2,070 results match your criteria Labor and Delivery in the Emergency Department


Do consumers who identify as Muslim experience culturally safe care (CSC) in the Emergency Department (ED)? A scoping review.

Australas Emerg Care 2018 Aug 1;21(3):93-98. Epub 2018 Sep 1.

School of Nursing, Midwifery and Paramedicine, Faculty of Health, University of Sunshine Coast, Maroochydore DC 4558, Queensland, Australia.

Lack of awareness about cultural and religious values and beliefs of patients presenting to Emergency Departments (ED) can compromise patient care and safety. Muslim Australians represent the fastest growing religious demographic group, with over a 77% growth in the last decade. The changing face of the Australian population requires that Australian health care carefully consider the dominant Western cultural paradigm currently influencing health care delivery. Read More

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http://dx.doi.org/10.1016/j.auec.2018.08.001DOI Listing

Respiratory Physiology for the Anesthesiologist.

Anesthesiology 2019 Apr 12. Epub 2019 Apr 12.

From the Department of Anesthesiology and Perioperative Medicine, Tufts Medical Center, Tufts University School of Medicine, Boston, Massachusetts (L.B.) the Department of Emergency, Anesthesia and Critical Care, Foundation IRCCS Ospedale Maggiore Policlinico, and Department of Surgical Pathophysiology and Transplantation, University of Milan, Milan, Italy (A.P.).

Respiratory function is fundamental in the practice of anesthesia. Knowledge of basic physiologic principles of respiration assists in the proper implementation of daily actions of induction and maintenance of general anesthesia, delivery of mechanical ventilation, discontinuation of mechanical and pharmacologic support, and return to the preoperative state. The current work provides a review of classic physiology and emphasizes features important to the anesthesiologist. Read More

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http://Insights.ovid.com/crossref?an=00000542-900000000-9661
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http://dx.doi.org/10.1097/ALN.0000000000002666DOI Listing
April 2019
1 Read

Screening for breech presentation using universal late-pregnancy ultrasonography: A prospective cohort study and cost effectiveness analysis.

PLoS Med 2019 Apr 16;16(4):e1002778. Epub 2019 Apr 16.

Department of Obstetrics and Gynaecology, University of Cambridge, NIHR Cambridge Comprehensive Biomedical Research Centre, Cambridge, United Kingdom.

Background: Despite the relative ease with which breech presentation can be identified through ultrasound screening, the assessment of foetal presentation at term is often based on clinical examination only. Due to limitations in this approach, many women present in labour with an undiagnosed breech presentation, with increased risk of foetal morbidity and mortality. This study sought to determine the cost effectiveness of universal ultrasound scanning for breech presentation near term (36 weeks of gestational age [wkGA]) in nulliparous women. Read More

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http://dx.doi.org/10.1371/journal.pmed.1002778DOI Listing

Making cesarean delivery SAFE in low- and middle-income countries.

Semin Perinatol 2019 Mar 16. Epub 2019 Mar 16.

Department of Obstetrics and Gynecology, Columbia University Medical Center, New York, NY, USA.

Cesarean birth (CB) rates are rising, globally. The global burden of CB is having a mixed effect on pregnancy outcomes and requires significant clinical and economic resources. The context of CB care in low- and middle-income countries is further complicated by barriers to facility-based care itself, followed by issues with quality and delivery of care in these resource-limited settings. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S01460005193004
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http://dx.doi.org/10.1053/j.semperi.2019.03.015DOI Listing
March 2019
1 Read

Needs Assessment for Turkish Family Caregivers of Older Persons with Cancer: First-Phase Results of Adapting an Early Palliative Care Model.

J Palliat Med 2019 Apr 10. Epub 2019 Apr 10.

2 School of Nursing, University of Alabama at Birmingham (UAB), Birmingham, Alabama.

Background: Although palliative care is expanding globally for patients with serious illness, Turkey has not had widespread integration of early concurrent oncology palliative care. Hence, adapting and testing models of concurrent oncology palliative care for Turkish patients is imperative. Furthermore, it is critical that these care models also address the needs of family caregivers. Read More

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http://dx.doi.org/10.1089/jpm.2018.0643DOI Listing

Delayed Initiation of Hemodialysis in Pregnant Women with Chronic Kidney Disease: Logistical Problems Impact Clinical Outcomes. An Experience from an Emerging Country.

J Clin Med 2019 Apr 8;8(4). Epub 2019 Apr 8.

Unidad de Investigación Médica en Enfermedades Nefrológicas, CMN Siglo XXI, 06720 CdMx, México.

Background: Chronic kidney disease (CKD) is associated with reduction of fertility and increased complications during pregnancy. The aim of this work is to analyze the clinical outcomes and risk factors in pregnant women who needed to start dialysis with different schedules in a public hospital in Mexico City, with particular attention on the interference of social and cultural elements as well as resource limitations.

Material And Methods: CKD women who needed dialysis in pregnancy over the period 2002⁻2014 and had with complete demographic and outcome data were included in this retrospective study. Read More

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http://dx.doi.org/10.3390/jcm8040475DOI Listing

Development of a Quality Improvement Curriculum in a Pediatric Emergency Medicine Fellowship.

