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https://www.readbyqxmd.com/read/28804862/oncological-patients-in-the-intensive-care-unit-prognosis-decision-making-therapies-and-end-of-life-care
#1
Ewelina Biskup, Fengfeng Cai, Marcus Vetter, Stephan Marsch
The effectiveness of intensive care unit (ICU) care for cancer patients remains controversial. Advances in antitumour and supportive care led to major improvements in outcomes of oncological patients in the ICU. Improved cancer therapies and supportive management of organ dysfunctions have contributed to improved survival rates. As a consequence, the number of cancer patients requiring ICU admission is rising. Frequently, cancer patients have a poor performance status and are vulnerable. It is a heterogeneous population, where the nature and curability of the neoplasm and the severity of critical illness cause a plethora of issues about ICU admissions...
August 14, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/28797473/biomarker-research-to-improve-clinical-outcomes-of-peritoneal-dialysis-consensus-of-the-european-training-and-research-in-peritoneal-dialysis-eutripd-network
#2
REVIEW
Christoph Aufricht, Robert Beelen, Matthias Eberl, Michel Fischbach, Donald Fraser, Achim Jörres, Klaus Kratochwill, Manuel LópezCabrera, Peter Rutherford, Claus-Peter Schmitt, Nicholas Topley, Janusz Witowski
Peritoneal dialysis (PD) therapy substantially requires biomarkers as tools to identify patients who are at the highest risk for PD-related complications and to guide personalized interventions that may improve clinical outcome in the individual patient. In this consensus article, members of the European Training and Research in Peritoneal Dialysis Network (EuTRiPD) review the current status of biomarker research in PD and suggest a selection of biomarkers that can be relevant to the care of PD patients and that are directly accessible in PD effluents...
August 8, 2017: Kidney International
https://www.readbyqxmd.com/read/28792060/screening-for-housing-instability-and-homelessness-among-families-undergoing-child-maltreatment-investigation
#3
Anne F Farrell, Kate E Dibble, Kellie G Randall, Preston A Britner
This paper reports results of mixed methods, population survey of housing instability, and homelessness. Child welfare personnel conducted the Quick Risks and Assets for Family Triage (QRAFT), a three-question screening tool intended to identify housing instability and homelessness. The QRAFT requires users to assess family housing history, current housing arrangement, and current housing condition, on a four-point scale from "asset/not a risk" to "severe risk." The QRAFT was completed among 6828 families undergoing new child maltreatment investigations...
August 9, 2017: American Journal of Community Psychology
https://www.readbyqxmd.com/read/28789607/assessing-the-validity-of-the-triage-risk-screening-tool-in-a-third-world-setting
#4
Ravi Lalla, Ian Sammy, Joanne Paul, Paula Nunes, Vidya Ramcharitar Maharaj, Paula Robertson
Background Social risk is rarely evaluated in older emergency department (ED) patients, although its identification can reduce re-attendance. Objectives This study assessed the diagnostic accuracy of the Triage Risk Screening Tool (TRST) in the ED of a developing country. Methods The diagnostic accuracy of the TRST to detect elderly adults in need of social service intervention was compared with routine clinical evaluation, using comprehensive evaluation by an experienced social worker as the "gold standard"...
January 1, 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/28781062/value-of-geriatric-screening-and-assessment-in-predicting-postoperative-complications-in-patients-older-than-70-years-undergoing-surgery-for-colorectal-cancer
#5
Katleen Fagard, Julie Casaer, Albert Wolthuis, Johan Flamaing, Koen Milisen, Jean-Pierre Lobelle, Hans Wildiers, Cindy Kenis
OBJECTIVES: This study examines the association between geriatric screening and geriatric assessment (GA) and the risk of 30-day postoperative complications (30d-POCs) in older patients undergoing surgery for colorectal cancer (CRC). MATERIALS AND METHODS: Patients were identified from a prospectively collected database (2009-2015). All patients underwent geriatric screening with the G8 screening tool and the Flemish version of the Triage Risk Screening Tool (fTRST)...
