External validation of EPIC's Risk of Unplanned Readmission model, the LACE+ index and SQLape as predictors of unplanned hospital readmissions: A monocentric, retrospective, diagnostic cohort study in Switzerland.

Introduction: Readmissions after an acute care hospitalization are relatively common, costly to the health care system, and are associated with significant burden for patients. As one way to reduce costs and simultaneously improve quality of care, hospital readmissions receive increasing interest from policy makers. It is only relatively recently that strategies were developed with the specific aim of reducing unplanned readmissions using prediction models to identify patients at risk.

Three near fatal or fatal complications during implantation of tunnelled hemodialysis catheters : Learning from experts.

Tunnelled hemodialysis catheters are well accepted and widely used devices to provide vascular access for dialysis in patients when an arteriovenous shunt is not feasible or dysfunctional. In the literature complications after implantation are well documented but fatal or near-fatal events during implantation are seldom reported. In this article 3 such cases from a single tertiary center over a period of more than 10 years are presented and discussed.

Validity of screening instruments for the detection of dementia and mild cognitive impairment in hospital inpatients: A systematic review of diagnostic accuracy studies.

Introduction: As the population ages, Alzheimer's disease and other subtypes of dementia are becoming increasingly prevalent. However, in recent years, diagnosis has often been delayed or not made at all. Thus, improving the rate of diagnosis has become an integral part of national dementia strategies.

A Hospital-wide Outbreak of Serratia marcescens, and Ishikawa's "Fishbone" Analysis to Support Outbreak Control.

A nosocomial outbreak of Serratia marcescens in respiratory samples predominantly from patients in a surgical intensive care unit is reported. Most of these patients were cardiac surgical patients. Initially, a vigorous but inconclusive investigation was implemented on the basis of standardized (according the US Centers for Disease Control and Prevention) steps of outbreak investigation.

Effect of rivaroxaban on blood coagulation using the viscoelastic coagulation test ROTEM™.

This study investigated the influence of the oral direct inhibitor of factor Xa rivaroxaban on blood coagulation measured by rotation thrombelastometry ROTEM™. Blood was obtained from 11 healthy male volunteers before and 2.5 h after oral administration of 10 mg rivaroxaban.

Scientific fraud in 20 falsified anesthesia papers : detection using financial auditing methods.

Data from natural sources show counter-intuitive distribution patterns for the leading digits to the left of the decimal point and the digit 1 is observed more frequently than all other numbers. This pattern, which was first described by Newcomb and later confirmed by Benford, is used in financial and tax auditing to detect fraud. Deviations from the pattern indicate possible falsifications.

Effects on coagulation of balanced (130/0.42) and non-balanced (130/0.4) hydroxyethyl starch or gelatin compared with balanced Ringer's solution: an in vitro study using two different viscoelastic coagulation tests ROTEMTM and SONOCLOTTM.

Background: Hydroxyethyl starch (HES) solutions compromise blood coagulation. Low molecular weight, low-substituted HES products, and electrolyte-balanced solutions might reduce this effect. We compared the effects of in vitro haemodilution on blood coagulation with a balanced 6% HES 130/0.

Tetrahydrocannabinol (Delta 9-THC) Treatment in Chronic Central Neuropathic Pain and Fibromyalgia Patients: Results of a Multicenter Survey.

Central neuropathic pain is difficult to treat, but delta 9-Tetrahydrocannabinol (delta 9-THC) may be a promising therapeutic agent. We administered in 172 patients on average 7.5 mg delta 9-THC over 7 months.

[Statistical process control as a monitoring tool for the evaluation of reorganisation measures. Investigation in an intensive care unit].

Introduction: The German health care system is currently in a constant state of flux owing to enhanced competition and to the increasing focus on economic aspects. Medical services, especially treatment processes, are being reorganised in an attempt to adapt them to the new economic challenges. Ideally, radical reorganisation and streamlining of medical therapy processes should be accompanied by controlling and quality management systems.

Reduction of pulmonary edema by short-acting local anesthetics.

Background And Objectives: Local anesthetics (LAs) possess a variety of effects that cannot be explained by the typical block of neuronal sodium channels. Antithrombotic effects of LAs are well known, but LAs also act as bactericides. Therefore, an investigation of the influence of LAs on the inflammatory response of the isolated rat lung (n = 78) to an N-formyl-l-leucin-methionyl-l-phenylalanine (FMLP) stimulus was performed.

[Respiratory failure due to delta-9-tetrahydrocannabinol in a tetraplegic patient].

We report on a patient with an incomplete tetraplegia below C2 who suffered from a post-traumatic abdominal spasticity, spasticity of the legs, and bladder contractions of high intensity. Breathing was possible during the day using accessory respiratory musculature. All standard therapeutic regimes against spasticity failed.

