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https://www.readbyqxmd.com/read/29908198/in-hospital-delays-result-in-worse-patient-outcomes-and-higher-cost-after-cardiac-surgery
#1
Diane R M Somlo, Nelson P Repenning, Abeel A Mangi
BACKGROUND: Contemporary reimbursement systems allow hospitals to maintain profitability by offering procedural services. However, increasing procedural volume can be met with structural inefficiencies that in turn cause delays, worse patient outcomes, and increased cost. METHODS: A multidisciplinary team assessed operations and outcomes at the Heart and Vascular Center at Yale New Haven Hospital, a tertiary academic medical center. Data were analyzed retrospectively to assess delays in transferring patients between care environments, patient outcomes, and cost...
June 13, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29908046/sepsis-induced-acute-kidney-injury-a-disease-of-the-microcirculation
#2
Shuai Ma, Roger G Evans, Naoya Iguchi, Marianne Tare, Helena C Parkington, Rinaldo Bellomo, Clive N May, Yugeesh R Lankadeva
Acute kidney injury (AKI) is a common complication of sepsis and is significantly associated with mortality. Sepsis accounts for more than 50% of the cases of AKI, with a mortality rate of up to 40%. The pathogenesis of septic AKI is complex, but there is emerging evidence that, at least in the first 48 hours, the defects may be functional rather than structural in nature. For example, septic AKI is associated with an absence of histopathological changes, but with microvascular abnormalities and tubular stress...
June 16, 2018: Microcirculation: the Official Journal of the Microcirculatory Society, Inc
https://www.readbyqxmd.com/read/29907656/temporal-trends-in-the-outcomes-of-dialysis-patients-admitted-with-acute-ischemic-stroke
#3
Fahad Alqahtani, Chalak O Berzingi, Sami Aljohani, Mohamed Al Hajji, Anas Diab, Muhammad Alvi, Khaled Boobes, Mohamad Alkhouli
BACKGROUND: There is a paucity of contemporary data on the characteristics and outcomes of acute ischemic stroke (AIS) in patients on maintenance dialysis. METHODS AND RESULTS: We used the nationwide inpatient sample to examine contemporary trends in the incidence, management patterns, and outcomes of AIS in dialysis patients. A total of 930 010 patients were admitted with AIS between 2003 and 2014, of whom 13 642 (1.5%) were on dialysis. Overall, the incidence of AIS among dialysis patients decreased significantly ( P trend <0...
June 15, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29907086/potential-risk-factors-and-prevalence-of-helicobacter-pylori-infection-among-adult-patients-with-dyspepsia-symptoms-in-cameroon
#4
Laure Brigitte Kouitcheu Mabeku, Michelle Larissa Noundjeu Ngamga, Hubert Leundji
BACKGROUND: Helicobacter pylori is a Gram negative bacterium that colonizes the stomach of approximately two-thirds of the human population and it is involved in the pathogenesis of gastroduodenal diseases. This study sought to determine potential risk factors associated with seroprevalence of H. pylori among dyspepsia patients in Cameroon for a better management of the disease. METHODS: The study was carried out from August to December 2014 at Laquintinie Hospital and District Hospital of Bonassama in Douala metropolis...
June 15, 2018: BMC Infectious Diseases
https://www.readbyqxmd.com/read/29905060/therapeutic-options-to-manage-bleeding-in-a-dentist%C3%A2-s-office
#5
Claudio Rostetter, Tim Finkenstädt, Martin Rücker, Heinz-Theo Lübbers
This manuscript provides an overview of therapeutic options for the problem of bleeding in a dentist’s office. Bleeding after tooth extraction is a very common finding in dental medicine and persistent blood in the mouth is obviously uncomfortable and sometimes terrifying for the patient. Most bleedings can be stopped simply with compression, in some cases a homeostatic therapy is necessary. For local compression, a swab with tranexamic acid is useful. If local compression is not sufficient, sutures are often an option...
