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https://www.readbyqxmd.com/read/29896556/are-patients-being-evaluated-for-periprosthetic-joint-infection-prior-to-referral-to-a-tertiary-care-center
#1
Matthew W Tetreault, Kenneth A Estrera, Erdan Kayupov, Caroline Brander, Craig J Della Valle
Background: Patients with a painful or failed total joint arthroplasties should be evaluated for periprosthetic joint infection (PJI). The purpose of this study is to determine if patients referred to a tertiary care center had been evaluated for PJI according to the American Academy of Orthopaedic Surgeons (AAOS) clinical practice guidelines. Methods: One hundred thirteen patients with painful hip (43) or knee (70) arthroplasties were referred to a single provider by orthopaedic surgeons outside our practice between 2012 and 2014...
June 2018: Arthroplasty Today
https://www.readbyqxmd.com/read/29896022/incidence-management-and-outcome-assessment-of-post-operative-infection-following-single-bundle-and-double-bundle-acl-reconstruction
#2
Pallav Mishra, Ajay Lal, Mukul Mohindra, Nitin Mehta, Deepak Joshi, Deepak Chaudhary
Introduction: Post-operative infection is a dreadful complication of ACL reconstruction with gray zone over management guidelines. We aimed to establish commonest etiology, assess incidence of infection and effect on outcome, individually for single and double bundle ACL reconstruction techniques, so as to formulate appropriate management guidelines. Methods: Our prospective study involved 1152 patients operated for ACL reconstruction (437- DBACL, 715- SBACL) from 2010-2013...
April 2018: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/29889726/evolution-of-delivery-room-management-for-meconium-stained-infants-recent-updates
#3
Shilpi Chabra
BACKGROUND: The approach to intrapartum and postnatal management of an infant born through meconium-stained amniotic fluid (MSAF) in the delivery room (DR) has changed several times over the last few decades, leading to confusion and anxiety among health care providers (nurses, nurse practitioners, respiratory therapists, midwives, and physicians). This article provides state-of-the-art insight into the evidence or lack thereof for the changes in guidelines. PURPOSE: To discuss the evidence for evolution of DR management of vigorous and nonvigorous infants born through any type of MSAF...
June 8, 2018: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
https://www.readbyqxmd.com/read/29887359/how-reliable-is-the-cell-count-analysis-in-the-diagnosis-of-prosthetic-joint-infection
#4
Akos Zahar, Christian Lausmann, Camila Cavalheiro, Anoop C Dhamangaonkar, Tommaso Bonanzinga, Thorsten Gehrke, Mustafa Citak
BACKGROUND: Synovial analysis of joint aspirates is a key diagnostic tool; all major diagnostic algorithms include cell count (CC) and polymorphonuclear percentage (PMN%) as important criteria to make the diagnosis. In this context, we conducted this study to analyze the overall accuracy of CC and PMN%. METHODS: A single-center retrospective analysis was performed with clinical data of included patients, with a total of 524 preoperative joint aspirations (255 hips, 269 knees)...
May 17, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29874653/rapid-on-site-evaluation-of-fine-needle-aspiration-by-non-cytopathologists-a-systematic-review-and-meta-analysis-of-diagnostic-accuracy-studies-for-adequacy-assessment
#5
Lauren Pearson, Rachel E Factor, Sandra K White, Brandon S Walker, Lester J Layfield, Robert L Schmidt
OBJECTIVE: Rapid on-site evaluation (ROSE) has been shown to improve adequacy rates and reduce needle passes. ROSE is often performed by cytopathologists who have limited availability and may be costlier than alternatives. Several recent studies examined the use of alternative evaluators (AEs) for ROSE. A summary of this information could help inform guidelines regarding the use of AEs. The objective was to assess the accuracy of AEs compared to cytopathologists in assessing the adequacy of specimens during ROSE...
