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https://www.readbyqxmd.com/read/29352349/factors-affecting-n-terminal-pro-b-type-natriuretic-peptide-levels-in-preterm-infants-and-use-in-determination-of-haemodynamic-significance-of-patent-ductus-arteriosus
#1
Sarah Louise Harris, Kiran More, Bronwyn Dixon, Richard Troughton, Chris Pemberton, John Horwood, Nicola Ellis, Nicola Austin
This study aimed to investigate factors affecting N-terminal pro-B-type natriuretic peptide (NTproBNP) in preterm infants and the ability of NTproBNP to predict haemodynamically significant patent ductus arteriosus (HsPDA). Prospective cohort study of 51 infants < 30 weeks gestation. Blood NTproBNP and heart ultrasound were performed on day of life 3, 10, 28 and 36 weeks corrected age. NTproBNP levels analysed for prediction of HsPDA. The effect of gestational age, ventilation, hypoxia, bronchopulmonary dysplasia (BPD), creatinine and haemoglobin levels on NTproBNP levels were investigated...
January 19, 2018: European Journal of Pediatrics
https://www.readbyqxmd.com/read/29341110/eurogin-roadmap-2017-triage-strategies-for-the-management-of-hpv-positive-women-in-cervical-screening-programmes
#2
REVIEW
K Cuschieri, G Ronco, A Lorincz, L Smith, G Ogilvie, L Mirabello, F Carozzi, H Cubie, N Wentzensen, P Snijders, M Arbyn, J Monsonego J, S Franceschi
Cervical cancer screening will rely, increasingly, on HPV testing as a primary screen. The requirement for triage tests which can delineate clinically significant infection is thus prescient. In this EUROGIN 2017 roadmap, justification behind the most evidenced triages is outlined, as are challenges for implementation. Cytology is the triage with the most follow-up data; the existence of an HR-HPV positive, cytology negative group presents a challenge and re-testing intervals for this group (and choice of re-test) require careful consideration...
January 17, 2018: International Journal of Cancer. Journal International du Cancer
https://www.readbyqxmd.com/read/29340526/simulating-the-behavior-of-patients-who-leave-a-public-hospital-emergency-department-without-being-seen-by-a-physician-a-cellular-automaton-and-agent-based-framework
#3
Milad Yousefi, Moslem Yousefi, F S Fogliatto, R P M Ferreira, J H Kim
The objective of this study was to develop an agent based modeling (ABM) framework to simulate the behavior of patients who leave a public hospital emergency department (ED) without being seen (LWBS). In doing so, the study complements computer modeling and cellular automata (CA) techniques to simulate the behavior of patients in an ED. After verifying and validating the model by comparing it with data from a real case study, the significance of four preventive policies including increasing number of triage nurses, fast-track treatment, increasing the waiting room capacity and reducing treatment time were investigated by utilizing ordinary least squares regression...
January 11, 2018: Brazilian Journal of Medical and Biological Research, Revista Brasileira de Pesquisas Médicas e Biológicas
https://www.readbyqxmd.com/read/29338968/an-alternative-tool-for-triaging-patients-with-possible-acute-coronary-symptoms-before-admission-to-a-chest-pain-unit
#4
Kuang-Chau Tsai, Ray F Lin, Chieh Lee, Ai-Hsien Li
OBJECTIVE: This study aimed to develop a triage tool to more effectively triage possible ACS patients presenting to the emergency department (ED) before admission to a protocol-driven chest pain unit (CPU). METHODS: Seven hundred ninety-three clinical cases, randomly selected from 7962 possible ACS cases, were used to develop and test an ACS triage model using cluster analysis and stepwise logistic regression. RESULTS: The ACS triage model, logit (suspected ACS patient)=-5...
