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https://www.readbyqxmd.com/read/28429083/intravenous-treprostinil-infusion-via-a-fully-implantable-pump-for-pulmonary-arterial-hypertension
#1
Ralf Ewert, Manuel J Richter, Regina Steringer-Mascherbauer, Ekkehard Grünig, Tobias J Lange, Christian F Opitz, Christian Warnke, Hossein-Ardeschir Ghofrani
OBJECTIVES: Parenteral prostanoids infused via external pumps are well-established pulmonary arterial hypertension (PAH) treatments. However, local side-effects and systemic infections restrict their use. The purpose of this study was to investigate the safety of a fully implantable treprostinil infusion pump (LENUS Pro(®)) in patients with PAH. METHODS: Thirty patients with PAH undergoing pump implantation (with stable PAH therapy for ≥3 weeks pre-implantation) were included in this prospective, multicenter, observational study (NCT01979822)...
April 20, 2017: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/28396108/augmented-nurse-care-management-in-ckd-stages-4-to-5-a%C3%A2-randomized-trial
#2
Steven Fishbane, Sofia Agoritsas, Alessandro Bellucci, Candice Halinski, Hitesh H Shah, Vipul Sakhiya, Leah Balsam
BACKGROUND: Outcomes for patients with late-stage chronic kidney disease (CKD) in the United States are suboptimal. There is poor education and preparation for end-stage kidney disease, as well as a high rate of hospitalization in this group of patients. STUDY DESIGN: A randomized, parallel-group, 2-arm, controlled trial. SETTING & PARTICIPANTS: The study was conducted at 3 sites: a clinic of an academic medical center, a public hospital academic clinic, and a community-based private practice...
April 7, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28386787/prospective-evaluation-of-systematic-use-of-peripherally-inserted-central-catheters-picc-lines-for-the-home-care-after-allogeneic-hematopoietic-stem-cells-transplantation
#3
J Cornillon, J A Martignoles, E Tavernier-Tardy, M Gire, P Martinez, C Tranchan, A Vallard, K Augeul-Meunier, B Hacquard, D Guyotat
PURPOSE: Long-term catheters are often necessary for outpatient care after an allogeneic hematopoietic stem cell transplantation (HSCT), However, there is paucity of data on the use of peripherally inserted central catheter (PICC) in post-HSCT setting. METHODS: We prospectively evaluated the systematic use of PICC in 37 consecutive patients returning home after HSCT. RESULTS: In 6 out of 37 patients, the PICC was exclusively used for weekly blood controls...
April 6, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28383770/cost-effectiveness-analysis-and-obstetrics-the-time-has-come
#4
Robert M Silver, Brett D Einerson
In this issue of BJOG, ten Eikelder and colleagues report that oral misoprostol and foley bulb catheters for cervical ripening have equal cost-effectiveness. If women receiving foley bulbs undergo ripening at home or on a less intensive unit than a labor and delivery suite, the foley bulb is considerably more cost-effective. They used data from a Dutch RCT, the PROBAAT2 trial, comparing the two methods, which had similar efficacy. The analysis has many strengths including using comparisons from within an RCT, careful assessment of measurable direct hospital costs, and the use of well-chosen sensitivity analyses to evaluate the assumptions under a wide variety of clinical scenarios...
April 6, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28383394/methicillin-resistant-staphylococcus-aureus-as-a-uropathogen-in-an-irish-setting
#5
Aisling T Looney, Elaine J Redmond, Naomi M Davey, Padraig J Daly, Carole Troy, Brian F Carey, Ivor M Cullen
Urinary tract infections are one of the most common infectious diseases diagnosed in the community and in the hospital setting. Their treatment is complicated by drug-resistant pathogens and the colonization by microbes of indwelling urinary catheters. This study assessed the occurrence and antimicrobial susceptibility of methicillin-resistant Staphylococcus aureus (MRSA) uropathogens isolated for 5 consecutive years at University Hospital Waterford between 2010 and 2014. We created 4 clinically relevant subdivisions, based on urine source: hospital inpatients, patients from the Emergency Department, patients referred from their General Practitioner, and Nursing Home patients...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28350743/home-based-drainage-of-refractory-ascites-by-a-permanent-tunneled-peritoneal-catheter-can-safely-replace-large-volume-paracentesis
#6
Philipp Solbach, Christoph Höner Zu Siederdissen, Richard Taubert, Szilvia Ziegert, Kerstin Port, Andrea Schneider, Katja Hueper, Michael P Manns, Heiner Wedemeyer, Elmar Jaeckel
BACKGROUND AND AIM: Refractory ascites has a poor prognosis. Recurrent large-volume paracentesis is the current standard of care; however, it results in circulatory dysfunction and renal dysfunction, and hospitalization is commonly required. Transjugular intrahepatic portosystemic shunt placement is not an option in a substantial number of patients because of contraindications. The placement of a tunneled peritoneal drainage catheter has been shown to be effective in patients with malignant ascites...