June 6, 2018: Acta Cytologica
https://www.readbyqxmd.com/read/29858195/new-nutrition-guidelines-promoting-enteral-nutrition-via-a-nutrition-bundle
#6
Ashleigh VanBlarcom, Mary Anne McCoy
Malnutrition in hospitals is often overlooked, underdiagnosed, and untreated. Malnourished patients have increased risk for infection and pressure injuries, longer duration of mechanical ventilation, anemia, depressed cardiac and respiratory functions, and an overall higher risk for mortality. These complications contribute to longer hospital stays and higher health care costs. The benefits of early nutritional support in hospitals may be enhanced by use of a new nutrition care bundle that addresses all aspects of nutrition assessment and intervention...
June 2018: Critical Care Nurse
https://www.readbyqxmd.com/read/29843854/the-ins-and-outs-of-faecal-microbiota-transplant-for-recurrent-clostridium-difficile-diarrhoea-at-wits-donald-gordon-medical-centre-johannesburg-south-africa
#7
S Lee, K Drennan, G Simons, A Hepple, K Karlsson, W Lowman, P C Gaylard, L McNamara, J Fabian
BACKGROUND: Clostridium difficile-associated diarrhoea (CDAD) is a potentially life-threatening condition that is becoming increasingly common. A persistent burden of this infectious illness has been demonstrated over the past 4 years at Wits Donald Gordon Medical Centre (WDGMC), Johannesburg, South Africa, through implementation of active surveillance of hospital-acquired infections as part of the infection prevention and control programme. Oral treatment with metronidazole or vancomycin is recommended, but there is a major problem with symptomatic recurrence after treatment...
April 25, 2018: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/29800944/association-of-preprocedural-fasting-with-outcomes-of-emergency-department-sedation-in-children
#8
Maala Bhatt, David W Johnson, Monica Taljaard, Jason Chan, Nick Barrowman, Ken J Farion, Samina Ali, Suzanne Beno, Andrew Dixon, C Michelle McTimoney, Alexander Sasha Dubrovsky, Mark G Roback
Importance: It is not clear whether adherence to preprocedural fasting guidelines prevent pulmonary aspiration and associated adverse outcomes during emergency department (ED) sedation of children. Objective: To examine the association between preprocedural fasting duration and the incidence of sedation-related adverse outcomes in a large sample of children. Design, Setting, and Participants: We conducted a planned secondary analysis of a multicenter prospective cohort study of children aged 0 to 18 years who received procedural sedation for a painful procedure in 6 Canadian pediatric EDs from July 2010 to February 2015...
May 7, 2018: JAMA Pediatrics
https://www.readbyqxmd.com/read/29798347/-the-role-of-ata-2015-guidelines-superb-microvascular-imaging-and-spectral-doppler-in-differentiation-between-malignant-and-benign-thyroid-nodules
#9
Y H Li, D H Wen, C X Li, X J Li, G Xue
Objective: To evaluate the diagnostic value of ultrasound patterns of 2015 American Thyroid Association (ATA) guidelines, color Doppler flow imaging (CDFI), superb microvascular imaging (SMI), and spectral Doppler in the differentiation of benign and malignant thyroid nodules. Method: The study included 254 thyroid nodules confirmed by fine needle aspiration cytology (FNAC) or histopathologic examination. All nodules were detected by ultrasonography, SMI, CDFI and spectral Doppler respectively. Blood flow detection technologies (CDFI and SMI) were used to classify flow distribution characteristics of thyroid nodules according to Kim's grading criteria...
August 5, 2017: Journal of Clinical Otorhinolaryngology, Head, and Neck Surgery
https://www.readbyqxmd.com/read/29793462/eliminating-the-high-abortion-related-complications-and-deaths-in-cameroon-the-restrictive-legal-atmosphere-on-abortions-is-no-acceptable-excuse
#10
Luchuo Engelbert Bain, Eugene Justine Kongnyuy
BACKGROUND: The abortion law in Cameroon is highly restrictive. The law permits induced abortions only when the woman's life is at risk, to preserve her physical and mental health, and on grounds of rape or incest. Unsafe abortions remain rampant with however rare reported cases of persecution, even when these abortions are proven to have been carried out illegally. DISCUSSION: Available public health interventions are cheap and feasible (Misoprostol and Manual Vacuum Aspiration in post abortion care, modern contraception, post-abortion counseling), and must be implemented to reduce unacceptably high maternal mortality rates in the country which still stand at as high as 596/100...