Pediatr Emerg Care 2019 Jan 4. Epub 2019 Jan 4.

From the Department of Pediatrics, Section of Emergency Medicine, University of Colorado School of Medicine, Children's Hospital Colorado, Aurora, CO.

Quality improvement (QI) is a science of systematic analysis and improvement of health care delivery systems. Working knowledge of QI models is imperative to professional development of future pediatric emergency medicine practitioners. The Accreditation Council for Graduate Medical Education has established a list of QI and patient safety expectations for trainees. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001824DOI Listing
January 2019

Drone delivery of an automated external defibrillator - a mixed method simulation study of bystander experience.

Scand J Trauma Resusc Emerg Med 2019 Apr 8;27(1):40. Epub 2019 Apr 8.

Department of Medicine, Centre for Resuscitation Science, Karolinska Institute, SE-17177, Stockholm, Sweden.

Background: Out-of-hospital cardiac arrest (OHCA) affects some 275,000 individuals in Europe each year. Time from collapse to defibrillation is essential for survival. As emergency medical services (EMS) response times in Sweden have increased, novel methods are needed to facilitate early treatment. Read More

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http://dx.doi.org/10.1186/s13049-019-0622-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6454735PMC
April 2019
1 Read

Precipitous Labor and Emergency Department Delivery.

Emerg Med Clin North Am 2019 May;37(2):265-276

Department of Emergency Medicine, MedStar Georgetown University, MedStar Washington Hospital Center, 3800 Reservoir Road, Washington, DC 20007, USA.

A precipitous delivery can be among the most stressful events an emergency physician encounters. The physician must assess 2 patients (mother and fetus) and be prepared to manage a variety of complications that may arise during delivery. A majority of precipitous deliveries result in good outcomes for both mother and baby, but emergency physicians must be prepared to manage feared complications, such as tight nuchal cords, shoulder dystocia, and breech presentation. Read More

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http://dx.doi.org/10.1016/j.emc.2019.01.007DOI Listing
May 2019
2 Reads

Learning in a High-Stress Clinical Environment: Stressors Associated with Medical Students' Clerkship Training on Labor and Delivery.

Teach Learn Med 2019 Mar 25:1-8. Epub 2019 Mar 25.

a Department of Obstetrics and Gynecology , Brigham and Women's Hospital, Harvard Medical School , Boston , Massachusetts , USA.

Phenomenon: Obstetrics and gynecology can be a high-stress clinical environment for medical students due to the specialty's fast-paced and unpredictable nature. Little is known about learning stressors for medical students on the obstetrics and gynecology clerkship to inform stress-reducing interventions and improve learning experience. This study investigated (a) which aspects of the learning environment are most stressful for obstetrics and gynecology clerkship students, (b) how perceived learning stressors in this environment differ for medical students and teachers (residents, fellows, and faculty), and (c) what interventions students propose to address these stressors. Read More

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http://dx.doi.org/10.1080/10401334.2019.1575742DOI Listing

Effect of maternal age on emergency cesarean section.

J Matern Fetal Neonatal Med 2019 Mar 25:1-8. Epub 2019 Mar 25.

a Department of Obstetrics and Gynecology, College of Medicine , The Catholic University of Korea , Seoul , Republic of Korea.

Objectives: This study aims to investigate the independent influence of maternal age on the risk of emergency cesarean section (CS) due to nonreassuring fetal heart rate or arrest disorder.

Methods: This was a cross-sectional study on women with nulliparous pregnancies, who are attempting vaginal delivery at term and have a cephalic presentation without the indication of elective CS at the onset of labor. The primary outcome was the rate of emergency CS. Read More

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https://www.tandfonline.com/doi/full/10.1080/14767058.2019.1
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http://dx.doi.org/10.1080/14767058.2019.1593958DOI Listing
March 2019
4 Reads

Patient and hospital factors predict use of coronary angiography in out-of-hospital cardiac arrest patients.

Resuscitation 2019 Mar 15;138:182-189. Epub 2019 Mar 15.

Rescu, Li Ka Shing Knowledge Institute, St Michael's Hospital, Division of Emergency Medicine, Department of Medicine, University of Toronto, 30 Bond Street, Toronto, Ontario, M5B 1W8, Canada; Departments of Emergency Medicine and Public Health Sciences, Queen's University at Kingston, Kingston Health Sciences Centre, KGH Site, Victory 3, 76 Stuart Street, Kingston, Ontario, K7L 2V7, Canada. Electronic address:

Aim: To describe the association between patient- and hospital-level factors and coronary angiography among patients who suffer out-of-hospital cardiac arrest (OHCA).

Methods: A population-based retrospective cohort study using data from 28 hospitals in Southern Ontario between March 1, 2010 and December 31, 2014. We included consecutive adult patients with atraumatic, OHCA, who achieved return of spontaneous circulation, and were alive at least six hours after hospital arrival. Read More

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http://dx.doi.org/10.1016/j.resuscitation.2019.03.013DOI Listing

High risk twin pregnancy complicated with severe rachiterata and huge dorsal mass suffering from refractory infection: A case report.

