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https://www.readbyqxmd.com/read/28804011/functional-outcomes-subsequent-healthcare-utilization-and-mortality-of-stroke-postacute-care-patients-in-taiwan-a-nationwide-propensity-score-matched-study
#1
Li-Ning Peng, Wan-Hsuan Lu, Chih-Kuang Liang, Ming-Yueh Chou, Chih-Ping Chung, Shu-Ling Tsai, Zhi-Jun Chen, Fei-Yuan Hsiao, Liang-Kung Chen
OBJECTIVE: To evaluate the benefits of the national stroke postacute care (PAC) program on clinical outcomes and subsequent healthcare utilization. DESIGN: Propensity score-matched case-control study using the National Health Insurance data. PARTICIPANTS: A total of 1480 stroke cases receiving PAC services and 3159 matched controls with similar stroke severity but without PAC services. MEASUREMENTS: Demographic characteristics, functional outcomes (modified Rankin Scale, Barthel Index, Lawton-Brody Instrumental Activities of Daily Living, Functional Oral Intake Scale, Mini-Nutritional Assessment, Berg Balance Test, Usual Gait Speed Test, 6-Minute Walk Test, Fugl-Meyer Assessment (modified sensation and motor), Mini-Mental State Examination, Motor Activity Log, and the Concise Chinese Aphasia Test), subsequent healthcare utilization (90-day stroke re-admission and emergency department visits), and 90-day mortality...
August 10, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28800938/using-hospital-use-trends-to-improve-transitional-care
#2
Joe Feinglass, Celeste A Mallama, Angela Rogers, Caroline Teter, Courtney Hurt, Christine Schaeffer
BACKGROUND: This study evaluates the Northwestern Medicine Group Transitional Care clinic (NMG-TC), which transitions patients from an urban hospital to primary care at partner community clinics. We evaluate change over the 55 month study period in emergency department, observation or inpatient use within 90 days of an initial NMG-TC visit. METHODS: Electronic health records were used to determine patient demographic, insurance and clinical characteristics, including inflation-adjusted total hospital charges in the 90 days prior and the 90 days after an initial NMG-TC visit...
August 8, 2017: Healthcare
https://www.readbyqxmd.com/read/28800178/outcomes-of-catheter-ablation-of-ventricular-tachycardia-with-mechanical-hemodynamic-support-an-analysis-of-the-medicare-database
#3
Arash Aryana, André d'Avila, Christina L Cool, Marc A Miller, Fermin C Garcia, Gregory E Supple, Srinivas R Dukkipati, Dhanunjaya Lakkireddy, T Jared Bunch, Mark R Bowers, Padraig Gearoid O'Neill, Vivek Y Reddy, Francis E Marchlinski
INTRODUCTION: There is a paucity of data in favor of mechanical support during catheter ablation of ventricular tachycardia (VT). This study investigated the outcomes of VT ablation associated with mechanical support using percutaneous ventricular assist device (PVAD) versus intra-aortic balloon pump (IABP). METHODS AND RESULTS: We retrospectively examined the outcomes of patients who underwent VT ablation associated with PVAD versus IABP from 2010-2013, captured by the Medicare Inpatient Standard Analytic File database...
August 11, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28797589/association-between-frailty-and-cognitive-impairment-cross-sectional-data-from-toulouse-frailty-day-hospital
#4
Bertrand Fougère, Matthieu Daumas, Matthieu Lilamand, Sandrine Sourdet, Julien Delrieu, Bruno Vellas, Gabor Abellan van Kan
BACKGROUND: A consensus panel, based on epidemiologic evidence, argued that physical frailty is often associated with cognitive impairment, possibly because of common underlying pathophysiological mechanisms. The concepts of cognitive frailty and motoric cognitive risk were recently proposed in literature and may represent a prodromal stage for neurodegenerative diseases. The purpose of this study was to analyze the relationship between cognition and the components of the physical phenotype of frailty...
