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Hospital throughput

Grant C O'Connell, Phillip Stafford, Kyle B Walsh, Opeolu Adeoye, Taura L Barr
Accurate stroke recognition during triage can streamline care and afford patients earlier access to life-saving interventions. However, the tools currently available to clinicians for prehospital and early in-hospital identification of stroke are limited. The peripheral immune system is intricately involved in stroke pathology and thus may be targetable for the development of immunodiagnostics. In this preliminary study, we sought to determine whether the circulating antibody pool is altered early in stroke, and whether such alterations could be leveraged for diagnosis...
February 19, 2019: Neurotherapeutics: the Journal of the American Society for Experimental NeuroTherapeutics
Hui-Jie Zhang, Shi-Biao Wang, Xiao-Feng Guo, Bin Weng, Ling Lin, Yan Hao
The patient was a female infant aged 1 month and 29 days. She was admitted to the hospital due to convulsions for 6 days and increased blood glucose level for 5 days. She had unstable blood glucose levels. The level of glycosylated hemoglobin was too high to measure. Urine glucose was positive (+ - ++++). The levels of fasting C-peptide and insulin were 0.19 ng/mL and 11.68 μIU/mL respectively. High-throughput sequencing of the genetic endocrine disease gene Panel (412 detected genes, including 49 known diabetes-related genes) showed that the EIF2AK3 gene in the infant had two novel compound heterozygous mutations, c...
February 2019: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
Ali Amar, Amar J Majmundar, Ihsan Ullah, Ayesha Afzal, Daniela A Braun, Shirlee Shril, Ankana Daga, Tilman Jobst-Schwan, Mumtaz Ahmad, John A Sayer, Heon Yung Gee, Jan Halbritter, Thomas Knöpfel, Nati Hernando, Andreas Werner, Carsten Wagner, Shagufta Khaliq, Friedhelm Hildebrandt
Nephrolithiasis (NL) affects 1 in 11 individuals worldwide and causes significant patient morbidity. We previously demonstrated a genetic cause of NL can be identified in 11-29% of pre-dominantly American and European stone formers. Pakistan, which resides within the Afro-Asian stone belt, has a high prevalence of nephrolithiasis (12%) as well as high rate of consanguinity (> 50%). We recruited 235 Pakistani subjects hospitalized for nephrolithiasis from five tertiary hospitals in the Punjab province of Pakistan...
February 18, 2019: Human Genetics
(no author information available yet)
No abstract text is available yet for this article.
March 2019: American Journal of Surgery
Jarrod Basto, Rani Chahal, Bernhard Riedel
BACKGROUND: Value-based healthcare is strongly advocated to reduce the spiralling rise in healthcare expenditure. Operating room efficiency is an important focus of value-based healthcare delivery due to high costs and associated hospital revenue derived from procedural streams of care. A parallel induction design, utilising induction rooms for anesthetising patients, may improve operating room efficiency and optimise revenue. We used time-driven activity-based costing (TDABC) to model personnel costs for a high-turnover operating list to assess value of parallel induction redesign...
February 12, 2019: Healthcare
Md Tabish Rehman, Mohamed F AlAjmi, Afzal Hussain, Gulam Mohmad Rather, Meraj A Khan
The bacteria expressing New Delhi Metallo-β-lactamase-1 (NDM-1) can hydrolyze all β-lactam antibiotics including carbapenems, causing multi-drug resistance. The worldwide emergence and dissemination of gene bla NDM-1 (produces NDM-1) in hospital and community settings, rising problems for public health. Indeed, there is an urgent need for NDM-1 inhibitors to manage antibiotic resistance. Here, we have identified novel non-β-lactam ring-containing inhibitors of NDM-1 by applying a high-throughput virtual screening of lead-like subset of ZINC database...
February 14, 2019: International Journal of Molecular Sciences
Ming-Jr Jian, Cherng-Lih Perng, Jun-Ren Sun, Yun-Hsiang Cheng, Hsing-Yi Chung, Yu-Hsuan Cheng, Shih-Yi Lee, Shu-Chen Kuo, Hung-Sheng Shang
Elizabethkingia species are ubiquitous bacteria that uncommonly cause human infection. Elizabethkingia anophelis was first identified in 2011 from the mosquito Anopheles gambiae. The currently available bacterial typing systems vary greatly with respect to labour, cost, reliability, and ability to discriminate among bacterial strains. Polymerase chain reaction (PCR)-based fingerprinting using random amplified polymorphic DNA (RAPD) is commonly used to identify genetic markers. To our knowledge, no system coupling RAPD-PCR and capillary gel electrophoresis (CGE) has been utilized for the epidemiological typing of E...