December 13, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29324048/peer-observation-of-rounds-leads-to-collegial-discussion-of-teaching
#5
J Rush Pierce, Patrick Rendón, Deepti Rao
PROBLEM: Faculty in the Division of Hospital Medicine provide most of the clinical teaching for learners at our institution. The majority of these faculty are Assistant Professors with limited formal instruction in clinical teaching. Previous Divisional strategies to improve clinical teaching ability included discussion of effective teaching behaviors, developing written expectations for teaching faculty, and instituting seminars on effective clinical teaching. Heretofore, the Division had not utilized a direct observation exercise...
January 11, 2018: Teaching and Learning in Medicine
https://www.readbyqxmd.com/read/29319365/the-prognostic-value-of-mid-regional-pro-adrenomedullin-in-the-evaluation-of-acute-dyspnea
#6
Justin J Choi, Matthew W McCarthy
Acute dyspnea is a common chief complaint among patients who visit an emergency room and presents diagnostic challenges for clinicians in both identifying the etiology and determining the clinical severity. The study of biomarkers in the prognostication and risk stratification of these patients has been increasing, including the investigation of the prognostic value for mid-regional pro-adrenomedullin (MR-proADM). Areas Covered: In this review, the authors cover what is known about MR-proADM testing in patients presenting with acute dyspnea and the supporting evidence of its prognostic value in common conditions in medical patients with acute dyspnea, including acute heart failure, community acquired pneumonia, acute exacerbation of chronic obstructive pulmonary disease, and acute pulmonary embolism...
January 10, 2018: Expert Review of Molecular Diagnostics
https://www.readbyqxmd.com/read/29318084/how-does-frailty-factor-into-mortality-risk-assessment-of-a-middle-aged-and-geriatric-trauma-population
#7
Sanjit R Konda, Ariana Lott, Hesham Saleh, Sebastian Schubl, Jeffrey Chan, Kenneth A Egol
Introduction: Frailty in elderly trauma populations has been correlated with an increased risk of morbidity and mortality. The Score for Trauma Triage in the Geriatric and Middle-Aged (STTGMA) is a validated mortality risk score that evaluates 4 major physiologic criteria: age, comorbidities, vital signs, and anatomic injuries. The aim of this study was to investigate whether the addition of additional frailty variables to the STTGMA tool would improve risk stratification of a middle-aged and elderly trauma population...
December 2017: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/29306269/sealone-safety-and-efficacy-of-coronary-computed-tomography-angiography-with-low-dose-in-patients-visiting-emergency-room-trial-study-protocol-for-a-randomized-controlled-trial
#8
Joonghee Kim, Joon-Won Kang, Kyuseok Kim, Sang Il Choi, Eun Ju Chun, Yeo Goon Kim, Won Young Kim, Dong Woo Seo, Jonghwan Shin, Huijai Lee, Kwang-Nam Jin, Soyeon Ahn, Seung Sik Hwang, Kwang Pyo Kim, Ru-Bi Jeong, Sang Ook Ha, Byungho Choi, Chang-Hwan Yoon, Jung-Won Suh, Hack-Lyoung Kim, Ju Kyoung Kim, Sujin Jang, Ji Seon Seo
OBJECTIVE: Chest pain is one of the most common complaints in the emergency department (ED). Cardiac computed tomography angiography (CCTA) is a frequently used tool for the early triage of patients with low- to intermediate-risk acute chest pain. We present a study protocol for a multicenter prospective randomized controlled clinical trial testing the hypothesis that a low-dose CCTA protocol using prospective electrocardiogram (ECG)-triggering and limited-scan range can provide sufficient diagnostic safety for early triage of patients with acute chest pain...
December 2017: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/29302517/nuclear-medicine-consultation-a-useful-tool-in-primary-care-to-enable-more-accurate-diagnosis
#9
Asif Ali Fakhri
In the high volume general practitioner setting, there is a need for triaging clinical questions pertaining to specific patients into ones that are readily answered, and those that would more effectively and efficiently be answered by the subspecialist. In this way, the nuclear medicine consultation provides the general practitioner a physiologic imaging specialist's perspective for answering complex clinical questions. A formal nuclear medicine consultation can be a valuable tool in identifying a targeted molecular imaging approach to answering a specific clinical question and can prove useful in both appropriate diagnostic study selection as well as accurate image interpretation...
