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https://www.readbyqxmd.com/read/28447413/laboratory-measurement-of-the-direct-oral-anticoagulants-indications-and-impact-on-management-in-clinical-practice
#1
REVIEW
C Wright, R Brown, A Cuker
Although the direct oral anticoagulants (DOACs) do not require routine laboratory monitoring, there may be special situations in which measurement of drug levels is desirable. There is a paucity of information on how measurement of DOAC levels is used in clinical practice. We conducted a retrospective cohort study of dabigatran, rivaroxaban, and apixaban levels measured at our institution. Of 9793 patients with an active prescription for dabigatran, rivaroxaban, or apixaban in the electronic medical record during the 2...
May 2017: International Journal of Laboratory Hematology
https://www.readbyqxmd.com/read/28447107/-role-of-anesthesiology-in-pain-medicine-and-palliative-care-treatment-in-german-hospitals-survey-of-department-heads-of-anesthesiology-on-treatment-structures
#2
J Erlenwein, F Petzke, U Stamer, W Meißner, F Nauck, E Pogatzki-Zahn, W Koppert, C Maier
BACKGROUND: The aim of this analysis was to describe the role of anesthesiology departments in pain medicine and palliative care services in German hospitals. METHOD: In the year 2012, all heads of departments of anesthesiology registered with the German Society of Anesthesiology and Intensive Care Medicine were surveyed about structures of pain medicine and palliative care services in their hospitals using a standardized postal questionnaire. RESULTS: Out of 408 returned questionnaires (response rate 47%) 403 could be evaluated...
April 26, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28446221/effectiveness-of-three-commonly-used-transition-phase-diets-in-the-inpatient-management-of-children-with-severe-acute-malnutrition-a-pilot-randomized-controlled-trial-in-malawi
#3
Christian J Versloot, Wieger Voskuijl, Sara J van Vliet, Meta van den Heuvel, Jane C Carter, Ajib Phiri, Marko Kerac, Geert Tom Heikens, Patrick F van Rheenen, Robert H J Bandsma
BACKGROUND: The case fatality rate of severely malnourished children during inpatient treatment is high and mortality is often associated with diarrhea. As intestinal carbohydrate absorption is impaired in severe acute malnutrition (SAM), differences in dietary formulations during nutritional rehabilitation could lead to the development of osmotic diarrhea and subsequently hypovolemia and death. We compared three dietary strategies commonly used during the transition of severely malnourished children to higher caloric feeds, i...
April 26, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28444155/hospitalization-rates-among-people-with-hiv-aids-in-new-york-city-2013
#4
Rachael Lazar, Laura Kersanske, Qiang Xia, Demetre Daskalakis, Sarah L Braunstein
Background: Hospitalizations are an important indicator of health care quality and access for people with HIV/AIDS. This study assesses hospitalization rates among people with HIV/AIDS in New York City. Methods: We performed a deterministic match between people in the New York City HIV surveillance registry alive as of 1/1/2013 and diagnosed with HIV as of 12/31/2013 and patient-level inpatient hospitalization records during 2013. Event-level data were analyzed to determine characteristics of and reasons for hospitalizations...
April 24, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28442924/a-framework-for-measuring-self-management-effectiveness-and-health-care-use-among-pediatric-asthma-patients-and-families
#5
REVIEW
Pavani Rangachari
Asthma is associated with substantial health care expenditures, including an estimated US$56 billion per year in direct costs. A recurring theme in the asthma management literature is that costly asthma symptoms, including hospitalizations and multiple emergency department (ED)/outpatient visits, can often be prevented through patient/family adherence to the national (National Institutes of Health Expert Panel Report-3) guidelines for effective self-management of asthma, specifically 1) medication adherence and 2) environmental trigger avoidance, as outlined in the patient's personalized Asthma-Action Plan...
