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https://www.readbyqxmd.com/read/28079673/differences-in-use-of-high-quality-and-low-quality-hospitals-among-working-age-individuals-by-insurance-type
#1
Ioana Popescu, Kevin C Heslin, Rosanna M Coffey, Raynard E Washington, Marguerite L Barrett, Lucy H Karnell, José J Escarce
BACKGROUND: Research suggests that individuals with Medicaid or no insurance receive fewer evidence-based treatments and have worse outcomes than those with private insurance for a broad range of conditions. These differences may be due to patients' receiving care in hospitals of different quality. RESEARCH DESIGN: We used the Healthcare Cost and Utilization Project State Inpatient Databases 2009-2010 data to identify patients aged 18-64 years with private insurance, Medicaid, or no insurance who were hospitalized with acute myocardial infarction, heart failure, pneumonia, stroke, or gastrointestinal hemorrhage...
February 2017: Medical Care
https://www.readbyqxmd.com/read/28074841/the-mito-damp-cardiolipin-blocks-il-10-production-causing-persistent-inflammation-during-bacterial-pneumonia
#2
Krishnendu Chakraborty, Mahesh Raundhal, Bill B Chen, Christina Morse, Yulia Y Tyurina, Anupriya Khare, Timothy B Oriss, Rachael Huff, Janet S Lee, Claudette M St Croix, Simon Watkins, Rama K Mallampalli, Valerian E Kagan, Anuradha Ray, Prabir Ray
Bacterial pneumonia is a significant healthcare burden worldwide. Failure to resolve inflammation after infection precipitates lung injury and an increase in morbidity and mortality. Gram-negative bacteria are common in pneumonia and increased levels of the mito-damage-associated molecular pattern (DAMP) cardiolipin can be detected in the lungs. Here we show that mice infected with Klebsiella pneumoniae develop lung injury with accumulation of cardiolipin. Cardiolipin inhibits resolution of inflammation by suppressing production of anti-inflammatory IL-10 by lung CD11b(+)Ly6G(int)Ly6C(lo)F4/80(+) cells...
January 11, 2017: Nature Communications
https://www.readbyqxmd.com/read/28063674/predictors-of-30-day-hospital-readmission-after-hip-fracture-a-systematic-review
#3
REVIEW
Adam M Ali, Charles E R Gibbons
BACKGROUND: Early readmission to hospital after hip fracture is associated with increased mortality and significant costs to the healthcare system. There is growing interest in the use of 30-day readmission rates as a metric of hospital performance. Identifying patients at increased risk of readmission after hip fracture may enable pre-emptive action to mitigate this risk and the development of effective methods of risk-adjustment to allow readmission to be used as a reliable measure of hospital performance...
January 3, 2017: Injury
https://www.readbyqxmd.com/read/28053969/pneumococcal-urinary-antigen-test-use-in-diagnosis-and-treatment-of-pneumonia-in-seven-utah-hospitals
#4
Devin M West, Lindsay M McCauley, Jeffrey S Sorensen, Al R Jephson, Nathan C Dean
The pneumocococcal urine antigen test increases specific microbiological diagnosis over conventional culture methods in pneumonia patients. Data are limited regarding its yield and effect on antibiotic prescribing among patients with community-onset pneumonia in clinical practice. We performed a secondary analysis of 2837 emergency department patients admitted to seven Utah hospitals over 2 years with international diagnostic codes version 9 codes and radiographic evidence of pneumonia. Mean age was 64.2 years, 47...
October 2016: ERJ Open Research
https://www.readbyqxmd.com/read/28024955/pregnancy-as-a-risk-factor-for-severe-outcomes-from-influenza-virus-infection-a-systematic-review-and-meta-analysis-of-observational-studies
#5
REVIEW
Dominik Mertz, Johanna Geraci, Judi Winkup, Bradford D Gessner, Justin R Ortiz, Mark Loeb
BACKGROUND: Pregnancy is considered to be an important risk factor for severe complications following influenza virus infection. As a consequence, WHO recommendations prioritize pregnant women over other risk groups for influenza vaccination. However, the risk associated with pregnancy has not been systematically quantified. PURPOSE: Systematic review and meta-analysis of observational studies that reported on pregnancy as a risk factor for severe outcomes from influenza virus infection...