April 2017: Journal of Family Medicine and Primary Care
https://www.readbyqxmd.com/read/29301857/triage-and-the-modified-physiological-triage-tool-24-mptt-24
#10
James Vassallo, S Horne, J E Smith
Major incidents occur on a regular basis. So far in 2017, England has witnessed five terrorism-related major incidents, resulting in approximately 40 fatalities and 400 injured. Triage is a key principle in the effective management of a major incident and involves prioritising patients on the basis of their clinical acuity. This paper describes the limitations associated with existing methods of primary major incident triage and the process of developing a new and improved triage tool-the Modified Physiological Triage Tool-24 (MPTT-24)...
January 4, 2018: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/29284734/impact-of-prehospital-triage-scales-to-detect-large-vessel-occlusion-on-resource-utilization-and-time-to-treatment
#11
Ludwig Schlemm, Martin Ebinger, Christian H Nolte, Matthias Endres
BACKGROUND AND PURPOSE: Prehospital stroke severity scales may help to triage acute ischemic stroke patients with large vessel occlusion (LVO) for direct transportation to a comprehensive stroke center. The impact on resource use and time to reperfusion treatment for patients with and without LVO is unknown. METHODS: Based on empirical distributions of stroke symptom severity, prehospital delay times, and stroke symptom severity-dependent likelihood of LVO, we simulate prehospital incidents of stroke-like symptoms in abstract geographical environments to estimate the impact of prehospital triage strategies based on different cutoffs of the rapid arterial occlusion evaluation scale...
December 28, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29258973/two-way-social-media-messaging-in-postoperative-cataract-surgical-patients-prospective-interventional-study
#12
Thuss Sanguansak, Katharine E Morley, Michael G Morley, Kavin Thinkhamrop, Jaruwan Thuanman, Isha Agarwal
BACKGROUND: Social media offers a new way to provide education, reminders, and support for patients with a variety of health conditions. Most of these interventions use one-way, provider-patient communication. Incorporating social media tools to improve postoperative (postop) education and follow-up care has only been used in limited situations. OBJECTIVE: The aim of this study was to determine the feasibility and efficacy of two-way social media messaging to deliver reminders and educational information about postop care to cataract patients...
December 19, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/29258762/the-joint-clinic-managing-excess-demand-for-hip-and-knee-osteoarthritis-referrals-using-a-new-physiotherapy-led-outpatient%C3%A2-service
#13
David P Gwynne-Jones, Liam R Hutton, Kirsten M Stout, J Haxby Abbott
BACKGROUND: There are increasing problems with access to both outpatient assessment and joint replacement surgery for patients with hip or knee osteoarthritis. METHODS: Data were collected on all patients seen at the Joint Clinic over a 2-year period with minimum 12-month follow-up. Patients were assessed by a nurse and a physiotherapist, baseline scores and demographic details collected, and an individualized personal care plan developed. Patients could be referred for a first specialist assessment (FSA) if their severity justified surgical assessment...
December 1, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29241698/telephone-triage-and-midwifery-a-scoping-review
#14
Carolyn M Bailey, Jennifer M Newton, Helen G Hall
BACKGROUND: Midwives use telephone triage to provide advice and support to childbearing women, and to manage access to maternity services. Telephone triage practises are important in the provision of accurate, timely and appropriate health care. Despite this, there has been very little research investigating this area of midwifery practice. AIM: To explore midwives and telephone triage practises; and to discuss the relevant findings for midwives managing telephone calls from women...