Medicine (Baltimore) 2019 Mar;98(11):e14462

Department of Obstetrics & Gynaecology, West China Second Hospital.

Rationale: Severe rachiterata is rarely described as a complication of pregnancy, and it was assumed as a contraindication to pregnancy. We first report a case of severe spinal deformity associated both with scoliosis and kyphosis in pregnancy.

Patient Concerns: A 38-year-old pregnant woman [28+1 weeks of twin pregnancy, gravida 3, para 2 (G3P2)] was admitted to the emergency department with complaints of persistent productive cough, with increased expectoration, dyspnea, dizziness, fatigue, and irregular abdominal pain. Read More

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http://dx.doi.org/10.1097/MD.0000000000014462DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6426513PMC
March 2019
2 Reads

Our Experience with Iatrogenic Ureteric Injuries among Women Presenting to University College Hospital, Ibadan: A Call to Action on Trigger Factors.

Obstet Gynecol Int 2019 10;2019:6456141. Epub 2019 Feb 10.

Genitourinary/Urogynaecology Unit, Faculty of Clinical Science, UI, Ibadan, Nigeria.

Background: Ureteric injuries leading to ureterovaginal fistula (UVF) is less common than vesicovaginal fistula, as a cause of urinary incontinence. Recently, there is a surge in the number of UVF cases presenting to University College Hospital (UCH) following a caesarean delivery. The urogynaecology unit at UCH is at the forefront of providing surgical repair for women with all forms of genitourinary fistulas. Read More

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http://dx.doi.org/10.1155/2019/6456141DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6387707PMC
February 2019
1 Read

Vaginismus and pregnancy: epidemiological profile and management difficulties.

Psychol Res Behav Manag 2019 12;12:137-143. Epub 2019 Mar 12.

Emergency Department of Gynecology and Obstetrics, Maternity and Neonatology Center of Tunis, Faculty of Medicine of Tunis, El Manar University of Tunis, Tunis, Tunisia,

Background: Vaginismus affects up to 1% of the female population and often represents a physical manifestation of an underlying psychological problem. Our objective was to investigate the psychosomatic impact of vaginismus in pregnant women and evaluate the quality of their therapeutic care in Tunisia.

Methods: We included pregnant patients with vaginismus who presented at our obstetric emergency department between October 2016 and March 2017. Read More

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http://dx.doi.org/10.2147/PRBM.S186950DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6419599PMC
March 2019
2 Reads

Challenges associated with providing diabetes care in humanitarian settings.

Lancet Diabetes Endocrinol 2019 Mar 13. Epub 2019 Mar 13.

Médecins Sans Frontières, London, UK.

The humanitarian health landscape is gradually changing, partly as a result of the shift in global epidemiological trends and the rise of non-communicable diseases, including diabetes. Humanitarian actors are progressively incorporating care for diabetes into emergency medical response, but challenges abound. This Series paper discusses contemporary practical challenges associated with diabetes care in humanitarian contexts in low-income and middle-income countries, using the six building blocks of health systems described by WHO (information and research, service delivery, health workforce, medical products and technologies, governance, and financing) as a framework. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S22138587193008
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http://dx.doi.org/10.1016/S2213-8587(19)30083-XDOI Listing
March 2019
11 Reads

Exploring Obstetrical Interventions and Stratified Cesarean Section Rates Using the Robson Classification in Tertiary Care Hospitals in the United Arab Emirates.

Rev Bras Ginecol Obstet 2019 Mar 14;41(3):147-154. Epub 2019 Mar 14.

Bedfordshire Centre for Mental Health Research in association with University of Cambridge, Cambridge, United Kingdom.

Objective:  The objective of the present study was to explore obstetric management in relation to clinical, maternal and child health outcomes by using the Robson classification system.

Methods:  Data was collected from obstetrics registries in tertiary care hospitals in Dubai, United Arab Emirates (UAE).

Results:  The analysis of > 5,400 deliveries (60% of all the deliveries in 2016) in major maternity hospitals in Dubai showed that groups 5, 8 and 9 of Robson's classification were the largest contributors to the overall cesarean section (CS) rate and accounted for 30% of the total CS rate. Read More

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http://dx.doi.org/10.1055/s-0038-1676524DOI Listing
March 2019
2 Reads

Addressing the Third Delay in Saving Mothers, Giving Life Districts in Uganda and Zambia: Ensuring Adequate and Appropriate Facility-Based Maternal and Perinatal Health Care.

Glob Health Sci Pract 2019 Mar 13;7(Suppl 1):S85-S103. Epub 2019 Mar 13.

Division of Reproductive Health, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA.

Background: Saving Mothers, Giving Life (SMGL) is a 5-year initiative implemented in participating districts in Uganda and Zambia that aimed to reduce deaths related to pregnancy and childbirth by targeting the 3 delays to receiving appropriate care: seeking, reaching, and receiving. Approaches to addressing the third delay included adequate health facility infrastructure, specifically sufficient equipment and medications; trained providers to provide quality evidence-based care; support for referrals to higher-level care; and effective maternal and perinatal death surveillance and response.

