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https://www.readbyqxmd.com/read/28806373/patient-aligned-care-team-engagement-to-connect-veterans-experiencing-homelessness-with-appropriate-health-care
#1
Adi V Gundlapalli, Andrew Redd, Daniel Bolton, Megan E Vanneman, Marjorie E Carter, Erin Johnson, Matthew H Samore, Jamison D Fargo, Thomas P O'Toole
BACKGROUND: Veterans experiencing homelessness frequently use emergency and urgent care (ED). OBJECTIVE: To examine the effect of a Patient-aligned Care Team (PACT) model tailored to the unique needs of Veterans experiencing homelessness (H-PACT) on frequency and type of ED visits in Veterans Health Administration (VHA) medical facilities. RESEARCH DESIGN: During a 12-month period, ED visits for 3981 homeless Veterans enrolled in (1) H-PACT at 20 VHA medical centers (enrolled) were compared with those of (2) 24,363 homeless Veterans not enrolled in H-PACT at the same sites (nonenrolled), and (3) 23,542 homeless Veterans at 12 non-H-PACT sites (usual care) using a difference-in-differences approach...
September 2017: Medical Care
https://www.readbyqxmd.com/read/28804875/prehospital-pathways-of-occipital-stroke-patients-with-mainly-visual-symptoms
#2
S Räty, K Silvennoinen, T Tatlisumak
OBJECTIVES: Occipital ischemic strokes typically cause homonymous visual field defects, for which means of rehabilitation are limited. Intravenous thrombolysis is increasingly and successfully used for their acute treatment. However, recognition of strokes presenting with mainly visual field defects is challenging for both patients and healthcare professionals. We studied prehospital pathways of occipital stroke patients with mainly visual symptoms to define obstacles in their early recognition...
August 13, 2017: Acta Neurologica Scandinavica
https://www.readbyqxmd.com/read/28801791/effectiveness-of-healthcare-coordination-in-patients-with-chronic-respiratory-diseases
#3
Donata Kurpas, Katarzyna Szwamel, Dorota Lenarcik, Marika Guzek, Artur Prusaczyk, Paweł Żuk, Jolanta Michalowska, Agnieszka Grzeda, Bożena Mroczek
Coordination of healthcare effectively prevents exacerbations and reduces the number of hospitalizations, emergency visits, and the mortality rate in patients with chronic respiratory diseases. The purpose of this study was to determine clinical effectiveness of ambulatory healthcare coordination in chronic respiratory patients and its effect on the level of healthcare services as an indicator of direct medical costs. We conducted a retrospective health record survey, using an online database of 550 patients with chronic respiratory diseases...
August 12, 2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/28801131/health-care-demand-elasticities-by-type-of-service
#4
Randall P Ellis, Bruno Martins, Wenjia Zhu
We estimate within-year price elasticities of demand for detailed health care services using an instrumental variable strategy, in which individual monthly cost shares are instrumented by employer-year-plan-month average cost shares. A specification using backward myopic prices gives more plausible and stable results than using forward myopic prices. Using 171 million person-months spanning 73 employers from 2008 to 2014, we estimate that the overall demand elasticity by backward myopic consumers is -0.44, with higher elasticities of demand for pharmaceuticals (-0...
July 29, 2017: Journal of Health Economics
https://www.readbyqxmd.com/read/28800834/benefits-and-harms-of-sacubitril-in-adults-with-heart-failure-and-reduced-left-ventricular-ejection-fraction
#5
REVIEW
Wilbert S Aronow, Tatyana A Shamliyan
The quality of evidence regarding patient-centered outcomes in adults with heart failure (HF) after sacubitril combined with valsartan has not been systematically appraised. We searched 4 databases in February 2017 and graded the quality of evidence according to the Grading of Recommendations Assessment, Development and Evaluation working group approach. We reviewed 1 meta-analysis and multiple publications of 2 randomized controlled trials (RCT) and 1 unpublished RCT. In adults with HF and reduced ejection fraction, low-quality evidence from 1 RCT of 8,432 patients suggests that sacubitril combined with valsartan reduces all-cause (number needed to treat [NNT] to prevent 1 event [NNTp] = 35) and cardiovascular mortality (NNTp = 32), hospitalization (NNTp = 11), emergency visits (NNTp = 69), and serious adverse effects, leading to treatment discontinuation (NNTp = 63) and improves quality of life when compared with enalapril...