December 23, 2016: Vaccine
https://www.readbyqxmd.com/read/28019110/severe-kaposi-sarcoma-in-an-urban-public-hospital
#6
Shirin Kasturia, Clifford Gunthel, Cheng Zheng, Minh Ly Nguyen
INTRODUCTION: The national incidence of epidemic Kaposi Sarcoma (KS) has decreased dramatically since the availability of combined antiretroviral therapy (cART). Despite national trends, we continue to see admissions for KS. Methods: Electronic medical records were queried to identify patients with HIV who were admitted with active KS between 2010 and 2013 and records were reviewed to determine patient characteristics and factors affecting survival. Data were collected from all hospital admissions until death or May 1, 2015...
December 26, 2016: AIDS Research and Human Retroviruses
https://www.readbyqxmd.com/read/28017813/association-between-state-medical-malpractice-environment-and-postoperative-outcomes-in-the-united-states
#7
Christina A Minami, Catherine R Sheils, Emily Pavey, Jeanette W Chung, Jonah J Stulberg, David D Odell, Anthony D Yang, David J Bentrem, Karl Y Bilimoria
BACKGROUND: The U.S. medical malpractice system assumes that the threat of liability should deter negligence but it is unclear whether malpractice environment impacts healthcare quality. We thus sought to explore the association between state malpractice environment and post-operative complication rates. STUDY DESIGN: This observational study included Medicare fee-for-service beneficiaries undergoing one of the following surgeries in 2010: colorectal, lung, esophageal, or pancreatic resection, total knee arthroplasty, craniotomy, gastric bypass, abdominal aortic aneurysm repair, coronary artery bypass grafting, or cystectomy...
December 22, 2016: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28013258/epidemiology-of-carbapenem-resistant-klebsiella-pneumoniae-in-a-network-of-long-term-acute-care-hospitals
#8
Jennifer H Han, Ellie J C Goldstein, Jacqueleen Wise, Warren B Bilker, Pam Tolomeo, Ebbing Lautenbach
BACKGROUND: The rapid emergence of carbapenem-resistant Klebsiella pneumoniae (CRKP) represents a major public health threat, including in the long-term acute care hospital (LTACH) setting. The objective of this study was to describe the epidemiologic characteristics of CRKP in a network of United States LTACHs. METHODS: An observational study was performed among 64 LTACHs from January 2014 to March 2015. Clinical cultures were included, with the first CRKP isolate recovered from each patient per study quarter evaluated...
December 24, 2016: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28007308/a-point-prevalence-survey-of-healthcare-associated-infection-in-fifty-two-chinese-hospitals
#9
Y Chen, J Y Zhao, X Shan, X L Han, S G Tian, F Y Chen, X T Su, Y S Sun, L Y Huang, L Han
BACKGROUND: Healthcare-associated infection (HCAI) represents a major problem for patient safety worldwide. AIM: To demonstrate the prevalence, causative agents, and risk factors for HCAI in Chinese hospitals. METHODS: A one-day point-prevalence survey was conducted in 52 Chinese hospitals between October 2014 and March 2015. A web-based software system was developed for data entry and management. FINDINGS: Among 53,939 patients surveyed, the prevalence of patients with at least one HCAI was 3...
January 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28005691/clinical-and-bacterial-risk-factors-for-mortality-in-children-with-carbapenem-resistant-enterobacteriaceae-bloodstream-infections-in-india
#10
Laura E B Nabarro, Chaitra Shankar, Akila Prakasam, Georgekutty Mathew, Visali Jeyaseelan, Balaji Veeraraghavan, Valsan P Verghese
BACKGROUND: Carbapenem-resistant Enterobacteriaceae (CRE) are an increasing cause of nosocomial infection in hospitalized children worldwide. Few studies have investigated risk factors for mortality in children with CRE bloodstream infection (BSI). Data are particularly scarce in areas where NDM and OXA carbapenemases predominate. Here, we investigate mortality rates, clinical and microbiologic risk factors for mortality in 50 pediatric patients with CRBSI in India. METHOD: Children younger than 17 years old with meropenem-resistant Klebsiella pneumoniae or Escherichia coli isolated from blood culture in 2014 and 2015 were identified from laboratory records...