Methods: SMGL used a mixed-methods approach to describe intervention strategies, outcomes, and health impacts. Read More

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http://dx.doi.org/10.9745/GHSP-D-18-00272DOI Listing
March 2019
3 Reads

Prevalence and factors affecting the negative childbirth experiences: a systematic review.

J Matern Fetal Neonatal Med 2019 Mar 12:1-8. Epub 2019 Mar 12.

a Student Research Committee, School of Nursing and Midwifery , Shahroud University of Medical Sciences , Shahroud , Iran.

Background: Childbirth and its related experiences have the potential physical and psychological effects on women's lives in the short and long term. Many factors play an effective role in the positive and negative childbirth experiences of the mother. This study aimed to examine the prevalence and factors affecting negative labor experiences. Read More

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https://www.tandfonline.com/doi/full/10.1080/14767058.2019.1
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http://dx.doi.org/10.1080/14767058.2019.1583740DOI Listing
March 2019
8 Reads

Intracoronary Gene Delivery of the Cytoprotective Factor Vascular Endothelial Growth Factor-B in Canine Patients with Dilated Cardiomyopathy: A Short-Term Feasibility Study.

Vet Sci 2019 Mar 6;6(1). Epub 2019 Mar 6.

Institute of Life Sciences, Scuola Superiore Sant'Anna, 56100 Pisa, Italy.

Dilated cardiomyopathy (DCM) is a myocardial disease of dogs and humans characterized by progressive ventricular dilation and depressed contractility and it is a frequent cause of heart failure. Conventional pharmacological therapy cannot reverse the progression of the disease and, in humans, cardiac transplantation remains the only option during the final stages of heart failure. Cytoprotective gene therapy with vascular endothelial growth factor-B (VEGF-B) has proved an effective alternative therapy, halting the progression of the disease in experimental studies on dogs. Read More

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http://dx.doi.org/10.3390/vetsci6010023DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6466215PMC
March 2019
1 Read

Evaluating visual analytics for health informatics applications: a systematic review from the American Medical Informatics Association Visual Analytics Working Group Task Force on Evaluation.

J Am Med Inform Assoc 2019 Apr;26(4):314-323

Carolina Health Informatics Program, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.

Objective: This article reports results from a systematic literature review related to the evaluation of data visualizations and visual analytics technologies within the health informatics domain. The review aims to (1) characterize the variety of evaluation methods used within the health informatics community and (2) identify best practices.

Methods: A systematic literature review was conducted following PRISMA guidelines. Read More

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http://dx.doi.org/10.1093/jamia/ocy190DOI Listing
April 2019
2 Reads
3.504 Impact Factor

Process Evaluation of a Treatment Program for Mood and Anxiety Disorders Among Emerging Adults: Preentry Factors, Engagement, and Outcomes.

Psychiatr Serv 2019 Mar 3;70(3):211-218. Epub 2019 Jan 3.

Lawson Health Research Institute, London Health Sciences Centre, London, Ontario (Osuch, Summerhurst, Demy, Wammes, Arcaro); Department of Family Medicine, Schulich School of Medicine and Dentistry, and the Western Centre for Public Health and Family Medicine, University of Western Ontario, London, Ontario (Vingilis).

Objective:: Effective mental health services for emerging adults are needed. This work evaluated the logic model of one such program and assessed participation and medium-term outcomes.

Methods:: Baseline data were collected from 398 emerging adults attending an intake appointment at a mood and anxiety disorders treatment program in Canada for persons ages 16-25. Read More

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http://dx.doi.org/10.1176/appi.ps.201800219DOI Listing
March 2019
5 Reads

A journey from being preterm to pediatric neurology.

Sudan J Paediatr 2018 ;18(2):72-73

Saudi Board of Pediatric Neurology Residency Program, Division of Pediatric Neurology, Department of Pediatrics, College of Medicine and King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia.

This article highlights the story of two pediatric neurology residents (identical twin sisters Rana and Rawan) who work at the Division of Pediatric Neurology, Department of Pediatrics, College of Medicine and King Khalid University Hospital (KKUH), King Saud University, Riyadh, Saudi Arabia. They were born in October 1990 in the same hospital (KKUH), following preterm delivery at 33 weeks. Their birth weight was 2,000 and 1,900 g, respectively. Read More

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http://dx.doi.org/10.24911/SJP.106-1545214668DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6378575PMC
January 2018
1 Read

Simulation of a Spontaneous Vaginal Delivery and Neonatal Resuscitation in a Biocontainment Unit.

Health Secur 2019 Jan/Feb;17(1):18-26

Brian T. Garibaldi, MD, is Director, Johns Hopkins Biocontainment Unit, Department of Medicine, Johns Hopkins Hospital, Johns Hopkins University School of Medicine, Baltimore, MD.

