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Hospital Practice (Minneapolis)

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https://www.readbyqxmd.com/read/28510501/mechanical-ventilation-in-the-acute-respiratory-distress-syndrome
#1
Oleg Epelbaum, Wilbert S Aronow
The management of the acute respiratory distress syndrome (ARDS) patient is fundamental to the field of intensive care medicine, and it presents unique challenges owing to the specialized mechanical ventilation techniques that such patients require. ARDS is a highly lethal disease, and there is compelling evidence that mechanical ventilation itself, if applied in an injurious fashion, can be a contributor to ARDS mortality. Therefore, it is imperative for any clinician central to the care of ARDS patients to understand the fundamental framework that underpins the approach to mechanical ventilation in this special scenario...
May 16, 2017: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/28490205/frequency-and-evaluation-of-the-perceptions-towards-caesarean-section-among-pregnant-women-attending-public-hospitals-in-pakistan-and-the-implications
#2
Rabia Ishaq, Nosheen Baloch, Qaiser Iqbal, Fahad Saleem, Mohamed Hassali, Javeid Iqbal, Fiaz Ahmed, Mohammad Anwar, Sajjad Haider, Brian Godman
OBJECTIVES: There is increasing prevalence of caesarean sections (CS) worldwide; however, there are concerns about their rates in some countries, including potential fears. Consequently, we aimed to determine the frequency of CS, and explore patient's perception towards CS attending public hospitals in Pakistan, to provide future guidance. METHODS: A two-phased study design (retrospective and cross sectional) was adopted. A retrospective study was conducted to assess the frequency of CS over one year among four public hospitals...
May 11, 2017: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/28475430/alignment-between-physicians-and-hospital-administrators-historical-perspective-and-future-directions
#3
Anish Bhardwaj
Unfortunately, the working relationship between physicians and hospital administrators is often not congruent and can even become contentious, resulting in antagonism across many Healthcare Organizations (HCOs). This treatise provides a broad, literature-based, descriptive overview in an evolving historical context, coupled with observations based on extensive professional experience. It highlights the root causes of the nonalignment between physicians and hospital administrators. Most importantly, this manuscript proposes a framework for short and long-term solutions toward a more cohesive and collaborative team approach, based on understanding the respective roles, as well as the strengths, and contributions of the two groups...
May 5, 2017: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/28468527/spinal-racemose-cysticercosis-case-report-and-review
#4
Hussam A Yacoub, Ira Goldstein, Mohammad El-Ghanem, Leroy Sharer, Nizar Souayah
Cysticercosis is a common helminthic infection worldwide, endemic in Central and South America, sub-Saharan Africa, and Southeast Asia. Neurocysticercosis typically involves brain parenchyma, subarachnoid space, and the ventricular system. Although the spinal cord is frequently involved in patients with parenchymal neurocysticercosis, isolated spinal involvement is rare, occurring in only 1-3% of patients. We report a case of racemose spinal neurocysticercosis with brain parenchyma involvement in a 49-year-old Mexican man, who presented with unsteady gait and bilateral arm numbness and weakness...
May 4, 2017: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/28449624/an-economic-analysis-of-tolvaptan-compared-with-fluid-restriction-among-hospitalized-patients-with-hyponatremia
#5
Varun Ramamohan, Deirdre Mladsi, Naoko Ronquest, Siddhesh Kamat, Susan Boklage
OBJECTIVE: The vasopressin-receptor antagonist tolvaptan is used for the treatment of hyponatremia (HN) in hospitalized patients with congestive heart failure (CHF) or syndrome of inappropriate antidiuretic hormone secretion (SIADH). The objective of this economic modeling study was to assess the potential cost and health outcomes associated with tolvaptan in comparison with fluid restriction (FR). METHODS: A decision-analytic model was developed to estimate potential cost and health outcomes associated with tolvaptan compared with FR among hospitalized CHF and SIADH patients with severe HN (serum sodium [SS] levels < 125 mEq/L)...
April 28, 2017: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/28402686/the-creation-and-implementation-of-an-outpatient-pulmonary-embolism-treatment-protocol
#6
Christopher Kabrhel, Rachel Rosovsky, Christopher Baugh, Blair Alden Parry, Erin Deadmon, Charlotte Kreger, Nicholas Giordano
The ability to rapidly and accurately risk-stratify patients with venous thromboembolism (VTE), and the availability of direct acting oral anticoagulants have reduced the need for intravenous anticoagulation for patients with deep vein thrombosis (DVT) and pulmonary embolism (PE). Emergency physicians are generally reluctant to discharge patients with VTE without defined and reliable follow up in place, and VTE patients treated with anticoagulants can be at risk for complications related to recurrent VTE and bleeding...