Duration of effects of aspirin on platelet function in healthy volunteers: an analysis using the PFA-100.

Study Objective: The aim of the study was to determine the duration and effects of aspirin on platelet function.

Study Design: Prospective investigation.

Setting: Blood samples from volunteers.

Psoas compartment block (PCB) in children: Part II--generation of an institutional learning curve with a new technique.

Background: Literature concerning institutional learning processes for anesthesia procedures in pediatric anesthesia is rare. Until recently only small series of psoas compartment blocks (PCB) in children have been reported. We report on a series of 100 consecutive blocks using new landmarks and the institutional learning process.

Psoas compartment block in children: Part I--description of the technique.

Background: Until recently only small series of psoas compartment blocks (PCB) in children have been reported. A high incidence of epidural spread as an important side effect was noted. A series of 100 consecutive blocks using new standardized landmarks is reported.

Generating a learning curve for penile block in neonates, infants and children: an empirical evaluation of technical skills in novice and experienced anaesthetists.

Background: Literature concerning learning curves for anaesthesiological procedures in paediatric anaesthesia is rare. The aim of this study was to assess the number of penile blocks needed to guarantee a high success rate in children.

Methods: At a teaching hospital, the technical skills of 29 residents in anaesthesiology who performed penile blocks under the supervision of two staff anaesthesiologists were evaluated during a 12-month period using a standardized self-evaluation questionnaire.

Improving time-sensitive processes in the intensive care unit: the example of 'door-to-needle time' in acute myocardial infarction.

Objective: To assess and reduce delays in coronary thrombolysis in patients with acute myocardial infarction.

Design: Prospective, descriptive study using statistical process control.

Setting: Interdisciplinary intensive care unit of a 300-bed community hospital.

Generating a learning curve for pediatric caudal epidural blocks: an empirical evaluation of technical skills in novice and experienced anesthetists.

Background And Objectives: Learning curves for anesthesia procedures in adult patients have been determined, but no data are available on procedures in pediatric anesthesia. The aim of this study was to assess the number of caudal blocks needed to guarantee a high success rate in performing caudal epidural analgesia in children.

Methods: At a teaching hospital, the technical skills of 7 residents in anesthesiology who performed caudal blocks were evaluated during 4 months using a standardized self-evaluation questionnaire.

In vitro effects of different medium molecular hydroxyethyl starch solutions and lactated Ringer's solution on coagulation using SONOCLOT.

Unlabelled: Hydroxyethyl starch (HES) solutions are widely used to replace intravascular volume. HES solutions differ from each other with regard to molecular weight and mode of hydroxyl substitution (degree of hydroxylation, C2:C6 hydroxyethyl ratio, concentration), factors which may have varying effects on coagulation. We studied, in vitro, three different HES preparations (molecular weight/degree of hydroxylation/concentration/C2:C6 ratio of substitution 70.

The effects of in vitro hemodilution with gelatin, hydroxyethyl starch, and lactated Ringer's solution on markers of coagulation: an analysis using SONOCLOT.

Unlabelled: Blood-saving strategies have recently been established to avoid allogeneic transfusion during surgery or after trauma. This includes an expanding use of crystalloids and colloids. These solutions interfere with coagulation systems, but quantitative measurements are still lacking.

Transurethral resection syndrome: effect of the introduction into clinical practice of a new method for monitoring fluid absorption.

Study Objective: To determine the effects of introduction of a new monitoring system for fluid absorption during transurethral resection of the prostate (TURP) using an irrigating solution containing 0.5% alcohol.

Study Design: Prospective clinical investigation, with implementation of statistical process control.

The prevalence of latex sensitivity among anesthesiology staff.

Reports dealing with allergic reactions to latex among health care professionals are increasing steadily. This study is the first epidemiological investigation of latex allergy among anesthesia staff. We tested 101 persons of the staff of the Institute of Anesthesiology, Kantonsspital, Lucerne, Switzerland, using a standardized questionnaire, prick test (latex extract), scratch test (latex glove), and immunoglobin E (IgE) analysis.

Are fractures of the base of the skull influenced by the mass of the protective helmet? A retrospective study in fatally injured motorcyclists.

Study Hypothesis: Information on the influence of the mass of the helmet on the pattern of head injuries suffered by motorcyclists involved in collisions is scarce. This study was undertaken to verify a possible connection between the weight of the helmet worn and the occurrence of a ring fracture of the base of the skull surrounding the foramen magnum.

Design: One hundred twenty-two fatally injured motorcyclists were studied retrospectively.