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https://www.readbyqxmd.com/read/28091865/improving-the-diagnostic-workup-of-hyponatremia-in-the-setting-of-kidney-disease-a-continuing-medical-education-cme-initiative
#1
Ladan Golestaneh, Joel Neugarten, William Southern, Faraj Kargoli, Amanda Raff
PURPOSE: Hyponatremia is a common electrolyte disorder and is associated with mortality. We examined the frequency of appropriate testing in response to an episode of inpatient hyponatremia in a large urban hospital to better inform our educational intervention. We then evaluated the impact of a live CME activity with a focus on CKD- and ESRD-associated hyponatremia physiology, on diagnostic practices of audience hospitalist attendings. METHODS: We performed a retrospective database analysis of all patients admitted to Montefiore Medical Center in 2014 to examine the performance of hospital staff in response to hyponatremia across all CKD stages...
January 13, 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/28088183/incidence-aetiology-and-outcome-of-community-acquired-acute-kidney-injury-in-medical-admissions-in-malawi
#2
Rhys D R Evans, Ulla Hemmilä, Alison Craik, Mwayi Mtekateka, Fergus Hamilton, Zuze Kawale, Christopher J Kirwan, Hamish Dobbie, Gavin Dreyer
BACKGROUND: Epidemiological data on Acute Kidney Injury (AKI) from low-income countries is sparse. The aim of this study was to establish the incidence, severity, aetiology, and outcomes of community-acquired AKI in Malawi. METHODS: We conducted a prospective observational study of general medical admissions to a tertiary hospital in Blantyre between 27(th) April and 17(th) July 2015. All patients were screened on admission with a serum creatinine; those with creatinine above laboratory reference range were managed by the nephrology team...
January 14, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28087188/operative-fusion-of-multilevel-cervical-spondylotic-myelopathy-impact-of-patient-demographics
#3
Shearwood McClelland, Bryan J Marascalchi, Peter G Passias, Themistocles S Protopsaltis, Anthony K Frempong-Boadu, Thomas J Errico
Cervical spondylotic myelopathy (CSM) is the most common cause of spinal cord dysfunction in patients older than age 55, with operative management being a widely adopted approach. Previous work has shown that private insurance status, gender and patient race are predictive of the operative approach patients receive (anterior-only, posterior-only, combined anterior-posterior). The Nationwide Inpatient Sample from 2001 to 2010 was used to assess the potential role of multilevel CSM as a contributing factor in determining which operative approach CSM patients receive, as it is rare for an anterior-only approach to be sufficient for CSM patients requiring fusion of four or more involved levels...
January 10, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28078378/post-procedural-care-in-interventional-radiology-what-every-interventional-radiologist-should-know-part-i-standard-post-procedural-instructions-and-follow-up-care
#4
Bedros Taslakian, Divya Sridhar
Interventional radiology (IR) has evolved into a full-fledged clinical specialty with attendant patient care responsibilities. Success in IR now requires development of a full clinical practice, including consultations, inpatient admitting privileges, and an outpatient clinic. In addition to technical excellence and innovation, maintaining a comprehensive practice is imperative for interventional radiologists to compete successfully for patients and referral bases. A structured approach to periprocedural care, including routine follow-up and early identification and management of complications, facilitates efficient and thorough management with an emphasis on quality and patient safety...
January 11, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28076735/reducing-medication-errors-in-hospital-discharge-summaries-a-randomised-controlled-trial
#5
Erica Y Tong, Cristina P Roman, Biswadev Mitra, Gary S Yip, Harry Gibbs, Harvey H Newnham, De Villiers Smit, Kirsten Galbraith, Michael J Dooley
OBJECTIVES: To evaluate whether pharmacists completing the medication management plan in the medical discharge summary reduced the rate of medication errors in these summaries. DESIGN: Unblinded, cluster randomised, controlled investigation of medication management plans for patients discharged after an inpatient stay in a general medical unit. SETTING: The Alfred Hospital, an adult major referral hospital in metropolitan Melbourne, with an annual emergency department attendance of about 60000 patients...