April 21, 2017: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/28399675/evaluating-the-appropriateness-of-hospital-doctors-requests-for-pulmonary-function-tests-beyond-basic-spirometry-results-from-a-prospective-observational-study
#7
Krishna Bajee Sriram, Zoe Fountain, Jessica Hockenhull, Debbie Zagami
OBJECTIVES: Hospitalists request 'complete' pulmonary function tests (PFTs), typically comprising of spirometry, diffusion capacity of the lung for carbon monoxide (DLCO) and absolute lung volumes (ALVs), the results of which assist in the management of patients with respiratory disorders. Recently, concerns have been raised about over-requesting of 'complete' PFTs, but there is a paucity of information on the proportion of requests that can be considered clinically inappropriate. This study prospectively evaluated the 'complete' PFTs requested in a hospital service and assessed the impact of medical review of the requests...
April 19, 2017: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/28325091/nuts-and-bolts-of-running-a-pulmonary-embolism-response-team-results-from-an-organizational-survey-of-the-national-pert%C3%A2-consortium-members
#8
Geoffrey Barnes, Jay Giri, D Mark Courtney, Soophia Naydenov, Todd Wood, Rachel Rosovsky, Kenneth Rosenfield, Christopher Kabrhel
OBJECTIVES: Pulmonary embolism response teams (PERT) are developing rapidly to operationalize multi-disciplinary care for acute pulmonary embolism patients. Our objective is to describe the core components of PERT necessary for newly developing programs. METHODS: An online organizational survey of active National PERT™ Consortium members was performed between April and June 2016. Analysis, including descriptive statistics and Kruskal-Wallis tests, was performed on centers self-reporting a fully operational PERT program...
March 31, 2017: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/28353375/determination-of-serum-carbamazepine-concentration-using-dried-blood-spot-specimens-for-resource-limited-settings
#9
Saibal Das, Denise H Fleming, Binu S Mathew, Blessed Winston A, Appaswamy T Prabhakar, Mathew Alexander
OBJECTIVES: Carbamazepine (CBZ) is a commonly used anti-epileptic in rural hospitals in India. These hospitals lack the facilities to measure CBZ concentration; however, in larger hospitals this is performed using high performance liquid chromatography (HPLC). Dried blood spot (DBS) represents a feasible matrix for safe transportation by post/courier. This study was to determine whether the concentration of CBZ in serum can be predicted from that measured in DBS using an inexpensive HPLC method and inexpensive standard filter paper...
April 2017: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/28335637/reversing-the-anticoagulation-effects-of-dabigatran
#10
REVIEW
William E Dager, Linda Banares
The standard of care for oral anticoagulation therapy has primarily been warfarin, which is limited by its indirect mechanism-of-action, variable kinetics, tolerability, and routine monitoring concerns. The direct-acting oral anticoagulants (DOACs) have predictable pharmacokinetics and pharmacodynamics, and improved safety and efficacy compared to warfarin for the prevention of stroke in patients with nonvalvular atrial fibrillation and prevention or management of venous thromboembolism. Consequential bleeding is a concern with all anticoagulants...
April 2017: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/28306345/a-retrospective-study-on-non-drug-related-poisoning-in-the-community-among-children-from-south-india
#11
Debasis Das Adhikari, Saibal Das, Blessed Winston A, Kaysina Vazhudhi, Aniket Kumar, Margaret Shanthi Fx, Indira Agarwal
OBJECTIVES: This retrospective study was performed to determine the incidence, demographic distribution, types and outcomes across various non-drug related poisonings among children attending a tertiary care center in south India. METHODS: All children from 0-16 years who presented to the Paediatric Emergency Department, Christian Medical College, Vellore with non-drug related poisoning from October 2004 to September 2013 were included. RESULTS: Out of the total 997 cases of poisoning, 629 (63...
April 2017: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/28114816/a-case-of-chronic-hypomagnesemia-in-a-cancer-survivor
#12
Marko Velimirovic, Joshua Charles Ziperstein, Andrew Zoltan Fenves
OBJECTIVES: Hypomagnesemia is common among hospitalized patients, particularly those who are critically ill. It can be associated with a number of potentially life-threatening cardiovascular, neurological and behavioral manifestations. As opposed to acute, chronic hypomagnesemia is often underdiagnosed and underreported and as such may pose a diagnostic and therapeutic problem. CASE PRESENTATION: We describe a case of magnesium wasting in a middle-aged woman with head and neck cancer who presented with recurrent syncopal episodes complicated by a femur fracture 4 months after completing a course of carboplatin-containing chemotherapy...