August 7, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28780622/outcomes-after-bariatric-surgery-according-to-large-databases-a-systematic-review
#5
Andrea Balla, Gabriela Batista Rodríguez, Santiago Corradetti, Carmen Balagué, Sonia Fernández-Ananín, Eduard M Targarona
PURPOSE: The rapid development of technological tools to record data allows storage of enormous datasets, often termed "big data". In the USA, three large databases have been developed to store data regarding surgical outcomes: the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP), the Healthcare Cost and Utilization Project (HCUP) National Inpatient Sample (NIS) and the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP)...
August 5, 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/28772046/gender-adjusted-and-age-adjusted-economic-inpatient-burden-of-congestive-heart-failure-cost-and-disability-adjusted-life-year-analysis
#6
Khal Salem, Osama ElKhateeb
AIMS: The two components of disability-adjusted life year (DALY), years of life lost (YLL) and years lived with disability (YLD), are underutilized in evaluating heart failure with reduced ejection fraction (HFrEF) and in assessing the global burden of disease. We aim to describe both the direct (medical) and the indirect (morbidity and mortality) inpatient cost of congestive heart failure in a high-income non-Organization for Economic Cooperation and Development Middle Eastern country in relation to YLL and YLD...
August 2017: ESC Heart Failure
https://www.readbyqxmd.com/read/28765654/-analysis-of-clinical-safety-in-the-units-of-allergy-of-the-valencian-community
#7
M D De Las Marinas Alvarez, B E Garcia Figueroa, R Alamar, C Pérez Francés, C Martorell Calatayud, M D Hernandez Fernandez de Ro
The introduction of new diagnostic and therapeutic procedures involving allergen exposure may increase the risk of allergic reactions. We designed and distributed an anonymous questionnaire among the allergy units of the Valencian Community in order to collect information on measures to ensure clinical safety. Twelve hospital outpatient clinics and 8 ambulatory care centres reported similar patterns of activities, including the use of critical care units, emergency rooms or day hospitals for higher risk techniques...
July 28, 2017: Anales del Sistema Sanitario de Navarra
https://www.readbyqxmd.com/read/28748652/bleeding-related-hospital-admissions-and-30-day-re-admissions-in-patients-with-nonvalvular-atrial-fibrillation-treated-with-dabigatran-versus-warfarin
#8
Wallis C Y Lau, Xue Li, Ian C K Wong, Kenneth K C Man, Gregory Y H Lip, Wai K Leung, Chung W Siu, Esther W Chan
BACKGROUND: Reducing 30-day hospital re-admission is a policy priority worldwide. Warfarin-related bleeding is among the most common cause of hospital admissions due to adverse drug events. Compared to warfarin, dabigatran achieve full anticoagulation effect more quickly following its initiation, hence may lead to early-onset bleeds. OBJECTIVES: To compare the incidence of bleeding-related hospital admissions and 30-day re-admissions with dabigatran versus warfarin in patients with nonvalvular atrial fibrillation (NVAF)...
July 27, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28745946/mentalization-based-treatment-for-borderline-personality-disorder-in-adults-and-adolescents-for-whom-when-and-how
#9
Dine J Feenstra, Patrick Luyten, Dawn L Bales
Borderline personality disorder (BPD) is common in clinical practice. Psychotherapy is the treatment of choice, and mentalization-based treatment (MBT) is one of the empirically supported treatments that are currently available. For adults, two variants of MBT (MBT day hospital [MBT-DH] and MBT intensive outpatient [MBT-IOP]) have been developed and empirically evaluated. The authors review research on the development, efficacy, and implementation of MBT. In conclusion, the authors focus on the implementation of treatment programs for BPD patients...
July 26, 2017: Bulletin of the Menninger Clinic
https://www.readbyqxmd.com/read/28742105/long-term-risk-of-dementia-after-acute-respiratory-failure-requiring-intensive-care-unit-admission
#10
Chih-Cheng Lai, Chung-Han Ho, Chin-Ming Chen, Shyh-Ren Chiang, Chien-Ming Chao, Wei-Lun Liu, Yu-Chieh Lin, Jhi-Joung Wang, Kuo-Chen Cheng
This retrospective, population-based cohort study aims to investigate the long-term risk of newly diagnosed dementia in patients discharged for acute respiratory failure that required mechanical ventilation (MV) and intensive care unit (ICU) admission. From the Taiwan National Health Insurance Research Database, first-time ICU patients using MV between June 1, 1998, and December 31, 2012, were enrolled, and they were followed-up until the earliest onset of one of our two endpoints: a new diagnosis of dementia (primary endpoint), or the end of the study...