May 24, 2018: BMC Women's Health
https://www.readbyqxmd.com/read/29789053/management-of-meconium-stained-newborns-in-the-delivery-room
#11
Chintan Kiritkumar Gandhi
The approach to the management of meconium-stained newborns in the delivery room has been changing for over 40 years. The goal is to prevent meconium aspiration syndrome (MAS) and complications related to MAS. For decades, airway obstruction was believed to be a major component of MAS and, consequently, suction maneuvers to remove meconium from the airways were recommended to decrease the frequency and severity of MAS. Initial recommendations were based on observational studies. However, the incidence of MAS and mortality related to MAS has declined since the 1970s, mostly because of a decrease in the number of postterm deliveries...
May 1, 2018: Neonatal Network: NN
https://www.readbyqxmd.com/read/29785074/challenges-in-diagnosis-of-pancreatic-cancer
#12
REVIEW
Lulu Zhang, Santosh Sanagapalli, Alina Stoita
Pancreatic cancer is a growing source of cancer related death, yet has poor survival rates which have not improved in the last few decades. Its high mortality rate is attributed to pancreatic cancer biology, difficulty in early diagnosis and the lack of standardised international guidelines in assessing suspicious pancreatic masses. This review aims to provide an update in the current state of play in pancreatic cancer diagnosis and to evaluate the benefits and limitations of available diagnostic technology...
May 21, 2018: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/29771776/comparison-of-sample-adequacy-and-diagnostic-yield-of-19-and-22-g-ebus-tbna-needles
#13
Udit Chaddha, Reza Ronaghi, Waafa Elatre, Ching-Fei Chang, Ramyar Mahdavi
BACKGROUND: The 2016 CHEST consensus guidelines recommend use of either 21- or 22-G needles for endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). We decided to prospectively compare sample adequacy and diagnostic yield of the 19-G with the 22-G EBUS needle, hypothesizing that a larger gauge difference might magnify the differences between 2 needle sizes. METHODS: Twenty-seven patients undergoing EBUS-TBNA at our institution were evaluated...
May 16, 2018: Journal of Bronchology & Interventional Pulmonology
https://www.readbyqxmd.com/read/29763295/supraparticles-functionality-from-uniform-structural-motifs
#14
Susanne Wintzheimer, Tim Granath, Maximilian Oppmann, Thomas Kister, Thibaut Thai, Tobias Kraus, Nicolas Vogel, Karl Mandel
Under the right process conditions, nanoparticles can cluster together to form defined particular structures, which can be termed supraparticles. Controlling the size, shape, and morphology of such entities is a central step in various fields of science and technology, ranging from colloid chemistry and soft matter physics to powder technology and pharmaceutical and food sciences. These diverse scientific communities have been investigating formation processes and structure/property relations of such supraparticles under completely different boundary conditions...
May 15, 2018: ACS Nano
https://www.readbyqxmd.com/read/29750692/trainability-of-cricoid-pressure-force-application-a-simulation-based-study
#15
Eric Noll, Shivam Shodhan, Arnavi Varshney, Christopher Gallagher, Pierre Diemunsch, F Barry Florence, Jamie Romeiser, Elliott Bennett-Guerrero
BACKGROUND: Aspiration of gastric contents is a leading cause of airway management-related mortality during anesthesia practice. Cricoid pressure (CP) is widely used during rapid sequence induction to prevent aspiration. National guidelines for CP suggest a target force of 10 N before and 30 N after loss of consciousness. However, few studies have rigorously assessed whether clinicians can be trained to consistently achieve these levels of force. We hypothesized that clinicians can be trained effectively to deliver 10-30 N during application of CP...