July 14, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28792137/healthcare-costs-for-acute-hospitalized-and-chronic-heart-failure-in-south-korea-a-multi-center-retrospective-cohort-study
#6
Hyemin Ku, Wook Jin Chung, Hae Young Lee, Byung Soo Yoo, Jin Oh Choi, Seoung Woo Han, Jieun Jang, Eui Kyung Lee, Seok Min Kang
PURPOSE: Although heart failure (HF) is recognized as a leading contributor to healthcare costs and a significant economic burden worldwide, studies of HF-related costs in South Korea are limited. This study aimed to estimate HF-related costs per Korean patient per year and per visit. MATERIALS AND METHODS: This retrospective cohort study analyzed data obtained from six hospitals in South Korea. Patients with HF who experienced ≥one hospitalization or ≥two outpatient visits between January 1, 2013 and December 31, 2013 were included...
September 2017: Yonsei Medical Journal
https://www.readbyqxmd.com/read/28782243/the-la-and-related-rna-binding-proteins-larps-structures-functions-and-evolving-perspectives
#7
REVIEW
Richard J Maraia, Sandy Mattijssen, Isabel Cruz-Gallardo, Maria R Conte
La was first identified as a polypeptide component of ribonucleic protein complexes targeted by antibodies in autoimmune patients and is now known to be a eukaryote cell-ubiquitous protein. Structure and function studies have shown that La binds to a common terminal motif, UUU-3'-OH, of nascent RNA polymerase III (RNAP III) transcripts and protects them from exonucleolytic decay. For precursor-tRNAs, the most diverse and abundant of these transcripts, La also functions as an RNA chaperone that helps to prevent their misfolding...
August 7, 2017: Wiley Interdisciplinary Reviews. RNA
https://www.readbyqxmd.com/read/28779828/clinical-and-community-strategies-to-prevent-falls-and-fall-related-injuries-among-community-dwelling-older-adults
#8
REVIEW
Ruth E Taylor-Piliae, Rachel Peterson, Martha Jane Mohler
Falls in older adults are the result of several risk factors across biological and behavioral aspects of the person, along with environmental factors. Falls can trigger a downward spiral in activities of daily living, independence, and overall health outcomes. Clinicians who care for older adults should screen them annually for falls. A multifactorial comprehensive clinical fall assessment coupled with tailored interventions can result in a dramatic public health impact, while improving older adult quality of life...
September 2017: Nursing Clinics of North America
https://www.readbyqxmd.com/read/28777512/carbon-monoxide-poisoning-in-utah-1996-2013
#9
Lindell K Weaver, Kayla Deru, Susan Churchill, Joshua Legler, Greg Snow, Todd Grey
INTRODUCTION: The true incidence of carbon monoxide (CO) poisoning is not clearly known, but a description of possible trends could aid in prevention. METHODS: Investigators searched Utah state databases for emergency department (ED) visits and admissions for CO poisoning and medical examiner records for CO-related fatalities. RESULTS: From 1996-2013, 7,590 individuals were diagnosed with CO poisoning: 6,469 were treated/ released from EDs; 596 were admitted; 525 died...
November 2016: Undersea & Hyperbaric Medicine: Journal of the Undersea and Hyperbaric Medical Society, Inc
https://www.readbyqxmd.com/read/28777450/self-management-interventions-including-action-plans-for-exacerbations-versus-usual-care-in-patients-with-chronic-obstructive-pulmonary-disease
#10
REVIEW
Anke Lenferink, Marjolein Brusse-Keizer, Paul Dlpm van der Valk, Peter A Frith, Marlies Zwerink, Evelyn M Monninkhof, Job van der Palen, Tanja W Effing
BACKGROUND: Chronic Obstructive Pulmonary Disease (COPD) self-management interventions should be structured but personalised and often multi-component, with goals of motivating, engaging and supporting the patients to positively adapt their behaviour(s) and develop skills to better manage disease. Exacerbation action plans are considered to be a key component of COPD self-management interventions. Studies assessing these interventions show contradictory results. In this Cochrane Review, we compared the effectiveness of COPD self-management interventions that include action plans for acute exacerbations of COPD (AECOPD) with usual care...