May 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28331776/urinary-tract-infections-in-hospitalized-ischemic-stroke-patients-source-and-impact-on-outcome
#7
Einar Bogason, Kathy Morrison, Omar Zalatimo, David M Ermak, Erik Lehman, Eric Markley, Kevin Cockroft
BACKGROUND:  Urinary tract infections (UTIs) in ischemic stroke patients are a common occurrence and the frequent focus of quality improvement initiatives. However, many UTIs are community-acquired and the impact of such infections on patient outcomes remains controversial. METHODS:  We conducted a retrospective analysis of our Stroke Center Database and electronic medical records to determine the incidence of both community-acquired UTI (CA-UTI) and hospital-acquired UTI (HA-UTI) in hospitalized ischemic stroke patients...
February 6, 2017: Curēus
https://www.readbyqxmd.com/read/28275918/robotic-thoracic-surgery-results-in-shorter-hospital-stay-and-lower-postoperative-pain-compared-to-open-thoracotomy-a-matched-pairs-analysis
#8
Christopher Darr, Danjouma Cheufou, Gerhard Weinreich, Thomas Hachenberg, Clemens Aigner, Sandra Kampe
BACKGROUND: To evaluate postoperative pain intensity and length of hospital stay after open or robotic thoracic surgery in a standardized postoperative pain therapy setting. METHODS: In the present retrospective (oberservation period: January 2015 until January 2016) study we matched data of 38 patients with robotic thoracic surgery ("robotic patients"; age: 62.2 years, male gender: 42.1%) with 38 patients with open thoracic surgery ("open patients"; age: 62.5 years, male gender: 42...
March 8, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28271332/exparel-peripheral-catheter-use-in-the-ambulatory-setting-and-use-of-peripheral-catheters-postoperatively-in-the-home-setting
#9
REVIEW
Adam L Bromberg, Jeremy A Dennis, Karina Gritsenko
PURPOSE OF REVIEW: With the increasing number of ambulatory surgeries being performed, regional anesthesia has become an increasingly popular anesthetic modality, and many choices exist to provide efficient, effective quality perioperative analgesia. In this paper, we will review the various regional anesthesia options in addition to the advantages and disadvantages of each. Lastly, we will discuss liposomal bupivicaine, a long acting local anesthetic, and its future role in the anesthesiologist's armamentarium...
March 2017: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/28267070/adherence-to-a-multimodal-analgesic-clinical-pathway-a-within-group-comparison-of-staged-bilateral-knee-arthroplasty-patients
#10
Rachel C Steckelberg, Natasha Funck, T Edward Kim, Tessa L Walters, Gregory Milo Lochbaum, Stavros G Memtsoudis, Nicholas J Giori, Pier F Indelli, Lorrie J Graham, Edward R Mariano
BACKGROUND AND OBJECTIVES: Multimodal analgesic clinical pathways for joint replacement patients often include perineural catheters, but long-term adherence to these pathways has not yet been investigated. Our primary aim was to determine adherence rate to a knee arthroplasty clinical pathway for patients undergoing staged bilateral procedures. METHODS: This study was performed at a hospital with a Perioperative Surgical Home program and knee arthroplasty clinical pathway using multimodal analgesia and adductor canal catheters...