December 21, 2016: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28002979/antibiotic-stewardship-in-community-acquired-pneumonia
#11
Diego Viasus, Milly Vecino-Moreno, Juan M De La Hoz, Jordi Carratalà
Community-acquired pneumonia (CAP) continues to be associated with significant mortality and morbidity. As with other infectious diseases, in recent years there has been a marked increase in resistance to the antibiotics commonly used against the pathogens that cause CAP. Antimicrobial stewardship denotes coordinated interventions to improve and measure the appropriate use of antibiotics by encouraging the selection of optimal drug regimens. Areas covered: Several elements can be applied to antibiotic stewardship strategies for CAP in order to maintain or improve patient outcomes...
December 27, 2016: Expert Review of Anti-infective Therapy
https://www.readbyqxmd.com/read/27999875/outcomes-of-percutaneous-nephrolithotomy-in-spinal-cord-injury-patients-as-compared-to-a-matched-cohort
#12
Kristin G Baldea, Robert H Blackwell, Srikanth Vedachalam, Anai N Kothari, Paul C Kuo, Gopal N Gupta, Thomas M T Turk
Spinal cord injury patients are at increased risk of developing nephrolithiasis and may require percutaneous nephrolithotomy for treatment of large stone burdens. Our objective was to compare outcomes of PCNL in SCI patients as compared to a matched cohort of non-SCI patients. Data from the Healthcare Cost and Utilization Project State Inpatient Database for Florida and California were used to identify patients by ICD-9 codes who underwent PCNL between 2007 and 2011. SCI was identified by having a paralysis diagnosis on the chronic comorbidity indicator...
December 20, 2016: Urolithiasis
https://www.readbyqxmd.com/read/27999665/estimating-the-morbidity-and-mortality-associated-with-infections-due-to-multidrug-resistant-bacteria-mdrb-france-2012
#13
M Colomb-Cotinat, J Lacoste, C Brun-Buisson, V Jarlier, B Coignard, S Vaux
BACKGROUND: A study based on 2007 data estimated that 386,000 infections due to multidrug-resistant bacteria (MDRB) occurred in Europe that year and 25,000 patients died from these infections. Our objective was to estimate the morbidity and mortality associated with these infections in France. METHODS: The MDRB considered were methicillin-resistant Staphylococcus aureus (MRSA), glycopeptide-resistant enterococci, third-generation cephalosporin-resistant (3GC-R) Escherichia coli and Klebsiella pneumoniae, carbapenem-resistant Klebsiella pneumoniae, Acinetobacter spp...
2016: Antimicrobial Resistance and Infection Control
https://www.readbyqxmd.com/read/27999052/trimethoprim-sulfamethoxazole-versus-vancomycin-in-the-treatment-of-healthcare-ventilator-associated-mrsa-pneumonia-a-case-control-study
#14
Noa Eliakim-Raz, Moran Hellerman, Dafna Yahav, Jonathan Cohen, Ili Margalit, Sharon Fisher, Oren Zusman, Hila Shaked, Jihad Bishara
OBJECTIVES: Therapeutic options available to treat MRSA pneumonia are limited. Trimethoprim/sulfamethoxazole is an attractive treatment because of its bactericidal anti-MRSA activity, oral and parenteral formulations and good penetration to the lung tissue. We aimed to compare the efficacy and safety of trimethoprim/sulfamethoxazole with vancomycin in the treatment of healthcare/ventilator-associated MRSA pneumonia. METHODS: We carried out a retrospective case-control study of all consecutive hospitalized adult patients diagnosed with MRSA pneumonia at Beilinson Hospital during 2010-15 and treated with either vancomycin or trimethoprim/sulfamethoxazole...
December 20, 2016: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/27984449/operative-treatment-of-rib-fractures-in-flail-chest-injuries-a-meta-analysis-and-cost-effectiveness-analysis
#15
Eric Swart, Joseph Laratta, Gerard Slobogean, Samir Mehta
OBJECTIVES: Flail chest is a common injury sustained by patients who suffer from high energy blunt chest trauma, and results in severe respiratory compromise due to altered mechanics of respiration. There has been increased interest in operative fixation of these injuries with the intention of restoring the mechanical integrity of the chest wall, and several studies have shown that ventilation requirements and pulmonary complications may be decreased with operative intervention. The purpose of this study was to evaluate fixation of rib fractures in flail chest injuries using cost effectiveness analysis, supported by systematic review and meta-analysis...