May 9, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29744655/does-the-acr-ti-rads-scoring-allow-us-to-safely-avoid-unnecessary-thyroid-biopsy-single-center-analysis-in-a-large-cohort
#16
Fatos Dilan Koseoglu Atilla, Basak Ozgen Saydam, Nihat Ali Erarslan, Ayse Gulden Diniz Unlu, Hamiyet Yilmaz Yasar, Muhammet Ozer, Baris Akinci
INTRODUCTION: The American College of Radiology (ACR) has recently proposed a guideline that recommends clinicians to perform thyroid fine-needle aspiration biopsy (FNAB) on the basis of ultrasound features. In this study, we focused on nodules for which no biopsy is recommended by the ACR Thyroid Imaging, Reporting and Data System (TI-RADS) guideline. SUBJECTS AND METHODS: Two-thousand eight-hundred and forty-seven consecutive patients with thyroid nodules who underwent FNAB according to the 2009 American Thyroid Association (ATA) guideline were included...
May 9, 2018: Endocrine
https://www.readbyqxmd.com/read/29742978/needle-biopsy-of-routine-thyroid-nodules-should-be-performed-using-a-capillary-action-technique-with-24-to-27-gauge-needles-a-systematic-review-and-meta-analysis
#17
William J Moss, Andrey Finegersh, John Pang, Joseph A Califano, Charles S Coffey, Ryan K Orosco, Kevin T Brumund
BACKGROUND: Fine-needle biopsy is the international standard for diagnostic evaluation of thyroid nodules. There is a lack of consensus regarding the optimal needle biopsy technique. The implementation of capillary action versus aspiration and the optimal needle gauge remain topics of debate. METHODS: A systematic review of the Medline, Embase, and Cochrane databases was performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines...
June 5, 2018: Thyroid: Official Journal of the American Thyroid Association
https://www.readbyqxmd.com/read/29731649/comparative-evaluation-of-methods-for-the-detection-of-biofilm-formation-in-coagulase-negative-staphylococci-and-correlation-with-antibiogram
#18
Lok Bahadur Shrestha, Narayan Raj Bhattarai, Basudha Khanal
Introduction: Coagulase-negative staphylococci (CNS) are normal commensals of human skin and mucous membranes. The objective of the study was to determine the prevalence of CNS among clinical isolates, characterize them up to species level, compare the three conventional methods for detection of biofilm formation, and study their antimicrobial susceptibility pattern. Materials and methods: CNS were obtained from various clinical samples including blood, urine, central venous catheter tips, endotracheal tube aspirate, and pus during a 1-year period (July 1, 2014, to June 30, 2015)...
2018: Infection and Drug Resistance
https://www.readbyqxmd.com/read/29726317/anaesthesia-practice-in-denmark-for-relocation-of-the-dislocated-hip-after-total-hip-arthroplasty
#19
Christine P Holler, Nicolai Lohse, Nicolai B Foss
INTRODUCTION: The prevalence of hip dislocations after total hip arthroplasty (THA) is 2-4% in Denmark. Patients with a dislocated THA are often elderly citizens with comorbidities and severe pain in the pre-reposition phase. Evidence as to which method of anaesthesia and airway management is best for hip relocation is lacking. The aim of this study was to determine how anaesthesiologists in Denmark provide anaesthesia for relocation of THAs, and if a local guideline is available. METHODS: A questionnaire was distributed by e-mail to all members of the Danish Association of Anaesthesiology and Intensive Care and the Danish Society of Young Anaesthesiologists...
May 2018: Danish Medical Journal
https://www.readbyqxmd.com/read/29726295/duodenal-neuroendocrine-neoplasms-a-still-poorly-recognized-clinical-entity
#20
Roberta Elisa Rossi, Emanuele Rausa, Federica Cavalcoli, Dario Conte, Sara Massironi
BACKGROUND: Duodenal neuroendocrine neoplasms (dNENs) are rare tumors, which usually show good prognosis. The optimal management of these tumors is still far from being clearly understood because of their rarity and the poor level of knowledge about their natural history. Herein, we have reviewed the literature on dNENs to collect and analyze the current data on epidemiology, diagnosis and management of these rare tumors. METHODS: Bibliographical searches were performed in PubMed, using the following keywords: duodenal neuroendocrine neoplasm; duodenum; gastrinoma; diagnosis; therapy; guidelines...
May 4, 2018: Scandinavian Journal of Gastroenterology
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