January 16, 2017: Medical Journal of Australia
https://www.readbyqxmd.com/read/28075624/use-of-preprocedural-mdct-for-cardiac-implantable-electric-device-lead-extraction-frequency-of-findings-that-change-management
#6
Wendy L Ehieli, Daniel T Boll, Daniele Marin, Robert Lewis, Jonathan P Piccini, Lynne M Hurwitz
OBJECTIVE: Five percent of cardiac implantable electric devices (CIEDs) are removed each year. Percutaneous extraction is preferred but can be complicated if the leads adhere to the vasculature or perforate. The goal of this study is to assess the frequency of findings on dedicated MDCT that alter preprocedural planning for percutaneous CIED extraction. MATERIALS AND METHODS: One hundred patients with CIEDs who underwent MDCT before percutaneous lead extraction were analyzed...
January 11, 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28075067/national-implementation-of-a-mental-health-service-model-a-survey-of-crisis-resolution-teams-in-england
#7
Brynmor Lloyd-Evans, Bethan Paterson, Steve Onyett, Ellie Brown, Hannah Istead, Richard Gray, Claire Henderson, Sonia Johnson
In response to pressures on mental health inpatient beds and a perceived 'crisis in acute care', Crisis Resolution Teams (CRTs), acute home treatment services, were implemented nationally in England following the NHS Plan in the year 2000: an unprecedentedly prescriptive policy mandate for three new types of functional community mental health team. We examined the effects of this mandate on implementation of the CRT service model. Two hundred and eighteen CRTs were mapped in England, including services in all 65 mental health administrative regions...
January 11, 2017: International Journal of Mental Health Nursing
https://www.readbyqxmd.com/read/28074817/extracorporeal-membrane-oxygenation-for-refractory-cardiac-arrest
#8
REVIEW
Steven A Conrad, Peter T Rycus
Extracorporeal cardiopulmonary resuscitation (ECPR) is the use of rapid deployment venoarterial (VA) extracorporeal membrane oxygenation to support systemic circulation and vital organ perfusion in patients in refractory cardiac arrest not responding to conventional cardiopulmonary resuscitation (CPR). Although prospective controlled studies are lacking, observational studies suggest improved outcomes compared with conventional CPR when ECPR is instituted within 30-60 min following cardiac arrest. Adult and pediatric patients with witnessed in-hospital and out-of-hospital cardiac arrest and good quality CPR, failure of at least 15 min of conventional resuscitation, and a potentially reversible cause for arrest are candidates...
January 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28072808/use-of-high-concentration-capsaicin-patch-for-the-treatment-of-pelvic-pain-observational-study-of-60-inpatients
#9
Amelie Levesque, Thibault Riant, Jean-Jacques Labat, Stephane Ploteau
BACKGROUND: Chronic pelvic, perineal and gluteal neuralgia is often experienced in a similar way to neuropathic pain, in the territories of four nerves: ilio-inguinal, pudendal, inferior cluneal and posterior gluteal nerves. These pains are often refractory to medical treatment based on the use of systemic molecules with disabling adverse effects and surgical procedure may be necessary. OBJECTIVE: The objective of this study was to evaluate the efficacy and safety of treatment with a high-concentration capsaicin patch in these indications...
January 2017: Pain Physician
https://www.readbyqxmd.com/read/28067697/national-administrative-databases-in-adult-spinal-deformity-surgery-a-cautionary-tale
#10
Aaron J Buckland, Gregory Poorman, Robert Freitag, Cyrus Jalai, Eric O Klineberg, Michael Kelly, Peter G Passias
STUDY DESIGN: Comparison between national administrative databases and a prospective multicenter physician managed database. OBJECTIVES: This study aims to assess the applicability of National Administrative Databases (NADs) in Adult Spinal Deformity (ASD). Our hypothesis is that NADs do not include comparable patients as in a physician-managed database (PMD) for surgical outcomes in adult spinal deformity. SUMMARY OF BACKGROUND DATA: NADs such as National Inpatient Sample (NIS) and National Surgical Quality Improvement Program (NSQIP) provide large numbers of publications owing to ease of data access and lack of IRB approval requirement...
