Hoscarborough8239

in English, German EINLEITUNG  Sollten Notaufnahmepatienten mit bauchbezogenen Beschwerden einer fokussierten Sonografie zugeführt werden oder bietet eine vollständige Abdominalsonografie Vorteile? METHODEN  Retrospektive Analyse konsekutiver Notfallsonografien von 06/2012 bis 06/2013. Alle Patienten erhielten eine vollständige Abdominalsonografie. Die Befunde der vollständigen Sonografie wurden mit denjenigen verglichen, die eine auf die Beschwerden fokussierte Sonografie detektiert hätte, deren Untersuchungsgebiet von der jeweiligen Indikation abhing. Befunde wurden als relevant betrachtet, wenn sie zu diagnostischen oder therapeutischen Konsequenzen führten.Es wurden Sensitivität und negativ prädiktiver Wert der fokussierten Sonografie bezogen auf relevante Befunde und geklärte Fragestellungen im Vergleich zur Abdominalsonografie (= Standard) berechnet. ERGEBNISSE  629 Patienten erhielten Notfallsonografien (53 % Frauen). Das durchschnittliche Alter betrug 59 Jahre (18–97). Die fokussierte Sonografie entdeckte bei 63 % der Patienten (396/629) relevante Befunde. selleck kinase inhibitor Bei 17 % (106/629) führte die vollständige Abdominalsonografie zu zusätzlichen relevanten Befunden. Die number needed to scan (NNScan) betrug 6 für einen zusätzlichen relevanten Befund. Die Sensitivität der fokussierten Sonografie bezüglich relevanter Befunde betrug 76 %, der negativ prädiktive Wert lag bei 64 %. Die Fragestellung konnte durch die fokussierte Sonografie in 57 % geklärt werden. Vollständige Sonografien klärten die Fragestellung in 63 %. Die NNScan lag bei 18.Die Klärung der Fragestellung hing von der Indikation ab (90 % bei Ikterus und 45 % bei Schmerzen im linken oberen Quadranten) und nahm mit dem Alter der Patienten zu (37 % in der zweiten und 85 % in der zehnten Dekade). DISKUSSION  Vollständige Abdominalsonografien entdecken bei Notaufnahmepatienten mit bauchbezogenen Beschwerden mehr relevante Befunde und führen häufiger zu einer Klärung der Fragestellung als fokussierte Sonografien.INTRODUCTION  Some surgeons believe that patients with benefit of additional stability provided by a cast after the treatment of pediatric tibia fractures with elastic stable intramedullary nails. Whereas in some institutions, complementary immobilization is not used after elastic stable intramedullary nails (ESIN). At our trauma center, half of our surgeons treat tibia fractures with ESIN alone and half use complementary casting. We hypothesized that our outcomes are the same between the two groups. MATERIALS AND METHODS  Patients with tibia shaft fractures were treated in accordance with the preference of attending surgeon with one of two initial interventions ESIN or ESIN and complementary immobilization with long-leg cast. Outcomes of these two treatment groups were compared. The main outcome variables were redisplacement and angulation at the time of union. RESULTS  Treatment groups did not differ significantly on sex, type of fracture, or on age. Four patients developed a varus malalignment exceeding 10 degrees during first 2 weeks of follow-up and were corrected in the outpatient clinic by application of wedging cast. Three out the four were originally in the no cast group (p = 0.3). Final angulation and time to union were higher in no cast group, but there was no statistical significance (p = 0.5 and p = 0.4). CONCLUSION  This study showed good outcomes in both treatment methods without any surgical deformity correction after operative treatment. Though we could not find any advantages in complementary casting. Georg Thieme Verlag KG Stuttgart · New York.National registries for primary and revision knee arthroplasty in Australia, New Zealand, and Europe have been successful in ensuring quality control and providing information to drive crucial research. However, they face challenges in delivering the granularity of data useful at a local hospital level. Our aim was to address these challenges by designing and initiating a local revision knee arthroplasty registry and combining the data with national figures to better evaluate the types of revisions undertaken, and improve patient outcomes and care. All revision knee arthroplasty cases in our center were analyzed from April 2014 to December 2015 using our standardized diagnostic algorithm. Information such as reason and type of revision was collected. Results were compared with Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR) data. Primary outcome was comparison against our center's historical data between January 1999 and December 2013 and secondary outcome was comparison againeded in reducing incidences of major revisions, complications, and the risk of re-revision surgery. This will improve the quality of our service with a significant cost reduction for our local health care budget. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.OBJECTIVE  Understanding patients' acceptance of and satisfaction with telehealth use is important for workplace health promotion. In this study, we used a questionnaire to measure patients' usage behavior and satisfaction with cloud-based telehealth services in the workplace. We empirically investigated the factors that influence patients' usage and satisfaction based on data collected from 101 participants. METHODS  As its main research framework, this study utilized a revised version of the technology acceptance model 2 that was based on the telehealth services provided for chronic disease management. Through integrating a cross-sectional research design with an author-developed structured questionnaire that was assessed using reliability and validity tests, an anonymous survey was conducted on selected participants. The proposed research model and hypotheses were validated through path analysis using SPSS. RESULTS  We found that users believe telehealth services can promote their workplace health management; that job relevance, result demonstrability, and perceived ease of use (PEOU) positively affect the perceived usefulness (PU), which implies that cognitive instrumental processes have the most significant impact on the PU of cloud-based telehealth; and that both PEOU and PU positively affect the intention to use (IU), but PU has a bigger influence than PEOU on users' intentions to continue using telehealth. In particular, the IU and actual usage behavior were critical to the patients' satisfaction with telehealth services. CONCLUSION  This research contributes to the rapid developing field of technology acceptance research by examining workplace telemedicine engagement. Our results will provide researchers with useful advice and a user-centered strategy for promoting workplace health management, which benefits both health care providers and corporate managers. Georg Thieme Verlag KG Stuttgart · New York.