August 4, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28777267/mistaken-identity-asthma-and-croup-in-a-previously-healthy-9-year-old-male
#11
Sylvia Owusu-Ansah, Oluwakemi Badaki-Makun, Thuy L Ngo
Cough is one of the most common presenting complaints encountered in primary care settings and the emergency department. In 2010, the Centers for Disease Control and Prevention reported approximately 31 million visits to ambulatory care centers for cough, making cough the most frequent presenting complaint in ambulatory visits (2010 National Ambulatory Medical Care Survey). Significant causes of cough can often be overlooked because it is a common symptom of a myriad of pathologies. We report the case of an otherwise healthy 9-year-old male who presented with worsening cough over a month and a half, subsequently noted to have a mediastinal mass, and diagnosed with lymphoma...
August 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28774550/association-between-burn-injury-and-mental-illness-among-burn-survivors-a-population-based-self-matched-longitudinal-cohort-study
#12
Stephanie A Mason, Avery B Nathens, James P Byrne, Janet Ellis, Robert A Fowler, Alejandro Gonzalez, Paul J Karanicolas, Rahim Moineddin, Marc G Jeschke
BACKGROUND: Mental health disorders are prevalent before and after burn injury. However, the impact of burn injury on risk of subsequent mental health disorders is unknown. STUDY DESIGN: We conducted a population-based, self-matched longitudinal cohort study using administrative data in Ontario, Canada between 2003 and 2011. All adults who survived to discharge following major burn injury were included, and all mental health-related emergency department visits were identified...
June 28, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28769893/imported-zika-virus-in-a-european-city-how-to-prevent-local-transmission
#13
Joan-Pau Millet, Tomàs Montalvo, Ruben Bueno-Marí, Arancha Romero-Tamarit, Albert Prats-Uribe, Lidia Fernández, Esteve Camprubí, Lucía Del Baño, Victor Peracho, Jordi Figuerola, Elena Sulleiro, Miguel J Martínez, Joan A Caylà
Background: On February 1st 2016 the WHO declared the Zika Virus (ZIKV) infection a worldwide public health emergency because of its rapid expansion and severe complications, such as Guillain-Barré Syndrome or microcephaly in newborn. The huge amount of people traveling to endemic areas and the presence of Aedes albopictus in Barcelona increase the risk of autochtonous transmission. The objective of this study was to describe the first ZIKV cases diagnosed in our city and to analyze the surveillance, prevention, and control measures implemented to avoid autochthonous transmission...
2017: Frontiers in Microbiology
https://www.readbyqxmd.com/read/28760788/childhood-hospitalisation-and-related-deaths-in-hanoi-vietnam-a-tertiary-hospital-database-analysis-from-2007-to-2014
#14
Nhung T T Nguyen, Tran Minh Dien, Christian Schindler, Nguyen T B Lien, Nicole Probst-Hensch, Vu T H Lan, Nino Künzli, Laura Perez
OBJECTIVE: To describe hospital admission and emergency visit rates and potential risk factors of prolonged hospitalisation and death among children in Hanoi. STUDY DESIGN: A retrospective study reviewed 212 216 hospitalisation records of children (aged 0-17) who attended the Vietnam National Children's Hospital in Hanoi between 2007 and 2014. Four indicators were analysed and reported: (1) rate of emergency hospital visits, (2) rate of hospitalisation, (3) length of hospital stay and (4) number of deaths...
July 31, 2017: BMJ Open
https://www.readbyqxmd.com/read/28756081/temporal-trends-in-epinephrine-dispensing-and-allergy-immunology-follow-up-among-emergency-department-anaphylaxis-patients-in-the-united-states-2005-2014
#15
Megan S Motosue, M Fernanda Bellolio, Holly K Van Houten, Nilay D Shah, Venkatesh R Bellamkonda, David M Nestler, Ronna L Campbell
BACKGROUND: Anaphylaxis is a potentially life-threatening allergic reaction; measures including prescription of an epinephrine autoinjector (EAI) and allergy/immunology (A/I) follow-up may prevent future morbidity. OBJECTIVE: The objective of this study was to evaluate trends in outpatient management of anaphylaxis by studying EAI dispensing and A/I follow-up among patients seen in the emergency department (ED) for anaphylaxis from 2005 through 2014. METHODS: We analyzed administrative claims data from the OptumLabs Data Warehouse database using an expanded International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis code algorithm...