January 6, 2017: Spine
https://www.readbyqxmd.com/read/28067472/efficacy-of-basal-bolus-insulin-regimens-in-the-inpatient-management-of-non-critically-ill-patients-with-type-2-diabetes-a-systematic-review-and-meta-analysis
#11
REVIEW
Merete B Christensen, Anders Gotfredsen, Kirsten Nørgaard
BACKGROUND: Hyperglycemia during hospitalization is associated with increased rates of complications and longer hospital stays. Various insulin regimens are used in the inpatient diabetes management of non-critically ill patients. We aimed to assess the efficacy and safety of basal-bolus insulin therapy (BBI) by summarizing evidence from studies of BBI versus sliding scale insulin therapy (SSI) in the management of hospitalized non-critically ill type 2 diabetes patients. METHODS: We searched MEDLINE, EMBASE, Scopus and the Cochrane Library for studies comparing BBI therapy with SSI therapy in hospitalized non-critically ill patients with type 2 diabetes...
January 9, 2017: Diabetes/metabolism Research and Reviews
https://www.readbyqxmd.com/read/28067033/2016-updated-american-society-of-clinical-oncology-oncology-nursing-society-chemotherapy-administration-safety-standards-including-standards-for-pediatric-oncology
#12
Michael Neuss, Terry Gilmore, Kristin Belderson, Amy Billett, Tara Conti-Kalchik, Brittany Harvet, Carolyn Hendricks, Kristine LeFebvre, Pamela Mangu, Kristen McNiff, MiKaela Olsen, Lisa Schulmeister, Anne Von Gehr, Martha Polovich
Purpose: To update the American Society of Clinical Oncology (ASCO)/Oncology Nursing Society (ONS) Chemotherapy Administration Safety Standards and to highlight standards for pediatric oncology. Methods: The ASCO/ONS Chemotherapy Administration Safety Standards were first published in 2009 and updated in 2011 to include inpatient settings. A subsequent 2013 revision expanded the standards to include the safe administration and management of oral chemotherapy. A joint ASCO/ONS workshop with stakeholder participation, including that of the Association of Pediatric Hematology Oncology Nurses and American Society of Pediatric Hematology/Oncology, was held on May 12, 2015, to review the 2013 standards...
6, 2017: Oncology Nursing Forum
https://www.readbyqxmd.com/read/28065768/ventricular-septal-defect-complicating-st-elevation-myocardial-infarctions-a-call-for-action
#13
Vikas Singh, Alex P Rodriguez, Parth Bhatt, Carlos E Alfonso, Rahul Sakhuja, Igor F Palacios, Ignacio Inglessis-Azuaje, Mauricio G Cohen, Sammy Elmariah, William W O'Neill
BACKGROUND: Ventricular septal defect is a lethal complication after an acute myocardial infarction which have become infrequent with the advent of reperfusion strategies however; they remain a major contributor to mortality. METHODS: We identified patients using the ICD-9CM procedure codes from the Nationwide Inpatient Sample between the years 2001 and 2013. A multivariate hierarchical logistic regression model was used to identify significant predictors of in-hospital mortality...
January 5, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28062313/evolution-in-the-utilization-of-biliary-interventions-in-the-united-states-results-of-a-nationwide-longitudinal-study-from-1998-to-2013
#14
Robert J Huang, Nirav C Thosani, Monique T Barakat, Abhishek Choudhary, Alka Mithal, Gurkirpal Singh, Saurabh Sethi, Subhas Banerjee
BACKGROUND AND AIMS: Bile duct surgery (BDS), percutaneous transhepatic cholangiography (PTC), and endoscopic retrograde cholangiopancreatography (ERCP) are alternative interventions used to treat biliary disease. We aim to describe trends in ERCP, BDS, and PTC on a nationwide level in the United States. METHODS: We used the National Inpatient Sample to estimate age-standardized utilization trends of inpatient diagnostic ERCP, therapeutic ERCP, BDS, and PTC between 1998 and 2013...
January 3, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28061357/characteristics-of-alcohol-related-facial-fractures
#15
Kai Lee, Michael Qiu
PURPOSE: Excessive indulgence in alcohol is a key causative factor in facial fractures especially in settings of interpersonal violence (IPV) and motor vehicle accidents. This study aims to explore characteristics of alcohol-involved facial fractures in the state of Victoria, Australia, over a 10-year period. MATERIALS AND METHODS: This retrospective study analyzed data from the Victorian Admitted Episodes Dataset between 2004 and 2014; the Victorian Admitted Episodes Dataset is a standardized database reported by all Victorian hospitals for every admission...
