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https://www.readbyqxmd.com/read/28445873/pregnancy-outcomes-in-patients-with-glomerular-disease-attending-a-single-academic-center-in-north-carolina
#1
Michelle M O'Shaughnessy, Meghan A Jobson, Katy Sims, Abigail L Liberty, Patrick H Nachman, William F Pendergraft
BACKGROUND: Contemporary data regarding pregnancy outcomes in US patients with primary glomerular diseases are lacking. We aimed to report fetal and maternal outcomes among women with biopsy-proven primary glomerular disease who received obstetric care at a single large academic US center. METHODS: All women with a biopsy-confirmed primary glomerular disease diagnosis and without end-stage kidney disease who received obstetric care at the University of North Carolina (UNC) Hospitals (1996-2015) were identified using the Glomerular Disease Collaborative Network registry and the UNC Hospitals Perinatal Database...
April 27, 2017: American Journal of Nephrology
https://www.readbyqxmd.com/read/28435501/impact-of-clinical-decision-support-on-radiography-for-acute-ankle-injuries-a-randomized-trial
#2
Shahein Tajmir, Ali S Raja, Ivan K Ip, James Andruchow, Patricia Silveira, Stacy Smith, Ramin Khorasani
INTRODUCTION: While only 15-20% of patients with foot and ankle injuries presenting to urgent care centers have clinically significant fractures, most undergo radiography. We examined the impact of electronic point-of-care clinical decision support (CDS) on adherence to the Ottawa Ankle Rules (OAR), as well as use and yield of foot and ankle radiographs in patients with acute ankle injury. METHODS: We obtained institutional review board approval for this randomized controlled study performed April 18, 2012-December 15, 2013...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28431848/epidemiology-of-device-associated-infections-in-an-intensive-care-unit-of-a-teaching-hospital-in-nepal-a-prospective-surveillance-study-from-a-developing-country
#3
Narayan Prasad Parajuli, Subhash Prasad Acharya, Santosh Dahal, Jaya Prasad Singh, Shyam Kumar Mishra, Hari Prasad Kattel, Basista Prasad Rijal, Bharat Mani Pokhrel
BACKGROUND: Device-associated health care-acquired infections (DA-HAIs) in intensive care unit patients are a major cause of morbidity, mortality, and increased health care costs. METHODS: A prospective, structured clinicomicrobiological surveillance was carried out for 3 common DA-HAIs: ventilator-associated pneumonia (VAP), central line-associated bloodstream infection (CLABSI), and catheter-associated urinary tract infection (CAUTI) present in the patients of an intensive care unit of a teaching hospital in Nepal...
April 18, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28393128/prevalence-and-predictors-of-mental-health-among-farmworkers-in-southeastern-anatolia-of-turkey
#4
Zeynep Simsek, Ayşana Zehra Keklik, Canan Demir, Kerim M Munir
BACKGROUND: Mental health problems represent a major component of the global burden of disease. The primary objective of this study was to assess the prevalence and predictors of psychological wellbeing among farmworkers and to evaluate their mental health services need for in rural primary health care settings. METHODS: The study sample comprised 1855 farmworkers (918 women, and 937 men) who were selected using probability cluster sampling method at 95% confidence interval (87...
January 2017: Int J Environ Agric Res
https://www.readbyqxmd.com/read/28392599/a-call-to-promote-healthcare-justice-a-summary-of-integrated-outpatient-clinics-exemplifying-principles-of-catholic-social-teaching
#5
Nicole P Waters, Trenton Schmale, Allison Goetz, Jason T Eberl, Jessica H Wells
There is an urgent need to promote healthcare justice for patients as well as members of the healthcare team including physicians. In this article, we explain how principles of Catholic social teaching (i.e., dignity of the individual, common good, destination of goods, solidarity, and subsidiarity) are applied to health care, by featuring various types of outpatient clinics including free, charitable-direct primary care, hybrid, federally qualified health center, and rural health clinic. We describe how attempts have been made to improve the quality and access of health care by creating new medical schools (i...
