option. While single-ventricle patients currently represent a small proportion of the total number of patients who receive MCS, as the single-ventricle patient population increases, this number will increase as well...
April 2018: Translational Pediatrics
https://www.readbyqxmd.com/read/29769369/comparison-of-severe-trauma-treatment-standards-in-civilian-china-with-current-practice-in-the-chinese-military-peacekeeping-level-2-military-hospital-in-gao-mali
#16
Jian Li, J Tian, Y B Wang, H Zhang
INTRODUCTION: The People's Republic of China has been successfully deploying medical teams to support the peacekeeping mission at the Level 2 Military Hospital in Mali since December 2013. The aim of this paper was to compare the current practice in Chinese Peacekeeping Level 2 Military Hospital with the severe trauma treatment standards reported in China. METHODS: A retrospective analysis was conducted between 26 April 2014 and 18 May 2016 using records stored in the Chinese Peacekeeping Level 2 Hospital (CHN L2)...
May 16, 2018: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/29769160/cross-border-outbreak-of-extensively-drug-resistant-tuberculosis-linked-to-a-university-in-romania
#17
O Popovici, Ph Monk, D Chemtob, D Chiotan, P J Freidlin, R Groenheit, M Haanperä, D Homorodean, M Mansjö, E Robinson, E Rorman, G Smith, H Soini, M J Van Der Werf
Extensively drug-resistant (XDR) tuberculosis (TB) poses a threat to public health due to its complicated, expensive and often unsuccessful treatment. A cluster of three XDR TB cases was detected among foreign medical students of a Romanian university. The contact investigations included tuberculin skin testing or interferon gamma release assay, chest X-ray, sputum smear microscopy, culture, drug susceptibility testing, genotyping and whole-genome sequencing (WGS), and were addressed to students, personnel of the university, family members or other close contacts of the cases...
May 2018: Epidemiology and Infection
https://www.readbyqxmd.com/read/29769117/a-protocol-for-a-network-meta-analysis-of-interventions-to-treat-patients-with-sudden-sensorineural-hearing-loss
#18
Nadera Ahmadzai, Shaun Kilty, Dianna Wolfe, Jamie Bonaparte, David Schramm, Elizabeth Fitzpatrick, Vincent Lin, Wei Cheng, Becky Skidmore, David Moher, Brian Hutton
BACKGROUND: Hearing loss is one of the leading causes of disability worldwide, with greater than 20% of Canadian adults having measurable hearing loss in at least one ear. Patients with hearing loss experience impaired quality of life, and emotional and financial consequences that affect themselves and their families. Sudden sensorineural hearing loss (SSNHL) is a common but difficult to treat form of hearing loss that has a sudden onset of ≤ 72 h associated with various etiologies, with the majority of cases being idiopathic...
May 16, 2018: Systematic Reviews
https://www.readbyqxmd.com/read/29769028/-careful-goodbye-at-the-door-is-there-role-for-antimicrobial-stewardship-interventions-for-antimicrobial-therapy-prescribed-on-hospital-discharge
#19
R Chavada, J Davey, L O'Connor, D Tong
BACKGROUND: Antimicrobial stewardship (AMS) interventions largely target inpatient antimicrobial prescribing. Literature on appropriateness of antimicrobials prescribed at the interface between hospital and the community is minimal. This study was designed to assess the appropriateness of antimicrobials prescribed on hospital discharge and evaluate the impact of AMS interventions. METHODS: Patients with discharge medications processed by the pharmacy were identified using a computerized pharmacy medication tracker over a four week period...
May 16, 2018: BMC Infectious Diseases
https://www.readbyqxmd.com/read/29769026/cost-effectiveness-of-a-multicomponent-primary-care-program-targeting-frail-elderly-people
#20
Franca G H Ruikes, Eddy M Adang, Willem J J Assendelft, Henk J Schers, Raymond T C M Koopmans, Sytse U Zuidema
BACKGROUND: Over the last 20 years, integrated care programs for frail elderly people aimed to prevent functional dependence and reduce hospitalization and institutionalization. However, results have been inconsistent and merely modest. To date, evidence on the cost-effectiveness of these programs is scarce. We evaluated the cost-effectiveness of the CareWell program, a multicomponent integrated care program for frail elderly people. METHODS: Economic evaluation from a healthcare perspective embedded in a cluster controlled trial of 12 months in 12 general practices in (the region of) Nijmegen...
May 16, 2018: BMC Family Practice
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