June 18, 2018: Swiss Dental Journal
https://www.readbyqxmd.com/read/29904613/prevalence-of-musculoskeletal-pain-in-association-with-serum-25-hydroxyvitamin-d-concentrations-in-patients-with-type-2-diabetes-mellitus
#6
Mohammad J Alkhatatbeh, Khalid K Abdul-Razzak, Lubna Q Khasawneh, Nesreen A Saadeh
The aim of the present study was to investigate the prevalence of musculoskeletal pain in patients with type 2 diabetes mellitus (T2DM) in association with 25-hydroxyvitamin D levels, anxiety, depression and neuropathy. A cross-sectional study was conducted involving a total of 124 T2DM patients. Musculoskeletal pain was determined by self-reporting of painful body sites. Pain intensity was assessed using a scale of 0-10. Anxiety and depression were assessed using the Hospital Anxiety and Depression Scale. Neuropathy was assessed using the PainDETECT questionnaire...
June 2018: Biomedical Reports
https://www.readbyqxmd.com/read/29904449/red-cell-distribution-width-and-mortality-in-patients-with-acute-coronary-syndrome-a-meta-analysis-on-prognosis
#7
Lauro L Abrahan, John Daniel A Ramos, Elleen L Cunanan, Marc Denver A Tiongson, Felix Eduardo R Punzalan
Background: Red cell distribution width (RDW), a routine component of the complete blood count (CBC), measures variation in the size of circulating erythrocytes. It has been associated with several clinical outcomes in cardiovascular disease. We sought to strengthen the association between RDW and mortality in patients admitted for acute coronary syndrome (ACS) by pooling together data from available studies. Methods: Studies that fulfilled the following were identified for analysis: 1) observational; 2) included patients admitted for ACS; 3) reported data on all-cause or cardiovascular (CV) mortality in association with a low or high RDW; and 4) used logistic regression analysis to control for confounders...
June 2018: Cardiology Research
https://www.readbyqxmd.com/read/29903781/how-good-are-gps-at-adhering-to-a-pragmatic-trial-protocol-in-primary-care-results-from-the-addition-cambridge-cluster-randomised-pragmatic-trial
#8
Michael Laxy, Edward C F Wilson, Clare E Boothby, Simon J Griffin
OBJECTIVE: To assess the fidelity of general practitioners' (GPs) adherence to a long-term pragmatic trial protocol. DESIGN: Retrospective analyses of electronic primary care records of participants in the pragmatic cluster-randomised ADDITION (Anglo-Danish-Dutch Study of Intensive Treatment In People with Screen Detected Diabetes in Primary Care)-Cambridge trial, comparing intensive multifactorial treatment (IT) versus routine care (RC). Data were collected from the date of diagnosis until December 2010...
June 14, 2018: BMJ Open
https://www.readbyqxmd.com/read/29903693/mechanical-circulatory-support-in-patients-with-cardiogenic-shock-in-intensive-care-units-a-position-paper-of-the-unit%C3%A3-de-soins-intensifs-de-cardiologie-group-of-the-french-society-of-cardiology-endorsed-by-the-groupe-ath%C3%A3-rome-et-cardiologie-interventionnelle
#9
REVIEW
Laurent Bonello, Clement Delmas, Guillaume Schurtz, Guillaume Leurent, Eric Bonnefoy, Nadia Aissaoui, Patrick Henry
Cardiogenic shock (CS) is a major challenge in contemporary cardiology. Despite a better understanding of the pathophysiology of CS, its management has only improved slightly. The prevalence of CS has remained stable over the past decade, but its outcome has seen few improvements, with the 1-month mortality rate still in the range of 40-60%. Inotropes and vasopressors are the first-line therapies for CS, but they are associated with significant hazards, and have well-known deleterious effects. Furthermore, a significant number of patients develop refractory CS with haemodynamic instability, causing critical organ hypoperfusion and/or pulmonary congestion, despite increasing doses of catecholamines...
June 11, 2018: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/29903680/-non-infective-endocarditis
#10
A Le Bot, P Jégo, E Donal, E Flécher, M Revest, P Tattevin
Non-infective endocarditis, also referred to as non-bacterial thrombotic endocarditis, represent a wide range of rare pathologies, often severe. This review gathered the data available in the literature, to decipher the major information collected on the pathophysiology, the diagnosis and the treatment of these heterogeneous diseases, often misdiagnosed. Characteristics of non-infective endocarditis are similar to infective endocarditis in terms of valvular lesions (mostly left-sided, with regurgitations and vegetations), and their complications (embolism)...