2017: PloS One
https://www.readbyqxmd.com/read/28737647/risk-factors-for-30-day-hospital-readmission-for-diverticular-hemorrhage
#11
Jonah N Rubin, Daniel Shoag, John N Gaetano, Dejan Micic, Neil Sengupta
INTRODUCTION: The 2010 Affordable Care Act introduced the Hospital Readmissions Reduction Program to reduce health care utilization. Diverticular disease and its complications remain a leading cause of hospitalization among gastrointestinal disease. We sought to determine risk factors for 30-day hospital readmissions after hospitalization for diverticular bleeding. MATERIALS AND METHODS: We utilized the 2013 National Readmission Database sponsored by the Agency for Healthcare Research and Quality focusing on hospitalizations with the primary or secondary discharge diagnosis of diverticular hemorrhage or diverticulitis with hemorrhage...
July 21, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28734636/-clinical-and-genetic-aspects-of-albinism
#12
Benoit Arveiler, Eulalie Lasseaux, Fanny Morice-Picard
Albinism is a genetic disease affecting 1/17,000 person worldwide. It constitutes the second cause of congenital loss of visual acuity after optic atrophy. Albinism is heterogeneous both at the clinical and genetic levels. It is characterized by ocular development anomalies and by a variable degree of hypopigmentation. Clinically, three forms of the disease are described: oculocutaneous, ocular and syndromic (Hermansky-Pudlak syndrome, Chediak-Higashi syndrome). Nineteen genes involved in the different types of albinism have been described so far...
July 19, 2017: La Presse Médicale
https://www.readbyqxmd.com/read/28728783/enhanced-recovery-pathway-versus-standard-care-in-patients-undergoing-video-assisted-thoracoscopic-lobectomy
#13
Alessandro Brunelli, Caroline Thomas, Padma Dinesh, Andrew Lumb
OBJECTIVE: The objective of this study was to compare outcomes after video-assisted thoracoscopic lobectomy or segmentectomy before and after introduction of an enhanced recovery program. METHODS: Data from 600 patients undergoing video-assisted lobectomy or segmentectomy between April 2014 and January 2017 were analyzed. A comparative analysis was performed between patients undergoing operation before (365 patients) and after (235 patients) the start of the enhanced recovery program...
June 22, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28722594/fatal-leptospira-spp-zika-virus-coinfection-puerto-rico-2016
#14
Paige Neaterour, Aidsa Rivera, Renee L Galloway, Myriam Garcia Negrón, Brenda Rivera-Garcia, Tyler M Sharp
Coinfection with pathogens that cause acute febrile illness (AFI) can complicate patient diagnosis and management. This report describes a fatal case of Leptospira spp./Zika virus (ZIKV) coinfection in Puerto Rico. The patient presented with a 5-day history of AFI; reported behavioral risk factors for leptospirosis; was diagnosed with possible leptospirosis, dengue, chikungunya, or ZIKV disease; and received appropriate treatment of leptospirosis and dengue. Following a 3-day hospitalization, the patient died due to acute gastrointestinal hemorrhage, and kidney and liver failure...
June 26, 2017: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/28721895/late-cardiac-toxicity-after-mediastinal-radiation-therapy-for-hodgkin-lymphoma-contributions-of-coronary-artery-and-whole-heart-dose-volume-variables-to-risk-prediction
#15
Ezra Hahn, Haiyan Jiang, Angela Ng, Shaheena Bashir, Sameera Ahmed, Richard Tsang, Alexander Sun, Mary Gospodarowicz, David Hodgson
PURPOSE: Mediastinal radiation therapy (RT) for Hodgkin lymphoma (HL) is associated with late cardiotoxicity, but there are limited data to indicate which dosimetric parameters are most valuable for predicting this risk. This study investigated which whole heart dosimetric measurements provide the most information regarding late cardiotoxicity, and whether coronary artery dosimetry was more predictive of this outcome than whole heart dosimetry. METHODS AND MATERIALS: A random sample of 125 HL patients treated with mediastinal RT was selected, and 3-dimensional cardiac dose-volume data were generated from historical plans using validated methods...