This article describes a large-scale scenario designed to test the capabilities of a US biocontainment unit to manage a pregnant woman infected with a high-consequence pathogen, and to care for a newborn following labor and spontaneous vaginal delivery. We created and executed a multidisciplinary functional exercise with simulation to test the ability of the Johns Hopkins Hospital biocontainment unit (BCU) to manage a pregnant patient in labor with an unknown respiratory illness and to deliver and stabilize her neonate. The BCU Exercise and Drill Committee established drill objectives and executed the exercise in partnership with the Johns Hopkins Simulation Center in accordance with Homeland Security and Exercise Program guidelines. Read More

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http://dx.doi.org/10.1089/hs.2018.0090DOI Listing
February 2019
2 Reads

The importance of non-technical performance for teams managing postpartum haemorrhage: video review of 99 obstetric teams.

BJOG 2019 Feb 16. Epub 2019 Feb 16.

School of Applied Psychology, University of Applied Sciences and Arts Northwestern Switzerland, Altan, Switzerland.

Objective: Little is known about how teams' non-technical performance influences clinical performance in obstetric emergencies such as postpartum haemorrhage.

Design: Video review - observational study.

Setting: A university hospital (5000 deliveries) and a regional hospital (2000 deliveries) in Denmark. Read More

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http://dx.doi.org/10.1111/1471-0528.15655DOI Listing
February 2019
2 Reads

Impact of menthol on oral nicotine consumption in female and male Sprague Dawley rats.

Nicotine Tob Res 2019 Feb 11. Epub 2019 Feb 11.

Department of Pharmacology, Faculty of Medicine, Uludag University, Bursa, Turkey.

Introduction: One of the most preferable flavors in oral nicotine delivery systems is menthol which masks the harshness of tobacco. However, possible interactions between oral menthol and nicotine on intake and preference remain unclear. Therefore, we aimed to determine the impact of menthol on oral nicotine consumption. Read More

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http://dx.doi.org/10.1093/ntr/ntz019DOI Listing
February 2019
1 Read

Novel synthesized zinc oxide nanoparticles loaded alginate-chitosan biofilm to enhanced wound site activity and anti-septic abilities for the management of complicated abdominal wound dehiscence.

J Photochem Photobiol B 2019 Mar 30;192:124-130. Epub 2019 Jan 30.

Department of Emergency, Linyi Central Hospital, Linyi 276400, Shandong, China. Electronic address:

Wound dehiscence is a surgical complication and its management is inevitable because 25% to 35% of patients suffered from post laparotomy wound dehiscence. The excellent biodegradability and biocompatibility of chitosan and alginate have provided ample space for future developments in biomedical applications. Hence, the present work is directed towards the synthesis of robust biofilm made up of chitosan (CS), zinc oxide (ZnO) nanoparticles and Alginate (Alg). Read More

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http://dx.doi.org/10.1016/j.jphotobiol.2019.01.019DOI Listing
March 2019
2 Reads

Impact of automated OCT in a high-volume eye urgent care setting.

BMJ Open Ophthalmol 2019 20;4(1):e000187. Epub 2019 Jan 20.

Department of Ophthalmology, New York Eye and Ear Infirmary of Mt. Sinai, New York City, New York, USA.

Background/aims: Optical coherence tomography (OCT) has become standard of care in the diagnosis and management of a myriad of retinal and optic nerve pathology. Access to diagnostic equipment and skilled imaging personnel in the after-hours setting is often limited. We examined the utility and diagnostic indications for automated OCT in a high-volume after-hours clinic within an eye institute. Read More

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http://bmjophth.bmj.com/lookup/doi/10.1136/bmjophth-2018-000
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http://dx.doi.org/10.1136/bmjophth-2018-000187DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6340595PMC
January 2019
12 Reads

Demographic changes and effects on the mode of delivery: a retrospective analysis of a large birth registry containing 27,729 singleton deliveries in a level I center.

Arch Gynecol Obstet 2019 Mar 6;299(3):747-754. Epub 2019 Feb 6.

Department of Women's Health, University Hospital of Tuebingen, Tuebingen, Germany.

Purpose: To characterize and understand the demographics (age and body mass index, BMI) of a cohort of women who delivered at a single institution over an 11-year period. The purpose of this analysis is to look for effects over time of demographic characteristics on mode of delivery.

Methods: Retrospective analysis of singleton deliveries between 2004-2014, n = 27,729; level 1 perinatal center, university hospital setting. Read More

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http://dx.doi.org/10.1007/s00404-019-05073-4DOI Listing
March 2019
3 Reads

Emergency rural obstetric transfers in South Australia: a review of the clinical and precipitating factors.

Rural Remote Health 2019 02 6;19(1):4634. Epub 2019 Feb 6.

Flinders University Rural Clinical School, Flinders University, Ral Ral Avenue, Renmark, SA 5341, Australia

Introduction: The provision of critical management of obstetric emergencies is a vital service for rural women and their families. Emergency obstetric transfers are indispensable to reduce maternal and neonatal mortality and morbidity because local rural hospitals often do not have the resources or expertise to manage both maternal and neonatal outcomes. However, the transfer of a rural pregnant woman to a higher level, tertiary perinatal centre (TPC) is often stressful for the patient and costly for health services. Read More

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http://dx.doi.org/10.22605/RRH4634DOI Listing
February 2019
5 Reads
0.868 Impact Factor

High mobility group box 1 and markers of oxidative stress in human cord blood.