February 2017: Linacre Quarterly
https://www.readbyqxmd.com/read/28375958/evidence-based-practice-standard-care-for-acute-pain-management-in-adults-with-sickle-cell-disease-in-an-urgent-care-center
#6
Sunghee Kim, Ron Brathwaite, Ook Kim
BACKGROUND: Vaso-occlusive episodes (VOEs) with sickle cell disease (SCD) require opioid treatment. Despite evidence to support rapid pain management within 30 minutes, care for these patients does not consistently meet this benchmark. This quality improvement study sought to decrease the first analgesic administration time, increase patient satisfaction, and expedite patient flow. METHODS: A prospective pre-/postevaluation design was used to evaluate outcomes with patients 18 years or older with VOEs in an urgent care (UC) center after implementation of evidence-based practice standard care (EBPSC)...
April 2017: Quality Management in Health Care
https://www.readbyqxmd.com/read/28371896/an-analysis-of-patient-provider-secure-messaging-at-two-veterans-health-administration-medical-centers-message-content-and-resolution-through-secure-messaging
#7
Stephanie L Shimada, Beth Ann Petrakis, James A Rothendler, Maryan Zirkle, Shibei Zhao, Hua Feng, Gemmae M Fix, Mustafa Ozkaynak, Tracey Martin, Sharon A Johnson, Bengisu Tulu, Howard S Gordon, Steven R Simon, Susan S Woods
Objective: We sought to understand how patients and primary care teams use secure messaging (SM) to communicate with one another by analyzing secure message threads from 2 Department of Veterans Affairs facilities. Methods: We coded 1000 threads of SM communication sampled from 40 primary care teams. Results: Most threads (94.5%) were initiated by patients (90.4%) or caregivers (4.1%); only 5.5% were initiated by primary care team members proactively reaching out to patients...
March 24, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28351324/the-5th-annual-one-mind-summit-lessons-learned-about-science-informing-brain-health-policies-and-practice
#8
Ramona Hicks, Stephen Johnson, Amy Porter, Douglas F Zatzick, The One Mind Summit Panel Participants
Advances in science frequently precede changes in clinical care by several years or even decades. To better understand the path to translation, we invited experts to share their perspectives at the 5th Annual One Mind Summit: "Science Informing Brain Health Policies and Practice", which was held on May 24-25, 2016 in Crystal City, VA. While the translation of brain research throughout the pipeline - from basic science research to patient care - was discussed, the focus was on the implementation of "best evidence" into patient care...
March 29, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28346597/association-of-risk-of-viremia-immunosuppression-serious-clinical-events-and-mortality-with-increasing-age-in-perinatally-human-immunodeficiency-virus-infected-youth
#9
Anne M Neilan, Brad Karalius, Kunjal Patel, Russell B Van Dyke, Mark J Abzug, Allison L Agwu, Paige L Williams, Murli Purswani, Deborah Kacanek, James M Oleske, Sandra K Burchett, Andrew Wiznia, Miriam Chernoff, George R Seage, Andrea L Ciaranello
Importance: As perinatally human immunodeficiency virus-infected youth (PHIVY) in the United States grow older and more treatment experienced, clinicians need updated information about the association of age, CD4 cell count, viral load (VL), and antiretroviral (ARV) drug use with risk of opportunistic infections, key clinical events, and mortality to understand patient risks and improve care. Objective: To examine the incidence or first occurrence during follow-up of key clinical events (including Centers for Disease Control and Prevention stage B [CDC-B] and stage C [CDC-C] events) and mortality among PHIVY stratified by age, CD4 cell count, and VL and ARV status...
March 27, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28294880/-results-of-monitoring-of-the-plan-of-measures-directed-to-reduction-of-ischemic-heart-disease-in-north-caucasus-republics-analysis-of-dynamics-of-cardio-vascular-mortality
#10
M N Mamedov
Comparative analysis of dynamics of cardiovascular mortality in Russia and foreign countries as well as main directions of development of cardiological service in Russia are presented in this review article. Plan of measures for reduction of mortality from ischemic heart disease (IHD) was created in 2015. This plan comprises 4 blocks of assessment of the following measures: directed at improvement of primary IHD prevention (1), directed at secondary prevention of complications of IHD (2); directed at improvement of efficacy of medical care of patients with IHD (3), and directed at monitoring of some demographic parameters (4)...