June 11, 2018: La Revue de Médecine Interne
https://www.readbyqxmd.com/read/29903481/performance-of-stochastic-targeted-blood-glucose-control-protocol-by-virtual-trials-in-the-malaysian-intensive-care-unit
#11
Ummu K Jamaludin, Fatanah M Suhaimi, Normy Norfiza Abdul Razak, Azrina Md Ralib, Mohd Basri Mat Nor, Christopher G Pretty, Luqman Humaidi
BACKGROUND AND OBJECTIVE: Blood glucose variability is common in healthcare and it is not related or influenced by diabetes mellitus. To minimise the risk of high blood glucose in critically ill patients, Stochastic Targeted Blood Glucose Control Protocol is used in intensive care unit at hospitals worldwide. Thus, this study focuses on the performance of stochastic modelling protocol in comparison to the current blood glucose management protocols in the Malaysian intensive care unit...
August 2018: Computer Methods and Programs in Biomedicine
https://www.readbyqxmd.com/read/29902802/relationship-between-paronychia-and-drug-concentrations-of-epidermal-growth-factor-receptor-tyrosine-kinase-inhibitors
#12
Katsuhiro Masago, Kei Irie, Shiro Fujita, Fumiko Imamichi, Yutaka Okada, Nobuyuki Katakami, Shoji Fukushima, Yasushi Yatabe
PURPOSE: The purpose of the study was to evaluate the site of paronychia in patients with non-small cell lung cancer harboring an epidermal growth factor receptor (EGFR) gene activating mutation who were treated with EGFR tyrosine kinase inhibitors (EGFR TKIs). PATIENTS AND METHODS: The study included 55 patients with non-small-cell lung cancer who were treated with an EGFR TKIs. Resulting all toxicities were graded using the Common Terminology Criteria for Adverse Events version 4...
June 14, 2018: Oncology
https://www.readbyqxmd.com/read/29901631/neurological-melioidosis-burkholderia-pseudomallei-in-a-chronic-psychotic-patient-treated-with-antipsychotics-a-case-report
#13
Guan-Bo Chen, Sheng-Hui Tuan, Li-Hsiang Chen, Wen-Sou Lin
RATIONALE: Neurological melioidosis, an extremely rare condition, is caused by the gram-negative bacterium Burkholderia pseudomallei. If treatment is suboptimal or delayed, this infection can produce diverse clinical symptoms and result in death. PATIENT CONCERNS: A healthy 65-year-old female who had been treated with antipsychotic medication for neurotic depression for over 2 years presented with acute-onset fever, headache, lead-pipe rigidity of all limbs, and delirium...
June 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29901544/limits-of-intravascular-contrast-extravasation-on-computed-tomography-scan-to-define-the-need-for-pelvic-angioembolization-in-pelvic-blunt-trauma-a-specific-assessment-on-the-risk-of-false-positives
#14
Séverin Ramin, Margaux Hermida, Ingrid Millet, Thibault Murez, Valérie Monnin, Mazen Hamoui, Xavier Capdevila, Jonathan Charbit
BACKROUND: The objective was to assess the predictive performance of different intravascular contrast extravasation (ICE) characteristics for need for pelvic transarterial embolization (TAE) to determine the risk factors of false-positives. METHODS: A retrospective study was performed in our trauma center between 2010 and 2015. All severe trauma patients with pelvic fracture were included. Pelvic ICE characteristics on computed tomography (CT) scan were studied: arterial (aSICE), portal surface (pSICE), and extension (exSICE) anatomic relationships...
June 12, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29901543/early-arterial-access-for-reboa-is-related-to-survival-outcome-in-trauma
#15
Yosuke Matsumura, Junichi Matsumoto, Hiroshi Kondo, Koji Idoguchi, Tokiya Ishida, Yohei Okada, Yuri Kon, Kazuyuki Oka, Kenichiro Ishida, Yukitoshi Toyoda, Tomohiro Funabiki
INTRODUCTION: Resuscitative endovascular balloon occlusion of the aorta (REBOA) has been employed in refractory hemorrhagic shock patients. Since the optimal timing of arterial access remains unclear, we evaluated the pre-occlusion status of patients and elapsed time from the arrival to the hospital are associated with the survival outcomes in the REBOA patients. METHODS: From August 2011-December 2016, The DIRECT-IABO investigators registered refractory hemorrhagic shock patients undergoing REBOA from 23 hospitals in Japan...