August 3, 2017: Journal of Geriatric Oncology
https://www.readbyqxmd.com/read/28780493/can-an-observational-pain-assessment-tool-improve-time-to-analgesia-for-cognitively-impaired-older-persons-a-cluster-randomised-controlled-trial
#6
Margaret Fry, Lynn Chenoweth, Glenn Arendts
OBJECTIVE: The primary objective of the study was to measure the impact of an observational pain assessment dementia tool on time from ED arrival to first dose of analgesic medicine. METHODS: A multisite cluster randomised controlled trial was conducted to test the Pain Assessment in Advanced Dementia (PAINAD) tool. Patients aged 65 years or older suspected of a long bone fracture were screened for cognitive impairment using the Six-Item Screening (SIS) tool. Patients scoring 4 or less on SIS (intervention sites) were assessed for pain using PAINAD...
August 5, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28777159/icu-admission-after-surgery-who-benefits
#7
Sadia Ghaffar, Rupert M Pearse, Michael A Gillies
PURPOSE OF REVIEW: Death following surgery remains a major cause of death worldwide, and ICU admission following major surgery is considered a standard of care in many healthcare systems. However, ICU resources are finite and expensive, thus identifying those most likely to benefit is of great importance. RECENT FINDINGS: Advances in surgical and perioperative management have moved the focus of postoperative care to preventing complications and reducing duration of hospitalisation...
August 1, 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28771209/point-of-care-testing-in-acute-stroke-management-an-unmet-need-ripe-for-technological-harvest
#8
REVIEW
Dorin Harpaz, Evgeni Eltzov, Raymond C S Seet, Robert S Marks, Alfred I Y Tok
Stroke, the second highest leading cause of death, is caused by an abrupt interruption of blood to the brain. Supply of blood needs to be promptly restored to salvage brain tissues from irreversible neuronal death. Existing assessment of stroke patients is based largely on detailed clinical evaluation that is complemented by neuroimaging methods. However, emerging data point to the potential use of blood-derived biomarkers in aiding clinical decision-making especially in the diagnosis of ischemic stroke, triaging patients for acute reperfusion therapies, and in informing stroke mechanisms and prognosis...
August 3, 2017: Biosensors
https://www.readbyqxmd.com/read/28766103/protocol-driven-decision-support-within-e-referral-systems-to-streamline-patient-consultation-triaging-and-referrals-from-primary-care-to-specialist-clinics
#9
Ehsan Maghsoud-Lou, Sean Christie, Samina Raza Abidi, Syed Sibte Raza Abidi
Patient referral is a protocol where the referring primary care physician refers the patient to a specialist for further treatment. The paper-based current referral process at times lead to communication and operational issues, resulting in either an unfulfilled referral request or an unnecessary referral request. Despite the availability of standardized referral protocols they are not readily applied because they are tedious and time-consuming, thus resulting in suboptimal referral requests. We present a semantic-web based Referral Knowledge Modeling and Execution Framework to computerize referral protocols, clinical guidelines and assessment tools in order to develop a computerized e-Referral system that offers protocol-based decision support to streamline and standardize the referral process...
September 2017: Journal of Medical Systems
https://www.readbyqxmd.com/read/28764818/emergency-response-of-iranian-hospitals-against-disasters-a-practical-framework-for-improvement
#10
Ali Janati, Homayoun Sadeghi-Bazargani, Edris Hasanpoor, Mobin Sokhanvar, Elaheh HaghGoshyie, Abdollah Salehi
OBJECTIVE: Hospital emergency management is a continuous process that requires monolithic integration of planning and response attempts with local and national schemes. The aim of the current study is to evaluate emergency response by hospitals against potential disasters in Tabriz, north-west Iran. METHODS: A cross-sectional study was conducted in the city of Tabriz, in Iran, in 2016. The study population included all hospitals in Tabriz. A total of 18 hospitals were assessed...