2017: Journal of Asthma and Allergy
https://www.readbyqxmd.com/read/28440686/severe-ovarian-hyperstimulation-syndrome-after-combined-gnrh-agonist-and-low-dose-human-chorionic-gonadotropin-trigger-in-a-patient-with-a-single-kidney
#6
Nigel Pereira, Jovana P Lekovich, Isaac Kligman, Zev Rosenwaks
Ovarian hyperstimulation syndrome (OHSS) following gonadotropin-releasing hormone agonist (GnRH-a) trigger is rare. Here, we report a case of severe OHSS after combined GnRH-a and low-dose human chorionic gonadotropin (hCG) trigger in a patient with a single kidney. The patient is a 32-year-old women with a two-year history of infertility. The patient's history was significant for a single kidney, that is, she had donated a kidney to a family member three years ago. The patient underwent controlled ovarian stimulation (COS) for in vitro fertilization (IVF) and received a combined 2 mg GnRH-a and 1500 IU hCG ovulatory trigger...
April 25, 2017: Gynecological Endocrinology
https://www.readbyqxmd.com/read/28440533/nationwide-trends-in-inpatient-admissions-of-pulmonary-hypertension-in-the-united-states-from-2000-to-2013
#7
Rutuja R Sikachi, Sonu Sahni, Dhruv Mehta, Abhishek Agarwal, Abhinav Agrawal
INTRODUCTION: Pulmonary hypertension (PH) is a disorder of the pulmonary vasculature with high mortality and bears a large economic burden on the healthcare system. We conducted a review of the largest inpatient database in the United States and analyzed the trends in hospitalizations due to PH from the turn of the century (2000) to 2013 to evaluate the rate of hospitalizations and determine the cost and mortality associated with PH. MATERIAL AND METHODS: We analyzed the National Inpatient Sample Database (NIS) for all patients in which PH (Primary or Secondary) or cor pulmonale was the primary discharge diagnosis (ICD-9: 416...
2017: Advances in Respiratory Medicine
https://www.readbyqxmd.com/read/28439852/stevens-johnson-syndrome-and-toxic-epidermal-necrolysis-a-concise-review-with-a-comprehensive-summary-of-therapeutic-interventions-emphasizing-supportive-measures
#8
REVIEW
Jeremy A Schneider, Philip R Cohen
INTRODUCTION: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are two of the most severe dermatologic conditions occurring in the inpatient setting. There is a lack of consensus regarding appropriate management of SJS and TEN. PURPOSE: The scientific literature pertaining to SJS and TEN (subsequently referred to as SJS/TEN) is summarized and assessed. In addition, an interventional approach for the clinician is provided. METHODS: PubMed was searched with the key words: corticosteroids, cyclosporine, etanercept, intravenous immunoglobulin, Stevens-Johnson syndrome, and toxic epidermal necrolysis...
April 24, 2017: Advances in Therapy
https://www.readbyqxmd.com/read/28438827/implementing-a-pharmacist-consultation-model-for-multimodal-insulin-therapy
#9
Angela Hodges, James Hall, Esther Castellanos, Edward Laue, Tammy Ellis, LaDonna Oelschlaeger
PURPOSE: The implementation of pharmacist-managed insulin dosing for selected hospitalized patients under a multimodal insulin protocol (MMIP) is described. SUMMARY: Hyperglycemia has been linked to increased thrombosis, decreased wound healing, and decreased immune response. Current recommendations support the use of multimodal (basal-bolus) insulin therapy in noncritically ill inpatients. As part of a systemwide quality-improvement initiative to improve glycemic management, the pharmacy department of a community hospital initiated a service to provide protocol-directed insulin dosing for selected patients under a pharmacist consultation model...
May 1, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28438496/from-the-implementing-best-practice-guidelines-in-pain-assessment-and-management-on-a-women-s-psychiatric-inpatient-unit-exploring-patients-perceptions
#10
Cheryl Rolin-Gilman, Bonnie Fournier, Kristin Cleverley
Assessing and managing chronic pain in women with histories of interpersonal trauma, mood disorders and co-morbid addiction is complex. The aim of this paper is to report on the findings from a quality improvement project exploring women's experiences who have co-occurring mental health issues, addiction and chronic pain. Exploring perceptions was an initial step in implementing the Registered Nurses' Association of Ontario (RNAO) Best Practice Guideline (BPG) on the Assessment and Management of Pain. Focus group discussions were conducted using an exploratory design with 10 women who were hospitalized in an acute psychiatric unit...