Pediatr Int 2019 Mar;61(3):264-270

Neonatal Intensive Care Unit, Gaetano Barresi Department of Human Pathology in Adult and Developmental Age, University of Messina, Messina, Italy.

Background: Parturition induces considerable oxidative stress and many inflammatory mediators, such as high mobility group box 1 (HMGB1), are involved from the beginning of the pregnancy to birth. The aim of the present study was to evaluate serum cord blood concentration of diacron-reactive oxygen metabolites (d-ROM), biological antioxidant potential (BAP), and HMGB1 to investigate the perinatal oxidative status of neonates and correlation with mode of delivery, as well as the influence of labor.

Methods: The subjects consisted of 214 neonates delivered at University Hospital "G. Read More

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http://dx.doi.org/10.1111/ped.13795DOI Listing
March 2019
7 Reads

Assessing Organizational Readiness for Change Comment on "Development and Content Validation of a Transcultural Instrument to Assess Organizational Readiness for Knowledge Translation in Healthcare Organizations: The OR4KT".

Int J Health Policy Manag 2018 10 28;8(1):55-57. Epub 2018 Oct 28.

Department of Medicine, University of Toronto, Toronto, ON, Canada.

This commentary provides an overview of the organizational readiness for change (ORC) literature over the last decade, with respect to prevailing definitions, theories, and tools to guide assessment of ORC in preparation for implementation. The development of the OR4KT by Gagnon et al is an important contribution to this body of work. This commentary highlights the strengths of the OR4KT including development based on two systematic reviews conducted by the authors to synthesize OR theory and measurement tools, and applicability to a wider range of high-income country healthcare settings through inclusion of input from a diverse group of international experts and transcultural adaptation of the tool, in the context of the literature to date. Read More

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http://dx.doi.org/10.15171/ijhpm.2018.101DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6358647PMC
October 2018

A RARE CASE OF OXYTOCIN-INDUCED MATERNAL CARDIAC BRADYARRHYTHMIA DURING LABOUR.

Georgian Med News 2018 Dec(285):28-31

Gold Coast University Hospital, Department of Obstetrics and Gynecology, QLD, Australia.

The report a rare case of oxytocin-induced severe maternal bradyarrhythmia of a young healthy term primigravida with a singleton pregnancy in spontaneous labour. Augmentation of labour was initiated immediately following the diagnosis of poor progression of labour at four centimetres dilatation. An oxytocin infusion was administered as per standard hospital titration protocol. Read More

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December 2018
1 Read

Evaluating the Usefulness of Translation Technologies for Emergency Response Communication: A Scenario-Based Study.

JMIR Public Health Surveill 2019 Jan 28;5(1):e11171. Epub 2019 Jan 28.

School of Public Health, Department of Health Services, University of Washington, Seattle, WA, United States.

Background: In the United States, language barriers pose challenges to communication in emergency response and impact emergency care delivery and quality for individuals who are limited English proficient (LEP). There is a growing interest among Emergency Medical Services (EMS) personnel in using automated translation tools to improve communications with LEP individuals in the field. However, little is known about whether automated translation software can be used successfully in EMS settings to improve communication with LEP individuals. Read More

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http://dx.doi.org/10.2196/11171DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6369422PMC
January 2019

Homeless people's A&E visits treble in seven years.

Authors:
Gareth Iacobucci

BMJ 2019 Jan 21;364:l323. Epub 2019 Jan 21.

The BMJ.

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http://dx.doi.org/10.1136/bmj.l323DOI Listing
January 2019

Vaginal delivery in women with a low-lying placenta: a systematic review and meta-analysis.

BJOG 2019 Jan 21. Epub 2019 Jan 21.

Department of Obstetrics, Amsterdam Reproduction and Development Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.

Background: Low-lying placentas are positioned close to the internal os of the cervix. The preferred way of delivery within this group is unclear.

Objectives: To review the literature on the success of a vaginal delivery with a low-lying placenta. Read More

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http://dx.doi.org/10.1111/1471-0528.15622DOI Listing
January 2019
2 Reads

Location, Location, Location: The Association Between Imaging Setting and Follow-Up of Findings of Indeterminate Malignant Potential.

J Am Coll Radiol 2019 Jan 17. Epub 2019 Jan 17.

Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania; Perelman School of Medicine, the University of Pennsylvania, Philadelphia, Pennsylvania; Institute for Biomedical Informatics, University of Pennsylvania, Philadelphia, Pennsylvania.

Purpose: To evaluate the relationship between patient location at time of imaging and completion of relevant imaging follow-up for findings with indeterminate malignant potential.