July 26, 2017: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/28746159/percutaneous-endoscopic-gastrostomy-confirming-the-clinical-benefits-far-beyond-anthropometry
#16
Gonçalves T Cúrdia, Carla Marinho, Joana Magalhães, Mara Barbosa, Sara Monteiro, Francisca Dias de Castro, Pedro Boal Carvalho, Bruno Rosa, Lília Figueiredo, José Cotter
OBJECTIVES: The real benefit of gastrostomy is still a matter of debate. We aimed to prospectively evaluate the global impact of percutaneous endoscopic gastrostomy (PEG) in patients followed at a specialized multidisciplinary clinic, namely, the impact on the need for healthcare resources, anthropometric measures, pressure ulcers prevention and healing, and nutritional and hydration status. PATIENTS AND METHODS: From the 201 patients who underwent PEG between May 2011 and September 2014, 60 were included in a prospective study...
September 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28742675/committee-opinion-no-710-counseling-adolescents-about-contraception
#17
(no author information available yet)
Modern contraceptives are very effective when used correctly and, thus, effective counseling regarding contraceptive options and provision of resources to increase access are key components of adolescent health care. Regardless of a patient's age or previous sexual activity, the obstetrician-gynecologist routinely should address her contraceptive needs, expectations, and concerns. Obstetrician-gynecologists should be aware of and be prepared to address the most common misperceptions about contraceptive methods in a way that is age appropriate and compatible with the patient's health literacy...
August 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28742669/committee-opinion-no-710-summary-counseling-adolescents-about-contraception
#18
(no author information available yet)
Modern contraceptives are very effective when used correctly and, thus, effective counseling regarding contraceptive options and provision of resources to increase access are key components of adolescent health care. Regardless of a patient's age or previous sexual activity, the obstetrician-gynecologist routinely should address her contraceptive needs, expectations, and concerns. Obstetrician-gynecologists should be aware of and be prepared to address the most common misperceptions about contraceptive methods in a way that is age appropriate and compatible with the patient's health literacy...
August 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28738953/morbidity-associated-with-diverting-loop-ileostomies-weighing-diversion-in-rectosigmoid-resection
#19
Nathan Belkin, Liliana G Bordeianou, Paul C Shellito, Alexander T Hawkins
Anterior resection with primary anastomosis is the procedure of choice for patients with rectosigmoid cancers with good sphincter function. Surgeons may perform an associated diverting loop ileostomy (DLI) to minimize the likelihood and/or the severity of an anastomotic leak. To examine the morbidity of DLIs, we performed a review of a prospectively maintained database. Participants included all patients at the Massachusetts General Hospital who underwent anterior resection from January 2013 to July 2015 for rectosigmoid cancers and who subsequently underwent adjuvant chemotherapy...
July 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28738911/sentinel-visits-in-emergency-department-patients-with-diabetes-mellitus-as-a-warning-sign-for-hyperglycemic-emergencies
#20
Justin W Yan, Katherine M Gushulak, Melanie P Columbus, Alexandra L Hamelin, George A Wells, Ian G Stiell
OBJECTIVES: Patients with poorly controlled diabetes mellitus may have a sentinel emergency department (ED) visit for a precipitating condition prior to presenting for a hyperglycemic emergency, such as diabetic ketoacidosis (DKA) or hyperosmolar hyperglycemic state (HHS). This study's objective was to describe the epidemiology and outcomes of patients with a sentinel ED visit prior to their hyperglycemic emergency visit. METHODS: This was a 1-year health records review of patients≥18 years old presenting to one of four tertiary care EDs with a discharge diagnosis of hyperglycemia, DKA, or HHS...
July 25, 2017: CJEM
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