June 12, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29901292/-subcapsular-renal-hematomas-after-ureteroscopic-lithotripsy
#16
B G Guliev, B K Komyakov, A Yu Zaikin
INTRODUCTION: Renal hematomas (RH) are a rare complication of retrograde endoscopic lithotripsy (REL). This study aimed to investigate the incidence and causes of RH after REL in patients with ureteral stones of different locations. MATERIALS AND METHODS: From 2001 to 2016, 1214 REL were performed at the Urology Clinic of the Mechnikov NWSMU. The analyzes of patients who had RH after REL included the following parameters: age, gender, history of upper urinary tract (UUT) surgery and concomitant diseases (diabetes mellitus, hypertension), the baseline kidney function, the stone characteristics and the degree of hydronephrosis observed in the postoperative period, results of laboratory tests, ultrasound and spiral computed tomography (SCT) of the kidneys...
May 2018: Urologii︠a︡
https://www.readbyqxmd.com/read/29900001/transfusion-management-of-incident-dialysis-patients-in-canada-a-prospective-observational-study
#17
Aminu K Bello, Christine M Ribic, Serge H Cournoyer, Mercedeh Kiaii, Martine LeBlanc, Melanie Poulin-Costello, David N Churchill, Norman Muirhead
Background: Several studies have demonstrated harm associated with using erythropoiesis-stimulating agents (ESA) to achieve higher hemoglobin (Hb) levels. Subsequently, more conservative use of ESAs has changed anemia therapy in patients with chronic renal failure. Objective: The objectives were to identify transfusion rates in hemodialysis (HD) patients during the first year of therapy, to identify factors associated with the probability of transfusion, describe reasons for the transfusions, and identify the Hb values associated with each transfusion...
2018: Canadian Journal of Kidney Health and Disease
https://www.readbyqxmd.com/read/29899761/precision-diagnostics-of-ewing-s-sarcoma-by-liquid-biopsy-circulating-ews-fli1-fusion-transcripts
#18
Matteo Allegretti, Beatrice Casini, Chiara Mandoj, Stefania Benini, Laurent Alberti, Mariangela Novello, Elisa Melucci, Laura Conti, Renato Covello, Edoardo Pescarmona, Giuseppe Maria Milano, Alessio Annovazzi, Vincenzo Anelli, Virginia Ferraresi, Roberto Biagini, Patrizio Giacomini
Background: Limited information is available on the applicative value of liquid biopsy (LB) in rare tumors, including Ewing's sarcoma (ES). The accepted precision diagnostics standards would greatly benefit from a non-invasive LB test monitoring pathognomonic gene rearrangements in the bloodstream. Methods: Tissue and blood samples were collected from six and four ES patients, respectively. Plasma was cleared by two successive rounds of centrifugation and stored frozen until RNA extraction by the QIAmp CNA kit...
2018: Therapeutic Advances in Medical Oncology
https://www.readbyqxmd.com/read/29899463/the-cami-score-a-novel-tool-derived-from-cami-registry-to-predict-in-hospital-death-among-acute-myocardial-infarction-patients
#19
Chenxi Song, Rui Fu, Kefei Dou, Jingang Yang, Haiyan Xu, Xiaojin Gao, Wei Li, Guofeng Gao, Zhiyong Zhao, Jia Liu, Yuejin Yang
Risk stratification of patients with acute myocardial infarction (AMI) is of clinical significance. Although there are many existing risk scores, periodic update is required to reflect contemporary patient profile and management. The present study aims to develop a risk model to predict in-hospital death among contemporary AMI patients as soon as possible after admission. We included 23417 AMI patients from China Acute Myocardial Infarction (CAMI) registry from January 2013 to September 2014 and extracted relevant data...
June 13, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29899374/role-and-prognostic-value-of-individual-ambulatory-blood-pressure-components-in-chronic-kidney-disease
#20
Fabio Angeli, Giorgio Gentile, Monica Trapasso, Paolo Verdecchia, Gianpaolo Reboldi
Hypertension is a key risk factor for chronic kidney disease (CKD), but can also be a detrimental consequence of established CKD. Unsurprisingly, the majority of subjects with abnormal creatinine in the general population are also hypertensive, with a huge toll on national health care systems worldwide due to a staggering increase in the risk of cardiovascular complications and end-stage renal disease requiring renal replacement therapy. In this setting, a comprehensive and careful assessment of the whole 24-h blood pressure (BP) profile could be of paramount importance in ensuring a timely diagnosis of hypertension and an optimal therapeutic control...
June 13, 2018: Journal of Human Hypertension
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