April 21, 2017: Pain Management Nursing: Official Journal of the American Society of Pain Management Nurses
https://www.readbyqxmd.com/read/28437818/-towards-a-rehabilitation-and-participation-oriented-psychotherapy
#11
Beate Muschalla, Jürgen Bengel, Matthias Morfeld, Ulrike Worringen
Mental disorders (such as recurrent mood disorders, personality disorders, or psychotic disorders) come along with enduring impairment in daily life activities. Therefore psychotherapeutic actions in inpatient or outpatient settings require a life-span and participation-oriented treatment perspective. Participation-oriented treatment aims at social and vocational integration in general life despite enduringly recurring or resting symptoms. According to the model of health problems offered by the International Classification of Functioning, Disability and Health, ICF (WHO, 2001), disability can be defined as context-dependent activity impairment due to illness...
April 24, 2017: Die Rehabilitation
https://www.readbyqxmd.com/read/28437321/medical-expenditures-associated-with-diabetes-among-youth-with-medicaid-coverage
#12
Sundar S Shrestha, Ping Zhang, Theodore J Thompson, Edward W Gregg, Ann Albright, Giuseppina Imperatore
BACKGROUND: Information on diabetes-related excess medical expenditures for youth is important to understand the magnitude of financial burden and to plan the health care resources needed for managing diabetes. However, diabetes-related excess medical expenditures for youth covered by Medicaid program have not been investigated recently. OBJECTIVE: To estimate excess diabetes-related medical expenditures among youth aged below 20 years enrolled in Medicaid programs in the United States...
April 21, 2017: Medical Care
https://www.readbyqxmd.com/read/28436194/impact-of-living-arrangements-on-clinical-outcomes-among-older-patients-with-dementia-or-cognitive-impairment-admitted-to-the-geriatric-evaluation-and-management-unit-in-taiwan
#13
Cheng-Hao Hung, Ting-Ching Tang, Chih-Jen Wang, Li-Kuo Liu, Li-Ning Peng, Liang-Kung Chen
AIM: To evaluate the impact of living arrangements on mortality and functional decline among older patients with dementia or cognitive impairment after discharge from a geriatric evaluation and management unit (GEMU) in Taiwan. METHODS: The present retrospective cohort study used data from the Veteran Affairs Comprehensive Geriatric Assessment from January 2015 to May 2016 for analysis. Data of patients aged 65 years and older with dementia or cognitive impairment at admission to the GEMU of Taipei Veterans General Hospital during the study period were retried for study...
April 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28435912/one-and-two-level-posterior-lumbar-interbody-fusion-plif-using-an-expandable-stand-alone-interbody-fusion-device-a-varilift-%C3%A2-case-series
#14
Rebecca Barrett-Tuck, Diana Del Monaco, Jon E Block
BACKGROUND: Surgical interventions such as posterior lumbar interbody fusion (PLIF) with and without posterior instrumentation are often employed in patients with degenerative spinal conditions that fail to respond to conservative medical management. The VariLift(®) Interbody Fusion System was developed as a stand-alone solution to provide the benefits of an intervertebral fusion device without the requirement of supplemental pedicle screw fixation. METHODS: In this retrospective case series, 25 patients underwent PLIF with a stand-alone VariLift(®) expandable interbody fusion device without adjunctive pedicle screw fixation...