May 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28262925/washout-policies-in-long-term-indwelling-urinary-catheterisation-in-adults
#11
REVIEW
Ashley J Shepherd, William G Mackay, Suzanne Hagen
BACKGROUND: People requiring long-term bladder draining with an indwelling catheter can experience catheter blockage. Regimens involving different solutions can be used to wash out catheters with the aim of preventing blockage. This is an update of a review published in 2010. OBJECTIVES: To determine if certain washout regimens are better than others in terms of effectiveness, acceptability, complications, quality of life and critically appraise and summarise economic evidence for the management of long-term indwelling urinary catheterisation in adults...
March 6, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28260726/cooperation-between-single-handed-and-group-practices-ensures-the-replacement-of-gastrostomy-tubes-and-tracheal-cannulas-in-home-medical-care-settings
#12
Takuma Kimura, Satoru Yoshie, Rumiko Tsuchiya, Shohei Kawagoe, Satoshi Hirahara, Katsuya Iijima, Toru Akahoshi, Tetsuo Tsuji
In Japan, patients who require home medical care are increasing especially in the elderly. In home medical care settings, devices such as gastrostomy tubes, tracheal cannulas, and urethral catheters are usually replaced by visiting physicians or nurses. However, device replacement services are not always available in Japan. Unless device replacement services are sufficiently provided to patients at home, patients have to suffer various disadvantages, including a forced visit to a hospital for device replacement despite inability to walk...
2017: Tohoku Journal of Experimental Medicine
https://www.readbyqxmd.com/read/28230563/implementation-of-an-early-mobility-pathway-in-neurointensive-care-unit-patients-with-external-ventricular-devices
#13
Megan Moyer, Bethany Young, Joseph Borst, William Pino, Marisa Hart, Jesse LoBreglio, Derek Zaleski, Isaira Leonor, David Kung, Michelle Smith, Eric Zager, M Sean Grady, Monisha Kumar
BACKGROUND: Patients with an external ventricular drain (EVD) may not be readily mobilized because of concerns of catheter dislodgment and/or inappropriate cerebrospinal fluid drainage. Delayed mobilization may result in longer hospital stays and an increased risk for complications related to immobility. We aimed to determine the safety, feasibility, and outcome of an EVD mobilization protocol in patients with subarachnoid hemorrhage (SAH). METHODS: A multidisciplinary group developed a formal algorithm for the mobilization of patients with SAH with EVDs...
February 23, 2017: Journal of Neuroscience Nursing: Journal of the American Association of Neuroscience Nurses
https://www.readbyqxmd.com/read/28199998/delayed-intraparenchymal-and-intraventricular-hemorrhage-requiring-surgical-evacuation-after-mri-guided-laser-interstitial-thermal-therapy-for-lesional-epilepsy
#14
Sean M Barber, Luke Tomycz, Timothy George, Dave F Clarke, Mark Lee
BACKGROUND: Symptomatic intracranial hemorrhage is a rare complication of laser interstitial thermal therapy (LITT). OBJECTIVES: To present a unique case of delayed symptomatic intracranial hemorrhage occurring after a LITT procedure for epilepsy in a high-volume center (68 LITT procedures for pediatric epilepsy have been performed). METHODS: An 18-year-old male with epilepsy underwent LITT to an area of heterotopia near the right lateral ventricle...
February 16, 2017: Stereotactic and Functional Neurosurgery
https://www.readbyqxmd.com/read/28198656/fungicidal-activity-and-pk-pd-of-caspofungin-as-tools-to-guide-antifungal-therapy-in-a-fluconazole-resistant-c-parapsilosis-candidemia
#15
Carlo Tascini, Emanuela Sozio, Antonello Di Paolo, Giancarlo Tintori, Alessandro Leonildi, Giacomo Bertolino, Franco Carmassi, Enrico Tagliaferri, Francesco Menichetti, Francesco Barchiesi
Candida parapsilosis may be responsible for bloodstream infections (BSI) and it is characterised by an increased incidence of fluconazole resistance. A 75-year old woman with severe comorbidities received the insertion of a peripherally inserted central venous catheter. Fluconazole did not prevent a C. parapsilosis BSI hence caspofungin was started after a nephrotoxic first-line treatment with amphotericin B. The ratio of peak plasma concentration over the minimum inhibitory concentration (Cmax/MIC) was adopted to maximise efficacy of caspofungin...