December 11, 2017: Women and Birth: Journal of the Australian College of Midwives
https://www.readbyqxmd.com/read/29233854/efficacy-of-educational-video-game-versus-traditional-educational-apps-at-improving-physician-decision-making-in-trauma-triage-randomized-controlled-trial
#15
Deepika Mohan, Coreen Farris, Baruch Fischhoff, Matthew R Rosengart, Derek C Angus, Donald M Yealy, David J Wallace, Amber E Barnato
OBJECTIVE: To determine whether a behavioral intervention delivered through a video game can improve the appropriateness of trauma triage decisions in the emergency department of non-trauma centers. DESIGN: Randomized clinical trial. SETTING: Online intervention in national sample of emergency medicine physicians who make triage decisions at US hospitals. PARTICIPANTS: 368 emergency medicine physicians primarily working at non-trauma centers...
December 12, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/29233110/accounting-for-misclassification-bias-of-binary-outcomes-due-to-underscreening-a-sensitivity-analysis
#16
Nanhua Zhang, Si Cheng, Lilliam Ambroggio, Todd A Florin, Maurizio Macaluso
BACKGROUND: Diagnostic tests are performed in a subset of the population who are at higher risk, resulting in undiagnosed cases among those who do not receive the test. This poses a challenge for estimating the prevalence of the disease in the study population, and also for studying the risk factors for the disease. METHODS: We formulate this problem as a missing data problem because the disease status is unknown for those who do not receive the test. We propose a Bayesian selection model which models the joint distribution of the disease outcome and whether testing was received...
December 12, 2017: BMC Medical Research Methodology
https://www.readbyqxmd.com/read/29227137/corrigendum-the-effectiveness-of-the-south-african-triage-tool-use-in-mahalapye-district-hospital-emergency-department-botswana
#17
Stephane T Tshitenge, Gboyega A Ogunbanjo, Deogratias O Mbuka
No abstract available.
December 1, 2017: African Journal of Primary Health Care & Family Medicine
https://www.readbyqxmd.com/read/29215711/triage-tools-for-detecting-cervical-spine-injury-in-pediatric-trauma-patients
#18
REVIEW
Annelie Slaar, M M Fockens, Junfeng Wang, Mario Maas, David J Wilson, J Carel Goslings, Niels Wl Schep, Rick R van Rijn
BACKGROUND: Pediatric cervical spine injury (CSI) after blunt trauma is rare. Nonetheless, missing these injuries can have severe consequences. To prevent the overuse of radiographic imaging, two clinical decision tools have been developed: The National Emergency X-Radiography Utilization Study (NEXUS) criteria and the Canadian C-spine Rule (CCR). Both tools are proven to be accurate in deciding whether or not diagnostic imaging is needed in adults presenting for blunt trauma screening at the emergency department...
December 7, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29214444/the-respiratory-rate-a-neglected-triage-tool-for-pre-hospital-identification-of-trauma-patients
#19
John D Yonge, Phillip Kemp Bohan, Justin J Watson, Christopher R Connelly, Lynn Eastes, Martin A Schreiber
BACKGROUND: Under-triaged trauma patients have worse clinical outcomes. We evaluated the capability of four pre-hospital variables to identify this population at the lowest level trauma activation (level 3). METHODS: A retrospective review of adult trauma activations from 2004 to 2014 was completed. Pre-hospital vital signs and Glasgow Coma Scale were converted to categorical variables. Patients were under-triaged based on meeting current level 1 or 2 criteria, or requiring a pre-defined critical intervention...
December 6, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29202769/impact-of-systolic-blood-pressure-limits-on-the-diagnostic-value-of-triage-algorithms
#20
Tobias Neidel, Nicolas Salvador, Axel R Heller
BACKGROUND: Major incidents are characterized by a lack of resources compared to an overwhelming number of casualties, requiring a prioritization of medical treatment. Triage algorithms are an essential tool for prioritizing the urgency of treatment for patients, but the evidence to support one over another is very limited. We determined the influence of blood pressure limits on the diagnostic value of triage algorithms, considering if pulse should be palpated centrally or peripherally...
December 4, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
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