May 2016: Kardiologiia
https://www.readbyqxmd.com/read/28282654/approach-to-human-immunodeficiency-virus-sexually-transmitted-infection-testing-for-men-at-an-urban-urgent-care-center
#11
Sarah B Schechter, Dina L Romo, Alwyn T Cohall, Natalie M Neu
BACKGROUND AND OBJECTIVES: Sexually transmitted infection (STI) rates have increased among men. Urgent care centers are increasingly common sites for medical care. The objectives of this study are to describe practices surrounding STI testing at an urban urgent care center. METHODS: Electronic medical record data were analyzed for men ages 20 to 55 years seen at the urgent care center of a large urban hospital from June 7, 2011, to April 30, 2015 (n = 10,983). A subset of charts was reviewed to assess sexual history documentation (n = 906)...
April 2017: Sexually Transmitted Diseases
https://www.readbyqxmd.com/read/28282377/before-the-bombing-high-burden-of-traumatic-injuries-in-kunduz-trauma-center-kunduz-afghanistan
#12
Hamayoun Hemat, Safieh Shah, Petros Isaakidis, Mrinalini Das, Nang Thu Thu Kyaw, Sattar Zaheer, Abdul Qayeum Qasemy, Mutallib Zakir, Gbane Mahama, Catherine Van Overloop, Lynette Dominguez
BACKGROUND: Médecins Sans Frontières (MSF) has been providing healthcare in Afghanistan since 1981 including specialized health services for trauma patients in Kunduz Trauma Center (KTC) from 2011. On October 3rd, 2015, a US airstrike hit the KTC, killing 42 people including 14 MSF staff. This study aims to demonstrate the impact on healthcare provision, after hospital destruction, by assessing the extent of care provided for trauma and injuries by the MSF KTC and to report on treatment outcomes from January 2014 to June 2015, three months prior to the bombing...
2017: PloS One
https://www.readbyqxmd.com/read/28281893/universal-adolescent-suicide-screening-in-a-pediatric-urgent-care-center
#13
Aimy Patel, Catherine Watts, Sheri Shiddell, Karla Couch, Amber M Smith, Michael J Moran, Gregory P Conners
The aim of this article is to describe the implementation of a 2-question suicide screening tool in a pediatric urgent care center to identify patients at risk of suicide. Adolescents presenting during a 12-month period completed the screening tool. Positive response to either question triggered further social work evaluation, including a Columbia-Suicide Severity Rating Scale (C-SSRS). Of 4,786 patients screened, 95 (2%) responded positively. Of these, 75 (79%) also had a positive C-SSRS. Only 7 (7%) had chief complaints related to mental health...
March 10, 2017: Archives of Suicide Research: Official Journal of the International Academy for Suicide Research
https://www.readbyqxmd.com/read/28273502/ruptured-berry-aneurysm-with-minimal-subarachnoid-hemorrhage
#14
Tyler J Gardner, Joseph A Prahlow
Cerebral artery aneurysm rupture is usually associated with significant subarachnoid hemorrhage; however, there are rare cases where there is a lack of hemorrhage into the subarachnoid space. While subdural hemorrhage can occur with ruptured aneurysms, isolated subdural hemorrhage is more often associated with trauma. In this case, a 51-year-old obese woman, who recently visited an Urgent Care Center for elevated blood pressure, was found dead roughly a month later. She had been complaining of headaches, and received medication for her blood pressure at the visit...
April 2017: Journal of Forensic and Legal Medicine
https://www.readbyqxmd.com/read/28262320/comparing-utilization-and-costs-of-care-in-freestanding-emergency-departments-hospital-emergency-departments-and-urgent-care-centers
#15
Vivian Ho, Leanne Metcalfe, Cedric Dark, Lan Vu, Ellerie Weber, George Shelton, Howard R Underwood
STUDY OBJECTIVE: We compare utilization, price per visit, and the types of care delivered across freestanding emergency departments (EDs), hospital-based EDs, and urgent care centers in Texas. METHODS: We analyzed insurance claims processed by Blue Cross Blue Shield of Texas from 2012 to 2015 for patient visits to freestanding EDs, hospital-based EDs, or urgent care centers in 16 Texas metropolitan statistical areas containing 84.1% of the state's population. We calculated the aggregate number of visits, average price per visit, proportion of price attributable to facility and physician services, and proportion of price billed to Blue Cross Blue Shield of Texas versus out of pocket, by facility type...