March 2017: Journal of Spine Surgery (Hong Kong)
https://www.readbyqxmd.com/read/28435481/a-patient-centered-emergency-department-management-strategy-for-sickle-cell-disease-super-utilizers
#15
Grant G Simpson, Hallie R Hahn, Alex A Powel, Robert R Leverence, Linda A Morris, Lara G Thompson, Marc S Zumberg, Deepa J Borde, Joseph A Tyndall, Jonathan J Shuster, Donald M Yealy, Brandon R Allen
INTRODUCTION: A subpopulation of sickle-cell disease patients, termed super-utilizers, presents frequently to emergency departments (EDs) for vaso-occlusive events and may consume disproportionate resources without broader health benefit. To address the healthcare needs of this vulnerable patient population, we piloted a multidisciplinary intervention seeking to create and use individualized patient care plans that alter utilization through coordinated care. Our goals were to assess feasibility primarily, and to assess resource use secondarily...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28435316/subanesthetic-ketamine-for-pain-management-in-hospitalized-children-adolescents-and-young-adults-a-single-center-cohort-study
#16
Kathy A Sheehy, Caroline Lippold, Amy L Rice, Raissa Nobrega, Julia C Finkel, Zenaide Mn Quezado
BACKGROUND: Subanesthetic doses of ketamine, an N-methyl-d-aspartate receptor antagonist used as an adjuvant to opioid for the treatment of pain in adults with acute and chronic pain, have been shown, in some instances, to improve pain intensity and to decrease opioid intake. However, less is known about the role of ketamine in pain management in children, adolescents, and young adults. PURPOSE: We examined the effects of subanesthetic ketamine on pain intensity and opioid intake in children, adolescents, and young adults with acute and chronic pain syndromes treated in an inpatient setting...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28434102/outcomes-following-surgical-management-of-cauda-equina-syndrome-does-race-matter
#17
Amit Jain, Emmanuel Menga, Addisu Mesfin
Cauda equina syndrome (CES) is a surgical emergency requiring urgent spinal decompression. Our objective is to analyze the association between race and in-hospital outcomes (complications, mortality, length of stay, and discharge disposition) in patients with CES. This is a retrospective cohort study of CES patients identified via the Nationwide Inpatient Sample (NIS) from 2000 to 2010 in inpatient hospitalizations in the USA. The patient sample includes 46,017 patients ≥18 undergoing spine surgery for CES...
April 21, 2017: Journal of Racial and Ethnic Health Disparities
https://www.readbyqxmd.com/read/28431847/guideline-compliance-and-clinical-outcomes-among-patients-with-staphylococcus-aureus-bacteremia-with-infectious-diseases-consultation-in-addition-to-antimicrobial-stewardship-directed-review
#18
Kevin Buehrle, Jennifer Pisano, Zhe Han, Natasha N Pettit
OBJECTIVE: Previous studies have shown infectious diseases consultation (IDC) for Staphylococcus aureus bacteremia (SAB) improves management and outcomes. The influence of IDC on outcomes for SAB in addition to an antimicrobial stewardship program (ASP) review for adult inpatients with SAB has not been evaluated. The purpose of this study was to investigate the effect of IDC on SAB management with concomitant ASP review and resulting outcomes. METHODS: Adult inpatients with SAB admitted December 2012-October 2014 were included...
April 18, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28430850/trends-in-hospitalization-for-hypertensive-emergency-and-relationship-of-end-organ-damage-with-in-hospital-mortality
#19
Mahek Shah, Shantanu Patil, Brijesh Patel, Shilpkumar Arora, Nilay Patel, Lohit Garg, Sahil Agrawal, Larry Jacobs, Susan P Steigerwalt, Matthew W Martinez
BACKGROUND: There are no comprehensive guidelines on management of hypertensive emergency (HTNE) and complications. Despite advances in antihypertensive medications HTNE is accompanied with significant morbidity and mortality. METHODS: We queried the 2002-2012 nationwide inpatient sample database to identify patients with HTNE. Trends in incidence of HTNE and in-hospital mortality were analyzed. Logistic regression analysis was used to assess the relationship between end-organ complications and in-hospital mortality...
April 20, 2017: American Journal of Hypertension
https://www.readbyqxmd.com/read/28430760/resuscitative-endovascular-balloon-occlusion-of-the-aorta-or-resuscitative-thoracotomy-with-aortic-clamping-for-noncompressible-torso-hemorrhage-a-retrospective-nationwide-study
#20
Shotaro Aso, Hiroki Matsui, Kiyohide Fushimi, Hideo Yasunaga
BACKGROUND: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is an emerging treatment for noncompressible torso hemorrhage. It remains unclear if REBOA is superior to resuscitative thoracotomy with aortic cross-clamping (RT) in terms of improving outcomes. This study compared in-hospital outcomes between REBOA and RT in trauma patients with uncontrolled hemorrhagic shock, using data from a national inpatient database in Japan. METHODS: Using the Diagnosis Procedure Combination database, we identified patients who received REBOA or RT within 1 day after admission from July 1, 2010, to March 31, 2014...
May 2017: Journal of Trauma and Acute Care Surgery
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