February 12, 2019: Scientific Reports
Anne Frawley, John Hickey, Christine Weaver, James P Williams, Tamas Szakmany
BACKGROUND: The management of pain, agitation and sedation for ventilated patients who are admitted to intensive care is an essential part of their care. The introduction of sedation protocols is associated with improved patient outcomes. METHODS: We conducted an observational cohort study among mechanically ventilated patients in a 16-bed ICU over a two-year period. We retrospectively examined data from two patient populations, namely those before and after the introduction of a new sedation protocol in July 2015...
February 12, 2019: Anaesthesiology Intensive Therapy
Mireille E M Platter, Roel A J Kurvers, Loes Janssen, Marjoke M J Verweij, Dennis G Barten
OBJECTIVE: Crowding is a growing concern in general and pediatric Emergency Departments (EDs). The Emergency Care Access Point (ECAP) - a collaboration between general practitioners and the ED - has been established to reduce the number of self-referrals and non-urgent ED visits. The aim of this study was to determine the impact of an ECAP on pediatric attendances in the ED. METHODS: Retrospective analysis of 3997 pediatric patients who visited the ED of a regional teaching hospital in the Netherlands, one year before and one year after the implementation of an ECAP...
February 6, 2019: American Journal of Emergency Medicine
Kanokporn Pongjetanapong, Cameron Walker, Michael O'Sullivan, Margaret Lovell-Smith, Nikolaus Furian
Many health delivery services have required performance targets. Typically, these targets are presented as percentiles of patients to be seen within specified timeframes. These targets present hospital administrators with a resourcing problem complicated by conflicting objectives: How to minimize costs while maximizing throughput to achieve the performance targets? In this paper, we describe the use of a simulation model to evaluate the effect of changes to staff levels in a cytology department, investigating the trade-off between staff levels and turnaround times in light of performance targets specified by government...
February 8, 2019: International Journal of Health Planning and Management
Kristyn C Huffman
Fast tracks are widely used in emergency departments to increase patient throughput as annual visits continue to rise in the United States. A modified triage process known as QuickLook, which omits patients' past medical history, is used in some hospitals to further increase throughput. This article discusses the effects of QuickLook on patient placement, reviews the role of past medical history in triage, and discusses the impact of integrating a targeted history question into the QuickLook process of an emergency department in Arizona...
March 2019: Nursing Clinics of North America
L G Gordon, A J Rodriguez-Acevedo, K Papier, K Khosrotehrani, N Isbel, S Campbell, A Griffin, A C Green
BACKGROUND: A long-term complication among organ transplant recipients (OTRs) is skin malignancies which are associated with level and duration of immunosuppressive treatment, sun exposure and age. Dermatological surveillance is recommended for OTRs at high risk of skin malignancies, but evidence is lacking on the benefits of such services. OBJECTIVE: To examine the economic impact on patients and on the hospital service of a multidisciplinary high-throughput skin cancer Clinic in Brisbane, Australia, dedicated to dermatological and surgical care of high-risk OTRs...
February 1, 2019: Journal of the European Academy of Dermatology and Venereology: JEADV
Daniel J Corwin, Dennis R Durbin, Katie L Hayes, Mark R Zonfrillo
OBJECTIVE: The aims of this study were to evaluate trends over time in computed tomography (CT) scan utilization after implementation of a clinical pathway in a tertiary care children's hospital emergency department (ED), to determine how ED throughput differs by CT utilization, and to determine provider reasoning for obtaining head CT in low-risk patients. METHODS: This was a retrospective cohort study of patients 21 years or younger discharged from our ED with head trauma (Glasgow Coma Scale score ≥13 and a head trauma International Classification of Diseases code) over a 5-year period, starting 1 year after pathway implementation (January 2012 to December 2016)...