February 15, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28260440/vascular-complications-after-renal-transplant-a-single-center-experience
#16
Ebru H Ayvazoglu Soy, Aydincan Akdur, Mahir Kirnap, Fatih Boyvat, Gokhan Moray, Mehmet Haberal
OBJECTIVES: Despite surgical and medical advances, vascular complications are still among the major concerns after renal transplant, with a reported incidence of 3% to 15%. We evaluated the incidence and management of our transplant team 's vascular complications over 40 years. MATERIALS AND METHODS: From November 1975 to the present, we have performed a total of 2594 renal transplant procedures. Of these, 1997 grafts (76%) were obtained from living donors, and 597 grafts (24%) were obtained from deceased donors...
February 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28256327/st-segment-elevation-myocardial-infarction-systems-of-care-an-urgent-need-for-policies-to-co-ordinate-care-in-order-to-decrease-in-hospital-mortality
#17
Ali Osama Malik, Oliver Abela, Gayle Allenback, Subodh Devabhaktuni, Calvin Lui, Aditi Singh, Jimmy Diep, Takashi Yamashita, Ji Won Yoo, Sanjay Malhotra, Chowdhury Ahsan
BACKGROUND: Regional trends for ST-segment elevation myocardial infarction (STEMI) treatment is not known in the state of Nevada. HYPOTHESIS: Great disparity exists for treatment for STEMI in different geographical areas of Nevada. There is a great potential to improve treatment and outcomes of STEMI patients in the State of Nevada. METHODS: Admissions to non-federal hospitals in the state of Nevada, using 2011 to 2013 discharge data from the Nevada State Inpatient Data Base (acquired from Healthcare Cost and Utilization Project, Agency for Healthcare Research and Quality), were analyzed...
February 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28245880/pre-hospital-ct-diagnosis-of-subarachnoid-hemorrhage
#18
Maren Ranhoff Hov, Annette Ryen, Katrine Finsnes, Janne Storflor, Thomas Lindner, Jostein Gleditsch, Christian Georg Lund
BACKGROUND: Subarachnoid hemorrhage (SAH) is associated with higher mortality in the acute phase than other stroke types. There is a particular risk of early and devastating re-bleeding. Patients therefore need urgent assessment in a neurosurgical department, and the shorter the time from symptom onset to diagnosis the better. CASE PRESENTATION: The Norwegian Acute Stroke Pre-hospital Project (NASPP) has developed a Mobile Stroke Unit (MSU) model, which is staffed with anesthesiologists also trained in pre-hospital clinical assessment of acute stroke patients and interpretation of computerized tomography (CT)...
February 28, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28242966/over-the-counter-mtp-pills-and-its-impact-on-women-s-health
#19
Sarojini, T R Ashakiran, B T Bhanu, Radhika
OBJECTIVES: To study the complications and consequences including maternal morbidity and mortality following indiscriminate self-consumption of abortion pills reporting to a tertiary care center. METHODOLOGY: This is an observational study conducted at Vanivilas hospital between January 2012 to December 2013 for 24 months. After applying inclusion and exclusion criteria, 104 women were studied with respect to period of gestation, parity, clinical features at presentation and management in the institution...
February 2017: Journal of Obstetrics and Gynaecology of India
https://www.readbyqxmd.com/read/28238501/is-tachycardia-at-discharge-from-the-pediatric-emergency-department-a-cause-for-concern-a%C3%A2-nonconcurrent-cohort-study
#20
Paria M Wilson, Todd A Florin, Guixia Huang, Matthew Fenchel, Matthew R Mittiga
STUDY OBJECTIVE: We evaluate the association between discharge tachycardia and (1) emergency department (ED) and urgent care revisit and (2) receipt of clinically important intervention at the revisit. METHODS: The study included a nonconcurrent cohort of children aged 0 to younger than 19 years, discharged from 2 pediatric EDs and 4 pediatric urgent care centers in 2013. The primary exposure was discharge tachycardia (last recorded pulse rate ≥99th percentile for age)...
February 23, 2017: Annals of Emergency Medicine
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