August 1, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/28717918/-syncope-falls-and-vertigo
#16
REVIEW
C Weingart, H-J Schneider, C C Sieber
Dizziness/vertigo, falls and syncope are among the most common reasons for seeking medical care. As clinical entities they share common pathogenetic and clinical features and differences. The diagnostic work-up can often be initiated in a general practitioner's or internist's practice and, if necessary, completed in an interdisciplinary emergency unit. Simple diagnostic tools can be used in an outpatient setting to obtain valuable diagnostic information. First and foremost, it is important to differentiate between prognostically favorable clinical events and potentially serious disease...
July 17, 2017: Der Internist
https://www.readbyqxmd.com/read/28715464/impact-of-an-implicit-social-skills-training-group-in-children-with-autism-spectrum-disorder-without-intellectual-disability-a-before-and-after-study
#17
Jokthan Guivarch, Veena Murdymootoo, Sara-Nora Elissalde, Xavier Salle-Collemiche, Sophie Tardieu, Elisabeth Jouve, François Poinso
INTRODUCTION: Children with Autism Spectrum Disorders (ASDs) have problems with social skills. Social skills training groups are among the proposed therapeutic strategies, but their efficacy still needs to be evaluated. OBJECTIVE: To evaluate the efficacy of an implicit social skills training group in children with ASDs without intellectual disability. METHODS: A before-and-after study of children with ASD without intellectual disability was conducted in a child psychiatry day hospital, where they participated in an implicit group with cooperative games...
2017: PloS One
https://www.readbyqxmd.com/read/28713211/early-extubation-in-pediatric-heart-surgery-across-a-spectrum-of-case-complexity-impact-on-hospital-length-of-stay-and-chest-tube-days
#18
Staci Beamer, Sunita Ferns, Lloyd Edwards, Greer Gunther, Jennifer Nelson
Early extubation is increasingly common in congenital heart surgery, but there are limited outcomes data across the spectrum of case complexity. We performed a retrospective review of 201 pediatric operations using cardiopulmonary bypass between 2012 and 2014. Patients extubated in the operating room or immediately on arrival to the ICU were compared to those extubated by traditional protocols. In-hospital mortality, major complications, need for re-intubation, hospital length of stay, and chest-tube days were compared between groups and by Society of Thoracic Surgeons-European Association for Cardiothoracic Surgery Congenital Heart Surgery (STAT) mortality category...
June 2017: Progress in Pediatric Cardiology
https://www.readbyqxmd.com/read/28712118/farm-injury-hospitalisations-in-new-south-wales-2010-to-2014
#19
Tony Lower, Rebecca J Mitchell
OBJECTIVE: To examine gender differences in the characteristics, treatment costs and health outcomes of farm injuries resulting in hospitalisation of New South Wales (NSW) residents. METHOD: A population-based study of individuals injured on a farm and admitted to hospital using linked hospital admission and mortality records from 1 January 2010 to 30 June 2014 in NSW. Health outcomes, including injury severity, hospital length of stay (LOS), 28-day readmission and 30-day mortality were examined by gender...
July 16, 2017: Australian and New Zealand Journal of Public Health
https://www.readbyqxmd.com/read/28710226/evaluating-the-predictive-strength-of-the-lace-index-in-identifying-patients-at-high-risk-of-hospital-readmission-following-an-inpatient-episode-a-retrospective-cohort-study
#20
Sarah Damery, Gill Combes
OBJECTIVE: To assess how well the LACE index and its constituent elements predict 30-day hospital readmission, and to determine whether other combinations of clinical or sociodemographic variables may enhance prognostic capability. DESIGN: Retrospective cohort study with split sample design for model validation. SETTING: One large hospital Trust in the West Midlands. PARTICIPANTS: All alive-discharge adult inpatient episodes between 1 January 2013 and 31 December 2014...
July 13, 2017: BMJ Open
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