August 2, 2017: Disaster Medicine and Public Health Preparedness
https://www.readbyqxmd.com/read/28760726/triaging-patient-complaints-monte-carlo-cross-validation-of-six-machine-learning-classifiers
#11
Adel Elmessiry, William O Cooper, Thomas F Catron, Jan Karrass, Zhe Zhang, Munindar P Singh
BACKGROUND: Unsolicited patient complaints can be a useful service recovery tool for health care organizations. Some patient complaints contain information that may necessitate further action on the part of the health care organization and/or the health care professional. Current approaches depend on the manual processing of patient complaints, which can be costly, slow, and challenging in terms of scalability. OBJECTIVE: The aim of this study was to evaluate automatic patient triage, which can potentially improve response time and provide much-needed scale, thereby enhancing opportunities to encourage physicians to self-regulate...
July 31, 2017: JMIR Medical Informatics
https://www.readbyqxmd.com/read/28754516/recall-tests-are-effective-to-detect-mild-cognitive-impairment-a-systematic-review-and-meta-analysis-of-108-diagnostic-studies
#12
Kelvin K F Tsoi, Joyce Y C Chan, Hoyee W Hirai, Adrian Wong, Vincent C T Mok, Linda C W Lam, Timothy C Y Kwok, Samuel Y S Wong
BACKGROUND: Mild cognitive impairment (MCI) is a prevalent symptom associated with the increased risk of dementia. There are many cognitive tests available for detection of MCI, and investigation of the diagnostic performance of the tests is deemed necessary. OBJECTIVE: This study aims to evaluate the diagnostic performance of different cognitive tests used for MCI detection. DATA SOURCES: A list of cognitive tests was identified in previous reviews and from online search engines...
July 25, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28751974/coronary-ct-angiography-in-acute-chest-pain
#13
REVIEW
Nikhil Goyal, Arthur Stillman
Coronary computed tomographic angiography has become a reliable diagnostic tool in the evaluation of patients with chest pain. Studies have shown this modality to be accurate and safe when compared with conventional methods of assessing patients with chest pain. We review the recent developments with coronary computed tomographic angiography and devote particular attention toward its application to triage patients in the emergency department.
2017: F1000Research
https://www.readbyqxmd.com/read/28739579/the-prospective-validation-of-the-modified-physiological-triage-tool-mptt-an-evidence-based-approach-to-major-incident-triage
#14
James Vassallo, S Horne, J E Smith, L A Wallis
INTRODUCTION: Triage is a key principle in the effective management of major incidents. There is limited evidence to support existing triage tools, with a number of studies demonstrating poor performance at predicting the need for a life-saving intervention. The Modified Physiological Triage Tool (MPTT) is a novel triage tool derived using logistic regression, and in retrospective data sets has shown optimum performance at predicting the need for life-saving intervention. MATERIALS AND METHODS: Physiological data and interventions were prospectively collected for consecutive adult patients with trauma (>18years) presenting to the emergency department at Camp Bastion, Afghanistan, between March and September 2011...
July 23, 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/28737573/investigating-the-impact-of-different-suspicion-of-infection-criteria-on-the-accuracy-of-quick-sepsis-related-organ-failure-assessment-systemic-inflammatory-response-syndrome-and-early-warning-scores
#15
Matthew M Churpek, Ashley Snyder, Sarah Sokol, Natasha N Pettit, Dana P Edelson
OBJECTIVE: Studies in sepsis are limited by heterogeneity regarding what constitutes suspicion of infection. We sought to compare potential suspicion criteria using antibiotic and culture order combinations in terms of patient characteristics and outcomes. We further sought to determine the impact of differing criteria on the accuracy of sepsis screening tools and early warning scores. DESIGN: Observational cohort study. SETTING: Academic center from November 2008 to January 2016...
July 21, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28731050/genomic-abnormalities-in-invasive-endocervical-adenocarcinoma-correlate-with-pattern-of-invasion-biologic-and-clinical-implications
#16
Anjelica Hodgson, Yutaka Amemiya, Arun Seth, Matthew Cesari, Bojana Djordjevic, Carlos Parra-Herran
The pattern-based classification system for HPV-related endocervical adenocarcinoma, which classifies tumors based on the destructiveness of stromal invasion, is predictive of the risk of nodal metastases and adverse outcome. Previous studies have demonstrated clinically important molecular alterations in endocervical adenocarcinoma, including KRAS and PIK3CA mutations; however, correlation between the molecular landscape and pathological variables including pattern of invasion has not been thoroughly explored...