November 16, 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27981921/emerging-trends-of-bloodstream-infections-a-six-year-study-at-a-paediatric-tertiary-care-hospital-in-kabul
#16
Tariq Mahmud Tariq, Esmatullah Rasool
OBJECTIVE: To determine the frequency of pathogens causing bloodstream infections and evaluate their trends and antibiogram patterns among in-patients in a paediatric tertiary care centre. STUDY DESIGN: Descriptive study. PLACE AND DURATION OF STUDY: French Medical Institute for Mothers and Children (FMIC), Kabul, Afghanistan in two phases, from January 2010 to December 2015. METHODOLOGY: Results of blood cultures from suspected cases of sepsis admitted in the FMIC, from January 2010 to December 2012 (Period-1), and from January 2013 to December 2015 (Period-2) were completed...
November 2016: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/27965626/high-prevalence-of-gut-microbiota-colonization-with-broad-spectrum-cephalosporin-resistant-enterobacteriaceae-in-a-tunisian-intensive-care-unit
#17
Elaa Maamar, Sana Ferjani, Ali Jendoubi, Samia Hammami, Zaineb Hamzaoui, Laure Mayonnove-Coulange, Mabrouka Saidani, Aouatef Kammoun, Amel Rehaiem, Salma Ghedira, Mohamed Houissa, Ilhem Boutiba-Ben Boubaker, Amine Slim, Veronique Dubois
Healthcare-associated infections due to cefotaxime-resistant (CTX-R) Enterobacteriaceae have become a major public health threat, especially in intensive care units (ICUs). Often acquired nosocomially, CTX-R Enterobacteriaceae can be introduced initially by patients at admission. This study aimed to determine the prevalence and genetic characteristics of CTX-R Enterobacteriaceae-intestinal carriage in ICU patients, to evaluate the rate of acquisition of these organisms during hospitalization, and to explore some of the associated risk factors for both carriage and acquisition...
2016: Frontiers in Microbiology
https://www.readbyqxmd.com/read/27960211/the-modern-diagnostic-approach-to-community-acquired-pneumonia-in-adults
#18
James D Chalmers
Respiratory tract infections, the majority of which are community acquired, are among the leading causes of death worldwide and a leading indication for hospital admission. The burden of disease demonstrates a "U"-shaped distribution, primarily affecting young children as the immune system matures, and older adults as the process of immunosenescence and accumulation of comorbidities leads to increased susceptibility to infection. Diagnosis of community-acquired pneumonia (CAP) is traditionally based on demonstration of a new infiltrate on a chest radiograph in a patient presenting with an acute respiratory illness or sepsis...
December 2016: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/27960207/antibiotic-resistance-in-community-acquired-pneumonia-pathogens
#19
Richard G Wunderink, Yudong Yin
The overwhelming majority of cases of community-acquired pneumonia (CAP) can be treated with the standard antibiotic regimens of a macrolide and cephalosporin or a fluoroquinolone. Despite high rates, current levels of β-lactam resistance generally do not result in treatment failure for patients with CAP when appropriate agents and doses are used. Following the introduction of the pneumococcal conjugate vaccines, the incidence of invasive pneumococcal disease declined drastically, coinciding with a decrease in penicillin resistance...
December 2016: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/27960204/community-acquired-pneumonia-a-global-perspective
#20
Grant W Waterer
Community-acquired pneumonia (CAP) is a global disease responsible for a large proportion of deaths and having significant economic cost. As diagnostic tools have increased in sensitivity, our understanding of the etiology of CAP has begun to change with a significant increase in confirmed viral infections and the recognition that multiple pathogens are frequently present. Empiric therapy remains the standard of care and guidelines are mostly based on published data from the United States or Europe. Blindly applying guidelines without any consideration of local etiological differences can lead to a risk of under or overtreatment...
December 2016: Seminars in Respiratory and Critical Care Medicine
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