December 18, 2016: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28060046/serious-adverse-reactions-from-anti-tuberculosis-drugs-among-599-children-hospitalized-for-tuberculosis
#16
Yiyuan Li, Yu Zhu, Qin Zhong, Xiaojun Zhang, Min Shu, Chaomin Wan
BACKGROUNDS: The purpose of the study was to summarize the clinical characteristics of serious adverse reactions (ARs) related to anti-tuberculosis (TB) drugs in children hospitalized for TB. A comprehensive understanding of these drug-related ARs may serve to improve patient prognosis. METHOD: Inpatients diagnosed with TB from 2008 to 2013 were enrolled retrospectively. The patients' demographics, diagnosis and ARs were recorded and analyzed for comprehensive evaluation...
January 3, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28059982/morbidity-of-adult-spinal-deformity-surgery-in-elderly-has-declined-over-time
#17
Peter G Passias, Gregory W Poorman, Cyrus M Jalai, Brian Neuman, Rafael de la Garza-Ramos, Emily Miller, Amit Jain, Daniel Sciubba, Shearwood McClelland, Louis Day, Subbu Ramachadran, Shaleen Vira, Bassel Diebo, Evan Isaacs, Olivia Bono, Shay Bess, Michael Gerling, Virginie Lafage
STUDY DESIGN: A retrospective review of a prospectively collected database, the Nationwide Inpatient Sample (NIS), years 2003 to 2012. OBJECTIVES: The aim of this study was to examine trends in the management of scoliosis in elderly (age >75 yrs) patients from 2003 to 2012. SUMMARY OF BACKGROUND DATA: Scoliosis incidence rises with increasing age, and age has been shown to be an independent risk factor for surgical complications in scoliosis surgery...
January 4, 2017: Spine
https://www.readbyqxmd.com/read/28059786/death-of-dementia-patients-in-psychiatric-hospitals-and-regional-supply-of-psychiatric-services-study-of-the-national-data-from-1996-to-2014-in-japan
#18
Miharu Nakanishi, Junko Niimura, Syudo Yamasaki, Atsushi Nishida
BACKGROUND: Japan designates psychiatric inpatient care for behavior management of individuals with dementia and for helping dementia patients discharge to home. However, there has been no examination of the effectiveness of this strategy. OBJECTIVE: The present study investigated the association between dementia and the discharge destination of patients in psychiatric hospitals. METHODS: Data from the National Patient Survey, which is a nationally representative cross-sectional survey of inpatient care, were used...
December 3, 2017: Journal of Alzheimer's Disease: JAD
https://www.readbyqxmd.com/read/28058496/-traumatology-in-the-elderly-multimodal-prevention-of-delirium-and-use-of-augmentation-techniques
#19
D Wähnert, A Roos, J Glasbrenner, K Ilting-Reuke, P Ohrmann, G Hempel, T Duning, N Roeder, M J Raschke
Recent data show that 20-80% of surgery patients are affected by delirium during inpatient clinical treatment. The medical consequences are often dramatic and include a 20 times higher mortality and treatment expenses of the medical unit increase considerably. At the University Hospital of Münster a multimodal and interdisciplinary concept for prevention and management of delirium was developed: all patients older than 65 years admitted for surgery are screened by a specialized team for the risk of developing delirium and treated by members of the team if there is a risk of delirium...
January 5, 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/28058026/economic-burden-of-irritable-bowel-syndrome-in-china
#20
Fang Zhang, Wei Xiang, Chun-Yan Li, Shu-Chuen Li
AIM: To estimate annual direct and indirect costs for patients diagnosed with irritable bowel syndrome (IBS) and subtypes. METHODS: Patients completed a standardized questionnaire concerning usage of healthcare resources, travel costs, meals, and productivity loss of patients when seeking treatment for IBS. Total annual costs per patient were calculated as the sum of direct (including medical and nonmedical) and indirect costs. Total annual costs per patient among various IBS subtypes were compared...
December 21, 2016: World Journal of Gastroenterology: WJG
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