July 21, 2017: Modern Pathology: An Official Journal of the United States and Canadian Academy of Pathology, Inc
https://www.readbyqxmd.com/read/28730227/hpv-genotyping-and-p16%C3%A3-ki-67-dual-staining-in-the-detection-of-high-grade-cervical-lesion-in-patients-with-lsil-on-pap-smear
#17
Lavinia Cristina Moleriu, Ioan Sas, Adrian Claudiu RaŢiu, Mădălin Marius Margan, Cristina Anamaria Secoşan, Răzvan Ştefan Ilina, Florin George Horhat, Loredana Gabriela Stana, Dorin Grigoraş, LaurenŢiu Cornel Pirtea
p16÷Ki-67 dual-stained cytology, either alone or combined with human papillomavirus (HPV) 16÷18 genotyping, could be a useful tool for triage for colposcopy of HPV-positive patients. Based on this background, we aimed at comparing the diagnostic performance of the p16÷Ki-67 dual staining test, and high-risk HPV test for the detection of high-risk cervical intraepithelial neoplasia (CIN2÷3) in patients diagnosed with low-grade squamous intraepithelial lesion (LSIL) on Pap smear. We performed a retrospective study including 184 patients with LSIL cytology on Pap smear, of which 64 were referred for biopsy after colposcopy...
2017: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
https://www.readbyqxmd.com/read/28728604/target-d-a-stratified-individually-randomized-controlled-trial-of-the-diamond-clinical-prediction-tool-to-triage-and-target-treatment-for-depressive-symptoms-in-general-practice-study-protocol-for-a-randomized-controlled-trial
#18
Jane Gunn, Caroline Wachtler, Susan Fletcher, Sandra Davidson, Cathrine Mihalopoulos, Victoria Palmer, Kelsey Hegarty, Amy Coe, Elizabeth Murray, Christopher Dowrick, Gavin Andrews, Patty Chondros
BACKGROUND: Depression is a highly prevalent and costly disorder. Effective treatments are available but are not always delivered to the right person at the right time, with both under- and over-treatment a problem. Up to half the patients presenting to general practice report symptoms of depression, but general practitioners have no systematic way of efficiently identifying level of need and allocating treatment accordingly. Therefore, our team developed a new clinical prediction tool (CPT) to assist with this task...
July 20, 2017: Trials
https://www.readbyqxmd.com/read/28725580/pre-biopsy-mri-as-an-adjunct-for-cancer-detection-in-men-with-elevated-psa-and-no-previous-biopsy
#19
REVIEW
Facundo Uriburu-Pizarro, Veeru Kasivisvanathan, Philippe Puech, Arnauld Villers
The role of magnetic resonance imaging (MRI) prior to biopsy in the diagnosis of prostate cancer in biopsy-naïve patients has been strengthened by recent developments such as the PIRADS V2 criteria, which cover acquisition, interpretation, and reporting for clinical practice and data collection for research. Important questions on the role of prostate MRI remain: can MRI be used as a triage test before first biopsy series? Can it be used to avoid the use of systematic biopsies (SB) and instead use only targeted biopsies (TB) to MRI-suspicious lesions? Studies to evaluate image guided TB compared to SB have started to accumulate...
June 2017: Translational Andrology and Urology
https://www.readbyqxmd.com/read/28715794/an-introduction-to-the-emergency-department-adult-clinical-escalation-protocol-ed-ace
#20
Eoin Coughlan, Una Geary, Abel Wakai, Ronan O'Sullivan, John Browne, Eilish McAuliffe, Marie Ward, Fiona McDaid, Conor Deasy
PURPOSE OF THE STUDY: This study demonstrates how a participatory action research approach was used to address the challenge of the early and effective detection of the deteriorating patient in the ED setting. The approach enabled a systematic approach to patient monitoring and escalation of care to be developed to address the wide-ranging spectrum of undifferentiated presentations and the phases of ED care from triage to patient admission. This paper presents a longitudinal patient monitoring system, which aims to provide monitoring and escalation of care, where necessary, of adult patients from triage to admission to hospital in a manner that is feasible in the unique ED environment...
November 14, 2016: Emergency Medicine Journal: EMJ
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