April 2017: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/28095063/early-primary-care-follow-up-after-ed-and-hospital-discharge-does-it-affect-readmissions
#13
Sanjai Sinha, Joanna Seirup, Amanda Carmel
OBJECTIVES: After hospitalization, timely discharge follow-up has been linked to reduced readmissions in the heart failure population, but data from general inpatients has been mixed. The objective of this study was to determine if there was an association between completed follow-up appointments within 14 days of hospital discharge and 30-day readmission amongst primary care patients at an urban academic medical center. Index discharges included both inpatient and emergency room settings...
April 2017: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/28092990/in-hospital-statin-underutilization-among-high-risk-patients-delayed-uptake-of-the-2013-cholesterol-guidelines-in-a-u-s-cohort
#14
Subeer K Wadia, Mark Belkin, Kelsey S Chow, Jonathan Nattiv, Andrew Appis, Steven B Feinstein, Kim Allan Williams
OBJECTIVES: Clinician utilization of the 2013 cholesterol lowering guidelines remains variable and unknown. We sought to examine statin prescribing patterns and compare rates among specialists who treat high-risk cardiovascular patients admitted to the hospital. METHODS: We retrospectively (via chart review) examined four specialty groups: (i) Cardiology, (ii) Cardiovascular or Vascular (CV) Surgery, (iii) Neurology, and (iv) Internal Medicine. Adult patients were included based on a discharge diagnosis of acute coronary syndrome, coronary artery bypass graft surgery, carotid endarterectomy, acute ischemic stroke, transient ischemic attack, or high-risk chest pain...
February 2017: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/28064542/antibiotic-treatment-patterns-costs-and-resource-utilization-among-patients-with-community-acquired-pneumonia-a-us-cohort-study
#15
Christopher J Llop, Edward Tuttle, Glenn S Tillotson, Kerry LaPlante, Thomas M File
OBJECTIVES: The current treatment options for patients with community-acquired pneumonia (CAP) often present a trade-off between the potential for treatment failure and safety concerns. We set out to investigate real-world outcomes associated with the use of currently available antimicrobial treatment options for CAP in both the outpatient and inpatient (non-intensive care unit [ICU]) settings. METHODS: This claims-based retrospective study included adult patients diagnosed with CAP and treated with antibiotic therapies, including any oral fluoroquinolone, macrolide, or beta-lactam monotherapy in the outpatient setting, and intravenous (IV) levofloxacin or IV azithromycin/ceftriaxone in the inpatient setting...
February 2017: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/28055287/epidemiology-treatment-and-economics-of-patients-presenting-to-the-emergency-department-for-skin-and-soft-tissue-infections
#16
Kristin E Linder, David P Nicolau, Michael D Nailor
OBJECTIVES: Skin and soft tissue infections (SSTIs) are among the most common bacterial diseases and represent a significant disease burden. The purpose of this study was to describe the real-world management of patients with SSTIs presenting to the emergency department (ED). METHODS: This is a retrospective cohort study. Adult patients identified with a primary diagnosis of SSTI determined by ICD-9 codes were assessed from index presentation for up to 30 days...
February 2017: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/27985284/drug-poisoning-in-the-community-among-children-a-nine-years-experience-from-a-tertiary-care-center-in-south-india
#17
Blessed Winston A, Debasis Das Adhikari, Saibal Das, Kaysina Vazhudhi, Aniket Kumar, Margaret Shanthi Fx, Indira Agarwal
OBJECTIVES: This study was performed to determine the incidence, demographic distribution, types and outcomes across various drug poisonings among children from south India. METHODS: This retrospective study included children less than 16 years who presented to the Pediatric Emergency Department with drug poisoning from the 1st of October 2004 to the 30th of September 2013. RESULTS: Out of the total 997 poisoning cases, 366 (36.71%) were contributed by drugs; mainly antiepileptics, central nervous system depressants, psychotropics, analgesic-antipyretics and natural drugs...
February 2017: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/27901354/erratum
#18
(no author information available yet)
No abstract text is available yet for this article.
December 2016: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/27901348/erratum
#19
(no author information available yet)
No abstract text is available yet for this article.
December 2016: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/27900873/erratum
#20
(no author information available yet)
No abstract text is available yet for this article.
December 2016: Hospital Practice (Minneapolis)
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