miércoles, 30 de septiembre de 2015

SALUD EQUITATIVA: DIRECTORIO DE DOCUMENTOS EDITADOS EN SEPTIEMBRE de 2015 [*] ▲ SALUD EQUITATIVA - GESTIÓN EN SALUD PÚBLICA ► Contenidos Copyright by Cerasale, Víctor Norberto, 2008 a 2015. SALTA / ARGENTINA.

SALUD EQUITATIVA: DIRECTORIO DE DOCUMENTOS EDITADOS EN SEPTIEMBRE de 2015 [*] ▲ SALUD EQUITATIVA - GESTIÓN EN SALUD PÚBLICA ► Contenidos Copyright by Cerasale, Víctor Norberto, 2008 a 2015. SALTA / ARGENTINA.

Contenidos Copyright by Cerasale, Víctor Norberto. Salta, Argentina. 2008 a 2015. 

MIÉRCOLES 30 de SEPTIEMBRE de 2015
SALUD EQUITATIVA: GESTIÓN EN SALUD PÚBLICA
DIRECTORIO DE DOCUMENTOS EDITADOS EN SEPTIEMBRE de 2015[*]


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Contador Google ►
LECTORES acumulados desde enero 2009 a la fecha:  3.048.451
LECTORES totales conjuntos (todos los blogs: [5]): 14.306.947
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Páginas vistas por países

Gráfico de los países más populares entre los lectores del blog
EntradaPáginas vistas
Estados Unidos
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Alemania
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España
323.416
Francia
230.862
Argentina
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Rusia
82.010
Ucrania
64.049
México
57.465
Colombia
30.388
Reino Unido
28.383





Documentos EDITADOS durante el mes de SEPTIEMBRE de 2015: 1.009

Documentos acumulados en 2015: 8.711
Documentos editados desde el inicio del blog (2008/2015): 55.256
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Universo de páginas visitadas en el último mes (SEPTIEMBRE 2015): 288.686
Páginas vistas (historial completo):  3.048.451
Documentos totales editados en los blog´s ► 190.791

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Archivo del blog

NUESTRA SEÑORA DE LA MEDALLA MILAGROSA

NUESTRA SEÑORA DE LA MEDALLA MILAGROSA
Gracias por las tuyas concedidas
Publicado por en No hay comentarios:

CDRH New Update

CDRHNew

Date: September 30, 2015

The following new items were added to the CDRH web pages on September 29, 2015. Previous CDRH New Items can be found on theCDRHNew Page.
Publicado por en No hay comentarios:

The incremental risk of noncardiac surgery on adverse cardiac events following coronary stenting. - PubMed - NCBI

The incremental risk of noncardiac surgery on adverse cardiac events following coronary stenting. - PubMed - NCBI



 2014 Dec 30;64(25):2730-9. doi: 10.1016/j.jacc.2014.09.072.

The incremental risk of noncardiac surgery on adverse cardiac events following coronary stenting.

Holcomb CN1, Graham LA2, Richman JS3, Rhyne RR1, Itani KM4, Maddox TM5, Hawn MT6.

Abstract

BACKGROUND:

Recent coronary stent placement and noncardiac surgery contribute to the risk of adverse cardiac events, but the relative contributions of these two factors have not been quantified.

OBJECTIVES:

This research was designed to determine the incremental risk of noncardiac surgery on myocardial infarction (MI) and coronary revascularization following coronary stenting.

METHODS:

A U.S. retrospective cohort study of patients receiving coronary stents at Veterans Affairs medical centers between 2000 and 2010 was used to match patients undergoing noncardiac surgery within 24 months of stent placement to two patients with stents not undergoing surgery. Patients were matched on stent type and cardiac risk factors present at the time of stent placement. A composite endpoint of MI and/or cardiac revascularization for the 30-day interval post-surgery was calculated. Adjusted risk differences (RD) were compared across time periods following stent implantation, using generalized estimating equations.

RESULTS:

We matched 20,590 surgical patients to 41,180 nonsurgical patients. During the 30-day interval following noncardiac surgery, the surgical cohort had higher rates of the composite cardiac endpoint (3.1% vs. 1.9%; RD: 1.3%; 95% confidence interval: 1.0% to 1.5%). The incremental risk of noncardiac surgery adjusted for surgical characteristics ranged from 3.5% immediately following stent implantation to 1% at 6 months, after which it remained stable out to 24 months. Factors associated with a significant reduction in risk following surgery more than 6 months post-stent included elective inpatient procedures (ΔRD: 1.8%; p = 0.01), high-risk surgery (ΔRD: 3.7%; p = 0.01), and drug-eluting stent (DES) (ΔRD: 1.3%; p = 0.01).

CONCLUSIONS:

The incremental risk of noncardiac surgery on adverse cardiac events among post-stent patients is highest in the initial 6 months following stent implantation and stabilizes at 1.0% after 6 months. Elective, high-risk, inpatient surgery, and patients with DES may benefit most from delay from a 6-month delay after stent placement.
Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

KEYWORDS:

adverse; coronary stent; post-operative; surgery

Comment in


PMID:
 
25541124
 
[PubMed - indexed for MEDLINE]
Publicado por en No hay comentarios:

Understanding safety in prehospital emergency medical services for children. - PubMed - NCBI

Understanding safety in prehospital emergency medical services for children. - PubMed - NCBI



 2014 Jul-Sep;18(3):350-8. doi: 10.3109/10903127.2013.869640. Epub 2014 Mar 26.

Understanding safety in prehospital emergency medical services for children.

Cottrell EK, O'Brien K, Curry M, Meckler GD, Engle PP, Jui J, Summers C, Lambert W, Guise JM.

Abstract

OBJECTIVE:

For over a decade, the field of medicine has recognized the importance of studying and designing strategies to prevent safety issues in hospitals and clinics. However, there has been less focus on understanding safety in prehospital emergency medical services (EMS), particularly in regard to children. Roughly 27.7 million (or 27%) of the annual emergency department visits are by children under the age of 19, and about 2 million of these children reach the hospital via EMS. This paper adds to our qualitative understanding of the nature and contributors to safety events in the prehospital emergency care of children.

METHODS:

We conducted four 8- to 12-person focus groups among paid and volunteer EMS providers to understand 1) patient safety issues that occur in the prehospital care of children, and 2) factors that contribute to these safety issues (e.g., patient, family, systems, environmental, or individual provider factors). Focus groups were conducted in rural and urban settings. Interview transcripts were coded for overarching themes.

RESULTS:

Key factors and themes identified in the analysis were grouped into categories using an ecological approach that distinguishes between systems, team, child and family, and individual provider level contributors. At the systems level, focus group participants cited challenges such as lack of appropriately sized equipment or standardized pediatric medication dosages, insufficient human resources, limited pediatric training and experience, and aspects of emergency medical services culture. EMS team level factors centered on communication with other EMS providers (both prehospital and hospital). Family and child factors included communication barriers and challenging clinical situations or scene characteristics. Finally, focus group participants highlighted a range of provider level factors, including heightened levels of anxiety, insufficient experience and training with children, and errors in assessment and decision making.

CONCLUSIONS:

The findings of our study suggest that, just as in hospital medicine, factors at the systems, team, child/family, and individual provider level system contribute to errors in prehospital emergency care. These factors may be modifiable through interventions and systems improvements. Future studies are needed to ascertain the generalizability of these findings and further refine the underlying mechanisms.

KEYWORDS:

child health services; delivery of care; emergency medicine; health services research; safety

PMID:
 
24669906
 
[PubMed - indexed for MEDLINE] 
PMCID:
 
PMC4062591
 
Free PMC Article
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