February 15, 2017: Journal of Chemotherapy
https://www.readbyqxmd.com/read/28186928/collecting-biological-material-from-palliative-care-patients-in-the-last-weeks-of-life-a-feasibility-study
#16
Séamus Coyle, Aileen Scott, Amara Callistus Nwosu, Richard Latten, James Wilson, Catriona R Mayland, Stephen Mason, Chris Probert, John Ellershaw
OBJECTIVE: To assess the feasibility of prospectively collecting biological samples (urine) from palliative care patients in the last weeks of life. SETTING: A 30-bedded specialist hospice in the North West of England. PARTICIPANTS: Participants were adults with a diagnosis of advanced disease and able to provide written informed consent. METHOD: Potential participants were identified by a senior clinician over a 12-week period in 2014...
November 10, 2016: BMJ Open
https://www.readbyqxmd.com/read/28144977/changing-landscape-for-peritoneal-dialysis-optimizing-utilization
#17
Martin J Schreiber
The future growth of peritoneal dialysis (PD) will be directly linked to the shift in US healthcare to a value-based payment model due to PD's lower yearly cost, early survival advantage over in-center hemodialysis, and improved quality of life for patients treating their kidney disease in the home. Under this model, nephrology practices will need an increased focus on managing the transition from chronic kidney disease to end-stage renal disease (ESRD), providing patient education with the aim of accomplishing modality selection and access placement ahead of dialysis initiation...
March 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28118177/home-based-drainage-of-refractory-ascites-by-a-permanent-tunneled-peritoneal-catheter-can-safely-replace-large-volume-paracentesis
#18
Philipp Solbach, Christoph Höner Zu Siederdissen, Richard Taubert, Szilvia Ziegert, Kerstin Port, Andrea Schneider, Katja Hueper, Michael P Manns, Heiner Wedemeyer, Elmar Jaeckel
BACKGROUND AND AIM: Refractory ascites has a poor prognosis. Recurrent large-volume paracentesis is the current standard of care; however, it results in circulatory dysfunction and renal dysfunction, and hospitalization is commonly required. Transjugular intrahepatic portosystemic shunt placement is not an option in a substantial number of patients because of contraindications. The placement of a tunneled peritoneal drainage catheter has been shown to be effective in patients with malignant ascites...
January 21, 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28103856/relationship-between-the-presence-of-baccalaureate-educated-rns-and-quality-of-care-a-cross-sectional-study-in-dutch-long-term-care-facilities
#19
Ramona Backhaus, Erik van Rossum, Hilde Verbeek, Ruud J G Halfens, Frans E S Tan, Elizabeth Capezuti, Jan P H Hamers
BACKGROUND: Recent evidence suggests that an increase in baccalaureate-educated registered nurses (BRNs) leads to better quality of care in hospitals. For geriatric long-term care facilities such as nursing homes, this relationship is less clear. Most studies assessing the relationship between nurse staffing and quality of care in long-term care facilities are US-based, and only a few have focused on the unique contribution of registered nurses. In this study, we focus on BRNs, as they are expected to serve as role models and change agents, while little is known about their unique contribution to quality of care in long-term care facilities...
January 19, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28096251/healthcare-resource-consumption-for-intermittent-urinary-catheterisation-cost-effectiveness-of-hydrophilic-catheters-and-budget-impact-analyses
#20
Carla Rognoni, Rosanna Tarricone
OBJECTIVES: This study presents a cost-effectiveness analysis comparing hydrophilic coated to uncoated catheters for patients performing urinary intermittent catheterisation. A national budget impact analysis is also included to evaluate the impact of intermittent catheterisation for management of bladder dysfunctions over a period of 5 years. DESIGN: A Markov model (lifetime horizon, 1 year cycle length) was developed to project health outcomes (life years and quality-adjusted life years) and economic consequences related to patients using hydrophilic coated or uncoated catheters...
January 17, 2017: BMJ Open
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