January 21, 2019: Pediatric Emergency Care
Hailey J James, Michael J Steiner, George M Holmes, John R Stephens
BACKGROUND AND OBJECTIVES: To optimize patient throughput, many hospitals set targets for discharging patients before noon (DCBN). However, it is not clear whether DCBN is an appropriate measure for an efficient discharge. This study aims to determine whether DCBN is associated with shorter length of stay (LOS) in pediatric patients and whether that relationship is different between surgical and medical discharges. METHODS: From May 2014 to April 2017, we performed a retrospective data analysis of pediatric medical and surgical discharges belonging to a single academic medical center...
January 2019: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
Ana Batista, Jorge Vera, David Pozo
Effective admission planning can improve inpatient throughput and waiting times, resulting in better quality of service. The uncertainty in the patient arrival and the availability of resources makes the patient's allocation difficult to manage. Thus, in the admission process hospitals aim to accomplish targets of resource utilization and to lower the cost of service. Both objectives are related and in conflict. In this paper, we present a bi-objective stochastic optimization model to study the trade-off between the resource utilization and the cost of service, taking into account demand and capacity uncertainties...
January 15, 2019: Health Care Management Science
Ana P Christoff, Aline Fr Sereia, Camila Hernandes, Luiz Fv de Oliveira
Research concerning the microbiome of indoor environments like hospitals, houses or buildings could have several implications for human health. Today, there is an ongoing shift in the paradigm of microbial analysis, from single isolated bacterial samples to entire microbiome profiles using high-throughput DNA sequencing methods. The use of sequencing methods in several studies has revealed an unprecedented microbial diversity in indoor environments, leading to a larger comprehension of the entire microbiome context...
January 7, 2019: Experimental Biology and Medicine
Hylton E Molzof, Aoyjai Prapanjaroensin, Vivek H Patel, Mugdha V Mokashi, Karen L Gamble, Patricia A Patrician
Circadian rhythms greatly influence 24-h variation in cognition in nearly all organisms, including humans. Circadian clock impairment and sleep disruption are detrimental to hippocampus-dependent memory and negatively influence the acquisition and recall of learned behaviors. The circadian clock can become out of sync with the environment during circadian misalignment. Shift work represents a real-world model of circadian misalignment that can be studied for its physiological implications. The present study aimed to test the hypothesis that circadian misalignment disrupts vigilance and cognitive performance on occupationally relevant tasks using shift work as a model...
January 3, 2019: Neurobiology of Learning and Memory
Breanna L Luna, Javier A Garcia, Min Huang, Peter J Ewing, Sonya C Valentine, Yi-Ming Chu, Qi-Zhuang Ye, H Howard Xu
Acinetobacter baumannii has emerged as a globally important nosocomial pathogen characterized by an increased multi-drug resistance (MDR), leaving limited options for treating its infection. To identify novel antibacterial compounds with activity against clinical isolates of A. baumannii, we performed high-throughput screening against a chemical library of 42,944 compounds using nonpathogenic Escherichia coli MG1655 and identified 55 hit compounds. The antibacterial activities of 30 pure compounds were determined against MDR clinical isolates of A...
December 26, 2018: International Journal of Antimicrobial Agents
Sjur Reppe, Catherine Joan Jackson, Håkon Ringstad, Kim Alexander Tønseth, Hege Bakke, Jon Roger Eidet, Tor Paaske Utheim
There is a need to optimize storage conditions to preserve cell characteristics during transport of cultured cell sheets from specialized culture units to distant hospitals. In this study, we aimed to explore a method to identify additives that diminish the decrease in the viability of stored undifferentiated epidermal cells using multifactorial design and an automated screening procedure. The cultured cells were stored for 7-11 days at 12°C in media supplemented with various additives. Effects were evaluated by calcein staining of live cells as well as morphology...
2018: Stem Cells International
Patrick Murigu Kamau Njage, Pimlapas Leekitcharoenphon, Tine Hald
The ever decreasing cost and increase in throughput of next generation sequencing (NGS) techniques have resulted in a rapid increase in availability of NGS data. Such data have the potential for rapid, reproducible and highly discriminative characterization of pathogens. This provides an opportunity in microbial risk assessment to account for variations in survivability and virulence among strains. A major challenge towards such attempts remains the highly dimensional nature of genomic data versus the number of isolates...
December 4, 2018: International Journal of Food Microbiology
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