Methods: We used a mandatory hospital-wide standardized assessment categorization system to analyze all ultrasound, CT, and MRI examinations performed over a 7-month period. Multivariate logistic regression, adjusted for imaging modality, characteristics of patients, ordering clinicians, and interpreting radiologists, was used to evaluate the relationship between patient location (outpatient, inpatient, or emergency department) at the time of index examination and completion of relevant outpatient imaging follow-up. Read More

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http://dx.doi.org/10.1016/j.jacr.2018.11.010DOI Listing
January 2019
1 Read

Safety and efficiency of the fifth generation Woven EndoBridge device: technical note.

J Neurointerv Surg 2019 May 17;11(5):511-515. Epub 2019 Jan 17.

Department of Interventional Neuroradiology Neuro Brain Vascular Center, Hopital Bicetre, APHP, Paris Sud Université, Le Kremlin-Bicetre, Île-de-France, France.

Backround: The treatment of wide neck bifurcation aneurysms remains challenging despite the introduction of new techniques (Y stenting, waffle cone technique, or flow diverter stents). The Woven EndoBridge (WEB) device is an innovative solution for this type of cerebral aneurysm. A new WEB 17 is now available and has been designed to offer smaller sized devices to optimize navigability and delivery. Read More

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http://jnis.bmj.com/lookup/doi/10.1136/neurintsurg-2018-0143
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http://dx.doi.org/10.1136/neurintsurg-2018-014343DOI Listing
May 2019
15 Reads

Integration of Entrustable Professional Activities with the Milestones for Emergency Medicine Residents.

West J Emerg Med 2019 Jan 30;20(1):35-42. Epub 2018 Nov 30.

Penn State Health, Department of Emergency Medicine, Hershey, Pennsylvania.

Introduction: Medical education is moving toward a competency-based framework with a focus on assessment using the Accreditation Council for Graduate Medical Education Milestones. Assessment of individual competencies through milestones can be challenging. While competencies describe characteristics of the person, the entrustable professional activities (EPAs) concept refers to work-related activities. Read More

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http://dx.doi.org/10.5811/westjem.2018.11.38912DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6324698PMC
January 2019
4 Reads

Use of Systems Engineering to Design a Hospital Command Center.

Jt Comm J Qual Patient Saf 2019 Jan 11. Epub 2019 Jan 11.

Background: In hospitals and health systems across the country, patient flow bottlenecks delay care delivery-emergency department boarding and operating room exit holds are familiar examples. In other industries, such as oil, gas, and air traffic control, command centers proactively manage flow through complex systems.

Methods: A systems engineering approach was used to analyze and maximize existing capacity in one health system, which led to the creation of the Judy Reitz Capacity Command Center. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S15537250183020
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http://dx.doi.org/10.1016/j.jcjq.2018.11.006DOI Listing
January 2019
10 Reads

Reducing Cesarean Delivery Surgical Site Infections: A Resident-Driven Quality Initiative.

Obstet Gynecol 2019 Feb;133(2):282-288

Departments of Obstetrics and Gynecology, MedStar Washington Hospital Center and MedStar Georgetown University Hospital, Washington, DC; the Department of Biostatistics and Epidemiology, MedStar Health Research Institute, Hyattsville, Maryland; and Georgetown-Howard Universities Center for Clinical and Translational Science, Washington, DC.

Objective: To examine the association of a resident-driven quality initiative with cesarean delivery surgical site infections.

Methods: This was a quasi-experimental, preintervention and postintervention study of women undergoing cesarean delivery at 23 weeks of gestation or greater between January 2015 and June 2018 at a single tertiary care center. We implemented a resident-driven, evidence-based surgical bundle, excluding women who underwent emergency cesarean or had chorioamnionitis. Read More

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http://dx.doi.org/10.1097/AOG.0000000000003091DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6353635PMC
February 2019
3 Reads

Corneal and conjunctival injury seen in urgent care centres in Israel.

Ophthalmic Physiol Opt 2019 01;39(1):46-52

Department of Optometry, Hadassah Academic College, Jerusalem, Israel.

Purpose: Corneal and conjunctival injuries (CCI) comprise a large portion of the cases presenting to hospital-based emergency departments (ED) with ocular involvement. Urgent Care Centres (UCC) offer community based emergency care at lower cost than hospital-based emergency departments (ED) and with greater temporal convenience than primary care office settings. While CCI prevalence and treatment at hospital-based EDs has been well studied, this is the first report, to our knowledge, on CCI demographics and aetiology presenting to UCCs. Read More

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http://doi.wiley.com/10.1111/opo.12600
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http://dx.doi.org/10.1111/opo.12600DOI Listing
January 2019
8 Reads

Risk Factors for Postpartum Emergency Department Visits in an Urban Population.

Matern Child Health J 2019 Apr;23(4):557-566

Department of Obstetrics & Gynecology and Women's Health, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.

Objectives To identify risk factors associated with urban postpartum emergency department utilization. Methods This case-control study included 100 matched pairs of postpartum women who had delivered at a large, integrated urban medical system in Bronx, New York, in 2012-2013, with the cases having had an emergency department visit within 42 days of delivery. The cases, identified utilizing administrative and billing data, were matched 1:1 with controls by labor unit, delivery mode and date, excluding nonviable pregnancies. Read More

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http://link.springer.com/10.1007/s10995-018-2673-0
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http://dx.doi.org/10.1007/s10995-018-2673-0DOI Listing
April 2019
11 Reads

Permanent Supportive Housing and Specialized Co-Occurring Disorders Wraparound Services for Homeless Individuals.

J Dual Diagn 2019 Jan 4:1-10. Epub 2019 Jan 4.

d DMA Health Strategies , Boston , Massachusetts , USA.

Objective: Among individuals experiencing chronic homelessness, there is a high rate of co-occurring mental health and substance use, which has traditionally been addressed through the delivery of permanent supportive housing along with substance use and mental health services. However, this population often has difficulty engaging in treatment for co-occurring disorders, which can result in exacerbation of symptoms and housing loss. Maintaining Independence and Sobriety Through Systems Integration, Outreach, and Networking (MISSION) is a co-occurring mental health and substance use wraparound approach that was pilot-tested alongside Permanent Supportive Housing (PSH) to improve treatment access and engagement. Read More

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https://www.tandfonline.com/doi/full/10.1080/15504263.2018.1
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http://dx.doi.org/10.1080/15504263.2018.1506195DOI Listing
January 2019
14 Reads

Advanced cervical dilatation as a predictor for low emergency cesarean delivery: a comparison between migrant and non-migrant Primiparae - secondary analysis in Berlin, Germany.

BMC Pregnancy Childbirth 2019 Jan 3;19(1). Epub 2019 Jan 3.

School of Public Health, Department of Epidemiology & International Public Health, Bielefeld University, Bielefeld, Germany.

Background: Cesarean rates are higher in women admitted to labor ward during early stages rather than at later stages of labor. In a study in Germany, crude cesarean rates among Turkish and Lebanese immigrant women were low compared to non-immigrant women. We evaluated whether these immigrant women were admitted during later stages of labor, and if so, whether this explains their lower cesarean rates. Read More

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http://dx.doi.org/10.1186/s12884-018-2145-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6318868PMC
January 2019
4 Reads

Emergency Care Utilization Among Pregnant Medicaid Recipients in North Carolina: An Analysis Using Linked Claims and Birth Records.

Matern Child Health J 2019 Feb;23(2):265-276

Division of Maternal Fetal Medicine, Department of Obstetrics & Gynecology, School of Medicine, University of North Carolina, Chapel Hill, NC, USA.

Objectives To estimate the rate of pregnancy-associated emergency care visits and identify maternal and pregnancy characteristics associated with high utilization of emergency care among pregnant Medicaid recipients in North Carolina. Methods A retrospective cohort study using linked Medicaid hospital claims and birth records of 107,207 pregnant Medicaid recipients who delivered a live-born infant in North Carolina between January 1, 2008 and December 31, 2009. Rates were estimated per 1000 member months of Medicaid coverage. Read More

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http://dx.doi.org/10.1007/s10995-018-2651-6DOI Listing
February 2019
5 Reads

Quality and safety of in-hospital care for acute medical patients at weekends: a qualitative study.

BMC Health Serv Res 2018 Dec 29;18(1):1015. Epub 2018 Dec 29.

Department of Health Sciences, University of Leicester, Leicester, UK.

Background: The increased mortality risk associated with weekend admission to hospital (the 'weekend effect') has been reported across many health systems. More recently research has focused on causal mechanisms. Variations in the organisation and delivery of in-hospital care between weekends and weekdays have been identified, but this is not always to the detriment of weekend admissions, and the impact on mortality is uncertain. Read More

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http://dx.doi.org/10.1186/s12913-018-3833-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6310936PMC
December 2018

Analyzing the heterogeneity of labor and delivery units: A quantitative analysis of space and design.

PLoS One 2018 26;13(12):e0209339. Epub 2018 Dec 26.

Department of Pediatrics, Neonatal and Developmental Medicine, School of Medicine, Stanford University, Palo Alto, California, United States of America.

This study assessed labor and delivery (L&D) unit space and design, and also considered correlations between physical space measurements and clinical outcomes. Design and human factors research has increased standardization in high-hazard industries, but is not fully utilized in medicine. Emergency department and intensive care unit space has been studied, but optimal L&D unit design is undefined. Read More

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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0209339PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6306211PMC
December 2018
4 Reads

Saved by the Massive Transfusion Protocol: A Case Report of an Obstetric Patient With Hemolysis, Elevated Liver Enzymes, and Low Platelet Count (HELLP) Syndrome and Glisson Capsule Rupture.

A A Pract 2018 Dec 19. Epub 2018 Dec 19.

Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, Tennessee.

A 31-year-old primigravid parturient with no pertinent medical history was admitted at 40 weeks and 4 days of gestation for postdate induction of labor. She was subsequently diagnosed with preeclampsia and developed hemolysis, elevated liver enzymes, and a low platelet count. An emergency cesarean delivery ensued owing to fetal bradycardia. Read More

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http://dx.doi.org/10.1213/XAA.0000000000000949DOI Listing
December 2018